Concussion Management in your Area?


How are concussions being dealt with where you are?

Last year, my best friend’s son was catching in a little league game when he was hit in the head with a pitch. The helmet did its job and withstood the brunt of the force of the ball. Nevertheless, he was left with a mild concussion. His parents were given a rigid, structured program to help him rehab from the concussion. It included almost a week of complete physical and cognitive rest, followed by a gradual return to prior level of activity. If a headache recurred, he was to take a step back to the previous one. Within a few weeks, he was back to his prior level, with no residual complications (other than a mother who was reluctant to have him catch again).

Conversely, an acquaintance suffered a concussion this past year after being struck in the head (with something that had much less velocity than a baseball). She was out of work for a few days, and then returned. She was on the computer much of the time while out of work. Headaches plagued her, requiring multiple trips to the doctor and specialists over the course of months.

Thanks to researchers at my alma mater, Boston University, concussions and post-concussive syndrome are much more widely talked about these days. Post-concussion symptoms can last for three to six months after injury, and in about 10% of concussions, the injury is considered to be a traumatic brain injury. With professional football players retiring after a short career, the seriousness of concussions and post-concussive syndrome can no longer be ignored. Most coaches are now on board with not allowing players who have suffered a concussion to return in the same game.

Initially, concussions often present with headaches, neck pain, vertigo, mental sluggishness/confusion, and social-emotional disturbances. Concussions can have lasting vestibular, ocular-motor, sensory integration, balance, and visual motor implications. As therapists, we are seeing more patients across all settings who may present with concussions. Interestingly, the severity of the concussion is not a reliable predictor for who will present with lasting symptoms.

While the recognition and treatment protocol for concussions and post-concussive syndrome has gained some momentum, there is still much to be learned in terms of prevention, treatment, and long-term implications.

Please share your experiences in dealing with post concussion syndrome.  Who is your referral source?   Any helpful tips on screening, management and follow-up?  

~Kathryn Biel, PT, DPT