What is a concussion?
A concussion is defined as a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process. A concussion is classified as a subset of a mild traumatic brain injury. It is estimated that 3.8 million concussions occur in the USA per year during competitive sports and recreational activities, but as many as 50% go unreported. (American Medical Society for Sports Medicine position statement: concussion in sport; 2013)
If an athlete is suspected of having a concussion, they should be removed from the game or practice immediately and not allowed to return to play on that same day. The Zachary Lystedt Law, which was passed by the Washington State Legislature in 2009, states that, “ any youth athlete suspected of getting a head injury will be removed from the practice or game. The athlete may not return to play until he or she has been evaluated by a licensed health care provider and gets clearance to play.”
If an athlete continues to play with a concussion, or returns to play too soon, then they risk very serious, even fatal consequences. If untreated, concussions can result in short term and long term cognitive, physical, emotional and psychological deficits, as well as disturbed sleep patterns. Up to 33% of high scool athletes who have a sports-related concussion report two or more in the same year. [headcase-company.com]
Although frequently associated with sport, concussions occur with falls, neck injuries, car accidents and other incidents when the head and neck are shaken. Up to 90% of concussions do not involve a loss of consciousness.
CorePhysio Concussion Management Program
Our program uses the most current evidence-based concussion screening and evaluation tools, including IMPACT, the SCAT3, King Devick, and post-concussion syndrome checklist.
CorePhysio physical therapists perform pre-season screens and work with the client’s multi-disciplinary team (including physician, coach, ATC, psychologist and opthamologist) to design a customized post-concussion rehabilitation programs which ensures that clients receive the right treatment, at the right time, in order to safely return to sport.
Phase I (Pre-season) Baseline Testing
Pre-season baseline testing obtains comparative data that can be used to understand any cognitive and balance changes post-injury. Screening includes ImPACT testing, balance testing as well as musculoskeletal screening to identify impairments before the season starts. CorePhysio’s one hour pre-season baseline concussion screening is available for $40. In order to opimize valid test findings, pre-baselines screens require the client to be rested and healthy, without having participated in heavy exercise on the day of the test.
Phase II Post-Concussion Rehabilitation
CorePhysio physical therapists thoroughly evaluate clients for cognitive, balance, neck range of motion, vestibular and vision impairments. They also perform a full neurological screen, testing cranial nerves, dermatomes, myotomes, and reflexes. If the client has performed pre-season screening, we are able to compare post-injury testing to their baseline data to assess if there are any changes in balance, musculoskeletal and oculomotor function.
Based on that information, your CorePhysio PT develops a comprehensive treatment program and recommends if it is appropriate for athletes to begin the return to play process, or if specialty treatment is indicated. Post-concussion rehabilitation is a multidisciplinary approach and your CorePhysio PT works closely with the client’s multidisciplinary team to ensure the client is progressed at the right pace and at the right time.
Every client who has sustained any head or neck trauma should be evaluated by a physician immediately. Once cleared, the client should be referred to CorePhysio to work with one of our trained physical therapists who specialize in post-concussion rehabilitation, which is the gold standard in care of these complex injuries. If your child or adolescent is planning on playing a sport, call CorePhysio at 752-2673 to schedule baseline concussion screening or post-concussion rehabilitation.
Signs and Symptoms of Concussion
- Headache or “pressure” in head
- Nausea or vomiting
- Balance problems or dizziness
- Double or blurry vision
- Sensitivity to light
- Sensitivity to noise
- Feeling sluggish, hazy, foggy, or groggy
- Concentration or memory problems
- Just not “feeling right” or “feeling down”
- Appears dazed or stunned
- Is confused about assignment or position
- Forgets an instruction
- Is unsure of game, score, or opponent
- Moves clumsily
- Answers questions slowly
- Loses consciousness (even briefly)
- Shows mood, behavior, or personality changes
*A client may present with any or all of these signs and symptoms, but no abnormalities on standard structural neuro-imaging may be present.
Risk factors for concussions
- High impact or collision sports (such as football, soccer, hockey, basketball)
- Previous concussions
- ADHD/Learning disabilities
- Female Gender
- Younger Age
- Psychological diagnosis (such as Bipolar Disorder)