Concussions: Is it the Brain, a Strain, or Something Else? - IMPACT Physical Therapy

Concussions: Is it the Brain, a Strain, or Something Else?


By Tim Rylander, PT, EdD(c), MPT, OCS, CBIS

IMPACT Physical Therapy – Hinsdale – Managing Partner

Diagnosing a Concussion

With football season among us, great awareness tends to be placed on concussions and head injuries. A concussion is a form of a brain injury resulting from either a direct or indirect blow to the head. This trauma results in a cascade of neurometabolic adaptations that may contribute towards a plethora of physical, emotional, cognitive, or sleep-related symptoms. Simply put, a concussion is a very serious injury, however, it is very important to note that a concussion is a recoverable injury. The diagnosis of a concussion is commonly a clinical one, meaning that it comes from a combination of a clinical examination and an inventory of symptoms. Contrary to some misleading headlines, there currently is no definitive clinical test used to diagnose a concussion (i.e. blood test, X-ray, MRI, etc.).

A concussion can result in symptoms such as headaches, dizziness, nausea, sensitivity to light, mental fogginess, irritability, and visual disturbance. Many of these symptoms can often be associated with specific clinical examination findings. This boasts the importance of a comprehensive examination by a medical professional with a significant depth of experience with concussions. Research suggests that following the onset of a concussion, a majority of individuals will be asymptomatic within a matter of weeks – but there are many factors that may affect this timeline. When individuals do not follow the typical trajectory of recovery, skilled intervention may be necessary like physical therapy.

A common challenge for clinicians working with individuals following head trauma is determining the primary cause of symptoms. There are a number of injuries and conditions that mimic a concussion and it is the duty of the healthcare team to thoroughly vet out all potential contributions towards symptoms.


The primary symptom of a concussion is typically a headache. The type of headache commonly associated with a concussion, specifically during the initial stage, is described as a pounding pressure that is often located all throughout the head. Also, during this stage of a concussion, an individual will often report fatigue and increased symptoms associated with both cognitive and physical exertion.

Heat-Related Illness

With summer still hanging around, there is still the potential for high temperatures and oppressive heat during practice and play. The symptoms associated with heat-related illness include dizziness, nausea, headache, confusion, and even loss of consciousness. Athletes must make sure that hydration is prioritized, and proactive steps are made to actively recover after strenuous workouts and practices.

Cervical Strain/Sprain (whiplash)

Whiplash (also referred to as impact-related neck injury) is caused by an acceleration/deceleration stress to the head and neck. While whiplash is most commonly associated with motor vehicle accidents, these same stresses can be caused by sports-related injuries such as tackles and falls. Whiplash injuries can produce neck pain, dizziness, mental fogginess, and headaches. The types of headaches commonly related to whiplash include pain originating in the neck and extending through the back of the head and can reach all the way to behind the eyeball.


While many think of migraines as synonymous with “really bad headache,” it is important to realize that a migraine is a neurovascular disorder. The pathology of a migraine deals with the vascularity of the head and brain. While a headache is a primary symptom associated with a migraine, it is vital to realize that migraines can produce symptoms such as dizziness, visual disturbance, sensitivity to light, and nausea. Migraines can be related to a genetic factor, but they can also be brought on by trauma. Furthermore, migraines can evolve through time progressing in severity or symptom presentation.

Concussion Treatment in Chicago

As mentioned, a concussion is a very serious event. Failed management of a concussion may cause prolonged symptoms or even irreversible harm. However, not every symptom experienced following a “hit” is necessarily related to concussion. It is vitally important that if athletes sustain a significant hit, experiences any symptoms, or just simply isn’t acting themselves that they be thoroughly examined by a clinician trained in comprehensive concussion management. Our clinical team at Impact Physical Therapy boasts well over two decades of experience working with individuals following a concussion and head injury. Many of our clinicians hold advanced certifications and recognition in the field of concussion management and we are here to help you navigate your recovery. Please contact Impact Physical Therapy to get in touch with our concussion protocol team and receive an accurate diagnosis.

Tim Rylander

Tim Rylander is the managing partner at Impact Physical Therapy and the Chicago Recovery Room located in Hinsdale, Illinois. He brings over 12 years of experience working with head injuries and concussions. Tim is a board-certified orthopedic specialist, a certified brain injury specialist, and a certified vestibular rehabilitation specialist. He has contributed towards multiple texts on concussions and is currently a national instructor for the Academy of Neurologic Physical Therapy as well as an instructor of neuroscience therapeutics at Governors State University.