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Concussions in Kids

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What is a Concussion and What to do Next

A concussion is a Mild Traumatic Brain Injury that occurs with an impact or forceful movement to the head/body, causing a rapid motion of the brain in the skull. It can happen to children of any age as well as adults. Note: it’s not just blows to the head that can cause a concussion. Impact to the body can also transmit force to the neck and head, resulting in a concussion.

If your child has had an injury and you suspect a concussion, take them to the emergency room immediately if any of the following symptoms occur: What are the signs and symptoms of a concussion in children/teens?

Each person is different and may experience one, some or many of the below symptoms. These may vary from day to day or could be consistent. 
  •     Very Drowsy
  •      Vomiting
  •      Memory Deficits
  •      Seizure
  •      Blood from Eyes/Ears
  •      Bruising/ Black Eyes
  •      Severe Balance Issues
  •      Severe Injury
  •      Slurred Speech
  • Numbness in Arms or legs
 Emotional and Behavioural:

  • Irritability
  • Nervous/anxious/angry
  • Frustrated
  • Sadness

Physical symptoms:

  • Headache
  • Nausea/vomiting
  • Dizziness
  • Sensitivity to noise/light
  • Blurry vision
  • Decreased balance
 Mental symptoms:

  • Fogginess/tired
  • Feeling slowed down
  • Trouble remembering
  • Trouble concentrating

Sleep:

  • Trouble falling asleep
  • Trouble staying asleep
  • Sleeping too much
*Only 10% of concussions cause a loss in consciousness so this is not a reliable sign*

**Signs and symptoms of a concussion can be delayed by several hours or even several days! When it comes to kids and sports – if you’re not sure if a concussion has occurred – it’s best to rest for 48 hours after a blow to the body/head before returning to play. “When in doubt, sit them out.”

 

What are signs and symptoms of a concussion in toddlers and infants?

Infants and toddlers with a suspected concussion, or those experiencing behaviours that are abnormal/concerning for them, should seek immediate medical attention.  An infant or toddler with a concussion can present with some or all of these symptoms:

  • Crankiness/irritability that is not typical
  • Cannot be comforted or crying excessively
  • Changes in eating, sleeping or playing patterns
  • Worsened balance/walking
  • Decreased interest in toys/play
  • Increased fatigue/tiring easily
  • Decrease in skills (language, social, emotional or physical) 

What to do if your child has a concussion

Immediately:

  • Make them stop what they are doing
  • Stay with them to monitor them
  • Seek medical attention to be assessed

During the first 48 hours:

  • Allow your child to rest for a maximum of 2 days. They will need physical and cognitive rest to help their brain heal. 
  • Limit screen time and avoid activities that increase/cause symptoms. 
  • Schedule an appointment with a paediatric, concussion-trained physiotherapist to get started on a recovery plan.

After 48 hours: 

  • Limit physical exertion to activities that do not increase your child’s heart rate too high/cause them to break a sweat. 
    • Examples of things to avoid: Work outs, sports, running, biking, rough play, etc.
  • Cognitive activity should be slowly and gradually re-introduced as symptoms allow, including activities that require concentration and learning as well as exposure to loud noises. 

How long do symptoms last?

  • Most concussion symptoms resolve in 1-4 weeks. During this time we recommend that kids gradually return to school and sports with a return to play protocol, under the guidance of a trained professional.
  • Returning to full activity/sports too soon may result in more severe symptoms or long term problems. It can also put your child at risk of sustaining another concussion with more severe symptoms and a longer recovery period.

How do you treat a concussion?

Physiotherapy can help to assess and address concussion symptoms. Treatment can involve:

  • Neck dysfunction/whiplash 
  • Vestibular system – dizziness and nausea symptoms
  • Visual symptoms
  • Graded and monitored return to school and work with communication to teachers, coaches and more
  • Education on symptom management and how to successfully return to school and sports.
  • Comparing where your child is at to their Concussion Baseline Test, if they have one, and ensuring they get back fully to their baseline levels.

What’s different about Playworks Physio Concussion Treatment?

At PlayWorks Physio, our therapists have up to date concussion training and we individualize each patient’s treatment to their specific concerns and symptoms. We take the time to find out what your child’s interests are and use games and play to motivate them with their exercises! From high level athletes to toddlers, each child’s plan is catered to their level. 

Have a child with a suspected concussion? Click here to book an appointment or call us to see how we can help to identify if a concussion is present and provide treatment as necessary – 604-492-3888.

 

Written by: Kate Heays & Lindsay Eriksson

 

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The Top 4 Figure Skating Injuries

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Figure Skating and Common Injuries

Figure skating is a demanding sport that requires flexibility, balance, strength, and artistry. It is a skill-based sport that requires many repetitions of complex movement patterns across all disciplines. With the demands of on-ice, off-ice, flexibility, and dance training, overlooked injuries can grow to more complex injuries.

The Top 4 Figure Skating Injuries:

  1. Ankle Sprains
  2. Knee Pain
  3. Back Injuries, from extreme positions or the impact on landings with a rigid boot
  4. Concussions, can be from falls with or without a direct hit to the head

How physiotherapy can help:

  1. Addressing an injury early can prevent the progression from an acute to a chronic injury. By identifying injuries early on, skaters are able to return to their regular training earlier without pain, allowing the skater to focus on their coach’s feedback.
  2. Pre-habilitation and injury prevention can decrease a skater’s risk of an injury during the season.
  3. Concussions happen in the sport. Recovering from a concussion can be tricky and your physiotherapist can guide your return to sport in a safe manner.

To book an assessment with National Figure Skater and Physiotherapist, Kai-Jing Leong, click here.

Written by: Kai-Jing Leong

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Heel Pain/Sever’s Disease – What is it?

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Severs- what it is, what is happening, how physio can help

What is Sever’s Disease? 

Sever’s Disease occurs when the C shaped growth plate at the back of your heel gets inflamed from stress from the achilles tendon. Growth plates are areas of cartilage located near the ends of the bones, and this is where bone growth occurs. Since it is the last part of a child’s bone to harden, growth plates are particularly vulnerable to injury. Adults don’t have open growth plates anymore, so this condition is found only in kids. Sever’s Disease is also 2-3 times more likely to occur in boys than girls, and it is associated with big growth spurts!

What my child may complain of?

  • No pain in the morning, but usually is worse with increased load during the day
  • Pain worsens with repetitive activities (example: running or jumping)
  • Tenderness on both the inside and outside of the heel
  • No swelling, redness or skin changes noted with this condition
  • Calf tightness

Things that may make Sever’s worse:

  • Worn out shoes
  • Hard surfaces
  • High amounts of physical activity
  • Big growth spurts
  • Back to activity after a long break

How can physio help?!

At Playworks Physio we specialize only in kiddos! We see kids with this type of heel pain VERY often, especially with the start of sports seasons. Your Physio will take a good look at what is happening and what might be causing it, and give lots of tools to help. Some things include stretching and strengthening activities, suggestions for activity modifications, shoe recommendations, and of course, this will all be FUN for your kiddo.

Our main goal is to help reduce your kiddos pain, solve the source of the issue to prevent it from returning, and improve their ability to participate in their activities again, pain free!

– Darrien Cantelo, Physiotherapist

 

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A to Z what about Pee?!

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A to Z but what about Pee !?

Summer holidays – one of the most awaited times of the year! Perhaps it involves a camping trip, or a summer slumber party. Whatever it is; it’s time for kids, and parents to relax, reset, and be stress free from the school year! 

That is the case, unless you’re a kiddo (or a parent of a kiddo) with urinary incontinence. Summer holidays and fun, social plans can be absolutely terrifying. 

How can I go on a camping trip if I pee my pants sometimes?

How will my child go to the birthday sleepover if they wet the bed some nights? 

The most important thing to know is that wetting the bed, or clothing is not your fault, nor your kiddo’s fault. There are many things out there (including Paediatric Physio!) that can help kids decrease these occurrences, so keep smiling … we can help! 

A second crucial thing to know, is that this is more common than you might imagine. The number of children and teens who struggle with continence is astounding, so it’s not just you and your kiddo. And want to know something else? It’s especially common in athletes! So you’re not alone! Helping your child realize that several kids in their class or on their sports teams also live with this can help them appreciate this more. Urinary leakage typically comes with a bunch of shame, guilt and fear. So try to let it go, and again…it’s not your fault!

There are a few definitions I’m going to go over so you can start to understand what may be going on with your situation:

Continuous incontinence – this is for kiddos who constantly leak in non-discrete amounts. This is something that you should see a doctor about, and is usually more of a “hardware” issue, than a “software” issue.

Intermittent Incontinence – this applies to kiddos who have specific, urinary leakage incidents. This can be daytime only, nighttime, only, or both. It can be for kiddos who are over the age of 5 who never achieved continence (primary), but also for kiddos who have previously attained bladder control (secondary). More specific categories include:

    • Urge Incontinence: when a kiddo has a sudden or unexpected need to pee and can’t make it to the toilet in time.  
    • Stress Incontinence: when a kiddo has leakage with a specific activity such as coughing, sneezing, or laughing BUT ALSO during sports when you kick, run, or hop!
    • Nighttime Incontinence: when a kiddo wets the bed at night 

Who are the culprits ?!

Now you’re likely not going to believe this (as did I when I first heard it), but one of the main suspects of urinary incontinence is constipation! Let me explain…

When your rectum is full (even more so in little bodies), it pushes on the bladder and doesn’t allow it to fully fill. Furthermore, all that build up in the abdomen puts extra pressure on the “sensors” making it difficult to tell when it’s really time to go. Even pooping daily can mean constipation, so, everyone is assumed to be constipated until proven innocent! 

Next on the suspect list are those sneaky pelvic floor muscles. These muscles sit in your pelvis and control the flow of pee and poop out of your body. Sometimes they can be weak, however they can also be tight and gripping, trying to hold everything in. When these muscles can’t contract properly, it causes constipation, poo stains in undies, itchy bums, pee dribbles and even those bigger leaks. 

Other culprits can include things such as family history, life events (new sibling, divorce, illness/injury, etc), frequent urinary tract infections, early toilet training and sensory involvement. 

Ta-Da! The solution:

  1. Say it, repeat it, believe it: It is not your fault. You are not alone 🙂 
  2. Get yourself to a qualified physio who has extra training to treat the pelvic floor, but also who has experience working with kids. They will be able to assess the muscles (in a non-invasive way!!) as well as determine other culprits at play. Based on what they find, your paediatric physio can help you come up with a fun plan to becoming continent! CLICK HERE to book an appointment.
  3. It’s important to have a proactive health care team that is up to date with what’s going on. Knowledge is power and having a supportive team will help make the journey even easier! 

For more information check out this cool video made by SickKids in Toronto for a great summary!

https://www.youtube.com/watch?v=E8Khck8lWak

If you want to schedule an appointment with our paediatric physio and pelvic floor trained physio CLICK HERE.

Written by: Karly Dagys, Physiotherapist

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