Welcome to Stay in the Game, a monthly blog where the team from the Queen's Center for Sports Medicine shares the latest tips on the treatment and prevention of sports injuries. We want to help you play hard and be well - a winning combination that will keep you in the game all season long.

Concussion updates

On July 17, 2017, The Queen's Medical Center and the Hawaii Concussion Awareness and Management Program co-hosted a concussion summit to share knowledge about the latest strategies in diagnosing and treating concussions. Dr. John Leddy from the University of Buffalo and Emily Kosderka from Concordia University served as guest speakers, and the conference emphasized four main teaching points about concussions:

1. Earlier return to school after concussion
2. Earlier return to noncontact exercise after concussion
3. Concussion exercise testing as part of treatment
4. Vestibular physical therapy treatment techniques

Earlier Return to School after Concussion

Current research shows that people with concussion who rest at home 5 days or more take much longer to recover from their concussion than people who rest only 2-3 days. In fact, returning to school or work sooner after a concussion injury does not cause harm, even if the person still has symptoms, like headache or fatigue. Currently, it is recommended that students try to attend school within the first 2-3 days after their concussion, even if only part-time. They are allowed to return to their normal classwork and homework, taking breaks only as needed, when not feeling well.

Earlier Return to Noncontact Exercise after Concussion

More research has recently concluded that people with concussion who begin light aerobic exercise, such as stationary biking or walking, within a week of their concussion injury feel better and heal faster than those who do not exercise. Getting back to aerobic exercise earlier, even with mild concussion symptoms, is safe and can positively contribute to the overall well-being of the patient. Concussion patients may return to light exercise within the first week after their injury, starting with stationary biking or walking. As long as they will not be at risk of striking their head or falling down, patients are encouraged to increase their exercise gradually and try different activities. This may include elliptical training and non-strenuous hiking, or throwing, batting, kicking, or catching balls, along with other similar exercise routines.

Concussion Exercise Testing as Part of Treatment

Dr. Leddy and his partner, Dr. Barry Willer, have developed the Buffalo Concussion Treadmill and Bike Test. The first test takes place while the patient still has concussion symptoms and is prescribed an exercise plan to be followed five days per week, increasing activity levels each week, until symptoms resolve. The patient is then retested on a treadmill or bicycle to physically demonstrate that they are fully healed.

The test helps doctors and athletic trainers in two ways:

1. Determines how much exercise a concussed patient should be participating in during recovery
2. Provides clinical proof that a patient is fully healed and ready to return to contact sports

The testing has been proven to be safe for patients still experiencing symptoms.

Vestibular Physical Therapy Treatment

Finally, another way to heal concussion is to take part in physical therapy. A physical therapy method called vestibular therapy helps to treat dizziness, headaches, balance, and vision problems after concussion. Other physical therapy techniques can also address neck pain after a concussion. Additionally, a physical therapist can provide at-home exercise tips to allow patients to continue to improve on their own.

Stay tuned for more updates on concussions next month, as we continue to discuss different types of concussion treatment. In the meantime, for questions on concussion prevention or treatment contact our experts at the Queen's Center for Sports Medicine at 808-691-4449 or click the link below.

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