Category: Concussion

COVID – 19 Update: Clinic Closed Until The End of March


Greetings valued patient,

Our team has been closely monitoring the developing COVID-19 situation and we are here to help assist you during this difficult time.  As a collective group, we decided that the most responsible and ethical way to support our patients and our community at large is to temporarily change the way we deliver healthcare.

From March 18 – 31st, Advanced Health + Sports Clinic, will not be offering in-person/hands on treatment to ensure patient and practitioner safety and to adhere to the Canadian Health Authorities recommendations for social distancing and to follow recommendations provided by our respective professional colleges.

In this interim period, we will be transitioning operations to offer services online via video conferencing. Maintaining continuity of care for our patients is paramount to us and by transitioning to services online, you will still have access to care and consultation from most disciplines including: physiotherapy, chiropractic care, and athletic therapy.

While we won’t be able to offer the hands on skills such as manual therapy and dry-needling we often use, we can still provide assessment, education, exercise instruction, coaching and advice. Certainly, these treatment sessions will look a little different than our typical appointments – but our team is still here to provide you with valuable support.

Please note
We will be offering in-clinic appointments for EMERGENCY cases ONLY, these will be decided on a case by case basis by the appropriate practitioner. If you have an emergency case (i.e. post-surgical, acute concussion, etc), please call us between 9AM and 3PM between Monday and Friday, Natalie and Tara will be able to take your request and process it accordingly.

Advanced Health + Sports Clinic places tremendous value on our communities health, happiness and safety and we want to make it clear that we are here for you. Hard times often necessitate hard decisions – temporarily closing our doors certainly was one of them, but we feel it was a decision made for the right reasons pertaining to safety and ethical considerations. During the next two weeks we will remain accessible via phone, email, and video chat to connect with you and help you in any way shape or form that we can.

How does Telehealth work?

You will be able to book “Virtual” assessments and subsequents via phone or via our JaneApp platform as of Friday March 20th, at 3PM . At your virtual appointment time, you will receive an e-mail invitation to Physitrack, all one has to do is press on the highlighted link and accept the prompt for the video call (very similar to Skype). We assure all our patients that Physitrack is HIPPA compliant and offers encrypted Telehealth/Video Calling to ensure your confidentiality.

  • For new patients, virtual assessments can be very valuable, please ensure to book a “Virtual Assessment” to ensure an hour block is reserved for your appointment.
  • For any returning patients that would like to check-in with their health care provider, to progress their exercise program for example, please ensure to book a “Virtual Subsequent”.
Please feel free to contact us for any inquiries.
Let’s grow together, learn together, take care of one another, and we are confident we can come out of this stronger and wiser. Have a wonderful rest of your week and we look forward to hearing from you.

Yours in Health,
The Advanced Team

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Urgent Care Physiotherapy & Athletic Therapy in Nanaimo: Bumps and Bruises Clinic

 

Bumps and Bruises Clinic – Urgent Care Physiotherapy & Athletic Therapy in Nanaimo

We pride ourselves on being a clinic that takes great care of our community athletes – “Sports” is in our name!

During the high participation months of team sports in Nanaimo we have decided to provide urgent care hours to accommodate our community athletes. Athletes who compete on the weekends need to be assured that they can be PROMPTLY booked in to be assessed and treated when an injury occurs. Sprains, strains, concussions, contusions and anything in between … when in doubt – get checked out!

This system for quick assessment is vital in the diagnosis of acute injuries which is then followed by:

  • Treatment, rehabilitation, and return to sport plans
  • Referral for specialist/surgical assessment or diagnostic imaging (as needed)
  • Education and reassurance for the athletes
  • Communication with parent and coaches

Who is the Bumps and Bruises – Urgent Care Physiotherapy & Athletic Therapy Clinic FOR?

Our Bumps and Bruises – Urgent Care hours are reserved for MONDAYS and TUESDAYS between September and April and are designated for the following competitive sport channels in Nanaimo:

  • Teams and associations we are affiliated with
  • Minor sport associations (hockey, lacrosse, soccer, football baseball, etc)
  • Private and Community Sport Associations (ex, boxing, gymnastics, figure skating)
  • Highschool and Collegiate Athletes
  • Junior Sports (hockey, lacrosse, football)

CONTACT our reception staff first thing Monday morning (phones are open at 7:00am) to reserve your spot as they go fast!

(250) 585-8553

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Concussion: Why Am I STILL Experiencing Symptoms?

Good morning Nanaimo! Lets have a talk about a subject that’s gotten its fair share of attention over the past handful of years – concussion!

10-15% of Athletes involved in contact sports are expected to sustain a concussion annually. They happen. They aren’t fun. But despite the media coverage in recent years and the almost taboo nature they have come to be associated with – they TYPICALLY aren’t as bad as we have been led to believe.

WHAT Happens During Concussion? :

The occurrence of a concussion while initially thought to be a structural injury is actually now understood to be a “temporary dysfunction” stemming from a stretch/shear force applied to the brain. Without getting too far down the metabolic rabbit hole in this blog one of the primary problems following this injury this is we run into an ATP deficit (Yes, remember that from grade 11 biology?!). Basically, ion channels get stretched open, which results some in abnormal electrical activity and a subsequent imbalance occurs, which essentially leaves us with an energy deficit in the brain.

Now … The good news is that MOST concussions with proper rest, management, and return to play steps resolve and within 2-3 weeks. The battery recharges and we resume life/sport!

However …

Depending on the literature you read between 10 and 20% of concussion sufferers will still experience beyond four weeks following injury which then classifies them which three big words:  POST CONCUSSION SYNDROME (PCS).

While it can be stubborn, unpredictable, and bothersome for the patient – in truth, the malingering of “concussion-symptoms” is usually not driven by the insult to the brain at this point as most people metabolically recover FULLY between 22-28 days following injury but because ANOTHER neighboring system also got disrupted during the trauma that caused the concussion in the first place (ex, a whiplash injury to the neck).

To re-iterate … the brain is typically NOT the culprit for persistent PCS symptoms! Lets now discuss the other elements that usually drive the symptoms at this point and are absolutely treatable if identified by a well-trained clinician.

The 5 “fingers” that contribute to the “Fist” of post concussion syndrome:

What’s Happening?! What to do about it?!
1.      Metabolic Recovery

 ATP levels are low and need to recharge!
  • Rest (for a few days ONLY)
  • Nutrition
  • Adherence to return to school and return to sport protocols
  • Education and reassurance
2.      Cervicogenic

 Whiplash symptoms … neck is jacked up and now referring symptoms into the head/face/jaw!
  • Manual & manipulative therapy
  • Soft tissue therapy
  • Exercise!
  • Dryneedling/IMS/acupuncture
  • Pain Neuroscience Education
3.      Vestibular + Visual Dysfunction

 Inner Ear and/or visual system are not operating or communicating correctly
  • Vision Rehabilitation (via Neuro-Optometrist)
  • Vestibular Rehabilitation (via physiotherapist)
4.      Autonomic Dysregulation

 Temporary blood-flow abnormality … essentially the heart is not pumping the correct amount of blood to the brain post concussion.
  • Sub-symptom threshold cardiovascular exercise (train BELOW symptom threshold … then build it back up progressively!)
5.      Psychosocial Components

 Anxiety, depression, sleep disorder, OCD, etc.
  • Clinical counsellor, psychologist, etc. Resources are there, they are important, use them!!

 

To Summarize: 

The GOOD news is that these are all treatable! This means that a thorough assessment of the aforementioned systems to see what is driving the symptoms is imperative. We then need to intelligently LOAD and CHALLENGE that system and “nudge” its boundaries accordingly.

The old adage ”REST IS BEST” is NOT true, and is NOT evidence based practice. Will a brief period of rest (3-4 days) following initial injury is important a progressive supervised return to mental and physical activity is what is now being recommended.

Concussions are one of the many things we enjoy treating at Advanced Health and Sports Clinic when we aren’t treating low back pain, rotator cuff injuries, ACL repairs, and other “typical” injuries you commonly see in an Injury Rehabilitation Clinic. In future posts we will go deeper into each specific element of PCS mentioned today – but the message we wanted to get across is clear:

  • Concussions happen – that’s OK!
  • The body & brain do a good job of recharging post injury in MOST cases!
  • A predictive factor of quick and simpler recovery is getting assessed QUICKLY following injury to rule out red flags and provide education and re-assurance.
  • If you experience Post-Concussion Syndrome symptoms you’re not alone!
  • Your symptoms beyond four weeks are probably NOT your brain – but something close by!
  • Rest is NOT best!
  • Identify what’s driving the symptoms – then treat it!

Have a great week everybody!

concussion management cycle graphic

 

 

 

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