Concussion Assessment

August 1, 2022

Just saying the word concussion at a sporting event or during a preseason practice can be intimidating and can even scare off potential athletes or parents who are looking to get their athlete more involved. A concussion, even though it needs to be taken seriously, is common in sports and the more that we research what a concussion is, how long it takes to heal and what treatments are, the less scary it becomes. Before we get into the nitty gritty of a concussion let's first go over the basics. A concussion,also known as a traumatic brain injury, is caused by a coup counter coup movement of the brain inside the skull. This movement back and forth causes a bruise to form on the outer layer of the brain. Due to this bruise, abnormal nutrient and neurotransmission within the brain occurs.

Now that we are up to date on what a concussion is, let's look at some of the common symptoms of a concussion. In a study looking at1,438 high school and college athletes, 75% reported a headache, 57% reported difficulty concentrating, and 52% reported fatigue. These symptoms were all reported within the first seven days after the diagnosed concussion. Ok, so our athlete has a concussion, what do we do now?

The research has changed on what to do post-concussion. The theory used to be that the brain needs rest and an athlete was placed in a dark quiet room for a few days, up to a week. New research has shown that being active shows better results and decreases the time out from a sport, activity,or work. There is still much research to be done on how children respond to concussions, however, early research shows that because of the plasticity of a child's brain they are more likely to respond quicker to treatment and return faster.

In the unfortunate event that your athlete sustains a concussion a physical therapist can treat the symptoms of a concussion and assist your athlete in returning to their sport when appropriate. At Kinetic we have multiple physical therapists who are able to treat concussions, using up-to-date research on concussion clinical profiles and how an athlete, based on prior personality traits, can predict which profile an athlete could fit into. Using a good clinical evaluation and figuring out the proper clinical profiles allows a physical therapist to create an individualized treatment plan to address the deficits noted in the evaluation. Listed below are the clinical profiles:

- Vestibular

- Cognitive

- Mood/Anxiety

- Migraine

- Ocular

Each profile has key features that distinguish it from another profile. Most concussions, however, fall within two to three different profiles which can make it difficult when creating a plan but not impossible.

So as people are reading this article the big question is how do I know when my athlete is ready to return to the field? The answer to this is not a simple straightforward answer. There are many different factors that need to be taken into account before an athlete can be cleared. The first thing is how their symptoms present when they are at rest and with activity.Heart rate can exacerbate symptoms even when no symptoms were there before.Blood perfusion to the brain is always delayed in patients who are affected by heart rate. There are other tests and measures like the ImPACT test and other orthopedic tests which can be used to dictate whether an athlete is ready to return to the field or not.

Most information in this blog post focuses on mild to moderate concussion cases, which are more common in sports. In severe cases emergency services may be required and loss of consciousness can occur. An athlete who goes in and out of consciousness or starts to decline (slurred speech, blurry vision, vomiting) should seek medical attention immediately.

I finish up with these parting words, a concussion even though scary in the moment, can be like any other injury to the human body.When put through the correct examination and placed in the appropriate treatment plan an athlete or adult can return to normal levels of function and continue the sport or activity that they choose. The more information you know,the more you are prepared to take on what is next.  


Reference: Concussion Assessment: An Overview, Anne Mucha: Medbridge"