The Running Physio
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TRP's Running Blog

All things running. Good info only.

The New Face of Concussion Management - by Aras Ruslys (PT)

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Aras Ruslys is a Physiotherapist at TRP who specializes in assessing and treating concussions. Have more questions? Reach out at aras@therunningphysio.ca.

I remember sustaining a few (2 or 3) concussions when I was younger playing basketball. I had whacked my head on the floor once, was elbowed in the head another time, and took a knee to the head the last time.  There were also countless times that I’ve been hit in the head with an errant pass, or that time most recently that I took a baseball off the head three weeks before my wedding.

Were any of those concussions managed properly?  To be honest, I was too young to remember one or two, and the others that occurred later in my illustrious career, well, they probably were not managed accordingly at the time.  And if they were, it was the old-school mentality from doctors to go home and rest in a dark room with no phones, reading, TV or school for days on end until the symptoms resolve, then returning to school/ sports. They would also tell you to have someone wake you up every 2-3 hours.

Here’s what we know now. This treatment method is no longer considered the best concussion protocol. There are better ways to manage concussions.

Let me explain. There is no true way of diagnosing the severity of the concussion immediately after it happens. However, numerous studies have shown that the more intense symptoms are immediately following injury, the more severe the concussion may be, and this may result in a longer recovery time.

The “new” way of treating concussion is 24 hours of relative rest, including a good sleep. NO, you do NOT have to wake someone up every 2-3 hours. You can check on them, but it is advised to let them sleep if they are otherwise symptom-free. After the first 24 hours, you can start to re-introduce light daily activities such as walking and light household chores. You can eventually return to half day of school or work with modifications, and then to full days. You can eventually return back to sports following specific testing protocols. These progressions occur over 24-hour periods, ensuring that you are symptom free. If symptoms return, then we dial back the work and allow the body more time to recover.

How can physio help with your concussion management?

I do a thorough assessment to ensure there are no severe issues lingering from the concussion that may need more serious medical attention. Once clear, I put you through more testing to ensure that your body and mind are functioning properly.  Then, I put you through a graded exercise protocol to return you back to your normal physical abilities.

30-40% of people that have had concussions may go on to experience Post-Concussion related symptoms (symptoms experienced for > 4 weeks after injury). These are symptoms that may be caused by a number of factors including but not limited to the cervical spine, psychological issues, and metabolic issues.

More often than not, persistent symptoms come from the neck and treating this area with Physiotherapy and exercise is one of the best ways to help alleviate those nagging issues.

I’ve treated many patients with concussions over the years. Those who don’t listen to the protocols and rush back to work, school or sports too early often had symptoms that lingered for weeks. This is why it is so important to speak with a trained physiotherapist on how to best manage your concussion, as everyone experiences and deals with them differently.  I aim to EDUCATE you, so you can get back to your normal activities as fast as possible. This is to prevent you from wasting your time, money and risk of further injury.

If you have any concussion questions, please feel free to reach out to me at any time. I am here to help.

In health,

-Aras Ruslys



Lauren Roberts