Parent and Physical Therapist Perspective on Concussions

It happened like most concussions happen. My son hit his head on the pavement while playing with a friend. He needed stitches and so I took him to the hospital. As we drove there he told me that after he had fallen he was seeing “squiggly” lines and that the person who had come to help him seemed like he was far away even though he was right next to him. He was a little off balance, a little dizzy and had a headache that brought him to tears. The ER doctor confirmed my suspicion that he had a concussion, stitched him up and sent us on our way with instructions to rest and see his PCP to have the stitches removed in 4 days.

As a Physical Therapist working with patients with concussions, I have a good understanding of the injury, symptoms and management of concussions. I know that each concussion is unique and should be treated as such. There should not be a timeframe on returning to activities because not everyone heals at the same rate. As my pediatrician told us, I’ll tell you how long it will take to get better when you’re better.

Concussions are not easy to deal with

There are no visible signs such as a cast or brace so it can be difficult for others to see that there is an injury. Many people don’t realize that a concussion is a head injury and are under the impression that it is no big deal. The symptoms people experience after a concussion can be debilitating. My son had headaches, fogginess, fatigue, difficulty concentrating and extreme IRRITABILITY. These symptoms lasted about 5 days and then one morning I awoke to find my son was back to his normal, only slightly irritable, 12 year old self.

Rest is essential

There are physiological and metabolic changes that occur after a concussion that leave the brain energy compromised for a period of time. Usually these changes normalize in about 10 days, however over exerting during this healing time can lead to increased symptoms and an increased length of time for recovery. Physical and cognitive rest is crucial for the first couple of weeks to allow the brain to rest and heal. Cognitive rest means avoiding activities that cause you to have to concentrate. School work, reading, texting, video games and TV are all activities that may need to be limited.  Returning to activity needs to be gradual.

Risks of Second Impact

In children and young adults there is the risk of second impact syndrome which can occur if they get another concussion on top of one that is not completely healed. This is a devastating syndrome that can lead to permanent neurological damage or even death. That’s why it’s crucial that if your child has a concussion that they are not allowed to do anything that puts them at increased risk of getting another concussion.

Treatment

Once my son had been symptom free for 7 days, he began Physical Therapy at Marathon Physical Therapy and Sports Medicine and enrolled in Marathon’s concussion program. Step one of the program was an evaluation which included a musculoskeletal assessment as well as a balance and vestibular assessment to determine if he had any limitations. Treatment from there focused on improving his balance and vestibular system, which is the system that basically allows you to stay upright and balanced when moving. When someone has difficulty with their vestibular system they can have symptoms such as dizziness and often times visual disturbances which can cause headaches. Treatment also focused on using low level aerobic exercise while being closely monitored to gradually progress him back to full activities. The aerobic exercise was gradually increased in stages as he tolerated until he was functioning at his baseline level. My son was back to his baseline within 2 weeks and was discharged from the concussion program.

My son’s experience with his concussion made me see the difficulties that kids and their parents face when trying to recover. My son was compliant with the restrictions of physical and cognitive rest initially when he was symptomatic, but as soon as he began feeling better he was constantly nagging me to play video games or to go out and run around with his friends. It took all my strength and willpower not to give in and let him do what he wanted to do. I constantly reminded myself that even though he was feeling better, he was still recovering from a brain injury.

Do you think your child has a concussion or are there any questions you have regarding concussions? Feel free to contact Marathon Physical Therapy’s Jennifer Franceschelli, PT or Alyson O’Connell, DPT at 508-285-5533.

To learn more about Marathon Physical Therapy, visithttp://www.marathonphysicaltherapy.com.