What to do for a concussion or mild head injury/ traumatic brain injury? 

A concussion is a brain injury. It may involve loss of consciousness. However, a concussion most often occurs without a loss of consciousness. 

Concussions happen when bumps, blows, or jolts to the head or body cause the brain to move around inside the skull. It may also result from a whiplash effect on the head and neck. The brain injury that results can be mild or more severe and can disrupt how the brain normally works by causing bruising and swelling inside the skull which presses on sensitive neural tissue (brain). 

Concussions can be hard to recognise because there may not be obvious signs of trauma. Signs and symptoms may have delayed onset and may be worse later that day or even the next morning. 

Initial Response: If there is a loss of consciousness, call an ambulance by phoning 111. Assume possible neck injury. Only remove the victim from the current situation if it is dangerous to remain there. Do not leave the injured person alone: monitor signs and symptoms. The injured person should be evaluated by a trained health professional and they should not return to the activity until all steps below are clear.

Signs and Symptoms

• Poor balance or coordination

• Slow or slurred speech

• Poor concentration

• Delayed responses to questions

• Vacant Stare

• Unusual emotions

• Personality change

• Inappropriate behaviour

• Headache

• Dizziness

• Feeling Dazed

• Seeing stars

• Sensitivity to light

• Ringing in ears

• Tiredness

• Nausea

• Vomiting

• Irritability

• Confusion

• Disorientation

Steps for Returning to Normal Activity

The only treatment for a concussion is complete rest until all signs and symptoms resolve. Complete rest includes rest for the body (no playing sports or doing chores) and for the brain (no TV, video games or extensive reading). Each step should be last a minimum of one day.

Signs and symptoms may return later that day or the next and not necessarily when exercising. If signs and symptoms return you should return to the previous step and be re-evaluated by a health care professional.

Step 1: No Activity - complete physical and cognitive rest. Proceed to next step when advised by your Concussion Recovery expert.

Step 2: Light Activity - walking, swimming, cycling. light chores, reading, partial return to work/school

Step 3: Some Skilled Activity - Simple non-contact drills in sport, more time spent at school or work

Step 4: More Skilled Activity - progress to more complex drills in sport, may start progressive resistance training, not-contact play with other people

Step 5: Normal Routine and School/Work Routine - Following medical clearance you may participate in normal sport practices, games, chores, and your normal work and school routines

Note: The injured person should proceed through the above steps only when they do not experience symptoms or signs and a physician has given the clearance. If symptoms or signs return the injured person should return to the previous step and be re-evaluated by a trained health professional.

At City Osteopaths we have a Concussion Care Clinic. We have found that gentle osteopathic treatment combined with mild Hyperbaric Oxygen Therapy (mHBOT) is very helpful in aiding recovery from the symptoms of concussion listed above.

How do we do this? Gentle treatment of the muscles, fascia and nerves of the neck and upper back along with assisting normal tension of the membranes in the head, can allow an improvement in blood supply to the brain and drainage from the brain. To help concussion symptoms ease even further we combine this with Hyperbaric Oxygen Therapy to improve oxygen to dormant parts of the brain and reduce swelling to really help the brain function again.