Questions and Answers about Concussion Management

What is a Concussion?

 A concussion is a form of mild traumatic brain injury (mTBI) caused by a rapid acceleration or deceleration of the brain in the skull leading to changes in cellular function within the brain. Mild traumatic brain injury (mTBI) can result from a blow, bump, or jolt to the head or body and can result in a variety of symptoms including headache, nausea, confusion, neck pain or dizziness. Each concussion can range in severity from mild to severe and can cause a wide range of symptoms. 

What are symptoms of a concussion?

It is important to note that after sustaining a concussion, symptoms may or may not immediately show up and people who are suspected of sustaining a head injury should be closely supervised for the appearance of new symptoms.

New symptoms can appear in the next 24-48 hours after a head injury. The symptoms of a concussion can be wide ranging and can vary in intensity. The most common symptoms of concussion include, but are not limited to:

  • Headache
  • Neck Pain
  • Dizziness
  • Nausea/vomiting
  • Feeling tired, “not right”, or emotional
  • Confusion
  • Ringing in the ears
  • Irritability
  • Sensitivity to light
  • Sensitivity to noise
  • Blurry vision
  • Difficulty concentrating
  • Fatigue or drowsiness

It is important to note that a person DOES NOT have to lose consciousness to sustain a mTBI. In fact, about 90% of concussions occur without a loss of consciousness. Remember that symptoms can vary in intensity and in the number of symptoms present.

It is also important to note that many of these symptoms can be a result of other injuries (whiplash, migraines, dehydration, etc). In order to distinguish between other pathologies and concussions, it is important to remember that a bump, blow, or jolt to the head or body MUST have occurred in order to be diagnosed a concussion. 

When should a person be evaluated by a medical professional?

Following a suspected concussion a person should be moved to a safe area and evaluated by a licensed healthcare professional. Healthcare professionals that can help with the diagnosis of a concussion include physical therapists, athletic trainers, nurses, PA’s, nurse practitioners, and physicians.

A player should NOT be returned to play on that same day. After sustaining a concussion, a person should be monitored for worsening symptoms and seek emergency medical attention (call 9-1-1) if any of the below signs/symptoms are observed:

  • Vomiting
  • Seizure
  • Memory Loss
  • A headache “like no other”
  • Fluid or blood coming from the ears, nose or mouth
  • Slurring of speech
  • Numbness or tingling in the arms or legs
  • Increasing irritability or unusual behavior
  • Difference in pupil size
  • Black or blue discoloration below the eyes or behind the ears
  • Cessation of breathing
  • Loss of consciousness 

How long does it take to recover from a concussion?

Most mTBI symptoms tend to resolve in 7-14 days. However for other brain injuries, it may take longer to recover. Studies show that taking an active role in concussion treatment can help people recover quicker. 

It is highly recommended to reduce the intensity of mental and physical activity for 24-48 hrs following a concussion then gradually return to normal activities as symptoms allow. However, this should be determined on a case by case basis by a licensed healthcare professional after a complete evaluation. Symptoms lasting longer than a few weeks are often referred to as “post-concussion syndrome” and may warrant further medical evaluation.

How can Physical Therapy help with concussion related symptoms?

Every head injury is different and therefore requires a different, individualized treatment approach. The Physical Therapists at Optimal Sports Physical Therapy will complete a thorough evaluation assessing your orthopedic, neurological, and cardiovascular systems in order to prescribe a plan that fits your particular needs and helps you return to your normal activity level. 

Commonly, physical therapy interventions for concussion rehab will focus on restoring strength and endurance, reducing dizziness, reducing headaches and neck pain, improving balance, and safely progressing your return to daily activities. Exercises and activities may also be performed for oculomotor function. Exercise progression will typically follow a step-wise progression working to get you back to your normal activity level. Some of the most common physical therapy interventions include: manual therapy, therapeutic exercise, neuromuscular re-education, and other treatments.  

I think I have a concussion. What should I do?

If you have sustained a blow, bump, or jolt to the head or body and are now experiencing symptoms, you should be evaluated as soon as possible. Research shows that the sooner you start treatment, the better. Options for evaluation include:

  • Optimal Sports Physical Therapy
  • Urgent Care
  • Prompt Care
  • Performance Injury Care and Sports Medicine
  • Your Primary Care Provider (PCP)

Can I work after a concussion? 

This is a question that is best answered on an individual basis. For most people 24-48 hours of rest is recommended after sustaining a concussive injury. That rest can include  much lighter than normal level of activity as symptoms tolerate. While some people may be able to return to work after the initial rest period, others may require additional treatment or an individualized return-to-work process. Some people may require limited work duties, limited work hours, and work modifications initially until symptoms allow full duty activities. 

Will I make a full recovery after a concussion? 

Most concussions do make a full recovery and are able to continue to live life without any limitations, however some traumatic brain injuries unfortunately result in residual deficits. These deficits can include difficulty with memory, difficulty concentrating, difficulty with school and/or work, headaches, chronic pain, or balance problems. For your best chance of experiencing a full recovery, we recommend getting an evaluation and starting treatment as soon as possible so that Optimal Sports Physical Therapy can guide you in your recovery. 

In addition to physical therapy, are there other things I can do to help recover from a concussion? 

Absolutely. Current recommendations include 24-48 hours of relative rest after a concussion and then to begin a step-wise progression to return to normal activities. Guidance will be provided to you by your physical therapist. In addition to the exercises prescribed by your PT, proper nutrition and hydration can really help your recovery.

The current recommendations include:

  • increase Omega3s
  • increase protein consumption
  • do not restrict caloric intake while healing
  • if nauseous, attempt to eat a bland diet until appetite returns
  • hydrate properly

For more details on nutrition for concussion recovery , visit NATA: 

Are there specific concussion laws in Montana?

Yes! In Montana, many laws exist to protect your child athlete. The age of the child as well as what league the athlete play in will help determine which law(s) are applicable in your situation. As always, we recommend contacting a lawyer if you need legal assistance. 

For high school athletes, the Montana High School Athletic Association has several policies and procedures for concussions including insurance for athletes affected by concussion; education of parents, athletes, and coaches; removal from play if a concussion is suspected; and clearance by a licensed healthcare professional prior to returning to play. 

In 2013, the state legislature enacted the Dylan Steigers Protection of Youth Athlete Act requiring each high school to adopt policies removing athletes from play, seeking return to play clearance from a licensed healthcare provider, providing concussion education to parents, athletes, and coaches. 

In 2017, the state legislature enacted HB487 to expand the protection provided in the Dylan Steigers Protection of Youth Athlete Act to non-public schools and youth athletic organizations. This law would pertain to Helena Small Fry Football, HYSA, and other youth athletic leaques. 

For more information on Montana concussion laws for youth athletes, please check out the DPHHS website. 

If you are in need of more information on concussion or an evaluation of a concussion for yourself or your child, please contact Optimal Sports Physical Therapy. Our physical therapists are specifically trained on concussion recognition, assessment, and treatment. We can help guide you with treatment, recovery, and return to play decisions. Don’t delay, call today! 

 Additional  Concussion Information:

Get connected with concussion! Stay up-to-date with local concussion groups! For more information: