Treatment is rehab
Placing third on our list of the top five concussion breakthroughs of the past five years, is the greater understanding that concussion IS treatable. And the treatment is rehabilitation!
Unfortunately, patients are still provided with the poor advice that they need to “rest” and that concussions simply require “time” to heal. While concussions may require time, recent studies also find that we can reduce this “time” by providing rehabilitation and treatment of the injured or impaired systems.
A landmark study from the University of Calgary’s Dr. Kathryn Schneider, was the first randomized control trial to demonstrate that initiating treatment of the neck and vestibular system led to a significant reduction in recovery time of injured hockey players with persistent symptoms1. In this study, hockey players between 12 and 30 years old who were still experiencing symptoms between 10 and 14 days after injury, were randomized to get the “usual treatment” (rest until symptoms go away followed by a gradual reintroduction of activity) or rehabilitation of the cervical spine and vestibular system. Both groups received weekly sessions with a physiotherapist, however, only the treatment group received rehabilitation. The other group was provided with postural education. After 8 weeks, 73 percent of the treatment group had returned to full activity whereas only 7 percent of the usual care group had!
Since this study, there has been a large increase in the number of studies showing positive concussion recovery with treatment of the neck as well as vestibular and oculomotor therapies. In 2017, the most recent International Consensus Statement on Concussion in Sport2 suggested that vestibular and cervical spine rehabilitation be incorporated in patients with persistent concussion symptoms (i.e., lasting longer than 10-14 days).
Most patients will have a complete resolution of symptoms in the first 7 to 10 days. In the 30 percent or more who still have symptoms 10 days after their injury, the best available evidence shows that you should be seeking out concussion-trained rehabilitation professionals to help you kick your symptoms faster3.
To read the number two breakthrough of the past five years, click here!
- Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, Barlow K, Boyd L, Kang J, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. British Journal of Sports Medicine. 3rd ed. 2014 Aug 10;48(17):1294–8.
- McCrory P, Meeuwisse W, Dvořák J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine. 2017 Jun;51(11):838–47.
- Schneider KJ, Leddy JJ, Guskiewicz KM, Seifert T, McCrea M, Silverberg ND, et al. Rest and treatment/rehabilitation following sport-related concussion: a systematic review. British Journal of Sports Medicine. 2017 May 31;51(12):930–4.