When you break a leg or dislocate a shoulder, evidence of your injury is obvious. You might have a cast, sling or crutches for one thing. You might also have visible bruises or swelling. It’s clear to any person you encounter, from first glance, that you have sustained an injury. But, when you have a concussion, the immediate impact of your injury is not always obvious or very noticeable. That’s why a concussion is often called an “invisible injury.”
The cognitive, physical and emotional symptoms that post-concussion patients must deal with are largely experienced internally. The external invisibility of these physiological impacts of concussions does not diminish the severity of these traumatic brain injuries (TBIs). And concussions require the same level of assessment, care and treatment by healthcare professionals as do more visible injuries. We need to take concussions seriously, and provide the proper recovery time and treatments.
The Unseen Impact of Concussions
A concussion is a mild type of traumatic brain injury (TBI) caused by a blow to the head or body. Although they are sometimes still labeled “mild” TBIs, the effects of concussions can nonetheless be quite serious. CT scans and x-rays at the ER cannot accurately demonstrate that you have a concussion, which can lead some to either not recognize the TBI or assume it’s “no big deal.”
“Returning to work, study or play too soon can result in lingering symptoms, possible additional health risks and frustration,” Says Medical Director and founder of Mid-Atlantic Concussion (MAC) Alliance, Vincent Schaller, MD, DABFM, CIC.
If you are recovering from a concussion, know that your experiences and symptoms are real. Your head injury and your recovery process deserve to be taken seriously. If you have a loved one with a concussion, empathy and validation of their experience are essential components of aiding their recovery process. You can help create a space in which they feel comfortable expressing their frustration or sharing their ongoing symptoms. But it doesn’t just end there.
“Because brain injuries are invisible to the outside world, it is imperative to educate everyone—patients, families, athletes, teachers, coaches, referees, parents, school nurses, ER staff, athletic trainers, physical therapists, nurses, doctors, first responders, we all need to understand what concussions and TBIs really are,” says Dr. Schaller.
Underreporting of Concussions Makes the Invisible Injury Even More Elusive
In 2017, researchers from Youngstown State University and Michigan State University survey shocking findings in the Journal of Athletic Training: the rate of underreporting of concussion among high school athletes was 55 percent. The most reasons the athletes gave for not reporting possible concussions included that they didn’t think the injury was serious enough to seek medical attention, they didn’t want to lose playing time and they didn’t want to let their teammates down.
What Are Common Concussion Symptoms?
Some of persistent post-concussive symptoms (PPCS) symptoms may be outwardly noticeable, such as balance issues, since a person might appear wobbly. However, many PPCS aren’t really visible at all.
Common post-concussion symptoms include:
- Memory issues
- Brain fog
- Headaches and migraines
- Sleep disturbances
- Blurry and/or double vision
- Fatigue and low energy
- Concentration difficulty
- Balance issues
- Irritability
- Mental health issues
- Aphasia
What Will My Concussion Recovery Process Look Like?
So if you can’t put a cast on a concussed brain until it heals, what can you do? In the past, concussion protocols for recovery largely revolved around extended brain rest. However, while important, brain rest alone really isn’t enough. This is especially true for patients with PPCS, whose symptoms last for extended periods of time. They can suffer from symptoms for many weeks, many months or longer. Physicians also call this condition post-concussion syndrome (PCS).
“The brain is a very complex and amazing organ, and every concussion is as unique as a snowflake,” says Dr. Schaller. “Patients need individualized recovery plans that address their unique combination of injured brain tissues and symptoms.”
Common treatment protocols for concussions include:
- Brain rest
- Physical therapy for vestibular, ocular and balance issues
- Daily home exercises to improve vision, balance, memory
- Gentle non-jarring aerobic exercise
- Word Block Therapy for PCS patients struggling with anomic aphasia, a condition where a person struggles to retrieve words while communicating, even though they can still speak, read and write a language fluently
- Assessments and ongoing evaluations via objective data collected by a variety of advanced brain-health testing tools, such as BrainScope One, CBS Health, EyeGuide Focus, ImPACT, RightEye and Sway Balance.
- Cognitive Therapy to help rebuild reading and conversational skills, along with executive function. This is usually provided by an occupational therapist.
- Ocular Therapy to help retrain the 12 eye muscles to coordinate with the brain, so they work in harmony as they do necessary functions, such as following moving targets, reading, scanning, and assisting with fine motor skills. This type of therapy is usually provided by a vision therapist or occupational therapist.
Single Photon Emission Computed Tomography (SPECT) for TBI Screening
One of the most powerful tools in the world of concussion and TBI technology is Single Photon Emission Computed Tomography (SPECT). This type of nuclear medicine brain study evaluates blood flow and activity in the brain and provides a way to visualize the ongoing impact of concussions and TBIs in ways that traditional scans (such as CT scans or MRIs) can’t. Through our partnership with Amen Clinics, we are now using SPECT scans in conjunction with our other advanced brain health testing tools to treat some of our most difficult TBI cases. Amen Clinics has built the largest database of SPECT brain scans in the world (over 200,000 to date) to help patients with a wide variety of cognitive and mental health issues, as well as detecting areas of brain injury from trauma, hypoxia, toxic exposure and more.
An Invisible Injury Does Not Equal Invisible Concussion Patient
For those experiencing PCS and working through a concussion recovery plan, frustration is a common feeling. For some, symptoms can be vague, constantly evolving and difficult to describe to others. And, because the recovery process is different for everyone, the uncertainty of your prognosis and eventual return to a pre-concussion level of “normalcy” can be difficult to grapple with.
When you pile on top of all of this the feeling that the symptoms you are experiencing are invisible or not fully understood by others, it is easy to see why the recovery process can be extremely challenging. “Since the injury is invisible, a concussed person’s struggle and anguish can be invisible as well,” Dr. Schaller says. “The support of family and friends is crucial in the successful concussion recovery,” he says.
We Are Here for You!
While it may feel like your symptoms are invisible, know that we see you! And we are here to help. Mid-Atlantic Concussion (MAC) Alliance is a network of certified medical professionals and athletic trainer affiliates located throughout Delaware, Maryland, New York, Pennsylvania, Virginia and New Jersey. We are committed to the welfare of our patients through the diagnosis, treatment, and long-term care management of concussions and traumatic brain injuries. For more information, click here to find the nearest partner to you or call us at (302) 235-8808.
