football

Concussions

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As popularized throughout sports, concussion has been a trending topic throughout all media outlets. In the last decade expert scientists, physicians, and other healthcare providers have strived to address the wave of questions and concerns raised by those affected and their loved ones. 

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Though most of the literature reviews and studies sports related concussions, I believe much of the information can be applied to the many individuals with general concussions. With winter in full effect, concussions can be caused not only from winter sports, but also from accidents caused by ice (motor vehicle accidents, slip and falls, etc).

 

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This past summer, I attended a Seattle Pediatric Sports Medicine conference that had a panel of healthcare providers who manage patients with sports-related concussions. They discussed the current topics on concussion management and how they approach each case. Most members of the panel were a part of the University of Washington Concussion team.

 

The University of Washington does a great job in providing information on the background and general symptoms of concussion. You can access their tremendous resource here. 



 

The main points I took from the conference is that current up-to-date acute treatment of concussion does not require the affected individual to sit in a dark room until symptoms to diminish. These individuals don’t require prolonged avoidance of TV or phone screens. Additionally I learned that chronic traumatic encephalopathy (CTE) is still in its infant stages of research and scientists are unable to conclude that multiple concussions are the actual causes of CTE. The most important fact I was reminded of was that concussion treatment requires a team approach, which can sometimes include physical therapy. 


HOW PHYSICAL THERAPISTS CAN HELP

 

According to the most recent consensus statement released by the Concussion in Sport Group in 2016, “Sports related concussions can result in diverse symptoms and problems, and can be associated with concurrent injury to the cervical spine and peripheral vestibular system… the data support interventions including psychological, cervical, and vestibular rehabilitation.”1 You can read more here on the 2016 Berlin Concussion Consensus Statement.

 

Most concussion symptoms tend to resolve after 2 weeks. However if there are lingering symptoms, seeing a physical therapist may be a great option to help with an individual's recovery. Here is how we can help.

 

NECK REHABILITATION

 

Sustaining a concussion can result from multiple types of head trauma. What affects the head likely affects the neck. The body will do everything it can to protect the head and often stiffen your neck. With pain playing the role of your alarm system, it’s with no surprise that the neck becomes extra guarded and irritated when you try to move it. Physical therapists can improve your cervical and thoracic spine mobility and implement strategies and interventions to decrease your discomfort. From manual therapy to progressed therapeutic exercises, PT interventions can help improve neck function.

 

VESTIBULAR REHABILITATION

 

Vestibular specialized physical therapists can help those after concussion who continue to feel dizzy or off-balanced. Symptoms may include but are not exclusive to dizziness, vertigo (room spinning), disequilibrium (off balance, nausea), and visual impairment. Seeing a physical therapist who specializes in vestibular rehabilitation can be a valuable member on your team. After a thorough evaluation, they can provide you strategies and exercises to help your vestibular system adapt.2

 

Benign Paroxysmal Positional vertigo (BPPV) is the most common vestibular pathology that can occur after head trauma. Symptoms include head motion-induced vertigo, normally triggered when rolling in bed or turning the head quickly. This vertigo lasts for seconds, often followed with a fog or lightheadedness lasting for hours afterward. If diagnosed correctly, this can be treated with great success by a trained professional.3 You find more information here.

VESTIBULAR PAGE

 

LOWER LIMB INJURIES RISK REDUCTION

 

Though not mentioned in the 2016 Consensus, within the sports concussion literature there has been growing evidence on how concussions may have an influence on future lower limb injuries. What is proposed is that after a concussion, the joints, muscles, and tendons in your legs have an impaired ability to detect where they are in space. Though this may not fall into the category of concussion rehabilitation, orthopedic rehabilitation can help address proprioception and neuromuscular control impairments for athletes who are looking to return to play.4

 

As for other common symptoms stemming from a concussion, other professionals including neurologists (migraine/headache specialist), neuropsychologists, speech therapists, and vision therapists would be great resources to consult. Ask your concussion management team if physical therapy is right for you and your symptoms and find a local clinic that has a clinician there to help you.

 

REFERENCES:

 

1.     McCrory P, Meeuwisse W, Dvorak J, et al Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 Br J Sports Med 2017;51:838-847.

2.     Gurley JM, Hujsak BD, Kelly JL. Vestibular rehabilitation following mild traumatic brain injury. NeuroRehabilitation. 2013;32(3):519-528. doi:10.3233/NRE-130874.

3.     Benign Paroxysmal Positional Vertigo (BPPV). American Physical Therapy Association. https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=52822493-32f3-4d4c-8c56-8e18c41b2f85. Published September 1, 2015. 

4.     Kardouni JR, Shing TL, Mckinnon CJ, Scofield DE, Proctor SP. Risk for Lower Extremity Injury After Concussion: A Matched Cohort Study in Soldiers. Journal of Orthopaedic & Sports Physical Therapy. 2018;48(7):533-540. doi:10.2519/jospt.2018.8053.

 

Information provided on lakewashingtonPT.com and all of its web pages is intended for general educational and entertainment purposes and is not intended to be medical advice to you or any other person. You should always consult with your own medical provider about your health and medical questions and never rely on this or any other web site alone to make medical decisions. Never delay seeking medical advice or disregard any medical advice you have received from your provider because of anything you read or hear on this website.

DK Metcalf Has Knee Surgery

DK Metcalf Has Knee Surgery

Weeks after seeing their first-round pick, defensive end L.J. Collier, carted off the practice field with an ankle sprain, the Seahawks have been dealt another injury blow – and potentially two – to their 2019 draft class.  The Seahawks returned to practice last week, and did so missing their easiest to spot on the practice field number  14, DK Metcalf.  Not everyone will be available this week, and that includes the rookie receiver DK Metcalf, who had what Carroll called “a minimal surgery” on his knee last week.  

 

When a coach or GM says minimal what they are typically referring to is minimally invasive, which typically indicates arthroscopic surgery and a very small amount of work done. No formal explanation has been given, but left to speculate it was most likely a meniscus cleanup with a little PRP.

 

During his presser Carol stated, “It was a minimal surgery, minimal findings, so we have high expectations.” He added, “We’ll go week to week with it and see how he does. We really don’t have any concern that he won’t get back soon. So we’re excited that we got it done. It was the kind of deal we could have put off and waited, but we thought we would use the timeframe we had available and hopefully it’ll work out just right for us.”

Best of Luck

Best of Luck


"I've been stuck in this process," he told reporters. "I haven't been able to live the life I want to live. It's taken the joy out of this game. ..The only way forward for me is to remove myself from football.”

#NFL players have an average of 3-6 year playing careers. All players will eventually retire voluntarily or involuntary due to performance or injury. The individual will have the rest of their life to live. A much longer period of time than their playing career. Their bodies and all the injuries which they sustain to them are with them many times every day. Whether it be getting out of bed in the morning, picking up their kids, or working. For all of us that have played the game it is always with us both the drive to play and the physical reminders that we did. If you have a supportive family and the means to retire to other interests, do it. A player should not feel pressured into a team’s or sportswriter’s goals for you. They will not be in your body as you have to rehab to do trivial things and they will be on to the next crop of players.