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Movement Systems Physical Therapy in Gig Harbor – Pelvic Health Specialty

New Gig Harbor location featuring Terri Sullivan, OCS DPT

Everyone here at our Seattle location is excited about our new and bigger expansion on the west side of Lake Union, but there is one more location that is making a premiere the first week of April.  Starting on Wednesday, April 3, Movement Systems will have a presence in Gig Harbor at the office of Dr. Cindy Mosbrucker.  Terri Sullivan, an orthopedic clinical specialist and pelvic floor physical therapist, will be examining and treating patients within the doctor’s office.  The primary focus at this site is evaluation and treatment of pelvic issues, including hip and lumbar spine.  However, as is true with all patients seen at Movement Systems, acknowledgement of the whole body is an integral part of helping address aggravating factors and improve function.  If you have any questions, or know of someone who lives in the Gig Harbor/Tacoma area, please call the main office at 206-405- 1864, or contact Terri Sullivan directly at tsullivan@movementsystemspt.com.   

 

No excuses. Lift weights at any age! Advice from a 65 year old.

No excuses. Lift weights at any age! Advice from a 65 year old.

A post by Abby Halpin, DPT

 Yes, we are physical therapists, but we don’t just help people get back to where they were before an injury. We also help people level up after rehab.  As experts of the human movement system, we pay attention to what is good for it, and we teach it.  Muscle loss as we age is a huge problem. It affects our mobility, confidence, puts us at risk for falls, and decreases our longevity.  I recently came across this article in the New York Times, and thought, why not have a client tell her story.

Kristin, a participant in Movement Systems fitness programming, was interviewed to share her experience with weight training as a 65 year old. 

(Abby) What is your favorite strength training exercise and why?
(Kristin) “Deadlifting is my favorite.  That’s been a vast surprise to me since I never thought I’d do free weights, let alone deadlift. Being the age I am (65), I grew up thinking  deadlifting was for hunky guys in sweaty, competitive gyms. So wrong! I’ve found that I love how deadlifting makes me concentrate totally, both physically and mentally. It is thrilling to feel myself getting stronger, and to measure my progress by the increasing weight I can lift.” 
 
What led you to begin your strength training program?
“I was in a serious car accident and started physiotherapy with Abby in early 2017.  I’ve always been physically active, but I lost a lot of strength during my recovery so when physiotherapy ended I started doing physical training with her. I also needed to do more weight-bearing exercise to prevent bone loss as I age. Training one-on-one with Abby,  who knows my body quirks and can cheerfully push and encourage me,  has been immensely helpful. I started my physiotherapy with two-pound weights.  Now I can deadlift 145 pounds!” 
 
Have you noticed a change in how you move about your day since beginning your weightlifting routine?
“I love feeling stronger. And lifting things in everyday life  – from heavy shopping bags to suitcases and boxes of books – is much easier. I’m more conscious about my overall posture/alignment and it has improved.  And I’m less afraid of injuring myself.” 
 
What has surprised you the most about strength training?
“What has surprised me most about deadlifting in particular is how almost meditative it can be since it needs such  physical and mental focus. As I lift heavier weights, I’m working on and appreciating the mental/emotional side of it,  how it fosters the need to be positive and believe you can do it. It’s wonderful to talk positively to one’s self.” 
 
Is there anything else about your lifting life you’d like to share?
“It’s a cliche, but you truly are never too old to start.  Your body and brain will thank you.”
If you are interested in learning how you can safely and confidently begin strength training, consult a physical therapist. We are equipped to perform health screening prior to beginning a program, and we are experts in exercise prescription for the human movement system.

5 Reasons Why You Should Try Pilates

5 Reasons Why You Should Try Pilates 

Guest Blog by Allison Moss

Before I share Allison’s awesome blog post, I want to thank her and Club Pilates on Mercer Island for opening up their doors to us.  As a physical therapist, I am always trying to find ways for patients to either become more active or to diversify how they move to maintain a healthy movement system. Pilates is a great option, and Allison does a great job of explaining more…

Take it away, Allison.

Pilates has blown up in the U.S. these last few years and it has everyone wondering what it is about this system that has people flocking into the studios. Pilates is a progressive approach to modern-day fitness that helps people from all walks of life come into the studio with confidence that their instructor will know how to safely and effectively give them the best workout for their body. Whether you are dealing with an injury, recovering from a surgery or just wanting to add in another form of exercise; Pilates has you covered! So, let’s take a look at a few reasons you should consider trying Pilates.

  1. Pilates focuses on the powerhouse, which is the core and back muscles or the midsection of your body. These muscles initiate and support our every movement and also help to protect our spine by strengthening the muscles that surround it. The Pilates Method develops a significantly strengthened core through specifically targeted exercises using fun and integrated techniques to challenge you with every class.
  2. Pilates is a gentle workout that isn’t going to harm the body which is mainly done on an apparatus called a Reformer. The Reformer is a bed like structure and has a carriage that is on wheels and uses resistance via springs connected underneath. Laying down and being able to work out horizontally allows you to use a resistance that is lighter than your body which is very useful for anyone going thru physical therapy or with any medical conditions.
  3. Pilates provides a full-body workout, making sure that you leave every class feeling balanced, energized and focused. Paying attention to all planes of the body, Pilates offers a whole-body commitment in every class. Connecting your mind and body to each exercise helps you understand how and why you benefit from Pilates exercises and keeps you coming back for the same good feeling every time you leave.
  4. Pilates instructors really know their stuff. A major requirement for instructors is that they know anatomy and have knowledge of injuries and medical conditions and how Pilates can help with each one. They look at the why behind each exercise and provide safe progressions for those who are ready by layering on their exercises, this means by starting with the basic foundations of the movements and adding on progressions so that everyone gets the work out they are looking for.
  5. Every class is a new experience. Pilates instructors strive to bring new innovative techniques to keep the classes fun, engaging and challenging while still keeping all the original concepts and principles. Awareness, breath, control and efficiency play a huge part in every exercise and while they keep things fun and new these are always the upmost focus of each class.

 

 

3 bladder habits you should break

Bladder control issues?  Here are three habits you should break.

By Andrea Trask, DPT OCS

You likely don’t pay much attention to your bladder habits and urinary pattern unless it’s causing you problems, such as during pregnancy, postpartum, or prostate disease (or you’re potty training a toddler, like I currently am!). Many people don’t realize that the bladder is controlled both by reflex and conscious regulation from the brain, and it includes both voluntary (skeletal) and involuntary (smooth) muscle. Thanks to this design, our bladder “learns” much in the same way the rest of our muscles do – and it can learn some less-than-ideal habits, too. Try to avoid these three common mistakes – and please, seek help from a trained pelvic floor physical therapist if you have concerns about urinary incontinence or other bladder symptoms!

  1. Going “just in case.”

We all do this sometimes, when you’re about to get in the car for a long road trip, heading into a big meeting and feeling nervous, or trying to beat the rush before a sporting event starts. But frequently emptying your bladder before it’s truly full teaches your body to “reset” its perception of fullness – and will leave you regularly rushing to empty a partially-full bladder. Try to wait until you truly have a sense of urge before you go.

  1. Hovering or squatting.

Everyone has likely had to go somewhere less than ideal, where you’d rather keep your bare skin as far as possible from the toilet seat. But regularly squatting or hovering over the seat instead of sitting on it makes it difficult to relax your pelvic floor muscles, which can contribute to dysfunction of the muscles, and potentially lead to pelvic pain. If it makes you feel better, a recent study found that the average cell phone has 10x more bacteria than an average toilet seat.

  1. Consuming nothing but bladder irritants.

You start with coffee in the morning, switch to sparkling water mid-day, and have a glass of wine in the evening. Did you know all three of these beverages – caffeine, carbonation, and alcohol – are known bladder irritants, and can give you the urge to go more frequently? If you are struggling with urge-type urinary incontinence (not “making it to the bathroom” in time before urine leakage), bladder irritants may contribute to your symptoms. Other potential irritants include artificial sweeteners, so you may want to consider that gum and sugar-free sweets, too.

 

Andrea Trask, DPT OCS

 

Hamstring tightness? Should you be stretching or strengthening?

Hamstring tightness? Should you be stretching or strengthening?

Corley McBeth, DPT

Many people struggle with hamstring ‘tightness’ despite regular, sometimes daily, stretching. The tightness never seems to go away. Let’s talk about why this is happening and what you can do about it.

The hamstrings are comprised of three muscles: the semimembranosus, semitendinosus and biceps femoris. They are the primary bulk of muscle on the back of the thigh – originating on your ischial tuberosity (or “sits bone”) and running down behind the knee, where they attach on the bones of the lower leg (the tibia and fibula). This means that the hamstrings cross two joints, the hip and the knee. They are the primary flexors of the knee joint (meaning they bend the knee), as well as secondary hip extensors (meaning they help straighten the hip). The hamstrings also assist in providing rotational control at the knee, in addition to pelvic stability due to their anchoring role at the ischial tuberosities. They also play a role in deceleration when they contract eccentrically (meaning they are contracting while lengthening). This serves to slow the rate of knee extension, such as when you are trying to slow down from running to walking.

When we are focusing on stretching a muscle, it is important to differentiate muscle ‘shortness’ from ‘tightness.’ True muscle shortness is a structural issue related to a decrease in the length of the muscle fibers. Muscles become shortened due to immobilization or disuse, most often associated with casts/braces or non-weight bearing status following an injury and/or surgery. When muscles have shortened in this manner, it is called a contracture.

Muscle ‘tightness’ on the other hand, is neurologically driven and is a sensation associated with a muscle remaining in a contracted or tense state. Often the muscle is receiving input telling it to contract because the body is trying to generate stability. The nervous system may be increasing tone in the muscle as a protective response. The sensation of tightness might lead us to believe we need to stretch that muscle; however, providing input that stabilizes rather than stretches will likely be more effective in these situations.

“Muscle ‘tightness,’ on the other hand, is neurologically driven and is a sensation associated with a muscle remaining in a contracted or tense state.”

 

In many individuals experiencing ‘tight’ hamstrings, the hamstrings may actually be relatively overlengthened for optimal performance of a specific task. To improve postural control at the pelvis and/or knee, the nervous system will send excitatory input telling hamstrings to contract.  Without sufficient tension in the hamstrings (force production), the movement strategy for a particular task will be achieved through compensatory strategies impacting the performance of other muscles such as the abdominals, back extensors, hip flexors, etc. For example, consider lifting a heavy object from the floor using a hip bending strategy (i.e. deadlifting).  Without sufficient tension from the hamstrings, back extensors will create more compression on the spine.  One can debate whether this is good or bad for the back.

“Tight” muscles, despite the fact they are remaining in a relatively contracted state, are not necessarily strong muscles.  It may mean strengthening is the best course.

If you experience chronic hamstring ‘tightness,’ or have a history of hamstring strain and/or low back pain it is recommended to seek out a physical therapist for a formal evaluation. Expert advice based upon your specific experience and goals is very effective. An individualized assessment will help to address your mobility, stability, and overall movement patterns, which will increase the effectiveness of your stretching and strengthening routine.

Corley McBeth, DPT

Yoga 101: Tips to make the most of your Yoga practice

Yoga 101: Tips to make the most of your Yoga practice

By Terri Sullivan DPT, OCS

 

I’ve practiced yoga for over 15 years. Initially when I was practicing, the emphasis was on stretching. With more intensive study, however, I learned more details about the poses and integrated it into my practice as well as how I teach others to enhance their practice.  For example, a key question to ask is “Are you using your legs?”  You should be.  Strength and feeling certain muscles groups during poses is extremely important.  The more grounded, stable, aligned, and strong a person is in their pose, the less chance of injury.   Below, I’ve profiled a few common yoga poses, proper alignment of the legs, and which leg muscles should be targeted during practice.

Mountain Pose (Tadasana)

  • Keep weight balanced in the 4 corners of each foot
  • Toe mound down
  • Move from the ankle to help pull up arch vs tensing arch
  • Firm muscles of the legs (glut med, quads) without locking the knees
  • Create energetic lift from inner foot to the pelvis

 

Warrior 2 (Virabradasana 2)

  • Back foot turned in slightly, but still connecting with all four corners of the foot, hip in slight internal rotation
  • Front knee moved out towards pinky toe to help feel the deep hip lateral rotators
  • Press into front heel to help pull up through the inner thigh
  • Top of the pelvis level with the floor

 

Serpent Pose (Bhujangasana)

  • Anchor the pubic bone, ASIS, or whole pelvis to the floor, making sure the core is engaged and there is no back pain
  • Move the sacrum away from the lumbar spine
  • Lightly tighten the gluts, but not clenched
  • Feet straight, not turned in or out
  • Lightly squeezing the inner thighs towards each other to help recruit the pelvic floor

 

Triangle Pose (Trikonasana)

  • Unlock the knees by turning the legs on (to help prevent hyperextension) pulling up with inner thighs and quads
  • Externally rotate front femur bone while keeping the front big toe mound down
  • Tilt pelvis over front leg without curving the spine

 

 

Bridge Pose (Setu Bandhasana)

  • Feet hip with apart and parallel, heels directly under knees
  • Roll outer thighs in
  • Elongate tailbone with a tail tuck
  • Pressing into heels to feel the gluts and hamstrings

 

Terri Sullivan DPT, OCS, Certified Yoga Instructor

 

Dancers, It’s time to crosstrain!

Dancers, It’s time to crosstrain!

By Abby Halpin, DPT ACSM

Dancers hear that they should be ‘cross-training’ from instructors, parents, choreographers, and fellow dancers. But why is it important, and how do you do it? The goal of this post is to share the facts that should convince you to make cross-training part of your dance training.  Keep reading, and I’ll share how to do it too.

Health

It is no surprise to anyone that dancers are incredible athletes who train hard. But if dance is your primary method of exercise, it does not cover your bases for all aspects of health and wellness. Studies show that dancers get about 10 minutes per hour of dance class at a moderate to vigorous intensity, and that number gets lower as you advance into higher level classes.1 The American College of Sports Medicine (ACSM) recommends that adults participate in greater or equal to 150 minutes of moderate and 75 minutes of vigorous exercise training per week for cardiovascular health.2

Injury

Dancers also have frequent run-ins with injury. Dancers can experience 1-5 injuries per 1000 hours danced.3 Improving strength and motor control, with the help of a physical therapist, can help to reduce the risk of injury.

Performance

 This may be the most convincing argument to convince dancers to engage in cross-training exercise routines. IT IMPROVES PERFORMANCE. In one study, dancers who participated in a 12 week cross-training program demonstrated significant improvement in the performance of a 4 min piece compared to the control group.

Convinced yet?

Here is a list of 5 favorite cross-training exercises for dancers:

  1. Airplane balance with pelvis rotation: To improve your turnout strength by moving your pelvis on your thigh rather than the other way around. 12×3 each

Patients and clients lovingly refer to this as “Crashing Airplane”. Stand on one foot. Hinge forward so that you are a straight line from your opposite heal to your shoulder and your body is parallel to the floor. Hold that position as you rotate your pelvis open and closed. If you were wearing jeans, your zipper would point away from your standing leg, and then toward the standing leg.

  1. Push-ups: To improve upper body and core strength. 12 reps x3

Start in a plank position. Press your hands into the floor so that your shoulder blades move away from each other and your abs are engaged. Holding that position, bend your elbows and lower chest to the floor. Don’t let your trunk sag or lift your hips!

  1. Overhead Presses: To improve scapular strength in elevation and upward rotation. Reaching overhead strengthens the shoulder in a key functional movement pattern.  Insufficient serratus anterior strength and upward rotation mobility is common in neck and shoulder pain.  12 reps x3

Stand holding a moderate weight dumb bell in each hand (10 pounds).  From shoulder height, reach the weight vertically overhead.  DO NOT DEPRESS YOUR SHOULDERS!  The purpose is to reach the weight as high as possible with natural elevation and upward rotation of the shoulder blade (scapula).

4. Frog Jumps: To improve power for jumps. 12 reps x3

Stand with feet slightly wider than hip width apart. Squat down and touch the floor. From this position spring up into a jump with hands reaching toward the ceiling. Land and go right into the next one.

  1. 30 min of Cardio: Can be anything that keeps your heart rate up continuously for 30 minutes. Your choice! Some ideas include walking, running, swimming, hiking, biking, rowing, find your favorite cardio machine at the gym. Remember that 225 mins per week of moderate to intense exercise? Subtract the number of hours you danced times 10min, then do enough rounds of cardio hit the target for the week! Find a friend and have fun with it.

Resources:

  1. Grierson, M. (Presenter). (2016). Risk factors for dance related injury: A clinical application.     Speech presented at Movement Systems Physical Therapy, Seattle, Wa.
  2. Carol, G, et al. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory,     musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing     exercise. Medicine & Science in Sports & Exercise, 43, 1334-1359. Retrieved from     http://journals.lww.com/acsm-msse/Fulltext/2011/07000/     Quantity_and_Quality_of_Exercise_for_Developing.26.aspx
  3. Allen, N. (2012). Ballet injuries: Injury incidence and severity over 1 year. Journal of Orthopaedic & Sports Physical Therapy, 42(9), 781-A1. https://doi.org/10.2519/jospt.2012.3893

Abby Halpin DPT, ACSM

Benefits of Aerobic Exercise

 Aerobic Exercise and Benefits of Walking

By Kendall Wisehart DPT, ATC

What is aerobic exercise?

  • Simply put aerobic exercise or “cardio” is activity that requires increased activity of the heart to pump oxygen rich blood the muscles.
  • Examples include walking, running, hiking, and swimming
  • Aerobic refers to “with oxygen” whereas anaerobic refers to “without oxygen”

Benefits

  • Mental benefits include increased confidence, emotional stability, memory and brain function
  • Physical benefits include strengthened heart and lungs, lower cholesterol, improved immune function, and lower blood pressure – among many others!
  • Fitness benefits include improved muscle tone, stamina, and energy levels for both work and play

Disease Prevention (via ACSM)

  • Seniors who walk 6-9 miles/week are less likely to suffer from mental decline as they age, including dementia
  • Walking 30 minutes/day, 5 days/week, along with diet changes, can halve the risk of Type II Diabetes
  • Walking 30 minutes/day, 5 days/week can halve the risk of heart disease and reduce stress, cholesterol, and blood pressure
  • Walking can reduce pain and improve function, mobility, mood, and quality of life without worsening symptoms for those with arthritis
  • Walking triggers endorphins, promotes relaxation, and can help prevent anxiety and depression

Walking 30 minutes/day, 5 days/week can halve the risk of heart disease and reduce stress, cholesterol, and blood pressure

Other benefits of walking (via ACSM)

  • Walking 45 minutes/day halves your odds of catching a cold
  • Walking 1 minute can extend life by 1.5 to 2 minutes
  • Walking 20-25 minutes/week can extend life by several years!

How do I get started?

  • If you have health issues – talk to your doctor and ask to see a physical therapist
  • Choose an activity that you enjoy. It can be as easy as walking or gardening or as intense as hiking or running
  • Find a friend! Having the support of a friend of family member will help keep you going

How much should I do?

  • For most healthy individuals: 30 minutes, 5 days a week of moderate intensity aerobic exercise OR 20 minutes of high intensity aerobic exercise
  • A quick way to gauge intensity is Target Heart Rate. To calculate: 220 – (your age) x 70%. Example: 220 – 45 years old x .70 = 122.5 beats per minute (bpm)
  • You should be able to carry on a conversation with your walking partner without shortness of breath

Can I over-do it?

  • Absolutely! Just like a sedentary lifestyle, overactivity can have its own negative consequences like injury and reduced immune function
  • Developing a consistent exercise routine is key in preventing over-training, this includes rest days
  • A workout or training session is only as effective as how much you can recover from it

What’s considered “in-shape”?

  • Everyone will have their own unique definition of fitness, related to their fitness goal
  • A lower resting heart rate is just one indicator of fitness, normal RHR is 60-100 bpm

Other biomarkers like blood pressure and cholesterol may be used to determine fitness

 

Kendall Wisehart DPT, ATC Bio

Mood Disorders and Exercise

 Mood disorders: Does exercise matter?

By Kendall Wisehart DPT, ATC

In physical therapy, it’s easy to get caught up in the physicality of it all – muscles, bones, joints, biomechanics, and our favorite, physics. Unfortunately, what doesn’t get this well-deserved attention are the non-physical benefits, the mental and emotional benefits. Specifically, when examining mood disorders such as depression and bipolar disorder studies found that exercise impacts both physical and mental health outcomes. Exercise also positively affects conditions frequently associated with mood disorders such as anxiety, pain, and insomnia or other sleep disturbances.

Several mechanisms have been proposed for the anti-depressive effects of exercise, which can be divided into two categories – psychological and biological. Psychological variables include increased feelings of control (autonomy), physical wellness, quality of life, improved self-esteem / mood. Biological variables include several growth factors, oxidative stress, and genetics and their role in exercise-induced neurogenesis and anti-depressive effects.

“Studies have shown that after several weeks of moderate intensity exercise, oxidative stress and pro-inflammatory markers are decreased.”

Most of the recent work related to the anti-depressive effect of exercise and biological makers has focused on the role of BDNF or Brain Derived Neurotrophic Factor. By definition, BDNF supports neurogenesis or the growth of neurons. In fact, antidepressant medications up-regulate BDNF and patients with mood disorders exhibit lower levels of BDNF compared to their healthy counterparts. Simply put, BDNF may be the primary mechanism of the anti-depressive effects of exercise. While BDNF is important enough to have it’s own dedicated blog post, what’s important to know is that BDNF is essential in nerve survival, growth, and pathological levels of BDNF may contribute to psychological disorders and chronic pain sensitization.

Exercise may also impact oxidative stress. We’ve all heard the term anti-oxidant and generally accepted it as a good thing. Without going into the specifics of cellular (mitochondrial) energy production, it’s important to understand that oxidation is a normal part of the energy production system of the cell. In the absence of anti-oxidant defense, oxidative stress and cellular damage can occur. Fortunately, exercise can impact oxidative stress. This is especially important for those with mood disorders in which there are increases in inflammation and oxidative stress. Studies have shown that after several weeks of moderate intensity exercise, oxidative stress and pro-inflammatory markers are decreased. On the flip side, high intensity exercise increased oxidative stress. The summary here is simple, a balance of exercise intensity is key when achieving both physical and psychological benefits of exercise.

Finally, based on recent research, exercise has been associated with epigenetic changes that are beneficial for those with mood disorders. Epigenetic changes refer to changes in gene expression without an actual change in DNA sequence. For example, BDNF can be upregulated through these types of exercise induced changes. It has also been suggested that exercise promotes epigenetic changes that promote homeostasis, neuroplasticity, circadian rhythms, and endocrine and immune regulations.

Others have suggested that exercise induced epigenetic changes can reduce the aging process and have beneficial effects on the musculoskeletal system across the lifespan.

Exercise may be an acceptable alternative or adjunctive therapy to enhance mood, functioning, and co-morbid conditions for individuals with mood disorders. Overall, there is promising evidence to support the use of exercise in the treatment of mood disorders. Future research will focus on specific frequencies, durations and types of exercise for specific mood disorders.

For now, balance is key and something is always better than nothing – even a short walk can have it’s benefits (see upcoming post).

 

Kendall Wisehart DPT, ATC Bio

 

Concussions

Concussions – Enhance your awareness and take appropriate action

By Erica Clark, PT, DPT

Concussions are a hot topic. Professional sports organizations are adopting new concussion guidelines. For example, NFL players do not return to a game if a concussion is suspected. Improper fouls are met with stricter penalties. Scientists have begun to link degenerative brain disease with repeated head injuries. So it is certainly understandable to be concerned, even frightened, if you or a loved one sustains a head injury. The goal of this post is to help you, the reader, understand how the brain is affected after a concussion and learn what steps to take if a concussion is suspected.

First, understand that there are activities that increase the chance of someone sustaining a concussion. Contact sports such as football are clearly high risk. However, athletes in other sports like soccer and lacrosse are reporting more concussions. In my PT career I have treated patients with concussions due to falls, biking accidents, motor vehicle accidents, and construction/handyman activities. It is true that some activities bear greater risks than others, and while we tend to focus on sports, all of us are vulnerable to concussions.

Let us start by defining concussion. According to the CDC, “A concussion is a type of brain injury caused by a bump, blow or jolt to the head or by a hit to the body that causes the brain and head to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometime stretching and damaging brain cells“. I will add that a concussion can happen with or without loss of consciousness. Only in a small amount of concussion injuries (about 10%) is there a loss of consciousness. There are more than 3.8 million concussions a year in the USA.

The chemical change experienced in the brain affects each person slightly differently, but there are some common symptoms. The brain processes information more slowly than before the injury and requires a decrease in stimulation to allow it to heal. While the average recovery time for a concussion is 14 days, some people have symptoms for months. In some extreme cases symptoms can last for years.

Concussion symptoms can be broken down into four clusters:

  1. Cognitive: Fogginess, memory fatigue, cognitive fatigue
  2. Sleep alterations: Difficulty falling asleep, fragmented sleep, too much or too little sleep
  3. Somatic symptoms: Headaches, dizziness, nausea, light sound sensitivity
  4. Mood disruption: Irritability, feeling sad, anxiety

The symptoms above can overlap or be independent of one another. The most common symptom after a concussion is a headache, which occurs over 70% of the time.

 

So, what should you do if you sustain a concussion? First, identify if you need to seek immediate medical attention. It is critical to seek immediate medical attention if any of these symptoms are present after your injury:

RED FLAGS: Loss of consciousness, amnesia
, dazed or confused, vomiting, seizure
, asymmetrical pupil size 

If you do not have any of the above symptoms, then decide what activities increase your symptoms. These are known as triggers. Then make an effort to limit exposure to them in your everyday life. Next, get some sleep and rest your body. According to the CDC, “Rest is very important after a concussion because it helps the brain to heal. Ignoring your symptoms and trying to ‘tough it out’ often makes symptoms worse.” Rest means both physical and cognitive rest. Hopefully, by slowly increasing exposure to your triggers, you will help the brain heal and decrease your recovery time. If your symptoms persist and do not steadily decrease with rest, be sure to seek medical attention.

Your risk of a prolonged recovery increases if you have certain specific signs and symptoms. These include: loss of consciousness, post-traumatic amnesia, history of a prior concussion, ADHD, migraines, mood disorders, and being female. As stated above, if your symptoms are not resolving and decreasing with rest, finding a healthcare provider that understands and has a history of treating concussion patients is critical. Treating the post-concussive patient requires a multidisciplinary approach with a variety of providers. Depending upon your symptoms and severity you may be referred to one or more of the following specialist: neuropsychologist, physical therapist, behavior optometrist or cognitive therapist. If you are not happy with your care you can always seek out second or even third opinions. Post-concussive syndrome is the most common reason that people return to the emergency department within 72 hours. If left untreated the person with sustained concussion symptoms may have difficulty with academics, relationships, job performance, physical ability, and mental health issues.

The big take away is that we are all vulnerable to sustaining a concussion, and some of us participate in activities that increase that possibility. For most people symptoms should resolve with a few weeks with the appropriate amount of rest and graded exposure to aggravating factors. If symptoms do not resolve or your symptoms worsen, remember to seek medical professionals with experience in treating concussion.

Erica Clark PT, DPT