Are you ready for a fun-filled and safe winter season!?

The UVM Medical Center’s Rehab Therapy Center wants to ensure you know everything you need to in order to stay healthy. Concussion or traumatic brain injury (TBI) is a hot topic today — and for good reason. Sports-related concussions impact about 3.8 million athletes each year in the US (Pearce, et al., AM J Sports Med. 2015).

Prevention is so important.

Make sure everyone in your family has properly fitted headgear. Check out this link from ThinkFirst.org for some tips in proper fitting for your equipment.

We also recommend regular vision checks. This ensures we accurately see what is coming at us and judge and perceive depth for those higher speed winter sports.

What are the symptoms of concussion or TBI?

See your doctor if you experience any of the following symptoms: repeated nausea or vomiting, persistent headache, dizziness, feeling tired/no energy, vision changes, sleep changes, emotional or behavioral changes, weakness, and/or balance changes.

What to do if you hit your head

We learn more all the time about concussion. If you do, unfortunately, end up hitting your head, here are some things to know:

  • The acute phase of concussion may last up to 7 days. Recent research in concussion indicates heavy focus on rest ONLY initially within the acute phase.
  • After the acute stage, we recommend trying to get back to your normal daily activities, to your tolerance, to promote healing. One conclusion from the Journal of the American Medical Association (JAMA) — which looked at the association between early participation in physical activity following acute concussion and persistent post concussive symptoms in children and adolescents — indicates that physical activity within 7 days of acute injury compared with no physical activity was associated with reduction of risk of persistent post-concussion symptoms at 28 days (Grool, et al., JAMA, 2016).
  • If your doctor recommends rest, clarify if they intend strict rest, versus cognitive and physical rest, or activity as tolerated with recommended rest breaks.
  • Talk to your doctor about specific recommendations and guidance and potentially a referral to Occupational Therapy and/or Physical Therapy should symptoms persist beyond 10-14 days.
  • It is also noteworthy that vision problems are very common after concussion. Oculomotor problems are reported in 30-65% of mild TBI (Grool et al., JAMA, 2016). Often a binocular evaluation, or a visual efficiency evaluation is required by a behavioral optometrist to identify areas that can be strengthened by exercise or supported with glasses, prisms, or other tools while the brain is healing.
  • Never underestimate the impact of stress on our brain and how if functions. Especially while it is healing from a brain injury.

Four takeaways to remember

In summary with help from the American Physical Therapy Association 2018 combined sections meeting:

  1. Prevention is key!
  2. Though we do not know the exactly when or how much activity is best during recovery…We DO know that strict rest is NOT indicated for treating concussion beyond the acute phase.
  3. There IS evidence that active intervention supports positive outcomes following concussion.
  4. Rely on your medical team for guidance should you or someone you know experience any concussion-like symptoms.

Lindsey Schneider, OT, is an occupational therapist at the University of Vermont Medical Center. 

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