What Happens When I Suffer a Concussion?

fig.1. Natasha Wilch PT

After the initial contact,  there is resulting damage that occurs to the nerve fibres  within the brain. This is what scientists call “shearing forces” or simply put, damage. This can lead to vulnerability in the structure of the nerve fibre affecting its ability transmit signals. 

This shearing causes increased accessibility  for molecules such as Calcium (Ca+2) and Potassium (K) to flow in and out of the cells. This leads to damage within the cells and in particular the mitochondria, and ultimately creates an “energy-crisis” as the body uses ATP (an energy compound in the body) to control these ion pumps at a faster rate in order to maintain some level of balance or homeostasis in the brain. 

In the end, theres too much demand for ATP compared to the supply present, leading to reduced energy levels.

This ion imbalance is thought to be the source of migrainous symptoms (headache, light and noise sensitivity) post concussion in the acute stages.

This change in metabolism/ energy crisis creates a vulnerable period in the individual which lasts approximately 10 days post injury before normalizing.

Some studies show certain substances or chemicals take close to 30 days to normalize post concussion,  and almost 45 days to normalize in those who have sustained a second concussion.

The other significant finding is adolescents take approximately 4 weeks to recover, while adults take on average 2 weeks.

“The exceptions are children who have a history of previous head injury, learning difficulties, or family stressors.” (Leddy et al. 2012).

This is especially important to remember as symptoms alone are not an acceptable way to determine the extent of recovery that someone who sustained a concussion has gone through.

Between 2-4 weeks post concussion, these chemical levels begin to normalize. The body’s energy begins to return to pre-injury levels. Blood flow to the brain is also normalized. And cognitive function also increases to pre-injury levels and speeds. 

This is true for majority of individuals that suffer their first concussion, and in some cases, individuals that suffer a 2nd or 3rd.

In a smaller population of 10-20% of individuals post concussion, some of these issues may persist or take even longer to normalize, leading to post-concussion syndrome. Individuals with a pre-existing history of mental health challenges are more likely to develop post concussion syndrome and have prolonged recoveries. 

Post concussion syndrome patients may experience symptoms ranging from but not limited to: headaches, vision changes, hearing difficulties, balance and reaction time issues, fatigue, cognitive issues, sleep disturbances and even symptoms of anxiety/ depression.

Most individuals will recover with minimal need for intervention. But return to pre-injury activity/ work/ school levels should be started in a timely manner outlined and monitored by a health professional.

For those suffering from post concussion syndrome, be patient. Interventions from various professionals may be strongly recommended to help recovery. There is no special recipe for a faster recovery, as every individual and every concussion is unique. Pushing too hard as you try to recover may prolong the recovery.  

The other important note as i eluded to above, is that it may take interventions from VARIOUS professionals including but not limited to: physiotherapists, occupational therapists, family medicine physicians or sports medicine physicians, optometrists, neuro-optometrists, psychologists, social workers, athletic therapists, massage therapists, and more. 

Don’t shy away from help. And if any ONE professional implies they are the ONLY answer to your solution, find another therapist. 

Concussions are no joke and should be monitored by a physician throughout the process. They are not something to overlook and brushed under the carpet. So ensure you seek proper care from properly trained professionals.

As always, should you have any questions or concerns pertaining to this topic or another, do not hesitate to reach out.

Live active and prosper.

Aras Ruslys

Registered Physiotherapist

Vestibular Therapist/ Concussion Management