Concussion Discussion

Concussions are a growing topic of discussion in sports and the media recently. This increased awareness towards head injuries and the implications it can have for athletes has sparked more research into the topic of brain injury and concussions.

 

This research is great progress in the health care realm and will help people of every age suffering with concussions – kids, adults and seniors – whether it occurred during sport (with or without a helmet), or during a fall or other trauma such as work or motor vehicle related injuries.

 

There are two things to consider when evaluating the seriousness of your concussion:

  • the severity and the duration of your symptoms, and

  • the number of concussions you’ve had over your lifetime

 

Head injuries that clear up overnight or within a few days do not pose a large concern. When symptoms last weeks or more, or when they result after a history of multiple head injuries, it is recommended to see an appropriate knowledgeable practitioner who will do thorough concussion screening tests and who is able to treat both the cervical spine and assist vestibular (balance) rehab training

 

Research using advanced MRI imaging on hockey players at the University of British Columbia found that there was physical damage to the brain after concussions. Prior to this, there was no physical evidence of damage to the brain with any imaging modalities. Now it can be seen that the myelin sheath around each nerve in the brain (which acts likes the insulation on a wire) is damaged and appears to separate from the nerve and then slowly recover over a 2 month period. The new understanding of the physical damage to the brain and the time needed for recovery suggests athletes and anyone with a concussion should be recommended to follow more stringent activity restriction periods following a traumatic event to the head than is currently being followed.

 

Concussions can occur from a single or multiple blows to the head. A person who has had a symptomatic concussion is also more susceptible to have symptoms the next time an incident occurs. A study by the Canadian Medical Association Journal on NHL players found that recovery time more than doubles with each successive concussion. It is believed that this is because the brain has not yet fully healed from the previous trauma.

 

Not all concussions result in losing consciousness or blacking out. The most common symptoms are headache and dizziness, followed by nausea and neck pain. Although the majority of symptoms resolve in 7-10 days, in approximately 30% of athletes these symptoms persist longer. A 2014 randomized control trial on concussion patients with cervical spine involvement reported individuals who received cervical spine treatment and vestibular training were 10.27 times more likely to be medically cleared to return to sport in eight weeks as compared to the control group. The study concludes that the addition of cervical spine treatment and vestibular training shows promise for better outcomes regarding medical clearance to return to sport in those with concussion symptoms lasting more than 10 days.

 

Whether you are a seasoned athlete or an average Joe, you need to properly address and rehab your concussion appropriately. Health care professionals believe that earlier treatment and active therapies can reduce or eliminate concussions’ long term consequences. As with any other injured body part, the brain responds better to prompt treatment.

 

Sources:

  1. Schneider KJ, et al. Cervovestibular rehabilitation in sport-related concussion: a randomized control trial. Br J Sports Med 2014; 48:1294-1298

  2. Benson BW, et al. A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program. CMAJ May 17, 2011 vol. 183 no. 8

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visit parachutecanada.org for the latest Canadian Guideline on Concussion in Sport