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).  

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:

•  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. 

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