Concussions: The Sport's Clinicians Role

“An estimated 1.6 to 3.8 million sports-related mild tramatic brain injuries (mTBI), also commonly referred to as concussions, occur each year in the United States.”
 
The research on concussions has grown exponentially in the last decade.  With better information, sports medicine professionals have been equipped with diagnosis and treatment of concussions.  While it was once thought that complete rest for 7-10 days would clear up a concussion, we now know that some individuals sustain symptoms longer. We also have learned tools to better handle the post concussive symptoms and assist with treating these athletes.
 
While concussions are typically not seen in the clinic, in team sports they are much more common.  I’ve been fortunate to be side by side with athletic trainers on the field and basketball court for over 600 hours learning about concussions and other acute injuries.  During this time I was lucky enough to see the many faces of a concussed athlete.  Symptoms such as inability to articulate words, difficulty with memory, and a rash of different emotions were just a few of the symptoms that have stuck with me from some of the concussed athletes I helped off the field/court.  Learning to recognize these symptoms was one challenge, but treating them post-concussion was a whole different.
 
Treatment for concussions ranges.  We know that intense exercise too soon can be detrimental to a post concussed athlete. Exercises targeting balance and proprioception are a must.  Starting athletes out with simple balancing and progressing to ball tossing is a good start. Working on multi-directional lunge patterns or step-ups can be effective for neuromuscular control.  Furthermore, dual tasking can be implemented to help with the cognitive function of a post concussed athlete. Dual tasking also serves the purpose of improving athlete performance as athletics often requires the combination of motor tasks and cognitive functions.  Working an athlete in balance with a ball toss and reciting numbers or the alphabet is one example you can use to work dual tasking.  You might be surprised how challenging this is in the beginning.  Changing variables to progress the athlete is the goal. Moving from stable to unstable surfaces, adding a second ball, or tasking the athlete with a more complicated verbal recital are a few ways to progress.  Just remember to continue slowly progressing cardio during this time. 
 
Treating concussions can be a challenge without the right information.  Fortunately, we have lots of information and research available to us as sport clinicians.  Sideline coverage is a great way to start learning how to recognize the many different faces of concussions.  Treatment will vary athlete to athlete but dual tasking can be a very effective way to rehabilitate these athletes.

-Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
Board Certified Sports Physical Therapist

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