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A concussion is a mild traumatic brain injury (TBI). The word comes from the Latin concutere, which means "to shake violently." A concussion is most often caused by a sudden direct blow or bump to the head. It can occur after an impact to head or after a whiplash-type injury that causes head and brain to shake quickly back and forth. A concussion results in an altered mental state that may include becoming unconscious. Anyone can become injured during a fall, car accident, or any other daily activity. Active participation in impact sports such as football or boxing, have an increased risk of getting a concussion.
Concussions are usually not life-threatening, but they can cause serious symptoms that require medical treatment. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. A concussion is different from a contusion. A concussion specifically affects your brain, but contusions are bruises. Contusions can occur on your head, but they aren’t typically serious and tend to resolve within several days.
Concussions can be tricky to diagnose. Signs may not appear for days or weeks after the injury. Some symptoms last for just seconds; others may linger. Concussions are fairly common. But it's important to recognize the signs of a concussion so you can take the proper steps to treat the injury. There are some common physical, mental, and emotional symptoms a person may display following a concussion. Signs of traumatic brain injury include:
Confusion or feeling dazed
Nausea or vomiting
Balance problems or dizziness
Sensitivity to light
Sensitivity to noise
Ringing in ears
Irritability or other behavior or personality changes
Loss of memory
Fatigue or sleepiness
Loss of consciousness
Forgetfulness such as repeating yourself
Slowed response to questions
Problems with sleep
Problems with taste or smell
Brain tissue is soft and squishy. It’s surrounded by cerebrospinal fluid, which acts as a cushion between it and the hard protective exterior, the skull. A concussion occurs when our brain bounces or twists inside the skull or experiences rapid, whiplash-type back and forth movement that causes it to collide with the inside of your skull. This brain movement stretches and damages brain cells and leads to chemical changes in the brain.
These injuries cause brain not to function normally for a brief period of time and result in the signs and symptoms of concussion. Motor vehicle accidents falls, and sports injuries are common causes of concussions. Any sport that involves contact can result in a concussion. Among children, most concussions happen on the playground, while bike riding, or when playing sports such as football, basketball, ice hockey, wrestling, or soccer.
Treatment for a concussion depends on the severity of your symptoms. A patient suffering from concussion might need surgery or other medical procedures if he or she experiences, bleeding in the brain, swelling of the brain or a serious injury to the brain. However, most concussions don’t require surgery or any major medical treatment.
If the concussion is causing headaches, then the doctor may recommend over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol). Your doctor will also probably ask you to get plenty of rest, avoid sports and other strenuous activities, and avoid driving a vehicle or riding a bike for 24 hours or even a few months, depending on the severity of your injury.
Physical therapists can evaluate and treat many problems related to concussion. Because no two concussions are the same, a physical therapist will examine your neurological, orthopedic, and cardiovascular systems in order to best prescribe a routine to address your particular symptoms and your needs in all of your daily environments.
Treatment may include:
Rest and Recovery:
Your physical therapist will help you and your family understand why you should limit any kind of activity (daily tasks, work, school, sports, recreation, the use of electronics) after a concussion, until it is safe to return to these activities. A period of rest helps the brain heal and helps symptoms clear up as quickly as possible. Your physical therapist will prescribe the rest and recovery program most appropriate for your condition.
Restoring strength and endurance:
The physical and mental rest required after a concussion can result in muscle weakness, and a decrease in physical endurance. Your physical therapist can help you regain your strength and endurance when the right time comes, without making your concussion symptoms worse. It is common for elite-level athletes and fit “weekend warriors” to experience exercise intolerance with concussion and brain injury. Your physical therapist will work with you to identify and treat your particular concussion symptoms.
Your physical therapist will design a therapeutic exercise program just for you, and closely monitor your symptoms as you participate in the program.
Stopping dizziness and improving balance:
If you have dizziness or difficulty with your balance following a concussion, a type of physical therapy called vestibular physical therapy may help. The vestibular system, which includes the inner ear and its connections with the brain, helps you keep your balance and prevent dizziness. A qualified vestibular physical therapist may be able to help reduce or stop your dizziness or balance problems after a concussion by applying special treatments or teaching you specific exercises, some of which you may be able to do at home.
Your physical therapist will assess the different possible causes of your headaches, and use specific treatments and exercises to reduce and eliminate them. Treatment may include stretches, strength and motion exercises, eye exercises, hands-on techniques like specialized massage, and the use of technologies such as electrical stimulation.
Returning to normal activity or sport:
As symptoms ease and you are able to regain your normal strength and endurance without symptoms returning, your physical therapist will help you gradually add normal activities back into your daily routine. Your physical therapist will help you avoid overloading the brain and nervous system as you increase your activity level. Overloading the brain during activity after a concussion interferes with the healing of the brain tissue, and can make your symptoms return. Your physical therapist will help you return to your normal life and sport activities in the quickest and safest way possible, while allowing your brain to properly heal.
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