Concussions have received a lot of media attention in professional sports recently. But what is this condition and who does it really affect? Hint: Far more than professional athletes.
A concussion is defined as a traumatic brain injury caused by a bump, blow or jolt to the head or body. This impact causes the brain to suddenly move back and forth in the skull, resulting in chemical changes in the brain. Although often considered a "mild" injury, concussions can be serious and can happen to anyone.
Christine Schweidler, PT, Cert MDT;
Chester County Hospital.
"We see a mix of patients – from as young as seven to 90-years-old. The pediatric population (up to 17 years of age) often experience sports-related concussions but they can also happen while goofing around," said Christine Schweidler, PT, MDT, Balance and Vestibular Therapist who leads the Concussion Program at Chester County Hospital in West Chester, PA.
"The adults we see are weekend warriors, have been in a vehicular or work accident, or have fallen at home or while trying to become more active," she added.
Concussion Signs and Symptoms
There is an assumption that concussions will result in a loss of consciousness, but according to Schweidler this is not true. "Only 10% of people who have a concussion are knocked out," she explained.
Schweidler shares common signs and symptoms to watch for after experiencing an impact:
- Lingering headache
- Dizziness
- Nausea and vomiting
- Light and noise sensitivity
- Vision problems – difficulty with tracking or blurriness
- Balance problems
- Difficulty with memory
- Fogginess
- Sleep disturbance (sleeping too much or too little)
If you notice slurred speech, are vomiting persistently, your headache gets progressively worse or you experience mental confusion, immediately go to the Emergency Room. These could be signs of a more serious head injury.
Concussion Diagnosis
If symptoms are present, Schweidler recommends calling your primary care physician to help identify the concussion early on. Concussions must be diagnosed clinically since they cannot be seen through imaging tests like a CT or MRI scan.
During an examination, a physician will take a detailed history of the event and perform a variety of tests. These include checking to see how your eyes are tracking, testing balance, neck range of motion, and cognitive testing to get a sense of brain function. If your eyes are not tracking well, balance is off or you’re having trouble with memory, your physician may diagnose you with a concussion.
Schweidler explained that each patient’s concussion will be different. "One person may experience headaches, light and noise sensitivity, but may not have dizziness or memory problems. Another may only have trouble with eye tracking. Depending on the severity, the deficits can be life-changing for a period of time."
Concussion Treatment
Schweidler recommends full brain rest for the first 24 to 48 hours after a concussion. This means reducing lights and noise around you and avoiding television, computers, smart phones and texting. “After this rest, you should gradually return to your daily activities and begin moving around, like taking a light walk. Let the symptoms guide you. If your headache gets worse or you get dizzy, stop and take a break,” she explained.
Without this period of rest, recovery may be prolonged and the brain will take longer to heal, resulting in longer lasting symptoms. Instead of a few weeks, recovery from a concussion can take months.
On average, 80% of people will be free of their symptoms within three weeks. Those who experience longer lasting symptoms may be recommended by their physician to see a physical therapist for a vestibular (balance) assessment.
Physical therapists at Chester County Hospital begin by assessing a patient's symptoms and then implement balance exercises along with eye and head coordination. Patients work towards walking and moving their head from side to side and looking around the room.
"This can make people feel unsteady or aggravate their headache, but this therapy will help with those symptoms," says Schweidler.
Therapists also look at the cervical spine for musculoskeletal problems that may be contributing to headaches, dizziness and fogginess. If symptoms are seen to be related to the spine, neck or joints, therapists provide cervical exercises and manual therapy for added healing.
In addition, the program conducts an exertion treadmill test, also known as a modified BALKE test. "This helps us find the heart rate that brings on the patient’s symptoms. We prescribe a specific exercise regimen that falls just below that heart rate. This helps regulate blood flow to the brain to facilitate brain healing and reduce symptoms over time," she explained.
Patients receive treatment once or twice a week on average, but the duration will vary patient to patient. With enough rest and therapy, patients are able to recover fully and go back to their lives. Schweidler stresses the importance of early detection: "If you’ve experienced an impact to your head or body, remember the signs and symptoms and talk with your doctor. Detecting a concussion early is critical to a speedy recovery."
Chester County Hospital’s Concussion Program is offered at its outpatient physical therapy, rehabilitation and sports medicine locations in West Chester, PA; Exton, PA; Kennett Square, PA and West Grove, PA.
Additional Concussion Information from Chester County Hospital in West Chester, PA: