Concussion -Breaking the silence: The truth behind the silent injury

A concussion is a type of traumatic brain injury (TBI) caused by a blow or jolt to the head that disrupts normal brain function. Labeling it this way has caused underplaying of the seriousness of the injury and the importance of early care. A concussion IS a brain injury and it should be treated as one. As such, a concussive blow can affect cognitive, physical, and emotional functions, leading to a range of symptoms and varying recovery times.

Concussions are very prevalent-in the United States alone, it is estimated that approximately 1.6 to 3.8 million sports- and recreation-related concussions occur annually. While many concussions are mild and individuals recover fully, some cases can be severe, leading to prolonged symptoms and complications such as post-concussion syndrome (PCS).

Concussion symptoms can be classified into four main categories: cognitive, physical, emotional, and sleep-related. Cognitive symptoms include confusion, difficulty concentrating, memory problems, and feeling "foggy" or slowed down. Physical symptoms encompass headaches, nausea or vomiting, balance problems, dizziness, and sensitivity to light and noise. Emotional symptoms often involve irritability, sadness, anxiety, and mood swings. Sleep-related symptoms may include trouble falling asleep and sleeping more or less than usual.

Most individuals recover from a concussion within 7-10 days. However, some may experience symptoms for weeks or even months. If symptoms persist beyond the typical recovery period, it may indicate PCS, characterized by prolonged cognitive, physical, and emotional symptoms lasting several months and sometimes years.

Post-concussion syndrome (PCS) is a complex disorder where symptoms such as headaches, dizziness, and cognitive difficulties persist for an extended period after the initial injury. Management of PCS often involves medication to manage pain and other persistent symptoms, cognitive behavioral therapy (CBT) to help with emotional symptoms, and continued physical, occupational, and speech therapy to aid in recovery. Support groups can also be beneficial, providing emotional support and coping strategies by connecting with others who have experienced PCS.

Effective concussion management and recovery often require a multidisciplinary approach. The team typically includes a primary care physician who oversees overall health and initial diagnosis, a neurologist specializing in brain injuries and neurological symptoms, and a neuropsychologist who assesses and treats cognitive and psychological symptoms. A physical therapist helps with balance, coordination, and physical rehabilitation, while an occupational therapist focuses on improving daily functioning and adapting activities. A speech-language pathologist assists with communication and cognitive issues, and an athletic trainer monitors and manages recovery in athletes, often coordinating with coaches and other sports personnel. Additionally, a psychiatrist or psychologist provides mental health support, addressing emotional and psychological symptoms.

Occupational therapy (OT) plays a crucial role in concussion recovery. Occupational therapists help individuals return to their daily activities by adjusting tasks and environments to reduce symptoms and prevent exacerbation. They provide cognitive rehabilitation strategies to improve memory, attention, and problem-solving skills. Techniques for sensory integration help manage sensitivities to light, noise, and other sensory inputs. Occupational therapists also teach methods for energy conservation to manage fatigue and optimize energy levels throughout the day, and provide coping strategies for dealing with emotional changes and stress.

While concussions can be challenging, the majority of individuals recover fully with proper care and management. Advances in understanding and treating concussions mean that effective support and rehabilitation are available, ensuring that those affected can return to their normal activities and enjoy a high quality of life.

(information from Centers for Disease Control and Prevention (CDC), Mayo Clinic, and National Institutes of Health (NIH))