Concussion Management

What is a Concussion?

A concussion is a type of Traumatic Brain Injury—or TBI—caused by a by a hit to the body, a bump, blow, or jolt to the head, that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

Put simply, a concussion changes the way our brain functions – it causes it to work less optimally.

Current evidence suggests that the rapid stretch of nerve fibers within the brain during a concussive trauma results in the release of various neurotransmitters (signalling molecules within the brain), which triggers a complex cascade of neurometabolic activity. This causes a brain “energy crisis” where the brain is unable to produce the energy required to sustain its normal processes.

These changes take place within minutes of the injury and can last for hours, days, weeks, or months before getting back to normal. It is thought to be this metabolic imbalance, along with other impaired physiological processes that contribute to the physical, cognitive, behavioural and emotional signs and symptoms typically seen in a concussed individual.

If you have received a blow to the head and suspect you may have a concussion, here are some of the symptoms to watch for…

Common Symptoms Of A Concussion:

• Headache
• Dizziness
• Neck pain
• Nausea or Vomiting
• Loss of balance
• Poor coordination
• Trouble focusing on objects or words
• Poor concentration
• Feeling “foggy”
• Confusion
• Amnesia, or poor memory
• “Flashing lights”
• Blurred or double vision
• Seeing “stars”
• Irritability or emotional changes
• Ringing in ears
• Slow to follow direction
• Decreased playing ability
• Easily distracted
• Vacant stare
• Drowsiness/fatigue
• Difficulty falling asleep
• Feeling “off” or not like oneself
• Difficulty reading
• Sensitive to noise/light/sound
• Sensitive to movement
• Stationary objects appear to move

What is the Recovery Time After A Concussion?

Many symptoms related to concussions resolve in a relatively short timeframe (days to weeks). However, some people’s symptoms may persist for months.

Post-Concussion Syndrome (PCS) is a diagnostic term used when symptoms persist for several weeks and sometimes months after the injury. If untreated, this syndrome can lead to persistent difficulties at work or school, considerable discomfort and/or depression. These symptoms can also worsen as time goes on.

If your symptoms persist beyond 3-4 weeks, it is important that you undergo proper assessment by a practitioner with training in concussion management to receive the right education and management strategies for your condition.

With PCS, there is often dysfunction of the visual system. Not necessarily in sharpness or acuity of sight, but rather binocular vision dysfunctions (the coordination of both eyes for visual input). These dysfunctions are identified with a Vestibular Ocular Motor Screening (VOMS)for a concussion. This screening is performed by practitioners trained in concussion management and is one of the first evaluations performed by our concussion management team at One to One Wellness.

When Should I Return to School Or The Workplace?

Return to school or work will vary from individual to individual depending on the severity and nature of symptoms. It is important to seek the advice of a trained Health Professional before making the decision.

In general, return to school or work is encouraged as soon as some exposure to the classroom or workplace is likely to be tolerated (i.e. you do not need to be completely symptom-free). This may be with some modifications to improve toleration.

Excessive/prolonged rest at home can have some negative consequences such as the development or poor sleep habits, anxiety/depression, social withdrawal, hyper-awareness of symptoms, etc., that can impact your recovery.

Modifications may be required to limit symptom aggravation such as shorter days/shifts, reduced workload, frequent breaks, altered work tasks or temporary projects. Once symptoms improve, these accommodations can be lifted.

The One to One Concussion Management Program

One to One Wellness Centre’s concussion management program offers comprehensive concussion diagnosis, management and rehabilitation therapy. Through a multi-disciplinary approach that incorporates physiotherapy, osteopathic manual therapy, massage therapy and athletic training, the staff at One to One aim to support the individual patient’s needs and help them to identify and overcome the obstacles to recovery.

The Patient is the most vital part of this team. Though symptoms can be grouped as specific to post-concussion syndrome (PCS), every patient’s mechanism of injury is different. At One to One Wellness Centre that fact is acknowledge and utilized to help develop a strategy specific to each patient’s symptoms and lifestyle.

Concussion Management starts the moment you walk in the door. Often the reception areas of wellness clinics are busy, noisy and bright places. All of which are necessary, however, often symptom provoking for a concussed patient. At One to One we provide a supportive therapeutic environment to the concussed patient at reception by offering noise cancellation headphones, earplugs, and sunglasses (eyeshades).

Your visit will most likely start with VOMS testing. VOMS testing is a quick and non-invasive evaluation performed by the practitioner to check the vestibular ocular motor system, the parts of the brain that integrate vision, balance, and movement. The tests utilize eye, head and body movements to try to provoke concussion symptoms related to the eye muscles, visual and vestibular systems. The screening takes 10 minutes or less and provides immediate results which inform the course of treatment, referral to other healthcare professionals and return to play, school or work.

The One to One Program: Not Just For Athletes.

While some facility’s testing and programs are structured more toward athletes who have suffered a concussion. One to One Wellness Centre welcomes concussed and post-concussive syndrome patients from all walks of life.