By: Chelsea Brown, PT, DPT
Suffering from a concussion and not feeling like yourself? Gone are the days of complete rest and darks rooms until you are symptom free following a concussion. There are plenty of interventions available to get you back to your pre-injury self. Whether you are 2 days or 5 years post injury, there are treatments that can help you and Boston Sports Medicine is here to guide the way!
What is a Concussion?
A concussion is a form of traumatic brain injury often referred as a mild traumatic brain injury or mTBI, caused by a bump, blow or jolt to the head or a hit to the body that causes the head and brain to move rapidly back and forth.1 Although often referred to as a mild injury, concussions should be taken seriously as the deficits following the injury can be severe.
Common Signs and Symptoms Associated with Concussion:
- Headaches
- Dizziness
- Concentration and Memory Deficits
- Fatigue
- Changes to Sleep Pattern
- Motion Intolerance
- Decreased Coordination and Balance
- Irritability and Mood Changes
- Double Vision or Blurred Vision
- Eye Strain
- Neck Pain and Increased Muscle Tension
- Noise and Light Sensitivity
- Exercise Intolerance
RED FLAGS: If you present with any of the following symptoms in the first 48-72 hours, please seek immediate medical attention!!
- Very drowsy or cannot be awakened
- Repeated vomiting
- Seizures (arms and legs uncontrollably jerky)
- Slurred speech
- Weakness or numbness in arms or legs
- Can not recognize people or places
- Unrelenting headache that gets worse
Physical Therapy For Concussions
Early Management
Approximately 90% of concussions will recover within 4 weeks of injury, if they are managed appropriately.1 Early management of concussions includes cognitive and physical rest and LIGHT cardiovascular exercise. Immediately post injury, it is important to decrease cognitive load and avoid screens such as phones, computers and TVS. Sleep is also vital to recovery, allowing your body to sleep as much as you need in the first 2 weeks will help aide in a faster recovery.
Physical Therapy interventions can be implemented as early as 48 hours post injury and can help aide in early concussion recovery and preventing protracted concussion symptoms. Treatment options include interventions for headache management and neck pain, Primitive Reflex Integration (PRI), vertigo treatments for dizziness and guided cardiovascular exercise.
Late Management
While most individuals will experience concussion recovery within a 30 day window approximately 10-20% will experience protracted recovery with symptoms lasting beyond 30 days. Individuals who experience slow recovery where their symptoms persist for more than 3-4 weeks should seek an additional medical evaluation. Those who experience protracted recovery typically have a difficult time returning to school or work with complaints of headaches, dizziness and sensitivity to lights or noise contributing to difficulty with reading, concentration, or memory.
In conjunction with physical therapy interventions provided during the acute phase of concussion recovery, additional treatments can be implemented for individuals experiencing a protracted recovery. These interventions include advanced vision and vestibular rehabilitation, progressive exercise and PRI.
Return to Sport
An athlete should begin a return to sport protocol once deemed appropriate by their healthcare provider and symptoms have trended downward. A safe return to sport should take a minimum of 10 days but research has shown that it can take up to 30 days for the brain to heal from initial injury. If an athlete returns to sport too early they are at greater risk of re-injury and susceptible to second impact syndrome or protracted recovery. Let one of our physical therapists guide you through the return to sport protocol to ensure a safe return to sports!
Be on the look out for our concussion blog series for more information on post-concussion education and interventions!
Meet Our Concussion Team
Chelsea Brown, PT, DPT
Chelsea Brown began specializing in concussion management early in her career following a clinical rotation solely treating mild traumatic brain injuries and vestibular conditions during her schooling. She was very drawn to this patient population following a mismanagement of her own concussive injury and she continued to work with this patient population in Park City, UT. While in Park City, she completed research on treatment protocols following concussive injuries which were published in the past year; Physical Examination Findings in Patients with Protracted Concussion and the Impact of Integrative Concussion Rehabilitation Protocol and Sequencing and Integration of Cervical Manual Therapy and Vestibulo-oculomotor Therapy for Concussion Symptoms: A Retrospective Analysis. Since returning to the Boston Area, she has been working with individuals with concussion in our Watertown office treating a wide variety of concussive injuries from sports related injuries, slip and falls, motor vehicle accidents and assaults. Her treatments focus on both acute/early management post-concussion as well as treatments for individuals who are multiple years post injury. Her specialties include vision and vestibular interventions, primitive reflex integration and cervicogenic headache management. To schedule an appointment with Chelsea, please call the Watertown Office at 617-926-2300.
Aisling O’Sullivan Roche, PT, DPT, CIDN, AIB VRT-C
Aisling O’Sullivan Roche is certified to treat concussion and vestibular dysfunction through the American Institute of Balance. She has always had an interest in treating the vestibular population and in doing further research she found how much overlap there is between those with concussions and vestibular dysfunctions. Her typical patient population consists of individuals with concussions who have vestibular dysfunction. To schedule an appointment with Aisling, please call the Allston Office at 617-787-8700.
Michael Geiger, PT, DPT, ITPT
Michael Geiger serves as one of the two concussion care physical therapists in our Allston location. He became interested in treating patients with concussions due to his repeated history of concussions experienced while playing ice hockey. He has personally dealt with the prolonged symptoms concussions can cause if left untreated for many years, and decided he wanted to arm himself with the skills and knowledge that will help others avoid this type of experience after a concussion. His style of treatment and knowledge background comes from being an ImPACT Trained Physical Therapist (ITPT). This certification was achieved through the same institution that created the ImPACT Concussion Assessment – a popular baseline cognitive assessment used to determine readiness to return to sport and other activities after concussion. His typical patient population consists of active adolescents and adults, many competing in organized and/or recreational sports, who are suffering from short and long term symptoms following a concussion. To schedule an appointment with Mike, please call the Allston Office at 617-787-8700.
Joe Merullo, PT, DPT, CSCS
Joe Merullo is a physical therapist currently working in Davis Square, Somerville. He enjoys treating various orthopedic injuries and specializes in return to sports. Joe has a multi-faceted approach when treating concussion management plans that can help with returning to school, work, and sports. His additional certifications as an imPACT Trained Physical Therapist and Strength and Conditioning Specialist offers a unique approach in the complex realm of concussion management. He enjoys having his patients be active participants in their plans while keeping programs interactive and enjoyable. To schedule an appointment with Joe, please call the Somerville Davis Square Office at 617-623-6300.
Reference:
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. February 12, 2019. “What is a Concussion?” https://www.cdc.gov/headsup/basics/concussion_whatis.html.
