Sports Medicine Yes, Concussions Are Treatable. Here’s How. By Sports Medicine, March 5, 2017 The term concussion is used frequently to describe head injuries, but most people don’t fully understand what a concussion is, or realize that the injury is treatable. Let’s start with the basics. A concussion is defined as a mild traumatic brain injury (mTBI) caused by a jolt to the head or body that disrupts the function of the brain. This injury can result in physical, cognitive, emotional, and/or sleep-related symptoms that may or may not involve a loss of consciousness. The symptoms can last from several minutes, to days, weeks, months, or longer. “Concussions can have debilitating symptoms and prolonged recovery periods if they’re not diagnosed correctly and treated appropriately,” explained Micky Collins, PhD, executive and clinical director of the UPMC Sports Medicine Concussion Program. “Complex recoveries can lead to lost time at school or work, inability to participate in sports and recreational activities, and many other difficulties. “A multidisciplinary management approach is needed for patients to achieve optimal recovery.” What is a concussion? A concussion is defined as a mild traumatic brain injury (mTBI) caused by a jolt to the head or body that disrupts the function of the brain. Not only are no two concussions alike, but the experience of concussion is different for every individual. Therefore, the treatment method may also differ. In fact, researchers at the UPMC Sports Medicine Concussion Program have identified six primary clinical profiles, or trajectories, that a concussion may take, each with a different treatment method. Concussion Treatment Methods Vestibular Difficulties with balance and the ability to interpret space and motion are characteristics of this type of concussion. Patients may have trouble stabilizing their vision when moving their head, and hand-eye coordination may be affected. Vestibular rehabilitation is used for treatment and can be customized to suit the patient’s work or school demands, and the complexity of environments he or she is typically in. Ocular-motor This trajectory includes patients who have difficulty coordinating their eye movements. Their symptoms may include headache, fatigue, and difficulty focusing their vision. Reading and working on a computer may exacerbate these symptoms. Depending on the severity of symptoms, a neuro-optometrist may recommend vision therapy in addition to vestibular therapy. Cognitive Patients diagnosed with this trajectory may experience a decreased ability to concentrate, have difficulty learning new information, poor memory, and a decreased ability to multitask. Some may experience an increase in fatigue from the beginning to end of the day. Those suffering cognitive fatigue may benefit from having academic and workplace accommodations to reduce the cognitive load, taking breaks, and asking for a workload reduction. Strict sleep, diet, hydration, stress management, and exercise regulations must also be established. And some patients may need to consider medications. Post-traumatic migraine Headache, nausea, and sensitivity to light or noise are symptoms of this concussion trajectory. Treatment should first include a focus on strict behavioral management, with an emphasis on regular sleep – sleeping only at night and not taking naps. Proper hydration, diet, stress management, and some level of physical activity are also key. Medications to alleviate the symptoms may also be necessary. Cervical Cervical concussions are caused by an injury to the extra-cranial region, including the neck and spinal cord. Primary symptoms include headaches and neck pain. Treatment for these injuries focuses on expanding the range of motion through mobilization techniques and posture correction exercises. Biofeedback, training patients to control their body’s functions with their mind, and anti-inflammatory or analgesic agents may also be used for pain reduction. Anxiety/mood Many individuals with concussion will experience some changes in mood, but this trajectory refers to those with excessive anxiety or significant irritability that interferes with their lives. Exertion therapy can be useful. Patients follow a prescribed daily exercise plan to help stabilize their mood, improve their quality of sleep, and decrease anxious thoughts. “It’s important to remember that concussions are highly treatable,” Dr. Collins said. “Although one type of concussion may be more dominant in terms of symptoms experienced, patients may experience more than one trajectory. A correct diagnosis and treatment plan individually designed for the patient improves the clinical outcome.” For more information about the UPMC Sports Medicine Concussion Program, visit ReThinkConcussions.com or call 412-432-3681.