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Concussions

Concussions

 Updated September 13, 2024 ; written by Joe Ruzich & Caiden McPherson

As football season and school sports launch into another season, concussions are frequently a concern for athletes, parents, and coaches. Concussions, and similar head injuries, take only a moment to occur but can have lasting implications. Contact sports are not the only way to get a concussion, and everyone can benefit from understanding what a concussion is, how to spot it, and what to do next. Most concussions resolve with time, however, it is crucial that the condition is managed appropriately following the injury.

What is a concussion?

A concussion, or mild traumatic brain injury (mTBI) is a brain injury that negatively impacts the brain’s normal function. Concussions are most often caused by hard impacts to the head, but also commonly occur in motor vehicle accidents. On a physiological level, a concussion results in neurometabolic changes that temporarily alter brain function. It is this neurochemical event that causes the widespread and varying symptoms of a concussion. In recent decades, a growing amount of research is being conducted on sports-related head injuries, leading to guidelines that help coaches, athletic trainers, and health care providers promote healing after a concussion.

 

What are the symptoms of a concussion?

Concussions are not always obvious, and not every concussion presents the same, however there are signs and symptoms to help you determine when to seek medical care. A person with a concussion often will not show all of the symptoms associated with this injury, still it is important to be aware of the variety of symptoms that occur. 

The symptoms of a concussion occur across four established domains. First, look for somatic and physical symptoms such as headache, dizziness, balance difficulties, or reported changes in vision — including blurry vision or “seeing stars” — after the impact. Second, take note of any changes in cognitive function such as confusion, trouble with short or long term memory, difficulty concentrating, or brain fog. The third domain of symptoms includes changes in the individual’s regular emotional state; this includes irritability, and new or worsening symptoms of depression and anxiety. The last group of symptoms is sleep disturbances occurring after the impact. Some people have a harder time waking, while others have a harder time falling asleep, and many people post-concussion report feelings of drowsiness. Again, an individual does not need to experience all of the symptoms listed above; experiencing any of these symptoms after a blow to the head can indicate a concussion. 

Usually, these symptoms will dissipate after 10 to 14 days, but they can last longer. It is common for physical symptoms of a concussion to be noticed first, while symptoms regarding mood, sleep, and cognition may develop a few days after the initial injury. In some cases, when a concussion is severe your symptoms may take weeks to resolve. Persistent postconcussive syndrome is a condition that occurs in less than 10% of cases in which these symptoms last longer than 12 weeks. If you suspect that you, or a minor in your care, have a concussion, or if your concussion symptoms are getting worse, it is important to get treatment. Even mild concussions need to be evaluated by a certified health care provider.

How can you prevent a concussion?

Maintaining a strong core, neck, and trunk can reduce the risk of moderate to severe concussions when participating in sports. Additionally, proper helmet usage greatly reduces the risk for concussions in activities such as biking, skateboarding, hockey, baseball, football, and several other activities. In the past few years, some soccer coaches have limited the practice of ‘heading’ or hitting the ball with your head to reduce concussion risk. In work zones, hard hats may also be encouraged. Observe proper safety precautions to reduce risk of any injury, concussions included. 

 If you are a parent or guardian, emphasize the importance of helmets. When use of protective headgear is instilled at an early age, the child will be more likely to utilize a helmet as they grow older. Start early with this rule and be consistent. Because the brain is not fully developed until the age of 25, untreated concussions and recurring concussions in a young individual can have long lasting consequences. Help your child understand the importance of reporting concussion symptoms to their coach. Any time you, or a child in your care, participates in sports it is best practice to use the approved techniques and take the recommended safety precautions.

What is the best course of care and treatment for a concussion?

The most important step of care when a concussion is suspected, is protecting the injured person from further injury to the head or neck. Consequently, coaches and athletic trainers are instructed to ensure an athlete with a suspected concussion stops playing the sport until evaluated. Second Impact Syndrome is a life threatening condition that can occur when a second head injury takes place before the brain has healed from a prior concussion. Colorado Law requires that coaches pull youth athletes from a game or practice if there is suspicion of a concussion, and must be cleared by a medical professional before returning to their sport. Some athletes will try to press on or ignore symptoms and continue to play. This impulse is understandable, but can be very harmful. Student athletes must know, if they suspect an injury to themselves or a teammate, their coach needs to be informed. The best athletes understand the importance of prioritizing their long term health over the outcome of a game. 

Every case is different, and the best guidelines for concussion recovery will come from a licensed clinician who can evaluate you in person. You may receive guidelines to limit activity in the first 2-3 days following a concussion. Returning to activity yields the best results when done gradually. Do not return to any sports participation until you receive an okay from your primary care provider.  

How do we treat concussions? 

 At Synergy Physical Therapy & Wellness, concussion treatment entails an evaluation of brain function to determine the difficulties and most significant symptoms in the individual being examined. Based on the evaluation, we design an individualized treatment plan that can include vestibular therapy, visual therapy, neck therapy, and return to sport/activity training. Physical Therapy after a concussion can help prevent further injury as well as treat the symptoms of concussions. At Synergy, our certified, licensed clinicians are able to treat any individual, athlete or otherwise, at any age who has been diagnosed with a concussion.

Whether it is to promote injury prevention or if it’s to treat headache, dizziness or pain after the concussion…we are the local therapy experts in Pueblo CO. Call us at 719-568-9790. You only have 1 brain!

Sources: 

Centers for Disease Control and Prevention. (2024, May 16). About Mild TBI and Concussion. Centers for Disease Control and Prevention. https://www.cdc.gov/traumatic-brain-injury/about/index.html 

 Ferry, B., & DeCastro, A. (2023, January 9). Concussion. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK537017/

 

As we age, maintaining health and independence becomes a top priority. Strength training, a type of resistance exercise often overshadowed by cardio or flexibility exercises, is a cornerstone of healthy aging. Whether you’re in your 30s or 80s, incorporating strength training into your routine can help you live a longer, more vibrant life. Here’s why everyone needs to embrace strength training and how to overcome common barriers to getting started.

1. Avoiding Frailty

Frailty, marked by reduced strength, endurance, and physical function, is a growing concern with age. According to the National Institute on Aging, frailty increases the risk of falls, disability, and hospitalization. For women, who face a higher risk of osteoporosis, frailty can also lead to fractures with prolonged recovery. Strength training combats frailty by building muscle mass and bone density. 

A 2021 study in the Journal of Clinical Medicine found that resistance training significantly improved muscle strength and reduced frailty markers in older adults. For women, this is especially critical, as stronger muscles and bones reduce the risk of osteoporotic fractures. Exercises like weightlifting, bodyweight workouts, or resistance bands enhance physical resilience, making daily tasks like carrying groceries or climbing stairs safer and easier.

(Want to know more about osteoporosis and PT’s role in it’s prevention and treatment? Check out our previous article for more information: Osteoporosis, Osteopenia, and Physical Therapy) 

2. Staying Able to Do the Things You Love

Strength training ensures you can keep enjoying activities like gardening, hiking, or playing with grandkids. According to an article in Harvard Health Publishing, muscle strength can begin to decline by about 1-2% per year after age 35 due to sarcopenia, also known as age-related muscle loss. This muscle loss accelerates as our bodies age. This loss can limit your ability to perform daily tasks or pursue hobbies, particularly for women who may experience accelerated muscle loss during menopause due to declining estrogen levels. 

Regular strength training preserves functional capacity, and benefits multiple domains of health. A  2019 study published in Frontiers in Physiology showed that resistance exercise not only improved musculoskeletal health, but also helped patients manage chronic conditions like cardiovascular disease and diabetes (Mcleod et al., 2019). Older adults who participated consistently in resistance strength exercise maintained better mobility, overall health, and independence than those who did not. Additionally, the same study found that those using light weight or only body weight while strength training was just as effective as heavy weights (McLeod et al., 2019). The most important factor of strength training for healthy aging is finding a routine that is suited to your body and your ability. A consultation with a physical therapist can help you find the right routine and guide you through proper exercise form to ensure your exercise is preventing injury, not causing it.  Strength training empowers you to stay active, healthy, and independent.

3. More Muscle Mass Equals Improved Blood Sugar Control

Building muscle isn’t just about strength—it’s about metabolic health. Muscle tissue helps regulate blood sugar by improving insulin sensitivity, which is vital for preventing or managing type 2 diabetes, a condition more prevalent with age (Mcleod et al., 2019). Increased muscle mass enhances glucose uptake, reducing blood sugar spikes. This is particularly important for women, who may face increased risks for diabetes complications. Researchers have found that  resistance training improved glycemic control in older adults with type 2 diabetes (Mcleod et al., 2019). In their review of resistance exercise and blood sugar management, resistance exercise performed for 8 weeks resulted in clinical improvements in A1C management and improvements in insulin resistance. These findings are relevant not just to individuals living with diabetes, but also those with insulin resistance, metabolic disorders, or a family history of diabetes. More muscle mass means greater glucose storage capacity, supporting overall metabolic health. Even moderate strength training, like lifting weights twice a week, can make a significant difference.

Common Barriers to Starting Strength Training

Despite its benefits, many hesitate to start strength training. Here are common barriers and solutions:

  • Lack of Knowledge: Many feel intimidated by unfamiliar exercises. 
    • Solution: Start with simple bodyweight moves like squats or push-ups. Online resources from the American Council on Exercise (ACE) offer free beginner guides, or consult a certified personal trainer for a tailored program.
  • Fear of Injury: Older adults, especially women with lower bone density, may worry about getting hurt. 
    • Solution: Begin with low weights or resistance bands under professional guidance. A 2018 study in Journal of Strength and Conditioning Research confirms supervised strength training is safe and effective for all ages when done correctly.
  • Time Constraints: Busy schedules can make exercise feel daunting. 
    • Solution: Short, 20-minute strength workouts 2-3 times per week still deliver impactful benefits, per American College of Sports Medicine guidelines.
  • Gym Intimidation: Gyms can feel overwhelming for beginners. 
    • Solution: Try home workouts with minimal equipment or join small group classes for older adults, which foster a supportive environment. Women-only classes can also provide a comfortable starting point.

Getting Started with Strength Training

To reap the benefits, aim for 3 sessions per week. Focus on compound movements—exercises that work multiple muscle groups at once, like squats, deadlifts, lunges, assisted pull-ups, and pushing-pressing motions. These maximize efficiency and functional strength. Start with light weights, resistance bands, or bodyweight exercises, gradually increasing intensity.

Safety Tip: Deadlifts, a powerful and functional movement, we commonly integrate this into out-patient rehabilitation strategy, but it does require proper technique to avoid injury. Begin with no weight, using a broomstick or similar tool to master form under a skilled coach’s guidance before adding weight. This is especially important to protect against lower back strain or injury.

Always consult a healthcare provider before starting a new exercise program, especially if you have chronic conditions like osteoporosis, chronic low back pain or shoulder problems. If you do struggle with any of these, one of our physical therapists can design a program tailored to your needs, and we’re here to support you every step of the way. If you are free from chronic conditions or pain a skilled coach or trainer can also be a great fit to get you started safely.

Strength training isn’t just for bodybuilders—it’s for everyone who values aging gracefully, staying active, and feeling their best. By building strength now, you’re investing in a healthier, more independent future.

References:

Harvard Health. (2023, February 14). Age and muscle loss. https://www.health.harvard.edu/exercise-and-fitness/age-and-muscle-loss

Mcleod, J. C., Stokes, T., & Phillips, S. M. (2019). Resistance Exercise training as a primary Countermeasure to Age-Related Chronic Disease. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00645

Talar, K., Hernández-Belmonte, A., Vetrovsky, T., Steffl, M., Kałamacka, E., & Courel-Ibáñez, J. (2021). Benefits of Resistance training in Early and late Stages of Frailty and sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Journal of Clinical Medicine, 10(8), 1630. https://doi.org/10.3390/jcm10081630

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