Concussion Headaches: What are they? How can Physiotherapists Help?
What is a Concussion?
Concussion is defined as a direct blow or impulse that causes rapid onset of impairment which resolves spontaneously and quickly and is demonstrated by functional (e.g. symptomatic) rather than structural changes.
Studies show that between 95 to 100% of concussed subjects have headache as part of their symptoms, while only 10-15% suffer a loss of consciousness. These post concussion headaches are similar to those suffered in whiplash or by those with migraines and, like those headaches, are associated with an increased sensitivity (or excitability) in the base of the brain called the brainstem.
Treating Headaches Associated with Concussion
It has been shown that using a particular method of physiotherapy treatment (following the Dean Watson theory, named after the Physiotherapist who developed and pioneered the treatment) reduces sensitivity in the brainstem, and therefore headaches, in migraine and whiplash sufferers. Early results from ongoing research suggest this is true in people with headaches after concussion. A number of the physiotherapists at Bluff Rd and North Rd Physiotherapy are familiar with this form of treatment.
What is Post Concussion Syndrome?
Post Concussion Syndrome is the “arbitrary persistence of symptoms beyond normal” after a concussion, whereas concussion usually involves a spontaneous resolution of symptoms. It seems more likely to occur if the initial concussion is more significant or poorly managed and can involve persistent headaches or fatigue, dizziness, and mood or sleep disturbance.
What Happens in the brain after a concussion?
Multiple research projects show that brain function is impaired post concussion in adults for at least 10 days when it comes to attention and memory tasks, reaction time and brain electrical activity. It is thought that this is evident for at least twice as long in the immature (ie less than 18yo) brain. Importantly, these changes remain on testing even when the patient has returned to feeling fit and well, hence the brain is still recovering even after the symptoms have disappeared. For this reason, it is recommended that participants not return to contact sport for a least one week post concussion as adults, and for a significant concussion, at least 2 weeks afterwards in those less than 18 years of age. However a return to pain free non-contact activity as soon as possible and as soon as tolerated has been shown to be beneficial and essential in the recovery after concussion. Complete rest has shown to be more harmful than helpful!!
Can Physio Help in Post Concussion Syndrome?
As with the headaches associated with a straightforward concussion, it is believed that physiotherapy following the Watson philosophy can be of help with treating headaches associated with post concussion syndrome. And it is thought that some of the other symptoms in post concussion syndrome (including fatigue, dizziness, cognitive disturbance and balance issues) may also relate to excitability in the brainstem and, as mentioned above, therefore be amenable to treatment following that same philosophy.
Bluff/North Rd Physio and Concussion
Bluff/North Rd Physio are currently involved in pilot research through the De La Salle Amateur Football Club looking at recovery times post concussion in those 18 and under, and are likely to be involved in more detailed research in 2019 in this demographic as well as the club’s women’s team, which is another group not well researched at this time.
Myself/Family member/friend has suffered a concussion and has symptoms beyond a couple of days…what should I do?
Give us a call at whichever of our clinics is closest to you and make a booking with one of our physios who can begin treatment as soon as possible to aid your speedy recovery.