Physical Therapy and Concussions: What You Need to Know
Concussions are a hot topic among parents, coaches, trainers and students. Concussions in student-athletes are a growing public health concern. The Centers for Disease Control and Prevention (CDC) estimates nearly 3.8 million incidences of sports-related concussions occur every year.
What is a concussion?
A concussion is a traumatic brain injury caused by a bump, blow or jolt to the head that can change the way your brain typically functions. A concussion can even occur with just a blow to the body that causes the head to move quickly back and forth, like whiplash. As you can imagine, concussions are common in contact sports such as football, soccer, hockey and basketball. A common concussion misconception is that you must lose consciousness to suffer a concussion. This is false – loss of consciousness occurs in less than 10% of cases. Significant injury can occur without loss of consciousness. Concussions can interrupt your physical, mental and emotional well-being. The duration of concussion symptoms is highly variable and may last minutes to months.
What are the signs or symptoms an athlete has sustained a concussion?
Concussions can occur in any sport. Therefore it is important for all coaches, parents, and athletes to learn the following concussion signs and symptoms:
Difficulty with balance
Double or blurred vision
Difficulty with sleeping
Sensitivity to light and sound
Cognitive (mental) signs
Difficulty with memory
Decreased tolerance of stress
How can physical therapy help those who suffer a concussion?
In 2010, The American Physical Therapy Association’s Board of Directors issued a position on concussions which states that concussions should be evaluated and managed by a multidisciplinary team of licensed health care professionals, of which physical therapists are an integral part. Physical therapists can evaluate and treat many associated effects from concussions.
Following sports concussions, up to 79% of patients report dizziness and 56% of patients experience balance impairment. Vestibular physical therapy may help. The vestibular system involves the inner ear and its connections with the brain. It is responsible for sensing head movement, keeping your eyes focused when you move your head, and helping you keep your balance. A physical therapist can provide specific exercises and training to decrease or stop dizzy symptoms and improve balance and stability. Training the vestibular system and improving balance can help in returning the patient back to sport. Also, the physical therapist can perform occulomotor (eye movement) tests. Disruption in eye movement from concussion can contribute to dizziness, visual disturbance and headaches. A physical therapist can provide special exercises to improve occuolomotor coordination.
Commonly, when you suffer a concussion, you may also suffer from neck pain or injury due to the blow to the body. Neck injuries can cause headaches and add to dizziness. A physical therapist will evaluate and develop a plan of care to reduce these symptoms. The plan of care may involve manual therapy (hands on therapy) to assist in spinal movement, mechanics and decrease muscular restrictions. In addition, therapy will include exercises to improve strength. As the symptoms improve, your physical therapist will help you return to physical activity gradually, to prevent overloading the brain and nervous system that have been compromised by concussion.
Returning to Sports
Athletes who sustain a concussion may also benefit from structured physical therapy to help in recovery of strength and conditioning for their return back to sport. Since the symptoms of a concussion can be variable and specific to each patient, it can be difficult to determine when it is appropriate for a patient to return to sport. This should be a collaborative decision involving the patient/parent, the physical therapist, physician and coach.
If you have any questions or concerns, please do not hesitate to contact your primary care physician or AZOPT. AZOPT offers FREE walk-in injury screens for student-athletes.
- Physical Therapist’s Guide to Concussion. March 2011. Accessed at: http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=4f2ebb00-f1c0-4691-b2ab-742df8dffb99#.U9QLuF5sYjE on 1 August 2014.
- Injury prevention and control: traumatic brain injury, Concussion in Sports. Accessed at: http://www.cdc.gov/concussion/sports/on 1 August 2014.
- APTA Concussion Management. Accessed at: http://www.neuropt.org/docs/vsig-physician-fact-sheets/concussion-management.pdf?sfvrsn=2on 1 August 2014.
- The Concussion Discussion. Accessed at: http://physical-therapy.advanceweb.com/Archives/Article-Archives/The-Concussion-Discussion.aspxon 1 August 2014.