Physical Therapy for Head & Neck Injury - Wall 2 Wall Sports Rehab

Physical Therapy For Head & Neck Injuries

Concussion

A concussion is a mild traumatic brain injury (TBI) that occurs when a forceful impact or sudden movement causes the brain to shake inside the skull. This can lead to temporary changes in brain function, affecting balance, vision, memory, and coordination.

Causes

Direct blow to the head (e.g., sports injuries, falls, car accidents)
Sudden jolt or whiplash-like motion causing an indirect shaking of the brain
Contact with a hard surface (e.g., hitting the ground or an object)

Diagnosis

Clinical evaluation of symptoms and medical history
Neurological and cognitive testing (memory, concentration, balance)
Vestibular and ocular assessments for dizziness and vision changes
Imaging (CT or MRI) in severe or complicated cases

Treatment

Balance and vestibular therapy to improve dizziness and coordination
Vision therapy for eye tracking and focus issues
Cervical spine treatment to address neck pain and headaches
Gradual return-to-play/activity program to restore endurance and function
Education on symptom management and activity modification

Recovery

Most mild concussions resolve within 7-14 days with proper management
Some cases may take 3-4 weeks, especially with persistent symptoms
Post-concussion syndrome (PCS) may extend recovery beyond 4 weeks
A structured, supervised return-to-activity plan improves outcomes and reduces the risk of prolonged symptoms

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is a common vestibular disorder that causes brief episodes of dizziness or vertigo due to displaced calcium crystals (otoconia) in the inner ear. It is often triggered by specific head movements and can significantly impact balance and daily activities.

Causes

Age-related degeneration of the inner ear
Head trauma or concussion
Prolonged head positioning (e.g., after surgery or extended bed rest)
Inner ear infections or disorders
Unknown (idiopathic cases)

Diagnosis

Dix-Hallpike Test – a positional test to identify vertigo and eye movements (nystagmus)
Roll Test – used to diagnose horizontal canal BPPV
Balance and gait assessment – to evaluate functional impairments
Patient history – symptoms typically include dizziness triggered by head movements

Treatment

Canalith Repositioning Maneuvers (e.g., Epley, Semont, or BBQ roll) to move displaced crystals back into place
Vestibular rehabilitation exercises to improve balance and reduce dizziness
Habituation exercises to desensitize the brain to movement-induced dizziness
Gait and postural training to restore stability and prevent falls
Education on symptom management and activity modifications

Recovery

Many patients experience immediate relief after canalith repositioning maneuvers
Symptoms typically resolve within a few days to two weeks
Some cases may require multiple PT sessions for full resolution
Recurrence is possible, but vestibular exercises can help reduce future episodes

Neck Arthritis (Cervical Osteoarthritis)

Neck arthritis, or cervical osteoarthritis, is the degeneration of the joints, discs, and cartilage in the cervical spine. This condition can cause stiffness, pain, reduced mobility, and, in some cases, nerve compression leading to radiating symptoms in the arms.

Causes

Age-related wear and tear on cervical joints
Previous neck injuries or trauma
Repetitive stress from poor posture (e.g., prolonged screen use)
Disc degeneration leading to joint inflammation
Genetic predisposition to arthritis or spinal conditions

Diagnosis

Physical examination – assessing neck mobility, pain, and strength
Neurological testing – checking for nerve involvement, numbness, or weakness
X-rays – to identify joint space narrowing and bone spur formation
MRI or CT scans – to evaluate disc health and nerve compression if needed

Treatment

Manual therapy and mobilization to improve joint mobility and reduce stiffness
Postural retraining to reduce strain on the cervical spine
Strengthening exercises for the neck and upper back to support the spine
Stretching and flexibility exercises to improve range of motion
Neuromuscular re-education to restore proper movement patterns
Pain management strategies such as heat, ice, or electrical stimulation

Recovery

Symptom relief can be seen in a few weeks with consistent PT
Most patients experience significant improvement within 4-6 weeks
Long-term management may be necessary for chronic cases
A combination of therapy, lifestyle changes, and home exercises helps maintain mobility and reduce flare-ups

Neck Fusion (Cervical Fusion)

Cervical fusion is a surgical procedure that permanently joins two or more vertebrae in the neck to stabilize the spine. It is often performed to relieve pain, restore stability, and prevent further degeneration caused by conditions such as arthritis, herniated discs, or spinal instability.

Causes (Indications for Surgery)

Severe cervical arthritis or degenerative disc disease
Herniated discs causing nerve compression
Cervical spine instability due to trauma or fractures
Spinal stenosis leading to chronic pain or weakness
Failed conservative treatments for neck pain or nerve-related symptoms

Diagnosis

Physical examination – assessing pain, mobility, and neurological function
X-rays – to evaluate spinal alignment and degeneration
MRI or CT scans – to identify disc damage, nerve compression, or instability
Electromyography (EMG) – to assess nerve function if symptoms involve weakness or numbness

Treatment

Pre-surgical rehab (“Prehab”) – strengthening and mobility exercises to prepare for surgery
Post-surgical rehabilitation (after surgeon approval)
Gentle range of motion exercises to prevent stiffness
Postural retraining to reduce strain on the spine
Core and neck strengthening to improve stability
Manual therapy (as appropriate) to improve tissue mobility
Pain management strategies such as soft tissue work, heat, or ice

Recovery

Initial healing takes 6-12 weeks, depending on the surgical approach
Full recovery and return to normal activities may take 3-6 months
Physical therapy typically starts 4-6 weeks post-op (depending on surgeon guidelines)
Long-term rehabilitation focuses on strengthening and mobility to protect the fused area and reduce stress on surrounding joints

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Physical Therapy For Head & Neck Injuries

Concussion

Causes

Diagnosis

Treatment

Recovery

Benign Paroxysmal Positional Vertigo (BPPV)

Causes

Diagnosis

Treatment

Recovery

Neck Arthritis (Cervical Osteoarthritis)

Causes

Diagnosis

Treatment

Recovery

Neck Fusion (Cervical Fusion)

Causes (Indications for Surgery)

Diagnosis

Treatment

Recovery