Healing from the Invisible Injury

Returning to activity too soon after a concussion can have serious consequences, hindering brain healing and potentially leading to further damage. Multiple systems in the body can be impaired by a concussion, making it crucial to follow evidence-based guidelines for a safe return to activity. The International Conference on Concussion in Sport has published a specific return-to-play protocol to prevent further damage when returning to activity following a concussion.

While rest is initially important after a concussion, recent studies emphasize that “Exercise is Medicine.” However, it is essential to establish the appropriate amount and type of exercise under the care of a medical provider. Exertion therapy provides a controlled, step-wise approach to returning to sport or activity. Research indicates that early exercise in a controlled environment can improve recovery and reduce the chance of developing Persistent Post-Concussion Syndrome.

Physical therapists are well-equipped to guide individuals through exertion therapy. They monitor patients' symptoms and physiological responses during aerobic and strengthening activities, tailoring these activities to individual goals, whether returning to daily routines, work, or sports. Exertion therapy also plays a role in treating persistent post-concussive symptoms, such as those caused by dysautonomia.

If you have sustained a concussion, consult with a healthcare professional to determine an appropriate exertion therapy plan for your specific needs.

Chiropractic functional neurology offers a unique approach to treating concussions and other brain-related conditions, focusing on the brain's remarkable ability to heal and adapt. This specialized field gained wider recognition in the early 2010s when Dr. Ted Carrick successfully treated professional hockey player Sidney Crosby's concussion. Since then, it has been used to help many other athletes and individuals with neurological conditions.

Functional neurology utilizes a variety of techniques to address conditions like concussions, post-concussion syndrome, headaches, migraines, dizziness, and balance disorders. This therapy enhances brain performance and stimulates nervous system function. Treatment is individualized and tailored to specific needs based on a thorough initial consultation and examination.

Techniques may include specific chiropractic adjustments to the joints, muscle therapies, physical exercises, balance and vestibular rehabilitation, eye tracking exercises, and cognitive training. These treatments are rooted in the principles of neuroplasticity—the brain's capacity to change, rewire, and strengthen connections.

After a brain injury, the brain naturally attempts to heal by creating new pathways or strengthening existing ones. Functional neurology employs targeted methods to facilitate this process and enhance recovery. Many individuals have found relief through functional neurology when other medical approaches have been unsuccessful in resolving their chronic brain-related health conditions

The brain needs lots of energy to heal following a concussion, and oxygen is necessary for healing the brain. When oxygen is limited, the brain is unable to make necessary repairs. This is where hyperbaric oxygen plays a significant role in treatment.

Hyperbaric Oxygen therapy is a noninvasive, painless treatment that supports the body's natural healing capabilities. It involves breathing 100% pure oxygen in a pressurized chamber in which the atmospheric pressure is between 1.5 ATA (atmospheres absolute) and 3 times higher than normal air pressure.

Although research on HBOT for post-concussion symptoms is limited, there are strong believers who have seen substantial benefits. The benefits of hyperbaric oxygen increases blood flow, decreases inflammation and swelling, increases antioxidant defenses and stimulates the growth of new blood vessels in the brain. This is a beneficial treatment that helps to relieve post-concussion symptoms and promotes recovery.

A neuropsychological evaluation provides a comprehensive picture of your brain's functioning after a concussion. It's an in-depth assessment of skills and abilities linked to brain function, measuring how well a person's brain is working after a disruption.

This evaluation identifies strengths and weaknesses across multiple areas, including attention, memory, language skills, visuospatial skills, motor skills, academic skills, social-emotional functioning, and executive functions such as planning, time management, problem-solving, and self-control.

Unlike neurological evaluations, which focus on the physical structures of the brain through tests like EEGs, CT scans, and MRIs, neuropsychological evaluations delve into cognitive function. The results help healthcare providers diagnose cognitive impairments, establish a baseline, and develop targeted treatment plans.

Neuropsychological evaluations provide greater detail than sideline tests, allowing therapists to identify specific areas to focus on during rehabilitation. They can also help determine which strengths might compensate for weaknesses, inform decisions about school or work schedules, and guide the development of personalized interventions.

Neuropsychologists, specialists with expertise in neurology, psychology, and psychiatry, conduct these evaluations. They provide detailed reports summarizing the results and offer recommendations for improving cognitive skills, along with referrals to other professionals if needed.

Experiencing dizziness, blurred vision, or a sense of imbalance after a head injury? These could be signs of a vestibular system dysfunction. The vestibular system, a sensory system in the inner ear, works with our visual and somatosensory systems to maintain balance and spatial orientation.

This system can be impacted by a concussion. While many individuals recover quickly, up to 30% of concussion patients experience lingering symptoms for months or even years. Some may have vision problems, vestibular issues, or a combination of both.

A skilled vestibular therapist can create an individualized plan to address these problems. They use various techniques, including gaze stabilization, habituation, and balance training, to reduce and resolve symptoms. Therapists can also incorporate activity or sport-specific training to help patients return to work or their chosen sport more quickly.

Finding a good vestibular therapist can be crucial for a successful recovery after a concussion, helping individuals regain their balance and overall quality of life.

Did you know that concussions and other head injuries can significantly impact your vision? Acquired brain injuries can disrupt the communication between your eyes and brain, leading to various symptoms. These symptoms can range from double vision and blurred vision to difficulties with multitasking and memory, and they may not always seem directly related to your eyes.

Fortunately, specialized visual rehabilitation therapy can help restore normal visual function. This individualized therapy uses strategies, often involving lenses, prisms, and other devices, to help the brain and visual system communicate more effectively.

Visual rehabilitation therapy strengthens eye muscles to eliminate double vision, blurred vision, and erratic eye movements. It also trains the brain to process visual information accurately and efficiently. This can be achieved through various techniques, including strobe light therapy with associated software programs. Strobe light therapy helps improve visual and spatial awareness by challenging the brain to process visual information under dynamic conditions.

If you've experienced a brain injury and are struggling with any visual or cognitive symptoms, consider seeking an evaluation with a visual rehabilitation therapist. They can assess your specific needs and develop a customized treatment plan to help you regain optimal visual function.

Concussions pose a significant risk to young athletes, and the presence of an athletic trainer (AT) can dramatically improve outcomes. According to the CDC, over 15% of high school athletes experience concussions related to sports or physical activities, and this number is likely an underestimate. ATs play a critical role in concussion prevention, evaluation, treatment, and return to play.

Early and appropriate diagnosis, a key responsibility of the AT, is crucial for hastening recovery and reducing the risk of permanent injury. ATs are experts in making rapid sideline evaluations and recognizing subtle changes in athlete behavior that may indicate a concussion. They are best suited to make these decisions because they know the athletes well and can observe them closely both on and off the field.

Beyond diagnosis, ATs contribute significantly to concussion prevention. They are involved in equipment maintenance, ensuring that helmets are properly fitted and inspected. They also work with schools to maintain safe playing conditions and educate athletes, parents, coaches, and school officials about concussion prevention. Research shows that athletes with access to an AT are more knowledgeable about concussions.

Athletic trainers oversee all aspects of the return-to-play protocol, including monitoring symptoms, providing testing, and coordinating with physicians and healthcare teams. They also arrange baseline testing, an important component of determining an athlete's readiness to return to play. Furthermore, ATs ensure compliance with concussion management policies, which may include rules regarding removal from play, graduated return-to-play steps, and mandatory rest periods.

In conclusion, athletic trainers are indispensable in protecting young athletes from the potentially serious consequences of concussions. Their expertise and dedication contribute to a safer and more informed environment for all involved in youth sports.

Concussions can have far-reaching effects, including psychological and emotional challenges. Psychologists and mental health counselors play a vital role in supporting individuals through these difficulties. They work within a multidisciplinary team to provide comprehensive care for individuals recovering from concussions.

Symptoms of psychological and emotional dysregulation after a concussion may include anxiety, depression, mood swings, irritability, hostility, impulsivity, sadness, loneliness, personality changes, and affect lability (unpredictable shifts in emotions).

Psychologists and mental health counselors offer a range of services to help individuals navigate these challenges. They administer neuropsychological tests to assess cognitive function and identify specific areas impacted by the concussion. This information guides the development of an individualized treatment plan tailored to the person's unique needs.

These professionals provide support in various ways, including helping individuals understand and manage their emotions, process change and grief, and develop realistic expectations for their recovery journey. They also empower individuals to advocate for their needs and adjust to their daily routines after a concussion.

By providing emotional support, coping strategies, and guidance, psychologists and mental health counselors help individuals adapt to the challenges of concussion recovery and regain a sense of normalcy in their lives.

Post-traumatic headaches, a common consequence of concussions, can present unique challenges. The International Headache Society defines these headache types and recognizes both acute (lasting less than three months) and persistent (lasting more than three months) forms. Importantly, the underlying causes of these headaches differ from those of more common migraines. Individuals may also experience a worsening or change in their existing headache patterns after a concussion.

When treating post-traumatic headache, it's helpful to include a neurologist on your care team. Neurologists are skilled in differentiating these headaches from other types and can recommend appropriate treatments. Treatment typically focuses on both aborting existing headaches and preventing new ones.

Because concussions can affect various aspects of brain function, treatment must be tailored to each individual. Options range from common medications to botulinum toxin injections, natural alternatives, and newer therapies like monthly injectables. A team approach, with a focus on personalized medicine, is often most effective. Care plans may include medications, physical medicine (massage, magnetic stimulation, trigger point injections, nerve blocks), behavioral therapy, and sleep hygiene, among others.

By understanding the unique nature of post-traumatic headaches and employing a comprehensive treatment approach, individuals can find significant relief and improve their overall quality of life after a concussion.