The role of the physiotherapist in managing the treatment of a concussion

Every year, many people, just like the case we are going to talk about, suffer from a concussion (Mild Traumatic Brain Injury, MTBI). In many cases, the concussion goes unnoticed, the symptoms are not recognized so the person injured does not get a follow-up. However, if we recognize the symptoms, what should we do? Who can we refer to? Do you know that concussion can be treated by your physiotherapist? Do you know that a regular follow-up will help you achieve better recovery?

For the treatment of concussion, did you think about the physiotherapist?

How to recognize a concussion when we have one? Can we say that without impact, there is no concussion?

No! Absolutely not! The impact is not necessary!  In fact, 35% of concussion cases did not involve an impact. Concussion is an injury that affects the functioning of the brain and can be caused by a direct or indirect hit. Typically, symptoms occur immediately after the accident, but sometimes they appear later.

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En fait, 35 % des cas de commotion cérébrale n’ont pas subi d’impact.

Recently, Michael, a young patient from our clinics, consulted us for neck pain accompanied by headaches, dizziness and difficulty concentrating. Michael is a trainer in a martial arts gym and he receives several hits to the head during his training and his fights. He had symptoms of a concussion caused by repeated impacts to the head.

I had headaches, dizziness and difficulty concentrating.-Michael

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Gabrielle, a teacher, also arrived  at the clinic with a concussion caused by a fall on a slippery surface. Gabrielle had the same symptoms as Michaël, besides intolerance to light, nausea and vertigo.

In addition to headaches, I had intolerance to light, nausea and vertigo.-Gabrielle.

Why consult a physiotherapist?

For Gabrielle, she was referred to physiotherapy by her workplace. Otherwise, she probably would not have had the reflex to make an appointment with a physiotherapist. For Michael, it was more the pain that he felt than the concussion symptoms that prompted him to consult.

In 95% of cases, the symptoms of a MTBI disappear in less than a month. Why should you consult in this case?

The reason is simple:

The physiotherapist will guide you through the steps to follow to resume your work and your leisure activities. He or she will treat the impact of the MTBI such as the muscular tension, the stiffness and the decrease of muscular strength that it can cause.

Most importantly, the physiotherapist will work towards the complete resolution of symptoms by treating the concussion.

In some cases, a concussion that is not well cured can lead to anxiety, depressive symptoms, sleep disturbances, and concentration or attention deficits.

Treatment of the concussion by the physiotherapist

physiotherapist-CMI-clinicThe physiotherapist worked as a team with Michaël to establish steps to respect in order to gradually resume  fighting sports. It all started with a simple cardiovascular training and progressed to combat drills without impact and then with impact. For Michaël, physiotherapy treatments have helped reduce muscle tension in the cervical area and reduce headaches.

Michael finally returned to the sport and no longer has symptoms of concussion. However, he must be alert to the reappearance of symptoms.

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For Gabrielle, the treatments allowed her to return to work without symptoms. Manual therapy and muscle relaxation techniques have greatly helped to reduce the pain. Proper guidance by the physiotherapist was necessary to gradually resume her role with her students. Indeed, the school environment includes a lot of noise and requires a high level of concentration. The treatments also addressed vestibular problems, which is short-term vertigo caused by rapid changes of position, that occurred after the accident.

Towards an optimal recovery

When you consult a physiotherapist following a concussion, you are giving yourself the best chance to heal faster. Your physiotherapist will help you set up the best treatment plan for a return to your normal activities.

These steps will include a rest period of a few days, a progression of intellectual and physical activities and a return to work and sport.

The physiotherapist can also treat the impact of the injury and refer you to other health professionals as needed.

Do not hesitate to make an appointment at one of our clinics if you or a loved one has suffered a concussion. The physiotherapist, along with the other health professionals of the CMI Clinics, will be able to optimize your healing process and accompany you back to your normal activities.

By Vincent, B.Sc. M.Sc. pht


Physiotherapist-CMI-Clinic-Vincent Vincent has a masters in physiotherapy from the University of Montreal. Avid skier, Vincent is bringing his knowledge of skiing as an instructor for the Quebec Foundation for the Blind since 2014 and also works as a savior for Patro le Prévost, one of the oldest non-profit organizations in Quebec.