Concussion Frequently Asked Questions | Kansas City Head Injury Therapists
01 June 2020 — Physical Therapy
Suffering from a concussion is a serious matter that you should never take lightly. Therefore, it’s always important to do your research, because a concussion could happen to anyone.
Our physical therapists at F.I.T. Joint & Muscle Clinic work with a wide variety of patients to help them heal after a concussion. Based on our experience, here are a few frequently asked questions we receive from our patients.
What is a concussion?
We all have heard of concussions, but what is the true definition? A concussion is explained as “a complex and pathophysiological process affecting the brain, induced by biomechanical forces, which may involve different symptoms, impairment, clinical profiles or subtypes, and recovery trajectories that are influenced by a variety of risk factors.”
In other words, some degree of force causes your brain to be disturbed and, in turn, causes you to have symptoms such as headaches, nausea, double vision, concentration difficulty, and fatigue. Every concussion is different. So just because you have had one, it does not mean the next one will cause the same symptoms.
Do you lose consciousness when you sustain a concussion?
Not necessarily. Fewer than 10% of concussions involve a loss of consciousness (LOC), and a brief LOC of <1 minute has not been shown to be a predictor of outcome severity or duration. It is, however, an important symptom to share with your doctor during your initial evaluation.
Some of the most common symptoms immediately after sustaining a concussion are lethargy, confusion, double vision, dilated pupils, nausea, balance impairments, and headache. Although those symptoms may stay the same several hours after, it’s more common for symptoms to change as time passes. These symptoms include fatigue, headaches, nausea, neck pain, concentration difficulties, and vision deficits.
How do you get a concussion?
You don’t have to hit your head in order to sustain a concussion. It could simply occur from whiplash or enough force that the brain hits the skull. There is a phenomenon called “coup and countercoup,” which means the brain will hit the skull upon impact (coup) and then backlash and hit the opposite side of the skull (countercoup).
Concussions can occur from anything, but a few examples are as follows:
- Motor vehicle accident (MVA)
- Sport related concussion
- Intense head shaking
What is the physiology of a concussion?
If you want to understand what a concussion does on a cellular level, then get ready. At a cellular level, the brain is in a state of crisis immediately following a concussion due to an imbalance in energy demand and available resources. This means the brain is starved for energy.
Two things will happen: (1) potassium (K+) goes out of the cell and (2) calcium (Ca2+) goes into the cell. This shift disrupts the cerebral metabolism and impairs the connection within the brain, leading to temporary neuronal dysfunction.
This process is called neurometabolic cascade, which is most prominent the first few hours after the injury. The moments after a concussion are the most vulnerable times for the brain, and it becomes more susceptible to secondary injury. This could lead to Secondary Impact Syndrome.
Secondary Impact Syndrome is when you sustain a second concussion soon after the initial one. Since your brain is already in a vulnerable state, this can be a life-threatening injury. The brain has just been deprived of energy and is in a state of crisis, so adding another injury on top of that will ultimately send the brain into a deeper energy deprivation and could lead to permanent brain injury.
What is the treatment for a concussion?
The majority of concussions will typically resolve 2 to 3 weeks after the injury. However, you can’t assume that every concussion will respond this way. It is a good idea to get an evaluation from a physician who treats concussions and a physical therapist who specializes in concussion rehab. Doctors and physicians will address the deficits and give specific individualized treatments so you can return to your sport or work as soon as possible.
Below is a treatment timeline you could expect for concussion rehab:
Initial onset Day 1-3: Rest and recover, consensus guidelines endorse 24-48 hours of symptom-limited cognitive and physical rest. Patients should see a concussion specialist.
Acute injury: Day 3-14: After initial onset, rehabilitation can start immediately. Gradual increase in activity, staying below symptom-exacerbation thresholds
Why is treatment important?
Treatment is extremely important after a concussion to regain normal function during daily activities. Post concussion, some common symptoms are dizziness, blurred vision with head turns, problems reading or watching TV, difficulty with eye tracking, and memory issues. The goals of treatment include diminishing dizziness, enhancing gaze stabilization, and improving postural stabilization and dynamic balance.
Learn more concussion frequently asked questions from F.I.T. Muscle & Joint Clinic
Whether you think you may have a concussion or you’re taking proactive measures, we’re always willing to help you learn more. We specialize in concussion management, including collaborating with doctors to help you reach your goals.