Recovering from a vestibular head injury? Tips from a PT about recovery!

Recovering from a vestibular head injury? Tips from a PT about recovery!

Physical therapist Dr. Danit Macklin discusses the recovery process for a vestibular concussion, why you might need to see a PT, and what to look for in a concussion expert.



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Danit Macklin, DPT 

Hi, I’m Dr. Danit Macklin, physical therapist, and concussion and vestibular rehab specialist. Today I want to talk to you about vestibular rehabilitation for concussion, right after the concussion is really the most sensitive time typically. So what should you do right after you have a concussion, it’s good to be seen after the injury. This can be either on the sideline board in the emergency room, or by a primary care physician. And the reason you want to do that is to rule out a more serious injury in certain instances. Concussions can have a tremendous effect on your vestibular system. And many of the symptoms associated with vestibular disorders are associated with concussions as well. So it’s really important for us to consider that a vestibular provider might be necessary after a concussive injury. Some people are going to wonder, when do I know if I should go to the emergency room? That’s a great question. Because not every concussion really needs to be seen in the emergency room. And once you get to the emergency room, you might be disappointed that they don’t do any imaging. emergency room physicians and staff are trained to do imaging as needed, and they have a protocol they follow. You can trust them, that if they feel imaging is warranted, they will do it. You may leave there with a diagnosis of concussion, and you will have confirmation that it is limited to a concussive injury and not something more serious. It’s also appropriate to be under the supervision of a provider who is familiar with concussion, because somebody needs to assess a patient for a scope of symptoms that they may not be aware of, that may be attributable to this mild traumatic brain injury. Who is that knowledgeable provider who is that concussion specialist, the person who you’re seeing should be knowledgeable about things like taking a symptom scale, advising, relative rest, active rehab, maybe they don’t use those words. But they’re certainly not saying something like, stay in a dark room until you feel better. rest until you feel better with no more than that, that what we call cocoon therapy is really outdated. In fact, if you’ve seen a provider, who recommended that, that provider is not current, and you should seek another opinion. So what we look for now is what we call relative rest. It’s kind of Do as you feel, respond to your symptoms. But don’t be inactive on purpose. If you feel like doing something, try it. Be cautious. See how you respond to it. We’re trying to get back to your life, we want you to be able to re engage in your activities. So a provider that’s appropriate, is going to know that and help you understand how to advance your activities, whether or not the symptoms. Last, we still want a doctor to really clear you for full Return to your activities. Let me give you a few more tips of what to do right after a concussion to manage how you’re feeling. First of all, be yourself. But just try to stop. If you start to feel symptoms worsening. Or if a new symptom comes on. You can rest as needed for the first day or two. If you need to nap, nap, sleep as much as you want. Some people don’t some people sleep for over 12 hours. Don’t worry, you’re just your body’s resting trying to recover, because rest is helpful and sleeping is helpful in that point. But you also want to do a gradual return to activity. Let me explain how you can do that. Let’s say you enjoy drawing. So you’re feeling a little bit better. You had the hit yesterday. Today, you’re kind of chilling at home. And now you want to try drawing. Go ahead and try it. No problem. But what you want to do is pay attention to your symptoms. She starts to feel a headache coming on, you start to feel a little dizzy, even if you’re just getting a little extra tired. Take a break. When does somebody need rehabilitation for a concussion? Pretty much anyone who’s getting worse instead of better is probably going to be a good candidate for rehab. After you have had prolonged symptoms for a long time, it can be difficult to know what to do. Dr. Google is really confusing. There’s a lot of mixed messages online. Getting an appointment with a neurologist can be really difficult. Sometimes they don’t have an appointment for you for a few months. So look for a physical therapist. There are a lot of physical therapists who have specialized in can cut Shouldn’t rehab. And when you find them, you’d be surprised at how much they can do for your concussion. And let’s talk about why. Why is a physical therapist a great resource for concussion rehab, physical therapists are the experts in figuring out where you are right now functionally in your life as a result of the injury. What are the systems that are affecting you that need to be treated, and how to get you from that point to where you want to be in a gradual and appropriate way? Remember, no recovery is linear. But you should see a nice trajectory of recovery working with a good pte. Also, the PT scope of practice, actually addresses a lot of the symptoms of a concussion. Let’s go through a few physical therapists are experts at cervical spine treatment. Did you know that that’s not just for neck pain, that’s also sometimes going to address headaches, eye pain and fatigue, and dizziness. Physical Therapists are also with specialized training experts at working with patients with dizziness, patients with balance issues, and patients with visual problems like blurring or double vision. Physical Therapists are also exertion experts. When people are deconditioned. We help them get back into a good aerobic place. And then the stress management. This is something that physical therapists can help you with tremendously by teaching you breathing techniques, and different progressive muscle relaxation techniques. So we really want to help the whole system recover, and physical therapists are able to treat many aspects of what’s damaged after a concussion. I want to point out that there is a need for a team approach to a concussion. This injury is appropriate to be seen by many different medical providers. Sometimes you just need to see one person, sometimes you just see the neurologist, and you’re able to get better. Sometimes you get to the physical therapist and you get better. But you should be aware that there are other players on the concussion management team. You the patient, your player number one, your family or whoever is in your social support network is part of the team, your primary care physician, the neurologist or sports medicine doctor, physical therapy, may be occupational or speech therapy, certainly counseling a therapist to help with management of your feelings while you’re going through this impossibly neuropsychologist if the cognitive symptoms are the primary concern, or are not resolving with physical therapy intervention, just be aware that there are a lot of providers out there rooting for you to get better here to help you. And you can find them by going to the and looking in the referral section. Because a lot of us committed providers are happy to be on that website, to work directly with you and to be here for you and to help you with your recovery. Because concussions are treatable, and we expect full resolution and we want you to feel better