Concussion Management
What is a concussion?
A concussion is a mild traumatic brain injury that occurs when the body or head suddenly decelerates (and yes, that means you can have a concussion without even bumping your head!). Concussions are not just for athletes! Concussions can also occur in other cases such as whiplash, an object striking the head, or if a person falls.
They can be thought of as "brain sprains" - brain cells are shaken and stretched but are not killed; this is why concussions can not be seen on standard brain scans. They can cause a wide range of symptoms which typically resolve within 2 weeks, but it may take twice as long for brain cells to fully return to normal function.
While research in this area is developing quickly, it is becoming apparent that if multiple concussions that occur too close together, it can lead to more intense / longer lasting symptoms. On the more reassuring side, it is believed that if a concussion has fully resolved, subsequent concussions are much less likely to lead to long-term problems.
For more information on concussions, please visit The Australian Brain Foundation.
How are concussions managed?
In the first 48 hours, it is important that a concussed brain needs rest and to avoid further injury. While symptoms may take a few weeks to recover, it is important to begin resuming gentle (non-aggravating) exercise and mental activity as soon as possible.
There is a specified pathway that athletes should follow as they recover and consider returning to sport - please visit ConcussionInSport.gov.au for details. Some sporting organisations have their own pathways as well.
In many cases Physiotherapy is not required after a mild concussion. But research suggests up to 70% of concussion sufferers still report at least 1 symptom a year later! We also know that the sooner rehabilitation is commenced post-concussion, the quicker the recovery tends to be.
In concussion rehabilitation a variety of assessments are performed. This allows a clinician to create a "profile" for each concussion so treatment can be tailored to an individual. Physiotherapy may include aerobic exercise, vestibular and eye exercises, addressing problems with the neck, lifestyle management, and referral to other professionals. Each concussion is different so no two person's treatment program will be the same.
References
Leddy et al. (2023). Rest and exercise early after sport-related concussion: a systematic review and meta-analysis. British Journal of Sports Medicine, 57:12.
Qatman-Yates et al. (2020). Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury: Clinical Practice Guidelines. Journal of Orthopaedics and Sports Physiotherapy, 50:4.
Machamer et al. (2022). Symptom Frequency and Persistence in the First Year after Traumatic Brain Injury: A TRACK-TBI Study. Journal of Neurotrauma, 39:5-6.
