Concussion is a form of brain injury that causes a temporary disturbance in how the brain functions. Concussions can be caused by a direct or indirect impact to the player’s head or body. This impact causes the brain to move back and forth inside the skull. Concussion typically results in short lived signs and symptoms. However, in some cases the symptoms may evolve over several hours or days. Therefore, concussion must be taken seriously as there is a risk of brain injury with children most at risk.

Common Symptoms of a Concussion?

Each concussion case is different. Most concussions occur without a loss of consciousness and it is very important to recognise the other signs and symptoms. Concussion must be recognised as an evolving injury in the early stages. Some symptoms may develop immediately while others may be gradually over time. These symptoms may be physical, emotional, cognitive or sleep related.

• Headache and/ or Neck pain

• Light/noise Sensitivity

• ‘Feeling in a fog’

• Fatigue & low energy

Cognitive Function

• Short term memory loss

• Poor Attention & Concentration

• Confusion

Physical Signs

• Nausea/Vomiting

• Balance issues

• Slurred Speech

• Clutching Head

Sleep & Behavioural Signs

• Sleeping more and/or trouble falling asleep

• Anxiety

• Anger/ Highly irritable

• Emotional/ Sadness

Warning signs to look out for?

If you suspect any of the following signs or symptoms are present with the child or athlete, you should immediately go to the Emergency Department. These are known as RED FLAGS and could mean a more serious injury to the brain.

• Loss of Consciousness

• Seizures/ Convulsions

• Weakness/ Numbness in Arms or Legs

• Worsening Headache

• Repeated Vomiting

• Unsteady Walking/Standing

• Odd Behaviour

What to do if you Suspect a Concussion?

If there are any signs leading to a suspicion of a concussion for the athlete or child, they should be removed from play and not return to activity on the same day. Research has shown that by withdrawing a player from play immediately following a potential concussive impact, this reduced the players’ recovery time compared with those who remained in play. If you suspect a concussion or have been diagnosed, you should immediately stop playing, go to A&E or see your GP for an assessment and rest for at least 24 – 48 hours after the injury (physical and cognitive rest).

Tips for dealing with the symptoms

• Rest or take beaks from activities that require concentration or effort.

• Manual Therapy helps in the treatment of headaches which are caused by tension in the neck.

• Sensitivity to light: avoid long periods in front of the TV, laptop or on your phone.

• Practice good sleep hygiene: go to bed early, avoid caffeine before bed and reduce screen time.

• Try some relaxation techniques or breathing exercises to reduce stress, could also be coupled with light whole-body mobility/stretching at home.

• If you need more sleep, that’s OK. If you’re feeling extra tired, let your brain tell you when it is time to sleep or nap.

• Avoid Pro-inflammatory foods (processed fast food and sugar) and replacing them with nutritious foods (whole foods, fruit and vegetables) may help reduce inflammation and reduce symptoms.

So why have I got symptoms for so long?

You may get symptoms during recovery, but this is normal. Most of the time people will feel back to normal within 10-14 days and make a full recovery in 3-4 weeks. Following a concussion, energy stores in the brain drop over the first few hours to days. However, these changes in energy levels are usually only temporary, as most research shows that with the correct management these energy levels can be restored to normal levels within 3-4 weeks after injury. The impact that caused your injury can also result in other conditions that can have similar symptoms as concussion. These subtle issues are often missed by health care providers. Whiplash and injury to the muscles and joints of the neck, blood flow abnormalities, balance and visual problems, mild anxiety and depression can feel exactly like the symptoms of a concussion. However, with the correct approach these are all treatable symptoms.

How can Physiotherapy help?

Concussion is a treatable injury. Complete rest is no longer considered the best approach for concussion recovery. With early intervention of therapy and a step-by-step approach, physiotherapy can help patient’s safely return to learn, work and play.

• Manual Therapy: Headaches, balance and visual issues are common with both concussion and neck injuries. Oftentimes, ongoing symptoms are coming from your neck, which can be treated with manual therapy.

• Exercise Therapy: Following a period of rest, guided exercise therapy through research-driven timelines have shown to speed recovery.

• Reassurance: Education is an important part of concussion care. Understanding exactly what is going on and why you feel a certain way can help improve recovery.

Conclusion

So, should you suffer or suspect a concussion, do not return to play on the same day of the concussion. You may only return to play after you have been assessed and cleared by your medical doctor. Take some time off school, work and sport after a concussion. Most recovery protocols include frequent breaks, fewer hours at work/school and other interventions with the help of your physiotherapist. With the right approach, most people with a concussion can make a full recovery. A step by step return to activity program can help you through the process.

Concussion is a brain injury that needs to be taken seriously to protect you short- and long-term health. Therefore, monitoring of the child/athlete in the hours and days after the injury is an important aspect of concussion management.

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.