Often, someone who has sustained a concussion will think of visiting their GP to discuss their symptoms and situation. However, a physiotherapist is well equipped to assess and treat a concussion, at times offering a much more comprehensive recovery plan.

We had a chat with Tom, a senior sports physio based in Sydney, about his experience with patients who present with concussions.

“Often, I see professional athletes who have experienced a collision through high-impact sports, and they come in to be assessed and receive treatment,” says Tom.

The first thing Tom does is assess his patient to see how severe the concussion is. He asks them about their symptoms, which could include headaches, dizziness, nausea, confusion, memory problems, sensitivity to light and noise and mood changes.

“I tend to work with four systems when assessing a patient with a concussion – their visual system, vestibular system, autonomic system, and neck. The neck obviously isn’t part of the brain, but if things are off with the neck, it can affect and exacerbate the other three systems,” explains Tom.

Tom checks their visual and vestibular systems by performing various eye movement exercises to check for any abnormalities.

“Often, if their visual or vestibular systems have been affected from a concussion, their eye movements won’t be as quick or sometimes they find it hard to tolerate the exercises at all”.

When Tom assesses the patient's autonomic system, he watches the patient exercise to see how they tolerate the movement and how their body reacts when their heart rate increases. When it comes to assessing their neck, he focuses on the strength in their neck, their motor control, and their sensory awareness.

“Depending on which system is affected by a concussion is how I then decide on which treatment method would be best for the patient. When I am treating a patient with a concussion, I make sure to take their treatment plan slow. When a person has sustained a concussion, it is imperative that they also get enough physical rest, so I always consider that when treating patients”.

Treatments include vestibular rehabilitation, visual rehabilitation, exertion therapy and manual therapy techniques.

“I think there are many benefits to having a physio manage a patient’s concussion. Besides having a recovery plan that will always be tailored to the patient, in general, patients also experience reduced recovery time, improved balance and posture and, most importantly, the prevention of long-term complications that can arise if a concussion is severe or isn’t treated properly,” explains Tom.

Some of Tom’s elite athlete patients have also experienced a significant amount of trauma around a concussion, and it has made them nervous to return to sport. Part of his job has also been to help them feel confident about returning to sports and address some psychological concerns.

“I had a professional footy player come into my rooms last year after sustaining a pretty bad concussion that affected his balance. Needless to say, he was quite wary about heading back out onto the field once he had recovered. In conjunction with his coach, a psychologist and myself, we worked together to build the patient’s confidence back up and address his concerns about potentially being concussed again. He played again, but some tough decisions had to be made, and we ensured he was feeling tip-top before returning,” says Tom.