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Concussion - the brain

Concussion: Causes, Symptoms, and Treatment Solutions

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Concussions are common mild traumatic brain injuries (mTBI) that can occur from accidents, contact sports, and unintentional blows to the head. While a concussion may be scary when it happens, knowing how to react and treat the condition can be life-saving.

Not every knock to the head results in a concussion, but seeking medical help, when you suspect a concussion has occurred, is important for quick treatment.

Here is everything you need to know about a concussion, including the degrees of severity, the causes, symptoms, and treatment options. Each case of the injury will need to be diagnosed and treated uniquely, although there are similarities in how to deal with this type of head injury.

What Is a Concussion?

A concussion is a mild type of brain injury that occurs when your head is bumped or violently jolted back and forth, such as in the event of whiplash occurring. This injury usually happens after a fall, during contact sports, or in car accidents.

Concussions can lead to a temporary loss of consciousness, although this is more common in severe concussions. This injury is usually not life-threatening and most people make a full recovery afterwards. However, the effects of the injury can be serious and last for months.

This type of head injury causes the nerves and blood vessels in the area to stretch and bruise which results in a chemical change in the body. The result of these changes is a temporary reduction of normal brain activity. Single concussions are easier to fully recover from, but multiple concussions that occur fairly regularly can cause lifetime effects on the functioning of your brain.

Depending on the severity of the brain injury, a concussion will fall into one of three categories. The category of the injury will determine the severity of symptoms as well as the possible treatment solutions.

Concussion, children, sports injury

Types of Concussions

The severity of the head injury is classed as a Grade 1, 2, or 3 concussion. Your injury is ranked based on loss of consciousness, loss of equilibrium, or amnesia.

Grade 1 Concussions

Symptoms are mild without any loss of consciousness. The immediate effects are felt for about 15 minutes post-injury.

Grade 2 Concussions

Moderate symptoms without any loss of consciousness or brief loss of consciousness. The immediate effects last for longer than 15 minutes.

Grade 3 Concussions

Severe symptoms where loss of consciousness occurs for a few minutes or longer.

What Causes a Concussion?

Concussions are caused by any type of knock to the head which occurs suddenly and with excessive force. This can be caused by a tackle during contact sport, a hit to the head in boxing, a car accident, a fall on the head, or physical abuse. Concussions can also happen from severe whiplash in which the head is whipped backwards and forwards with force.

The sudden force causes the brain to move within the skull, which may lead to bruising in certain areas of the brain or stretching of neurons, which will affect the brain’s processing ability.

concussion, the brain

Symptoms of a Concussion

Since concussions affect the brain, they have an impact on the functioning of certain actions that require normal brain function. This includes judgement, memory, speech, muscle coordination, balance, and reflexes. The result is often a brief period of forgetfulness where the affected person can’t remember what happened immediately before or after they received the injury.

People who experience a concussion often report feeling confused, dazed, or seeing stars. In most cases, medical professionals will ask the person their name, where they are, or what month and year it is to gauge orientation.

No type of concussion should be taken lightly, even mild concussions should be assessed by a medical professional. While a mild concussion may not necessarily cause long term effects, repetitive concussions are more likely to have more severe effects on the brain, that manifest as physical limitations.

The part of the head that experiences the knock may determine which type of symptoms occur. This means that not all the symptoms will be felt by everyone and the symptoms can help your doctor determine the severity of the knock.

Concussion symptoms can occur a few minutes after impact or a few hours later. The symptoms can also appear after the brain is stressed from use later on. The common symptoms include:

  • Headaches
  • Confusion
  • Nausea and/or vomiting
  • Sensitivity to light and noise
  • Slurred speech
  • Blurred vision
  • Ringing in the ears (tinnitus)
  • Fatigue/drowsiness
  • Temporary loss of consciousness
  • Forgetfulness

Symptoms in Children

It is quite common for infants and young children to bump their heads. While not every head bump will cause a concussion, it is hard to tell the difference since the little ones can’t say how they feel. Keep an eye out for the following symptoms in children following a head bump.

  • Seizures
  • Irritability
  • Excessive crying
  • Dazed appearance/blank stare
  • Loss of balance
  • Tiredness
  • Lack of interest in toys
  • Vomiting

It is not a bad idea to call your paediatrician after your child experiences anything more than a mild head bump as a precaution.

When to Seek Urgent Medical Attention

Any type of concussion should be assessed by a medical professional as a precaution since it is difficult to know how severe a concussion was. Symptoms of mild concussions will likely go away on their own within a few hours without any treatment needed. However, consult your doctor to see if any additional treatment should take place.

While you should always seek medical help, it is especially important if the following symptoms are noticed:

  • Loss of consciousness for more than a minute
  • Constant vomiting
  • Blood or fluid from the nose and ears
  • A worsening headache
  • Drastic changes in pupil size
  • Unusual irritable behaviour
  • Numbness or tingling in legs or arms
  • Extreme fatigue
  • Drowsiness and difficulty waking up
  • Increasing confusion

Long-Term Complications

While most symptoms of mild to moderate concussions will clear up shortly after the injury, there is the rare possibility of long-term complications. These complications are more likely in instances of more severe concussions.

Possible long-term complications include:

  • Post-traumatic headaches — often feel like a tension-type headache that persists for days or weeks after the injury. In most cases, these are tension headaches caused by a neck injury that happened at the same time as the concussion.
  • Post-concussive syndrome — is a condition that occurs where you will experience symptoms of a concussion for weeks or months rather than a few hours or minutes. Typical symptoms include continuous dizziness, mood swings, headaches, anxiety, concentration issues, insomnia, and extreme fatigue.
  • Post-traumatic vertigo — can occur in some instances, where you experience spells of dizziness and the sensation of feeling off-balance or as if the world is spinning.

Treatment Options for a Concussion

Treatment for mild concussions often includes conservative management. This means you will need to take it easy for a few days, reduce screen time and light stimulation, and refrain from any strenuous activity.

It is vital to fully treat a concussion before returning to a sport that could cause another concussion. Suffering from a second concussion before you are completely healed can result in a severe or fatal brain injury.

Further rehabilitation options include physiotherapy to treat specific symptoms following the concussion, this may include rehabilitating neurological fallout, such as balance and coordination, and/or treatment of musculoskeletal injuries associated with the concussion injury (stiff neck, headaches, vertigo etc.).

Initiating physiotherapy early on in your recovery will facilitate a speedy recovery and return to sport. It will also minimize any long-term residual effects.

concussion, rest and recovery

How Long Is Recovery for a Concussion?

The majority of concussions will resolve after a week or two, with 10 days being the average recovery time. However, recovery from a concussion can take months based on the severity of the injury.

Anyone who experiences a concussion shouldn’t return to sport or physical activity sooner than a week after sustaining the head injury. You must follow the doctor’s guidelines on when you can return to sport, following the injury.

The recovery time will usually be determined by the grade of concussion that was experienced.

Mild Concussions

Grade one and two concussions will generally only need conservative treatment methods with a week or so of rest, minimized screen time, and no strenuous activity. The effects of these concussions should be resolved within two weeks following the injury.

Severe Concussion

Grade 3 concussions may take longer than two weeks for a full recovery. While you should be able to go back to normal daily life in about two weeks, you will likely need to refrain from sport and strenuous activity for a few weeks. It is important to wait until your doctor determines you are fit for sport and exercise again before returning.

correct sports equipment and proper surfaces

Preventative Measures for Head Injuries

Since concussions can happen at any time, without warning, it is hard to prevent these types of head injuries. However, you can take extra precautions to prevent the possibility of experiencing a head injury.

When partaking in high-risk or contact sports such as rugby, hockey, soccer, boxing, MMA, skateboarding, and cycling, be sure to wear appropriate protective gear.

Extra Sports Tips

  • Supervise young children during sporting activities and don’t let them use sporting equipment that is unsuitable for their age
  • Wear the correct clothing for the sport
  • Don’t wear any headgear or clothing that will reduce your vision
  • Don’t play sports or exercise when feeling tired or sick
  • Replace protective gear that is old or damaged
  • Make sure equipment and the grounds are given regular safety checks
  • Obey the rules of the road when cycling or skateboarding

cycling, safety first

Extra General Tips

  • Always wear a seatbelt and follow speed limits while driving
  • Don’t drive when impaired by lack of sleep, alcohol, or medication
  • Remove hazards at home that can lead to falls, especially for the elderly
  • Exercise regularly to improve balance and coordination
  • Install safety measures at home for young children

Frequently Asked Questions About Concussions

How likely is it to have repeated concussions?

After experiencing a concussion, athletes are three to five times more likely to experience another one. This is especially true for athletes and those who begin sports again before fully recovering from a concussion. Sport shouldn’t be resumed until all symptoms have gone away.

Can concussions result in jaw and neck pain?

Yes. Depending on the site of impact, you may experience pain and stiffness in your jaw and neck from the injury. Temporomandibular joint disorder (TMJ) is a condition that causes pain and clicking around the jaw and can be a result of a head injury. Neck pain can also occur from the force of the impact stretching and damaging muscles in the neck.

Should you wake someone up at regular intervals the night after a concussion?

No, there are no proven benefits of waking up someone the night after they have experienced a concussion. This can even slow down the recovery process, as the patient needs rest to recover. However, you can check in on them while sleeping to ensure their breathing is normal and they don’t seem to be in distress.

Which healthcare professionals treat concussions?

Primarily you should see your general practitioner after suffering a concussion. In the case of a suspected concussion in a child, you should take them to your paediatrician for an evaluation. After the initial screening, your doctor may refer you to a specialist depending on the severity of the injury. You may be referred to the following professionals:

  • Neurologists, neuropsychologists, and neurosurgeons: in extreme cases where a severe brain injury is suspected
  • Physiotherapists, sports physicians, and athletic trainers: to begin rehabilitation and assessment for when you are fit to return to sport. This can also be for neck injuries and to prevent long-term effects
  • Vestibular therapists and neuro-ophthalmologists: to help with recurring dizziness and vertigo

Final Thoughts

Most people fully recover from concussions and don’t need any further medical attention after the initial evaluation. However, due to the area of impact, it is always recommended to be assessed by a medical professional following a head injury that causes confusion, loss of consciousness, or headaches.

Treating a concussion with rest and any other directions from your healthcare provider will increase the chances of a full recovery and reduce the chances of experiencing further head injuries. If you have any long-term effects from a head injury including neck stiffness, TMJ pain, or back pain,  Contact Pegram Physiotherapy today to find out treatment options.

Hockey players img

How to Manage an Acute Sport Injury at Home and Further Treatment Options

An acute sport injury is devastating and frustrating when it happens and often the injury results in time off from playing sport. When you experience an injury, correct management after the injury will have you back to playing the sport you love as soon as possible.

Knowing how to look after an injury until you can seek further medical attention will help the healing process. Sport injuries occur in all types of sport as a result of muscle strains, overuse or knocks.

Here is all you need to know about the management of acute sport injuries.

What Is an Acute Sport Injury?

An acute sport injury happens during any type of sport. These injuries can be the result of an accident, improper training, over-use, or pushing your body past its limit. During sporting activities, especially contact sport, any part of your body can get injured.

However, sport injuries commonly affect the musculoskeletal system. This system involves your bones, muscles, tendons, and ligaments. Acute injuries may vary in intensity depending on the incident. These injuries can range from a mild injury such as a small bruise to a severe injury such as a fractured bone.

When experiencing an acute sport injury, you will feel sudden severe pain in the area of the injury.

However, often during sport, you won’t feel the pain immediately because of adrenaline, and other feel-good hormones that are released with exercise. In these cases, it is important to listen to the medical professionals who assess you during the game.

Common Sport Injuries

The common injuries that occur during sport include ankle sprains, knee pain (due to a ligament or muscle strain), shoulder injuries, and less commonly, fractured bones. Dislocations of joints can also occur during contact sport.

The common injuries happen from any sport including cricket, tennis, netball, water polo, golf, squash, and rugby. The likelihood of an injury occurring during sport depends on how you train and take care of your body when preparing for matches.

Contact sport such as rugby often leads to concussion injuries which require immediate medical attention. Concussions lead to dizziness, blurred vision, nausea, and vomiting after a knock to the head. In the case of a suspected concussion, you should go to a doctor immediately.

Difference Between a Strain and a Sprain

When injured while playing a sport, it is often a sprain or a strain that occurs to the musculoskeletal system.

A sprain happens when the connecting ligaments between bones are affected. This injury is likely to occur from an improper warm-up or a sudden awkward twist or movement. Symptoms of sprains include bruising, swelling, pain around the affected area, and limited flexibility.

A strain happens when the muscles or tendons are affected. This injury often occurs in the hamstrings (at the back of your thighs) or your lower back.

Symptoms of strains also include swelling, pain around the affected area, and limited flexibility. However, when an area is strained, muscle spasms usually occur which helps distinguish a strain from a sprain.

When to Seek Urgent Medical Attention

In most cases, you will be able to take care of an injury using home management methods and physiotherapy. However, in some cases, it is necessary to go to the emergency room after a severe injury.

If you notice any of these symptoms, seek urgent medical attention.

●  You can’t move the injured area at all

●  You can’t stand up or walk

●  You feel severe and debilitating pain around the injured area

●  Your limb is hanging or twisted in an incorrect position

●  There is excessive swelling and bruising that appears immediately (this may indicate a muscle or ligament tear)

●  Any concussion symptoms are evident (blurred vision, dizziness, nausea, or vomiting after a head injury)

Treatment Solutions for an Acute sport Injury

While many injuries may not seem severe enough to seek medical attention, they usually require a full recovery plan. To start, most injuries can be managed at home using short-term treatment solutions.

After the initial period of management, it is important to follow a structured recovery plan with the help of a physiotherapist. While many sporting individuals want to get back to playing their sport as soon as possible, this is not advised. Allowing the injury to heal completely, beyond when the pain has subsided and it “feels” better, is important.

Short-term Home Management for Acute Sport Injuries

At home, after the injury has occurred, use the POLICE method to care for the injury. This method was previously known as R.I.C.E, R.I.C.E.R, and then P.R.I.C.E.R. However, the latest research suggests that the POLICE method is the most effective way to manage acute injuries at home.

The POLICE Method

The POLICE method should be used at home after an injury and throughout the recovery process. Certain elements of this method should be directed by a medical professional to prevent further injury.

Follow the POLICE method by doing the below actions following an acute injury.

Protect: Protect the injured area by reducing the amount of load on the injury or by limiting movement. This can be achieved by using a crutch or cane to ease the pressure placed on a leg or ankle injury. You could also use a sling or brace for arm and wrist injuries.

Only add these measures with the advice of a physiotherapist or doctor. Incorrectly using these interventions can worsen the injury.

While protecting the injury can also be an adequate amount of rest, this step doesn’t mean complete immobilization. This management solution reduces the chance of further injury to the area while the body is in the healing process.

Optimal Loading: Optimal loading is the main difference from the R.I.C.E.R method, which is crucial to reduce the recovery time after an injury. Optimal loading refers to slowly increasing movement of the injured area to prevent muscle atrophy or tightness.

Optimal loading should only be done with the help of a medical professional. With the help of a physiotherapist, optimal loading may include gently moving your injured limb within a range that is tolerable without pain or you may be advised to activate the muscles against resistance. This movement will be increased as the area becomes more flexible.

In severe cases, where surgery is warranted, optimal loading will be determined by post-surgical guidelines and protocols as directed by your surgeon and physiotherapist.

Ice: Ice is necessary to manage inflammation that occurs after an injury. If there is slight swelling and bruising, ice will help reduce the pain and inflammation. Apply an ice pack for 15 minutes at a time for the first three days after an injury.

Compression: Compressing the area of injury will help reduce the swelling and encourage drainage of the area. Compression can be done by wrapping an injury in a bandage. This should only be done with directions from a medical professional or by a qualified first aider or paramedic.

Elevation: Elevation helps the healing process by draining excess fluid build-up. Limiting the fluid build-up creates an environment conducive to healing, and reduced swelling will result in

reduced discomfort. Ankle and knee injuries can be elevated by placing your leg on pillows while lying down. Elevating wrist and elbow injuries may require a sling.

Pain Relief With OTC Medications

Following an acute injury, you can relieve pain using paracetamol-based analgesics. Avoid cortisone anti-inflammatories and only use non-steroidal anti-inflammatory drugs (NSAIDs) from about 72 hours after an injury has occurred.

Early use of NSAIDs will hinder inflammation and blood flow which is necessary for the first phase of healing. In the first 72 hours, use ice & elevation to manage the inflammation while still allowing the body to naturally heal itself.

After 72 hours, NSAIDs such as ibuprofen and naproxen may be used for pain management.

How to Fully Recovery From an Acute Sport Injury

To fully recover from an acute sports injury, medical assistance is required. More often than not, a physiotherapist will be able to assist with the healing process. A biokineticist may be needed after physiotherapy, and in some cases, surgery is required.

Physiotherapy

Physiotherapists are seen as primary care providers for acute sport injuries. This means you can visit a physiotherapist to diagnose a sport injury, without a referral from your GP. To assist you with recovery from an acute sport injury, a physiotherapist will carry out the necessary medical interventions needed to promote healing.

During your sessions, your physiotherapist will promote active therapy, including certain exercises to continue with at home. However, you may receive a combination of passive therapy, which is when the physiotherapist works on the affected area, and active therapy in the first few sessions, depending on the severity of your injury.

Your physiotherapist can assist you every step of the way, from the acute injury phase right through to your full return to sport. Physiotherapists may work together with a biokineticist to help you reach full and optimal recovery.

Surgery

In severe cases, surgery is required to allow for full recovery from an injury. Usually, if surgery is necessary, you will have symptoms that require immediate medical assistance. Surgery is usually only required in cases where complicated fractures are sustained or in the case of a complete ligament or muscle tear.

You will still receive physiotherapy throughout the process from pre-operative preparation right through to your return to sport. The time it takes to return to sport will be delayed as healing times need to be respected and surgical protocols need to be followed.

How to Prevent Further Sport Injuries

If you have injured yourself in the past or simply want to prevent any sport injuries, follow these tips.

●  Warm-up adequately before training or exercising. This involves simple full-body movements or dynamic stretches and stretches.

●  Condition your body appropriately before placing yourself in a competitive situation.

●  Don’t overexert yourself during training or exercises. If you have been injured, give your body time to heal, rest, and recover properly.

●  Always listen to your body. If you feel pain or discomfort at any time during training or

playing a sport, take a break. Stretch your muscles and don’t continue if you keep feeling pain.

●  Give your body enough time to recover in between exercises and training sessions. This includes rest days during the week based on your level of activity. Rest days may also include active recovery.

●  Use the correct equipment when partaking in a sport. This may include the right shoes, clothing, and protective gear.

How Long Will It Take To Recover From an Acute Sport Injury?

In most cases, acute sport injuries will take between four to six weeks to fully heal. The time it takes to recover from an injury will depend on the type of injury you have. It is important to load your body to an extent based on the phase of healing you are currently in and only train to maximum capacity when you are fully recovered.

The 3 Healing Phases of an Acute Sport Injury

For uncomplicated acute injuries, the phases of healing will progress throughout four to six weeks. The three healing phases consist of the inflammatory phase, the proliferation/reparative phase, and the remodelling/maturation phase. These phases may overlap and the duration of each phase depends on your body’s healing progress.

The Inflammatory Phase

The inflammatory phase begins as soon as the injury takes place and usually lasts for four to six days. Bleeding usually occurs around the injury site, resulting in increased white blood cells necessary for healing to take place. A degree of blood clotting occurs at the site of injury to create a barrier preventing further bleeding and protects the area from further injury.

The inflammatory phase is essential in the healing process to give the body space to naturally heal. During this phase, you may experience bleeding, swelling, and bruising.

The Proliferation/Reparative Phase

The proliferation phase is the repairing phase where the body rebuilds the tissue around the injured area. This phase usually starts around four days after the injury occurs and can last up to 14 days or six weeks depending on the severity of the injury and the site of the injury.

Areas of the body that naturally have better blood flow will repair faster than the areas that don’t. During this phase, you should practice optimal loading on the area while making sure you don’t do any movements that cause excessive pain.

The Remodelling/Maturation Phase

The remodelling phase can begin two to four weeks after an injury and last for months or years depending on the severity and area of the injury. During this phase, you will need to help your body strengthen the new cells and tissue around the injured region.

Be sure to gradually increase the intensity of your training during this phase with the help of a medical professional. Correctly navigating through this phase will promote a full and healthy recovery.

Final Thoughts

An acute sport injury can be tough to manage, especially when you are not able to play the sport you love. However, making sure your body heals correctly with the help of a physiotherapist or medical professional will help you get back to training as soon as possible.

Properly managing a sport injury will also prevent future injuries that could be more severe and prevent you from training for even longer.