Concussions

Welcome to River East Physiotherapy's resource on concussions.

The brain is resilient but sensitive.  It is the control centre of our body, and even a mild brain injury can affect your day-to-day life.

Injuries to the brain are remarkably common, particularly if you play a sport. They are even more common if you play a contact sport.  That said, you don’t need to play a sport to cause a brain injury. Non-sport related injuries to the brain can occur from incidents such as falls or motor vehicle accidents. 

Mild trauma to the brain from an impact is termed a concussion.  In the medical world, a concussion is considered a mild head injury or mild traumatic brain injury (TBI).  In response to the injury, the brain cannot function the way it normally does. Your ability to perform your normal activities with the same speed, reaction time, and precision as you did before the injury can be significantly changed.  

Fortunately, in most cases, the symptoms of a concussion are temporary and resolve over time. However, with each concussion, however, there is a small chance that permanent brain damage can occur. Therefore, proper treatment and sound medical advice to manage this injury is crucial.

This guide will help you understand:

• How the condition develops
• How health care professionals diagnose the condition
• What treatment approaches are available
• River East Physiotherapy’s approach to rehabilitation

Prefer to talk, rather than read?  Call us to book a concussion assessment, or set up a FREE 15-minute phone consultation with one of our physiotherapists:

What is the anatomy of the brain?

The brain is a soft organ that sits in the hard skull for protection. It is cushioned by cerebrospinal fluid that fills in the space between the skull and the brain.  The cerebrospinal fluid acts like packing foam. It protects your fragile brain from the insides of your hard, moving skull.  It also protects your brain from rapid and sudden motions your head may experience.  

The brain is the control centre for everything you do. Damaging the brain can alter your ability to perform tasks both mentally and physically.

What causes a concussion?

Any force that causes the brain to move rapidly within the skull and bang against the inside of the skull can cause a concussion.  Essentially, a concussion can be caused by anything that ‘rattles the brain.’

Previously, concussions were thought to be caused only by direct blows to the head, such as in boxing or bar fighting, or by hitting your head on the ground during a fall.  But we now know indirect forces to the head commonly cause concussions. For example, a fall onto your buttocks or onto any other part of your body can transmit a force to your brain strong enough to cause a concussion - even if you do not hit your head during the fall.  Similarly, a blow to your neck, face or any other area of your body that is severe enough to transmit the force to your head can cause a concussion.

Motor vehicle accidents often cause concussions due to the whiplash motion of your neck, which may force your brain to rapidly hit the inside of your skull.

Shaken baby syndrome is another example of an indirect mechanism of brain injury. So is an explosion which rapidly transports your body.

What are the symptoms of a concussion?

Signs and symptoms of a concussion can vary extremely between people.  It is not always obvious that someone has a concussion, so if the mechanism of injury for a concussion was present, a concussion should always be suspected and thoroughly investigated.  

You do not need to lose consciousness to suffer a concussion, and in most cases there is no loss of consciousness.  If you do lose consciousness, however, you have most certainly sustained a concussion.  Any loss of consciousness should be taken seriously, and any bouts lasting more than approximately a minute are considered severe.

Signs and symptoms of a concussion can vary extremely between individuals and can last days, weeks, months, or even longer in some cases.  Fortunately, however, in the majority of cases symptoms usually resolve within 7-10 days.

One of the most common symptoms of a concussion is a headache.  Confusion is another common sign. This sign can easily be overlooked by an examiner unless you are moderately to severely confused.  So ruling out a concussion should not be based on the fact that the patient ‘did not appear confused.’  

Other signs and symptoms of a concussion may include:

• concentration difficulties,
• decreased attention,
• difficulty with mental tasks, memory problems,
• difficulties with judgment,
• a decrease in balance and coordination,
• a feeling of disorientation,
• a feeling of being ‘dazed,’ fatigue,
• blurred vision,
• light and/or sound sensitivity,
• difficulty sleeping or sleeping more than usual,
• being overly emotional,
• being irritable or sad,
• neck pain,
• a feeling of ‘not being right’, and
• ringing in the ears. 

Amnesia may be another symptom.  Two types of amnesia can occur:

• Retrograde amnesia, which is forgetting events that happened before or during the concussion event, or
• Anterograde amnesia, which is when you do not form new memories about events that occurred after the concussion.

In severe concussions, a change in personality may even occur. 

If someone shows even one sign or symptom listed above, a full concussion assessment is strongly recommended.

If your signs and symptoms are more severe after an injury to the head, you may have a severe brain injury. Get immediate medical attention. More severe signs and symptoms include:

• recurrent vomiting,
• a change in pupil size,
• blood or fluid coming from the ears or nose,
• seizures, or
• obvious physical coordination or mental difficulties.  

In most cases, signs and symptoms appear immediately after the concussion has occurred.  However, in some cases the signs and symptoms can be delayed by a few hours, or possibly even days.  This is why, even with a lack of obvious symptoms you should get a concussion assesment within a reasonable time frame, so a concussion must be thoroughly ruled out before returning to sport or activity. 

How do health care professionals diagnose a concussion?

Diagnosing a concussion can be easy in cases where there was an obvious mechanism of injury involving a blow to the head, and when there are immediate signs and symptoms to indicate the brain has suffered an injury.

In many cases, however, a concussion can be overlooked when:

• the mechanism of injury does not directly involve a blow to the head,
• the signs and symptoms are not obvious, or
• the signs and symptoms are delayed in their onset. 

The person may initially ‘appear fine.’

Diagnosis of a concussion begins with a complete history of the mechanism of injury. As stated above, any blow to the head or force through the body that is strong enough to transmit a force to the head will make your health care professional suspect a concussion.  At a sporting event, often the sideline health care professional has seen the mechanism of injury, which helps with diagnosing a concussion.

The history will include questions about any previous concussions. The more concussions you incur, the higher your chances of sustaining another concussion. And a concussion can more easily occur with decreased force.

Thorough questioning regarding the person's symptoms is the next step to diagnosing a concussion.  With sporting events, symptoms should be evaluated immediately on the sidelines by a health care professional or a coach well educated in concussion signs and symptoms.  If neither is available, they should be immediately referred to a medical doctor.  

Since symptoms can appear immediately or be delayed, it's important to monitor for concussion symptoms for at least a few hours.  Symptoms may even be delayed a few days. So if the injury indicates a potential for a concussion, the person should be monitored for a few days after the injury.  During this time the patient should not be allowed to participate in sport or challenging cognitive activities.

It is important to monitor for not only the initial emergence of any concussion signs or symptoms, but also for the worsening of any existing symptoms, or any decline at all in the patient’s ability to perform physical or cognitive tasks.

When initially diagnosing a conccusion, cognitive function should also be evaluated. General questions regarding orientation that have traditionally been used, such as ‘who are you?’, ‘where are you?’, and ‘what time is it?’.  But these have not been shown to be sensitive enough to pick up a decline in cognitive function. For this reason, diagnosis of a concussion should not be ruled in or out based solely on these general questions. 

More advanced questioning can help identify a decline in cognitive function, indicating injury to the brain. For instance, at a sporting event, questions such as ‘who scored the last goal?’, ‘which team was played last week?’, or ‘how far into the game is it?’ can help identify a concussive state.  More advanced sideline concussive cognitive tests are also available, and are useful in sports where concussions are common.  Outside of sport, more in-depth questioning such as the exact location of a street, or questions regarding the full date and time of day may help determine the person's cognitive status.

Whether on field, at the emergency department, or in the medical clinic, a person with a concussion should receive a thorough physical examination.  This exam will look for signs such as pain in the neck, which may indicate a concurrent cervical spine injury, amnesia, or soft tissue injury to the skull.

Following the physical examination, a clinical neurological examination may be done. This will include tests for:

• strength and sensation,
• reflexes,
• coordination,
• visual and auditory disturbances, and
• cognitive impairment, including deficits to memory or concentration. 

A balance and gait assessment should also be considered.  Balance issues are often a sign of reduced motor (movement) function when a patient suffers a concussion. Balance that is not disturbed, however, does not mean a concussion did not occur.

A concussion is a functional injury to the brain, rather than a structural injury.  This means we can't see physical damage to the brain tissue, but rather, the brain starts functioning differently.  For this reason, neuroimaging tests such as computerized tomography (CT) scans or magnetic resonance images (MRI) that look at brain structure are not able to diagnose a concussion. 

When someone does receive medical imaging, findings are usually normal, even when the person shows clinical signs of a concussion. In other words, you can still have a concussion, even a severe one, even if your CT scans or MRI results are normal.  For this reason, your doctor will likely not order neuroimaging, unless they suspect true structural damage to the brain. That said, sometimes X-rays of the skull may be considered to rule out bony injury to the skull itself, depending on how the injury occurred.

Currently there are no neuroimaging tests that can identify the changes in the brain that occur with a concussion. New MRI neuroimaging testing which is sensitive to brain electrical activity (functional MRIs also knows as fMRI) and MRIs that are more sensitive to minute structural damage (perfusion and diffusion tensor imaging).  And other types of new imaging technologies are currently being trialed and extensively researched.

These tests show hope in potentially creating a gold standard neuroimage test that identifies a concussive state.  Some major hospitals or clinics may already have these tests available, and if so, these tests add valuable information to diagnosing a concussion and analyzing clinical symptoms.  At this stage, however, not enough research has been completed on these tests to warrant their use as a standard procedure in the diagnosis of a concussion.

What is the treatment for a concussion?

The professional guidelines for treating concussion have changed over the years.  Previously, it was thought you had to rest until all symptoms are completely gone.  Now, it's recommend to only do activity as tolerated, although rest will likely be an important part of your recovery as well.  

Rest for a concussion means both a physical rest but also a cognitive rest. This means not only will sporting activities or manual work activities not be allowed, but also mental activities requiring attention and concentration.  This usually means watching television, working at the computer, reading, texting, and doing schoolwork should be avoided. The brain simply needs time to heal, as with any other injury to the body. 

The eyes and ears can be particularly sensitive to sound and light after a concussion. Even normal lights and sound can precipitate symptoms, so it's likely you'll need to limit your exposure to light and sound.  That said, it's rare to prescribe lying alone in a quiet and dark room anymore. 

On your own, it can be difficult to determine how much activity (physical or cognitive activity) is too much. Our physiotherapists can help guide your activity as you recover from concussion.

Once your initial signs and symptoms have resolved, then your physiotherapist will help you develop a plan to gradually increase your cognitive and physical activity, while monitoring your symptoms. Once you can tolerate this gradual increase in activity, without bringing your symptoms back, you'll consider together when a gradual return to work or sport is appropriate.

Treatment during a sporting event

If the concussion is suspected during a sporting event, the player should be immediately removed from the game and not be allowed to return to play that day, under any circumstance.  Serious injury to the cervical spine should be ruled out and then a full concussion examination should proceed.  An ice pack can be applied to the neck or head if pain is present in either of these areas. 

If it is unclear whether the player does have a concussion, err on the side of caution and assume a concussion is present, until it's thoroughly ruled out. Follow the common sporting cliché of “when in doubt, sit them out.” 

In the event of an injury from force occurring outside of sport, such as a motor vehicle accident or fall from a height, assume that a concussion has occurred until it has been thoroughly ruled out.

Immediately after a concussion, a person should not be left alone.  They should be monitored for a few hours for any new signs and symptoms, or any deterioration of existing signs and symptoms.

If the person does not exhibit any signs or symptoms indicating a severe concussion, and they have not deteriorated over several hours of monitoring them, it is fine to let them sleep - this will aid their recovery. They do not need to be awoken every few hours, unless a medical doctor has examined them and has specifically advised this be done. In severe cases, some concussed patients may be kept in the hospital for monitoring overnight.

Recovery time from concussions

Fortunately the majority of concussions (80-90%) resolve in a short period of 7-10 days.  Several factors, however, may lengthen recovery times and will require typical management of a concussion to be modified. 

Severe concussions, or those concussions where the symptoms last longer than expected, will require a longer recovery period.  People who have had a loss of consciousness of greater than one minute also generally require a longer recovery period, as do children and adolescents whose brains are still developing and are therefore more sensitive to injury. 

Repetitive concussions create cumulative injury to the brain and therefore generally require a longer period to recover after each time they occur. People with less muscular necks (often, but not necessarily, females) may incur more severe concussions. Increased neck musculature may help to absorb some of the forces that the body endures, which may decrease the severity of a concussion.  For this reason females may require a longer recovery period before returning to work or play.

Interestingly, patients who suffer from migraines, mental disorders, depression, sleep disorders or attention deficit syndrome may also require a longer period to recover. These factors should be considered when planning return to activity protocols.

Neurocognitive testing (testing one’s ability to think) can be used as a way to measure a person's cognitive abilities, reaction time, and overall mental processing abilities as they recover from a concussion.  It is not uncommon for a patient to ‘feel fine’ after a concussion, including having their physical symptoms resolve, but for their cognitive abilities to still be deficient. For many high level sports teams, a baseline neurocognitive test is done pre-season so that if a concussion occurs, test results post-concussion can be compared and used as an evaluation of whether the player is back to pre-concussion status before returning to play. 

There are several neurocognitive tests being used, and there is not one gold standard test yet identified.  Most tests consist of computer-generated tasks that measure reaction time and cognitive ability.  Tests are available in a variety of languages and normative value ranges are available if a pre-test has not been completed.  Neurocognitive testing should not, however, be used as a sole predictor of return to activity timelines.  All physical symptoms must still be considered, a full medical clearance completed, and then a graduated return to play protocol implemented.

Examples of these tests include The Axon Sports Computerized Cognitive Assessment Tool (CCAT) and The ImPACT test (Immediate Post-Concussion and Cognitive Test.)  Other tests that are designed to be administered once a concussion has occurred, such as the SCAT5, can also be administered pre-season in order to establish baseline information about each individual, however they are not as encompassing as the neurocognitive computerized tests available, therefore when available, a baseline computerized neurocognitive test should be carried out.

Post-concussion neurocognitive testing should not, however, be used as a sole predictor of return to activity timelines.  All physical symptoms must still be considered, a full medical clearance completed, and then a graduated return to play and return to learn protocol implemented.

Prevention

The best treatment for a concussion is prevention.  Regarding concussions from sport, protective equipment such as helmets and mouth guards should be worn to absorb forces, and equipment should be the latest in technology where feasible.  New equipment such as helmets and other protective pieces are continually being researched and tested in order to improve their shock absorbing ability and decrease the severity of concussive forces sent to the brain.

Athletes and non-athletes should maintain their body strength and physical fitness, since stronger musculature may protect against forces transmitted through the body.  It may also better control any abhorrent forces transmitted to the head and neck. This musculature may decrease the severity of any injury sustained.  

Decreasing risk-taking behavior in sport or everyday is also a way to prevent head injuries. For example, seat belts should be worn at all times when in a vehicle.  Helmets should be worn for biking, and hard hats during manual labor tasks.  Ladders should be well secured to avoid falling from a height.  Unnecessary hits during sport and overall sporting risk-taking behaviors should be minimized or avoided. 

In addition, athletes should stay well hydrated while partaking in their sport so that their cognitive awareness for injury-causing situations is at peak performance throughout their game.  Even something as simple as removing or securing throw rugs in your home can assist in decreasing the risk of a fall and a resultant concussion.

Can medications help me after a concussion?

Immediately after sustaining a concussion medications, avoid taking medications until you have a full concussion assessment. Until you consult a medical doctor, even over-the-counter drugs such as ibuprofen, nurofen, paracetamol, or acetaminophen may be risky.

Your doctor may prescribe you medication for your concussion for two main reasons:

1. Medication may target the concussion injury itself, to decrease initial symptoms or duration of symptoms. 
2. Medication may target the secondary symptoms arising from the concussion such as sleep deprivation, or emotional lability. 

Many doctors choose not to medicate at all when treating a concussion, in order to not mask any symptoms.  

Alcohol and illicit drugs should be strictly avoided when recovering from a concussion.

What will I do to rehabilitate from a concussion?

Returning to sport, work or everyday activities after a concussion requires a specific return to activity plan that is closely monitored for the re-appearance of concussion signs and/or symptoms.  Your physiotherapist at River East Physiotherapy, along with consultation from your treating doctor, can create, implement, and monitor your return to activity plan.

If you are a student, it is recommended that your health care professional contact your school to ensure they are aware of the recent concussion, and to also ensure they are on-board with Return to Learn and Return to Activity guidelines.  The whole health care team of a concussed patient should follow the same conservative guidelines, in order to optimize recovery.

The backbone of rehabilitating from a concussion is rest, until symptoms subside. Then follow a graduated return to cognitive and physical activity, under the guidance of your physiotherapist.

Returning to work or sport following a concussion proceeds through a basic sequential process.  Your physiotherapist will specifically guide you regarding the amount of activity you should engage in.  They'll monitor you for signs or symptoms to ensure the healing brain is ready for each progressive level of physical or cognitive activity.  

As a general guideline, the steps in this sequential process are:

1. No activity, complete cognitive and physical rest
2. Light aerobic activity; exercise such as walking or stationary cycling and/or light cognitive activity such as reading or computer work for a short period
3. Sport-specific training such as running and/or work/school specific tasks such as working on spreadsheets, solving math problems, or engaging in more mentally challenging tasks
4. Non-contact training drills for athletes, more intensive or longer duration physical activity for non-athletes (longer walks) and mental activities of longer duration or combined mental activities such as reading with the television on
5. Once cleared by a doctor, athletes begin with full-contact training.  Non-athletes are medically cleared to begin back to some regular everyday activity
6. Return to competition for athletes at a graduated level (ie: athlete returns to play in one quarter or only on certain offensive/defensive plays.) Non-athletes return to work/school gradually (ie: half days to start or fewer cognitive tasks during a full day).

Each of the 6 stages of the general return to activity plan will occur over a 24-hour period, which means that for athletes suffering a concussion, full return to sport will not occur earlier than approximately 6-7 days after the initial injury. 

If at any stage during rehabilitation signs or symptoms arise, your physiotherapist will ask you to cease the current activity and return to resting for a minimum of 24-hours, or until all symptoms have resolved.  Activity will begin again once all symptoms have subsided. 

Cognitive and physical tasks should begin again at the same level where no symptoms occurred (it is not necessary to return all the way back to stage one unless it is the progression to step two that has caused the symptoms) and proceed then to the next level only once the task at hand has been completed without generating signs or symptoms. 

Each step can be progressed if it is undertaken without any symptoms arising during or after the exertion, and your physiotherapist is content with all aspects of your exertion ability and your physical response to this exertion. 

It is worth mentioning again that no step should be progressed earlier than 24-hours after the previous step.  Latent signs and symptoms may appear within this time frame, so it is important to allow sufficient time for these to emerge, but also to give the brain time to recover from the exertion during the rehabilitation process itself.

By following a progressive sequence of increased physical and mental exertion you will be allowed (and encouraged) to exert yourself during rehabilitation - as long as this exertion does not bring on signs or symptoms.  In other words, exertion both physically and mentally during rehabilitation should be sub-maximal and below a symptom threshold. 

As mentioned above, in some cases a longer rehabilitation with a longer return to activity plan may be necessary.  For instance, when loss of consciousness was greater than one minute, or in patients who have had repetitive concussions.  In these cases, patients may find they must continue doing activity at one threshold for longer than the 24-hour period while the brain heals.  Allowing an athlete to exercise sub-maximally while recovering from a concussion (rather than not exercising at all) is important for helping them maintain their fitness and psychological state while sitting out with an injury.

While engaging in your rehabilitation plan, remember any additional physical or cognitive activity outside of this plan adds to the stress on your brain.  Going to the movies, completing your taxes, or walking around the shopping centre for the day will all add stress to your healing brain.  Tell your physiotherapist about all the extracurricular activity that you plan to do, so they can take this into account when developing and modifying your rehabilitation plan.

Your physiotherapist at River East Physiotherapy will be fundamental in guiding your rehabilitation and return to activity plan after a concussion.  They will provide you with criteria regarding the levels of physical and mental exercise to work towards, and will also monitor physical exertion signs, such as your heart and breathing rate, in order to appropriately progress your physical exertion levels from light through to heavy. 

Your physiotherapist will document your symptoms to monitor for any changes with increasing levels of exertion.  They will use special tests for balance and physical coordination to monitor your physical ability as you recover.  Your physiotherapist will also analyze your individual circumstances and specifically tailor your return to activity to incorporate any special circumstances that may apply to you. 

For instance, if you are returning to a sport where the risk of a second concussion is high (such as soccer), your physiotherapist may delay your return to play for a longer period than if you were returning to a lower risk sport. The period will also be shorter if you're only returning to work or scholastic situation where your risk for a second concussion is low, or none at all.

Your physiotherapist will also consider factors such as your predisposition to migraines, learning disabilities, and any previous concussions when tailoring your individual rehabilitation plan to you.

If you received any other injuries when you sustained your concussion, such as a soft tissue injury to your neck or any other injury, your physiotherapist at River East Physiotherapy can also treat this injury.  Your therapist will ensure that not only your brain is ready and prepared to return to your regular activity, but that the rest of your body is also ready. Manual therapy, massage, electrical modalities and specific exercises may be used to treat your neck.  It should be noted that in some cases hands-on treatment to the neck area after a concussion can bring symptoms on.  Your therapist will closely monitor for this, and treatment will be modified accordingly.

Each patient is unique in both their concussion signs and symptoms, as well as in the sport or job they need to return to, therefore close and frequent monitoring of your return to activity plan by your physiotherapist is necessary.  Your physiotherapist at River East Physiotherapy will be in close consultation with your doctor and any other health care professionals that have been involved in the care of your concussion injury to ensure you are returning to your regular activity as quickly but also as safely as possible.  Medical clearance from your doctor will be needed before certain levels of activity are undertaken.  For those returning to sport, your therapist may also consult with your coach to discuss implementing a gradual return to activity within your practices and matches.

It is worth mentioning again that full recovery from a concussion involves the ability to both physically as well as cognitively handle complex tasks without creating any symptoms.  Decreased cognitive function is more easily overlooked than physical symptoms and therefore special attention will be paid by your physiotherapist to your cognitive function as you recover.  Your physiotherapist may use neurocognitive testing to get an objective measure of where your reaction time is at, or to ensure that mentally challenging tasks do not provoke symptoms.

Variables such as stress in a job or the stress of an important sporting event can slow concussion recovery. Your physiotherapist will take this into account when designing your rehabilitation plan.  Other variables such as noise and lights can easily aggravate symptoms, and they will also be taken into account when you are in the final stages of returning to full activity. For instance, the music and lights during a dance/stage performance, the bright lights of a nighttime playoff game, a match within a large busy stadium, or an office/classroom that is lit with fluorescent lighting can aggravate symptoms.  Where possible, your physiotherapist will attempt to incorporate your regular sporting or work environment into your return to activity plan to ensure the activities you engage in are as similar as possible to those you will incur in your normal environment once you are fully back into action.

Is physiotherapy right for you, and your unique condition? Call us to book a FREE 15-minute phone consultation with one of our physiotherapists:

If even mild signs or symptoms resulting from the concussion are lingering, it is absolutely critical that you do not return to regular activity or sport.  This is more true if your activity/sport creates a risk of incurring another concussion.  If you do return to activity, the risk of getting a second and more damaging concussion is increased.  This is because your lagging cognitive function and reduced reaction time leaves you more vulnerable to a second injury. This is termed Second (Poly) Impact Syndrome.

Second Impact Syndrome

Second (Poly) Impact Syndrome (SIS) is a condition that occurs when a patient incurs a second concussion before full recovery has occurred from an initial concussion.  The second blow does not need to be forceful in order to cause SIS.

SIS is considered rare, but is a very serious condition and can result in death or severe brain damage.  In SIS, the brain rapidly swells and/or bleeds following the second blow. This trauma triggers progressive degeneration of the brain tissue, including a build-up of an abnormal protein called Tau.  

Symptoms of a build-up of Tau protein in the brain or spinal cord include:

• memory loss,
• confusion,
• impaired judgement,
• impulse control problems,
• aggression,
• depression,
• suicidality,
• parkinsonism, and, eventually
• progressive dementia.

SIS occurs most often in young athletes under the age of approximately 25.  When it does occur, it has a high fatality rate among these athletes.  Due to the real possibility of SIS, and the seriousness of this condition, a conservative rather than aggressive return to activity protocol should be followed after a concussion.

Post Concussion Syndrome

Post concussion syndrome (PCS) is the presence of symptoms from a concussion, which last much longer than expected.  Symptoms may last weeks, months, or occasionally even years.  Symptoms are varied but can be physical, such as a headache or dizziness, or may be cognitive such as difficulty concentrating or performing mental tasks.  Other symptoms such as light sensitivity, or emotional irritability may also occur.

The cause of PCS is unclear.  One belief is that structural damage to the brain causes the ongoing symptoms.  Others believe, however, that the symptoms develop due to a psychological or emotional reaction to the initial injury.  In any case it is considered abnormal and a complication of a concussion.

In most cases, PCS symptoms resolve in approximately 3 months.

Depression

Depression has been reported as being a potential long-term consequence of concussion and when present, may be considered a symptom of PCS.

Further research is needed to accurately link concussions to depression. However, research does suggest the greater the number of concussions sustained, the greater your risk for depression.

River East Physiotherapy provides services for physiotherapy in Winnipeg.

The brain is a resilient but sensitive organ.  Brain injury can affect how you function physically, mentally and emotionally.  This affects everything, from your day-to-day tasks, your work, and you ability to play the sports or hobbies that you love. 

Most signs and symptoms of a concussion resolve relatively quickly, and our physiotherapists can help you get back to your active lifestyle. In some cases signs and symptoms of concussion can last a long time, affecting a person's ability to function. A customized concussion rehabilitation plan can reduce the chance of persistent concussion symptoms.

The best treatment for concussion is prevention.  When a concussion does occur, however, we encourage you and your entire healthcare team to take a conservative, evidence-informed approach to getting you back to your activity.

Not sure if physiotherapy is right for you and your condition?  Call us to book an assessment, or to arrange a FREE 15-minute phone consultation with a physiotherapist: