Traumatic Brain Injury, Concussion & Whiplash
- Physical Therapy International Service
- Nov 1
- 4 min read
Authors: Anna Norton, Ella Bonner, and Livi Kovach
A traumatic brain injury (TBI) is an injury to your brain that affects how it functions and works. They can cause death or disability in the long or short term. There are also different kinds of TBIs, such as penetrating injuries or blunt injuries, and they can vary depending on the severity: mild, moderate, or severe. These injuries can be caused by something penetrating your brain, such as a bullet, knife, or other sharp object, or a blunt injury, when something hits your head hard enough that it moves the brain in your skull, such as falling and hitting your head, hitting your head in a car accident, or getting hit playing sports.
The main brain structures include the cerebellum, cerebrum, and brainstem. The cerebrum functions to coordinate movement throughout the body, speech, sensory, emotions, and learning. Therefore, if a TBI occurs in the cerebrum, memory issues, communication difficulties, and visual impairments may occur. The cerebellum functions in posture and equilibrium and in coordinating muscle movements. If a TBI happens to the cerebellum, the patient would have trouble with balance and coordination of movement, motor control, and other motor deficits. The brainstem functions to connect the cerebrum to the spinal cord. It is made of three different parts: the midbrain, pons, and medulla. The midbrain works for movement and coordination, hearing, and response to changes in the environment. The pons help with small movements on the face, such as blinking, tear formation, and expressions. The medulla is for everyday bodily movement that helps you survive, such as breathing, heart rate, and swallowing. If a TBI affects the brainstem, a lot of normal life functions will be affected, such as the regulation of breathing and heart rate, balance, and can even affect the consciousness of the patient.
The Glasgow Coma Scale is a “score” that determines how conscious a patient is. It looks at your speech, eye movement, and regular movement responses. The three factors that go into it are if you’re awake, like being able to “wake up” to voice or touch. When you are in a coma, you cannot wake up like when you are sleeping. The next factor is your alertness, like being able to respond to your surroundings. The last factor is your orientation like knowing the day, who is in the room with you, and your location. The scale affects treatment and rehabilitation in that it tells how conscious you are and how much treatment you are able to tolerate. It determines what treatment plan to take with the patient and how much more you can progress from the previous session.
A concussion is a mild traumatic brain injury that is often caused by an impact to the head or body. The brain injury causes a change in brain function and activity. Concussions are most commonly caused by falls and are a very prevalent injury among athletes who play contact sports. During these instances, the brain rocks back and forth against the inner walls of the skull, leading to damage to brain tissue. The most common symptoms of a concussion are headache, nausea, vomiting, dizziness and blurry vision, fatigue, and amnesia (loss of memory surrounding the event or fall). Other symptoms include slurred speech, concentration issues, forgetfulness, light and noise sensitivity, and trouble sleeping. Emergency care should be sought out when a person experiences these symptoms after a fall or other impact to the head. Concussions are often diagnosed using neurological exams and cognitive tests. Although rest is often used to treat concussions, PT rehab can also be very beneficial for recovery. A physical therapist will help the patient return to normal brain function by designing a therapeutic exercise program, improving balance, reducing headaches, and improving vision. The treatment will involve stretching, strengthening, and motion exercises targeted at addressing common symptoms of concussions.
A whiplash injury is an injury to the neck that occurs when the neck moves back and forth forcefully and rapidly. These injuries are commonly caused by car crashes (rear-end), trauma, sports accidents, and physical abuse. These movements cause damage to neck tissues and muscles. Most whiplash injury patients are healed within a few weeks with treatment of exercise and pain medication, but some longer-lasting complications are possible. The most common symptoms are stiffness and pain of the neck, decreased range of neck motion, shoulder and upper back tenderness, and numbness in the arms. Other symptoms include trouble with memory and focusing, ringing in the ears, crankiness, and sleep troubles. Physical therapy treatment for whiplash is focused on restoring movement, strengthening neck muscles, and improving posture. These goals are achieved through various movement exercises, including rotating, bending, and tilting your neck in different directions. The physical therapist will create an individualized exercise plan based on the severity of the injury.
A traumatic brain injury can cause lasting effects that depend on how severe the injury was and what part of the brain was affected. Some people may continue to have trouble with memory, focus, or communication, while others might struggle with movement, balance, or coordination. Emotional changes are also common. Things like irritability, mood swings, depression, or anxiety can develop over time. In more serious cases, people might face long term-challenges such as muscle weakness, difficulty walking, or trouble taking care of themselves. These effects can make everyday life harder and can also affect relationships, work, and independence.
Physical therapy can make a big difference in helping someone recover from a TBI and manage long term symptoms. A physical therapist works to improve strength, balance, and coordination through exercises and movement training. They help patients relearn how to move safely and build back confidence in their physical abilities. Because every person's recovery is different, PTs create treatment plans that fit the individual's specific needs and progress. Along with physical improvements, therapists also provide encouragement and support, helping patients stay motivated and positive throughout their recovery journey.
Traumatic brain injuries can change a person's life in many ways, but with the right care and rehabilitation, recovery is possible. Understanding how TBIs happen, how they affect the brain, and how treatments like physical therapy can help is an important part of supporting patients and their families. Recovery takes time, patience, and teamwork between healthcare providers and the patient. With continued effect and the right guidance, people living with TBIs can make meaningful progress and work toward improving their independence and quality of life.
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