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Persistent Concussion Symptom Management

Mild Traumatic Brain Injuries 

A mild traumatic brain injury (mTBI) is usually caused by a concussion, and it occurs when there is a blow to the head or a hit to the body that causes movement of the brain. The initial injury to the brain is referred to as the primary brain injury, whereas the secondary brain injury refers to the changes that occur over time after the incident that further impair brain tissue. Brain injuries can be caused by events like falls, motor vehicle collisions, violence, and sporting accidents. Mild traumatic brain injuries can cause various symptoms, including cognitive deficits, motor deficits, sensory deficits, communication and language deficits, functional deficits, social difficulties, regulatory disturbances, and personality changes. With proper care, most mild traumatic brain injuries heal over time.  


Post-Concussion Syndrome 

There are instances where symptoms from a mTBI persist for longer than expected, which is referred to as post-concussion syndrome. Individuals who have a history of concussions are at greater risk of experiencing a longer recovery, severe symptoms, and long-term challenges. Symptoms of post-concussion syndrome can include headaches, dizziness, fatigue, irritability, anxiety, sleeping difficulties, concentration difficulties, memory impairments, ringing in the ears, blurry vision, as well as noise and light sensitivity. These symptoms can make it difficult for individuals to take part in activities of daily living (ADLs) such as travel, shop, work, household tasks, and participate in social activities.  


Challenges Individuals with Mild Traumatic Brain Injuries Face  


Individuals with mild traumatic brain injuries (mTBIs) may face several challenges that can significantly impact their daily lives and well-being. Some of these barriers include: 

  • Difficult to have timely access to services and support for concussion management 

  • Must be your own advocate in medical and insurance systems  

  • Face challenges associated with living with an invisible injury  

  • Face stigma around concussions – patients do not always feel validated 

  • Difficult to Communicate boundaries and limitations  

  • Transportation can impact symptoms and make it difficult to get around 

  • Busy environments can be overwhelming, particularly shopping 


Rebecca’s Story and Symptom Management Tips 

After suffering from multiple concussions throughout her life, Rebecca Todd sustained a mTBI while cleaning her kitchen that led to persistent symptoms, preventing her from returning to her old job. To manage her symptoms, she has incorporated various compensatory strategies into her life that help optimize her functioning. She uses pacing and planning to avoid symptom flares by looking at the week ahead and scheduling activities and rest breaks. The MyBrainPacer App helps her keep her symptoms at bay. The app assigns numerical values to daily activities  to help individuals pace and plan. Rebecca stressed the importance of knowing her own symptom pattern and threshold, so she can intervene and rest before her symptoms peak. She prioritizes her time by trying to minimize household tasks by meal prepping and utilizing a dog walker and robot vacuum. Other strategies she employs to minimize her symptoms include performing mindfulness activities, breathing exercises, self-check-ins, and participating in hobbies. Further, she relies on resources like sunglasses and headphones to reduce her symptoms while out in public. She also leans on the community she has built for support at markets and cafes. Employing these strategies allow Rebecca to continue to participate in the activities she enjoys, such as teaching yoga.  


Future of Mild Traumatic Brain Injury Care 

After sustaining a mTBI, it can be difficult for patients to know how to manage their condition and access resources and support. Having timely access to care is important for recovery; however, many patients have difficulty accessing services due to funding and knowledge barriers. Thus, this population requires an increase in timely services, education, and funding. Group programming and virtual care are two services that may help address barriers impeding access to care. 


Resources for Individuals with Mild Traumatic Brain Injuries and their Families


MyBrainPacer App 

ABI 101: Steps to Success Series  

Regional Acquired Brain Injury Outpatient Program 

Living Concussion Guidelines 

Concussion Handbook for Parents and Kids 

Ontario Brain Injury Association  

Facebook Support groups  

Keep your Head Up 

Parkwood Virtual Fitness Center 



Special thanks to Dr. Laura Graham (MPT, PhD) and Rebecca Todd for Providing their Expertise. 




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