What is concussion?

Concussion is a type of traumatic brain injury that is caused by direct or indirect force to the head or any part of the body that transmits to the brain [1,2]. Although concussion is commonly associated with contact sport, it is important to acknowledge that concussion may also occur in non-contact sports. Concussion is a complex injury which presents differently among individuals and its full pathophysiology is not yet understood [1,2].

How do I know if I have a concussion?

Due to the complexity and variable presentations of concussion there is no single test or method for diagnosis and is often difficult to diagnose [1-3]. Any suspicion of concussion must be appropriately assessed and managed by a qualified medical professional. There does not have to be loss of consciousness for concussion to be present, a sign of concussion can be as minimal as someone reporting they just “do not feel right” [1]. Commonly reported symptoms with concussion include visual disturbance, feeling foggy, lethargic or slow, sensitivity to light or noise, feeling dizzy or nauseous or headaches [1]. It is important to remember that individual signs symptoms of concussion will vary greatly, and signs and symptoms may even be delayed (e.g. for house following the actual incident).

The Sport Concussion Assessment Tool 5th Edition (SCAT5) can be used by health professionals to assist in the diagnosis of and assessment of symptoms [4], and the Concussion Recognition Tool 5 (CRT5) can be used by anyone in the community to help recognise concussion [5]. Neither of these tools should be used in isolation in the recognition and management of concussion, there should always be appropriate follow up and seeking of medical advice [1].

SCAT 5 - https://bjsm.bmj.com/content/bjsports/51/11/851.full.pdf [4]

CRT 5 - https://bjsm.bmj.com/content/bjsports/51/11/872.full.pdf [5]

When and how do I return to sports and daily activities?

Anyone with suspected or confirmed concussion should not return to physical activity or sport, should not drive or consume alcohol or any medications (unless medically prescribed) until they have been assessed and cleared by a medical professional. It is also important that someone experiencing concussion symptoms is monitored by a responsible adult.

It is currently recommended that individuals should rest for the acute period (24-48 hours) post injury and gradually increase cognitive and physical activity [1,3]. Return to cognitive and light-moderate physical activity after the acute post-injury period may assist the recovery process but should be directed and monitored by a healthcare professional [1,3,6]. Most individuals will recover fully in 7-10 days but some may experience persistent symptoms relating to concussion that may last more than 2 weeks in adults, or 4 weeks in children and will require further medical assessment and intervention [1,7].

How can physiotherapy help?

As a health professional, physiotherapists can help assess and manage signs and symptoms of concussion as well as monitor and assist with return to activity or sport. Physiotherapists can also provide interventions around managing specific concussion-related symptoms and impairments. Physiotherapists can help treat symptoms related to the cervical spine (neck) or vestibular system using specific rehabilitation techniques including manual therapy, exercise and balance/vestibular training [1,7]. This is shown to be particularly beneficial for individuals experiencing persistent concussion-related symptoms [7].

Where can I get more information?

https://www.concussioninsport.gov.au

https://www.braininjuryaustralia.org.au/education-campaigns/concussion-in-sport/

If you have any questions regarding  your concussion, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble. 

References

  1. Elkington L, Manzanero S, Hughes D. Australian Institute of Sport Concussion in Sport Australia Position Statement. 2019 https://www.concussioninsport.gov.au/__data/assets/pdf_file/0005/683501/February_2019_-_Concussion_Position_Statement_AC.pdf.

  2. McCrory P, Feddermann-Demont N, Dvořák J, et al. What is the definition of sports-related concussion: a systematic review. Br J Sports Med. 2017;51(11):877-887.

  3. McLeod TCV, Lewis JH, Whelihan K, Bacon CEWJJoat. Rest and return to activity after sport-related concussion: a systematic review of the literature. Journal of athletic training. 2017;52(3):262-287.

  4. Sport concussion assessment tool - 5th edition. 2017;51(11):851-858.

  5. Concussion recognition tool 5©. 2017;51(11):872-872.

  6. Lal A, Kolakowsky-Hayner SA, Ghajar J, Balamane M. The Effect of Physical Exercise After a Concussion: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine 2018;46(3):743-752.

  7. Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med. 2014;48(17):1294-1298.

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