Concussion Program at Grand View Health

Many think of sports when they think of concussion, but concussions can happen to anyone. In fact falls and auto accidents remain the leading causes of concussion. A concussion is a traumatic brain injury caused by a bump, blow, or whiplash force to the head – causing the brain to shake within the head. The problem is a functional injury (how the brain works) not a structural injury. Therefore the problem cannot be seen on MRI or CT scan, except in severe cases. The average amount of force required for a concussion to occur is 96 Gs. One G is the amount of gravitational force pushing down on us at any given time on the Earth’s surface.

Symptoms of Concussion

Symptoms include physical changes such as imbalance, dizziness, headache, nausea, vomiting, light or noise sensitivity and eye-tracking difficulties. Concussion can also lead to emotional symptoms such as – irritability and mood changes, or cognitive symptoms such as – decreased memory, organization problems, and being easily distracted. Symptoms can occur immediately, a few hours later, or a day or two after injury. For some, symptoms may be hard to detect.

Recovery from Concussion

Obtaining and following the advice of your physician is essential for optimal recovery. Rest (both physical and mental) immediately after injury is extremely important when dealing with concussion. Without early rest, symptoms can worsen and recovery can be prolonged. Younger people are more susceptible to delayed recovery than adults due to their developing brain. For some, more help is needed for recovery and your physician may order post-concussion therapy.

Concussion Symptoms Treated with Vestibular Therapy

Our vestibular system, located in the inner ear, helps control sense of balance and orientation. Sometimes, a concussion can affect this system and its connections in the brain. Vestibular disorders can cause imbalance, dizziness, vertigo, nausea, headaches, and the inability to focus vision while moving your head. For those who do not recover from concussion on their own in a few weeks, exercises are utilized for imbalance and problems with eye tracking, gaze stability, and dizziness with movement. Additionally, gradually increasing physical activity through a Graded Exertion Protocol allows the person with concussion to tolerate more activity without worsening symptoms. Eventually sports or activity specific challenges are added to the program.

A Personalized Treatment Plan

During your first appointment, your physical therapist will thoroughly assess your dizziness, balance, walking, eye tracking and ability to focus your vision during head movements. Your strength and flexibility – with special attention to your neck – will be assessed. Whiplash injuries occur at about four to six Gs of force. Commonly, when one has enough force to cause a concussion, the neck is injured as well. You will learn about your disorder as your physical therapist designs as challenging and safe treatment plan. If necessary, your physical therapist may recommend additional services to speed your physical and mental recovery.

Our vestibular therapist uses a range of exercises and diagnostic tests, including but not limited to:

• Infrared video goggles to view and record specific eye movements and better identify the source of your dizziness (Located at our Sellersville and Harleysville sites)
• NeuroCom VSR Sport with InVision Technology to compare ones balance to norms for their age and height and to determine how quickly one can turn the head while maintaining the ability to focus on the surrounding environment. (Located at our Sellersville Site)
• Repositioning maneuvers (including Epley maneuver) to eliminate Benign Paroxysmal Positional Vertigo that results when crystals belonging in one part of the inner ear become dislodged
• Balance exercises to help regain stability and prevent falls
• Vestibular exercises to aid recovery of clear vision, especially during head movement
• Motion sensitivity exercises that allow your brain to become accustomed to normal movements that are causing you dizziness
• Cervical proprioception exercises to retrain your neck receptors to align to neutral.

These exercises are customized to help you meet your goal – whether it’s returning to activities of daily living or getting back to sports.

Learn more about concussion management at Grand View Health.