Category Archives: Industrial Rehab

What to expect in a Work Conditioning Program

April 11, 2018 Teresa Stockton - Blog, Industrial Rehab

If you have experienced an injury at your place of work that results in needing rehabilitation, you may be put into a physical therapy work conditioning program. A work conditioning program focuses on preparing the body to physically be able to complete the tasks required at work. Physical Therapists focus on improving an employees, strength, flexibility, and endurance to the point that they can safely return to the job they were performing before the injury. So what exactly does that look like and what can a patient typically expect in a work conditioning program?

Main Components of a Physical Therapy Work Conditioning Program:

While each program varies, and the exercises and practiced movements will be job specific, there are a few similarities that most physical therapy work conditioning programs provide. Let’s take a look.

2-4 hour progressive program attended 3-5 days per week
Licensed OT/PT supervision
Emphasis on job simulation tasks for specific job return
Emphasis on prevention of future injury teaching correct body mechanics and safe movement patterns
Exercise programming tailored toward improving flexibility, strength, and endurance required for successful return to work. At program completion, a comprehensive home exercise program will be provided to ensure long term success
Assist the work conditioning participant to resume appropriate work behaviors including attendance, punctuality, and response to supervision
Performance of graded job simulation activities, so the participants gain confidence in their ability to return to work and so they can apply their body mechanical changes in a meaningful way
Comprehensive patient education on pacing, stress management back care and injury prevention

The ultimage goal of a physical therapy work conditioning program is to progress the patient towards returning to full or modified duty. Many times a work conditioning program is partnered with a:

Work Hardening Program:
In a work hardening program patients supervised by licensed physical and occupational therapists, are asked to simulate specific job duties in the clinic. It’s a goal oriented program and may be provided simultaneously with each other. If that is the case then activities typically start first thing in the morning and on alternating days to begin with and then consecutive days to end to build up performance.

Functional Capacity Evaluations (FCE’s).
An FCE is a 2-4 hour test that would be given after a work conditioning program had been completed, to give patients and employers analytical data on a patients progress within recovery and the likelihood of an person’s ability to return to their previous job with or without restriction. This information helps employers bring people back to work with positions suitable to their ability levels.
Click here for more information on FCE’s

Work conditioning is an integral part of work injury rehabilitation. It is a great way to ensure that patients can return to work safely, and with a reduced risk of re-injury. Occupational and physical therapists do a great deal to make sure that each patients is valuable participant in the recovery process, and educate through each step of the process.

Safe Lifting Practices for Back Injury Prevention

September 14, 2017 Teresa Stockton - Back, Blog, Industrial Rehab

Whether at home or at work safe lifting practices can keep your back healthy and safe. Before lifting heavy objects decide how you will lift carry & place the item before you pick it up. Test the weight of the load by moving or tipping it. Figure out if you can break the load down by placing the contents of large containers into a number of smaller ones before moving them. Is the path clear? What is the weight of the load? How much stress will be placed upon your back? Is there traffic, a tripping hazard, a doorway to go through, or a stairway to go up or down? Avoid carrying an object that requires two hands to hold, either up or especially down a flight of stairs. Use the elevator. Plan a rest stop, if needed. Knowing what you’re doing and where you’re going will prevent you from making awkward movements while holding something heavy. Clear a path, and if lifting something with another person, make sure both of you agree on the plan.

KEY STEPS FOR SAFE LIFTING PRACTICES

Establish a Base of Support: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.

Keep Your Eyes Up: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

Get a Good Grip: With your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

Lift Gradually with Your Legs: Without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

Tighten you stomach muscles: As you begin the lift and keep you head and shoulders up.

Pivot – Don’t Twist: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

Weight: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

Handling: It is easier to pull or push a load than it is to lift, put down or carry.

Keep the Load Close: Holding a 20lb object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

Frequency: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

Distance: The farther the load has to be moved, the greater the risk of injury.

Duration (TIME): Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

Forces Applied: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

Nature of the Load: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

Terrain: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

Environment (Climate & Lighting): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

Condition of the Workplace: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

Age/Gender: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

Training: Proper training for the specific task is vital to reduce injury.

Team Lifting: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

Raise/Lower Shelves: The best zone for lifting is between your shoulders and your waist. *Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

Avoid Lifting from the Floor: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

Get Help When You Need It: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

This content was written by Fit2WRK who has partnered with PT and Me to give a comprehensive look into the services physical and occupational therapists provide. For more information on Fit2WRK click here.

Industrial Rehab Physical Therapy PTandMe

Health Aging for a Sustainable Workforce

August 3, 2017 Teresa Stockton - Aging, Blog, Industrial Rehab

What Can Employers Do to Protect an Aging Workforce?

Employers can start by revisiting job descriptions and knowing every detail each work task entails in order to help prevent costly and unnecessary workers’ compensation claims. Meanwhile, they should continue to promote health and wellness programs for all employees. Because older workers bring many benefits, from their experience and knowledge to their motivation and good work ethic, the advantages of employing older workers will outweigh the possible worker’s compensation claims, with preparation and planning.

Companies must utilize and implement preventative safety efforts. Specifically, companies should develop slip-and-fall prevention tactics, considering that slips and falls account for 33 percent of all injuries sustained by workers 65 and older, according to the National Safety Council. Safety training should consist of more than just scripted lectures, distributed
pamphlets and orientation videos. Employees should be taken through the physical movements and tasks that are specific to their job description–a hands-on learning experience. Because younger workers account for the majority of accidents while older workers have longer recovery periods, safety training benefi ts all employees and the employer. Bring in external experts such as physical therapists from the community to teach proper techniques and protocols.

Modification of work environment
Ergonomics and wellness programs
Industrial Athlete approach to exercise
Return to work accommodations

AGING WORKFORCE SERVICES:

Education:
A full battery of educational programs are available for both the professional staff of an employer to that of the general employee population such as slip and fall or back injury prevention.

Preventative Maintenance Testing:
A brief test – approx. 15 minutes that looks at the essential and critical factors of the job – usually body part specific and set up as a repeated test – every three to four months on a high risk job position – looking for trends or patterns of degradation of range of motion or strength of employees.

Fitness Programs for the Industrial Athlete:
Detailed stretching programs are customized per high risk job based upon historical injury determinations. The program is set up for employee participation prior to work, returning from lunch and at the end of the workday.

Physical Ability Maintenance:
A custom built strengthening program designed to maintain the physical abilities necessary to perform everyday work.

For more information about staying healthy and injury free in the workplace – try the links below:

Adapted from Fit2wrk Article 1.10 For more information on Fit2wrk click here.

Repetitive Strain Injury (RSI)

May 4, 2017 Teresa Stockton - Blog, Industrial Rehab, Wrist

The Following are Seen as Causes of Repetitive Strain Injury:

The overuse of muscles in our hands, wrists, arms, shoulders, neck and back
The area is affected by repeated actions, which are usually performed on a daily basis over a long period
The repetitive actions are done in a cold place
Forceful movements are involved
Workstations are poorly organized
Equipment is badly designed
The individual commonly adopts an awkward posture
There are not enough rest breaks

Prevention 101: Nine Easy Ways to Reduce Your Risk of Developing Repetitive Strain Injury:

TAKE BREAKS when using your computer. Every hour or so, get up and walk around, get a drink of water, stretch whatever muscles are tight, and look out the window at a far off object (to rest your eyes).
Use good posture. If you can’t hold good posture, it probably means it’s time for you to take a break from typing. If you are perpetually struggling to maintain good posture, you probably need to adjust your workstation or chair, or develop some of the support muscles necessary for good posture.
Use an ergonomically-optimized workstation to reduce strain on your body.
Exercise regularly. Include strengthening, stretching, and aerobic exercises. Yoga and pilates may also be helpful.
Only use the computer as much as you have to. Don’t email people when you could walk down the hall or pick up the phone and talk to them. It’s not only better for your hands – it’s friendlier. Think before you type to avoid unnecessary editing.
Don’t stretch for the hard-to-reach keys, e.g. BACKSPACE, ENTER, SHIFT, and CONTROL… basically everything but the letters. Instead, move your entire hand so that you may press the desired key with ease. This is crucial when you are programming or typing something where non-letter keys are used extensively.
Let your hands float above the keyboard when you type, and move your entire arm when moving your mouse or typing hard-to-reach keys, keeping the wrist joint straight at all times. This lets the big muscles in your arm, shoulder, and back do most of the work, instead of the smaller, weaker, and more vulnerable muscles in your hand and wrist. If you find it difficult to do this, then your shoulder and back muscles are probably too weak. It is OK, and in fact a good idea, to rest your elbows/wrists when you are not typing.
Use two hands to type combination key strokes, such as those involving the SHIFT and CONTROL keys.
When writing, avoid gripping the writing utensil tightly. Someone should be able to easily pull the writing utensil out of your hand when you are writing. If your pen or pencil requires you to press too hard, get a new one (my favorite is Dr. Grip Gel Ink).

Article provided by Fit2WRK. The information noted above is a summary of one of the components of Fit2WRK.

Functional Capacity / Work Capacity Evaluation

March 2, 2017 Teresa Stockton - Blog, Industrial Rehab

What is FCE / WCE Testing?
A Functional Capacity / Work Capacity Evaluation evaluates an individual’s ability to perform work activities post injury or illness. It documents the patient’s current ability from physical, medical, behavioral and ergonomic perspectives. It is within the scope of practice for occupational and physical therapists to provide such testing.

What to Expect
• FCE / WCE s can be used by physicians to complete work status reports. The FCE / WCE identifies the ability of an individual to safely return to work at full, modified or transitional duty
• The patient’s strength for material handling activities are identified via Department of Labor Standards: ex.) sedentary, light, medium or heavy
• An individual’s tolerance to non material activities such as sitting, walking, bending, etc. are quantified as never, occasional, frequent or constant as per Department of Labor standards
• A FCE / WCE will identify discrepancies between symptoms and objective findings
• FCE / WCEs can identify whether further medical evaluation or intervention is appropriate
• It can determine if there is a need for therapy or change in current therapy or direction
• If the individual is not ready for return to their previous job, it can establish a baseline for a work hardening program

This information provided by Rebound Physical Therapy, an outpatient physical therapy group located throughout Bend, OR. Rebound’s Bend North location specializes in industrial rehabilitation and More information about their industrial rehab center can be found here.

Work Related Stress & Increased Risk Zones: Part 2 of 2

January 17, 2017 Teresa Stockton - Blog, Industrial Rehab

THE SOLUTIONS

• Alternate Heavy Tasks with Light Tasks

• Develop Lifting, Carrying and Push / Pull Guidelines within limits and set up Lift Teams if necessary

• Provide variety in jobs to eliminate or reduce repetition (i.e., overuse of the same muscle groups)

• Adjust work schedules, work pace, or work practices

• Provide recovery time (e.g., short rest breaks)

• Modify work practices so that workers perform work within their power zone (i.e., above the knees, below the shoulders, and close to the body)

• Modify work environment to minimize work related stress (e.g., seating, lighting, workstation, process flow, angle of access to loads)

• Rotate workers through jobs that use different muscles, body parts, or postures (Administrative improvements, such as job rotation, can help reduce workers’ exposures to risk factors by limiting the amount of time workers spend on “problem jobs.”)

• Provide hands-on practice when new tools, equipment, or procedures are introduced to the workforce (review counter balancing of tools and take advantage of gravity flow in product movement)

• Use several types of visual aids (e.g., pictures, charts, videos of actual tasks in your workplace and the “right way to perform tasks”)

• Hold small-group discussions and problem-solving sessions

• Give workers ample opportunity for questions
• Industrial Athlete directed Exercises and Stretches (make them specific to those areas under most stress perform at beginning of day, when leaving for lunch and end of day)

• Ensure proper protective equipment (PPE) is available and used properly

• Research ergonomic assistive aids to accommodate heavier load lifting and movement

• Review packaging of items and research if handles or alternative coupling can be incorporated

• Review exposure to heat and cold extremes and take necessary precautions

• Minimize exposure to vibration (this can be done through tool selection, gloves, or limiting your time of exposure)

• Posture (change or modify your body position periodically throughout the day to relieve stress)

Part one of our Work Related Stress & Increased Risk Zones can be found here

Sources:
1) American Industrial Hygiene Association (AIHA)
2) Human Factors and Ergonomics Society (HFES)
3) National Institute for Occupational Safety & Health (NIOSH)

Work Related Stress & Increased Risk Zones: Part 1 of 2

January 10, 2017 Teresa Stockton - Blog, Industrial Rehab

INCREASED RISK ZONES
All Risks Increase with Duration, Frequency and Magnitude.

• Excessive Force

• Repetition of Activity (Can irritate tendons and increase pressure on nerves)

• Awkward Posture (Can compress nerves and irritate tendons)

• Sustained Static Posture (Can restrict blood flow and damage muscles)

• Unsupported Positions

• Motion (Increased speed or acceleration when bending / twisting, can increase the amount of force exerted on the body)

• Compression (Grasping sharp edges like tool handles, can concentrate force on small areas of the body, reducing blood flow and nerve transmission, and damaging tendons and tendon sheaths)

• Inadequate Recovery Time (Overtime, lack of breaks, & failure to vary tasks)

• Vibration of Tools (From vibrating tools, can decrease blood flow, damage nerves, and contribute to muscle fatigue)

• Whole Body Vibration (From driving trucks or operating subways, can affect skeletal muscles and cause low-back pain)

• Effects of Temperature (Cold temperatures can adversely affect a worker’s coordination and manual dexterity while Heat stroke can be very serious as when the body becomes unable to control its temperature, it rises rapidly, the sweating mechanism fails, and the body is unable to cool down.)

• Environment (Slip/Fall hazard-Uneven Floor Surfaces)

• Material Handling Guidelines:
Weight Loading over 50lbs
Lift Speed greater than 5/minute
Vertical Lift Exceeds 3ft
Carry over 1 minute
Sustained Push/Pull over 30 seconds
Static reach holding tasks over 1 minute

Part two of our Work Related Stress & Increased Risk Zones can be found here

Sources:
1) Ergonomics: The Study of Work, U.S. Department of Labor, Occupational Safety and Health Administration, OSHA 3125, 2000 (Revised)
2) T. R. Waters, “Manual Materials Handling”, in: Physical and Biological Hazards of the Workplace 2nd. Edited by P. Wald and G. Stave. New York: John Wiley and Sons, 2002.
3) Ergonomics and Musculoskeletal Disorders, Centers for Disease Control and Prevention/ National Institute for Occupational Safety and Health (NIOSH) © Fit2WRK 2015 R.Gagne

Safe Lifting Practices: Back Injury Prevention

November 8, 2016 Teresa Stockton - Back, Blog, Industrial Rehab

Whether you are getting ready for a move, or need to lift things at work, it’s important to use safe lifting practices. Don’t end up with a hurt back – use these tips to keep yourself injury free.

• ESTABLISH A BASE OF SUPPORT: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.•

• KEEP YOUR EYES UP: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

• GET A GOOD GRIP: with your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

• LIFT GRADUALLY WITH YOUR LEGS: without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

• TIGHTEN YOU STOMACH MUSCLES: as you begin the lift and keep you head and shoulders up.

• PIVOT DON’T TWIST: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

• WEIGHT: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

• HANDLING: It is easier to pull or push a load than it is to lift, put down or carry.

• KEEP THE LOAD CLOSE: Holding a 20 lb. object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

• FREQUENCY: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

• DISTANCE: The farther the load has to be moved, the greater the risk of injury.

• DURATION TIME: Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

• FORCES APPLIED: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

• NATURE OF THE LOAD: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

• TERRAIN: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

• ENVIRONMENT (CLIMATE & LIGHTING): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

• CONDITION OF THE WORKPLACE: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

• AGE/GENDER: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

• TRAINING: Proper training for the specific task is vital to reduce injury.

• TEAM LIFTING: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

• RAISE/LOWER SHELVES: The best zone for lifting is between your shoulders and your waist. Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

• AVOID LIFTING FROM THE FLOOR: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

• GET HELP WHEN YOU NEED IT: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

PROPER LIFTING TECHNIQUE

IMPROPER LIFTING TECHNIQUE

POSTURE

GOOD POSTURE

BAD POSTURE

Protect, Stretch & Rest: General Tips

September 13, 2016 Teresa Stockton - Blog, Industrial Rehab

These are some general healthy tips to remember during your day-to-day activities.

• If you are doing strenuous, household or outdoor work protect your hands with gloves in order to prevent injury and/or loss of moisture.
• Take frequent breaks or switch to a new activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome.
• If you find yourself sitting at your computer for hours each day, stop each hour and stretch your fingers, arms and the rest of your body to help prevent injury to your bones, joints and muscles.
• If you have pain during your activity, stop. Pain is one of the ways your body is letting you know that you are overextending a particular muscle group.

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

August 16, 2016 Teresa Stockton - Blog, Head, Industrial Rehab, Sports and Fitness

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.

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:

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.

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