Complete Concussion Management

Complete Concussion Management

What is a Concussion?

A concussion is a mild form of brain injury that results from acceleration or deceleration of the brain within the skull following a significant impact to the head or body. Concussions can be the result of a direct blow to the head, or of indirect forces causing quick movement of the head or neck. A concussion may occur with or without a loss of consciousness, and cannot be detected with imaging techniques such as a CT Scan or MRI.

Most concussion symptoms will resolve within 7-10 days, even though the full physiological effects of a concussion can last up to 30 days. For some, however, symptoms do not resolve within 7-10 days. In this scenario, the symptoms may be generated from multiple sources such as the neck, or the visual or vestibular systems. Symptoms may also be based on level of exertion. When symptoms persist beyond the 7-10 days, they may indicate Post Concussion Syndrome.

It is recommended that individuals who suffer a concussion undergo a full assessment in the early stages of their concussion, as a stepwise return to activity can help to prevent prolonged symptoms and suffering.

What are Common Symptoms of a Concussion?

Physical – headache, lightheadedness, dizziness, nausea, fatigue, changes in sleep patterns, changes in vision, sensitivity to light and noise.

  • Cognitive – reduced concentration, memory problems, feeling mentally foggy.
  • Emotional – irritability, anxiousness, depression, feeling more emotional than usual.

What sets CCMI Apart when it comes to Concussion Rehabilitation?

Baseline testing – The measures taken in an assessment following a concussion are most accurate when they can be compared against the same measures taken before your injury. This helps to most accurately determine the effects of your concussion, when you are fully recovered, and when it is safe to return to sport. CCMI uses a multi faceted baseline test which ensures that the many areas affected by concussion are accurately assessed. A series of physical and cognitive tests are performed at the beginning of the season and following an injury to determine whether a concussion has occurred, and the level and areas of impact. Once these areas can be identified, rehabilitation is focused where it is needed. Concussion symptoms often disappear days to weeks before the brain has recovered. Having valuable baseline information may help practitioners to make safer return to play decisions.

An integrated approach to rehabilitation – Following a short period of rest, the International Consensus Statement on Concussion in Sport (2016) recommends a gradual increase in mental and physical activity by a licensed healthcare practitioner trained in concussion management. CCMI concussion treatment includes: balance, exercise, and visual rehabilitation, manual therapy, nutritional interventions, and a gradual return to school, work, and sport.

The CCMI Concussion Tracker Smartphone Application for coaches, teachers, and athletes – The CCMI Concussion Tracker app supports safer return-to-sport decisions for young athletes. It captures and shares an athletes’ concussion status in real time. Where a concussion hits, Concussion Tracker enables the coach and athlete to:

  • Report and track concussion
  • Conduct sideline assessments
  • Record athlete’s recovery status and timeline
  • Scan and share medical documents if needed
  • Track daily symptoms for recovery progress
  • Store and view pre-season concussion test results

Lindsay Wourms  is a certified CCMI physiotherapist.

Contact us to start your concussion recovery today!

Call 250-861-8056

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
reception_dt@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
reception_gm@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
reception_wf@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
reception_lm@suncityphysiotherapy.com
more info

Making Sense of ‘Persistent’ Pain

Making Sense of ‘Persistent’ Pain

It seems self evident that pain is caused by tissue damage and is therefore resolved by tissue healing. But what about when the initial injury should have resolved long ago and yet our pain continues into many months and possibly even years? This is known as ‘persistent’ or ‘chronic’ pain and in order to understand how it can develop we need to explore where pain really comes from.

Tissue damage is not actually what causes us to feel pain per se, rather, it is our nervous system’s RESPONSE to PERCEIVED DAMAGE or even just the perception of POTENTIAL damage that leads to this. This mechanism can be described in terms of inputs and outputs.

An input is where the body picks up signs of potential tissue damage via ‘nociceptive’ nerves, which detect things such as increases in tissue pressure, shearing or tearing forces, extremes of hot or cold and so forth. This information is then sent to the central nervous system (CNS) for consideration.

If the CNS perceives these signals as a threat to your well-being, it will effect an output response by modifying or activating the function of a number of bodily systems. One good example is the sympathetic nervous system, which helps to bring about the body’s stress response commonly know as ‘fight or flight’. These output responses can lead to symptoms such as:

• Muscle spasms/aches/tightness/weakness,
• Changes in your posture
• Increased rate of breathing• Increased pain and sensitivity to pain
• Increased heart muscle tone,
• Increased arousal, alertness and attention.

These responses are generally necessary to aid our recovery, but there are times when they can become excessive and counterproductive. For example, if tissue damage is allowed to go on for prolonged periods, it can lead the CNS to accelerate its response causing it to react to things that would not normally be painful. Also, because responses are based on the CNS’s PERCEIVED level of injury or threat, a person’s beliefs, past experiences and emotional state (anxiety/low mood) can be enough to lead the body to mount a pain response even in the absence of any actual tissue damage.

A counterproductive or prolonged response like this can also lead to:

• Slow healing of cuts and recovery from illness
• Difficulty in concentration and memory
• Changes in sleep patterns
• Fatigue
• Altered libido
• Digestive problems
• Widespread and spontaneous pain
• Increased muscle activity

In these situations, conventional treatments alone are not always enough and a deeper knowledge of how to bring back true balance is essential. Holistic physiotherapy treatment will help you to move away from a persistent, painful and domineering ‘fight or flight’ state by boosting areas such as your immune and parasympathetic nervous
systems (areas all too often ignored!).

Some examples of things that can help include:

• Relaxation and breathing exercises
• Having a good understanding of your condition
• Graded fitness training and exercises
• Doing away with unhelpful and damaging beliefs and worries
• Developing a healthy sleep pattern

Further articles to come! If you’re struggling in the meantime, contact us today to start your journey of understanding and lasting recovery.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
reception_dt@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
reception_gm@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
reception_wf@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
reception_lm@suncityphysiotherapy.com
more info

To Kegel or not to Kegel?

To Kegel or not to Kegel?

You may have read on social media that you should be doing kegel exercises to help strengthen your pelvic floor. BUT, what is the pelvic floor? And more importantly, what are kegel exercises and should you be doing them? The answer is…it depends.

The pelvic floor is a sling of muscles located at the bottom of your pelvis that span from your pubic bone to your tailbone. These muscles have many different functions, including:

  • Sphincter control – they control the opening and closing of the urethral and anal sphincters and thereby help start and stop the flow of urine, gas and poop.
  • Support – they help support the pelvic organs (such as your bladder, rectum, +/- uterus).
  • Sexual – they play a role in orgasms and can help increase pleasurable sensations.
  • Sump pump – they help circulate lymphatic and venous fluid back towards the heart.
  • Stability – the pelvic floor is one of the four main “core” muscles, which work together to help provide stability for our abdomen, low back, and pelvis.

The Kegel refers to a pelvic floor muscle contraction, which involves contracting (flexing) and relaxing the pelvic floor muscles. Often times, however, these are done incorrectly.

When someone does have a weak pelvic floor, they may run into issues such as stress incontinence, urge incontinence, frequency, prolapse, and/or low back pain. Strengthening can be an effective way to improve these symptoms. HOWEVER, if you have symptoms such as pain with intercourse, pain with urinating or emptying your bowels, incomplete emptying, urgency, and/or frequency, then strength focused pelvic floor exercises may NOT be appropriate to start. In both cases a person may be experiencing incontinence…however, the treatment approach would be different.

In the latter scenario (increased tension), treatment may first focus on reducing pain, tension, and tightness with a variety of exercises, education and manual therapy techniques. Once this is accomplished, it may then be suitable to start pelvic floor strengthening.

A pelvic floor physiotherapist can help you determine if you have a weak or tense pelvic floor, and they can create an INDIVIDUALIZED program to help you meet your goals.

During an initial assessment, your pelvic floor physiotherapist will go over your health history, symptoms, and goals. They will then complete an external exam (i.e. posture, low back, sacroiliac joint (SI joint), hips) and/or an internal vaginal and/or rectal exam. This will allow your physiotherapist to evaluate your pelvic floor strength, coordination, tone, areas of pain, and potential prolapse. Please note that an internal exam is only completed with the Client’s consent and it does NOT involve a speculum. While an internal exam can help provide lots of useful information about the pelvic floor, it is not necessary if you are uncomfortable with the procedure, or you are experiencing a lot of pain. You do not need a doctor’s referral to see a pelvic floor physiotherapist. If you are interested in optimizing your pelvic floor, you can book an initial pelvic floor physiotherapy appointment by calling the Lake Country Sun City location, or book now with our direct online booking.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
reception_dt@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
reception_gm@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
reception_wf@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
reception_lm@suncityphysiotherapy.com
more info