What is a concussion?
Concussion is a type of brain injury that generally results from direct forces, i.e., a knock to the head, face, or neck. It can also occur from indirect forces to anywhere in the body, which then transmits force to the head. A concussion involves a short-lived impairment in brain function. Falls are the most common cause of concussion presentation to ED in Australia, followed by transport, sport, and assault.
What is Post Concussion Syndrome?
Post concussion syndrome is the prolonged series of symptoms following a concussion. Typically, in 85-90% of cases, concussion symptoms resolve within 2-3 weeks, and you can return to attending work or school, participating in daily activities, or playing sports without further issues. The prolonged symptoms typically include but are not limited to headaches, fatigue, balance disturbances, confusion, difficulty concentrating, and poor memory. These symptoms negatively impact your daily function and stop you doing the things you enjoy.
Why does this occur?
When we have a concussion, there is an injury to the brain that impacts the autonomic nervous system. The autonomic nervous system oversees the sympathetic and parasympathetic systems. Changes to the ANS can alter blood flow in the brain, which causes the ongoing symptoms following a concussion including headaches, vision changes, and dizziness leading to exercise intolerance. This normally resolves spontaneously with a short period of rest followed by a gradual return to normal activities. However, it can result in ongoing symptoms which require assessment and treatment.
What can we do at Back In Motion Rosny Park?
Our clinicians Tim and Charles can assess and treat aspects of post concussion syndrome. Just like other parts of the body, concussion can be rehabbed to decrease symptom severity. This involves finding what functions are limited and tailoring a rehab program to increase the ability of that system. These may include:
- Vestibular-oculomotor system
The vestibular-ocular system is where your inner ear and eyes work together to enable coordinated movement. This system keeps your vision stable whilst your head moves. When it is not working optimally, symptoms include dizziness, balance issues, headaches, blurred vision, sensitivity to light or sound, difficulty concentrating, anxiety, and fatigue. Rehabilitation exercises are tailored to what area needs attention based on the assessment completed. Common treatments are the use of gaze stabilization or saccades depending on your impairment.
- Neck pain
Neck pain and movement dysfunction can lead to a variety of impairments. Headaches with or without dizziness are common and can be treated with a combination of hands-on manual therapy and neck muscle retraining. Deficits in balance are also a common side effect which are treated through progressive balance training.
- Exertional intolerance - Increase in symptoms when exercising
Exertional intolerance is a common symptom of post concussion syndrome. You may be feeling okay at rest, but when you return to activity and increase your heart rate, you are met with symptoms of fatigue, headaches, dizziness, and not feeling right. We will assess your symptom threshold through a graded exercise test and prescribe exercise just below this level, known as sub-symptom threshold training. This allows the brain and body to adjust to the load of the activity. With time, this exertion level is slowly increased as tolerated to return you to the demands of your activity.
Post concussion syndrome outcomes
In general, concussion has a good prognosis with symptoms being relieved within a month. Greater symptom severity at the initial presentation and repeated head trauma have been associated with a greater likelihood of post concussion syndrome. Identifying a health professional early is important to ensure there is appropriate assessment, treatment, and return to work/sport/daily activities.
If you need assistance with recovery from a concussion, call reception on 6281 2499 or click the BOOK NOW below to book in an initial consultation with Tim or Charles.
Author: Tim Smith (Physiotherapist)