Concussion Management

What to do if you’ve sustained a Concussion

Following a suspected concussion, it is recommended that you consult a Medical Physician (Family GP or Sport Physician) as early as possible for medical evaluation. Most sport-related concussion injuries do not require emergent care. It is also important that the injured person remain under close observation over the first few hours following their injury, and should not be left alone or allowed to drive. See our FAQ page for a full list of concussion signs and symptoms.

When to go to the hospital:

Emergency evaluation is warranted in situations of deteriorating mental status such as increasing confusion and difficulty recognizing people or places. Other symptoms requiring immediate medical attention include worsening headache; worsening nausea or vomiting, and excessive drowsiness or lethargy.headache

When a concussion is suspected, we also recommend booking an initial assessment as early as possible with one of Shift’s Trained Healthcare Providers. To find a Provider near you, visit our Locator tool in the contact menu. Even if you have not had a baseline assessment with Shift, we will assess your injury and provide you with a management strategy to aid in your recovery.

What to expect at your Assessment

Our Healthcare Providers will conduct a thorough post-injury evaluation in order to gain a complete picture of your injury and how it’s impacted you. This includes a detailed interview in order to obtain information on:

  • How the injury occurred
  • How you felt immediately after
  • How you’re feeling currently
  • History of previous concussions
  • Current and past medical conditions
  • Previous trauma/injury
  • Medications

The physical examination provides us with insight into the severity of your injury, as well as specific impairments that may need to be addressed as part of an ongoing management strategy. This portion of testing may include a combination of the following:

  • Computerized neurocognitive testing
  • Balance testing
  • Strength and Coordination testing
  • Screening of visual motor skills
  • Vestibular (or equilibrium) testing
  • Gait assessment
  • Generalized neurological screen
  • Orthopedic assessment of secondary injuries (e.g. neck, shoulders)

The above testing procedures may not all be completed on the first visit. The assessment methods used are tailored to the immediate needs of the patient and each Healthcare Provider uses his/her discretion on a case-by-case basis.

Management Strategies

Following a concussion, the “sitting in a dark room” approach is only effective for so long. Concussions, like other sports injuries, should be properly managed and rehabilitated. While complete physical and cognitive rest is the mainstay of concussion care, having a health professional guide you through this step-by-step may prove to be invaluable.

Recovering from a concussion can be a difficult and frustrating time. At Shift, we understand that each athlete is affected differently and as such, requires individualized care. Management strategies are used to limit the amount of impairment as well as expedite recovery as much as possible. These strategies may include any one or a combinationbrain-in-hands of the following and are case-dependent:

  • Education around the injury, individualized strategies for rest and recovery
  • Specific recommendations around employment/academic demands
  • Manual therapy for associated complaints (neck pain, whiplash etc.)
  • Visual motor and Vestibular rehabilitation for dizziness, motion sensitivity, balance disorders and visual complaints
  • Physical exertion testing and exercise plans for return and active lifestyle

For athletes and those participating in sport, it is recommended that a step-wise process of physical exertion testing be completed once the patient is free of symptoms. Similar to weight training, athletes recovering from a concussion should not skip to 100% exertion from 0% in a short time frame. Physical exertion testing is important not only for physical re-conditioning, but to guard against symptom relapse and help prevent premature return-to-sport.