NEPA Vital Signs - Summer Fall 2018 - 35

SUMMER/ FALL 2018

S

everal years ago, my daughter suffered a
concussion while skiing . I had the opportunity at

Physical therapy is incredibly useful and effective for treating
post-concussive symptomatology manifested by headache, vertigo,
visual impairments and exercise intolerance.

that time to experience this event as both a father and a
physician. The conflicting feelings that I experienced included
both fear that she may have persistent symptoms and confidence
that most patients do ultimately recover.

Health care providers should hold the therapy and therapist
to high standards for both creativity (keep it interesting) and
completeness (to ensure full recovery). Too often students are
given clearance to return to play thanks to a reduction in their
symptoms, rather than resolution. It is my preference, when
treating children and young adults, to use medication/supplements sparingly and on a temporary basis. These are used to help
facilitate participation in therapy and normal school activities.

Sports concussions are a condition that are finally being recognized as a serious issue that requires attention and treatment to
both resolve and prevent. Health care providers, teachers, parents,
and coaches all play a role in their resolution and prevention.
Student athletics are often as much a part of the daily activity
as are the academic rigors they face at school. As a result of this,
both the students and the parents place a priority of the return
to sport. However, overriding emphasis should be on the safe
return to sport. That is, when fully recovered.

Symptoms can at times consist of emotional lability, personality
changes and anxiety, which are best addressed through a compassionate and flexible school support system and psychological
interventions and testing when necessary. Empathy regarding the
student's difficulties can go along way toward assisting in recovery.

Mounting research into both the short-, and perhaps more
importantly, the long-term effects of cerebral concussion
injuries demands our attention. Care must be taken to maximize full and complete concussion recovery and greater steps
taken to prevent the occurrence of concussions in all sports
into the future.

As important as treatment is, prevention is perhaps a loftier
goal. The best intervention available at this time for cerebral
concussion prevention is maximizing cervical and shoulder girdle muscular strength. This allows the athlete to better control
acceleration and deceleration of the head and neck complex.
Thusly reducing impulse force and the potential development
of concussions. This appears to be particularly important in
females, who tend to have less muscle bulk relatively speaking.

Dr. Robert Cantu, noted neurosurgeon, has gained attention
with his stance on the importance of limiting or eliminating
repetitive impacts to the brain in sports, especially in younger
children. He bases this upon research that has shown the potential
for the development of persistent cerebral inflammation in the
presence of repetitive concussive or even sub concussive blows.
This can result in the deposition of protein plaques in the brain
even at a young age and subsequent cognitive impairment, as
well as persistent post-concussive symptoms.

Helmet technology continues to advance, and is now pursuing
mechanisms to reduce rotational forces along with traditional
linear or straight forces. While no "concussion proof" helmet
currently exists, there is now a valid and scientifically based
rating system available to consumers to help drive their choices.
These ratings are available at the Virginia Tech website for helmet

It is known that cerebral concussions occur more readily in
the face of a partially recovered state. That is, in this condition,
even light blows that would normally cause no damage can cause
a reoccurrence of symptoms even more severe than the initial
presentation and take longer to resolve. Therefore, complete
and total recovery is the only acceptable goal. Often times, this
will require modification of school schedules, participation in
persistent therapies, and the judicious use of medications and/
or nutritional supplements that can help to ease some of the
symptomatology of a post-concussive condition and quell ongoing
cerebral inflammation.

N E PA

While no "concussion proof"
helmet currently exists, there is
now a valid and scientifically
based rating system available
to consumers to help drive their
choices. It is recommended
that all student
athletes utilize at
least a 4- or 5-star
helmet, as they have
been proven to reduce
concussion frequency.

35

VITAL SIGNS



Table of Contents for the Digital Edition of NEPA Vital Signs - Summer Fall 2018

NEPA Vital Signs - Summer Fall 2018 - 1
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