Concussion is a Mild Traumatic Brain Injury.

Concussions – Written by Kimberley Pilbrow (BHSc Physiotherapy)

With the start of another Winter Sports season now upon us, now is a good time for athletes, parents, coaches, officials & supporters to increase their knowledge about concussion.

Concussion is a Mild Traumatic Brain Injury which occurs when someone receives impact to the head or body causing a force to be transmitted to the brain, ie ‘shaking’ inside the skull. In a concussion injury there is no change to the macro-structure of the brain. Ie there is no permanent damage to the brain. However, there are changes at a micro level, meaning it may take some time to re-access the areas of the brain that were affected.

Historically people believed that to sustain a concussion you must be “knocked out” (loss of consciousness), this is not true- 90% of concussion occur without any loss of consciousness AND Loss of consciousness does not relate to their long-term outcomes. Ie someone who is knocked out may return safely to sport in 3-4 weeks, where as someone who is not may take 3months to recover- there is no relationship between “severity” of concussion and length of recovery.

As Concussion is a brain Injury- there is a wide range of symptoms such as:

Visible Signs:
-loss of consciousness
-slow to get up
-unsteady on feet/poor balance
-poor coordination or inappropriate playing behaviour (eg. standing out of position)
-clutching or grabbing at head
-dazed or confused
-vomiting (>once is of greater concern-take to Emergency Department)
-irritability/changes in emotions

Symptoms:
-dizziness
-headache
-nausea
-drowsiness
-“don’t feel right”
-blurred vision
-difficulty concentrating/remembering

If you (or your child) have an incident like this and have one or more of the following symptoms you should:
1) Be removed from sport immediately
2) Monitored by an adult
3) Seek Medical Attention from your GP or Concussion Trained Physiotherapist (Click here for our team)

A full list of symptoms can be found HERE– the Concussion Recognition Tool is a great resource for parents & coaches

Assessment and Treatment of Concussion:
A concussion must be diagnosed by a health professional. Examination from your Physiotherapist will include a group of tests as required including; SCAT5 or SCAT5 Child Assessment (Symptoms, Neurocognitive processing, Balance), Assessment of neck pain and movements, Neurological Exam, and Eye & Head Movements.
Treatment of each concussion is individual- REST IS NOT BEST!!
Your Physiotherapist will work with you on starting appropriate activities EARLY to aide a gradual return to daily activities (highly supported by research), followed by return to work/school and then return to sport. Your treatment plan may include; education about pacing activities, treatment of the neck joints and muscles, relearning eye tracking movements and gradual exercise progressing back to full function including work and sport specific tasks.

Key Points:
-90% of concussions occur without being knocked out
-If you suspect a concussion, remove the athlete from play IMMEDIATELY
-Seek Medical Assessment from someone trained in Concussion
-Rehabilitation is INDIVIDUALISED
-REST IS NOT BEST!
If you have had a concussion, Bureta Physiotherapy will work with you, your family and your doctor to take you through the required steps for full return to function-including sport, school or work.
Early Diagnosis is important for monitoring symptoms and guiding appropriate rehabilitation, contact us TODAY to book an appointment or discuss if our acute concussion service is right for you.

 

 

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Deep Neck Flexors- Small exercises for big neck pain.

Most people have heard of “the core” when talking about low back pain and strengthening, but not many have heard of the deep neck flexors (DNF) which are a group of muscles that are “the core” for neck. These small muscles are buried deep in your neck and are responsible for the stabilisation of the neck.

Neck trauma, poor posture, whiplash, muscle imbalance, and overuse can cause dysfunction in these muscles which may lead to ongoing and recurrent neck/ upper back / shoulder pain, headaches and on occasion other symptoms of dizziness, nausea, and visual disturbances

Most people with neck pain do not experience a complete resolution of symptoms, resulting in a persistent and recurrent condition. Between 50% and 85% of those who experience neck pain at some initial point report having it again 1 to 5 years later. Training of the neck stabilisation muscles has been shown to be crucial in the complete resolution of recurrent and chronic neck pain. It has also been shown to beneficial for athletes in contact sports in the head such as rugby and soccer for prevention of injury.

Training the DNF’s requires the participant to lye on their back with the neck supported with a rolled up towel under the head. The physiotherapists at Bureta use the pressure biofeedback cuff under the neck to help you train these muscles. To activate the DNF we ask you to perform a small head nod without activating the larger muscles around the neck. We grade the strength of your neck flexors which can be anywhere between 22mmhg and 30mmhg on the pressure cuff. Once you have the correct technique you will be asked to perform the exercises daily and we will review your progress on the next appointment.

Depending on your symptoms and what your goal is, we have a progressive strengthening program with specific exercises for the DNF’s to reach their optimum function. You should notice an improvement in symptoms within the first few weeks but it may take up to 12 weeks to build the strength you require depending on your goal. The physiotherapist at Bureta can guide you through the process, contact us for an appointment.

Your Injury, Our Challenge, Your future

An example of deep neck flexor training is seen in this video link https://youtu.be/6Of_10gUelI

Using a pressure cuff to train neck muscles

Using a pressure cuff to train neck muscles