Physical Therapy for Concussion Injuries

Concussions and Physical Therapy

It is not well known that patients who have had concussions can and should be treated by a physical therapist. It used to be thought that the only way to treat a concussion was with rest. However, a lot of research has emerged recognizing the effectiveness of PT on treating this injury. Physical therapists are an integral part of the multidisciplinary team of health care professionals that provide concussion management. 

Concussions are classified as a minor traumatic brain injury and make up 80-90% of brain injuries. They usually occur from a direct blow or jolt to the head or body. It is important to seek medical care if you suspect that you’ve sustained a concussion. After suffering from a concussion some symptoms you may experience include headaches, trouble concentrating, fatigue, drowsiness, dizziness, sensitivity to light and/or noise, diplopia (double vision), feeling mentally foggy or slowed down.

Rest is the most important consideration in early rehabilitation. The majority of concussions resolve independently with little to no symptoms after 7-10 days. If symptoms are still present after that time frame, your doctor may recommend physical therapy. A physical therapist will work closely with your referring doctor to help you get on the road to recovery. They will examine and evaluate you to establish a diagnosis, implement their plan of care, and monitor you to determine when you can return to your daily activities or sport. Your therapy plan will consist of treatment focused on determining the root of your symptoms as well as reducing their presence.

There are a number of clinical profiles under which your symptoms can be associated with. These are:

• Vestibular- disruption of the central vestibular system

• Oculomotor- disruption of the brain’s coordination of visual system and input, which can not be treated with PT.

• Cognitive fatigue- worsening of problems throughout the day

• Post-Traumatic migraine- which your PT will refer you to a medical specialist for

• Anxiety/Mood- changes in mood

• Cervical - neck pain, numbness, tingling, headache

During an initial assessment, a comprehensive exam will evaluate your symptoms, cognitive function, neuromotor skills, vestibular/oculomotor system, and psychological status. The goal of the initial exam is to rule out any emergency conditions that can not be treated with physical therapy. Some questions that your PT may ask you will include information about the injury, initial signs, symptoms, and severity, orientation to place and time, cognitive function, balance and motor coordination. Your therapist will ask you about the symptoms that you are currently experiencing, and may use scales to measure them objectively. They will also administer a neurocognitive assessment focused on memory, attention, processing speed, and reaction time. Your therapist will assess your balance and gait using tests and measures, as well as your vestibular system status. A psychological assessment may be administered as well for patients experiencing changes in mood, anxiety, stress, or other emotional issues. This information is important in order to determine the patient’s prognosis.

Once you are cleared for therapy and your goals are clear, you will come in for a comprehensive follow up.

Common treatments that you can expect at a physical therapy sessions include:

• Prescribed rest: this is beneficial to protect the brain from further injury and lessen disruption of cellular function. This is especially beneficial for patients with more severe signs and symptoms. However, active rehabilitation may be more effective for patients with chronic symptoms.

• Sleep program: 33% of patients experience sleep disruption. Patients should be on a healthy sleep program to promote recovery and limit development of a sleep disorder.

• Active therapy: this has been associated with improved outcomes, as it increases neuroplasticity, or the brain's ability to form new connections.This may include neck and back stretching or strengthening exercises, or soft tissue work.

• Vestibular therapies: dual gait and dynamic movement activities, gaze stability exercises, sensory organization exercises.

• Oculomotor therapies: pencil push ups, ladder beads, shifting focus based on distance

• Cognitive fatigue: patients may be advised to complete cognitive and physically demanding tasks early in the day

In order to return to activity your PT will make sure that you are asymptomatic, back to baseline for cognitive, balance or other impairments, and asymptomatic following exertion. 

Our physical therapists stay up to date on relevant research regarding rehabilitation techniques for treating concussions. They will work to build you a program to help you get back to your daily activities with confidence. Call to Schedule an Appointment- 1-718-258-3300

About Evolve Physical Therapy in Brooklyn, NY-

Brooklyn's Premier Holistic Physical Therapy Clinics-
There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

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