Category Archives: Head

Post Concussion Recovery: Why Baseline Testing is Important

August 10, 2022 Teresa Stockton - Blog, Head, Pediatrics, Sports and Fitness

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.

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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:

PT News February/March 2022

March 9, 2022 Teresa Stockton - Blog, General Information, Head, Industrial Rehab, PT News

This time in PT News we recap what our clinics have been posting throughout February and March 2022. We are excited to bring you current physical therapy-based posts featuring published articles from PTandMe partnering clinics!

1. Worker’s Compensation: What Is A Job Analysis?

Written by ARC Physical Therapy+ with locations throughout Missouri, Kansas, and Iowa.

A functional job analysis is the first and most critical step of a comprehensive injury management program. The job analysis is the cornerstone for determining the essential functions of the position and associated physical demands required as well as for developing testing to determine the physical capabilities of an employee. Read more

2. Physical Therapy Tackles Cervicogenic Headaches Head-On

Written by Jaco Physical Therapy, an outpatient physical therapy practice with locations throughout Oahu, Hawaii.

Are you noticing headaches on one side or the back of your head? Are you feeling worse at the end of your workday or headaches that worsen with computer usage or driving? You may be suffering from cervicogenic headaches. Thankfully, they are treatable with physical therapy! Read more

3. How you sleep matters.

Written by Riverview Physical Therapy, an outpatient physical therapy group with locations throughout Maine.

How you sleep matters. Are you waking up with lower back discomfort or neck soreness that you didn’t go to bed with? You may be sleeping wrong.

Try sleeping on your back or on one of your sides. Sleeping on your stomach is never advised. Just think about it, would you spend your workday with your head turned 90 degrees to the side for 6-8 hours? Of course not. Read more

We hope you enjoyed our picks for the PT News February/March 2022 edition.

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PT News September 2020

September 30, 2020 Teresa Stockton - Blog, General Information, Hand, Head, PT News

This time in PT News we recap what our clinics have been posting throughout September 2020. We are excited to bring you current physical therapy based posts featuring published articles from PTandMe partnering clinics!

1. Virtual Total Body Fitness Workout

Created by The Center for Physical Rehabilitation with locations throughout Greater Grand Rapids, MI.

This bodyweight-only class is sure to get your heart rate up and muscles burning! With modifications available to increase or decrease the intensity, this exercise circuit is great for everyone! Not ready to resume in-person classes? No problem! Check out this Virtual Fitness Class options here! Read more

2. Excercise Improves Learning

Written by The Jackson Clinics, an outpatient physical therapy practice with multiple locations throughout Northern Virginia.

Due to the COVID-19 pandemic, e-learning platforms have quickly become how many children will learn this Fall. As a result, our kids will experience a sharp jump in their screen time. Now, more than ever, we need to help to counteract this rise in sedentary time with some good old fashioned exercise and playtime! Read more

3. Minimizing Opioid Use Through Physical Therapy

Written by Wright Physical Therapy, an outpatient physical and hand therapy practice with locations throughout Southern, ID.

Chronic pain affects nearly one-third of the American population and is, more often than not, disabling. The assurance of repose can sound promising no matter which pain relief option is presented, even if the option is the introduction of habit-forming prescription medications. Despite the daunting stats, there is great news! Physical therapy (PT) is powerful as a highly recommended alternative to the use of dangerous and addictive pain medications. Read more

Find these locations and others to start feeling better today!

PT News August 2020

August 12, 2020 Teresa Stockton - Blog, General Information, Hand, Head, PT News

This time in PT News we recap what our clinics have been posting throughout June & July 2020. We are excited to bring you current physical therapy based posts featuring published articles from PTandMe partnering clinics!

1. Sports Periodization Can Help You Peak and Avoid Overuse Injuries

Written by Physical Therapy Plus with locations in Clinton, Hackettstown, and Washington, NJ.

As unfortunate as it is true, injuries and sports go hand in hand. An average of 8.6 million injuries in sports and recreational activities occur each year, which equates to about 34 injuries for every 1,000 individuals that participate. While some minor injuries might only lead to a short gap in participation, others can end seasons and lead to long-term complications if not rehabilitated properly. Read more

2. Baseball Throwing Injuries

Written by Mishock Physical Therapy, an outpatient physical therapy practice with multiple locations throughout Montgomery, Berks, and Chester Counties.

Most states have moved away from self-quarantine and are now resuming the “new normal” with COVID-19 in our midst. From March through June, youth and adolescent sports were canceled. Sports organizations are now trying to play catch up by squeezing spring and summer sports into July and August. With this ramp-up in games, we have seen a significant increase in sports-related injuries, especially baseball throwing injuries. Two such injuries are growth plate injuries of the throwing elbow and shoulder. Read more

3. Get Back In The Saddle With Help from a Hand Therapist

Written by Rebound Physical Therapy, an outpatient physical and hand therapy practice with locations throughout Bend, OR.

Reaching out your arm to brace for a fall is instinctual. It’s no surprise, then, that some of the most common mountain biking injuries are fractures of the wrist, hands, fingers, and elbows. When a bike’s front tire hits a rock or loose dirt, it can cause the rider to fly off the bike and land on an outstretched arm. Read more

Find these locations and others to start feeling better today!

PT News July 2020

July 8, 2020 Teresa Stockton - Blog, General Information, Hand, Head, PT News

1. Now is the Time to Start Physical Therapy

Written by Mishock Physical Therapy with multiple locations throughout Berks & Montgomery Counties in PA.

Now is the time to focus on your health and treat the pain that is limiting your function, leading to poor quality of life. This is the perfect time to start physical therapy. We can help! Read more

2. Physical Therapy for Cervical Headaches

Written by The Jackson Clinics, an outpatient physical therapy practice with multiple locations throughout Central Virginia

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 is needed to achieve a diagnosis. Following an initial evaluation, a physical therapist will have the basis for understanding Read more

3. Physical Therapy: Treating Arthritis the Safe and Easy Way

Written by Cornerstone Physical Therapy, an outpatient physical and hand therapy practice with 6 locations throughout the Columbus, OH Metropolitan Area.

Anyone living with arthritis knows how debilitating it can be. Several people dealing with arthritic aches and pains end up resorting to steroid injections, antirheumatic drugs, or even joint replacement surgery, in order to manage their pain. However, physical therapy itself has proven successful for many arthritis sufferers. Read more

Find these locations and others to start feeling better today!

How to Handle a Concussion in Youth Hockey

December 18, 2019 Teresa Stockton - Blog, Head, Pediatrics

Youth hockey is very much a contact sport so it’s no surprise that concussion is a particular problem that arises quite regularly. It’s a real concern though because while concussion can be quite a mild injury, it can also be serious but it’s difficult to detect the severity of it without medical intervention. The problem arises, especially in youth hockey circles when players don’t report their concussion injury specifically for fear they will lose out on the remainder of a game or any future games. Of course, that is incredibly naïve, but you’re dealing with young people who aren’t mature enough to understand the complexities and possible dangers of the injury.

In youth hockey, the players are exuberant and excited about every moment they get on the ice. If they receive a blow to the head, generally their aim is to bounce back as quickly as possible. However, a concussion in youth hockey can be debilitating and crucially, it requires firstly medical attention and then it requires a huge degree of rest in order to help the recovery. The victim also should be monitored at the early stages by a parent. Education is required also by coaches to make players understand how to avoid or prevent concussion through their skills in the game.

The guys at Tucker Hockey have created this comprehensive infographic below that covers everything you need to know about concussion specific to youth hockey, although the elements are transferable to youth players in any sport. It explains some interesting concussion-related statistics; it outlines the symptoms of a concussion; it details how players, coaches, and parents should react to an instance of concussion and it also looks at recovery from the injury plus lots more. Check out the full graphic below!

If a child experiences a concussion and struggles with recovery, physical therapy can help. Physical therapists that have return-to-play programs are able to guide patients through a stepwise protocol. This helps athletes remain symptom-free and to prevent serious conditions associated with a second head injury due to early return to sport.

PT News May 2019

May 30, 2019 Teresa Stockton - Blog, General Information, Head, PT News, Sports and Fitness

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!

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

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

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

September 12, 2018 Teresa Stockton - Blog, Head

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

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Physical Therapy for a Cervical Headache

August 8, 2018 Teresa Stockton - Blog, Head, Neck

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

Physical Therapy Helps With TMJ Pain

June 1, 2017 Teresa Stockton - Blog, Head

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

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.