concussion rehabilitation
Protecting your most precious asset.
Head injuries are on the rise for athletes at all levels of play. In North America, an estimated 4 to 5 million concussions occur annually.
Whether your concussion is sport, work, or accident related, our Concussion trained Physiotherapists will ensure that you return to performance as quickly and safely as possible.
“Last September I was in a car accident. I didn’t realize at the time how bad the injury was. I was diagnosed with a concussion at the hospital, but I expected to be back on my feet and living a normal life within 1-2 weeks. Unfortunately, things didn’t go the way I planned. I began suffering constant headaches, having vision difficulties and memory issues. I was afraid to drive, became anxious about regular daily activities and I found myself sleeping long and irregular hours. The best description I can give is to simply say that I was living in a fog. The pressure in my head was constant. All I wanted to do was sleep. My family doctor was excellent, and confirmed my concussion, making me feel a little better, but I was scared. I was told I needed someone who specializes in concussion. Thankfully, I was referred to Mandi Hayes and the Resolution Therapy team by a friend. Mandi truly became my lifeline. From the first appointment I attended at resolution … things were different. Mandi understood what I was going through. She took the time to listen to me. I never felt rushed, in fact, she spent countless extra time with me. Mandi was straight forward and honest with her management plan. She gave me clear instructions to follow at home and was excellent in providing the documentation I needed to communicate my injury with my employer. A large part of the concussion journey was mental and emotional as well. The anxiety of having a head injury is seldom talked about. Mandi would listen as I explained to her what I was feeling. She validated my fears and helped to realize that what I was going through was normal. The IMS Therapy, the techniques Mandi utilizes, and the atmosphere of Resolution Therapy became a part of my weekly routine. Soon I began to feel better. When my son suffered a concussion playing hockey, another local clinic was suggested. We visited twice … then booked him into Resolution as quickly as we could as we were confident in the care he would receive. Since then, Mandi and the Resolution team have helped myself, my son, and my daughter through various sports related injuries. Each time we visit, we are impressed with the Resolution team. Resolution has become a part of our family. ”
At Resolution Physiotherapy & IMS Clinic, Barrie, our Concussion trained Physiotherapists have post graduate training in the diagnosis and treatment of concussion. We use a variety of research validated outcome measures including the ImPACT Concussion Management System, which is the "most-widely used and most scientifically validated computerized concussion evaluation system".(impacttest.com)
What is a concussion?
A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way the brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth.
A concussion occurs when the brain moves within the skull, causing strain to neurons in the brain or the membranes around them. When the neurons or membranes are strained, it results in altered flow of ions into and out of the cells, leading to what experts call a “metabolic crisis” in the brain. When this ion flow is altered, the brain is temporarily deprived of sufficient blood supply, oxygen and glucose, all of which are required to ensure the brain has sufficient energy to function fully. This metabolic crisis impacts cognition and leads to concussion symptoms which may include (but are not limited to) headaches, memory difficulty, confusion and dizziness. This period of metabolic crisis also makes the brain more vulnerable to further injury, which is why it is so important that we ensure athletes are fully recovered before they risk another impact.
THIS IMAGE DEPICTS THE "METABOLIC CRISIS" WHICH OCCURS FOLLOWING A CONCUSSION. AT PRECISELY THE TIME THAT THE BRAIN REQUIRES BLOOD FLOW TO HEAL, THE BRAIN IS SIGNIFICANTLY STARVED OF BLOOD SUPPLY.
Studies show that up to 50% of athletes experience symptoms of concussion, but only 10% of athletes report these symptoms. Children, teens and athletes of any age or level may be reluctant to admit or address the possibility of a concussion, either because the effects are so subtle or because they may want to return to their normal activities as soon as possible. It is imperative that concussions are identified right away so that we can protect the brain until it gets past the ‘metabolic crisis’ period and recovers fully. The majority of concussions resolve, if managed properly, within 3 weeks.
What are the symptoms of a concussion?
Concussions are very difficult to diagnose and symptoms may not appear immediately. Symptoms of a concussion will vary significantly from athlete to athlete.
Common symptoms include:
headache
nausea
dizziness
fatigue
balance problems
vomiting
sensitivity to light
sensitivity to noise
visual problems
numbness/tingling
feeling mentally foggy
feeling slowed down
difficulty concentrating or remembering
irritability
sadness
more emotional
nervousness
drowsiness or difficulty falling asleep
sleeping more or less than usual
Why is it important to be assessed by a Physiotherapist
who is trained in concussion?
Concussions are complex and can impact multiple systems within one person. Concussion can impact the brain, the upper cervical spine, the dynamic vision system, the vestibular system and balance, as well as impact exertional capacity.
Evaluating the physical impact of a concussion is a complex process, and should be performed by a Physiotherapist with post-graduate training in the assessment and treatment of concussions.
Our Physiotherapists have completed post-graduate training in concussion management and are certified as ImPACT Concussion Trained Physical Therapists.
A soft tissue injury to Sydney Crosby’s neck was partially to blame for his ongoing concussion symptoms back in 2012. Click on the image to read more…
Our team also has unique post-graduate training in:
assessment and treatment of upper cervical spine dysfunction, which can lead to symptoms of headache and dizziness, common with concussion
assessment and treatment of vestibular dysfunction, which can lead to symptoms of dizziness and imbalance following a concussion
screening for ocular-motor dysfunction, which can lead to symptoms of dizziness and imbalance following a concussion
Our Physiotherapy teams’ ability to evaluate upper cervical spine stability, alignment, and myofascial tone, as well as vestibular and ocular-motor dysfunction helps us develop a program including manual physiotherapy, cervical core strengthening, balance and proprioceptive training with the goal of full resolution of concussion related symptoms and a safe return to athletic or work performance.
Exertional Training while recovering from a concussion.
Exertional testing is an important part of Concussion rehabilitation. Athletes often feel symptom free at rest or with light activity but experience an increase in their symptoms as soon as they are exerted physically.
Our Concussion Trained Physiotherapists use research validated exertional testing to ensure our athletes are fully recovered from concussion prior to returning to any contact sports.
It is very important that an athlete maintains their level of strength and performance while recovering from their concussion.
Our team of Physiotherapists work with each athlete to develop a safe, progressive, sports specific, exertion training program that maintains athletic performance without slowing recovery from concussion.
We also ensure that an athlete is able to return to full physical exertion without experiencing any symptoms of concussion prior to returning to contact sport.
“We cannot underestimate the importance of education with concussion. We believe that educating our clients about vestibular, ocular and motor issues which occur with a concussion, in a way that is easy to understand, gives our athletes peace of mind and reduces stress which accelerates recovery. We also keep our athletes active throughout their recovery which helps ensure they maintain their fitness level and has been shown to reduce the risk of prolonged symptoms.” Mandi Hayes, Concussion Trained Physiotherapist/Owner Resolution Physiotherapy & IMS Clinic
What makes the ImPACT Concussion Neurocognitive test
such a respected tool for concussion testing?
“ImPACT is supported by a database of clinical research, including more than 250 peer-reviewed and 145 independent studies. The ImPACT test is used by more than 7,400 high schools, 1,000 colleges and universities, 900 clinical centers, 475 Credentialed ImPACT Consultants, 200 professional teams.”
The ImPACT test (Immediate Post Concussion Assessment and Cognitive Testing) was developed by PhD Neuropsychologists in Pittsburgh and is now the "most-widely used and most scientifically validated computerized concussion evaluation system." (impact test.com)
The ImPACT test was developed to assess complex cognitive functions including visual and verbal memory, attention, visual motor speed, and reaction time, all of which are important to athletic success and are often affected by a concussion.
Full neurocognitive recovery is indicated when an athlete tests within normal range or are back to their baseline tested levels following a concussion. The results of this test in combination with results from upper cervical spine testing, ocularmotor and vestibular testing are used to determine whether an athlete has recovered fully and is safe to return to play.
Key Facts about ImPACT (taken from www.impacttest.com)
ImPACT is supported by a database of clinical research, including more than 250 peer-reviewed and 145 independent studies.
ImPACT's industry-leading normative database increases reliability and validity of testing results.
ImPACT assists qualified healthcare providers in the evaluation and management of concussion.
ImPACT and its products continue to evolve by incorporating the latest advancements in neurocognitive science and in technology for portability and ease of use.
ImPACT offers industry-leading educational resources and tools to raise awareness regarding the importance of proper concussion management.
Our Physiotherapists have completed training directly through ImPACT and are certified as ImPACT Concussion Trained Physical Therapists.
Who can take the impact test?
As concussions can occur at any age, the ImPACT has been developed to be used in patients aged 5 to 59 years of age. The ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) is indicated for clients aged 12 to 59 and the ImPACT Pediatric is indicated for clients aged 5 to 11.
What is baseline testing and how can it help get
athletes back to sport faster?
Athletes complete an ImPACT baseline test when they are injury free, establishing a baseline cognitive score. When an athlete completes a baseline ImPACT test we are able to compare post-concussion scores with their own ‘normal’ scores, rather than using 'average' scores taken from the general public. This allows us to more objectively determine when an athlete has recovered fully from a concussion and can safely return to sport. Many elite sporting organizations, including the NHL and NFL, have mandated that all their athletes complete pre-season baselines. Baseline ImPACT testing is an excellent way to ensure a safe and fast return to sport for all levels of athletes.
Return to learn is as important
as return to play.
Return to learn is as important as return to play which is why it is so important that we ensure our athletes are fully recovered cognitively and functioning fully at school prior to returning to any contact sport activities.
While an athlete is recovering, our Physiotherapists will connect with family physicians and teachers to ensure that accommodations are put in place which will help maximize recovery while also ensuring an athlete is able to stay on track with school while they recover.
If you, or your child, has sustained a concussion,
contact us today to book an appointment with one of our
Concussion Trained Physiotherapists
today so we can get you back to doing what you love to do.