Category Archives: Head

concussion baseline testing

Post Concussion Recovery: Why Baseline Testing is Important

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Concussion Baseline Testing

Concussions are serious

Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

Once an athlete has been suspected of having a concussion… when is it safe to go back to play? The answer is different for everyone, but there are few baseline tests that medical professionals can administer to make sure that a gradual return to play, work and activity is safe and won’t lead to further damage.

When an athlete has a concussion, it’s important to know how much their functional and cognitive abilities have been affected. With a baseline test you give medical professionals an accurate starting point to correctly evaluate the impact of the injury.

FAQs about Concussion Baseline Testing

Concussion baseline testing is a pre-season exam conducted by a trained health care professional. Baseline tests are used to assess an athlete’s balance and brain function (including learning and memory skills, ability to pay attention or concentrate, and how quickly he or she thinks and solve problems), as well as for the presence of any concussion symptoms. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a health care professional during the season if an athlete has a suspected concussion.

Baseline testing generally takes place during the pre-season—ideally prior to the first practice. It is important to note that some baseline and concussion assessment tools are only suggested for use among athletes ages 10 years and older.

How is baseline testing information used if an athlete has a suspected concussion?

Results from baseline testing can be used if an athlete has a suspected concussion. Comparing post-injury test results to baseline test results can assist health care professionals in identifying the effects of the injury and making more informed return to school and play decisions.

Education should always be provided to athletes and parents if an athlete has a suspected concussion. This should include information on safely returning to school and play, tips to aid in recovery (such as rest), danger signs and when to seek immediate care, and how to help reduce an athlete’s risk for a future concussion.

What should be included as part of baseline testing?

Baseline testing should include a check for concussion symptoms, as well as balance and cognitive (such as concentration and memory) assessments. Computerized or paper-pencil neuropsychological tests may be included as a piece of an overall baseline test to assess an athlete’s concentration, memory, and reaction time.

During the baseline pre-season test, health care professionals should also assess for a prior history of concussion (including symptoms experienced and length of recovery from the injury). It is also important to record other medical conditions that could impact recovery after concussion, such as a history of migraines, depression, mood disorders, or anxiety, as well as learning disabilities and Attention-Deficit/Hyperactivity Disorder.

Baseline testing also provides an important opportunity to educate athletes and others about concussion and return to school and play protocol.

Who should administer baseline tests?

Baseline tests should only be conducted by a trained health care professional such as a physician, physical therapist or trained ATC.

Who should interpret baseline tests?

Only a trained health care professional with experience in concussion management should interpret the results of a baseline exam. When possible, ideally a neuropsychologist should interpret the computerized or paper-pencil neuropsychological test components of a baseline exam. Results of neuropsychological tests should not be used as a stand-alone diagnostic tool, but should serve as one component used by health care professionals to make a return to school and play decisions.

How often should an athlete undergo concussion baseline testing?

If baseline testing is used, research suggests that most components of baseline testing be repeated annually to establish a valid test result for comparison. Baseline computerized or paper-pencil neuropsychological tests may be repeated every 2 years. However, more frequent neuropsychological testing may be needed if an athlete has sustained a concussion or if the athlete has a medical condition that could affect the results of the test.

Many physical therapy clinics have therapists that have been trained in baseline testing software and techniques. Physical therapists can also specialize in return to sports programs for athletes that have experienced concussions.  The decision of when you go back to your sport can be a critical one… especially if you go back to soon. Prevent this by having an accurate baseline available for your healthcare professionals.

Need Physical Therapy? Find a PT Near You!

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more information can be found at http://www.cdc.gov/headsup/

Additional articles from PTandMe about concussions can be found here:

concussion physical therapy   

concussion treatment   

PT News PTandMe

PT News May 2019

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PT News PTandMe

This time in PT News we recap what our clinics have been posting throughout May 2019. We are excited to begin a new year of new posts featuring published articles from PTandMe partnering clinics!

nutrition strategies

1. Effective Nutrition Strategies
Written by The Center for Physical Rehabilitation with 8 physical therapy locations throughout Greater Grand Rapids, MI.

How do you stay on target with eating healthy and being active? Between work schedules, kids schedules, appointments, and change of plans, finding time to exercise and eat right can sometimes feel impossible. Read more

 

physical therapy for headaches

2. Physical Therapy Can Help Headaches
Written by Mishock Physical Therapy and Associates, a privately owned, outpatient physical therapy practice throughout Montgomery, Berks and Chester Counties.

Headache pain is the third most common pain complaint worldwide. Some people suffer from the occasional headache, but others suffer from daily, chronic headaches which can be disabling, interfere with one’s ability to work and result in decreased quality of life. Read more

 

Does Mono Mean no exercise

3. Does Mono Mean No Exercise?
Written by The Jackson Clinics with 21 physical therapy locations throughout Northern Virginia and Maryland.

Mononucleosis—often known simply as “mono”—has an incubation period of one to two months. Once symptoms appear, recovery can take an additional four to six weeks. Until your physician tells you it is safe to resume more strenuous workouts, avoid any but the mildest exercise. Read more

Sternocleidomastoid (SCM) Muscle Pain

Sternocleidomastoid (SCM) Muscle Pain

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Sternocleidomastoid (SCM) Muscle Pain
Patients with complaints of ear pain or fullness could have Sternocleidomastoid (SCM) muscle pain.

Sternocleidomastoid (scm) muscle pain typically brings complaints of dizziness or sudden hearing loss, headache or jaw pain, even when everything appears to be normal. If this is the case it might be time to consider a muscular or mechanical reason for the symptoms. Many patients with these complaints are referred to physical therapy clinic after months of testing that are inconclusive and often negative. We have found the sternocleidomastoid muscle is often the source of the patient’s complaints.

Pain and Symptoms Associated with the Sternocleidomastoid

Sternal Division
This is the muscle head that connects to the breastbone (sternum).
Pain may be felt in these areas:

  • Cheek and jaw
  • Sinuses
  • Back of head at the bottom of the skull
  • Around one eye
  • Top of head

It may also be associated with these symptoms:

  • Tearing of eye
  • Visual disturbances when viewing parallel lines
  • Chronic “sore throat” when swallowing,
  • Chronic dry cough

Clavicular Division
This is the muscle head that connects to the collarbone (clavicle).
Symptoms may be felt in these areas:

  • Pain across the forehead
  • Frontal sinus-like headache
  • Earache
  • Nausea
  • Dizziness
  • Car-sickness
  • Faulty weight perception of held objects
  • Hearing loss in one ear

Physical Therapy can help patients experience Sternocleidomastoid (SCM) muscle pain relief in as little as one visit.
A physical therapist will evaluate the patient to determine which part fo the Sternocleidomastoid Muscle is causing the patient pain, as well as the sensitivity levels of trigger points. Once a treatment plan has been determined our licensed physical therapists will work with patients on certain exercises and stretches designed to increase flexibility and strengthen the Sternocleidomastoid muscle. Hands-on manual therapy techniques are used to relax the muscle to help reduce pain levels. Dry needling may also be utilized to give relief to multiple trigger points.

 

This article was written by the physical therapists at Quad City Physical Therapy, located in Davenport, IA. More information about Qaud City PT can be found at www.quadcityptandspine.com

Cervical Headache Physical Therapy

Physical Therapy for a Cervical Headache

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Cervical Headache Physical Therapy

What is a Cervical Headache and How Can Physical Therapy Help?

Cervical headaches are most often found in people around the age of 33, are usually one sided, and begin in the back of the head and radiates. A cervical headache is usually caused by agitation of the nerves exiting the skull or is a result of trauma, sustained postures, stiffness and general neck pain to the upper cervical segments.

Headaches are a common occurrence in daily life, and occur for a multitude of reasons. Usually, they pass without issue, and sometimes they might require Tylenol. However, sometimes the headaches are more severe and either remain present and linger, or recur at consistent (or inconsistent) intervals. When the headache begins in the back of the neck or following neck pain, it is likely a cervicogenic headache.  These headaches occur when there is a dysfunction in the upper cervical spine (upper neck), agitating nerves that share a pathway with the nerves that supply the jaw and temples.  These headaches often accompany stiffness in the neck, usually to one side or direction, and often react to postures (looking down, looking up, sleep, etc.). These headaches are mechanical in nature, meaning the movement and positions of joints are the cause of the headache. Therefore, movements either active or passive in the neck can change the stimulus that alerts the brain, causing pain.

Physical therapy, including manual therapy, repeated movements, exercise and posture education are the most effective treatment for these headaches. Further, and the best news of all, reduction does not take a long time, with relief usually in the initial visit and resolution in 4-5 visits.

How Physical Therapy for a Cervical Headache Typically Works

There are multiple types of headaches. Often a simple exam and a few questions can rule in or out cervical headaches as the cause. Very rarely are expensive imaging and testing needed to achieve a diagnosis. Following an initial evaluation, a physical therapist will have the basis for understanding:

  • How the headache is effecting function
  • Where the headache symptoms are coming from
  • Whether or not a red flag condition may be present
  • A direction to move the patient in to remove pain
  • Whether another headache type is present (migrain or tension headache) and how to proceed

When the initial evaluation is over the physical therapist will:

  • Identify the pain causing movement, posture, or spinal segment
  • Gear treatment around self management and the repetition of movements
  • Provide endurance exercises to help stabilize the neck
  • Use manual therapy may as needed to improve recovery times
  • Educate patients about posture and prevention

As physical therapists, our goal is not just to reduce the patient’s pain now, but to give them the tools to prevent injury and pain in the future. As a result our  headache physical therapy treatment plans include a good bit of patient education, including the best ways to manage headaches that may occur in the future. If you have a nagging headache that won’t go away, call your physical therapist to schedule an appointment and start feeling better today.

This article was written by the experienced physical therapists at STAR Physical Therapy. STAR physical therapy currently has over 65 locations throughout TN and provide a variety of specialty services to their surrounding communities. For more information about STAR visit them online at www.STARpt.com

Think you may have a Tension Headache instead? Find out in the PTandMe Injury Center

TMJ Pain

Physical Therapy Helps With TMJ Pain

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TMJ Pain

Physical Therapy can help those suffering with pain associated with the facial region, head, and/or neck, including those struggling with Temporomandibular (TMJ) disorders.

The temporomandibular joint or TMJ, is a complex joint located in front of each ear. It is responsible for allowing mouth opening and closing. When the TMJ is not working correctly, you may experience jaw pain, clicking, popping, or locking of the joint. You may also experience headaches, neck pain, sinus pain, dizziness, and ear ringing or pain. TMJ pain or Temporomandibular Dysfunction (TMD) is not strictly limited to the jaw, jaw, it can also be influenced by activities, positioning, or alignment of the head and neck.

COMMON CAUSES

  • Excessive grinding or clenching of teeth
  • Joint stiffness
  • TMJ Disorders
  • Poor Posture or Ergonomics
  • Other neck conditions including pain and headache
  • Stress and muscle tension

TMJ Pain

PHYSICAL THERAPY TREATMENT FOR TMJ
Physical therapy treatment includes an in depth evaluation of the structures of the cervical spine, jaw joints and head. Treatment could include manual therapy techniques for the spine, jaw and soft tissues, exercise for the jaw and neck, and modalities. Evaluation focuses on the relationship of the muscles, joints and nerves of the jaw, head, neck and face and how they relate to each other. Manual therapy may be used to improve range of motion and mobility of the jaw and neck. Exercise is designed to restore the proper balance of the spine and head to take unnecessary stress off of sensitive tissues and to support the body so it can perform the activities of daily living efficiently and comfortably. Modalities will decrease the short-term discomfort and joint irritation. We will look at how you interact with your environment to see if there are activates you preform that put increase stress on your body which could cause increased pain. Most importantly, in addition to these techniques, the patient is provided with a home exercise program to aid in symptom reduction. Each treatment plan is based on a patient’s individual needs and the therapist, patient, and referring practitioner work as a team to reach the patients goals.

This information was written by Rehab Associates of Central Virginia, an outpatient physical therapy group with 13 locations in Central Virginia. Their physical therapists have advanced degrees in specialty orthopedic care from head to toe. From musculoskeletal headaches to lower back pain to heel pain syndrome, they can help take away your pain and help you return to normal activity. For more information click here.

concussion

True or False: A Person With a Serious Head Injury or Concussion Should Be Kept Awake

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TrueorFalse_FBsize

All head injuries should be treated seriously. While most won’t cause lasting effects, if improperly treated, they can lead to long-term disabilities or even death.

The most common type of head injury is a concussion. It is a jarring trauma to the brain that can cause a person to lose consciousness or have amnesia.

What do you do if you are around someone who experiences a serious head injury or concussion? You may have heard that you should not let the person go to sleep, but is this true? Most health professionals don’t think so. It is generally considered safe for people with head injuries or concussions to go to sleep. In some cases, a doctor may recommend waking the person regularly to make sure his or her condition has not worsened.

Evidence for the Health Claim
Many people will go to great lengths to keep a person who has had a head injury from falling asleep. They argue that keeping the person awake will decrease the risk that he or she slips into a coma.

This misunderstanding probably stems from hearing about a rare occurrence known as a lucid interval that has been associated with certain types of severe head injuries. A lucid interval occurs when the initial bleeding in the brain does not cause loss of consciousness. The bleeding eventually worsens and brain structures become compressed. The person’s condition can rapidly deteriorate, requiring emergency brain surgery.

Evidence Against the Health Claim

Most medical professionals say it is fine—sometimes even advised—to let people sleep after incurring a head injury.

The American Academy of Family Physicians states it is not necessary to keep a person awake after a head injury. If a person needs to be watched that closely, a doctor will most likely admit him or her to the hospital. The Dartmouth College of Sports Medicine advises that it is fine to go to sleep after a concussion so long as someone wakes you up every two hours. They are to check to make sure you can be easily awakened and aren’t displaying symptoms of a worsening condition.

In a study in the September-October 2005 issue of the Journal of Head Trauma Rehabilitation, researchers reported greater levels of fatigue in people who have had head injuries, compared with those who have not. The researchers concluded that regular rest breaks and increasing intervals of restful sleep should be a part of the rehabilitation from head injury.

neon concussion

Conclusion
If you are around someone who has a head injury or possible concussion, monitor the symptoms closely. It is important to call a doctor or go to a hospital immediately if the person has worrisome symptoms such as:
• Open wound in the scalp or misshapen deformity of the skull
• Severe or progressive worsening headache
• Changes in behavior (eg, confusion, restlessness, irritability, lethargy)
• Dilated pupils or pupils of different sizes
• Convulsions or seizures
• Difficulty waking from sleep
• Trouble walking or speaking
• Bleeding or drainage of fluids from nose or ears
• Unusual sleepiness or decreasing alertness
• Severe or persistent nausea, or vomiting more than twice
• Weakness or numbness in the arms or legs

When a head injury is serious enough to require medical care, a doctor will give you instructions on how to monitor and treat the injury once the person is released from the hospital or clinic. These instructions will generally not include keeping the person awake and alert.

by Krisha McCoy, MS

More PTandMe articles about concussions can be found here:

concussion physical therapy   concussion treatment

   

REFERENCES:
Head injuries. KidsHealth.org website. Available at: http://www.kidshealth.org/parent/firstaid_safe/emergencies/head_injury.html. Accessed November 5, 2008.

Head injuries: what to watch for afterward. Familydoctor.org website. Available at: http://familydoctor.org/084.xml. November 5, 2008.

Head injury: concussion. Dartmouth College of Sports Medicine website. Available at: http://www.dartmouth.edu/~sportmed/concussion.html. November 5, 2008.

Radiology for traumatic brain injury. Trauma.org website. Available at:http://www.trauma.org/neuro/neuroradiology.html. Accessed July 23, 2006.

Subjective reports of fatigue during early recovery from traumatic brain injury. Journal of Head Trauma Rehabilitation. 2005;20:416-425.

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

TMJ

There is Hope for TMJ Pain

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HopeForTMJPain_FBsize

TMJ is where the lower jaw meets the skull.

The temporomandibular joint or TMJ, is a complex joint located in front of each ear. It is responsible for allowing mouth opening and closing. When the TMJ is not working correctly, you may experience jaw pain, clicking, popping, or locking of the joint. You may also experience headaches, neck pain, sinus pain, dizziness, and ear ringing or pain. TMJ pain or Temporomandibular Dysfunction (TMD) is not strictly limited to the jaw, it can also be influenced by the alignment of the head and neck.

The goal of Physical Therapy treatment for Temporomandibular Dysfunction (TMD) is to provide pain relief using a variety of techniques to improve your range of motion through exercise and manual therapy and to improve posture and muscle imbalance. There may be modifications to your activities or work station that would be helpful as well.

man with ear pain

SYMPTOMS
• Face or Jaw Pain
• Ear Pain
• Tinnitis (ringing in the ears)
• Dizziness
• Headache
• Jaw Clicking and/or Popping
• Neck Pain
• Limited Jaw Opening

TREATMENT
Your Physical Therapist will work closely with your Dentist or Physician to establish an individualized treatment plan based on results from a comprehensive evaluation. The most current treatment options will be utilized to ensure the best outcome for decreased pain and improved function.

TREATMENT WILL INCLUDE, BUT IS NOT LIMITED TO:
• Comprehensive evaluation of head, neck, and jaw
• Education regarding the diagnosis and related head, neck and jaw dysfunction. This includes addressing any of your questions or concerns.
• Individualized program specific to your needs including modalities, joint mobilization, soft tissue mobilization, postural education, neuromuscular re-education and TMJ management techniques.
• Collaboration between referring physician or dentist to ensure comprehensive and integrated care.