How Can a Sports Medicine Physician Help with my Concussion?

At Advantage Sport Medicine & Physiotherapy a Sport Medicine Physician plays an integral role in the management of your concussion rehabilitation team, much like the quarterback on a football team.

 

On your initial visit, a thorough exam will be completed which will include a lengthy interview where the physician will ask about your symptoms (i.e. things that you are feeling/experiencing).

 

Following this interview, the physician will complete a thorough physical assessment where they will assess A COMBINATION OF:

  • Reflexes
  • Vision
  • Balance/Vestibular System/Coordination
  • Hearing
  • Strength
  • Sensation
  • Memory
  • Spatial awareness

 

If after this assessment there are further medical concerns they may refer you for further Diagnostic Imaging such as a CT scan or MRI. This, however, is very rare.

Typically, the Sport Medicine Physician will provide information regarding the use of medication, return to work/sport, and they will refer you to other members of the rehabilitation team depending on your findings. 

 

Do I REST after a concussion?

 

The concept of REST is an important and key change in the new consensus statement.  In the past, the international concussion guidelines advised complete rest (mentally and physically) until concussion symptoms were completely gone.  It was thought that rest may promote recovery by decreasing the brain’s energy demands after a concussion.  

 

There was early research done on the concept of brain blood flow out of Buffalo, NY almost a decade ago.  The current research does not conclude that COMPLETE REST is helpful for recovery.  However, it is still important to REST (both mentally and physically) in the first 1-2 days after a diagnosis of concussion.  After this period of time, athletes are encouraged to be both physically and mentally active as long as the activity does not make their concussion symptoms worse.  It is also important to note that vigorous exercise or contact sport activities are NOT recommended.

 

Do I need REHABILITATION/PHYSIOTHERAPY after a concussion?

 

The data specifically supports rehabilitation/physiotherapy treatment for CERVICAL/NECK injuries and VESTIBULAR/BALANCE difficulties after a concussion.

 

The new guidelines are also supportive of closely monitored ACTIVE REHABILITATION PROGRAM.  This type of program is safe and benefits recovery. 

 

Do I need to see a Psychologist after a concussion?

 

Every concussion is different and because our brain controls our emotions just as much as it controls our balance or memory; a concussion can cause some patients to suffer from depression, anxiety, or anger.

 

Patients suffering from PSYCHOLOGICAL PROBLEMS can be treated in the form of Cognitive Behavioural Therapy (CBT).  This treatment is very helpful in the settings of depression and anxiety and are usually delivered by a Neuropsychologist, Psychiatrist, nurse or other healthcare providers trained in CBT.

 

As you recover from your concussion the members of the ASM healthcare team will guide you through a return to activity progression that is generally overseen by the Physiotherapist/Athletic Therapist. The final return to play clearance is done by the Sports Medicine Physician once the steps are achieved without an increase in symptoms.

 

If however, the symptoms worsen or do not progress as expected, the team will refer you back to the Sport Medicine Physician for further evaluation.

TAKE HOME MESSAGE

Both mental and physical REST is important 1-2 days after a concussion.  Then, a closely monitored ACTIVE REHABILITATION PROGRAM is important to benefit recovery

 

Current research supports REHABILITATION by a qualified healthcare provider, like a Physiotherapist if you have NECK or BALANCE problems after your concussion.   

 

PSYCHOLOGICAL difficulties, like depression and anxiety, can be treated by a healthcare professional such as a Psychologist trained in Cognitive Behavioural Therapy.

 

If you have any questions, don’t hesitate to contact one of our Advantage Sport Medicine & Physiotherapy professionals.  

 

Dhiren

 

Dhiren Naidu, MD, is a specialist in Physical Medicine and Rehabilitation and has a Sport Medicine subspecialty (Dip. Sport Med).  He is an Associate Professor at the University of Alberta in the Faculty of Medicine & Dentistry.  He is a team physician with the Edmonton Oilers Hockey Club, Edmonton Eskimos Football Club and the University of Alberta Golden Bears Football Team.  His clinical interests include sport medicine, concussion, spine-related pain and specialized injections.

 

Consensus statement on concussion in sport – the 5th international conference on concussion in sport held in Berlin, October 2016

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