As a physiotherapist I have witnessed and managed dozens of concussions, but only experienced two. The first was in 1999 when I hit my head in phys ed class, and the second was in 2007 when I fell off my bicycle on my way to work at the local grocery store. Both times I was able to take time to rest and recover and I didn’t really think about the process all that much.
This spring, I experienced my third concussion; my first as a physiotherapist and business owner. It was an informative journey and I’d like to share some of the things that I learned.
In this day and age when we are so aware of head injuries, “concussion” is the first word that comes to mind after all the expletives have been voiced. When you’re lying on the sidewalk and your dog is taking the opportunity to lick your face, you know. This is not good.
A concussion is defined as an injury to the brain that results from a blow to the head or body. Some people get caught up on whether it is a brain injury per se or a separate entity. As someone who has experienced several, I can say that it doesn’t matter. A concussion is an injury that changes you, usually temporarily. You may develop a headache, feeling of slowness or fogginess, irritability, dizziness, and more. You may have been an athlete, a professional or a scholar, but now you’re only a fraction of your normal self.
Note that this fraction might be 9.5/10. Concussions can be mild or serious, and there’s a lot of variability. It’s this element that makes them so difficult to diagnose and manage.
After slipping on the ice and landing on the back of my head, my first step was to feel my head for any obvious bleeding. Then I slowly got up. First I got on all fours, then on one knee, and finally, on two feet. I walked the 20 metres home (so lucky!) and cancelled all commitments for the following days.
In the first 24 hours after a concussion, there are two main priorities: make sure there are no serious injuries (like an internal bleed) and rest.
Concerning signs are:
If these are present, get to an emergency room right away. Note that fatigue is common after a concussion and is different from drowsiness.
After resting in a dark, quiet room for a day or two, I was able to get to the bathroom without my head exploding. I was happy to see that I was making progress. My husband asked when I could expect to be better, and I told him that the research says that most people recover in 7-10 days.
During that time I kept an eye on my signs and symptoms. I had visual processing difficulties, which are common after concussions. My pupils took a while to adapt to changing light conditions, natural light gave me headaches, and I couldn’t do any reading.
Other triggers for my symptoms were loud sounds (anything higher than a moderate whisper) and physical activity (ie. walking around the house). Knowing this allowed me to understand what activities I should limit and what I could reasonably do. For example, I was able to knit as long as the pattern was simple. This kept me occupied and feeling productive while I recovered.
In addition to experiencing a concussion, I also had whiplash. My neck muscles were in a protective spasm and they were making my headache worse. Essentially, I had a tension headache in addition to the concussion headache.
Knowing that early access to care can be very helpful in motor vehicle-related whiplash, I called my physiotherapist right away. She was able to see me the day after my fall and the following day. Three days after the fall, my neck felt 100% better.
This is a crucial piece of concussion recovery that is often overlooked. Just because you’re supposed to rest in the beginning doesn’t mean that you can’t have your other injuries taken care of. It can also help to get out of the house and access some fresh air!
One week after my fall, I continued to have a headache but was able to perform my work duties without my symptoms worsening. I was able to walk, talk, and problem solve for 2-3 hours at a time. This allowed me to return to work part time with confidence. Ten days after the fall, I was back to my normal life.
It’s important to identify the work tasks that may aggravate the concussion symptoms and determine where their limits are. For example, in my case I would get a headache and feel unwell after about 3 hours of being upright. I knew that I could not work for more than 2 hours because I’d also need to get there and back.
The key is to do what you can without spiking your symptoms. If you’re making progress and improvements – no matter how small – you’re moving in the right direction. Each concussion takes a different path to healing and it’s difficult to predict what that path will look like for an individual. However, the research tells us that most people do recover their function quite quickly.
It can be frustrating to get to day 6 and still not be able to walk around the block. Before my concussion, I was walking 1.5-2 hours per day. Just take your time and remember that pushing your progress can result in a setback, which only lengthens your recovery time in the long run.
Try to find things that you can do that don’t make your symptoms worse. For me, it was knitting. Others may be able to walk but not run. Find your own balance.
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