Headache

Concussion
Therapy

What is concussion? 

Also known as Traumatic Brain Injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

What are considered Normal symptoms?

  • Headaches

  • Dizziness

  • Blurred vision

  • Vertigo

  • Mood changes

  • Anxiety

  • Balance issues

  • Nausea

  • Motion sensitivity

  • Change in sleep pattern

  • Motor or sensory changes

  • Change in hearing

  • Appetite alteration

  • Fatigue

  • Memory deficits

  • Poor concentration

 

Concussion Facts

  • 20-15% don't resolve in 1-2 weeks

  • Up to 7.5% post concussion syndrome emanates from the neck

  • 15-24yr are the highest risk for concussion

  • Motor vehicle accidents have the highest concussion rate in adults

  • 90% of diagnosed concussions do not involve loss of consciousness

  • 33% of high school athletes who have a sports concussion report two or more in the same year

  • Symptoms can show up to 2 weeks after the injury

  • No single test to diagnose a concussion

  • Having one concussion makes you more susceptible for another

  • According to the World Health Organization, traumatic brain injury will surpass many diseases as the major cause of death and disability by the year 2020.

How is it Treated?

Following a concussion, there is no specific treatment other than rest - both physical and mental. However, during the early stages following injury, relative physical and cognitive rest is recommended for 24 to 48 hours; however, these decisions are made on a case-by-case basis.

A short period of rest after a concussion can involve a variety of treatments and rehabilitation from a team of health professionals depending on symptoms and how individuals respond to therapy. Treatment for a concussion is not one treatment fits all, treatment and care should be on an individualized basis which may include a gradual increase in mental and physical activity. Treatment for concussions have been shown to respond to a team based approach which can include physiotherapy, chiropractic, naturopathy, acupuncture, massage therapy, exercise therapy, diet and nutritional interventions along with vestibular and visual rehabilitation all of which have been proven to be effective treatments and rehabilitation options.

Vestibular

Balance issues at the time of injury is the top risk factor to prolonged concussion. The sensory system provides the leading contribution to the sense of balance and spatial orientation for the purpose of coordinating movement with balance. The vestibular system sends signals primarily to the neural structures that control eye movements, and to the muscles that keep people upright. The brain uses information from the vestibular system in the head and from proprioception throughout the body to understand the body's dynamics and kinematics (including its position and acceleration) from moment to moment. This requires assessment by a properly trained practitioner.

Somatosensory

This part of the nervous system relays information to the brain regarding temperature, body position & movement, tactile pressure, taste, smell, environmental chemicals, pain and damage to tissues. Concussions and whiplash can demonstrate damage to the high concentration of proprioceptors (nerves) in the neck which can create a disturbance in the integration of information that is being relayed to the brain and may lead to balance issues as an example. 

Hormones

Hormone therapy (because the hypothalamus and pituitary gland can be affected after an impact to the brain, therefore affecting the function of these two very important hormone regulators). This is achieved by the hypothalamus inside the brain. The hypothalamus controls body temperature, hunger, important aspects of parenting and attachement behaviours, thirst, fatigue, sleep, and internal clock. The hypothalamus functions as a type of thermostat for the body. A change in the hormone levels can effect mood and physical well-being, a reduction in growth hormone can result in strength, aerobic ability, problems with attention, memory, depression, anxiety and fatigue. 

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Eye Exam

Vision

67% of neural connections within the brain are involved with some aspect of vision, whether it is visual input, visual perception, or visual integration.  With so many of the connections within the brain involved with the process of vision, it is no wonder that vision problems are so common following an acquired brain injury.

Below are a few of the area of vision that may be affected following a concussion or with a mild brain injury. At Lab Health and as part of your concussion recovery your therapist may refer you to a vision therapy rehab optometrist who can work with you  

  • Accommodative Insufficiency – This condition is a reduction in eye focusing ability that results in blurry vision at near, even in young athletes.  Near vision may be constantly blurry or may pulse in and out of clarity during near activities like reading.

  • Blurry Vision - Blurry vision following a concussion can occur at distance, near, or both.

  • Convergence Insufficiency – This inability to use the eyes comfortably at near can result in a number of symptoms including: headaches, eyestrain, fatigue, or even double vision during near activities.

  • Double Vision – There are several causes of double vision, which is why anyone who sees double (even intermittently) should be evaluated by an optometrist with advanced training in neuro-optometry, binocular vision, and vision therapy.

  • Light Sensitivity – Photophobia, or light sensitivity, can result from various types of acquired brain injuries (including concussions).

  • Ocular-Motor Dysfunction – Deficiencies in eye movement abilities are quite common following concussions and other forms of mild traumatic brain injuries.  These eye movement deficits can pose challenges with many activities of daily life, including reading and driving.

  • Reduced Cognitive Abilities With Visual Tasks - Visual perceptual deficits can be caused by concussions and have dramatic effects on academic and even athletic success.

  • Reduced Visual Processing Speed or Reaction Time – Prolonged visual processing speed can slow down an athlete both on and off the field.  The speed with which an athlete processes visual information affects many aspects of athletic competition, including: reading the field of play, judging the speed of a moving ball or puck, and judging the speed of other players on the field.

Psychological

Mental health and concussion rehab is concerned with the applied science of brain-behaviour relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental, post traumatic stress and psychiatric conditions, as well as other cognitive and learning disorders. Clinical assessment is primarily by way of neuropsychological testing, but also includes taking the patient's history, qualitative observation and may also draw on findings from brain imaging and other diagnostic investigations. A comprehensive neuropsychological assessment may take several hours and may need to be conducted over more than a single visit.

Physiological

The impact of a concussion affects the mechanical, physical, and biochemical functions of humans, their organs and the cells of which they are composed. These processes can be interrupted or over stimulated with brain injuries changing how the organs function and or control processes in the body.

After a head injury the brain experiences decreased blood flow and a disruption in autonomic regulation. This leads to a higher likelihood of transitioning to a fight or flight state, during physical or mental situations that are usually easily managed. this may present itself as a short temper, irritability, anxiety, fatigue, frustration and exhaustion.