Concussion: How Do We Manage It?

Concussion: How Do We Manage It?

A concussion is a type of traumatic brain injury (TBI) caused by a blow; jolt to the head, or by a hit to the body that causes the head and brain to move rapidly back and forth. The sudden movement can cause the brain to bang against or twist in the skull. This contusion causes damage to the brain cells and creating chemical changes in the brain that can alter brain function.

According to the National Institute of Health a person with a Concussion can:

Demonstrate Signs of:

⦁ Inability to recall events prior to or after a hit or fall.

⦁ Appears dazed or stunned.

⦁ Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.

⦁ Moves clumsily.

⦁ Answers questions slowly.

⦁ Loses consciousness (even briefly).

⦁ Shows mood, behavior, or personality changes.

Report Symptoms of:

⦁ Headache or “pressure” in head.

⦁ Nausea or vomiting.

⦁ Balance problems or dizziness, or double or blurry vision.

⦁ Bothered by light or noise.

⦁ Feeling sluggish, hazy, foggy, or groggy.

⦁ Confusion, or concentration or memory problems.

⦁ Just not “feeling right,” or “feeling down.”

Really you can define it as any altered mental state after an injury involving stress to the brain. There isn’t any more “he got his bell rung” diagnosis. Those types of symptoms are a concussion.

When Does the Athlete Need to Go to the ER?

When in doubt error on the side of caution, perform a thorough assessment of the athlete, and if the athlete experiences any danger signs, they should be taken to an emergency room for further evaluation for more serious brain injury.

Dangerous Signs And Symptoms of a Concussion Can Include:

⦁ One pupil larger than the other.

⦁ Drowsiness or inability to wake up.

⦁ A headache that gets worse and does not go away.

⦁ Slurred speech, weakness, numbness, or decreased coordination.

⦁ Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).

⦁ Unusual behavior, increased confusion, restlessness, or agitation.

⦁ Loss of consciousness; Even a brief loss of consciousness should be taken seriously.

What Happens When We Get Home?

If the athlete, does not have any of these danger signs they can be sent to a physician that commonly manages these types of injury.

One key component is Rest, both of the body and the mind. We want them to get good restorative sleep. Do not wake them up every few hours. No cell phones, computers, TV or gaming for long periods of time. The brain needs rest and nourishment. The athlete needs healthy food and plenty of hydration, with main component being water. Do not give any medications that could create more bleeding such as ibuprofen or aspirin. And always follow you doctor’s advice.

When Can I Play?

We get asked this question by parents and athletes all the time while the athlete is recovering. Return to school, work, sport and stressful activity should be gradually reintroduced. This should be done systematically and should be under supervised care.

The biggest dilemma with concussion is not recognizing one or telling people to go home and rest. It is accurately assessing the patient’s progress and transitioning them efficiently in returning to their activity or sport.

The return should be based on the athlete’s resolution of symptoms and response to activity. We have a very graduated process to take the athlete safely through this process monitoring all aspects of the symptoms including: vision, memory, balance, and vestibular (inner ear) function.

Once the athlete is symptom free and has been cleared by the trainer, therapist and physician, they can return to contact and play.

What Can I Do to Protect My Child?

Accidents will happen. As my pastor once said, tragedies don’t schedule appointments. We can’t always prevent injury, but good technique in their sport, protective equipment is critical. Most coaches and teams have taken a proactive response in protecting their players.

A new helpful tool is baseline testing. Baseline testing is provides a starting point for the athlete and helps determine their “normal.”

This includes computerized neurocognitive testing that assesses the athlete’s response time, visual spatial awareness, and memory. This is the same test, ImPACT, many professional teams and colleges have been utilizing for many years. We also perform physical tests that provide the patient with a thorough picture of their mental and physical baseline pre-injury.

The testing can be performed in about 45 minutes and the results are kept in a database for easy access. Having a starting point with the athlete can help the physician, therapist, trainer, coach, and parent accurately assess the athlete’s progress and guide their return to play.

I am a Certified ImPACT Physical Therapist and also have been certified through the National Institute of Balance in Tampa’s Concussion Management Program. If you would like more information, feel free to contact our Robb Seahorn PT CSCS at our office 674-7454 or email: peakrehabtn@gmail.com.