Concussions: Physical Therapy’s Role in Treatment
A concussion is a common injury that requires a thorough and skilled treatment plan for optimal recovery. Physical therapists can effectively manage concussion injuries through evidence-based treatment and a careful, personalized rehabilitation plan.
What is a concussion?
A concussion is a mild traumatic brain injury that can cause physical, cognitive, and behavioral symptoms. It affects between 1.6 to 3.8 million people annually in the United States. Concussions may happen during sports and other recreational activities or result from car accidents, falls, or work accidents.
A concussion occurs when the brain is violently shaken due to the head receiving a direct hit or due to rapid movement changes, such as whiplash. This can cause an unpredictable injury to any part of the brain. Symptoms may develop immediately or the injury may lead to delayed changes in the brain’s function.
Symptoms of a concussion include:
Headache
Dizziness
Sensitivity to light and sounds
Nausea and vomiting
Mental fog
Disturbed sleep
Irritability
Quick cognitive fatigue
Difficulty thinking
Double or blurred vision
Mild rest immediately following a concussion is important. If symptoms do not resolve within seven to ten days, an individual may develop post-concussive syndrome (PCS). Between 10% to 30% of people experience prolonged mild traumatic brain injury symptoms. It is important to have a staged, patient-specific trajectory of recovery and a well-monitored treatment plan to address PCS.
How do physical therapists treat concussions?
A physical therapist examines and evaluates individuals who have had a concussion to establish a diagnosis, treatment, and monitoring in order to safely return the individual to participation in sports and daily activities. Receiving rehabilitative care post-concussion can decrease time to medical clearance and leads to a faster, safer recovery.
A physical therapist works in concert with a team of medical professionals to care for a patient with a concussion, including sports medicine doctors, neurologists, optometrists, neuropsychologists, and occupational therapists. A physical therapist initially runs a variety of tests to evaluate an individual’s symptoms, including a dizziness handicap inventory; post-concussion system inventory, which checks the cervical spine and neck; vestibular exam; and heart rate-based treadmill test so as to prescribe appropriate aerobic exercise.
Physical therapy treatment includes:
Vision rehabilitation
Graded aerobic exercise training that does not intensify symptoms
Balance testing and training
Gradual, sub-symptom exercise training is beneficial for the patient as it allows the brain to adapt to increased physiological demands of activity over time and allows athletes to begin regaining physical fitness. A study from the University of Buffalo revealed that a specific graded exercise program achieves complete symptom resolution and improves blood flow to the brain.
Vestibular and visual rehabilitation is another important aspect of treatment. Dizziness is a common complaint of post-concussive patients and is related to problems with the balance centers of the brain, the visual system, and problems with the muscle and joint sensors of the neck. Vision issues also contribute to difficulty concentrating and memory issues. All concussions involve a whiplash. This causes a sprain or strain injury to the neck, which can be effectively treated with manual therapy.
Receiving appropriate, timely, and well-monitored treatment for a concussion is imperative to achieve full recovery and return to activities safely. Working with a physical therapist, who is an expert in movement and function of the body, to rehabilitate post-concussion leads to better and safer post-concussive outcomes.
