Concussions: An Overview
As someone who personally administers these protocol tests weekly, let me provide you some insight. Concussions are serious, and no two concussions are alike. I like to describe a concussion as a bowl of jello, now think of that jello smashing into the sides of the bowl repeatedly. That is basically what happens to the brain when we suffer a concussion. The brain is essentially bruised, the same as if your arm were to get bruised. The major difference is that this is not just a simple muscle sustaining a bruise; the brain is a complex structure that does not tolerate ‘bruising’ well. Often there is no physical damage to the brain, but instead disruptions in the ‘wiring’ and chemical connections of the brain. Similar to the wiring in a car, if there are issues with the wiring then there is a good chance the car won’t function properly, same thing with the brain. Some of the symptoms of concussions including difficulty concentrating, sleeping (either too much or too little), fatigue, dizziness, lightheadedness, balance troubles, sensitivity to light (and sometimes sound), poor reaction time, and issues with fast moving objects (like being in a car sitting at a red light and watching cars go past you). Many patients have told me that the best thing for them when they experience these symptoms is just to sit in a quiet dark room and wait for things to settle down. The good news is that about 80-90% of the symptoms from a concussion resolve within 7-10 days. Unfortunately about 5-10% of people who suffer a concussion will deal with the symptoms for over a month after the injury, at this point the term is post-concussive syndrome.
The most important treatment for a concussion initially is rest, both physically and mentally. The brain needs time to heal. However, too much time off has shown to be counterproductive, so an early return to light activities, guided by a properly trained healthcare professional, is important. Vestibular therapy, which can involve retraining the balance and vision systems of the brain, is often essential in getting the patient back to their baseline. A graduated return-to-play (RTP) is vital in making sure that the symptoms completely resolve and do not return with increased activity. Once the patient is fully cleared, they can often return to full activity with the understanding that if any concussion-related symptoms return, then backing off is the smartest idea. Suffering from a single concussion places the person at about 6-8x increased risk for sustaining another concussion (compared to someone who has never sustained a concussion before). I could write about concussions all day, but I think this is a good place to stop, as it provides you with a brief summarization of what occurs when someone sustains a concussion.