In person in our Ridgefield, CT center and virtually with at-home neurofeedback and coaching, we support individuals with a concussion diagnosis and post-concussion symptoms every day. Commonly, individuals can suffer long-term for months or even years from a single concussion or multiple ones. Parents often come to us as a last resort to help restore their child’s cognitive, behavioral, or emotional functioning.
Neurofeedback and Biofeedback can help normalize brainwave activity, which the research says can result in improved cognitive, attention, and emotional functioning. This guide is designed as a reference tool for both understanding and treating a concussion, emphasizing the importance of proper management and patience during the recovery process.
Traumatic Brain Injury (TBI): Understanding Concussion
The medical definition of concussion is a complex pathophysiological process affecting the brain, induced by biophysical processes that can occur with or without the loss of consciousness.
TBI is caused by a blow to the head or body, a fall, or another injury (often during contact sports) that jars or shakes the brain inside the skull, which can result in prolonged injury and, in some cases, death. Car accidents, falls, weight lifting and injuries while playing sports are the primary causes.
What is a Concussion?
Although protected by fluid and membranes, the brain is pushed against the skull and can be bruised during an impact. When the membrane is disrupted, this creates dysfunction in the brain cells. Further damage can alter the balance of chemicals in the brain, impair nerve cell function, and result in various cognitive issues.
When the membrane is not working, the glucose transporter system is disrupted, and no energy gets into the cell. This shifts energy, results in a cellular energy crisis, and causes a disruption in brain function.
Further, different parts of the brain can move at different speeds, and these shearing forces can damage nerve tissue through stretching and tearing. More serious injuries can result in changes in cerebral blood flow.
Concussions and Mental Health
Concussions can significantly impact mental health, leading to various cognitive, emotional, and behavioral issues. Common effects include memory problems, difficulty concentrating, and impaired judgment. Emotional symptoms might involve anxiety, depression, irritability, and mood swings. Some individuals experience changes in sleep patterns, such as insomnia or excessive sleepiness. In severe cases, post-concussion syndrome can develop, prolonging these symptoms and affecting daily functioning.
I had an incredible experience on the Mel Robbins Show, where I provided expert advice on the impact of concussions on mental health. During the show, we delved into Chris Sullivan's journey as a former New England Patriots player, including the significant impact of his brain injury on his mental health and behavior. Watch below for more.
What Diagnosis Criteria Do Doctors Use?
Even though most people think there has to be a loss of consciousness, upwards of 90% of concussions do not involve the loss of consciousness. Sometimes, symptoms are evident with being dizzy and confused; sometimes the symptoms can appear later.
Common Concussion Symptoms Include:
- Confusion and disorientation
- Problems in thinking/cognitive processing/attention
- Slowed cognitive processing
- Pain
- Headache
- Lost consciousness
- Blurred vision
- Memory loss
- Dizziness
- Nausea and vomiting
- Balance problems
- Fatigue
- Sleep problems
- Emotional Lability
- Anger or agitation
- Anxiety
- Depression
If you or your child have suffered a head injury, you need to seek medical attention. Only a certified professional can appropriately diagnose brain injury.
What Are the 6 Stages of Concussion Recovery?
Medical professionals typically implement the following recovery outline, often called the recovery phase or the six stages of concussion recovery. The length of each stage varies based on the seriousness of your injury and the recommended care. Recovery involves a systematic approach that ensures a safe and complete return to normal activities.
The six stages of concussion recovery provide a structured path for individuals to follow.
Stage 1: Immediate Response
Immediately following your injury, you should see a doctor to determine if you need medical assistance or observation. This initial phase, known as acute injury or the acute phase, can last up to 72 hours. It's crucial to inform your athletic trainer or employer about your need for rest per your doctor's orders.
Stage 2: Initial Rest Phase
After your medical evaluation, your doctor will advise you on the expected recovery time. You may be sent home to rest, with a recommendation that a friend or family member monitor your condition and report any concerns. This first stage often involves physical rest and supervision for approximately 48 hours.
Stage 3: Monitoring and Stabilization
Entering the third stage means you're in an observation phase. You're progressing in your recovery, but you still need extra care. Even if you feel ready to resume your routine, it's important to continue taking it easy. Your doctor will schedule a follow-up appointment, as some symptoms can appear a few days after the initial injury. There is also a risk of developing post-concussion syndrome, which can cause headaches and dizziness.
Stage 4: Prolonged Rest and Recovery Process
One of the more challenging aspects of concussion recovery is the need for prolonged rest. Healthcare providers often recommend cognitive exercises to retrain the brain and improve balance. Despite feeling ready to return to normal activities after physical rest, underlying issues may still exist. Your doctor might recommend continuing to rest and engaging only in light, easy activities, including light physical activity, to avoid setbacks. Adequate, restful sleep is vital for healing, as sleep helps regenerate damaged brain tissues.
Stage 5: Rehabilitation and Therapy
The duration of concussion recovery and rehabilitation varies with the severity of the injury. In some cases, physical therapy may be necessary, especially for those experiencing long-term symptoms or pain. A physical therapist can provide neck or shoulder adjustments to relieve strain on affected muscles and joints, helping to alleviate pain and improve range of motion during the early recovery phase after injury. Common symptoms that might persist include anxiety, depression, difficulty making decisions, cognitive disruptions, and poor sleep quality.
Stage 6: Gradual Reintegration
The final stage involves gradually returning to your regular routine or transitioning to your day-to-day activities. This includes reintroducing physical activity as part of the gradual reintegration process. You should notice improvements in your symptoms after an observation period and sufficient rehabilitation. You can start to reintegrate parts of your previous activities into your regular activities and daily life.
These six stages ensure full recovery gradually and safely. Going through the 6 stages of concussion recovery needs medical care and guidance.
This comprehensive approach in a treatment plan helps manage concussion symptoms, promote recovery, and facilitate a smooth transition back to physical activities and daily life. By following these six stages—individuals can support their brain's healing process and prevent further complications.
How Long Do Concussion Symptoms Last?
A typical concussion recovery time for adults should occur within a few weeks (two to six weeks). Injuries with more severity can have longer recovery time.
Delayed concussion symptoms can be present days, weeks, months, and even years after the concussion treatment initial injury. Post-concussion symptoms can worsen gradually, which makes diagnosing Post-Concussion Syndrome even more challenging.
Concussion symptoms in children should be resolved similarly. Adults and children go through the same stages of concussion recovery. Physical therapy is also a part of the process to recover from a concussion.
Concussion Rates
Sports-related concussions have become a growing public health concern, garnering significant attention in academic literature over the past 20 years (Russell K. et al., 2015).
The CDC says that there are 2.5 million concussions a year. Of those concussions, 8% or over 225,00 concussions a year result in prolonged concussion syndrome. Sports-related injuries are the prevalent reason for concussions for youth who play sports. According to the CDC, boys (8.3%) were more likely than girls (5.6%) to have ever had a significant head injury.
What is Post Concussion Syndrome?
Post-concussion syndrome (PCS) is a condition where symptoms persist for weeks or months after a mild or severe concussion. It can include a range of issues such as headaches, difficulty concentrating, memory problems, and mood changes. These lingering symptoms can significantly impact daily activities and may require ongoing management and treatment to help alleviate the effects and support recovery.
What Treatments Are Recommended?
Sleep and Rest
After being medically assessed, the first concussion treatment is sleep. The next most important concussion recovery protocol is rest which encompasses limiting movements. During the concussed period, schoolwork should be put on hold, and avoid physical activities, as cognitive processing activities such as reading and visual processing, can exacerbate the brain injury and certainly interfere with healing. Reducing screen time can also significantly aid in the recovery process.
Diet and Supplements
Reducing inflammation in the body and brain also promotes healing. Following an anti-inflammatory diet — reducing or eliminating gluten, dairy, and sugar and increasing healthy fats, fruits, vegetables, protein, and water — can help heal, as can supplements that reduce inflammation, such as curcumin.
Neurologist Dr. Harry Kerasidis reports that specific supplements such as antioxidants, b-complex vitamins, and essential fatty acids also support brain health. Consulting an expert can give you the right treatment and diet, prescribe certain medications, and integrate the six stages of concussion to help patients recover.
Therapies like Neurofeedback and Biofeedback can help restore brain function through the stimulation of electrical activity.
How Can Neurofeedback Therapy Help? QEEG and Concussion
The neurofeedback and biofeedback process can help the brain recover from injury.
The first step in the neurofeedback process is a QEEG. A QEEG is an EEG brain map. Electroencephalography (EEG) is the measurement of electrical patterns at the surface of the scalp, which reflect cortical activity and are commonly referred to as “brainwaves.” A quantitative EEG is a computer analysis of the EEG data in which we identify dysfunctional patterns. It is a visual way to see brain functioning regarding brain waves and gives us a clear understanding of what areas of the brain are overworking or underperforming.
Neurofeedback can be very helpful for restoring attention and improving processing speed, as well as reducing anxiety. Whether you have a mild or severe head injury, neurofeedback therapy can be beneficial. QEEG sensitivity and specificity enable personalized and precise neurofeedback interventions that enhance treatment effectiveness (Chabot et al., 1996).
Neurofeedback and Biofeedback
A concussion often causes the brain waves to get stuck in a repetitive pattern, impairing thinking and processing. Neurofeedback training can help one learn to produce healthy brain waves again.
The process of Neurofeedback involves reinforcing a healthy combination of moderate brainwave activity. People with concussion symptoms typically come in two to three times a week. With Biofeedback, one can learn to control their autonomic functions to improve their physical and mental state, which helps manage post-concussion pain and physical issues.
Check out my discussions with one of our parents who came to my center in Ridgefield, CT, and how Neurofeedback sessions and our BrainBehaviorReset Program have helped her child recover from a brain concussion.
By reinforcing brainwave activity, neurofeedback stimulates new electrical activity in the brain and modifies neurotransmitter function. According to research by Ghaziri et al. (2013), neurofeedback affects brain structures by inducing changes in the brain's white and gray matter.
When dealing with a Traumatic Brain Injury, it is crucial to follow a comprehensive treatment plan to ensure proper healing. Consulting with a doctor is essential for creating an effective strategy to manage the symptoms and monitor progress.
As you begin recovering from the injury, adhering to the prescribed treatment helps facilitate the brain's healing ability and minimizes the risk of complications. By carefully following the doctor's advice and focusing on your recovery to heal, you can support your body, improve your overall outcome, and recover faster.
School Accommodations for Concussions
Athletes recovering from a brain injury may require accommodations to support their educational or physical therapy needs. With physical issues, they may need to use an elevator or avoid the hallway during class period changes.
Cognitive processing or memory issues may require a reduced workload, relief from board copying, eye breaks, frequent breaks, or the use of earplugs.
A young athlete with post-concussion syndrome, for example, might need a gradual return to school with a modified schedule. Further, some may be so impaired that they need homebound instruction for an extended period until they have healed enough to return to the classroom in full contact again. People recovering can take a moderate activity like short walks and very light aerobic activity with the guidance of a healthcare professional.
Each person can heal at different rates, and multiple factors promote and interfere with the process. If the brain isn’t healed and that child is displaying symptoms, then we must honor that child and provide the time their brain and body need. Therapies like neurofeedback and biofeedback, as well as dietary change, can help restore the brain more quickly.
To make an appointment with Dr. Roseann for a QEEG brain map or brain check or to discuss how one of our clinically effective and natural therapies can help your child, teen, or young athlete, such as neurofeedback, contact us or take our free solutions matcher.
Citations:
Ghaziri, J., Tucholka, A., Larue, V., Blanchette-Sylvestre, M., Reyburn, G., Gilbert, G., Lévesque, J., & Beauregard, M. (2013). Neurofeedback Training Induces Changes in White and Gray Matter. Clinical EEG and Neuroscience, 44(4), 265–272. https://doi.org/10.1177/1550059413476031
Chabot, R. J., & Serfontein, G. (1996). Quantitative electroencephalographic profiles of children with attention deficit disorder. Biological psychiatry, 40(10), 951–963. https://doi.org/10.1016/0006-3223(95)00576-5
Russell K, McDonald PJ, Ellis MJ. (2015) Measuring the scientific impact of sport-related concussion research: a citation analysis study. https://med-fom-neuroethics.sites.olt.ubc.ca/files/2017/03/Measuring-the-scientific-impact-of-sports-related-concussion-research.pdf
Dr. Roseann is a mental health expert in Neurodivergence who is frequently in the media:
- Mel Robbins Show: Neurofeedback and Concussions
- Creative Clinician's Corner: Teletherphy, Biofeedback and Neurofeedback
- How Humans Heal Podcast: Rewiring the Brain
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health.
Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain.
Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.
She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach. She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).
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