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About Physiatry

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Sports Concussion

Condition: Sports concussions are brain injuries that result from a blow to the head. Usually there is no loss of consciousness.

Background: According to the CDC, approximately 1.6 to 3.8 million concussions occur each year in the U.S amongst sports and recreational activities. The injury causes changes in the brain that may last for days, weeks or months.

Risk Factors: Concussions are most common in boys playing football and girls playing soccer but any sport can result in concussion. After one concussion, a person has a higher risk of having another concussion.

History and Symptoms: Symptoms usually appear right after the blow to the head, but may manifest in the coming days. They may include headache, confusion, nausea, memory loss, and ringing in the ears. Other symptoms may appear a little later, such as trouble sleeping, concentrating, feeling tired, or irritability.

Physical Exam:  After any blow to the head, the injured person should be examined by a physician. Once stabilized, a physical medicine and rehabilitation (PM&R) physician who specializes in concussions should evaluate the patient as an outpatient. The PM&R physician may prescribe specific therapies such as vestibular therapy to assist the patient in balance and dizziness management. If deemed necessary, the PM&R physician may also prescribe medication.    

Diagnostic Process: There are no blood tests or imaging tests to diagnose a concussion. Instead, the doctor will assess the patient’s symptoms and assess the patient on multiple visits. 

Rehab Management: The brain needs to rest after a concussion so it can heal. There will be a graduated system to allow for an athlete to return to sport or school. This will be determined by how quickly the patient can return to normal activities without any return of symptoms. Even watching TV and reading can make symptoms worse. The PM&R physician can provide guidance in the process. In more severe cases, they can manage headaches with various medications and injections. They may also refer the patient to a neuropsychologist for cognitive testing.       

Other Resources for Patients and Families: Families need to understand the importance of rest following a concussion and red flag symptoms. These symptoms include increased sleepiness, sudden debilitating headaches, or new weakness. These symptoms require a visit to the emergency room.

For Patients and Families:

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