Understanding Concussions and the Role of Conservative Care in Recovery
Author: Rachel Young, Physiotherapist
Concussions are unique and complex injuries that are often misunderstood. While they are classified as a mild traumatic brain injury, their effects can be far-reaching, impacting various organs, physical abilities, and even mental health. A concussion occurs when the brain is shaken inside the skull, either from a direct blow or an indirect movement of the head, such as a sudden jolt or impact. The most common causes of concussions include motor vehicle accidents, sports-related injuries, and being struck by an object.
Despite the frequency of concussions, studies show that at least 50% of concussions remain undiagnosed (Robertson & McLoughlin, 2024). Fortunately, physiotherapists and chiropractors can play a critical role in the rehabilitation of concussion, helping those return to daily activities and sports safely.
The Complexity of Concussions
A concussion can affect various systems of the body, not just the brain. Its symptoms can vary widely and might include headaches, dizziness, nausea, fatigue, difficulty concentrating, or sensitivity to light and sound. Additionally, some people may experience issues with balance, vision, and even mental health challenges such as anxiety or depression. Because of this broad impact, managing a concussion requires a comprehensive approach. Physiotherapists and chiropractors are trained to assess and address the many different symptoms a patient may experience, creating a recovery plan that is tailored to their specific needs.
The Role of Physiotherapy and Chiropractic in Concussion Recovery
Physiotherapists and Chiropractors are essential in providing both immediate and long-term rehabilitation for individuals who have suffered a concussion. We perform thorough assessments to get a full picture of the patient's symptoms and needs. These assessments typically include four key components related to concussion management:
Autonomic Function – This refers to the body’s automatic functions, like heart rate and blood pressure, which can be affected by a concussion.
Cervicogenic Issues – These are neck-related issues, such as pain or dysfunction, which are common after a concussion due to the jarring of the head and neck.
Vestibular-Oculomotor – This involves the balance system (vestibular) and eye movements (oculomotor), which can be disrupted by a concussion.
Psychological Approaches – Mental health can be significantly impacted by concussions, and addressing mood, anxiety, and cognitive function is a crucial part of the rehabilitation process.
By assessing these areas, a therapist can better understand the full scope of your symptoms and create an individualized rehabilitation plan that addresses all aspects of your recovery.
Interventions for Concussion Recovery
The approach to concussion rehabilitation is individualized and patient-centred. Each person’s symptoms and recovery process are unique, so treatments are customized to fit their needs. Physiotherapists and Chiropractors will incorporate interventions that focus on the autonomic, vestibular, and cervicogenic systems. Some of the most common interventions include:
1. Exercise Rehabilitation
Aerobic Exercise: Low-intensity aerobic activity helps improve cardiovascular health and can reduce concussion symptoms such as fatigue, dizziness, and difficulty concentrating. Gradual increases in activity can help patients return to their normal level of functioning.
Range of Motion Exercises: After a concussion, neck and upper body stiffness is common. Physiotherapists work on gentle range-of-motion exercises to restore flexibility and mobility, particularly in the neck and upper back.
Strength Training: Building strength, particularly in the neck and core muscles, helps improve posture and stability, which can ease headaches and neck pain.
Balance and Coordination: Exercises that challenge balance and coordination help restore proper brain-body connection, addressing the dizziness and unsteadiness that often accompany concussions.
2. Vestibular-Oculomotor Training
Concussions often lead to issues with balance (vestibular) and vision (oculomotor). Vestibular therapy includes exercises that focus on improving your sense of balance and coordination, while oculomotor therapy targets eye movement and tracking, helping to improve visual focus and reduce symptoms like dizziness or blurry vision. These exercises are designed to retrain the brain and help individuals regain their normal sensory and motor functions.
3. Education and Guidance
Education is a key part of concussion rehabilitation. Physiotherapists and Chiropractors educate patients, caregivers, and families about the recovery process and the importance of gradual return to activities. This includes:
Return to Learn (RTL): For students, this involves managing cognitive load and pacing school activities to ensure a safe return to learning without overwhelming the brain.
Return to Play (RTP): For athletes, we follow evidence-based protocols to safely reintegrate them into sports. This step-by-step process ensures they are physically and cognitively ready before resuming their athletic activities.
Proper education not only aids recovery but also ensures that both the patient and their support system are aligned on how to move forward with minimal risk of re-injury.
Conclusion
Concussions are serious, and their impact can be far-reaching. If you or someone you know has experienced a concussion, seeking physiotherapy treatment is a vital step in the recovery process. Through personalized assessments and individualized interventions, physiotherapists help patients restore balance, strength, and mental clarity, making it possible to return to everyday activities, sports, and work with confidence.
If you're recovering from a concussion or worried about a potential concussion, don't hesitate to reach out to a physiotherapist. We can guide you through the process, help you manage your symptoms, and work with you toward a full recovery.
Reference:
Robertson, M. K., & McLoughlin, J. (2024). The role of the physiotherapist in concussion. The South African journal of physiotherapy, 80(1), 2013. https://doi.org/10.4102/sajp.v80i1.2013
