A mild traumatic brain injury (mTBI), also known as a concussion is a caused by the forceful motion of the head or by a direct trauma to it which results in an insult to brain. This results in the person experiencing disorientation, being in a state of confusion and/or having a loss of consciousness for about 30 minutes or less. An mTBI is the most common form of traumatic brain injury that affects people of all age groups with the younger adults and elderly being at the highest risk. The diagnosis of a concussion does not rely on MRI or CT scans. Unless, the brain injury causes bleeding and contusion of brain, these diagnostic test are often negative. After an mTBI, the injured person experiences physical, cognitive and emotional symptoms.
What Causes Concussions?
The most common causes of concussions are:
- Car Accident – Car accidents in many cases involve an impact that results in whiplash of the neck. This accelerate movement of head causes the brain to hit the scull. In some cases, the head hits the headrest or steering wheel which furthers the impact on the actual brain.
- Workplace Accident – impact that can result from a slip and fall or falling object onto the head.
- Sports Injury – impact that can result from a clash of heads, running into an opponent or a ball hitting the player in the head.
- Violent Events – impact that can result from something from a direct blow to the face, head or neck.
Symptoms of Concussion
There are many symptoms that can be experienced with a MTBI. Physical symptoms can include:
- Headache
- Dizziness
- Loss of balance
- Blurred vision
- Sensitivity to light/noise
Cognitive symptoms usually include:
- Difficulty concentrating
- Hard time remembering
- Slower processing of information
- Confusion about recent events
Emotional symptoms can include:
- Anxiety
- Depression
- Aggression
- Irritability
- Restlessness
Most concussions resolve within one to two weeks but some people might continue to experience the symptoms persisting beyond these timelines. If symptoms continue beyond three weeks after the onset of the injury, a diagnosis of post-concussion syndrome is usually made.
Managing a mTBI
Initially after the onset of the mild brain injury, the less is the better:
- Rest is the most important management
- Getting as much sleep during the night and rest during the day would be very beneficial in managing the symptoms.
- Avoid the physically demanding tasks such cleaning, vacuuming, working-out, etc.
- Avoid mental tasks requiring a lot of concentration such as reading, studying, computer etc
- Put aside more time that you would normally require in order to perform your daily tasks such as going to the washroom, eating your meals, changing clothes, etc
- For athletes, limit any physical activities or playing sports until you are cleared by a healthcare professional to go back
- Consult a professional trained in concussion management and your doctor before going back to work
Can Physiotherapy Help with Managing a mTBI?
A physiotherapist who is certified in concussion management can help treat many of the problems and symptoms associated with an mTBI. After a thorough physical examination, the physiotherapist devises a personalized treatment plan for each patient because no two concussions are the same. Each treatment plan is structured differently with an incremental progression, depending on when the patient wants to get back to their activities of daily living, physical activities and/or sport teams.
After an injury, an assessment by a doctor or a trained health care practitioner is in order. This assessment may or may not include a baseline computerized neurological and cognitive test called imPACT.
Depending on the symptoms associated with the mTBI, the physiotherapy treatment will include a series of management techniques to educate patient how to stay active without aggravating symptoms, coping and pacing techniques as well as exercises to improve concentration, gaze stabilization, maintaining balance with movements. The program then will progress to facilitate activities required for work and specific sport. For example, the set of exercises for a patient who is returning to work as an office worker are different from one who is returning to construction work. Same applies to a patient who is returning to gymnastic than an athlete who is returning to hockey.
To learn more about how physiotherapy can help with mTBI management, please call our North York concussion management clinic at 416-444-4800 for a free consultation or to book an appointment.
