A concussion is an injury to the brain that results in a temporary loss of normal brain function. It is a type of traumatic brain injury (TBI) that can be caused by a blow to the head like hitting your head on the trunk door, a jolt like in a motor vehicle accident, or a bump like with a fall.
We often associate concussions with youths, and more media and attention has been drawn to concussion management for this population. This has helped elevate and produce more research behind the causes and treatments for concussions. This has enabled for better prevention and outcomes, which is great! However, there is a lack of evidence for the population who is most vulnerable to traumatic brain injuries--seniors.
Anatomy of concussions
When a concussion occurs, the brain moves on its axis causing stretching and tearing of axons (long-nerve cells that conduct impulses).
Concussions typically do not involve structural damage that can be viewed on common imaging tests like MRI and CT scans often come back with no visible structural damage.
So does this mean these people are making up their symptoms? NO WAY!
Because of the injury to the axons that occur within the brain during a concussion, a metabolic injury occurs which can not been seen on any imaging.
On initial impact, glutamate is released which causes calcium levels to go up, and potassium levels to go down within the axon interfering with mitochondrial function and ATP synthesis.
ATP is the repair mechanism for this problem, but it requires sodium and potassium (which is already lacking)
Additionally, concussion causes a decrease in cerebral blood flow which means there is not enough glucose in the blood to keep up with ATP's demand to help in the repair.
This change in the metabolic balance of the axon and a decrease in cerebral blood flood creates an energy crisis resulting in concussion symptoms.
Sensitivity to light and noise
Irritability and other personality changes
Concentration and memory complaints
Some symptoms of concussion may be immediate or delayed by hours or days after injury
Since there are many different symptoms that can be associated with symptoms, it is recommended to treat based on symptom presentation.
Treatments can include:
Balance and sensory training
Cervical (Neck) treatment and exercise
Pacing education with graded exposure to stress and activity
Family and professional support for managing behavioral and cognitive changes
Potential healthcare practitioners involved in concussion care:
Orthopedic physical therapist: can help is assisting with alleviating headaches, fatigue, exercise intolerance, back or neck pain.
Vestibular physical therapist: A therapist with specific and advanced training in our balance systems and can help assist with those dealing with motion sensitivity, impaired balance, difficulty walking, dizziness and more.
Speech (Cognitive) therapist: assist those dealing with speech, cognitive, or memory problems
Occupational therapist: this specialist can have many different specialities including cognitive tasks, household chores, and visual deficits.
Neurologist: can provide imaging, bloodwork, and medication
Neurodevelopmental Optometrist: After concussion, you may experience blurred vision, difficulty with screens, and light sensitivity. This kind of specialist helps to assess the connection between your visual system and your brain.
Cognitive behavioral therapist: For those dealing with mental health issues related to their concussion symptoms including PTSD, depression and/or anxiety.
Endocrinologist: Our food is our fuel! This specialist can help by changing your diet and nutrition to help regulate your gut health and hormones.
How can Piton Physical Therapy help you?
We are expertly trained in orthopedic and vestibular conditions and treat clients throughout the central NJ area. We understand that those who have suffered from a concussion may experience both orthopedic conditions like neck pain, and may also be struggling with symptoms like dizziness and fatigue and are equipped and ready to help you navigate it to provide long term relief! If needed, we make the right referrals for you, quickly, so that you have the most expert team of providers assisting you in your recovery journey.
We understand the complexities behind concussion symptoms and we purposefully designed our model of care to assist those who may struggle with transportation based on symptoms of dizziness, imbalance, and pain. We are here to provide you with the expert, evidence based care to alleviate your symptoms all from the comfort of your home anywhere in NJ virtually!