As March is also Brain Injury Awareness Month, we will be discussing concussions. Did you know that concussions are actually mild traumatic brain injuries?

Let’s unpack what actually happens during a concussion. 

First of all, a concussion can result from rapid movement such as whiplash, a direct blow to the head/ face/ neck, or indirectly by a significant blow elsewhere in the body that is transmitted to the head. These forces put stress on the brain cells and can cause microdamage. Whenever there is damage to a part of the body, the body responds with inflammation, changes in blood flow, and changes in tissue chemistry. While this body response can help assist healing, it requires a high demand of energy and also reduces the amount of energy and nutrients that the brain has access to due to changes in blood supply. This places the brain in a vulnerable state as the brain has limited resources to function as it heals. 

Once the brain has experienced a concussion it is more vulnerable to repeated injury. Subsequent concussions often have longer lasting and more severe symptoms, so it is important to avoid environments and activities that could expose the child to a second concussion. Therefore, it is vital to reduce the demands on the brain to allow it to rest and heal and minimize the symptoms. A concussion can impact cognitive, physical, emotional, and proper sleep function. 

Some symptoms of impaired Cognitive function include difficulty concentrating, reduced short term memory, feeling in a fog, and feeling slowed down. Physical symptoms of a concussion include headaches, dizziness, fatigue, nausea, sensitivity to light, balance impairments, ringing in the ears, and blurred vision. Emotional impacts include depression, irritability, and lack of interest in favorite activities. These symptoms impact many aspects of daily life like the ability to complete classroom assignments, withstand environments with bright lights, participate in sports and recreational activities, and complete daily tasks at home. 

This is where Physical Therapists can help. We have expert understanding of the healing process of the body and have the tools to assess and treat the individual child’s impairments. 

Below are Five Common Ways that we as physical therapists get our clients with concussions back to doing the things they love and the activities necessary for success at school and at home. 

Educate On Strategies to Promote Rest and Healing

As mentioned above, there is a high energy demand on the brain after a concussion as it heals and there is less access to energy resources due to inflammation and blood vessel changes. This can last up to several weeks. It is vital to allow mental and physical rest so that the body’s resources can be used to attend to the damaged brain. Ways to promote rest are limiting screen time, schoolwork, and recreational activities. Once a child is ready to return to the classroom, there are strategies to adapt the environment to improve reading tolerance and participation in class with less onset of symptoms by using colored films, tinted eyewear, and incorporating a schedule for physical and mental rest throughout the day. 

Facilitate and Guide The Process to Return to Sports

Return to sport activities should be overseen and directed by an informed clinician in order to provide the right amount of rest vs challenge. The sporting environment has a high risk for a second and more severe concussion that can have lasting effects. Avoiding competitive sports and recreational activities is a good way to reduce the risk of repeated injury. Also, if a child is challenged too quickly, their symptoms may last longer as healing is delayed. On the other hand, it is important to provide the “just right” challenge to the young athlete to avoid unnecessary deconditioning. A physical therapist has the expertise to create a plan of care that provides the appropriate amount of progression to return the athlete to his/ her sport in the safest and most efficient manner possible.

Promote Sensory Integration

The normal function of the brain is interrupted with a concussion. This can impact how the brain interprets and integrates sensory information from the vestibular, auditory, visual, and proprioceptive systems. A typical brain automatically takes in all the information that your senses perceive, organizes it, and then helps you to respond appropriately. This complex process of integrating the sensory information provides the child with body awareness, understanding where they are positioned in space, postural control, regulation skills, depth perception, coordination of the eyes, and so much more all while they are simultaneously breathing, moving, multi-tasking, and processing a changing environment. When the brain connections that integrate the sensory information are delayed or interrupted, it can be disorienting and lead to visual and balance problems and sensitivities to varied sensory stimuli. A physical therapist will assess what sensory systems are impacted and will progress the interventions to return the child to unhindered play.

Address any Musculoskeletal Injuries Associated with the Concussion

Often the forces that cause a concussion also result in injury to the neck, spine, or other areas of the body. Sometimes injury and muscle tightness in the neck can even cause symptoms of headaches or dizziness and will benefit from therapeutic interventions to promote flexibility, stability, and strength to reduce these symptoms. Physical therapists are experts at identifying and treating these injuries alongside the concussion.

Restore Strength and Endurance

Since rest and lack of physical activity after a concussion is so important, most children will need to build back strength and cardiovascular endurance to return to the state they were before the concussion. Physical therapists are experts in exercise prescription and provide a plan of care to restore strength and endurance at a pace that meets the “Rest vs Challenge” criteria mentioned earlier.

This information is intended for educational purposes only. Please seek the advice from the medical team that manages your healthcare to manage your personal medical needs. 

https://www.choosept.com/guide/physical-therapy-guide-concussion

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