Concussion Treatment

for post-concussion symptoms after a brain injury

 

Concussion Rehab

is a comprehensive treatment approach designed to address the diverse symptoms associated with concussion or brain injury. These symptoms include headaches, dizziness, vertigo, blurred vision, visual motion sensitivity, cognitive and emotional challenges, and exercise intolerance.

Evidence-based physiotherapy assessment and treatment are provided for individuals aged 18 and older who require education and management for a recent concussion injury, or for those experiencing persisting symptoms after a concussion.

Each concussion is unique, so my treatment approach is tailored to meet the individual needs and specific symptoms of each patient.

Physiotherapy for Acute Concussions

Early education and a guided return to activity in the first days and weeks after a concussion can help you get back to work, school, sports, and other activities safely.

Physiotherapy for Persistent Post-Concussion Symptoms

If you have been experiencing concussion symptoms for several months or years after your injury, it is still possible to receive treatment and improve your condition. Treatment focuses on identifying the specific areas that are still affected, which may include:

Cervical Spine: Issues like neck pain or stiffness related to a whiplash injury.

Visual and Vestibular Systems: Symptoms such as blurred vision, difficulties reading, dizziness, vertigo, and balance issues.

Physiological and Autonomic Nervous System: These can affect blood pressure, heart rate, and exercise tolerance.

Psychological and Emotional Symptoms: These may warrant a referral to the appropriate therapist for support.

Cognitive Issues: Challenges related to thinking and memory, which may also benefit from consultation with a specialized provider.

By addressing these specific areas, you can work towards alleviating your post-concussion symptoms.

What is a concussion?

  • A concussion is a type of traumatic brain injury caused by external forces, leading to various symptoms and functional issues. It does not always involve a loss of consciousness.

  • A concussion can occur in any of these situations:

    • A direct impact of the head against a stationary object, such as a fall resulting in the head hitting the ground

    • A direct impact of an object on the head, such as from a ball during a sport

    • Quick acceleration and deceleration of the head, such as during a whiplash injury in a car accident

a younger man rubbing his eyes to depict headaches in Toronto Ontario

Post-Concussion Symptoms

A concussion can result in a wide range of symptoms that can be present for several weeks, months, or years. These symptoms can include:

COGNITIVE (THINKING/ REMEMBERING)

  • Difficulty thinking clearly

  • Difficulty making decisions

  • Slowed thinking

  • Poor focus and concentration

  • Easily distracted

  • Forgetfulness and difficulty remembering new information

EMOTIONAL (MOOD)

  • Irritability and easily annoyed

  • Feeling depressed or sad

  • Poor frustration and easily overwhelmed

  • Feeling anxious or tense

PHYSICAL

  • Headaches

  • Vision problems, blurring, trouble seeing

  • Nausea

  • Dizziness

  • Light and/or noise sensitivity

  • Balance and coordination problems

  • Fatigue and having low energy

SLEEP

  • Sleeping more than usual

  • Sleeping less than usual

  • Trouble falling and/or staying asleep

For the first 1 to 2 days after a concussion, relative rest is recommended. This means taking it easy, not staying in bed: everyday activities, light walking, and less screen time are fine as long as they do not more than mildly increase your symptoms. After that, it is encouraged to become gradually more active without significantly triggering your symptoms (this involves staying below cognitive and physical symptom exacerbation thresholds). Speak to a healthcare professional to determine your symptom exacerbation thresholds.

Most people recover within about 4 weeks. Symptoms that last longer than 4 weeks are called persisting symptoms. If dizziness, neck pain, or headaches last longer than 10 days, neck and vestibular (inner ear and balance) rehabilitation is recommended. Depending on which symptoms you are still experiencing, you can benefit from one or many of the following concussion treatment techniques.

Post-Concussion Treatment

  • Providing education about concussion symptoms in Toronto Ontario

    Rest and education

    is a crucial aspect of concussion recovery. An extended period of rest is no longer recommended. Relative rest for the first 1 to 2 days, with light activity such as walking, followed by a gradual return to physical and cognitive activity (while keeping symptoms at a low level) is most appropriate.

  • Teaching cardio exercise post-concussion in Toronto Ontario

    Sub-threshold cardiovascular exercise

    is safe and can support your recovery. Sub-threshold means light aerobic exercise that does not more than mildly increase your symptoms. Cardiovascular exercise can involve going for walks, going on a stationary bike, walking on a treadmill, or doing low-impact home exercises.

  • Providing hands-on treatment for neck pain post-concussion in Toronto Ontario

    Manual therapy

    consists of hands-on treatment that may be helpful if you are experiencing headaches, neck stiffness and tightness. A neck (whiplash) injury often happens at the same time as a concussion, so assessing and treating neck issues after a concussion can help with many post-concussion symptoms.

  • Teaching balance exercises after a concussion in Toronto Ontario

    Balance training exercises

    are used to improve steadiness so that it can feel easier to do your daily activities. Balance exercises involve integrating inputs from your visual, vestibular, and proprioceptive systems to work better together and allow you to feel more stable and in equilibrium.

  • Providing education about brain health recovery post-concussion in Toronto Ontario

    Fundamental lifestyle education

    is provided to support your recovery. Education can be provided about sleep hygiene, headache and symptom management, basic nutrition and lifestyle changes, stress management, and other lifestyle areas that can impact brain health.

  • Teaching cervical proprioception after whiplash injuries in Toronto Ontario

    Cervical spine (neck) rehabilitation

    involves treatment for the cervical spine (a.k.a. neck). A whiplash injury can happen at the same time as a concussion, so symptoms of headaches and dizziness can come from the neck. Treatment can consist of hands-on therapy and neck strengthening and stabilization exercises. Integrating them with visual and vestibular exercises is essential so that the sensory systems work in coordination.

  • Teaching how to return to exercise post-concussion in Toronto Ontario

    Exercise prescription

    of an individualized exercise program can be helpful to address any areas of concern and will be modified as concussion recovery progresses. These areas can be related to strength, flexibility, posture, and going back to specific hobbies and sports.

  • Helping a patient return to work or school after a concussion in Toronto Ontario

    Recommendations for academic or employment accommodations

    can be provided in coordination with academic or employment personnel to ensure a graduated return to school or work plan conducive to concussion recovery.

  • Doing cognitive training post-concussion in Toronto Ontario

    Dual-task (cognitive-motor) training

    combines physical and cognitive skills, such as reaction time, agility, strength, decision-making, and focus, to simulate real-life situations involving multi-tasking.

  • Doing visual and vestibular exercises for concussion symptoms in Toronto Ontario

    Visual and vestibular rehabilitation

    addresses symptoms related to the visual and vestibular systems, which can often occur following a concussion. Symptoms can include vertigo, dizziness, blurred vision, double vision, balance issues, and oscillopsia (bouncing vision).

  • Providing referrals to other concussion providers in Toronto Ontario

    Referral for additional forms of care if appropriate (i.e. neuro-optometry, psychological)

    may be recommended for certain areas of concern to ensure that the multiple aspects of a concussion are appropriately addressed.