By Tara Winters
Physical Therapist, BASI Pilates teacher
The third week of September is Balance Awareness Week! This month also marks the start of the season for America’s favorite sport...football. Therefore, I thought it would be fitting to discuss a common balance related issue among athletes - concussions.
Concussions are highly prevalent, especially among the athletic population. However, information on concussions and evidence about appropriate treatment options has evolved over the years, leaving many of us confused as to what to do when someone we know is affected.
Fortunately, we know much more about concussions today than we did 10 years ago. Let’s review some of the background on concussions, signs and symptoms, and current treatment practices.
What exactly is a concussion?
A concussion is a traumatic brain injury (TBI) that can manifest into a wide array of symptoms that can last hours, days, or years.3 Symptoms can include mood swings, headaches, fatigue, brain fog, muscular tension, vertigo and memory loss.3 These symptoms can be influenced by diet, exercise, and stress.3
Recovery
Usually, a sports-related concussion will resolve within 2 weeks after the injury.3 Keep in mind that children take longer to recover as their brains are still developing at this age.3 Current evidence shows that the following may indicate a longer recovery time: 3,4
● Immediate dizziness
● Amnesia
● Acute exertion after the injury
● Repeated injuries
Treatment
If the concussion occurs during sport, the player should not return to play to avoid risking a second concussion.3 A second concussion is termed ‘second impact syndrome’ and can lead to more serious issues.3 During the initial few days following a concussion, light rest is recommended.3 Avoiding strenuous activity for one to two weeks allows for optimal healing.3 That is not to say that one must avoid activity altogether, but staying in the ‘light to moderate’ range of tolerable activity is typically appropriate. If visual stimulation is an issue, avoid bright lights or busy environments.3
A visit to your local physical therapist can also be helpful to address vestibular deficits and muscle tension, both of which can occur following a head injury. Vestibular impairments may include dizziness, motion sensitivity, vertigo, and headaches. Physical therapists can also assist you in creating an appropriate, graded return-to-sport exercise plan that will not lead to overexertion. Generally, mild to moderate aerobic exercise is helpful in stimulating brain-derived neurotrophic factor (BDNF).5,6 BDNF is involved in brain development, cell growth, and affects learning and memory.5,6 Another type of therapy that can be particularly effective in traumatic brain injury recovery is craniosacral therapy (CST).7 This type of therapy is performed by a physical therapist and involves gentle pressure to areas surrounding the craniosacral system of the body.7
Stress management should also be considered. Stress can negatively affect brain activity and exacerbate concussion symptoms as the brain is less able to handle increased energy demands following injury.2,7 Stress can mean many things for someone post-concussion. Examples include emotional stress, environmental stress, and overexertion (physically or mentally).3,7 Yoga, meditation, and breathing exercises are great stress relieving options to consider. Acupuncture is another great option for pain and headache relief.1 Many studies link acupuncture with the reduction of concussion symptoms such as headache or neck pain.1,8,9
If memory issues arise, try playing memory games. Lumosity is a great cell phone application that takes users through various levels of challenging memory games. SuperBetter is another app created by a woman with a TBI and is useful in setting goals and building habits.7 Journaling about gratitude can help those with a concussion ingrain positive thoughts along their healing journey.7
Healthcare Professionals are Here for You
Whether you’re a professional football player or a parent concerned about your child, concussions can occur at any moment. If you notice any of these symptoms following a bump to the head, remember that it is important to get assessed by a healthcare professional as soon as possible to ensure optimal recovery.
Cypress Center physical therapists specialize in vestibular evaluation and treatment as well as CST. We also have skilled acupuncturists ready to assist in the treatment of any residual deficits following a head injury.
References
- Gergen D. Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman Using Cervical Manipulation and Acupuncture: A Case Report. Journal Of Chiropractic Medicine [serial online]. September 1, 2015;14:220-224. Available from: ScienceDirect, Ipswich, MA. Accessed September 6, 2017
- Kozlowski K. Exercise and Concussion, Part 1: Local and Systemic Alterations in Normal Function. International Journal Of Athletic Therapy & Training [serial online]. March 2014;19(2):23-27. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed September 6, 2017..
- Laura Morris. Mild Traumatic Brain Injury. Presented at: Elmhurst Memorial Healthcare; June 2017; Chicago, IL.
- Lau BC, Kontos AP, Collins MW, Mucha A, Lovell MR. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? The American journal of sports medicine. 2011;39:2311-2318.
- Leddy JJ, Sandhu H, Sodhi V, Baker JG, Willer B. Rehabilitation of Concussion and Post-concussion Syndrome. Sports Health. 2012;4(2):147-154. doi:10.1177/1941738111433673.
- Schmolesky MT, Webb DL, Hansen RA. The Effects of Aerobic Exercise Intensity and Duration on Levels of Brain-Derived Neurotrophic Factor in Healthy Men. Journal of Sports Science & Medicine. 2013;12(3):502-511.
- Molly Parker. Mild Traumatic Brain Injury: how to identify and treat concussions with compassion. Presented at: University of St. Augustine; November 2016; San Marcos, CA.
- Gergen DM. Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman Using Cervical Manipulation and Acupuncture: A Case Report. Journal of Chiropractic Medicine. 2015;14(3):220-224. doi:10.1016/j.jcm.2015.08.006.
- Biçer M, Bozkurt D, Aktaş İ, et al. The clinical efficiency of acupuncture in preventing migraine attacks and its effect on serotonin levels. / Akupunturun migren ataklarının önlenmesinde klinik etkinliği ve serotonin düzeylerine etkisi. Turkish Journal Of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip Ve Rehabilitasyon Dergisi [serial online]. January 2017;63(1):59-65. Available from: SPORTDiscus with Full Text, Ipswich, MA.