Concussion Management

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I MAY HAVE A CONCUSSION: WHAT DO I DO?

STEP 1.
Make sure you tell someone (your partner, coach, parent, teacher etc.) so that you are not left alone. Remove yourself from sport, class, and/or work until a Medical Physician can properly assess you. Rest is the best treatment during the initial hours of the injury.

STEP 2.
Schedule an appointment to see a Medical Physician as soon as possible. It is usually unnecessary to visit the emergency room or have someone wake you at night, unless your symptoms are severe and/or rapidly worsening. Get a good night’s sleep! Limit use of your phone, television, and computer. Avoid visually demanding tasks such as reading and busy/loud environments such as the grocery store or sporting events – try to rest both your body and your brain.

STEP 3.
Undergo proper medical evaluation by a Physician. This typically does not include CT or MRI scans unless your injury is suspected to be more severe and/or needs to be ruled out.

STEP 4.
Visit a Concussion Management Provider in your area for further assessment. At Aspire, our PT Manas Kathuria will help you go through baseline testing, which will demonstrate any areas that may be impaired due to the injury and will help guide management recommendations. If you have not previously undergone baseline testing, a follow-up assessment with one of our Health Professionals is still highly recommended.

STEP 5.
Follow any management recommendations given to you by your Physician and Aspire Physiotherapy Professional. These may include physical rehabilitation (e.g. for associated neck pain), specific rest strategies and advice around modified school and/or work requirements, specialized rehabilitative techniques (e.g. vestibular therapy/exercises to help combat dizziness), and other recovery strategies.

STEP 6.
Follow-up with the Health Professionals involved in your care so that your recovery is properly monitored. If you have questions, please ask us as knowledge of your injury will aid in your recovery.

Some common symptoms often reported with concussive injuries include:

Headache
Dizziness
Neck pain
Nausea or Vomiting
Loss of balance
Poor coordination
Trouble focusing on objects or words
Poor concentration
Feeling “foggy”
Confusion
Amnesia, or poor memory
“Flashing lights”
Blurred or double vision
Seeing “stars”
Irritability or emotional changes
Ringing in ears
Slow to follow direction
Decreased playing ability
Easily distracted
Vacant stare
Drowsiness/fatigue
Difficulty falling asleep

What is the recovery timeframe after a concussion?
The majority of concussion-related symptoms are thought to resolve in a short
timeframe (days to weeks); however symptoms may persist for months for the following:

Some children & adolescents
Individuals who have suffered multiple concussions in a close timeframe
Individuals experiencing persistent migraine-like headaches, visual or vestibular dysfunction or a high symptom load
Individuals with history of migraine, depression, ADHD, learning disabilities or sleep disorders

Why do some individuals seem to recover quickly and others do not?
It can be unclear. Even when symptoms resolve quickly, it is advisable that a proper gradual return-to-play protocol be carried out for athletes returning to sport. Post-concussion syndrome is a diagnostic term used when symptoms persist for several weeks and sometimes months after the injury. If your symptoms persist beyond 3-4 weeks, it is important that you undergo proper medical assessment (or re-assessment) in order to receive the right education and management strategies for your condition.

What is “Second Impact Syndrome?”
Second Impact Syndrome is a rare, but serious consequence of head trauma, which results in rapid swelling of the brain – potentially leading to severe disability or death. Controversy exists as to whether second impact syndrome is a product of cumulative head trauma (when an athlete sustains a concussion while still suffering the effects of a previous concussion), or if it is simply a product of a single, mild traumatic brain injury.

Regardless of its cause, second impact syndrome is a severe consequence of head injury in young athletes. There should be absolutely NO return to play while an athlete is displaying signs and symptoms of a concussion, regardless of the level of competition.

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