Blog

Concussion Return to Activity – the what, how & when The American Medical Society of Sports Medicine recently published a position statement on concussions in sport.1 This statement covers many aspects of concussion management. I will be focusing only on their return to activity recommendations and how, if at all, they alter my current practices that follow the Berlin Consensus Statement of 2016. 2 According to the studies referenced, 80-90% of older adolescents and adults resolve their sports concussions (number of previous concussions not specified) in 2 weeks. When it comes to younger individuals (no definition provided) it takes about…

Concussion Vision Treatment – Overview Concussion vision treatment are commonly provided by Neuro-optometrists, OTs and PTs. Notwithstanding problems with the research (outlined below), there is emerging evidence that vision therapy is effective at accelerating & enhancing the natural neuroplastic recovery process. If patients had no limitations in their energy, time, &/or finances, they could consult each profession. Failing this, the professions need to work collaboratively and strategically to deliver these much-needed vision treatments. Concussion Vision Treatment – More in-depth This second part of Bits and Bytes on concussion vision treatment will look at the evidence, the dosages needed, and who…

Concussion Vision Issues – Overview Concussion vision issues affect a large number of patients. This leads to an inability for patients to comfortably carry out many activities of daily life (e.g. reading). Following an mTBI, it is theorized that the integration of vision subsystems, focal and ambient, break down. Full concussion vision evaluation should include: basic optometric considerations, as well as oculomotor & non-oculomotor functional testing. Repetitive vision exercises, +/- aids, are believed to accelerate & enhance the natural neuroplastic recovery. Concussion Vision Issues – More in-depth The first part of this Bits and Bytes article on concussions and vision…

Concussion Fatigue – Overview Our understanding about concussion fatigue is still developing.  This is because our knowledge of what causes Concussion and Post-concussion Syndrome (PCS) and how it should be best treated continues to evolve. Many things may be causing a concussed person’s fatigue including: increased mental effort, sleep disturbances, anxiety/depression, hypothyroidism, etc. Proposed treatments include: cardiorespiratory exercise, mindfulness-based stress reduction, bright light therapy, and medication. While these treatments will likely help, the bottom line is that Concussion and PCS fatigue is still relatively poorly understood, and there are no gold standard treatments for it yet. Concussion Fatigue – More…

As part of concussion education, I often explain to patients that a good concussion program is like a table. You need all 4 legs to be in place for the program to work well. However, in reality not all aspects of treatments have equal importance or evidence. Rather than a table, a better analogy for concussion treatment is the hierarchy of a pyramid; with a good foundation being the most important part. To best facilitate recovery, in my opinion a good program’s components, and the order they are delivered, should be as follows: In traditional physiotherapists we are used to…