Concussion Management

What is a Concussion?

A concussion is a mild-moderate brain injury following trauma to the head or violent shaking of the head and body (ie: MVA, fall, sports accident). This detrimental movement can result in bruising, edema, bleeding, and trigger harmful changes that interfere with normal brain function.



What are the symptoms of a concussion?

Headaches

  • Dizziness and blurred vision

  • Lack of concentration/coordination

  • Memory Disturbances

  • Nausea/Vomiting

  • Fatigue and “Brain Fog”

  • Sleep disturbances

  • Irritability and emotional lability

  • Personality change

  • Ringing in the Ears

  • Difficulty reading/focusing


What are some red flags I should look out for and immediately call my PCP, go to Urgent Care, or the Emergency Room for?

 

Repeated Vomiting

Can’t wake up

Seizures

Loss of Consciousness

Slurred Speech

Can’t recognize people/places

Numbness/tingling in face or both arms


Things to Avoid:

  • >10mins Screen Time

  • Loud Environments, Music

  • Bright flashing lights

  • Busy crowds

  • Reading, Gaming, TV, or Computer Work

  • NO Alcohol for 30 days

  • Limit Caffeine and non/prescription drugs (especially narcotics)

Things to DO!

  • Rest

  • Concussion Rehab

  • Aerobic Exercise

  • Track Symptoms

  • Eat a well-balanced diet

  • Gradual return to school, work, and sports

  • Work with school for temporary academic plan (IEP)

How long will this last?

Adults typically recover in 7-10 days, although this can be prolonged with repeated trauma, insufficient rest, and/or poor rehabilitation.

New research suggests that most children take a minimum of 30 days to recover.

What about work?

Ask your employer if you can work in an environment with limited noise, light, and activity levels. You may also see if you can limit computer work if this increases your symptoms, or work part-time or shorter shifts if necessary.

You are entitled to reasonable accommodations during your recovery!

What about school?

Ask your academic advisor if your school has a concussion protocol. A short-term Individualized Education Plan (IEP) to manage deadlines, tests, and assignments to optimize your academic success and full recovery may also be available.

Sometimes tutors, attending only 1-2 classes a day, and individual library study time can also help you re-integrate into the classroom.

What about sports?

Work with your physical therapist and physician to gradually return to sport and other strenuous activities. For kids, days 0-14 post-concussion focus on brain rest and regular daily activities. After 30 days you will return to non-contact sports and weight training <50% full exertion, and return to full contact practice and game play >30 days following your concussion monitored by your PT and MD.

Do I need to be woken up every hour while sleeping?

Nope! New research shows this older practice is now outdated. Sleep is a great opportunity for your brain to rest and heal. Get as much high-quality sleep as you can and don’t be afraid to block extra light and noise with an eye mask, blackout curtains, or ear plugs if needed

 

Is aerobic exercise (cardio) important?

YES! Aerobic exercise is exercise that gets your blood moving without causing the breakdown of long-term energy stores, such as walking, cycling, swimming, and jogging. Increasing your heart rate increases blood flow to your muscles and BRAIN. It’s like giving your healing brain a nutrient bath to help it recover faster! It’s completely safe 2 days post-concussion when your heart rate, symptoms, and exertion are monitored.

How much cardio do I need? How often?

After an initial 2 day rest period following your concussion, it is recommended you get 20-30mins of aerobic exercise EVERY DAY- as long as this does NOT exacerbate your symptoms or your heart rate exceeds the safe limit determined by your PT or MD.

If cardiovascular exercise does increase your symptoms, rest and try again later.

Why am I doing eye exercises?

Your brain helps manage a reflex between your eyes and the muscles in your neck to always move your head and eyes in opposite directions (VOR). This is what helps prevent your vision from bouncing up and down like a bad video recording when you’re walking. When you hit your head, this reflex is disrupted and can lead to difficulty focusing, dizziness, and nausea. Doing the eye exercises will help re-calibrate this reflex (VOR) and minimize symptoms, allowing you to return to work, school, and sports sooner.

How often do I do the eye exercises?

Ideally 5-6x/day because we are retraining a reflex that is being used 24/7, so we have to be very intentional about re-calibrating it.

What we offer

ImPACT- computer-based neurocognitive testing (Baseline/Post-Injuries)

Full Return to Play Protocol

Vestibular ocular rehabilitation

Occulomotor and vision testing

Balance retraining