Concussion in Sports 

Concussions are common in athletes.  They commonly occur in contact sports, such as football, and non-contact sports, such as soccer. BSR Physical Therapy and our doctors of physical therapy can help evaluate, manage and treat patients with concussion.  This article helps to answer some common questions you may have.

What is a Concussion?

“Sport-related concussion is a traumatic brain injury induced by biomechanical forces … This may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.”

Does it Show up in MRI, CT Scans or X-Rays?

Acute concussion injuries do not show up on imaging.  Emergency room departments will commonly perform CT scans for the brain and skull to ensure that there are no fractures, brain bleeds or serious injuries.  MRI will commonly not find any acute injuries as well, but new research has shown chronic changes in the brain long after the time of injury.

What are the signs and symptoms of a Concussion?

Some common symptoms include neck pain, dizziness, blurred vision, difficulty concentrating, sensitivity to light, sounds, and motion sickness.  Some people can also experience changes in mood or behavior.  It is common to have symptoms immediately but some can develop in hours or over the next couple of days.  In most cases, symptoms resolve on their own with relative rest, however, there are some cases that last a little longer than usual (more than a week or two).

When should I seek professional help?

High school athletes should have an athletic trainer as part of the sports medicine team to evaluate the athlete for a suspected concussion.  Athletic trainers are qualified healthcare professionals to manage suspected head injuries and refer out when appropriate. In cases where symptoms do not resolve with time and relative rest, appropriate referral to a healthcare professional is indicated.

How can physical therapists help?

Physical therapists may be asked to help manage and treat those who still have lingering symptoms from a concussion.  The physical therapist should take a good history of the injury and progression of the symptoms. A comprehensive physical examination should be performed to assess neck motions, balance, concentration and eye movements to see if there are impairments causing symptoms and limiting functional ability.  An individualized plan of care and treatment is then provided to decrease concussion symptoms and progressively return to activity.

When can I go back and play?

Each case is unique in presentation, so no two concussions are alike no matter how “bad” they initially looked.  So the answer really is, it depends. The physical therapist will put you through a thorough return to activity protocol to simulate the demands of your sport to help gauge the readiness to return to sport.  In the end, in the State of New Jersey, a physician has the power to medically clear an athlete to return to sport, but a collaborative effort between the physical therapist, athletic trainer and physician should be made to ensure a safe return at a high level.

Conclusion

In summary, sports-related concussions are common in athletic endeavors in both contact and non-contact sports.  Symptoms from concussions usually resolve on their own with time and relative rest.  When symptoms linger for longer than usual, a qualified healthcare professional should be consulted.  Physical therapists are able to help assist in treating patients who have post-concussive symptoms and help return an athlete to play at a high level.   Give us a call if you would like some help getting back in the game after a concussion.

by Dr. Mark Daitol, PT, DPT, CSCS

Blood Flow Restriction Therapy Improves Strength without Stressing Joints

Blood flow restriction (BFR) therapy uses external pressure over a body part during exercise. The applied pressure allows the flow of blood through the arteries.  However, it decreases blood flow in the veins past the restricted site. This makes the working muscles tire more easily.  Therefore, the patient is able to make greater strength gains while lifting lighter loads.  This reduces the overall stress placed on the injured joints or tendons.  The result is a stronger muscle without pain.

How Blood Flow Restriction Therapy Improves Strength

Normal strength and muscle size gains happen from lifting weights close to 70-80% of a person’s one-repetition maximal effort (1RM).  Lifting with so much weight is not a good idea for people recovering from an injury or surgery.

BFR therapy allows strength gains with only 20-30% 1RM.  Most importantly, it does so without stressing the injured areas. This is great for patients following an injury or surgery.  Also, a recent study looked at BFR exercise in a patient with Parkinson’s disease and found they were able to improve their walking ability.

Is Blood Flow Restriction Safe?

Medical-grade tourniquets maintain a safe level of pressure for a long time while a patient undergoes surgery.  Similar tourniquets are used with BFR therapy.  A 2016 large systematic review looked at BFR exercise and found little to no research showing a higher risk than typical exercise at higher resistance loads.

However, one should not take a simple rubber band or strap and wrap it around their leg or arm to stop blood flow.  This will increase the risk of bodily harm and serious injury.  Also, people with chronic medical conditions, a compromised cardiovascular system, or other medical problems are not suited for BFR therapy.  Only a trained medical professional can help you decide if BFR is right for you.

How to Get Started with BFR Therapy

Blood flow restriction therapy is a treatment physical therapists utilize to help patients increase strength without loading joints and muscles.  BFR therapy is proven to help people with arthritis, neurological disorders, tendon problems, and those recovering from surgery.

BSR Physical Therapy prescribes BFR exercises as part of a comprehensive treatment plan for patients at our Barnegat clinicCall our office to schedule an appointment.