Concussion! What do I do?
While most physiotherapists and chiropractors are trained in basic concussion rehabilitation, our clinics have some of the world’s most educated and involved concussion researchers.
Step 1
If you have any of the following symptoms after injury, call an ambulance:
- Severe or increasing headache
- Loss of consciousness
- Seizure or convulsion
- Vomiting
- Double vision
- Weakness or tingling/burning in arms or legs
Kathryn Schneider, PT, PhD, at our Evidence Sport and Spine North clinic, is a co-lead for the scientific committee and co-first author on the Amsterdam International Consensus Statement on Concussion in Sport. Kathryn Schneider is internationally sought for her clinical experience and research. If you have seen any of her presentations on concussion research and treatment, you will know that athletes and researchers around the world defer to her for answers.
Our physiotherapists have studied the concussion protocols as written by the international author panel and are trained to guide you through a concussion.
The three main components that Physiotherapy can address after a concussion are:
- Head on Neck Control (muscular balance)
- Vestibular System assessment and rehabilitation (Frenzel goggles available at some locations)
- Sensory motor/Oculomotor Nerve assessment and rehabilitation
Step 2
If you have been diagnosed with a concussion, or suspect you may have one, call to book an appointment. A medical practitioner will be able to determine a diagnosis and provide an individualized treatment plan to ensure you are following evidence based recommendations to facilitate recovery.
Step 3
Rest! It is critical to stop your sport and activity for 24-48 hours after a suspected concussion to remove the risk of a second injury.
The remaining steps will need to be supervised by one of our practitioners. Your return-to-sport or return-to-activity will require medical clearance. This step is one of the most important things you can do to prevent worsening symptoms and long-term concerns. We will collaborate closely with your doctor every step of the way.
If you are doing research on someone else’s behalf (so they can have a screen break!), consider these resources.
Kathryn Schneider, PT, PhD has written a ‘best practices‘ document for the Sport Injury Research Council, applicable to all sports. This details the latest guidelines and a summary of some of the latest information, including some of the action plans Dr. Schneider presented to the Government of Canada
Read Nicole’s blog on how much rest is appropriate after a suspected or confirmed concussion.
Check an interview transcript from Dr. Kathryn Schneider, PT, PhD and Dr. Cory Wowk, MD.
Read a blog from Kristen Hunter on the dangers of untreated concussions.
Parents, coaches, and trainers need to be part of the prevention strategy.
Read the resources available at Parachute Canada and the Canadian Concussion Collaborative and let our multidisciplinary group of clinics take good care of you.
| Standard Assessment | Extended Assessment | |
|---|---|---|
| ⏱️ Appointment duration | 1 hour | 2.5 hours |
| ⏳ Time since injury* | Typically within 4 weeks | Typically > 4 weeks |
| 🧠 Symptoms | 1-2 main symptoms | Multiple symptoms |
| Questionnaires | ✔️ | ✔️ |
| Screen | Detailed Exam | Screen | Detailed Exam | |
| 🧠 Neurological | ✔️ | +/- | ✔️ | ✔️ |
| 🦴 Cervical | ✔️ | +/- | ✔️ | ✔️ |
| 👂Vestibular | ✔️ | +/- | ✔️ | ✔️ |
| 💢 TMJ | ✔️ | +/- | ✔️ | ✔️ |
| 👁️ Oculomotor | ✔️ | +/- | ✔️ | ✔️ |
| 👁️↔️ Vestibular Ocular Motor (VOMS) | ✔️ | +/- | ✔️ | ✔️ |
| 🧍Balance | ✔️ | +/- | ✔️ | ✔️ |
| 🏃Physical Exertion** | – | – | – | ✔️ |
Standard assessment (one hour)
Typically for individuals within 4 weeks of injury, and with only one or two primary symptoms.
Key tests based on symptoms using a symptom targeted and exercise approach as tolerated by the patient based on the primary symptom generators. A screening of all relevant systems and a more comprehensive assessment of the primary symptom and related system(s) will be completed. Components may include (again based on the primary symptom generators): vestibulo-ocular reflex, cervical spine, oculomotor, balance, dynamic balance, infra-red blackout goggles (if indicated).
Overall cost of Assessment varies clinic to clinic, from $130 to $200.
Extended assessment (2.5 hours)
Typically for individuals who are 4 weeks or greater post injury or who are travelling in to Calgary for an assessment.
Detailed assessment of all relevant systems including neurological screen, vestibulo-ocular reflex, cervical spine, balance, dynamic balance, infra-red blackout goggles, vestibular ocular motor screen (VOMS), and physical exertion. Overall cost of Assessment $600. Only available at Evidence Sport and Spine North
The Most Common Questions our physiotherapists get about concussions
Q: How soon can I get back to my sport after a concussion?
A: Rest for 24-48 hours is absolutely paramount after any concussion. Returning to sport or play requires medical clearance. We will collaborate with your doctor or a Sport Medicine Physician as necessary to provide appropriate guidelines for you and a gradual return to sport.
Q: Won’t a concussion just get better with rest?
A: The majority of symptoms from a concussion can resolve independently within 10-15 days. Complications can occur without proper medical monitoring and the careful prevention of further injury even within this time period. To avoid long-lasting or serious complications, it is critical to seek a multidisciplinary approach including physiotherapy.
Q: If I have had a concussion in the past, does that put me at a higher risk of another concussion?
A: Unlike physical injuries, concussion recurrence does not have the same body of evidence involved. Some of this is because a concussion can come from multiple mechanisms of injury, ranging from slipping on ice to sport-related to a car collision. The most important part is to ensure you have medical clearance to begin a gradual return to your activities to reduce the risk of serious complications should a re-injury occur.
Q: What about imaging? Should I get a blood test or brain scan to diagnose a concussion?
A: Advanced imaging may be used in the emergency room to rule out life-threatening conditions. Concussion diagnosis, following the latest guidelines however, are individualized and continue to be based on healthcare provider assessments. While many forms of technology (such as brain scans, blood and saliva tests) hold promise from a research standpoint, these technologies aren’t yet ready for mainstream management of a concussion.
Your Next Steps…
Book An Appointment
Determine Coverage
Get An Assessment
Start Treatment