A concussion is a mild traumatic brain injury caused by a biomechanical force. It is sometimes called an invisible injury since we often can’t see the symptoms and they can also be very subtle. Only one symptom needs to be present to be considered a concussion and you do not have to lose consciousness. Although awareness and education has increased, concussions are still under reported and diagnosed.
A concussion is a functional disturbance of the brain rather than a structural one, so no abnormalities are seen on standard imaging like CT scans and x-rays. Damage to the brain can occur when it hits the skull – from a force to the head or to any other body part that causes the brain to move and come into contact the skull. This is why a helmet does not prevent all concussions; it does not stop the brain from moving within the skull.
Concussions should not be treated like other physical injuries – you cannot play through a concussion. Not only should physical activities be limited, but so should activities that require concentration and attention (school work, video games, text messaging, etc) since they may exacerbate symptoms and possibly delay recovery.
If you get a concussion and return to play before you’ve fully recovered, and then get another blow to the head, it can be very dangerous. The second hit can be much less intense, but symptoms can be more severe, recovery takes longer and full recovery is less likely. It’s much smarter to take time off and miss a game or two, than to return too early, get a second concussion and then miss a whole season.
Research shows that the effects of concussions which are not managed properly are cumulative and can still be measured months or years following the injury. The soonest that you should return to play is about a week from the time of the concussion, but it could be a month or a year, depending on the individual. Luckily, 80-90% of concussions fully recover.
The return to play decision can be a difficult one to make. A rule of thumb is that one is symptom free and back to their “baseline” or normal level. Baseline tests are recommended prior to the start of a season to establish the player’s normal physical and mental state.
Sue Underhill is a Registered Physiotherapist at Maximum Physiotherapy. She does concussion baseline testing, retesting and management. Sue is also available to do a group/team presentation about concussion management.
If you would like more information or to book an appointment call 705-444-3600 or go to www.maximumphysiotherapy.com