PEDIATRIC AND ADOLESCENT CONCUSSIONS Physiotherapy IN MISSISSAUGA
Updated: Feb 1
Pediatric and adolescent concussions can be quite challenging to assess and treat as pediatric population often find difficulty in explaining their symptoms. Its hard to assess the intensity of symptoms and develop a comprehensive and compliant treatment plan. Pre-existing medical conditions and subsequent concussions make it even harder to gauge the severity of concussion. However, Registered Physiotherapist at Curezone Physiotherapy are trained and have extensive training in assessing and treating pediatric and adolescent concussions. At the initial assessment, Registered Physiotherapist will look out for any potential signs and symptoms that might indicate more severe damage to brain or that might warrant immediate medical attention or further imaging techniques (CT, Spine X-Ray).
Regardless of the magnitude of concussive brain injury once your Registered Physiotherapist/ER Physician/GP rules out severe brain injury following guidelines could be used to facilitate brain healing during first few weeks using following strategy.
1. maintains the same bed and wake times every day throughout the year (including summer). Try to maintain them throughout the weekend as well; however, if this is not possible, try to keep them within one hour of weekday bed and wake times.
2. has a fixed bed time routine: a warm bath about one hour before bed may help to facilitate sleep.
3. turns off the computer and electronic devices including cell phones, at least 30 minutes before bed time.
4. takes naps based on the amount of time post-concussion and the severity of daytime sleepiness (not on fatigue). In the first few hours/days after concussion, increased sleep and need for naps are a natural part of the recovery process and should not be limited.
5. limits naps to once a day, ideally before 3 pm and for 30 minutes maximum, if he/she is very sleepy during the day and cannot avoid them.
6. naps in bed, not in another room or in front of the TV, etc.
Nutrition, Exercise and Lifestyle Make sure the child/adolescent:
a) avoids caffeine (coffee, tea, chocolate, some over-the-counter medications) within 4-6 hours of bed time.
b) avoids energy drinks and alcohol altogether.
c) avoids eating heavy meals late in the evening.
d) avoids sugar four hours before bed time. Try a bed time snack containing proteins.
e) has enough magnesium, iron and Vitamin B in his/her diet. Adequate vitamin and mineral intake is important to help the body produce melatonin, which promotes sleep.
f) does 30-60 minutes of vigorous exercise a day, when tolerated and medically indicated, and at least two hours before bed time. Exercise during the two hours before bed time can delay sleep while regular exercise earlier in the day can promote sleep.
g) gets some natural light during the day, especially in the morning.
h) gets 15-30 minutes of quiet time after periods of cognitive activity, if he/she has significant cognitive fatigue (not sleepiness) during the day. Ideally, quiet time should be in an environment with natural light and no electronic devices. This can also promote night time sleep.
i) avoids loud music with a strong beat before bed time in favour of music that promotes relaxation—if he/she is used to listening to music before bed.
Sleeping Environment Make sure the child/adolescent
1. has a dark, cool and comfortable sleeping area.
2. removes all sources of light in the bedroom while sleeping.
3. opens the curtains and has natural light immediately upon wakening.
4. keeps the bedroom clean, tidy and quiet. Neutral or natural sounds can help to block out distracting sounds.
5. reserves the bed and bedroom for sleep, and does other activities (reading, watching TV, using internet, playing games) in another room. Ideally, there should be no electronic equipment in the bedroom. If this is
6. unavoidable, make sure that all computers, tablets, cell phones, etc. are turned off or in “sleep” mode.
7. turns any digital clocks with numbers that light up away from the bed during sleep.
B) General Activity Guideline for recovery stages after concussion- [adapted from Can Child+ Mc-master University]- Teenagers (11+)
Stage 1- REST
Sleep habits, no visual stimulation (any near screen activities- Phone, I-pad), auditory stimulus (audio books, talking over phone), light craft work scrap books, molding clay)
Stage 2- Light Activity
1. Cooking and baking
2. Listen to quiet music (no headphone)
3. Magazines
4. Poetry
5. Archery
6. Billiards
7. Camping
8. Darts
9. Fishing
10. Light jogging
11. Stationary cycling
Stage 3- Sport Specific Activity
1. Calisthenics
2. Crosswords
3. Air hockey/ Football
4. Curling
5. Golf
6. Hiking/running/skating
7. Windsurfing
8. Tai-chi/karate
9. Light badminton
Stage 4- Non -contact Practice
1. Aerobics and plyometrics
2. Canoeing/kayaking
3. Basketball/ cricket
4. dance and cheer (no stunts)
5. Football drills
6. Hockey drills
7. Non contact soccer (no heading)
8. Pilates
9. Shadow boxing
10. Squash or tennis
11. Track and field
12. Volleyball (no diving)
Registered Physiotherapist
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PEDIATRIC AND ADOLESCENT CONCUSSIONS Physiotherapy IN MISSISSAUGA
Updated: Feb 1
Pediatric and adolescent concussions can be quite challenging to assess and treat as pediatric population often find difficulty in explaining their symptoms. Its hard to assess the intensity of symptoms and develop a comprehensive and compliant treatment plan. Pre-existing medical conditions and subsequent concussions make it even harder to gauge the severity of concussion. However, Registered Physiotherapist at Curezone Physiotherapy are trained and have extensive training in assessing and treating pediatric and adolescent concussions. At the initial assessment, Registered Physiotherapist will look out for any potential signs and symptoms that might indicate more severe damage to brain or that might warrant immediate medical attention or further imaging techniques (CT, Spine X-Ray).
Regardless of the magnitude of concussive brain injury once your Registered Physiotherapist/ER Physician/GP rules out severe brain injury following guidelines could be used to facilitate brain healing during first few weeks using following strategy.
1. maintains the same bed and wake times every day throughout the year (including summer). Try to maintain them throughout the weekend as well; however, if this is not possible, try to keep them within one hour of weekday bed and wake times.
2. has a fixed bed time routine: a warm bath about one hour before bed may help to facilitate sleep.
3. turns off the computer and electronic devices including cell phones, at least 30 minutes before bed time.
4. takes naps based on the amount of time post-concussion and the severity of daytime sleepiness (not on fatigue). In the first few hours/days after concussion, increased sleep and need for naps are a natural part of the recovery process and should not be limited.
5. limits naps to once a day, ideally before 3 pm and for 30 minutes maximum, if he/she is very sleepy during the day and cannot avoid them.
6. naps in bed, not in another room or in front of the TV, etc.
Nutrition, Exercise and Lifestyle Make sure the child/adolescent:
a) avoids caffeine (coffee, tea, chocolate, some over-the-counter medications) within 4-6 hours of bed time.
b) avoids energy drinks and alcohol altogether.
c) avoids eating heavy meals late in the evening.
d) avoids sugar four hours before bed time. Try a bed time snack containing proteins.
e) has enough magnesium, iron and Vitamin B in his/her diet. Adequate vitamin and mineral intake is important to help the body produce melatonin, which promotes sleep.
f) does 30-60 minutes of vigorous exercise a day, when tolerated and medically indicated, and at least two hours before bed time. Exercise during the two hours before bed time can delay sleep while regular exercise earlier in the day can promote sleep.
g) gets some natural light during the day, especially in the morning.
h) gets 15-30 minutes of quiet time after periods of cognitive activity, if he/she has significant cognitive fatigue (not sleepiness) during the day. Ideally, quiet time should be in an environment with natural light and no electronic devices. This can also promote night time sleep.
i) avoids loud music with a strong beat before bed time in favour of music that promotes relaxation—if he/she is used to listening to music before bed.
Sleeping Environment Make sure the child/adolescent
1. has a dark, cool and comfortable sleeping area.
2. removes all sources of light in the bedroom while sleeping.
3. opens the curtains and has natural light immediately upon wakening.
4. keeps the bedroom clean, tidy and quiet. Neutral or natural sounds can help to block out distracting sounds.
5. reserves the bed and bedroom for sleep, and does other activities (reading, watching TV, using internet, playing games) in another room. Ideally, there should be no electronic equipment in the bedroom. If this is
6. unavoidable, make sure that all computers, tablets, cell phones, etc. are turned off or in “sleep” mode.
7. turns any digital clocks with numbers that light up away from the bed during sleep.
B) General Activity Guideline for recovery stages after concussion- [adapted from Can Child+ Mc-master University]- Teenagers (11+)
Stage 1- REST
Sleep habits, no visual stimulation (any near screen activities- Phone, I-pad), auditory stimulus (audio books, talking over phone), light craft work scrap books, molding clay)
Stage 2- Light Activity
1. Cooking and baking
2. Listen to quiet music (no headphone)
3. Magazines
4. Poetry
5. Archery
6. Billiards
7. Camping
8. Darts
9. Fishing
10. Light jogging
11. Stationary cycling
Stage 3- Sport Specific Activity
1. Calisthenics
2. Crosswords
3. Air hockey/ Football
4. Curling
5. Golf
6. Hiking/running/skating
7. Windsurfing
8. Tai-chi/karate
9. Light badminton
Stage 4- Non -contact Practice
1. Aerobics and plyometrics
2. Canoeing/kayaking
3. Basketball/ cricket
4. dance and cheer (no stunts)
5. Football drills
6. Hockey drills
7. Non contact soccer (no heading)
8. Pilates
9. Shadow boxing
10. Squash or tennis
11. Track and field
12. Volleyball (no diving)
Registered Physiotherapist
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