Post-Concussion Syndrome: Navigating Life After Concussion
Experiencing lingering symptoms after a concussion can be unsettling and disruptive. Post-Concussion Syndrome (PCS) is a complex disorder in which a variety of symptoms — such as headaches, dizziness, and cognitive disturbances — persist for weeks, months, or even a year or more after the initial injury that caused the concussion.
Importantly PCS is broken up into 3 sub-categories of post-concussion dysfunction [PCD]:
physiological PCD - wide-spread changes to the brain, neurotransmitters, cerebral spinal fluid etc…
vestibulo-ocular PCD - changes affecting the vestibular-occular subsystem (relating to balance and vision)
cervicogenic PCD - symptoms such as persistent headaches brought on be neck related issues
What Causes PCS?
The persistence of symptoms can sometimes be baffling, as they can continue long after the initial impact. Experts believe PCS may result from structural damage to the brain or disruption of neurotransmitter systems. Ultimately we don’t know why symptoms persist for some and not for others as CT and MRI imaging doesn’t always reveal an obvious answer. However, we do know returning to sport too quickly and psychological factors like stress and anxiety can exacerbate the situation.
Symptoms to Watch For
PCS manifests in diverse ways, affecting both physical and emotional health. Each individual's experience with PCS can vary significantly - common symptoms include:
chronic headaches
nausea
mental fog
irritability
insomnia
fatigue
sensitivity to noise and light.
Managing Symptoms
Effective management of PCS requires a tailored approach:
Sleep Hyigene: Sleep is the #1 most important thing to get right. A consistent bed time and routine allows for deep sleep processes to activate which quite literally cleans the brain and restores normal cerebral spinal fluid pressures. Without this important recovery aid, progress will be slow. A minimum 8 hours is recommended without use of “sleeping pills” or pharmacological aids.
Physical Therapy:
Techniques such as vestibular rehabilitation can address balance issues, dizziness and visual disturbances.
Myofascial release, fascia scraping, trigger point dry needling, joint adjustments and more can be used to reduce cervicogenic symptoms and may assist with some physiological symptoms.
Exercise therapy can be used to strengthen and mobilise the tissue surrounding the head, neck and spine to increase tissue health and provide a long-term protective mechanism against returning symptoms and vulnerabilities.
Cognitive Behavioral Therapy (CBT): May help manage the psychological impacts of PCS, such as depression and anxiety.
Medication: Certain medications may alleviate specific symptoms like headaches or sleep disturbances. However it is advisable to avoid if possible and reduce dependency as soon as possible.
Education and Support: Understanding your condition and having a strong support network are crucial in managing PCS.
Time & Patience: Avoiding sudden return to sport and high intensity activity is important
Moving Forward
Recovery from PCS can be a gradual process, and it's important to adjust activities to avoid aggravating symptoms. With comprehensive care, most people see significant improvements and gradually return to their daily routines.
If you or someone you know is struggling with persistent symptoms after a concussion, it's important to seek professional medical advice. Early intervention can make a significant difference in managing symptoms and improving quality of life.
