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Concussions Happen, PT Can Help

Written by Brad Kruse, PT, DPT, SCS, CSCS, Cert DN

Concussions happen. 

When people talk about concussions, the first thing that comes to mind is a sport related injury.  While those who play football or hockey see the highest incidence of this type of injury, the rate of concussions in other sports like soccer are not far behind.  At Dubuque Physical Therapy, we have worked with patients who have had a concussion while participating in swimming, and in golf, as well as people who were injured at work or who slipped and experienced a fall. 

A concussion is a mild traumatic brain injury (mTBI).  

Concussions Happen, PT Can Help

Anyone, at just about any age, can have a concussion. Concussion symptoms can sometimes be missed, particularly when they follow a non-sport related incident.  This type of injury generally is the result of the brain moving around within the skull and often coming into contact with the inside of the skull.  A direct blow to the head can be the cause, but a concussion can also occur with no direct contact to the head.  A blow to the body that results in the head moving or stopping quickly can result in what is called an impulse mechanism of injury.  In either case, there is a change in brain function that results in altered brain and neural function.

Concussion Symptoms Vary

The forces involved in a concussion impact many systems in the body.  While there is a wide range of symptoms that can be present following a concussion, among the most common symptoms are:

Concussions Happen, PT Can Help
  •  headache
  • dizziness/lightheadedness
  • nausea
  • sensitivity to light or noise
  • mental impairments such as difficulty with concentration or retention of information. 

The vast majority of concussions resolve relatively quickly.  In adults, about 75% of those with a concussion recover within a week, and 90+% of concussion related symptoms resolve within the first 2 weeks. In teenagers or younger individuals, the recovery time is typically longer.  Most of our younger population with a concussion recover within 2 weeks, and 85% of symptoms resolve within 4 weeks.

Physical therapists can help guide a person through the concussion recovery process.  This recovery process includes the return to mental as well as physical activity.  A school aged individual needs to tolerate being in the classroom before we worry about a return to athletic activities.  An adult may need to work through the recovery process in order to return to work.  Mental/cognitive issues can be treated in a similar fashion to physical limitations, with the prescription of specific activities or exercises from your PT.

Persistent Post-Concussion Symptoms

Persistent post-concussion symptoms, those that linger for more than 2 weeks in adults, and 2-4 weeks in younger individuals, can be subdivided into various categories.

  • Symptoms such as a headache or dizziness can be cervicogenic in nature, meaning some dysfunction in the cervical spine (neck) is contributing to the problem.
  • Dizziness, ringing in the ears and vision related problems can be related to the vestibular system (helps with balance and the brain’s ability to determine the position of the body), or the ocular system (eyes).
  • Another common subgroup of persistent concussion related symptoms relates to the cardiovascular system.  Heart rate and blood pressure changes can trigger post-concussion symptoms.

Research shows us that simply resting and completely avoiding exercise or mental activity does not help the recovery process. 

Research shows us that simply resting and completely avoiding exercise or mental activity does not help the recovery process. 

Instead, a specific process that gradually increases the intensity and duration of the offending task(s) leads to a faster resolution of symptoms.  Every person and their individual circumstances are unique, just as every concussion is unique.  Recovery from persistent post-concussion symptoms can be bolstered by having a physical therapist as part of the health care team involved in an individual’s recovery.

The expert physical therapists at Dubuque Physical Therapy are trained to assess which components are contributing to post-concussion symptoms.  We will then work with you, and in coordination with your physician or health care provider and your school or employer, to develop an individual plan for recovery.

When a concussion happens, Dubuque Physical Therapy can help!

Written by Brad Kruse, PT, DPT, SCS, CSCS, Cert DN

Physical Therapist and Sports Clinical Specialist

Dubuque Physical Therapy

Making the turn: Heading into the the back nine of the golf season

Written by Jeff Eisel, PT, DPT

As we swing into the latter half of the golf season, some of us may be feeling the effects that come with efforts to improve our game. The asymmetrical and repetitive stresses that come with excessive practice and play can lead to a multitude of ailments from head to toe. While golf-related injuries may include any part of the body, many researchers agree that gradual onset of low back pain is the most common golf injury. This is not surprising considering the high velocity rotation during downswing combined with a lumbar spinal compression load of up to 8 times the golfers body weight1.

Whether it’s the low back, hips, shoulders, or elbows; awareness in a few keys areas can help reduce the aches and pains that may be limiting your best swing. PTs are NOT golf instructors but optimizing posture, mobility, and strength with your game will help keep you on the right course. Keep these tips in mind to prevent injury.

Posture

A proper address is key to any golf swing but as we age, many of us start to get to the ball from our spine rather than through the legs. This can be due to weakness through the core and legs, or from stiffness throughout the spine. Ideally, we want to be in a “spine neutral” position so as to maximize the spine’s ability to rotate and reduce stress on the low back. In order to attain and maintain this posture, both joint mobility and strength to control the movement are needed.

Mobility

Warm up! A repetitive theme that helps prepare the body for upcoming activity. Be sure to incorporate stretches for the shoulders, hips, and spine to prepare for the activity ahead. Check out our Golf Warm Up video from earlier this summer for some of our favorites. Mobility limitations may be due to soft tissue restrictions or tight muscles but they may also be from stiff joints.

Limitations in L hip internal rotation or a stiff thoracic spine for example, may be limiting the ability to follow through on the ball after contact, thus contributing to a right handed slice. While your golf pro can help with the specifics of your swing, optimizing soft tissue extensibility and joint mobility is something that we PTs are here to help with.

Strength

It’s been said that the glutes are the king of the golf swing. Without a strong, stable base, trying to launch a drive can be like firing a cannon from a canoe. Strength deficits in the glutes increase stresses on the core and upper extremities. A weak base also means you are likely sacrificing distance and accuracy. Another fault weak glutes can contribute to is “standing up” at contact which increases stresses on the low back and can cause issues at the elbows. Core strength is needed to maintain a neutral spine throughout the swing and also prevents “standing up” at contact. These are just a few examples of how strength deficits can limit your ability to complete a pain free, consistent golf swing.

As PTs, we can help tailor a strengthening program appropriate for your specific needs. 

With the days growing shorter, we all want to make that late season push to end on a high note. While physical therapists cannot advise on how to lower your handicap (get with one of Dubuque’s awesome local golf pros for that), we can help target a specific, multi-tiered approach to ensure not only a pain free wrap-up of the golf season, but also the confidence to “take dead aim” and swing away.

See you out there. 

Citation 1: McHardy A, Pollard H, Luo K, Golf injuries: a review of the literature. Sports Med. 2006;36(2):171-87. (PubMed) (Google Scholar)