A concussion is often a result of a direct blow to the head, neck or face. It can also result from a blow to another part of the body where the mechanical force is transmitted to the head. Not all individuals actually experience loss of consciousness with the incident. The most common causes of concussions are sport injuries, motor vehicle accidents (MVA’s) falls and assaults. Falls are more common in older adults. The sports resulting in the largest number of concussions are hockey, cycling, football and rugby.
Common symptoms after a concussion may include one or more of the following:
headache, neck pain, memory loss, a sense of pressure in the head, vertigo and dizziness, balance problems, difficulty thinking, concentrating and remembering new information, blurred vision and sensitivity to light, fatigue and nausea. Emotional changes, sleep disturbances and irritability are also common.
A concussion does not show up on a MRI or CT scan and most symptoms resolve within 7-10 days in the sport population and within 3 months in the non sport population. However 33% of individuals may have continued symptoms after 3 months. This is know as post concussion syndrome and some risk factors for this are having had a previous concussion, a history of migraine headaches, and having ADD/ADHD.
Anyone sustaining a concussion should seek a medical assessment. Immediately after a concussion there are metabolic changes with an increase in glycolysis, that is accompanied by a decrease in circulation to the brain. There are also changes in the regulation of the autonomic nervous system with an increase in sympathetic nervous system activity. A return to normal function occurs within 7-10 days. During this period physical and mental rest is indicated. This includes not watching TV or using a computer, avoiding bright lights and activities requiring concentration.
Gradual return to activity is then advised; basically this is avoiding activities that aggravate symptoms.
Osteopathy is a gentle form of manual therapy that can be helpful to aid recovery from concussion by treating restrictions in the cranial bones, face, neck and the dura mater. The dura mater is the protective tissue around the brain (like a bathing cap). Removing restrictions in these structures can help decrease tensions on cranial nerves and improve circulation to the brain. Most people see a change within 2-4 treatments and if no change is seen then other treatment options are discussed. Please look at our next blog article to learn more about cranial osteopathy
A physiotherapist can help guide you in safe return to sports and activity levels. If there are problems with vertigo and dizziness then vestibular rehabilitation may be helpful. Basically this helps the crystals in the inner ear realign. A physiotherapist can also help with retraining balance, strengthening exercises for the neck (as often the deep stability muscles are inhibited by tension in the base of the skull) and visual exercises to help with tracking and convergence.
The brain is adaptable and with time most individuals can return to a full pre-injury activity level.
For further information re return to activity and sports post concussion visit the following link.