As an athletic trainer one of the most difficult tasks is convincing the athlete, parent, and coaches that their son or daughter is hurt. With a concussion everything “looks normal” most times (except for the cases of overt signs). Even with the signs that present most resolve rather quickly and again those affected by the head injury think everything is OK; it’s not like a bone is broken or there is imaging to SHOW an injury/problem.
For a long time researchers have been trying to identify what sign or symptom relates to prolonged recovery. Early on, 80’s and 90’s, the thought was loss of consciousness was the indicator; later to be not the case, and the understanding that one does not have to be KO’ed to get a concussion. Within the community we have used the term feeling “foggy” as a high indicator of prolonged recovery, but that is a very subjective symptom and really unproven, more observational. This might be changing as a very INITIAL study was released by Dr. Brian Lau of the UPMC in the American Journal of Sports Medicine. Continue reading
We all know, or should know, that balance issues are a primary concern with concussions and post-concussion syndrome. Along with memory problems, balance disturbance is high on the predictor list for duration of symptoms ergo severity.
As an athletic trainer one of our primary tests, and “go-to” is the Rhomberg Test, or sobriety test as most may know it as. What is tested there is the gross balance and fine motor movements controlled by the brain and vestibular system of our ears. During a concussive episode the synapses (or messages being sent) between the neurons in the brain get disrupted, each individual will experience different durations. Using the knowledge that balance is commonly and most immediately affected by a concussion the Rhomberg provides great feedback.
During the Rhomberg the athlete is challenged with single leg balance, tandem walking, spatial awareness and other concentration efforts that would otherwise be very simple. These menial tasks become very difficult when you are concussed. Now imagine those small but difficult tasks and dizziness plaguing you on a daily basis days, weeks or even months after you have sustained a concussion.
Alsalaheen, Mucha, et al. provided a research study in which they Continue reading