If you go back in medical history, concussions have been largely undermanaged.
It’s only recently that health professionals have sought to improve how they are treated thanks to an ever-growing body of data showing that early management of at least 28 days is crucial in achieving full recovery.
Concussions occur when the brain hits the skull and rebounds, stretching the outer membrane of the brain. This causes a disruption in the intra and extracellular substances, with altered ion exchange (sodium, chlorine, magnesium and potassium, for example) and inflammation. They are classified as mild TBI, meaning there is no structural damage to the brain.
The highest incidences of concussion in sport occur in rugby union, ice hockey, American football, boxing, mixed martial arts, football, lacrosse and ski sports. There are slight differences between sex, age, professional or amateur.
It’s important to note that concurrent sub-concussive impacts can be just as damaging as concussions.
As the brain is involved in so many functions, the symptoms can be quite varied when the organ is injured. These can be everything from headaches, nausea, neck pain, fatigue and difficulty concentrating and sleeping to mood disturbances, sensitivity to light and noises – and more.
Concussion symptoms are bi-products of the brain's functional limitations. Physiotherapy treatment focuses on Vestibular, Cervical, Cognitive, Oculomotor and Heart Rate Variability issues. Other symptoms may need to be managed by a multi-disciplinary team that might include a sports medicine doctor, opthamologist, and others.
Ultra Sports Clinic senior physiotherapist and clinical lead Christine Fletcher has undertaken additional specialised training to assist in managing these conditions.
“Rehabilitation is critical for managing and improving functional limitations,” she says.
“I also recommend avoiding pro-inflammatory foods, including high-processed sugars, excessive red meat and alcohol until we still substantial improvement. There are targeted exercises for the different issues, be they vestibular, heart rate variability or whatever limitation the patient may have.”
It’s essential that patients avoid instances where they may suffer another concussion before feeling 100% better. They also need to have been cleared by a medical professional. Many sporting associations, particularly at the under-16 level, stipulate that sportsmen and women may not play for 28 days after contact.
Fletcher can’t stress enough that imaging and a review with a medical professional (sports doctor, concussion specialist or A&E) must be sought in the event of a suspected concussion to clear any structural damage. Likewise, delaying rehabilitation increases the chance of suffering post concussion syndrome and any ongoing symptoms.
Message from Christine Fletcher
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