A concussion was also referred to as a mild traumatic brain injury. It is induced by biomechanical forces. It is a result of direct trauma to the head or face or rotational force at the neck. It creates a constellation of symptoms including physical, cognitive, behavioral and emotional changes.
The initial medical assessment would consist of information gathering regarding the mechanism of injury, initial symptoms and story of how the injury happened. A cognitive screen including symptomatic inventory from the SCAT5 questionnaire updated from the Berlin symposium 2017. Overall cranial nerve, neurological motor and sensory exam with be completed as well as modified balance test. Review of mental health is important during the assessment.
Information regarding exacerbation of symptoms including electronic and screen use such as TV computer. A detailed assessment of sleep including information regarding initiation of sleep and frequent waking, and if there is non-refreshing sleep upon waking.
Information related to difficulties in school, missing school or not be able to attend work or having modifications to the workplace duties because of symptoms.
The treating physician may determine if further investigations may be necessary including x-rays, CT scan, visual exam, cardiovascular testing, blood work.
Within the first 1-2 weeks, the best treatment option includes rest, reduced mental and physical exertion. Avoiding screens and avoiding bright light and loud environments. These help to improve symptoms.
If the athlete requires therapy it might include physiotherapy, sports chiropractor treatment, nutritional assessment, occupational therapy for cognitive training, massage therapy, breathing therapy, and counseling for mood-related issues.
At The Armoury the physicians are detailed in their assessment and attempt to categorize the type of concussion. This determines the appropriate therapy for the athlete instead of a hail mary approach.
Certain athletes may require medication for pain, sleep, nerve-related symptoms, nausea, lightheadedness or mood. The treating physician would be the expert in determining which medications would be helpful during the recovery period.
Exercise should be avoided until deemed okay by a therapist or physician and an exertional tolerance test can be completed to provide a subthreshold exercise training program
The Armoury has one of the most comprehensive concussion assessment and treatment programs
Baseline testing is also completed which includes Dynavision test, ImPACT test, cervical range of motion, grip strength and balance testing