Living Well September/October 2017

concussion and traumatic brain injuries SEPTEMBER/OCTOBER 2017

A Publication of the

September/October 2017 ~ living well

1

Call for an appointment today!

406.721.5600 | 800.525.5688

• 60 Healthcare Providers • 15 Different Specialities • 2 Urgent Care Facilities Open 7 days a week

Extraordinary Care

www.westernmontanaclinic.com | Facebook @westernmontanaclinic 2

living well ~ September/October 2017

publisher Mike Gulledge

missoulian.com

A publication of the Missoulian advertising department

graphic design Tyler Wilson

People in Missoula and western Montana want to feel good, look good and live well. Available at

advertising sales Mindy Glenna 406-523-5211 contributors John Bigart, III Kay Jennings Jill A. Olson Mary Thane

more than 150 newsstand locations throughout the area, Western Montana Living Well is well suited to more than 30,000 readers monthly who want health tips on fitness, nutrition, family, wellness, therapy and beauty.

The opinions, beliefs and viewpoints expressed by the various authors and forum participants in this publication do not necessarily reflect the opinions, beliefs and viewpoints of the Missoulian or Lee Enterprises. The author of each article published in this publication owns his or her own words.

No part of the publication may be reprinted without permission. Š2017 Lee Enterprises, all rights reserved. Printed in the USA.

SEPTEMBER/OCTOBER 2017 VOL. 42

IN THIS ISSUE CONCUSSION AND TRAUMATIC BRAIN INJURIES

CONCUSSIONS Rehabilitation has drastically changed

Page 4

ALSO IN THIS ISSUE

HEAD INJURIES and fish oil

Page 6

BRAIN INJURY facts

Page 8

UNMASKING brain injury in Montana

Page 12

OLDER ADULTS Page 14 WHICH HELMET? Page 16

September/October 2017 ~ living well

3

CONCUSSION REHABILITATION HAS DRASTICALLY CHANGED

by JILL A. OLSON, PT

Concussion management has drastically changed! A concussion is a type of mild traumatic brain injury (mTBI) caused by a bump, blow, or jolt to the head, or a blow to the body that can change the way your brain normally works.

Several years ago, we would manage a concussion with what we now refer to as “cave therapy;” i.e., keep patients in a dark room, take away all stimulation, and tell them not to come out until all of their symptoms disappear. You can only imagine the anxiety and depression that this might have generated, adding additional problems unrelated to the concussion.

Concussion specialists are now equipped to provide more specific clinical tests and assessments to determine what areas of the brain and body are most impacted by the concussion and what is specifically driving the symptoms.

Once this is determined, specific treatments can be immediately established to promote more efficient and comprehensive recoveries.

4

living well ~ September/October 2017

The classic areas that a concussion may affect include the following: COGNITIVE FATIGUE: The brain easily fatigues with symptoms like headache, mental blurring, and difficulty with attention, memory, focus and concentration.

VESTIBULAR SYSTEM: A collection of structures in the inner ear and areas in the brain that provide the balance center of the brain. Vestibular impairment affects one’s ability to interpret motion, coordinate head and eye movements, and stabilize vision with head movement. Injury to this area creates complaints of dizziness, impaired balance, blurry vision, difficulty focusing, motion sickness, fear of heights, difficulty in busy environments, anxiety, feelings of being overwhelmed, migraines and nausea.

OCULOMOTOR SYSTEM: The brain and the eye

muscles that control visual eye tracking. This can impact many eye functions such as the ability to focus on objects as they are moving from far away to close up (required to catch a ball), the ability to quickly move eyes from side-to-side (required for reading), and the ability to quickly move eyes up and down (required to scroll on a computer). When this system is impacted, there is often reduced visual processing speed and reaction time. Symptoms include blurred vision, double vision, headaches (especially behind the eyes or on top of the head), eye strain, nausea, sensitivity to light, trouble reading or focusing, trouble taking notes, avoidance of reading, and, over time, comprehension deficits.

MUSCULOSKELETAL SYSTEM: The muscles, tendons, ligaments and joints. Few concussions occur without a whiplash-type injury. Trauma to the cervical and thoracic joints, muscles, tendons, and nerves can also cause neck pain, headaches, dizziness, nausea, and blurred vision.

MIGRAINE: a constellation of symptoms including headaches that occur with other symptoms including nausea, light and sound sensitivity, dizziness, and visual aura. Migraines often involve the vestibular and oculomotor system and include components of musculoskeletal injuries. Migraines are greatly exacerbated by disrupted sleep patterns.

MOOD: Mood disorders can occur following concussion, including depression and anxiety. These disorders have to be closely assessed as they can be underlying issues triggered by other concussion pathways such as vestibular and ocular weakness or the effects of migraine.

EXERTION: The body’s ability to regulate heart rate, blood pressure, and stability while strengthening and performing aerobic exercise. When this area is impacted, the symptoms of light-headedness, dizziness, fogginess, and fatigue are experienced.

SLEEP SYSTEM: The sleep system is often disrupted with concussion. Insomnia, difficulty falling asleep, sleeping longer than normal, and feeling “tired all

the time” can occur when concussions hit the sleep cycle.

Regulated nights of deep, uninterrupted sleep is essential for restoration of a brain in a metabolic crisis. Often times these patients are frequently taking naps during the day, sleep more or less than they should, and have a hard time getting their sleep cycle regulated.

Finding a strong team of concussion specialists is imperative for safe and thorough rehabilitation. The physical therapists at Peak Performance Physical Therapy work closely with the Dylan Steigers Concussion Project to stay on the cutting edge of concussion research. They are certified concussion specialists with additional certifications in vestibular/ocular rehabilitation, manual therapy, dry needling, ASTYM, and strength and conditioning. They use state-of-the-art computerized programs for scientific objective measurements such as the RightEye Neurovision Program (which measures eye function and visual reaction times); ImPact Neurocognitive Test (measures attention, working memory, nonverbal processing, reaction time and processing speed); computerized posturography/balance assessments; and video Frenzel goggles (assesses for benign paroxysmal positional vertigo and other peripheral vestibular disorders). Once an accurate diagnosis is obtained as to what systems are impacted by the concussion, a very specific and individualized treatment plan is employed to address each area. When a medical professional evaluates concussion symptoms and detects areas of concern that are beyond his/her skill level, they will refer patients to other specialists such as neurologists, neuropsychologists, neuroophthalmologists, and speech and language pathologists. It takes a team of concussion specialists to treat the complex and multi-layered trajectories that a concussion can take in the midst of the chemical storm that it wages on the brain.

A strong team of concussion specialists will revolutionize the recovery from a concussion and expedite the most comprehensive and uncomplicated recovery.

Jill A. Olson, PT, CLT is the Director of Dylan Steigers Concussion Project and the owner of Peak Performance Physical Therapy.

To date, the DSCP has obtained over 4540 Baseline Concussion Tests on area athletes and has helped manage over 475 concussions.

Do you think you’ve had a concussion?

la,, Mt, 59801 ula ou So 1940 Harve St MiS 406-542-0808

Do you feel off?

Do you have neck pain, headaches, balance problems, dizziness, insomnia, learning/memory problems, anxiety, or increased symptoms with exertion?

Thanks to our generous sponsors:

Not sure what to do?

Schedule a Free

Concussion Mini-Consult with The Dylan Steigers Concussion Project.

We can help!

September/October 2017 ~ living well

5

HEAD INJURIES AND FISH OIL … fact or fiction?

by Kay Jennings, BSN, MSHSA, MSN, APRN-PMH

6

living well ~ September/October 2017

With the beginning of the school year, we see all types of sports activities starting … and the competition is on. Unfortunately, though, along with increases sports activities, we see increases in concussions and traumatic brain injury.

Concussions, TBIs and PCS

A concussion is a head injury from direct or indirect force with or without loss of consciousness, which may or may not lead to either traumatic brain injury (TBI) or postconcussion syndrome (PCS).

Symptoms may appear immediately after the injury or weeks or months after, and they can vary. Some of the symptoms are headache, fatigue, dizziness, nausea and vomiting, seizures, fatigue, depression, photophobia, sensitivity to sound, sleep difficulty, visual and hearing changes, anxiety, irritability and possibly post traumatic stress disorder (PTSD).

Traumatic brain injury is a condition with a loss of cognitive functions, with onset either after a concussion or with trauma to the brain with or without skull trauma. The signs and symptoms of TBI will persist longer then PCS.

What Happens Following Injury?

Of great importance for parents to know is that a certain amount of the dysfunction that patients experience is due to pathophysiology of events occurring after the injury (blood brain permeability, autoimmunity, excitotoxicity, neural inflammation, etc.). Because a functional approach to post-injury recovery often is ignored, many people with head injuries lose much more brain reserve and function than they should have from the original head injury.

The good news is that these changes can be treated with functional medicine approaches.

eggs and soy. MSG and artificial sweeteners are toxic to the brain and should be avoided.

4. Improve gut bacterial diversity with the use of a good probiotic, prebiotics and fermented foods.

5. Certain herbal/botanical compounds are effective in reducing brain inflammation. Find a functional practitioner who is familiar with these various combinations.

6. Finally, eat good fats. The brain is made primarily of fat, so eat healthy fats such as olive oil, avocado, coconut oil, cold water fish, and nuts and seeds.

Omega-3 (fish oil) supplementation in addition to fat in the diet will help with inflammation in the brain.

So the fact is, good fats and Omega-3s do help in the recovery process of brain injuries.

Kay Jennings, BSN, MSHSA, MSN, APRN-PMH, has more than three years of post-graduate training in functional medicine and is the owner of New Health, a functional medicine practice based in Missoula. In addition to providing in-office care to her patients, she also offers telemedicine appointments for clients across the State of Montana. To learn more about Kay and her Functional Medicine practice, call 406-721-2537 or visit newhealthmontana.com.

Add a Functional Approach with Diet – Including Fish Oil

Of course, parents need to work with a qualified medical team with special training in head injuries to oversee the care of their child, but parents also can add a functional approach to treatment in combination with the medical team’s care. Some of these approaches are: 1. Lower inflammation by offering a diet full of phytonutrients and color. Concussions increase the chance of having gut problems, so find a functional medicine practitioner to diagnose and treat any gut problems that arise.

2. Due to the connection of the gut to the brain, it is important to eat a diet that stabilizes blood sugar.

Eliminate sugars, starchy carbs and eat frequently enough to keep energy levels steady. Make sure enough protein is in the diet so that the body can get enough amino acids for neurotransmitter production.

3. Eliminate foods that may lead to inflammation such as gluten and dairy. These foods are inflammatory to the brain in many people, so just cut them out during the healing process. Other undiagnosed food intolerances might include corn, September/October 2017 ~ living well

7

Concussion and CTE A concussion is a traumatic brain injury (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, stretching and damaging brain cells and creating chemical changes in the brain.

There has been a lot of media attention on the prevalence of chronic traumatic encephalopathy (CTE) among professional athletes and those who have sustained repeated concussions. According to current research, people are in danger of developing CTE if they have sustained repeated concussions. Some people who sustain concussions experience symptoms that last longer than expected. This is known as post-concussive syndrome (PCS) and has some of the same symptoms as CTE. The following explains some of the similarities and differences between CTE and PCS. Chronic Traumatic Encephalopathy (CTE)

Post -Concussion Syndrome (PCS)

What Is CTE? CTE has been known for decades to occur in boxers.

More recent brain research has been able to identify more specifically how the brain seems to be affected as a result of multiple concussions over time. The research is still very much ongoing.

What Is PCS? PCS is the set of symptoms from a concussion or a series of concussions that do not resolve within the anticipated time frame.

Symptoms x Irritability, mood swings, depression, anxiety and problems with memory, impulse control, and judgment. x It is important to understand these symptoms can be associated with other issues besides CTE. A person who is having these issues does not necessarily have CTE. When Does CTE Present? x CTE is currently only officially diagnosed post mortem through an autopsy. x There is no known test to diagnose someone with CTE. x Symptoms typically present years after concussions have occurred.

Treatment x Treatment is normally focused on lessening the impact of the symptoms on day-to-day functioning and includes therapies and medication.

Symptoms x Attention, memory, problem solving, depression, anxiety, irritability, impulsivity and mood swings. x These symptoms may vary in frequency and intensity and are often worse after physical exertion, or when the person becomes “cognitively overloaded.�

When Does PCS Present? x A person who sustains a concussion and their symptoms do not resolve after 3- 6 months, are usually diagnosed with postconcussion syndrome. x These symptoms can present at different times and at different levels of intensity.

Treatment x Some symptoms can be managed through effective compensatory strategies. x Others symptoms may be managed through therapies or medications.

For information about brain injury, visit www.biausa.org 8

living well ~ September/October 2017

About Brain Injury Symptoms of Brain Injury • Physical Impairments- speech, vision, hearing, headaches, motor coordination, spasticity of muscles, paresis or paralysis, seizure disorders, balance, and fatigue.

• Cognitive Impairments- short term memory deficits, impaired concentration, slowness of thinking, limited attention span, impairments of perception, communication skills, planning, writing, reading, and judgment.

• Emotional Impairments- mood swings, self-centeredness, anxiety, depression, lowered self-esteem, sexual dysfunction, restlessness, lack of motivation, and difficulty controlling emotions.

Traumatic Brain Injury (TBI) A traumatic brain injury is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force.

Typical Causes of TBI • Falls • Assault • Motor Vehicle-Traffic • Struck by/Against • Sports Injury

Tips to Aid Recovery • If you suspect a head injury, first go to a physician for an exam.

• Get lots of rest. Don’t rush back to daily activities such as work or school.

• Avoid doing anything that could cause another blow or jolt to the head.

• Ask your doctor when it’s safe to drive a car, ride a bike, or use heavy equipment because your ability to react may be slower after a brain injury.

• Take only the medications your doctor has approved, and don’t drink alcohol until your doctor says it’s OK. • Write things down if you have a hard time remembering.

• You may need help to re-learn skills that were lost. Contact the Brain Injury Association in your state to learn more about the programs, supports, and services available to people with brain injury and their families.

• Visit www.biausa.org for resources and support.

Acquired Brain Injury (ABI) An acquired brain injury is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. An acquired brain injury is an injury to the brain that has occurred after birth.

Typical Causes of ABI • Stroke • Substance Abuse • Near Drowning • Infectious Disease • Seizure Disorders • Tumor • Electric Shock • Toxic Exposure • Lightning Strike • Oxygen Deprivation (Hypoxia/Anoxia)

Learn more.

Help raise awareness.

Severity of Brain Injury Emergency personnel evaluating an individual who recently sustained a brain injury typically assess the severity of a brain injury by using an assessment called the Glasgow Coma Scale (GCS). The scale, which generates a score between 3-15, comprises three tests: eye opening, verbal and motor responses.

NOTE: There may be no correlation between the initial Glasgow Coma Scale score and the initial level of brain injury and a person’s short or long-term recovery or functional abilities.

3

Severe Traumatic Brain Injury (GCS below 8)

8

Moderate Traumatic

FindBrain help.

Injury

(GCS 8-12)

12 Mild Traumatic 15 Brain Injury (GCS above 12)

#NotAloneinBrainInjury www.biausa.org

1608 Spring Hill Road • Suite 110 • Vienna, VA 22182 • 800-444-6443 • www.biausa.org

BRAIN INJURY FACTS AND STATISTICS More than 3.5 million children and adults sustain an acquired brain injury (ABI) each year, but the total incidence is unknown.

• •

September/October 2017 ~ living well

9

ǀĞƌLJ ĚĂLJ͕ ϭϯϳ ƉĞŽƉůĞ ŝŶ ƚŚĞ h͘^͘ ĚŝĞ ďĞĐĂƵƐĞ ŽĨ Ă d /Ͳ related injury.

Leg Pain?

Varicose Veins?

10

living well ~ September/October 2017

Renew your legs . . . renew your life!

541-3200 Missoula

www.VeinMontana.com September/October 2017 ~ living well

11

UNMASKING BRAIN INJURY IN MONTANA

By John Bigart, III Development and Outreach Director, Brain Injury Alliance of Montana

The Montana Brain Injury Alliance booth at A Carousel for Missoula’s annual Fairytale and Super Hero Festival.

Photo provided by Montana Brain Injury Alliance

It has been said that brain injury doesn’t have a face until it happens to you or someone who you love. Unfortunately, we, at the Brain Injury Alliance of Montana (BIAMT), have seen the truth in that statement every day for the past 30 years.

Brain injury in Montana We live in a state that works hard and plays hard, so we 12

living well ~ September/October 2017

all know that injuries can happen. What most Montanans don’t realize is just how common brain injuries are in our state. Montana has one of the highest rates of death from brain injury per capita in the nation and 33 Montanans each day experience a brain injury. Currently, there are more than 45,000 Montanans living with brain injury.

Brain injuries can occur from traumatic events, such as falls, motor vehicle crashes, assaults, and sports and recreation, and brain injury from nontraumatic events can

be the result of stroke, lack of oxygen, tumors or other medical conditions, to name just a few. While there has been growing attention and concern of brain injury nationwide, in Montana, too many individuals die from brain injury. Those who survive often live with its burdensome effects for the rest of their lives. Brain injury also takes its toll on those caring for survivors.

Our brains are incredibly complex and powerful organs that allow us to think, feel and store memories while controlling and coordinating our body’s actions and reactions. Brain injuries are like snowflakes in that no two are exactly alike and affect every person differently. This can make treatment and recovery challenging. This is where BIAMT is here to help.

How we help BIAMT’s mission is to create a better future for those impacted by brain injury through awareness, support, advocacy, community engagement and prevention. This fall we will celebrate our 30th year of helping people in Montana.

As the only organization in the state solely dedicated to helping brain injury survivors, we are proud of the difference we have made in peoples’ lives, but we also know how far we still have to go. BIAMT’s services are driven by our continued dedication to this mission to prevent brain injuries, to minimize their impact and to ensure those affected maximize their quality of life.

Prevention and advocacy BIAMT is also a strong advocate for prevention and believes in the importance of collaboration. Each year, BIAMT partners with other organizations to host free helmet giveaways across the state to encourage Montana’s kids to make healthy head decisions. To date, we have given away more than 4,000 helmets to kids of all ages. These events enable us to help protect heads and save brains.

BIAMT was also part of the collective team that worked to draft and subsequently pass the Dylan Steigers Protection of Youth Athletes Act in 2013 and its expansion in 2017.

This act requires public schools, private schools and other organizations to adopt standardized concussion and safety protocols for all youth athletic programs, as well as provide education to coaches, athletes, their parents, and others on the nature and risks of concussion and repetitive injuries. We are confident the new policies will improve safety and BIAMT is proud to have played a part in the betterment of our youth athletes.

Even though brain injury may not have a face to you today it likely may someday and the Brain Injury Alliance of Montana and our Brain Injury Help Line will be there to help.

For more information, please call 1-800-241-6442 or visit us online at biamt.org.

Educational conferences Each year BIAMT holds a conference for health care professionals and survivors. This year’s conference, Unmasking Brain Injury in Montana: Facing the New Normal will be held on Saturday, Oct. 14, at the Holiday Inn Bozeman.

Everyone is encouraged to attend to learn more about brain injury and recovery, how to build treatment relationships with providers, and strategies to improve communication after brain injury. The conference will also feature an art-based activity for attending survivors to create personalized masks that symbolically express their feelings about how the impact of brain injury has affected their lives. These masks will be featured as part of our statewide initiative to bring about greater awareness of brain injury in Montana and will give survivors a voice and the means to educate others of what it’s like to live with a brain injury and how they found their “new normal.”

Brain Injury Help Line Since 2006, BIAMT has operated the Brain Injury Help Line -- a free telephone-based follow-up and support service that links survivors and their families throughout the state to local information, resources, service providers and other supports. Participation is a collaborative process that respects and encourages the involvement and choices of individuals with brain injury and their family members, while at the same time helping to address and meet their individual needs.

BIAMT partners with other organizations to host free helmet giveaways across the state.

Photo provided by Montana Brain Injury Alliance September/October 2017 ~ living well

13

Older Adults and traumatic brain injuries

by Mary Thane, PT, GCS

Oh, my! What just happened, what do I do? My mind is racing in these few seconds and I am in a panic, scared and afraid for so many uncertainties. My 80-year-old mom just fell down a couple steps landing hard on the wood floor. She is conscious, in shock, and scared, stating her arm and hip hurt and she is having difficulty breathing. As my brain fills with all that needs to be done, I ask myself how this could have happened to my very active and independent mom. What will this mean for her future?

Then my mind snaps back into action mode and I dial 911.

Minutes later the emergency medical crew arrives promptly and tends to her emergent needs.

Addressing the immediate pain in the hip and arm turned out to be the least complicated part of Mom’s health care recovery. The more difficult parts were the headaches, the inability to perform routine kitchen tasks such as making coffee and scrambling eggs, because she was so distractible.

She often would forget to turn off the stove or leave a pan on a hot burner, causing us to be very concerned about her safety.

She also had blurred vision and difficulty concentrating to read and do her daily crossword puzzle, which caused her distress and increased frustration. She wasn’t acting like the 14

living well ~ September/October 2017

patient mom I knew; she was a lot more irritable and couldn’t handle increased stimuli in her environment.

The fact that our mom suffered a traumatic brain injury (TBI) initially was overlooked. Although these injuries are often a major cause of death and disability; memory loss and changes in language and emotion are not easily recognized.

Information is more readily available about traumatic brain injuries for 15- to 24-year-olds. Often overlooked is the fact that more than 60 percent of all TBIs occur among people older than 65 years, as reported by the Centers for Disease Control and Prevention in Atlanta. Falls are responsible for more than one-third of these traumatic brain injuries.

Did you know that older adults are more likely to develop complications because of head trauma?

These complications include balance impairment, physical and cognitive fatigue, depression, vision and hearing changes and cognitive deficits. One may misattribute the older person’s symptoms to other causes, such as natural aging, therefore overlooking the fact that these symptoms may be from an unwitnessed fall.

Did you know that common events can cause traumatic brain injuries? People often describe it as “getting my bell

rung.” Events such as falling out of bed, slipping in the bath tub or a severe jolt like in a motor vehicle crash can cause multiple points of damage, as the brain may move within the skull colliding with bone. The CDC reports that fall-related TBIs among older individuals are responsible for an estimated 142,000 emergency room visits and more than 14,000 deaths.

Mom was put into a sling for the fractured humerus, instructed to use a walker to minimize pain in the hip and told her fractured ribs would heal with time. She was sent home to recover. Little did we know that the most troubling events for her would be the dizziness, nausea, memory loss and headaches.

Only later was Mom diagnosed with a mild TBI and encouraged to write things down for improved memory, follow a routine, take extra rest breaks throughout her day, avoid distractions like loud noises, crowds and do one task at a time. She was relieved to learn that these symptoms are normal after a head injury and her symptoms were not a sign of her aging.

The next action of care was making Mom’s home and other common environments safer by being vigilant about making them as fall-proof as possible. We started with the obvious: installing grab bars in the bathroom, a grab bar on the door jamb as she enters the house from the garage and extending the handrail on the basement stairs.

Simpler changes included installing an adapter on her bedside lamp so it is now turns on with a light touch, placing colored tape on steps to help her with her depth perception so it is obvious there is a step and rearranging cupboards so everything she uses is within her safe reach.

Did I also mention she no longer is wearing shoes with heels, carries a small flash light when she is out after dark and uses a walking stick when walking on unfamiliar or uneven surfaces? She now chooses a quieter time and lower lighting grocery store when she needs to shop.

Traumatic brain injuries can be a definite life changer; most certainly for an aging adult who is accustomed to living independently. As one ages, being proactive to make the environment accessible and safe will decrease the probability of having a fall that may lead to a TBI. As a physical therapist who specializes in aging adults I would encourage the following proactive measures to minimize the risk for a brain injury for aging adults: S er g i n e St io n uSS Ct a l C je Dy Con ro P

1.

Complete a home safety evaluation with an occupational therapist.

2. Schedule a physical therapy consult to evaluate mobility and strength deficits.

3. Involve adult children or close friends to evaluate home and community environments.

Certified Brain Injury Specialists can be found at Community Medical Center Bridges, Outpatient Rehabilitation. The admissions coordinator can be contacted at 406-327-4692 for more information.

Mary Thane, PT, GCS Geriatric Clinical Specialist Community Medical Center mthane@communitymed.org

Retirement Living, Montana Style Independent, Assisted Living, & Respite Services

225 Co verd ell R d . , B ig fo rk, Mo n t an a 599 1 1 ( 406) 837-2698 • w w w. ris in g m o u n t ain s . c om T T Y 711 ( 406) 257-8162

Baseline Concussion T Testing $30 Baseline Concussion Testing Includes: • ImPact Neuropsych Test • RightEye Neurovision Computerized Assessment • Vestibular Ocular Motor Screen • Posturography • Thorough screen of Concussion Symptoms and History

406-542-0808 1940 Harve ST. MiSSoula, MT 59801

Testing performed by Peak Performance Physical Therapy’s Certified Concussion Specialists

Thanks to our generous sponsors: September/October 2017 ~ living well

15

Which Helmet for Which Activity?

It takes brains to be safe — Be smart and wear a helmet!

Information provided by the United States Consumer Product Safety Commission

Why are helmets so important?

For many recreational activities, wearing a helmet can reduce the risk of a severe head injury and even save your life.

How does a helmet protect my head?

During a typical fall or collision, much of the impact energy is absorbed by the helmet, rather than your head and brain.

Does this mean that helmets prevent concussions?

No. No helmet design has been proven to prevent concussions. The materials that are used in most of today’s helmets are engineered to absorb the high impact energies that can produce skull fractures and severe brain injuries.

However, these materials have not been proven to counteract the energies believed to cause concussions. Beware of claims that a particular helmet can reduce or prevent concussions.

To protect against concussion injury, play smart. Learn the signs and symptoms of a concussion so that after a fall or collision, you can recognize the symptoms, get proper treatment, and prevent additional injury. See http://www. cdc.gov/concussion/ for more information.

Are all helmets the same?

No. There are different helmets for different activities.

Each type of helmet is made to protect your head from the kind of impacts that typically are associated with a particular activity or sport. Be sure to wear a helmet that is appropriate for the particular activity you’re involved in. (Helmets designed for other activities may not protect your head as effectively.

16

living well ~ September/October 2017

How can I tell which helmet is the right one to use?

There are safety standards for most types of helmets.

Bicycle and motorcycle helmets must comply with mandatory federal safety standards. Helmets for many other recreational activities are subject to voluntary safety standards. The standards for each type of helmet are shown at www.cpsc. gov. Don’t choose style over safety. When choosing a helmet, avoid helmets that contain nonessential elements that protrude from the helmet (e.g., horns, Mohawks)—these may look interesting, but they may prevent the helmet’s smooth surface from sliding after a fall, which could lead to injury.

Don’t add anything to the helmet, such as stickers, coverings, or other attachments that aren’t provided with the helmet, as such items can negatively affect the helmet’s performance.

Avoid novelty and toy helmets that are made only to look like the real thing; such helmets are not made to comply with any standard and can be expected to offer little or no protection.

Are there any activities for which one should not wear a helmet?

Yes. Children should not wear a helmet when playing on playgrounds or climbing trees. If a child wears a helmet during these activities, the helmet’s chin strap can get caught on the equipment or tree branches and pose a risk of strangulation. The helmet may also prevent a child’s head from moving through an opening that the body can fit through, and entrap the child by his/her head.

How can I tell if my helmet fits properly?

A helmet should be both comfortable and snug. Be sure

that the helmet is worn so that it is level on your head—not tilted back on the top of your head or pulled too low over your forehead. Once on your head, the helmet should not move in any direction, back-to-front or side-to-side. For helmets with a chin strap, be sure the chin strap is securely fastened so that the helmet doesn’t move or fall off during a fall or collision. If you buy a helmet for a child, bring the child with you so that the helmet can be tested for a good fit. Carefully examine the helmet and the accompanying instructions and safety literature.

What can I do if I have trouble fitting the helmet?

Depending on the type of helmet, you may have to apply the foam padding that comes with the helmet, adjust the straps, adjust the air bladders, or make other adjustments specified by the manufacturer. If these adjustments do not work, consult with the store where you bought the helmet or with the helmet manufacturer. Do not add extra padding or parts, or make any adjustments that are not specifically outlined in the manufacturer’s instructions. Do not wear a helmet that does not fit correctly.

Will I need to replace a helmet after an impact?

That depends on the severity of the impact and whether the helmet was designed to withstand one impact (a singleimpact helmet) or more than one impact (a multiple-impact helmet). For example, bicycle helmets are designed to protect against the impact from just a single fall, such as a bicyclist’s

fall onto the pavement. The foam material in the helmet will crush to absorb the impact energy during a fall or collision.

The materials will not protect you again from an additional impact. Even if there are no visible signs of damage to the helmet, you must replace it after such an event. Other helmets are designed to protect against multiple impacts.

Two examples are football and ice hockey helmets. These helmets are designed to withstand multiple impacts of the type associated with the respective activities. However, you may still have to replace the helmet after one severe impact if the helmet has visible signs of damage, such as a cracked shell or permanent dent in the shell or liner. Consult the manufacturer’s instructions or certification stickers on the helmet for guidance on when the helmet should be replaced.

How long are helmets supposed to last?

Follow the guidance provided by the manufacturer. In the absence of such guidance, it may be prudent to replace your helmet within 5–10 years of purchase, a decision that can be based, at least in part, on how much the helmet was used, how it was cared for, and where it was stored. Cracks in the shell or liner, a loose shell, marks on the liner, fading of the shell, evidence of crushed foam in the liner, worn straps, and missing pads or other parts, are all reasons to replace a helmet. Regular replacement may minimize any reduced effectiveness that could result from degradation of materials over time, and allow you to take advantage of recent advances in helmet protection.

CONCUSSION REHABILITATION Headaches? Dizziness? Blurred vision?

Eye strain? Fatigue? Fogginess? Nausea?

Just feel out of it and one step behind yourself?

WE CAN HELp! Our Specialized Vestibular-Ocular and Manual Physical Therapists are Certified Concussion Physical Therapists.

We will get you recalibrated and back to Montana We are the first in RightEye to bring you The are Platform Neurovision Softw t eye to assess and trea ibular tracking and vest d in problems sustaine concussions!

“YOU”!

406-542-0808 • peakptmt.com 1940 Harve St. • Missoula MT, 59801 September/October 2017 ~ living well

17

Accepting New Clients • • • • • •

Community-based Rehab & Support Adult Group Homes Children’s Mental Health Services Recovery Mall Case Management Same Day or Next Day Appointments

406 541 HOPE

1120 Cedar Street - Missoula Montana www.WellnessMT.com

406 721 2537

www.WellnessMT.com Missoula Montana

• • • • • • • •

18

Treatment for Depression TMS (Transcranial Magnetic Stimulation Treatment) Medication Management Migraine Treatment Weight Loss Draw Site for Lab Corp Genetic Testing Nutraceuticals

living well ~ September/October 2017

GET FIT

step by step

Mallwalkers Fitness Program Be a part of Missoula’s longest running free health program. Join us in Southgate Mall’s Community Room at 9 a.m. Mondays, Wednesdays and Fridays.

COME SEE WHAT’S

in store

SHOPSOUTHGATE.COM

September/October 2017 ~ living well

19

HEALTH RESOURCE GUIDE

The Health Resource Guide is a joint project between the Missoulian and the Missoula Chamber of Commerce.

This comprehensive publication describes how and where to access appropriate health care information, prevention and treatments in the following categories: Exercise & General Health • Hospitals & Health Facilities • Rehabilitation Services • General Information Domestic Violence Resources • Mental Health • Common Definitions • Preventive Care Emergency Services • Children’s Services • Pregnancy • Seniors • Veterans Nutrition • Dental Disability Services • Native American Services • Cultural Diversity in our Community Disease Specific Resources • Complementary Care End of Life • Alcohol/Drug Abuse & Addiction Health Insurance • Other Financial Options • Educational Resources • Hearing Environmental Safety • Chiropractors

Watch for the Health Resource Guide Sunday, October 22

406-523-5223

or advertising@missoulian.com

20

living well ~ September/October 2017