Post-Concussion Symptoms
Wednesday, February 26, 2025
Understanding Post-Concussion Symptoms (PCS)
Post-concussion symptoms (PCS) is a complex and often misunderstood condition that can persist for weeks or even months after a concussion. While most concussions resolve completely within 30 days, PCS occurs when symptoms extend beyond this timeframe, affecting an individual’s physical, cognitive, and emotional well-being.
Effectively managing PCS requires a multidisciplinary approach, often involving specialists such as those at Complete Concussion Management Inc. (CCMI) registered physiotherapist at Physio Inq Sutherland. These Physiotherapists work with both community sport and with high-performing athletes.
What Are the 5 Key Systems That Can Be Affected in PCS?
There are five key systems that can become dysregulated following a concussion, leading to persistent symptoms post-concussion. These systems include:
1. Autonomic Dysregulation
The autonomic nervous system (ANS), which regulates involuntary bodily functions such as heart rate and blood pressure, can be disrupted after a concussion. This dysregulation may cause:
- Increased heart rate with minimal exertion
- Difficulty tolerating exercise
- Symptoms worsened by changes in position (e.g., standing up quickly)
Management:
- Graded aerobic exercise, guided by a physiotherapist, at a sub-symptom threshold (just below the level at which symptoms begin). This helps retrain the ANS and improve exercise tolerance.
- Heart rate monitoring during physical activity ensures safe progression.
- Vagus nerve stimulation through techniques such as chanting, grounding, deep breathing, and meditation.
2. Hormonal and Neuroinflammatory/Gut Dysregulation
The hypothalamic-pituitary axis (HPA), which regulates hormones, can be disrupted post-concussion. Additionally, brain injury can lead to neuroinflammation, which impacts gut health. Symptoms may include:
- Fatigue
- Sleep disturbances
- Digestive issues (e.g., bloating, diarrhea)
- Mood changes
Management:
- Collaboration with healthcare providers to assess and address hormonal imbalances.
- Nutrition support focusing on anti-inflammatory foods and gut health.
- Sleep hygiene practices to improve rest and recovery.
3. Vestibular and Ocular Dysfunction
Concussions often affect the vestibular system (responsible for balance) and the ocular system (responsible for eye movements), leading to symptoms such as:
- Dizziness or vertigo
- Blurred vision or difficulty focusing
- Sensitivity to motion or busy environments
Management:
Vestibular rehabilitation therapy (VRT) to improve balance and spatial awareness.
Oculomotor exercises prescribed by a physiotherapist or neuro-optometrist.
Gradual exposure to challenging environments to reduce sensitivity.
4. Cervical Spine Dysfunction
Neck injuries often occur alongside concussions due to the forces involved. Cervical spine dysfunction can result in:
- Headaches
- Neck pain
- Dizziness originating from the neck (cervicogenic dizziness)
Management:
- Manual therapy and soft tissue techniques by a qualified physiotherapist.
- Specific exercises to restore neck strength and mobility.
- Education on posture and ergonomic adjustments.
5. Psychological Factors
PCS can significantly impact mental health, with common challenges including:
- Anxiety
- Depression
- Post-traumatic stress
- Fear of symptom exacerbation
Management:
- Cognitive behavioural therapy (CBT) or other forms of counselling.
- Stress management techniques, including mindfulness and relaxation exercises.
- Building a structured routine to promote normalcy and facilitate a gradual return to daily activities.
Why See a CCMI Registered Physiotherapist?
A concussion care specialist such as a Complete Concussion Management Inc. (CCMI) registered Physiotherapist specialises in evidence-based concussion care. They use a holistic, individualised approach to guide your recovery and address all aspects of PCS.
Key benefits of seeing a CCMI physiotherapist include:
- Comprehensive Assessment: They evaluate all affected systems, identifying specific areas of dysfunction.
- Targeted Treatment Plans: Using evidence-based protocols, they create tailored exercise and rehabilitation programs.
- Collaborative Care: CCMI physiotherapists collaborate with other healthcare professionals to ensure a multidisciplinary approach to recovery.
- Ongoing Support: They monitor your progress and adjust treatment as needed, helping you safely return to work, sport, or daily activities.
Conclusion
Recovering from PCS can be challenging, but understanding the systems involved and seeking appropriate care can make a significant difference. If you’re struggling with persistent symptoms, consider consulting one of Physio Inq Sutherland’s Their expertise in concussion management can help you regain control, improve your quality of life, and get back to doing what you love.
Further Reading
Concussion Guidelines for Community Sport
