To book a physiotherapy assessment following a concussion please phone 519-719-1782 and request an assessment with Denise Vandermeulen or book online.
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Physiotherapy Role in Management of Concussion

  • A concussion is a brain injury. It may be caused by a blow to the head, face, neck or body that results in a jarring of the brain inside the skull.  Loss of consciousness does not need to have occurred. A concussion can result from a variety of activities including contact in sport, falling or being in a motor vehicle collision.  
  • Signs and symptoms of a concussion may include:  headache, neck pain, dizziness, blurred vision, nausea or vomiting, fatigue, sensitivity to light or noise, general confusion or fogginess, difficulty concentrating and difficulty remembering.  Mood changes may also occur including irritability, emotional lability, sadness, or anxiety. After a medical evaluation, most concussions will heal gradually with an initial period of mental and physical rest, followed by gradual return to mental and physical activity. 
  • Physiotherapists understand the acute process occurring and the nature of the changes in brain function following concussion or mild traumatic brain injury and the importance of activity modification to ensure full recovery. 
  • Physiotherapists provide education and guidance for individuals, families and athletes on safe and progressive return to cognitive and physical activities after concussion. 
  • Physiotherapists will assist with assessment of any neck related issues that may be contributing to symptoms following concussion and provide a thorough assessment of the neck to determine if treatment would be beneficial.  Treatments would include gentle manual therapy and/ or modalities and exercise to address symptoms and restore mobility.  
  • Balance difficulties and dizziness are common after concussion. Physiotherapists will perform tests to assess for difficulties in balance and vestibular function and prescribe appropriate retraining activities.
  • Increasing exercise tolerance is also an area that often needs to be addressed and physiotherapists will address activity tolerances and increasing this when appropriate with an individualized program. 
  • Physiotherapists will assess visual function following concussion. Physiotherapists are able to provide education into providing increased visual comfort, as well vision retraining activities. Physiotherapists can provide referral to other professionals for further assessment and treatment for visual system dysfunction.
  • Cognitive function can be screened by physiotherapists to identify and monitor areas of difficulty, and referral made to the appropriate medical professionals.
  • In addition, sleep and mood disorders can be an issue following concussion, and may require referral to the appropriate medical professionals.
  • Research is ongoing in many areas related to concussion. These include diagnosis and detection of concussion, management of concussion, ie. the appropriate length of the initial rest period and the optimal time to introduce activity, and how clinical recovery relates to recovery of brain neurophysiology.  
 
 
Resources: 
Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016
https://bjsm.bmj.com/content/bjsports/51/11/838.full.pdf
5 Key Messages from Berlin:
http://casem-acmse.org/wp-content/uploads/2016/07/5-key-messages-from-Berlin_ENG-1.pdf
Canadian Academy of Exercise and Sport Medicine:
https://casem-acmse.org/
Canadian Concussion Collaborative:
http://casem-acmse.org/education/ccc/
Concussion Awareness Training Tool:
https://cattonline.com/
Ontario Neurotrauma Foundation:
http://onf.org/documents/guidelines-diagnosing-and-managing-pediatric-concussion
Parachute Canada:
http://www.parachutecanada.org/resources
Sport Physiotherapy Canada:
https://www.sportphysio.ca/sportphysiou/concussion/