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Traumatic Brains Injuries (TBIs) & Concussions

Teen following eyes to doctor's moving finger.

Traumatic Brain Injuries (TBIs) are a result of a direct blow to the head or an indirect force such as whiplash.  This impact causes the brain to violently shake inside the skull.  TBIs can be classified and broken down into three categories:  mild, moderate and severe. Concussions are considered mild TBIs, but make no mistake; they are still a very serious injury that can have fatal consequences if ignored.  TBIs that are considered moderate or severe are characterized by serious physical, cognitive and emotional changes in the brain that require hospitalization, and can cause disability.


Symptoms vary from person to person, but there are many physical, emotional and mental effects that you can watch for.  Common physical symptoms include but are not limited to headaches, dizziness, poor balance/coordination, nausea/vomiting, fatigue/sleepiness, double or blurred vision, light/sound sensitivity, slurred speech or distant stare.  Noticeable cognitive symptoms could include memory loss, confusion, slow metal processing, fogginess or difficulty concentrating.  Possible emotional effects are irritability, restlessness, anxiety/depression, mood swings, aggression or change in personality/behavior.  Because of the variety of potential symptoms can impair day-to-day functions, it is important to seek coordinated medical care immediately.  It is additionally important that extreme care is taken to avoid a second concussion.  Second-impact syndrome, what happens when two concussions occur close together, can cause permanent brain damage.


TBIs are normally diagnosed by evaluating the person’s ability to move, speak and think in response to commands or questions.  Diagnosis cannot rely on hi-tech testing or brain scans because they often don’t show any brain abnormality, even when a person is showing signs of a TBI.

How Can a Physical Therapist Help?

Physical therapists can help evaluate and treat several problem areas following a concussion.  Because no two concussions are the same, determining the specific symptoms and limitations following each concussion is an important part of the physical therapy examination.  If you are experiencing dizziness or having difficulty maintaining balance following a concussion, vestibular physical therapy may be able to help.  The vestibular system, which includes the inner ear and its connections with the brain, is responsible for sensing head movement, keeping the eyes focused during head movement and helping to maintain balance.  A qualified vestibular physical therapist can perform treatments and prescribe specific exercises to significantly reduce or eliminate dizziness and increase balance and stability.  As some of your symptoms following concussion resolve, a physical therapist can also help to reintroduce a gradual and progressing level of physical activity, being careful not to overload the brain and nervous system compromised by a concussion.  With a concussion, like every other medical diagnosis, it is important that the recommendations of all medical professionals be followed in order to maximize recovery in the shortest amount of time.