Concussions – What Happens to the Brain?

September 17, 2024

Concussions have become a topic of increasing concern in recent years, particularly in the world of sports and athletics. As a physical therapist at Gordon Physical Therapy, I’ve seen firsthand the impact that concussions can have on individuals’ lives. 

Understanding Concussions

A concussion is a type of traumatic brain injury caused by a blow, bump, or jolt to the head that can disrupt the normal functioning of the brain. It’s important to note that concussions can also occur from a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist inside the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

Contrary to popular belief, you don’t need to lose consciousness to have a concussion. In fact, most concussions occur without a loss of consciousness. This misconception often leads to underreporting of concussions, which can have serious consequences for brain health and recovery.

The Immediate Impact on the Brain

When a concussion occurs, several immediate changes take place in the brain. The brain, which normally floats in cerebrospinal fluid that acts as a cushion against impact, can collide with the inner skull during the injury. This collision can cause bruising of the brain tissue and damage to blood vessels and nerves.

At a cellular level, the impact disrupts the delicate balance of chemicals in the brain. There’s a sudden release of neurotransmitters, which are chemicals that help brain cells communicate. This chemical imbalance can lead to a temporary loss of normal brain function, manifesting as the various symptoms associated with concussions.

Moreover, the injury can cause a sudden change in cellular metabolism. The brain requires a constant supply of energy to function properly, and a concussion can disrupt this energy supply. This metabolic imbalance can persist for days or even weeks after the initial injury, contributing to ongoing symptoms and vulnerability to further injury.

Common Symptoms of Concussions

The symptoms of a concussion can be wide-ranging and may not appear immediately after the injury. Some individuals might experience symptoms right away, while others may not notice any issues for hours or even days after the impact.

Common physical symptoms include headache, dizziness, nausea, sensitivity to light or noise, balance problems, and fatigue. Cognitive symptoms may involve confusion, difficulty concentrating, memory problems, and feeling mentally “foggy.” Emotional symptoms can also occur, such as irritability, anxiety, or depression.

Sleep disturbances are another common issue following a concussion. Some individuals may experience increased sleepiness, while others might have trouble falling asleep or staying asleep throughout the night.

It’s crucial to remember that concussion symptoms can be subtle and may not be immediately apparent to the injured person. This is why it’s essential for coaches, parents, and teammates to be aware of the signs of a concussion and to encourage proper evaluation if there’s any suspicion of injury.

The Recovery Process

The brain’s recovery from a concussion is a complex process that can vary greatly from person to person. In most cases, concussion symptoms resolve within a few weeks, but for some individuals, symptoms can persist for months or even longer, a condition known as post-concussion syndrome.

During the acute phase of recovery, the brain is in a vulnerable state. It’s working hard to restore normal function and repair any damage, but during this time, it’s more susceptible to further injury. This is why proper rest and a gradual return to activities are crucial in the early stages of concussion recovery.

As recovery progresses, the brain gradually returns to its normal chemical balance and energy metabolism. However, this process takes time, and pushing too hard too soon can prolong recovery or even lead to setbacks.

The Role of Rest in Recovery

Rest has long been considered the cornerstone of concussion management, but our understanding of “rest” in this context has evolved. While complete physical and cognitive rest was once recommended, current guidelines suggest a period of relative rest followed by a gradual return to activities.

In the first 24-48 hours after a concussion, more intensive rest may be beneficial. This might involve limiting screen time, avoiding strenuous physical activities, and getting plenty of sleep. However, prolonged strict rest beyond this initial period may actually slow recovery.

After this initial rest period, a gradual return to light activities is encouraged, as long as they don’t exacerbate symptoms. This might include short walks, light reading, or brief periods of screen time. The key is to stay below the threshold that triggers or worsens symptoms.

The Importance of Proper Management

Proper management of a concussion is crucial for optimal recovery and to prevent potential long-term consequences. This begins with prompt recognition of the injury and removal from play for any athlete suspected of having a concussion.

A thorough evaluation by a healthcare professional experienced in concussion management is essential. This typically involves a comprehensive neurological exam, assessment of balance and coordination, and evaluation of cognitive function.

Based on this evaluation, a personalized management plan can be developed. This plan should take into account the individual’s specific symptoms, as well as factors like their age, overall health, and the demands of their daily life or sport.

The Role of Physical Therapy in Concussion Recovery

While rest is important in the early stages of concussion recovery, physical therapy can play a crucial role in the rehabilitation process, especially for individuals experiencing persistent symptoms or those looking to safely return to sports or physically demanding activities.

As a physical therapist, I work with concussion patients to address a range of issues that can arise following a brain injury. This might include:

Vestibular Rehabilitation: Many concussion patients experience dizziness, balance problems, or visual disturbances. Vestibular rehabilitation involves exercises and techniques to help the brain compensate for inner ear or balance system issues.

Cervical Spine Treatment: The impact that causes a concussion can also injure the neck, leading to headaches and other symptoms. Manual therapy and specific exercises can help address these cervical spine issues.

Exertional Training: For athletes or individuals looking to return to physically demanding activities, a graded exercise program can help safely increase activity levels without exacerbating symptoms.

Visual Motor Training: Exercises to improve coordination between visual inputs and motor outputs can be beneficial, especially for those experiencing visual disturbances or difficulty with tasks requiring hand-eye coordination.

Education and Guidance: A crucial part of physical therapy for concussion patients is providing education about their condition, strategies for managing symptoms, and guidance on safely returning to daily activities or sports.

Prevention and Long-Term Considerations

While not all concussions can be prevented, there are steps that can be taken to reduce the risk. This includes wearing proper protective equipment in sports, following safety guidelines, and practicing good technique in contact sports.

It’s also important to be aware of the potential long-term effects of concussions, especially in cases of repeated injuries. Multiple concussions, or even subconcussive impacts, can have cumulative effects on brain health. This underscores the importance of proper management and allowing full recovery before returning to risk of further injury.

When to Seek Help

If you’ve experienced a head injury and are experiencing any symptoms of a concussion, it’s crucial to seek medical attention promptly. Even if symptoms seem mild, a proper evaluation can ensure appropriate management and reduce the risk of complications.

For those who have been diagnosed with a concussion and are struggling with ongoing symptoms, or for athletes looking to safely return to their sport, physical therapy can be an invaluable resource. At Gordon Physical Therapy, our team of experienced physical therapists specializes in concussion management and can provide personalized care to support your recovery.

Conclusion

Concussions are complex injuries that can have significant impacts on brain function and overall well-being. Understanding what happens to the brain during a concussion, recognizing the signs and symptoms, and knowing the importance of proper management are crucial steps in addressing these injuries effectively.

If you or a loved one has experienced a concussion, or if you’re an athlete looking to learn more about concussion prevention and management, we’re here to help. At Gordon Physical Therapy, we offer comprehensive concussion assessment and management services, including specialized physical therapy for concussion recovery.

Don’t hesitate to reach out if you have any questions or would like to schedule an appointment. You can contact us at 509.892.5442 or visit our clinic located at Spokane Valley, WA. Remember, when it comes to brain health, it’s always better to err on the side of caution. Let us support you in your journey to recovery and help you safely return to the activities you love.