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Leah Braithwaite didn't see the out-of-control skier barrelling down the hill toward her in February, 2011. But she certainly felt the impact after he skidded over the backs of her skis and sent her flying. She landed hard, and feared a major shoulder injury.

What she didn't realize until days later was that the biggest source of concern was not her shoulder, but her head. Although she had been wearing a helmet, and didn't develop a headache or other symptoms in the immediate aftermath, the blow to her head was forceful enough to cause a concussion.

At first, Braithwaite thought her fatigue and general feeling of being unwell was a virus. A few days after her fall, however, she vomited at work and was so dizzy she couldn't walk. Her doctor diagnosed a concussion and told her to rest. But her symptoms persisted. For the next four months, Braithwaite, a 52-year-old Ottawa mother of two, struggled to recover, and her family doctor had little concrete advice.

Finally, after doing her own research and reading about how the NHL's Sidney Crosby was recovering from concussion, Braithwaite learned it was important to stay in a dark room and avoid using her laptop or reading for prolonged periods. She also realized that she needed expert help.

She sought the advice of a specialist who knew how to treat people with long-lasting concussion symptoms and who helped Braithwaite manage her fatigue, dizziness and headaches, and accelerate her recovery.

Now a group of Canadian researchers has developed guidelines to assist family doctors and other health professionals treating patients with persistent concussion-related symptoms. There are ample resources on how to treat concussions in the immediate aftermath. But many health professionals don't have specific training when it comes to headaches, nausea, dizziness and other symptoms that can linger for months. It's hoped these new guidelines can close that gap, said Dr. Shawn Marshall, lead author and physician at the Ottawa Hospital Rehabilitation Centre.

"There is a significant minority of patients that have significant ongoing symptoms that need to be addressed," Marshall said.

For instance, while rest is typically prescribed, this may not be long-term advice for people with lingering symptoms. Treatment needs to focus on helping those patients establish and maintain physical activity, while helping their brains to continue recovering.

The guidelines, based on new research on treating persistent symptoms, are being published Tuesday for free at and Marshall said they are primarily directed at health-care providers, but patients can also use them.

"My doctor was well-meaning," Braithwaite said, adding that her physician "didn't have any other advice." She hopes the guidelines will arm health professionals with the knowledge to help others like her.

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