Most concussed patients will start to feel better within 10 to 14 days. However, roughly 10-15% of concussed athletes will go on to have prolonged symptoms that can last for weeks or years. These symptoms can effect an individuals daily life from school or work to doing basic activities like grocery shopping or going out to see a movie. Given how debilitating these symptoms can be, research has focused greatly on trying to find out “why” some people have long lasting symptoms.
Symptoms following a concussion can come from a number of different areas. For days or weeks after experiencing a concussion, there are metabolic and physiological changes in the brain, which have been shown to produce a variety of symptoms. However, the cervical spine, visual integration system, vestibular system and/or psychological factors can all be affected following a concussion and lead to a variety of similar symptoms.
The cervical spine is particularly vulnerable following a concussion, given the whiplash mechanism, which usually occurs with concussions. Studies have shown the range of linear acceleration needed to sustain a concussion is between 70-120 G’s, whereas a mild neck strain only takes 4.5 G’s. Therefore, it could be hypothesized that the majority of concussions will also have some degree of cervical spine injury, which may involve the soft tissue and/or joints of the neck. These resulting symptoms are very similar to concussions, including:
- Vision changes;
- Irritability/mood disturbances;
- Cognitive changes (i.e., concentration/memory issues)
Current research has shown that following a concussion, physiotherapy focusing on cervical and/or vestibular rehabilitation significantly helps in the recovery of concussion symptoms. Treatment for cervical injury includes soft tissue release, mobilizations and exercises to strengthen the deep neck flexors, as well as proprioceptive exercises for the neck region. For more information regarding assessment and treatment of the visual system, click here, and for the vestibular system, click here.
At Sheddon Physiotherapy and Sports Clinic, our post-concussion assessment carefully examines the cervical spine, vestibular system and visual system, as well as a full neurological exam. Based on the patient’s findings, the appropriate therapy and exercises are given in order to reduce the symptoms. The key to a speedy recovery post-concussion is to have a thorough assessment of all the different systems in order to see which are dysfunctional and leading to symptoms. If these areas are treated early on in the injury, it may help prevent long-term symptoms.
Leddy et al., (2014). Brain or strain? Symptoms alone do not distinguish physiological concussion from cervical/vestibular injury. Clinical Journal of Sports Medicine. 0:1-6.
Marshall et al., (2015). The role of the cervical spine in post-concussion syndrome. The Physician and Sports Medicine. 1-11.