When to seek treatment for Concussions?

When to seek treatment for Concussions?

Concussions are just one of the MOST COMMON, yet most misunderstood injuries that occur throughout an individual’s lifetime and can occur from a variety of causes – not just sports related injuries. Concussions are very difficult to determine because of vast symptoms. Clinical diagnosis of a concussion is the only accurate technique available.  Due to the varying symptoms and presentations, there is no true definition of what is considered a concussion. The two closest definitions, according to (Dr. Warren Flautt DPT, 2023), of a concussion include:

  • “A change in brain function following a force to the head, which may be accompanied by temporary loss of consciousness, but is identified in awake individuals with measures of neurologic and cognitive dysfunction.”
  •  “Sport-related concussion is a traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain that occurs in sports and exercise-related activities. This initiates a neurotransmitter and metabolic cascade, with possible axonal injury, blood flow change and inflammation affecting the brain. Symptoms and signs may present immediately, or evolve over minutes or hours, and commonly resolve within days, but may be prolonged.”

Concussions symptoms can range as previously mentioned. Those symptoms could include the following according to (Dr. Warren Flautt DPT, 2023):

  • Reduced focus, attention, and lapse of memory
  • Neck Pain
  • Headaches
  • Changes in vision and cognition 
  • Dizziness and reduced balance
  • Disruption in sleep
  • Large levels of fatigue
  • Disinterest in normal activities that you may have enjoyed prior to the injury.
  • Higher levels of anxiety, agitation, and/or depression
  • Increase in general symptoms with higher activity levels
  • Light and noise sensitivity 

Typically, the first thing people think of when someone has a concussion is to tell them that they need to go lock themselves in a dark room, not do any form of activity, and to not look at any screens. However, the research now reports that all this information is now false and unhelpful with return to their normal lifestyle/sports related activities (Leddy et. al., 2023) (Leddy et al., 2019). 

There is very limited research and evidence regarding steps to recovery. In regard to school age children/athletes, the overall effects of mental rest on recovery from concussion, recommendations of prolonged periods of mental rest, and particularly absence from school, should be approached cautiously (Leddy et. al., 2023) (Leddy et al., 2019). 

A study performed by McCann et al. (2022) assessed college age athletes and it was noted that those who were not properly treated/rehabilitated, were at an increased risk of a lower extremity injury even up to a year post- concussion. Therefore, it is imperative that individuals look into proper rehabilitation following a concussion to reduce all risks of further injury and improve their overall function. 

According to Thomas et al. (2018) it was determined that engaging in physical therapy post-concussion by a certified specialist allows the individual to reduce their symptoms as well as risk of other forms of injury within a median time of 17 days post-concussion rather than the 21 to 28 days without proper rehabilitation. 

Given all the new information presented and with every concussion having different symptoms, a physical therapy plan that is individualized and focused to each patient will help with decreasing their symptoms and progressing towards returning to play or work-related activities! Come join us at Synergy Physical Therapy and Wellness for an evaluation and a return back to normal if you are suffering from concussion symptoms. 

  • Dr. Kass Lotrich, PT, DPT, VCS

Sources:

McCann, R. S., Schussler, E., Martinez, J. C., & Ramirez, V. (2022). The Effect of Concussion History on Lower Extremity Injury Risk in College Athletes: A Systematic Review and Meta-Analysis. The International Journal of Sports Physical Therapy, 17(5). https://doi.org/10.26603/001c.36810 

Leddy, J. J., Haider, M. N., Ellis, M. J., Mannix, R., Darling, S. R., Freitas, M. S., Suffoletto, H., Leiter, J., Cordingley, D. M., & Willer, B. (2019). Early subthreshold aerobic exercise for Sport-Related concussion. JAMA Pediatrics, 173(4), 319. https://doi.org/10.1001/jamapediatrics.2018.4397

Leddy, J. J., Burma, J. S., Toomey, C., Hayden, A., Davis, G. A., Babl, F. E., Gagnon, I., Giza, C. C., Kurowski, B. G., Silverberg, N. D., Willer, B., Ronksley, P. E., & Schneider, K. (2023). Rest and exercise early after sport-related concussion: a systematic review and meta-analysis. British Journal of Sports Medicine, 57(12), 762–770. https://doi.org/10.1136/bjsports-2022-106676

Thomas, D., Coxe, K., Li, H., Pommering, T. L., Young, J., Smith, G. A., & Yang, J. (2018). Length of recovery from Sports-Related concussions in pediatric patients treated at concussion clinics. Clinical Journal of Sport Medicine, 28(1), 56–63. https://doi.org/10.1097/jsm.0000000000000413 

Flautt, Warren, DPT, S. F. (2023). VCS-1: Diagnosis & Management of Concussions in the Athlete: An Evidenced-based approach Part 1 of the Vestibular Concussion Specilaist Certification., (pp. 1-112). Denver.

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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