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Concussion Care

Why see a sports specialist? 

What is a concussion? The Centers for Disease Control and Prevention (CDC) defines a concussion as “a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.” Concussions “result in a range of clinical signs and symptoms that may or may NOT involve loss of consciousness.”  

  • Concussion symptoms can range from mild to severe and may present very differently with each individual. Common symptoms are: headache, feeling tired or in a fog, troubles with concentration or memory, blurry vision, nausea, dizziness, feeling emotional and changes in sleep patterns, among many others.

  • At PICSM, we take pride in providing up-to-date concussion care. After performing a thorough physical exam, our providers will educate you on your condition, provide you with a detailed care plan, including supplementation options, and will coordinate any necessary referrals to physical therapy, speech, further imaging, etc.

PICSM Concussion Specialists

Dr. Brian Abbott


Dr. Brian Abbott specializes in the nonsurgical management of orthopedic injuries including fractures, osteoarthritis, neck and low back pain, and tendon and ligament injuries. He also has additional training in concussion care and management.​ Dr. Abbott often employs osteopathic manipulation in the care of his patients. Viewing the body as a functional unit, he performs a comprehensive exam, taking into account that few injuries occur in isolation and can be reflected throughout the body. With the use of gentle osteopathic techniques, he is able to help improve pain, body movement, and function.




Abby Barnhart, PA-C


Abby has a special interest in concussion injuries in soccer. She was a member of the soccer team at Helena High School and is passionate about making sure athletes from our local high schools safely return to sport after a concussion. Abby is experienced in return to play protocols and ImPACT® testing. She has been actively involved in weekly after-school high school training room visits and event coverage at both schools.





Concussion Information

What Are the Symptoms of a Concussion?


The most common symptoms of a concussion include: Amnesia Sensitivity to light or noise Confusion Nausea Headache Feeling sluggish Slowed reaction time Feeling foggy or groggy Concentration or memory problems Feeling unusually irritable Balance problems Double or fuzzy vision Loss of consciousness




What Is ImPACT® Neurocognitive Testing?


Computer-based neurocognitive testing is used by the NFL, NBA, NHL, and all Division 1 NCAA sports programs. When it comes to conducting baseline or post-concussion testing with this valuable tool, no one in Montana has more experience than our staff. We help with baseline testing for both Capital and Helena High Schools, and we review much of the data after yearly testing. We work closely with both high schools to establish our return to play program and post-injury testing program. For those athletes without baseline testing, we utilize post-injury testing to help understand the depth of injury and when brain function has returned to normal.




What Is Return to Play Progression?


Montana’s Dylan Steiger Protection of Youth Athletes Act took effect during the 2013-14 athletic season. It requires that all athletes suspected of a concussion are cleared by a medical provider before returning to play. Once evaluated and cleared for return to play progression, each athlete is required to complete a 6-step program before returning to full participation: Baseline: Back to school Step 1: Light aerobic activity Step 2: Moderate activity Step 3: Heavy, non-contact activity Step 4: Practice and full contact Step 5: Competition Each sport has a unique return to play progression. At PICSM we specialize in returning your athlete back to their sport in a timely but safe manner. We are the experts on sports-related concussions and can help your athlete on their path to recovery. Dr. Steele was actively involved in writing the progression guidelines for Montana, and every member of our concussion team is well-versed on concussion management and returning your athlete back to sport. Although each concussion is a unique event with the severity of concussion depending on which parts of the athlete’s brain was injured, we are well-informed on the latest recommendations and protocols. We understand the risks of returning an athlete back to sport too quickly and the importance of a gradual progression back to sport to prevent re-injury.




What Can I Do to Feel Better After a Mild Traumatic Brain Injury?


Although most people recover after a concussion, how quickly you improve depends on many factors, such as how severe your concussion was, your age, how healthy you were before the concussion, and how you take care of youself after the injury. You may find it difficult to do your daily activities, perform your job, go to school, get along with everyone at home/work/school, and even relax. Rest is very important after a concussion because it helps the brain heal. Ignoring your symptoms and trying to “tough it out” often makes symptoms worse. Be patient, because healing takes time. Only when your symptoms have decreased significantly, and after consulting with your healthcare professional, should you slowly and gradually return to your daily activities, such as work or school. If your symptoms come back or you experience new symptoms as you become more active, this is a sign that you are pushing yourself too hard. Stop these activities and take more time to rest and recover. As the days go by, you can expect to gradually feel better. While you are healing, you should be careful to avoid doing anything that could cause a bump, blow, or jolt to the head or body. If you already had a medical condition at the time of your concussion (i.e., chronic headaches), it may take longer for you to recover from a concussion. Anxiety, depression, learning disabilities, and bipolar disorder also make it harder to adjust to the symptoms of a concussion. On rare occasions, receiving another concussion before the brain has healed can result in brain swelling, permanent brain damage, and even death, particularly among children and teens.




Getting Better: Tips for Adults


Get plenty of sleep and rest during the day.

  • Avoid activities that are physically demanding (housecleaning, weight lifting/working out) or that require a lot of concentration (balancing your checkbook). They can make your symptoms worse and slow your recovery.
  • Avoid activities that could lead to another concussion, such as contact or recreational sports.
  • When your healthcare professional says you are well enough, return to your normal activities gradually, not all at once.
  • Your ability to react may be slower after a concussion. Ask your healthcare professional when you can safely drive a car, ride a bike, or operate heavy equipment.
  • Talk to your healthcare professional about when you can return to work.
  • Talk to your employer about returning to work gradually and limiting activities and/or your schedule until you recover.
  • Don’t drink alcoholic beverages, as they may slow your recovery.
  • Write down the things that may be harder than usual for you to remember.
  • Avoid sustained use of the computer and additional screens like iPads and mobile phones.
  • Eat well, drink lots of water, and get plenty of sleep.




Getting Better: Tips for Children


Parents and caregivers of children who have had a concussion can help them recover by taking an active role in their recovery:

  • Help your child get plenty of rest and keep a regular sleep schedule, including no late nights and no sleepovers.
  • Limit screen use (i.e., watching TV, playing video games, texting).
  • Make sure your child avoids high-risk/high-speed activities, such as riding a bike, skateboarding, climbing playground equipment, contact recreational sports, or going on rides that could result in another bump, blow, or jolt to the head.
  • Talk with your healthcare professional about when your child should return to school and other activities, and how you can help your child deal with the challenges they may face. For example, your child may need to spend fewer hours at school, rest often, or require more time to take tests.
  • Sharing information about concussions with parents, siblings, teachers, counselors, babysitters, coaches, and others who interact with your child helps them understand what has happened and how to help meet your child’s needs.





If you or someone you know is suspected to have suffered a concussion, don’t hesitate to visit Performance Injury Care & Sports Medicine. We are the concussion experts in Helena, Montana and surrounding areas.

Concussions must be treated immediately to avoid re-injury or long-term damage. Call (406) 422-5817 for a same-day appointment or just walk in and be seen.

Related Resources
CDC HEADS UP Concussion Education Program
Brain Injury Alliance Montana
Save the Brain Helena
Concussion Care for Patient

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