Did you know that there are over 43 definitions of concussion?
Basically, a concussion is a brain injury that causes a change in brain function following a force (blow, jolt or hit) to the head or body, which may be accompanied by temporary loss of consciousness, but is identified in awake individuals, with measures of neurologic and cognitive dysfunction. Common causes include sports injuries and car accidents. Usually, a combination of linear and rotational forces from an impact cause stretching or injury to the sensitive tissues of the brain.
A concussion may cause many symptoms such as a headache, confusion, dizziness, fogginess, blurred vision, memory loss, nausea and vomiting, mood swings, and loss of consciousness. Symptoms overlap with other psychological, neurological, and musculoskeletal diagnoses and thus remains a clinical diagnosis. Accurate and timely diagnosis will help facilitate earlier recovery, reduce the risk of early complications and avoid further head and musculoskeletal injuries. Because the brain tissue is healing, additional injury to the head while concussed, especially in a younger individual, can lead to significant long-term impairments.
In community-level sport, there may not be adequately trained medical staff present to observe possible concussion. Thus, a dedicated observer should be educated on signs of concussion and appropriate action. Signs include clutching the head, being slow to get up, suspected facial fracture, possible ataxia, and behavior change thus further evaluation and action is required. The athlete should be removed from play, undergo an evaluation in a distraction-free environment, and only return to the sport if the signs are determined to have been from a cause other than a concussion.
Many concussions happen without a healthcare professional present. Thus, the public, athlete, parent and coach awareness are an important aspect of initiating care. To help identify concussion in children, adolescents and adults the concussion recognition tool 5 (CRT5) may be helpful. It can be used to identify red flags, observable signs, symptoms, and memory assessment. Athletes or individuals suspected with a concussion should not be left alone initially (at least for the first 1-2 hours), not drink alcohol, not use recreational/prescription drugs, not be sent home by themselves. They need to be with a responsible adult and not drive a motor vehicle until cleared to do so by a healthcare professional. The athlete should not return to sport until an appropriate medical evaluation has been completed by an appropriately qualified healthcare professional.
Active rehabilitation may improve symptom recovery more than prescribed rest alone after a concussion. Helmets do not prevent a concussion but help with energy absorption. For more information regarding which helmets visit Virginia Tech’s website. They provide unbiased helmet ratings that allow consumers to make informed decisions when purchasing helmets. The helmet ratings are the culmination of over ten years of research on head impacts in sports and identify which helmets best reduce concussion risk. Overall, physical therapists can play an important role in the diagnosis and treatment of concussions.