Vestibular Rehabilitation for Post-Concussion Syndrome: A Step-By-Step Approach
Those who have had a concussion know just how disorienting and complicated the recovery process can be. A concussion isn't just a "bump on the head"; it's a form of mild traumatic brain injury that can interrupt one's sense of balance, attention span, and proprioception.
Unfortunately, in certain situations, extended beyond the typical time frame, beyond weeks or even months, medical professionals can determine something called post-concussion syndrome (PCS). The good news, however, is that PCS does not have to be a permanent condition, and one of the most effective forms of treatment for post-concussion syndrome is vestibular physiotherapy. This focused physiotherapy treatment combats balance issues, vertigo, and dysfunctions in movement.
This article explores how vestibular therapy aids post-concussion syndrome patients so they can feel strong, stable, and like themselves again.
What Are The Causes of A Concussion?
A concussion is defined as a blow to the head or an impact to the body that jars the body so that the brain moves and bumps into the walls of the skull.
Common causes of a concussion include the following:
Falls
Falling is the number one reason for concussions, especially among young children and seniors. Falling off a bike, slipping on a wet floor, and even falling off a swing are all causes.
Sports Injuries
In a sport where collision occurs, a concussion is common. Sports that are considered contact sports include football, soccer, hockey, basketball, boxing, and skateboarding. This does not mean that a person hitting you in the head will cause a concussion; it is just as likely that an aggressive tackle or a non-aggressive fall may slam your brain against your skull and result in a concussion.
Car Accidents
A person can experience a concussion during a car accident if they slam their head against the window, steering wheel, or dashboard, or if the quick deceleration causes the brain to rattle within the skull without any direct impact.
Physical Assault/Being Hit
Punches, kicks, or even being hit in an accident or attacked can cause a person's head to whip back and forth, thereby causing a concussion.
Being Struck by an Object
Blows to the head happen when something drops on your head or you are struck by an object or a ball, displacing the brain inside the skull. They can come from a baseball bat, a ball, something falling off a shelf, or construction equipment.
It's important to know that a person does not need to be knocked out to sustain a concussion. Many people stay awake and instead feel lightheaded, confused, or even sick to their stomach.
What is Post-Concussion Syndrome?
The misconception exists that concussion recovery occurs in a matter of weeks after an incident. For some, however, their brains need more recovery time.
If months after your accident you still feel dizzy, tired, off balance, nauseous, confused and have a persistent headache, you might have post-concussion syndrome. This happens when the impact from the concussion disrupts the vestibular system in your brain—the part of the brain and inner ear that controls balance and function. When the vestibular system is not working properly, it may feel uncomfortable to walk in a straight line or turn one's head.
How Does Vestibular Physiotherapy Help?
Vestibular physiotherapy teaches the body and brain how to talk to each other again. Skilled practitioners utilize vestibular exercises, maneuvers, and techniques to improve balance, readjust focus, and reduce bouts of dizziness.
The goal of vestibular physiotherapy is to remove the "static" of a concussion in the brain to allow individuals to go back to feeling like themselves.
Step-By-Step Approach to Vestibular Therapy for Concussion Treatment
Vestibular therapy for someone who is recovering from post-concussion syndrome is not a one-time treatment. Instead, it follows the following steps;
Step 1: Evaluation
A physical therapist evaluates how your brain and body are working together using the following techniques;
- Static and dynamic balance tests while standing and/or walking
- Gaze stabilization and vestibulo-ocular reflex challenges
- Positional changes that elicit differences in balance
- Movements that induce dizziness or lightheadedness
The evaluation helps your therapist understand the problem and create a unique treatment plan to address your symptoms.
Step 2: Balance Exercises
Rehabilitation with vestibular therapy involves balance exercises, as losing one's balance is a commonly reported symptom of concussions. These are safe movements that stimulate the brain's ability to learn balance in a controlled setting.
Balance exercises may include balancing on one foot, walking in a straight line, heel to toe, and slowly turning your head while maintaining balance.
The more the brain and body can be exposed to reintegration, the more likely they will adjust.
Step 3: Habituation Exercises
This involves being exposed to the motions that make you dizzy. For instance, people with concussions get dizzy from bending down, from turning their heads, from getting in and out of cars, and through therapy, people are exposed to these as gradual engagements so that their brains learn they're not as inflammatory as previously thought.
This is counterintuitive, and you may feel dizzy at first, but as you undergo these movements, your body and brain get used to it, and dizziness dissipates.
Step 4: Strength and Endurance Training
Concussions can cause weakness and fatigue because you’ve been resting a lot. Hence, the need for strength and endurance training.
As your balance improves, your therapist will help reestablish muscle strength and endurance through low-resistance exercise, stretching, and bodily movement. This approach works well during vestibular therapy, as it prepares you to return to school, play, and work with added confidence.
Step 5: Return to Real Life
The final part of concussion treatment is the transition back to life. Your therapist may create exercises that replicate aspects of your life, like navigating busy crowds or reengaging with your sport.
This is the final little touch for the complete restoration of your mind, body, and proprioception.
Why Vestibular Therapy is Important for Concussion Treatment
Without intervention, post-concussion syndrome sticks around for weeks, sometimes months, sometimes years, and makes life difficult. Children do not return to their classrooms. Athletes skip games, and those who fear getting dizzy or falling develop phobias.
However, vestibular therapy solves the problem instead of masking symptoms. It recalibrates the brain-body connection, enabling faster and safer healing.
Final Thoughts
If you or someone you love suffers from continued dizziness or balance problems, or if post-concussive headaches extend beyond the typical treatment timeframe, vestibular physiotherapy is the solution. This comprehensive program allows for gradual re-introduction to confidence, strength, stability, and function for a successful re-integration into life.
The most secure, best-informed, and successful approach to acclimation via concussion treatment and returning to pre-injury activities without worry is with a licensed, specialized physiotherapist in vestibular rehabilitation.
