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Concussions are serious injuries that are too often dismissed as nothing big, or something that someone should be able to power through. In fact, any traumatic brain injury, or TBI, is something that needs to be approached with the patient’s best interests in mind.

Did you know that the most common cause of a TBI is a fall? Here in Texas, we often think about football players when we think about concussions but actually the elderly are much more at risk of concussion than the average young adult. According to the CDC (2010), 60% of TBIs are experienced by people over the age of 65. Most people who suffer a concussion will recover within 21 days, but some may take much longer.

Sometimes this delay in recovery can be due to trying to return to activity too quickly. In order to progress appropriately, it’s important to follow the 3-to-5 Minute Rule. Symptoms provoked by higher levels of activity are ok as long as they only last 3 to 5 minutes before coming back to baseline. If symptoms take longer than 5 minutes to go away or to return to baseline, then the activity is too intense and the concussed person is in danger of setting themselves back on their path to recovery. Think about recovery in stages:

Step 1: Complete rest until asymptomatic at rest. Think about this step as though the you have the flu. No activity and no exertion until you no longer feel any of the symptoms you incurred as a result of the concussion when you are resting.

Step 2: Light activity. You can now get up and walk around, maybe even go for a brisk walk, but nothing that would leave you winded or sweaty. If you’re a student, try doing schoolwork from home. Gradually increase tolerance to daily activities by starting with only 5-15min of activity and increasing your endurance.

Step 3: Functional activity. Now that light activity is mastered, try going back to work or school part-time. If you’re involved in social clubs, see about attending short gatherings. Don’t feel like you need to power through work, school, or events, instead have a plan to leave partway through and allow yourself the flexibility to leave a little earlier if your symptoms increase too much.

Step 4: Return to full activity. Gradually increase your tolerance to work, school, or social engagements. The goal is to return to previous levels of function without undue increase in symptoms.

Step 5 (athletes only): Return to contact sports. This stage should only be attempted with medical clearance. Consult with your doctor and physical therapist to see if it’s appropriate for you to return to full contact sports.

While working through these stages, you should stay on each step until you’re completely asymptomatic with the expectations of that step. If you progress a step and your symptoms come back for longer than 5 minutes, then drop back a step.

Symptoms can be diverse, and each concussion is different. Common symptoms can include nausea and vomiting, imbalance, dizziness, fatigue, trouble falling asleep or sleeping too much, sensitivity to light or noise, emotional disturbances (irritability, nervousness, sadness), numbness or tingling, mentally foggy, difficulty concentrating or remembering, and visual problems.

If you’ve experienced a concussion or traumatic brain injury and as a result you’re experiencing imbalance or dizziness, we at 360 Balance & Dizziness are here to help! Make an appointment with one of our Vestibular Physical Therapists today!