Health Matters: All about concussions

brain safety

August 29, 2019

By Physical Therapist Dale Koch, PT MS, NCS and Trauma Coordinator Jenn Lambertson, RN, BSN in the Helena Independent Record on August 28, 2019.  

It is estimated that approximately 1.7 million people sustain a traumatic brain injury (TBI) every year in the United States, according to the Centers for Disease Control and Prevention (CDC). A TBI is caused by some external force that is applied to the head and the brain inside. The severity of the injury depends on the force associated with the incident and if any safety precautions were in place. Types of TBIs include concussions, bruising of the brain tissue and even shearing of the brain tissue.

TBIs can be life-changing and even life-ending. Individuals across the entire lifespan are susceptible to TBIs, and common causes vary based on age. For instance, infants typically sustain head injuries from accidental causes like not being properly buckled into a carrier that falls over, or in some cases, abuse. On the other hand, falls are the leading cause of TBI for the aging and elderly. Youth are at-risk to sustain TBIs while participating in sports or riding skateboards, bicycles or ATVs.

Unfortunately, Montana regularly ranks between second and third in the nation per capita for TBI-related deaths. The Brain Injury Alliance of Montana estimates that 33 Montanans every day sustain some type of brain injury and survive.

Concussions are the most common type of TBI, and probably the most well-known. A concussion changes the way the brain normally works and is caused by a bump, blow or jolt to the head or body that causes the head and brain to move rapidly back and forth. The damage to the brain occurs as the chemical level and normal brain cell function is disrupted. Diagnostic imaging studies like MRI or CT scans typically come back normal after a concussion.

Motor vehicle accidents, falls and sports injuries are common causes of concussions. Concussions are most prevalent in contact sports. Among children, most concussions happen on the playground, while bike riding or while playing sports such as football, basketball or soccer.

Signs and symptoms of a concussion can show up right after the injury, but they may not appear or be noticed for up to three days after the injury. This is why it is especially important for parents to understand the signs and symptoms of concussions. Most concussions occur without loss of consciousness, but can impact our thinking and cause confusion or difficulty concentrating. Physical symptoms can include prolonged headache, vision disturbances and dizziness. Our emotional systems can be impacted as well, resulting in increased irritability, sadness or anxiety. Following a concussion, even sleep and energy cycles can be altered.

Anyone who has had a concussion at some point in their life has an increased risk for another concussion. Young children and teens are more likely to get concussions, and may experience longer recovery times.

As with most types of injuries, there are precautions you can take to help prevent concussions. Always wear your seatbelt while in a vehicle, do not drive under the influence and do not text or use a cell phone. Put up handrails on stairs and use safety gates to protect young children. Use grab bars in bathrooms, place nonslip mats in tubs and remove trip hazards from your home. We cannot emphasize enough the importance of wearing a helmet that fits while riding a bike, skiing/snowboarding, skateboarding, horseback riding, riding ATVs or playing contact sports.

For youth who play contact sports, baseline concussion testing is important. The baseline test essentially assesses the child’s balance and brain function. It can be used to detect if there are any existing concussion symptoms, and medical professionals can complete a similar exam following a suspected concussion, using the baseline results as a comparison. Locally, the nonprofit Save the Brain Helena offers several free baseline concussion screening events each year.

If you suspect that you or a loved one has sustained a concussion, it is important to seek immediate medical attention. Any loss of consciousness, amnesia, confusion, headache, vomiting, seizures, or unusual behavior means you need to seek emergency care. When in doubt, get prompt medical care.

The basis of concussion management is physical and cognitive rest for 24-72. After experiencing a concussion, returning to athletic activity and work/school should be a gradual process carefully monitored and managed by a healthcare professional.

Being active is a great way to stay healthy, and youth sports can help kids establish lifelong healthy habits. However, it is important to know about TBIs and do all you can to protect your head and brain. For additional information on TBIs, you can visit

Jenn Lambertson, RN, BSN is the trauma program coordinator at St. Peter’s Health. She is nearing the completion of a master’s degree and plans to become a nurse practitioner, serving the Helena area.

Dale Koch, PT MS, NCS is a physical therapist at St. Peter’s Health, certified neurological clinical specialist and is on the board of Save the Brain-Helena, a multidisciplinary group of professionals dedicated to promoting brain health and safety.