What is a Concussion? Understanding the Condition and Your Road to Recovery

[For Patients]

Concussions are common. They happen every single day to people of all ages from all walks of life.

But the very frequency of concussions does not mean they are not serious, sometimes life-limiting and potentially fatal.

Here, use of the acronym TBI, which stands for traumatic brain injury, can help highlight what is so dangerous about concussions.

Your brain has just taken a hit. Will it bounce back? How long will that take? Will your recovery be full or partial?

As scary as this sounds, there is a lot you can do to influence the answers to these frequently asked questions.

How Many People Suffer Concussions Each Year?

If you or a loved one has sustained a concussion, it is important to understand you are not alone.

According to the Centers for Disease Control (CDC), an estimated 2.87 million people – which is about the equivalent of the entire state of Kansas – visit a health professional due to a traumatic brain injury each year.

While this is a daunting statistic to swallow, it does have somewhat of a silver lining.

Since concussion is a relatively common occurrence, medical science has a lot of data to work with to identify the best treatment and recovery strategies and techniques.

What Is a Concussion?

Recovery begins with understanding what has just happened to your brain. What does the word “concussion” really mean? What did your brain just go through?

The CDC’s Heads Up Program defines a concussion, or a traumatic brain injury, as a jolt, hit or blow to the head that causes the brain to move back and forth rapidly inside the skull.

If you have ever picked up a raw egg and shaken it back and forth, what was going on inside the eggshell was essentially the same thing that goes on inside your skull when you have a concussion.

Your brain gets shaken. Sometimes it gets bounced, stretched or twisted around. Some areas may endure more motion and damage than others depending on the nature and intensity of the impact.

As pediatrician and researcher Dr. Julie Gilchrist explains, this internal movement of the soft tissue structure that is the brain causes changes to how the brain works.

This means concussions are categorized as “functional” rather than “structural” injuries, because a concussion either temporarily or permanently changes how your brain functions.

What Happens When You Have TBI?

Researchers and physicians that label any concussion as “mild” do the experience and its impact a disservice.

To this point, as the American Association of Neurological Surgeons (AANS) explains, regardless of the spectrum, no concussion outcome is ever truly minor.

For classification purposes, however, TBI, or traumatic brain injury, is typically graded on a spectrum from mild to severe.

Within the spectrum, symptoms are generally grouped into five major categories: speech, sensory, cognitive, pain and motor.

So let’s take a look now at what symptoms from each major category you can expect along this spectrum.

Common temporary symptoms.

– Headache.
– Seeing “stars.”
– Vision issues (such as double-vision or blurred vision).
– Nausea.
– Vomiting.
– Mental confusion.
– Trouble concentrating.
– Light sensitivity.
– Problems with balance.
– Dizziness.
– Ears “ringing.”
– Loss of taste.
– Loss of smell.
– Loss of memory.
– Difficulty falling asleep.

Less common persistent or chronic symptoms.

– Symptoms persist longer than 14 days.
– Headache remains or gets worse.
– Cannot wake up.
– Ongoing nausea.
– Chronic vomiting.
– Seizures.
– Loss of coordination.
– Weakness or numbness.
– Slurred speech.
– Losing consciousness.
– Mood changes.

If any of these symptoms are present and this is not your first concussion, don’t wait. Seek urgent care now. Brain swelling can occur if a second injury occurs before the first one is completely healed.

What Treatment Is Available for Concussion?

Speaking of healing and recovery, you are likely wondering what types of treatments are available for traumatic brain injury.

It is common for patients to be sent for CT scans and then put on a period of rest.

But now we know that CT scans don’t always pick up on the types of microscopic tissue and blood vessel injury that TBI can inflict.

While an initial period of rest is always warranted if there is any evidence of bleeding, swelling, bruising or skull damage, for less severe TBI symptoms, the new school of concussion treatment favors a strategy of active physical and cognitive rehabilitation over rest.

Here, it can be especially important to avoid any type of physical exertion that requires or causes any additional brain movement. This is the last thing your brain needs right after a concussion!

Why Physical Activity Is Good Medicine for Concussion Recovery

It is easy to see why opting for a return to physical exercise and cognitive exertion might seem to fly in the face of reason when treating a concussion.

After all, physicians have been prescribing strict rest to treat traumatic brain injuries for decades!

As Translational Research in Traumatic Brain Injury points out, all that began to change around the mid-21st century when researchers confirmed the brain’s talent for neuroplasticity.

Neuroplasticity basically means a damaged brain can often reorganize itself to recover lost function after an injury such as a concussion.

But the brain needs oxygen to do this. What brings fresh oxygen to the brain? In order for the brain cells to get more oxygen, they have to wait for the circulatory system to bring it to them. Exercise gets the blood pumping and energizes the circulatory system, which has the happy result of sending more oxygen-rich blood to the brain so it can repair itself.

If there is damage to the point where the brain needs to use neuroplasticity to re-route lost function, then it needs a protein called the BDNF gene (brain-derived neurotrophic factor) to help it make those new connections.

And guess how the brain orders up more BDNF? As the Christopher and Dana Reeve Foundation highlights, exercise can help the brain place its order.

Today, the “exercise is TBI medicine” theory has largely replaced the “cocooning rest” prescription that was formerly the norm for TBI treatment.

After the first 48 hours, unless your physician specifically advises otherwise, it is time to get back up and get moving again.

What Role Does Cognitive “Exercise” Play in Concussion Recovery?

Now you understand the reasoning and research behind why appropriate physical aerobic exercise has replaced total extended rest for treatment of the majority of concussion cases today.

However, what place does cognitive exertion have in the bigger picture of TBI recovery?

Physical exercise gets the circulatory system moving again, pumping fresh oxygen through the body and up to the healing brain cells and at the same time flushing toxins out of the body.

Cognitive or mental exercise is how the brain identifies which functions have been altered or lost and now need to be rerouted by way of neuroplasticity – and specifically through the making of new neural connections in the brain.

This is why both physical and mental exercise are prescribed for treating traumatic brain injury.

Ideally, do your physical exercise first and then do your cognitive exercise. This way, your brain cells are flush with fresh oxygen and ready to jump in and begin making new neural connections to facilitate the restorative cognitive exercises you are doing.

Safety Tips for Exercising Body and Brain After a Concussion
After reading through the information here, you may feel inspired and eager to begin a regimen of physical and mental exercise to start feeling better right away.

But it is important to select the right types of exercise to experience the most benefit. It is also vital to steer clear of any type of body or brain exercise that may inadvertently make the injury you’ve sustained worse!

Specifically, avoid any type of physical activity that could jostle your brain as it heals. As an example, if you want to get your circulatory system pumping and boost oxygen to your brain, you want to do aerobic exercise.

But you don’t want to jog or run, which will set your brain bouncing around in your head like the beads in a mariachi rattle. Rather, choose a stationary activity such as the elliptical that allows you to move your limbs while keeping your head and neck stable.

Similarly, when you are working out your mind, try to avoid too much screen time, which could make some of your concussion symptoms worse.

Instead, read actual books, have conversations with loved ones, do paper-based puzzles like Sudoku, get a deck of cards and play Solitaire, do crossword or word association puzzles – you get the idea. Board games with friends can also be fun and mentally healing.

One Final Note for Healing After a Concussion
Be aware the information you are reading in this article is not meant to be taken as a substitute for the individual diagnosis and treatment of a medical professional.

However, you can use the information in this article to talk with your practitioner about all of your options for giving your brain its best chance to heal and recover after traumatic brain injury.

Contact Your Provider for a Customized Web Exercises Prescription

Have you or a loved one suffered a concussion? Exercise has proven to be a beneficial aspect of recovery from traumatic brain injury.

Contact your health care provider for a WebExercises prescription that is tailored to your specific condition and needs.

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David Cruz

Author David Cruz

Dr. David Cruz, DC practiced as a sports chiropractor in an medical orthopedic setting for 20 years treating athletic injuries, from weekend warriors to college athletes serving as the team chiropractor for Dominican University. He is a Certified Strength and Conditioning Specialist (CSCS) as well as having both FMS and SFMA certifications. The combination of his background in sports medicine and interest in technology made him passionate about bringing these two worlds closer together, resulting in the foundation of his company WebExercises in 2005. WebExercises is used by health and fitness professionals to create, share and monitor patient exercise programs.

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