Physiotherapy based Concussion Management

Author: Greg Bamber

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Over the last several years, there has been significant uncertainty and fear surrounding concussions in sport. By using a few simple strategies, concussions can be fairly routine and simple to manage with Physiotherapy based concussion management. A physiotherapist who has completed specialized training can use a variety of assessment tools to properly assess and diagnose a concussion. These tools are helpful to identify when it is safe to return to sport. 

How can a physiotherapist help with my concussion? 

Baseline testing

Performing as baseline test is the most effective tool that can be done to identify a concussion or to determine when a concussion has been fully recovered. The test should be performed prior to a concussion happening when an athlete is at full health. Baseline data includes measures of memory, visual tracking, reaction time, balance, etc. in order to identify an athlete’s “normal”. From there, if an athlete suspects a concussion, we simply retest these measures to see if the athlete is suffering from a concussion or is fully recovered. Having an athlete’s baseline data takes the guessing out of the return to play decision. 

Treatment

If an athlete does not have a baseline test, concussions can still be diagnosed and treated by a physiotherapist.

  1. Your physiotherapist can perform an assessment to identify your primary symptoms, test visual tracking ability, screen for whiplash signs, and rule out “red-flags”.
  2. From there, we will prescribe exercises that work on visual tracking and neck range of motion. Hands-on work during a physiotherapy session will attempt to improve neck pain and headaches. 
  3. After the initial assessment and treatment, your physiotherapist will provide you with recommendations for at home. These will include recommended screen time and mental activity, physical activity, return to school/work, and return to sport. 
  4. Once initial symptoms begin to subside, your physiotherapist will guide you through a variety of tests to identify if you are safe to return to non-contact physical activity.
  5. Lastly, once symptoms have disappeared, your physiotherapist will guide you through a final physical test to determine if it is safe to return to contact sport. This test will be physically demanding, as we are looking to challenge your body’s ability to elevate it’s heart rate, visually track, and perform compound movements. 

Had a concussion before? Did it take a long time to recover? 

If a concussion goes untreated, the most common condition that occurs is called post-concussion syndrome. This issue is not necessarily related to brain damage or brain healing. Rather, it is most commonly due to issues with whiplash, visual tracking, or vestibular (inner-ear) malfunction. Physiotherapists can easily help treat each of these issues through guided exercises and manual therapy. 

However, it is very important to clarify: Concussions need time to heal, like any other injury, but physiotherapy can help prevent side-effects that linger beyond the healing timeline. 

Greg Bamber
Physiotherapist at Pivotal Physiotherapy

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