Treatment and acknowledgement of concussions have drastically changed over the past few decades. In the 1970’s and 1980’s athletes weren't accurately screened, nevermind diagnosed with a concussion. A “stinger” or “hard knock” were common ways to describe those who took a hit to the head or appeared dazed. The injured athletes were commonly held out for a short period of time. As soon as they started feeling better, they were sent back into the game.
Moving into the 1990's and 2000's, many millennials who had been diagnosed with a concussion were told to remain in a dark room, not look at computer screens, and stay away from school and the outside world. Also, the in-game screenings were not very complex and we knew little about return-to-practice and game protocols. When I was in high school, the screening process was a single question, “Is Mickey Mouse a cat or a dog?” You were cleared to return to play if you hadn't thrown up in the past 24 hours.
Today, many schools and club programs have athletes examined with baseline testings such as the popular ImPact test. The athlete’s return to practice and the playing field is based upon their ability to achieve the same baseline on the test as they achieved at the beginning of the season. Some will rely more upon testing of balance and stability compared to prior to injury and follow up.
The prescribed treatment for athletes has also greatly changed. It is no longer recommended to remain in a sensory deprived state (a dark room) following a concussion. Earlier exposure to stimuli (light, computers, cell phones, etc.) in a graded exposure has proven to be the best course of action. The exposure should remain below their symptoms, and then gradually working their way back to previous levels of function.
What is the number one predictor of long lasting concussion symptoms? Research reveals that longer periods in a sensory depressed state (dark room prescription), or avoiding symptoms (not working into low levels of symptoms) is the number one predicting factor of prolonged post-concussion syndrome.
Post-concussion syndrome is defined as symptoms lasting longer than 7-10 days for adults, and more than 2 weeks for adolescents. My treatment approach involves using symptoms as a guide. Working into minimal symptoms is necessary for recovery. It is common knowledge that recovery from an orthopedic issue will have minimal symptoms with return to play or activity. Concussions are no different.
As members of society and parents of youth athletes, it is important to know that being told to stay in a sensory deprived state is no longer the best practice. Here's an excellent article published in the Washington Post that I commonly ask my clients and their parents to read after being diagnosed with a concussion. If I can help pass along this information to more people, I believe education and interventions can greatly reduce the likelihood of prolonged suffering from concussions. This, combined with a customized multi-sensory approach by a concussion specialist will pave the path to recovery.
As a physical therapist, I can provide valuable education, specific exercises and training techniques to help prevent these injuries. For those who do sustain a concussion, rehabilitation can be key to helping the brain recover.
Check out our contact sports and concussions page to learn more.
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.
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ABOUT THE AUTHOR:
Nick Passe is a Doctor of Physical Therapy (DPT) who specializes in contact sports like football, basketball, lacrosse and ice hockey. He works at Activcore in Princeton, New Jersey, located just 2 miles from Princeton University.
As a former football player and college cheerleader, Nick knows what it takes to succeed in competitive sports and to overcome injuries. He holds a Bachelors degree in Psychology and Natural Sciences from Pittsburgh University, as well as a Doctorate degree in Physical Therapy from the University of Medicine and Dentistry of New Jersey (now part of Rutgers University), ranked among the top 50 PT schools in the country. He also has advanced post-graduate training in movement assessment and treatment of athletes, including concussion management and prevention.
Nick goes beyond the symptoms and looks at the whole body to help his athletes recover from pain and injury, and safely return to a fulfilling life of sport, activity and wellness. He is among just a handful of physical therapists nationwide to have earned the prestigious designation as a Certified Neurac Provider (CNP), making him exceptionally equipped to evaluate and treat each athlete from head to toe.
Applying the principles of Neurac (Neuromuscular Activation), Nick utilizes the Redcord suspension system to optimize how the mind and muscles work together as one. This is an evidence-based method that a few high-level sports teams are using to keep their athletes healthy and free from pain and injury. In fact, Nick has the pleasure every few months to teach these principles to both the Washington Capitals NHL team and the Washington Nationals MLB team. [READ MORE]