Concussion treatment: 5 areas to focus concussion treatment

Concussion treatment in 5 buckets

Learn about what concussion is, common symptoms, recovery timeline and the 5 main areas of concussion treatment. Dr. Madison talks with concussion expert Dr. Heisig in Vestibular Group Fit to go over the different areas of concussion and important treatment areas to consider. check out some of the great information below! 

What is a Concussion

A concussion is classified as a mild traumatic brain injury. Traumatic brain injuries are classified  on a spectrum from mild to severe, we are only looking at concussion in this post. 

A concussion occurs from hitting your head, or a sudden speed change that impacts the brain. You don’t have to hit your head for this rapid speed change, but is a common way concussions occur. 

Imaging will not show a concussion. imaging can show blood clots, bleeding, or broken bones and other structures, but it cannot show a doctor that there is a concussion. This is determine by the method of injury and reported symptoms. 

Concussion Metabolic Cascade

What happens to our body during an acute concussive event happens at the cellular level. The sudden change in speed creates stretching and shearing of the brain cells and neurons. 

Sudden stretching and shearing of our neurons changes the balance of our electrolytes. These electrolytes are important for brain function and how our neurons fire. This sudden change in electrolyte balance results in random neuron firing and neural toxicity. 

Getting our brain’s electrolytes back in proper balance takes a lot of energy and time. Typically around 3-4 weeks. During this time our brain is functioning in a metabolic energy deficit.  Our brain has difficulty carrying out typical functions due to the metabolic energy deficit. This energy deficit leads to many symptoms people experience such a disorientation, fatigue, brain fog, headaches etc.

One way to think of this is with a circle or pie analogy. A full circle is the total amount of energy we have to perform daily functions. The electrolyte rebalancing is taking up a large part of this energy pie. This leaves a smaller amount of energy pie to do the typical activities our brain does. This leaves to picking and choosing certain activities, or having to take additional time between tasks to restore energy. 


Concussion treatment: 5 areas to focus concussion treatment

Rest or not rest? What research says about best concussion treatment

New guidelines in concussion have changed the way concussion treatment is performed. Typically in concussion treatment, someone might be told to rest for weeks, this should no longer be the case. Research shows that resting after a concussion for 24-48 hours and then gradually getting back into typical activities yields the best results. 

Rest doesn’t mean sleeping all day. It means taking things a little slower than you normally would. This might look like a short walk instead of a high intensity workout, or limiting screen time with more breaks in between screen use. This can vary by the person depending on their concussion treatment buckets we’ll talk about next. 

The goal with concussion is to gradually increase the intensity of activity to get back to your baseline. Again this can take up to 3-4 weeks. Listen to your body as guidance, new or worsening symptoms is your body saying that you’re taking on more than your body can tolerate. Take a note from your body to rest and recover and adjust the activity. 

What are the 5 main buckets of concussion treatment

Recent concussion treatment and management has taken on a new way to help classify concussion to better include the many different presentations and symptoms someone with a concussion can have. A questionnaire tool called the CP Screen gives a series of questions that help determine the main categories of symptoms someone is experiencing. This screen has 5 main subtypes and 2 modifiers to help capture the main symptom areas to address on a person to person basis. 

The five concussion treatment buckets are:

  1. Autonomic and Exercise Intolerance
  2. Visual Vestibular 
  3. Neck and Cervical
  4. Hormonal and Metabolic
  5. Psychological (Mental and Emotional) 

In the next section, we’ll go into more detail on each of these 5 areas of concussion treatment. More than one can apply to someone with a concussion but breaking down into these categories can help determine how to prioritize treatment to address the major concerns being experienced. 

5 Buckets of Concussion Treatment Cont.

1.Autonomic and Exercise Intolerance

Concussion can impact blood flow. This can lead to autonomic dysfunction such as lightheadedness, dizziness, tunnel vision or elevated heart rate when standing up. In other cases, symptoms might be gone at rest, and reappear during exercise or increased exertion. Graded movement, and testing such as the Nasa lean test or buffalo concussion testing performed by a medical provider can assist in working with you in exercise progression and treatment. 

2. Visual Vestibular 

A concussion can impact our visual and vestibular system making us feel dizzy, off balance, or even difficulty with reading, screens or eye strain. BPPV prevalence increases after concussion and should be screened as part of a  comprehensive concussion assessment. VRT or vision therapy can further determine areas to work on to address these symptoms. 

3. Neck and Cervical 

Neck pain, stiffness, limited range of motion are common after a concussion. This again can vary based on the mechanism of injury and individual presentation. Focused treatment on the neck can assist with headaches, muscle pain, reduced range of motion and more.

4. Hormonal and Metabolic 

Keeping the full picture in mind includes looking at lifestyle and other medical conditions someone has. Nutrition and hydration is key for overall health and recovery. Avoiding any allergies or food sensitivities is important to reduce stress and inflammation while healing from a concussion. Pre existing metabolic conditions such as a thyroid condition can also contribute to concussion symptoms and should be evaluated and ensure it is being properly managed. 

5. Psychological (Mental and Emotional) 

A concussion can create a major shift in how you’re feeling, your usual routine, or maybe even result in trauma from the event that the concussion came from. Those with a concussion will report feeling more irritable, anxious, depressed, or just not like their typical self. for concussion treatment, having a skilled professional to assist with mental health can be extremely helpful as part of concussion treatment. There are ways to see someone over telehealth or over the phone to make this essential healthcare more accessible and provide the privacy some may want. Check out some options here or here or here, yup that important!  

Learn more with Vestibular Group Fit


Want to learn more about concussion  and other vestibular tools from the experts and be a part of a supportive community to get back to your daily life?  Find out more at this link: https://thevertigodoctor.com/about-group/


Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

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