Post Concussion Syndrome: Symptoms and Management

By Senior Physio Helen Sibbald

So you hit your head, suffered a concussion, and it’s a few weeks later and you still have some weird symptoms. Did you know there is a condition called “Post Concussion Syndrome (PCS)” and it has some real symptoms that may be quite bothersome to you.

Occasionally, after a concussion, symptoms persist after the expected time frames of recovery. Children usually recover from a concussion in 4 weeks and adults in 10-14 days.

If 3 or more of the symptoms below persist longer than this, you may have PCS:

• headache,
• dizziness,
• fatigue,
• irritability,
• difficulty concentrating or performing mental tasks,
• impaired memory,
• insomnia,
• reduced tolerance to stress/emotional excitement/alcohol

And remember, these are all also symptoms of Concussion and you don’t actually have to lose consciousness to have sustained a concussion event.  Read more about Concussion

How Do You treat PCS?

A multidisciplinary approach to PCS is best. Your Dr, Physiotherapist, exercise Physiologist, Dietician, ( and sometimes a Neuro Psychologist or Neuro Optometrist) all work together to get you back on track.

Most often, when you hit your head, you also sustain a whiplash-type injury to your neck leading to neck pain, stiffness and sometimes headaches. Physiotherapists are well equipped to help you get relief from these interfering symptoms. Your Physio will assess and treat your neck with specific manual therapy techniques and therapeutic exercises targeting the neck joints and neck muscle tone, length, motor control and pain.

A large percentage of people with PCS experience dizziness, balance, and visual symptoms (vestibular symptoms): balance and vestibular assessment from a trained Physio and rehabilitation is a vital part of your management. Your Physio would screen you with Vestibular Ocular Motor Screening tests (VOMS) and other tests and prescribe specific exercises to settle these symptoms. Read more about Dizziness and VOMS screening 

Occasionally the force that caused the blow to the head and give you concussion is enough to dislodge calcium carbonate “crystals” in the inner ear and cause short duration spinning /vertigo brought on by certain changes in head position. You may also have Benign Paroxysmal Positional Vertigo – BPPV. Your Vestibular Physio is again equipped to assess for this and apply specific treatment techniques to clear this.

Physiologically, a concussion causes an “energy crisis” in the brain, so you can also feel symptoms while doing aerobic exercise. An Exercise Physiologist can test you to see when symptoms come on while exercising, and prescribe the correct intensity of exercise to perform during your recovery period.

A Dietician can advise you on the best nutrition to feed your body and brain and enhance your recovery. We need proper nutrition for energy, reducing fatigue and improving sleep, all of which will aid recovery of symptoms.

Some people need to see a Neuropsychologist to help with memory, attention, reasoning and sometimes a Neuro Optometrist may be needed for some visual disturbances. Your Physio & GP can help organise the best referral if this is needed.

At Gold Coast Physio and Sports Health there are Physiotherapists with an interest in treating PCS, and our Dietician  and Exercise Physiologist are all available for consultation, Book your Physio appointment with Helen Sibbald by phoning 07 55006470 or online mygcphysio.com.au

We Would Love to Welcome You Back to Clinic with our WELCOME BACK offer

Our Team have missed seeing you around the Clinics, so we wanted to send you a Special Offer to encourage you, or your family/friend to let us help you again.

How would you like an awesome Massage or Physio consult with nothing to pay out of your pocket*?

So if you:
– have pain, aches or niggles,
– want to be pain-free in activity or exercise
– want to improve your posture or how you feel,
– want to improve in your ability to exercise
– want to improve your sports performance
– are keen to prevent previous problems re-occurring,
come and say “Hi” again by using this special offer & let us help you achieve your goals.

Our Team is one of the most experienced Therapy Teams on the GC & all of us really care about helping you.

Because we care so much we thought we would offer you:

a FREE* physio or massage consult. HOORAY FOR YOU!

*please make sure you read Terms & Conditions below

or you can pass this offer on to a friend, family member or work colleague who is new to our services, so they may take advantage of our expertise.

To use this offer, simply book a “Physio/Massage email offer” appointment online via our website:

•  
• or call the clinic on 07 5500 6470 and mention this email
• you can also expect a phone call followup from us to check how you are and to see if you would like to take up the offer, with no further obligations. We always appreciate polite conversations with you during these calls 🙂

Yours in good health,

 Britt, Albie & the Gold Coast Physio & Sports Health Team

*Free = Some Conditions Do Apply:
– This offer MUST be presented at the time of the appointment (either printed or displayed on a phone) and is valid for 2 months from the email date. Our Friendly Staff will also call you as a Courtesy followup to confirm if you would like to take the offer.
– There is no out of pocket expense for the consultation when combined with your private health fund rebate (ie HICAPS/ TYRO) that can be swiped in-clinic;
– Clients without private health insurance or unable to claim electronically at the time of the consultation via HICAPS/ TYRO will receive a discount consultation (a 30min Physio consultation or a 45min Massage consultation will be provided for the cost of $40). Please note that HCF does not participate in Hicaps /Tyro for Massage consultations so if you have HCF cover for Massage, you would be entitled to the $40 consultation fee;
– If this offer is transferred to another individual they must be a new client to Gold Coast Physio & Sports Health to receive the offer;
– Not available for consult with Britt Caling or Rick Bain Principal Physio & Health Fund Rebates unavailable for Massage Therapists Kelly Wright or Tim Harman
– Offer strictly available for 2months from date of email;
– NO further discounts apply.

When asked what the “1 Best Thing is about being part of the Gold Coast Physio & Sports Health Team”, this is what Our Team said:

“For me? The opportunity to be the physio you’ve always wanted to be”

“To be able to work with passionate therapists who always strive to be better. Plus working with a team that’s positive and enjoys each other’s company “

“The awesome staff, clinic vibe is professional but cruisy and fun”

“The high calibre of staff/ high standards of knowledge or expertise of staff”

“I’ve found everyone (all the staff) to be super helpful, patient and friendly

“Definitely the people, I love working with everyone”

“The facilities and experience of the staff”

“I’d say 2 things. The diverse team of practitioners. And the facilities/equipment”

“Facilities and the collective experience of staff”

“Support and contribution towards further learning, and the team I am lucky enough to work with”

“The facilities – space, equipment. Supportive front desk team”

To Find Out more about Joining our Team, read here

What happens physically when you have repeated negative thoughts?

Have you heard the phrase “Thoughts are Things”?

By Massage Therapist with an interest in emotional and mental well-being, Tim Harman

How does a thought, an untouchable, invisible, formless flash in our mind become something tangible? Some-thing seemingly from no-thing…

“I’m falling to bits”
“My stupid body keeps letting me down”
“I can’t afford to miss training”
“If I don’t get back training soon………” (catastrophe)

If only I could have a fiver for every time I’ve heard this over 20+ years of working with people’s bodies.

We Get It

All our Therapists get it, you’re passionate about your health, sport & pushing the limits. You hate missing racing and training, you’re terrified of putting on a couple of KG’s, you’ve come too far for your body to fail you or to miss competing.

So without denying the validity of frustration around an injury let’s take a look at what these thoughts do physically. And then, how you can manage them to help get you back to the training track quicker.

Your brain doesn’t know the difference between a perceived threat and an actual threat. In other words, the proverbial rustle in the bush, at night, will elicit a similar physiological response to the actual appearance of, let’s say…. a snake.

That is, to say, a stress response can begin with a thought, such as those above, in italics. Here’s how the process goes:

The thought (fear, frustration, anger, sadness, anxiety, grief etc) =

Autonomic nervous system responds =

Excretion of hormone epinephrine (adrenalin) into the blood =

If stress passes, return to relaxed state.

If continued =

Hormone cortisol, then released into blood to help survive the ongoing (perceived or real) threat. =

At the same time digestion is slowed down as are processes of reproduction and growth. The NS de-prioritises other systems to focus on this stress response.

Ongoing stress, worry or rumination perpetuate this process, which can eventually lead to inflammation & damage to cells.

Research does indicate that, following an episode of acute (short term) stress, hormones can gradually return to normal level. It’s ongoing & repeated stresses that are linked with a large list of disease and disfunction.

As a sidenote to athletes (or anyone concerned with body fat levels) ongoing higher than average levels of cortisol favours the accumulation of fat in the belly area.

The bottom line, what can you do?

Easy, don’t stress right? (hmm…). Your body actually doesn’t care about an upcoming game or race as much as it does about staying alive.

Statements of frustration, anger, fear, such as the above, are catalysts for more damage to your body. So taking some steps to calm your mind into more relaxing thoughts like trust and acceptance will make a big difference to your recovery and health, in general.

Easier said than done, it’s going to take a bit of effort. Try to be accepting of time out’s as part and parcel of your sport. Work on managing stressful thoughts around injuries and forced time out. You could opt to take up table tennis instead? The higher the risks you take in training & competing, the higher the rewards….and potential for injury.

There are many methods to elicit a relaxation response including visualisation, acceptance techniques, acupuncture, quality sleep, quality sleep (yes I said that twice!!) massage, breathing techniques, journaling, meditation, tai chi, qi gong, and yoga.

Quiet hobbies like reading or music also provide balance.

Load up one of those mindful apps like smiling mind or headspace. They’re full of fabulous information.

Removing the guilt we can feel for slowing down a little is also important. Oh and easy weeks, many high level athletes I’ve seen over the years go eerily silent when I ask if they take rest weeks!

If you need further support in this area, Sport Psychologist Abra Garfield Consults from both Clinics, phone 07 55006470 for an appointment. Or Tim Harman can guide you to the support services for you while having a restorative Massage – Book with Tim for a Massage online at www.mygcphysio.com.au

REF:

Stress and Health

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037