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Concussion Rehabilitation at Prostaff Physical Therapy

Increasing focus on concussion and head trauma over the past couple of years has prompted us to develop the following information as to the role Prostaff Physical Therapy can play in management of concussions.

The athlete or individual should be evaluated by their physician after an occurrence to see if a referral to physical therapy is warranted. A concussion should be managed with a team approach including a physician, physical therapist, and parent. The patient should not have worsening symptoms at rest for 24 hours prior to beginning physical therapy.

Prostaff Physical Therapy is able to evaluate and treat many of the symptoms and problems related to concussion. After the athlete or individual is asymptomatic at rest, or is with extended symptoms, they need to be assessed while performing symptom provoking movements and activities to ensure they have fully recovered, or assess their status in recovery. Treatments would include vestibular rehabilitation (balance, visual movements, hand-eye coordination) and neck problems (tightness, soreness and pain) following a concussion. We can also address any other possible injuries or limitations the patient may have sustained. This can be initiated while the patient is still symptomatic at rest.

Our physical therapists will focus on the symptoms and limitation observed during the evaluation and continually as the patient is being treated.

Treatment sessions will focus on, but are not limited to:

The majority of patients with concussion symptoms will recover in 7-10 days. However they still need to be tested for any concussion symptoms with balance, vestibular activities, and through a progression of activities to assess for symptoms. Simply because the patient has no symptoms at rest does not mean they won’t with activity.

As the patient’s symptoms improve they will gradually and properly be progressed through physical activity towards return to sport, or normal level of activity, using the following graded exercises approach for return to play.

Resumption of Physical Activity progression from Concussion Health

1. Light aerobic exercise (e.g., walking or stationary cycling) at 30-50% heart rate for 15-25 min; Vestibular/visual/balance exercises as needed.

2. Sport specific training (e.g., running drills, agility skills) at 50-70% heart rate for 25-40 min; advanced vestibular/visual/balance exercises as needed.

3. Non-contact training drills at 70-90% heart rate for >45 min

4. Full contact drills

5. Game play