Concussions and Physical Therapy

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Concussions are a very common injury to the brain that generally occur as a result of direct trauma to the head or trauma to the body that causes a whiplash type motion to the head and neck.  It is estimated that 1.6 to 3.8 million sports related concussions occur annually in the US.  There is a 12% incidence rate of concussion in youth sports and in addition many concussions in children occur during recreational activities such as biking, horseback riding, and playing on the playground. Girls in sports are 1.5 times as likely to sustain a concussion than boys when participating in the same sport.   In addition to sports and recreational activities adults often experience concussions due to falls, car accidents, or work- related incidents.  In the military concussions also often occur as a result of a blast.  It is estimated that symptoms from concussion resolve in 80% of people within 3 weeks but that means that 1 out of 5 people continue to suffer from the symptoms of concussion for greater than 3 weeks.

The most common symptom of concussion is a headache but many people will also experience symptoms such as nausea, light or noise sensitivity, fatigue, dizziness, memory loss and moodiness/depression. Attempts at increasing physical activity or returning to activities which require increased levels of concentration such as work or school will often cause an increase in symptoms.  Historically concussions were treated with strict rest but it has been discovered that this can actually cause a delay in recovery.  Typically, rest is prescribed for the first 24-48 hours with a gradual and graded return to physical and mental activity being the next step.  Patients need to listen to their symptoms and gradually increase activity levels with periods of rest as needed.

Physical therapy may be able to help in the recovery process.  Certain eye and vestibular exercises as well as exercise and manual therapy for the cervical spine may help with headaches and dizziness.  Gradual increases in aerobic exercise may also help to speed recovery.  Physical therapy can also address any balance disturbances that may be present.  There is some evidence that neck strength can play a role in reducing your concussion risk.  It has also been reported that following a concussion people are at increased risk for a lower extremity injury for up to a year.  Physical therapy may be able to address this increased risk through strengthening and balance exercises.  Your physical therapist can also help to guide you through the return to sport process which will include gradual return to sport specific drills, return to non-contact practice, full practice, and finally full return to competition. 

If you or a loved one has experienced a concussion and the symptoms have not resolved the physical therapists at Great Northern Physical Therapy may be able to help.  We have specialized equipment and training to assess your condition and apply appropriate treatment techniques to speed recovery and reduce the risk of recurrence.  Don’t think you have to continue to suffer or assume there is nothing you can do, take an active role in your recovery and contact us today.

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Breathing and Your Pelvic Floor

The pelvic floor is certainly a hot topic of conversation for many men and women. Specifically, people begin to focus on their pelvic floor when they are having incontinence, urgency/frequency, prolapse, or pain associated with going to the bathroom or having sex. These are all issues related to pelvic floor dysfunction. But, what many don’t realize, is that your pelvic floor is also integral in one of our most basic functions: breath.

The diaphragm, our respiratory muscle, is located at the bottom of the ribcage. At rest, the diaphragm is a domelike shape, and with inhalation the diaphragm muscle contracts and drops downward toward your pelvis. This downward motion is followed by a shifting downward of internal organs, into the pelvic bowl. The pelvic floor muscles and fascia make up the bottom of the pelvic bowl. So, with this downward force during inhalation, the pelvic floor muscles also descend or stretch slightly downward. Immediately following inhalation and pelvic floor descent, is exhalation, and similarly, the pelvic floor follows the diaphragm as it rises upward to a resting position. This synchronous rising and falling of the diaphragm and pelvic floor is often referred to as the “piston effect”.

Not to be left out, the lower abdominal muscles (transverse abdominis) also contribute to this synchronous movement pattern. Working together by relaxing and stretching with inhalation and a “belly breath”, and tightening and drawing inward slightly with exhalation. In this way, the diaphragm, abdominals, and pelvic floor make up an abdominal cylinder that modulates intra-abdominal forces and pressure changes.

When this cylinder isn’t coordinating well together, or if there is tightness or weakness within the system, we see common musculoskeletal complaints: low back pain, SIJ pain, poor stability through the back and pelvis, hip pain, pelvic pain, incontinence, urgency/frequency of urine or stool, prolapse, poor posture, balance issues, and intolerance to exercise.

Our pelvic floor physical therapists can help evaluate these movement patterns and coordination of these systems, and create a treatment approach specific to you and your individual challenges.