Concussion 101

A Q&A session with Nicole Somers, PT, DPT

Did you know?

  • A concussion is a type of brain injury.
  • Imaging, such as MRI and CT scans, are not able to diagnose a concussion.
  • Most concussions (90%) are not associated with a loss of consciousness.

What is a concussion?

A concussion is a type of mild traumatic brain injury or mTBI. It occurs as a result of a direct blow to the head or a blow elsewhere to the body where the force is transmitted up through the head (think about whiplash and how the brain is bouncing around inside the skull). Loss of consciousness does not always occur. In fact, most people who have a concussion do not lose consciousness.

So, what really happens?

The impact on the brain causes the brain cells to stretch and become damaged. The damage to the brain cells causes them to release neurotransmitters, which are the chemicals of the brain that allows it to function normally. The imbalance of these chemicals causes the brain to have to work harder and requires more energy, resulting in an “energy crisis” within the brain.

What are the signs and symptoms?

Signs and symptoms of a concussion can occur immediately or hours to days following the injury and include¹:

  • Emotional: anger, sadness, nervous or anxious, irritability
  • Mental: confusion, feeling foggy, poor memory, poor concentration
  • Physical: headache/migraine, clumsiness, dizziness or loss of balance, nausea or vomiting, fuzzy or blurry vision, sensitivity to noise or light
  • Sleep: feeling tired, trouble falling asleep, trouble staying awake, too much or too little sleep

What is the recovery time?

A typical concussion will fully resolve in less than 3 weeks with minimal intervention, with significant improvement in the first 7-10 days. In about 20% of concussed people, a concussion takes greater than 4 weeks to resolve. A second concussion before fully recovering from the initial injury can have detrimental effects, including prolonged recovery, permanent brain damage, and even death.

How can physical therapy help?²

Physical therapists are part of the multidisciplinary team capable of helping people return to their normal activities and lifestyles after a concussion. Physical therapists will complete a comprehensive assessment and are highly qualified to address:

  • Orthopedic issues and pain from the injury
  • Balance, dizziness, and vestibular/vertigo problems
  • Visual and ocular motor problems

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¹ “Symptoms of Traumatic Brain Injury (TBI).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 Mar. 2019, www.cdc.gov/traumaticbraininjury/symptoms.html.

² Mucha, Anne, and Susan Whitney. 4 May 2020., MedBridge Education. https://www.medbridgeeducation.com/certificate_programs/11026-concussion-assessment-medical-management.

 

Constipation Trouble?

By: Kennan Wyne, PT, DPT

Everyone has had constipation at some point or another and it is uncomfortable, painful and embarrassing.  Chronic constipation and/or straining can lead to excessive stress on pelvic organs and nerves.  This may contribute to bladder dysfunction, pelvic floor dysfunction, and/or prolapse (bulging of structures occurring commonly due to weakened supportive structures).  Constipation is defined as infrequent (fewer than 3) bowel movements per week.  Normal stools should be about the size, shape, and consistency of a ripe banana.*

Listed below are tips to keep your colon happy.

Tip #1: Avoid regular use of laxatives and enemas.

Tip #2: Discuss fiber needs with physician/pharmacist/nutritionist. Typical recommendations for fiber intake are 25-35 grams per day. If adding fiber to diet remember to DRINK 6-8 cups of WATER to move stool through the colon. You may experience a bloating feeling and/or gas when adding fiber to your diet, but this should pass in a few weeks.  This may be eased by adding fiber SLOWLY to your diet.

    • Examples of high fiber foods are bran, shredded wheat, whole grain bread, and whole fresh fruits with skin (apples, raw veggies).

Tip #3: Proper positioning: Position yourself on the toilet to allow for maximal relaxation of your pelvic floor muscles by using a Squatty Potty or stool to obtain maximal knee and hip flexion (similar to a squat position) and leaning forward and supporting elbows on knees. NO STRAINING OR HOVERING as this increases intraabdominal pressure and pressure on the pelvic floor.

Tip #4: Regular exercise helps stimulate a sluggish bowel.

 

*Any persistent change in bowel habits, such as increase or decrease in frequency, size of the stool, blood in the stool, or an increased difficulty in evacuating, warrants a medical consultation.

Is Working From Home Becoming a Pain In Your Neck (shoulders, wrists and hands too)?

By: Kara Everett, DPT, CSCS, CKTP, and LSVT BIG Certified

COVID-19 has caused a lot of changes in all of our everyday lives and routines.   You may even find yourself in a new working environment – your own home! Working from home has most likely presented new challenges. No desk at home may mean working from your couch or kitchen table.  You may notice your back hurts.   Come to think of it, you have been noticing your neck, shoulder, wrist, and hand all hurt – what is wrong?!?  Luckily for you, Carousel is here to help! We’ve got tips to improve your at-home make-shift “work” stations to avoid new injuries (no Workman’s Comp at home ladies and gents! 😊).

Table Manners: If you do not already have a desk at home, sitting at your kitchen table may be your best bet to set up shop. Elevate your laptop to eye level by placing books or boxes under the computer. Place your mouse close enough so that your arm can rest on the table and you do not have to hold arm outstretched to reach the mouse. This will prevent increased stress to your shoulder and neck.  Sit in a chair that has a tall back or use pillows behind you to support lower and upper back. Place a box to support your feet if you cannot reach the floor.

Deep Couch Sitting: Although not the most ideal place to work but let’s be real, we know at times you will be working from your couch. When doing so, make sure that your computer is elevated to eye level by placing pillows under your lap (be sure to put a book on top of pillow to prevent computer from overheating and allow good airflow through computer vents). This will prevent you from looking down excessively and increasing chances of neck pain. You can also use pillows for lumbar (back) support or between your shoulder blades to prevent slouching and forward head posture that may cause neck and/or back pain.

Don’t Squint:  Another tidbit is if you typically wear glasses to read be sure to use when working at the computer. If you have difficulty seeing your screen this will cause squinting and moving your head forward to see the screen better. This forward head posture can increase your likelihood of neck and shoulder pain.

Stretch it Out: Finally, our bodies are made to move so staying in one position for too long can increase pain in any part of our body. Yes, every 30-minutes get up and change position. Rotate your trunk side to side, side bend trunk to one side while reaching overhead with other hand, lean backwards with hands on hips, turn head left and right, and side bend head left and right (bring ear to shoulder on each side).

Working from home should be all about productivity, not pain! Stay healthy and be well, we are all in this together!