Many athletes involved in contact sports receive concussions. Consequently, concussions are common experiences seen by sports physiotherapists. In light of the fact that concussions are always concerns for athletes who love playing football, hockey and similar types of contact games, the topic has been brought up more than once.
In the United States, approximately 3.2 million people suffer from concussions every year. One definition that is widely accepted is as follows:
“A complex pathophysiological process affecting the brain,
induced by traumatic biomechanical forces (Aubry et al. 2001)”
Prolonged recovery is associated with symptoms related to migraine headaches and sleep disorders. (Iverson, 2007; Lau et al., 2009; Lau et al., 2011). In addition, research shows that concussions resulting in lower cognitive abilities are possibly due to prolonged recovery periods.
An article written by Lau et al. (2011) seeks to classify symptoms that foretell recovery occurring after 21 days as opposed to less than seven days. The five-year study followed 107 athletes after they received concussions.
However, the researchers lost contact with some of the participants. Sports medicine therapists examined the athletes immediately after the incidents. The therapists noted the following symptoms:
Researchers wanted to know how much time athletes needed before they could return to play. Concussion specialists gave the athletes return to play clearance when all the known protocols were established. In essence, the clearance procedure included total restoration of all symptoms including restored cognitive abilities as measured by the Post Concussion Symptom Scale and the Immediate Post Concussion Assessment and Cognitive Test (ImPACT).
The main question focuses on which symptoms are related to a prolonged recovery. Dizziness is the number one factor associated with the time it takes to recover from a concussion. People who reported that they felt dizzy were 6.34 times more likely to experience prolonged recoveries.
However, the study has a few shortcomings:
Commenting on social networks is an excellent way to make thoughtful contributions. Anyone who wants to contribute may help researchers probe the mysterious world of concussions.
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
