Post-Concussion Symptom Management!

With winter comes the start of hockey season, Canada’s sport of choice. However, as we all know with the aggressive sport comes an increased risk of concussion, our golden boy Sydney Crosby being a perfect example. Concussions or mild traumatic brain injuries are described as a neurophysiological effect that occurs after blunt impact or sudden acceleration, deceleration or rotational force to the head and neck. Concussions are one of the most common neurological conditions reported in 493-653/10000. You do not have to lose consciousness to have a concussion but they are often associated with a series of symptoms.

Concussion symptoms are often categorized as

1. Physical
   • Headaches
   • Nausea
   • Vomiting
   • Blurred or double vision
   • Seeing stars
   • Balance problems
   • Dizziness
   • Sensitivity to light or noise
   • Tinnitus
2. Behaviour/Emotional
   • drowsiness
   • Fatigue/lethargy
   • Irritability
   • Depression
   • Anxiety
   • Sleeping more than usual
   • Difficulty falling asleep
3. Cognitive
   • Feeling “slowed down”
   • Feeling “in a fog” or “dazed”
   • Difficulty concentrating
   • Difficulty remembering

Concussions are usually diagnosed by a primary health care provider whether at the Emergency Department or at your local family physician’s office. Based on the initial exam which includes a pre-injury history, physical examination and psychosocial evaluation, your doctor will determine whether further neuroimaging is needed or just close monitoring at home. Generally a period of rest is encouraged to facilitate a quick recovery – this includes both physical rest and cognitive rest. This may include time off work, school and sport. Patients are often advised to avoid reading, exercise and exertion and visually stimulating activities (i.e. computer/cell phone use and watching tv). Depending on the extent of the concussion symptoms may take a few days or a few months to resolve.

Physiotherapists can play an important role in managing post-concussion symptoms. Patients often complain of muscle and soft tissue pain associated with spasm and trigger points in the musculature of the neck. Soft tissue release, postural education and retraining can help to reduce these symptoms. Dizziness and vertigo are also common symptoms. A physiotherapist can help by retraining your body’s vestibular system, prescribing balance exercises and gait and stair retraining.

Most importantly any treatment plan must be highly individualized as every concussion and its associated symptoms are unique. If you have questions about concussion or think you would benefit from an assessment feel free to speak with our sports medicine physician or physiotherapists.