For some of us, Easter means fluffy bunnies, delicious chocolates, and pretty eggs. For others, it means vicious Easter egg hunts. With children (and adults) running around with their heads down searching for Easter eggs (and kids), there is a high risk of head-related injuries (concussions).
Overview
A concussion occurs when the brain is violently shaken. The brain is made of soft tissue, and it is cushioned by fluid and encased in a protective shell (the skull). The impact of jolting the brain inside the skull causes damage to the surrounding tissues. Depending on the area of the brain that's jostled against the skull, symptoms may vary. It can range from changes in mood and personality, to headaches and dizziness, to poor coordination and balance, to vertigo and eye problems, to memory loss and fogginess, etc. etc. After a concussion, the brain is confused and very sensitive, so extra precautions must be taken to improve recovery.
Causes
Concussions are a result of sudden trauma. It could be caused by the head hitting a stationary object (i.e. walking into a pole), a blow to the head (i.e. getting hit during hockey), or even during rapid movement changes (i.e. in a motor vehicle accident). Participating in sports increases the likelihood of getting a concussion, especially with contact sports like hockey, football, rugby, boxing, and many more. Concussions can also occur after slip and falls, motor vehicle or bike accidents, work injuries, and other activities that involve physical contact.
Signs and symptoms
Concussions are hard to diagnose as there are no visible or physical signs of brain trauma. Signs and symptoms may be immediate or delayed, and they will depend on the area of the brain that is affected. These may or may not include some of the following:
- Temporary loss of consciousness
- Headache, migraine, or feeling of pressure in the head
- Dizziness or vertigo
- Sensitivity to light and noise
- Nausea or vomiting
- Changes in sleeping and eating patterns
- Tinnitus or ringing in the ears
- Amnesia or memory loss
- Confusion, fogginess, poor concentration, or low attention span
- Clumsiness
- Tiredness and fatigue
- Changes in mood or personality (such as depression, aggressiveness, irritability, or impulsiveness)
- Loss of balance and coordination
- Delayed or slowed reactions to stimuli
If you have signs and symptoms that are more serious than the above (i.e. seizures, inability to wake up [coma], draining of blood or fluids from the nose or ears, lasting confusion, unequal pupil size, weakness, or inability to walk), seek immediate emergency medical help.
Physiotherapy Treatment
- Rest: Rest is one of the most (if not the most) important treatments for a concussion. Your brain needs time to heal, so if you're constantly bombarding it with stimuli, it will never be able to recover. Stimuli includes anything that your brain needs to process. It can be as simple as light and sound or as complicated as studying and working. Rest could refer to physical rest (from sports, gym, housework, leisure activities, etc.) or cognitive rest (from school, work, reading, watching TV, playing video games, texting, etc.). You don't necessarily have to be on bed rest, but getting lots of sleep and giving your brain a break from activity will be beneficial.
- Activity modification: This goes hand-in-hand with the above. Due to feeling more tired/fatigued, or feeling the inability to concentrate for long, or feeling frustrated with yourself, you might find that you will need to take frequent breaks when doing certain activities. It is also normal if you find that you cannot do certain things at all. You'll need to make sure that resuming to work/school/sport activities are gradual. It might be helpful to keep a diary of all your signs and symptoms and keep track of the things that aggravate them/make them better.
- Modalities: Since head injuries also cause trauma and damage to the neck, electrotherapeutic modalities are typically aimed at decreasing the inflammation and tension/stiffness in the soft tissues and joints of the neck.
- Acupuncture and dry needling: A lot of people with concussions find relief with acupuncture. It can be beneficial in improving headaches/migraines, dizziness, nausea, fatigue, and overall wellbeing by decreasing anxiety and stress. Acupuncture also helps to relax your body and give it the rest that it needs
- Manual therapy: Joint mobilizations and soft tissue release are important to restore proper movement and function in the neck. What most people don't realize is that when your head gets hit, the neck follows your head and suffers some trauma as well.
- Exercise: This is another important treatment for concussions and is dependent on your signs and symptoms. If you have poor balance and coordination, your physiotherapist might give you exercises to work on improving that. If you have problems with your vision or dizziness, exercises will focus more on vestibular rehabilitation. It is also beneficial to strengthen the muscles of the neck.
Other treatments
- Surgery (if there is bleeding in the brain)
- Medications to manage symptoms (i.e. for sleeping, headaches, anxiety, nausea, etc.)
Baseline testing
Baseline concussion tests are a series of tests taken prior to an athletic event or season (for athletes) before they are exposed to training and/or competition. In the event of a concussion, the same test is taken post-injury to yield comparative scores. These tests measure an individual's reaction time, memory capacity, speed of mental processing, and executive functioning of the brain. If you know that you or a loved one are at a high risk of concussions, it is important to do baseline testing as it is an objective measure that indicates whether the brain has fully recovered after an injury.
