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Concussion is a pathology that is diagnosed after a person receives a hit to the head or when the body comes to a sudden stop and the head is thrust around causing the brain to move violently inside the skull. Concussion is really a mild traumatic brain injury and are common in contact sports, sports where falls are common, after a car accident and in older adults who fall. Symptoms can occur immediately or over the following several hours. The most common symptoms reported after a concussion are – dizziness, vertigo, headache, neck pain, imbalance, blurred or altered vision, confusion, fatigue / sleepiness. Loss of consciousness (30 minutes or less) may also occur along with amnesia. 

 

For any person who suffers a concussion it is important that they cease all sporting and thinking activities to rest. Treatment or recovery success is better when a concussed person ‘takes it easy’ no need to go to bed and lay in a darkened room but rest of body and mind is important. This means for children no screen time and adults to stop using computers or electronic devices. The person with a concussion should be monitored closely as symptoms can worsen or develop indicating greater damage to the neural structures or vascular supply to the brain. Ideally any person who suspects or has a concussion should see their doctor or go to the  emergency department for an evaluation. Care should be taken to avoid further injury as a second concussion can have much more severe effects. 

 

Most people recover from their symptoms associated with concussion within 3-4 weeks. Children and young adults may take longer as their brain is slower to recover as it is still maturing. All persons who have a concussion should undergo assessment by a skilled team of health professionals, particularly their primary care GP, a specialist neurological or musculoskeletal physiotherapist. A return to school, work or play protocol is then established to ensure successful transition and recovery. The physiotherapist may identify some key symptoms that would benefit from treatments. It is now clearly identified that treatment by such specialist’s early in the recovery phase can hasten recovery and reduce the number of people who go onto develop post-concussion syndrome. 

 

If symptoms persist beyond the expected acute time frame, it is considered the person is suffering from post-concussion syndrome. Post concussion syndrome is simply ongoing symptoms that were experienced after the concussion that have not resolved. Again here ongoing evaluation by specialist health professionals, your primary doctor (GP), and specialists neurological or sports / musculoskeletal physiotherapists is highly recommended. They can identify clearly the systems that are not recovering and provide individualised and targeted treatments. Identification and management of concussions is an advanced area of practise so many physiotherapists have limited training or skills and would need to have undertaken advanced training in vestibular, cervical and neurological assessments and treatments. The key goal of treatment is to reduce symptoms experienced, increase fitness, reactivity and resilience to learning, activity and life. Many patients with post-concussion syndrome may require specialised fitness assessments and ocular-motor assessments. 

 

At UpRight Physiotherapy our staff have all the needed advanced training, with Katrina being the only physiotherapists in Australia with the combined skill set and having been externally examined and accredited. She has close links with other health professionals that if required can provide support via assessment of fitness or eye control. This means she has a complete understanding on your individual symptoms and can develop a targeted treatment plan to address your symptoms and needs. 

 

For more information about concussions and post-concussion visit some of the web links below or download the articles. 

The Brain Foundation 

https://brainfoundation.org.au/disorders/concussion

 

Queensland Brain Institute 

https://qbi.uq.edu.au/concussion/what-is-concussion

Investigating the validity and reliability of Electrovestibulography (EVestG) for detecting post- concussion syndrome (PCS) with and without comorbid depression