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