Managing a concussion
July 16, 2015
So hopefully we all wear helmets when engaging in skiing, biking and climbing. The helmet won’t reduce the risk of a concussion but will certainly reduce the risk of contusions and fractures which can further complicate the injury.
After a head injury the first step should always be appropriate medical examination and treatment to exclude the possibility of any further injury.
Approximately 85% to 95% will recover in the first three months with roughly 10% having a more complicated recovery. Patients suffering the longer term effects of a post concussive symptom are usually the ones I see presenting in my osteopathy clinics in Vancouver and Whistler.
Initially cognitive rest is usually recommended for patients. This involves complete avoidance of stressors such as television, PC, texting, video games and work. Patients also need to rest in a quiet often dark environment to help relieve their symptoms.
When returning to work it is useful to have a reduced work week with shortened days, including regular scheduled breaks every 30 minutes or so. Any exposure to tasks that worsen the symptoms should be decreased.
6 Step Return to play protocol
- Baseline Patient must be on physical and cognitive rest with no symptoms for at least 24 hours.
- Increase heart rate increase heart rate for 5-10 minutes through mild activity such as walking, light jogging or exercise bike.
- Moderate exercise limited body and head movement through more moderate intensity such as brief running or moderate weight lifting.
- Noncontact exercise increase intensity but avoid contact. More intense running, stationary biking or non-contact sport specific drills.
- Practice reintegrate into full contact practice.
- Play return to competition
From May KH et al. Int Journal Sports Phys Ther 2014:9(2): 242-255
At each stage of the process symptoms should be closely monitored and athletes should not progress if they experience symptoms. If symptoms are experienced there is a need for additional rest. When symptoms have been absent for a minimum of 24 hours you can begin at the previous step where symptoms occurred. Each athlete will progress at different rates and it may take several weeks to complete all phases of recovery.
In my next blog I will discuss how osteopathy can help.
Taken from an article by Pat F Bass III, MD, MS, MPH Aug 01,2014