By Aleisha Theisen, PTA and NBC-HWC
When you think of a physical therapist, you might visualize someone helping you rehabilitate your knee or shoulder. At FYZICAL-Forest Grove, our PTs can do that, plus more. They are head-to-toe PTs. That means if you are dizzy, if you’re dealing with back pain, if you’ve had a concussion, or if you need to strengthen an ankle joint or get your pelvic floor back in working order, they’ve got you covered.
The role of PTs continues to expand. One area where their expertise shines is in the testing and treatment of concussions. While concussions are commonly associated with athletes, they can affect individuals across various age groups and scenarios, from youths engaged in sports to older adults experiencing falls or people of all ages involved in motor vehicle accidents. The pivotal role of PTs in concussion management is underscored by their ability to address the wide spectrum of symptoms that can arise from concussions.
Because concussions can affect numerous parts of the brain as well as the rest of the body, a PT will conduct a thorough evaluation to gather important information and create a customized treatment plan based on the patient’s unique needs. Aaron Frye, physical therapist and owner of FYZICAL-Forest Grove, says the evaluations can help the PT determine if the patient needs exercises that focus on their oculomotor (visual) system, vestibular (inner ear and balance) system, cervical (neck) sensors, agility, or coordination, among other areas.
1. Concussions in Athletes
For athletes, especially those in contact sports, there is a risk of sustaining a concussion. The PTs at FYZICAL-Forest Grove are equipped with specialized training to assess and manage concussions in this demographic. Beyond recognizing overt symptoms like headaches, fatigue, and dizziness, our PTs can also delve into vestibular dysfunctions and oculomotor issues using the modified sensory organization test and other evaluation and screening techniques. From there, they design tailored rehabilitation programs to restore balance, coordination, and visual tracking — crucial skills for athletes returning to their sports.
Aaron says custom rehabilitation programs for athletes can work up to a higher intensity than they might for the average population, because these patients must be able to safely return to their sport and tolerate quick movements. They also must be able to handle a high rate of physical exertion. He might, for example, have them practice spins, running and cutting in a quick turn, hopping on one foot versus another, and other high-level drills related to their sport.
The clinic’s Virtualis virtual reality system is another great option our PTs can use to challenge the high-level athlete. They stand on a “motion plate” and experience a simulated environment. They’ll play games that test their timing and reaction speed, improve how their eyes keep up with a challenging visual field, and work on their eye-neck-head coordination. The Virtualis system also tracks their progress over time, which can be a rewarding way for the athlete to gauge their improvement during the rehab process.
2.) Concussions in Motor Vehicle Accidents
Concussions resulting from auto accidents present unique challenges due to the sudden, forceful impact involved. Alongside evaluating for vestibular and oculomotor dysfunction, PTs also assess the patient’s neck. They might incorporate manual therapy techniques that help improve mobility as well having the patient practice stretches to improve range of motion and strengthening exercises to decrease pain and build stability.
Visual motion sensitivity and motion sickness also can occur after a concussion, and these are additional areas where the Virtualis VR system can be useful. Aaron says any form of treatment for motion sickness is done carefully and gradually to avoid overdoing it and provoking nausea — this is true whether the exercise involves the VR system or not. PTs also incorporate the VR driving simulator, where patients can be the driver or the passenger. The level of visual stimulation can be adjusted to the patient’s tolerance.
3.) Concussions in Older Adults After a Fall
Older adults experiencing concussions from a fall might face additional complexities, particularly if they also suffer orthopedic injuries. Our PTs at FYZICAL-Forest Grove skillfully navigate this intersection of conditions, recognizing the importance of a holistic approach.
This might include treating a hip, knee, shoulder, or ankle injury in addition to the concussion. Our PTs are also on the lookout for the need to test and treat benign paroxysmal positional vertigo, aka BPPV, a common cause of dizziness and imbalance that can be triggered by a head injury — and that can also be the cause of a fall. The PTs are ready to treat other causes of imbalance or dizziness with vestibular therapy as needed.
In addition to assessing vestibular and oculomotor function, PTs pay close attention to cervicogenic dizziness — a common symptom among concussion patients. They can create a home exercise program that will improve the way the joint position sensors in the neck detect movement and get them working together with the visual and vestibular systems again. Once all those signals are in sync, cervicogenic dizziness typically improves.
A Comprehensive Approach to Concussion Care
In each of these scenarios, our PTs employ a multifaceted approach to concussion evaluation and treatment, focusing not only on symptom management but also on addressing underlying impairments that may slow the recovery process.
We also want to highlight the fact that June is Migraine & Headache Awareness Month. It’s not uncommon for concussion sufferers to also experience headaches and migraines. Our PTs are skilled at treating all of these conditions, which sometimes require a comprehensive approach to manage. But with the right plan in place, and a supportive team helping you, you can get back on track and start feeling better.
If you’ve had a fall and hit your head or suspect you may have had a concussion, and you are experiencing any lingering dizziness, fogginess, unsteadiness, vision changes, headaches or neck pain, ask your doctor for a referral to FYZICAL-Forest Grove for a PT concussion evaluation. Rather than just “waiting it out,” your PT can help you get back on track faster and even help you prevent another fall or injury.
Call us at 503-357-1706 to schedule an evaluation.
Aleisha Theisen is a physical therapist assistant and a board-certified health and wellness coach.
Disclaimer: This blog is provided for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.
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