Concussions

WHAT IS A CONCUSSION?

A concussion is a neurologic injury that causes a temporary disturbance in brain cells, as a result of extreme acceleration or deceleration of the brain within the skull. The common misconception is that you must be hit in the head to cause a concussion injury – this is not true! Because a concussion is the result acceleration or deceleration of the brain, a concussion can happen with a significant blow to anywhere on the body, provided sufficient acceleration/deceleration is transmitted to the brain tissue.

The brain cell disturbance causes the brain cells to discharge uncontrollably which may cause any one, or more of the following signs or symptoms:

  • Loss of consciousness (more than 90% of concussions do not result in loss of consciousness)

  • Headache or pressure in the head

  • Neck pain or whiplash

  • Dizziness or vertigo

  • Nausea and/or vomiting

  • Blurred or distorted vision

  • Balance problems

  • Feeling tired, fatigue, slowed down, drowsy or having no energy

  • Feeling “foggy” or not thinking clearly

  • Not feeling right or feeling off

  • More emotional

  • Feeling sad, upset or angry

  • Nervousness or anxiety

  • Sensitivity to light or noise

  • Difficulty concentrating

  • Difficulty reading or working at a computer

  • Difficulty remembering or concentrating

  • Confusion

  • Difficulty falling asleep

  • Sleeping more or sleeping less

  • Irritability

 

Visual signs of a concussion may include:

  • Loss of consciousness

  • Lying motionless on the field or ice

  • Disorientation or inability to respond to questions

  • Blank or vacant stare

  • Balance, slowed movement, stumbling or incoordination

  • Clutching head

  • Slow to get up after a hit to the head or body

If you experience any one of these symptoms following a significant impact to the head or body, then you should have a high suspicion of concussion.

 

 

 

 

 

 

 

 

 

WHAT HAPPENS AFTER A CONCUSSION?

The massive discharging of brain cells will likely calm down in a very short period of time and the patient may even feel better after a few minutes to an hour after injury. Don’t be fooled by this improvement, as there is a second phase to a concussion known as “Spreading Depression”. The initial brain cell discharge creates an imbalance within the cells of the brain, that ultimately leads to an energy deficit as the cells frantically use up all of their energy stores to reset the normal balance. These energy stores will continue to decline over the next 3-7 days. 

 

Anyone who has been around someone who has suffered a recent concussion, or has had a concussion themselves, will attest to the fact that the injured person is extremely fatigued, irritable and emotional; similar to a tired and cranky child. This is because their energy levels are depleting. This is also why the first step in dealing with any concussion is always rest, which helps to conserve energy stores and potentially help with recovery.

The second phase of the concussion is actually the most dangerous. When someone is in this low energy state, another blow, even one of much lower magnitude, can cause another concussion. Because the energy levels of the brain are already severely depleted, another concussion can cause extreme energy depletion, which may cause permanent death of the involved brain cells, potentially causing permanent disability, or in some instances, death of the individual.

 

On the other hand, the research has shown that if the brain has fully recovered from an energy standpoint and the person receives another concussion, there is no evidence of an additive effect. This means that it may not be the NUMBER of concussions an individual suffers but rather the way each injury is managed that is the major determining factor for long-term problems due to concussions.

 

The major problem with concussions is that symptoms, meaning how someone feels, does not coincide with the energy levels in the brain. Most people feel better long before their brain has recovered to the point that they are actually safe to return to their sport. Unfortunately, there is no scan, MRI, or X-ray that can detect a concussion. This is where the benefits of baseline testing come in.

WHAT TO DO AFTER A CONCUSSION?

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.

Following a short period of rest, treatment and rehabilitation may include a gradual increase in mental and physical activity. If symptoms persist beyond 10 days, exercise therapy, manual therapy of the neck, diet and nutritional interventions, and vestibular and visual rehabilitation are proven to be effective treatment and rehabilitation options.

Licensed healthcare practitioners should provide step-by-step processes and graduated stages of recovery to help concussion patients and athletes return to learn, work and/or play.

Our approach to concussion management may include:

  • Moderate, symptom-limited activity

  • Light cognitive activity

  • Half-day of school/work (with restrictions)

  • Full day of school/work (with restrictions)

  • Buffalo treadmill test (to assess for blood flow abnormalities and readiness to return to exercise)

  • Light, non-contact sport specific activity (athletes only)

  • Higher intensity, non-contact sport specific activity

  • High intensity physical exertion test (a physical exertion assessment which tests various systems and mimics game-like exertion and function) followed by immediate baseline retesting

  • Return to full contact and game

This process may vary by individual. We recommend that you schedule an appointment with a licensed healthcare practitioner if you are at risk for concussion or have suffered a concussion.

WHEN CAN I GO BACK TO SCHOOL OR WORK?

 

Studies have shown that just because you feel better, it does not mean that all of your systems have returned to normal.  One of the major problems with the management of concussions, is that people present to the emergency department following an injury and they are told to simply “take it easy” for a little while with no additional guidance, explanation, or follow-up options. Then, once the athlete is feeling better (usually within a few days), with no additional assessment of neurological systems, functional or physical capacity, they are back out playing as if nothing ever happened. This puts young athletes at tremendous risk of a serious secondary injury.

Studies have shown that even after someone is free from symptoms there are still significant deficits in brain energy levels, reaction time, cognitive function, neuropsychological testing and physical capacity. This indicates that even though you may be feeling better, your brain may not be fully recovered. This places you at extreme risk of suffering a serious brain injury should you get another concussion during this period.

Feeling better does not equal BEING better!

There are programs in place for athletes to get the proper treatment they need before returning to their everyday life. For further information on Return-to-Work, Return-to-Play and Return-to-Learn visit Complete Concussion Management or one of their clinics closest to you. 

LOCATION

Langley Sportsplex

Address:

20165 91a Ave, Langley, BC V1M 3A2

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