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Traumatic Brain Injury

Traumatic brain injury (TBI) is damage to the brain following a sudden trauma usually caused by either a blunt impact or a penetration injury. Symptoms of TBI can vary greatly depending upon the area of the brain damaged and the extent of the injury.

Recovery following TBI can be a long and sometimes frustrating process for both the individual affected and their loved ones. Our specialist neurological physiotherapists are experts at creating tailor made treatment programmes to help you to reach your maximum physical potential as quickly as possible.

What is TBI?

A traumatic brain injury is sudden damage to the brain caused initially by an external force however, complications and further injury can occur following the initial trauma due to lack of oxygen, swelling in the brain and a subsequent rise in pressure within the skull.

Hydrotherapy has a number of benefits for patients who have suffered a TBI.Above: Hydrotherapy has a number of benefits for patients who have suffered a TBI.

This chain of events is often thought of as three separate injuries:
  • First injury:? the initial injury in the seconds following the trauma. The damage can be described as closed, open or crush injuries.

  • Second Injury: occurs as the brain is starved of oxygen which increases damage to the brain further.

  • Third Injury: occurs over a period of days or weeks and is the result of possible swelling, bleeding or bruising of the brain tissue.
The effects of a TBI are wide ranging dependent upon the area of the brain damaged and the severity of the injury.

The effects of a brain injury can include physical problems, emotional and behavioural changes, cognitive changes and hormonal imbalances.

Our specialist physiotherapists can aid you to reach your physical potential in a holistic manner taking into account all effects of your head injury.

What causes TBI?

The main cause of traumatic brain injury is being involved in a road traffic accident but other common causes include sporting injuries, damage following a violent attack and injury following a fall.

Figures show that approximately 80% of incidences of TBI occur in males.

How is TBI diagnosed?

Diagnosis of a TBI is usually made by a doctor who will use information about recent events alongside a physical examination to ascertain how severe the injury may be.

Physical examination will include examination of the skull, a neurological examination and then a CT scan may be carried out to provide the medical team with a detailed picture of the brain enabling them to identify any areas of damage.

Patients can regain balance, strength and confidence in the pool.Above: Patients can regain balance, strength and confidence in the pool.

If the TBI is fairly severe it is common practice for the Glasgow Coma Scale (GCS) to be used as a way of monitoring a person?s level of consciousness by assessing their ability to speak, move and open their eyes to give them a score out of a possible 15. The more severe the injury, the lower the score will be. For patients who have decreased levels of consciousness or are in a coma, the GCS is used regularly in hospital to monitor any decline or improvement in their condition.

What problems caused by TBI can physiotherapy help with?

Physiotherapy will benefit a person with a head injury. It is known that in order to make the best possible recovery, physiotherapy should be started as soon as you are discharged from hospital and can continue until you reach your own personal maximum physical potential.

It is common practice for those with head injuries to have regular physiotherapy whilst staying in hospital but it is extremely important to continue therapy after discharge as the brain can continue to repair itself for a number of years after the injury.

Physiotherapy can help with the following problems:
  • Reduced strength
  • Reduced balance
  • Poor posture
  • Walking difficulties
  • Skin problems
  • Decreased mobility
  • Muscle spasm and stiffness

How does physiotherapy help TBI?

Physiotherapy is able to assist you in regaining as much movement and function as possible by making your own long and short term goals the focal point of your rehabilitation.

Physiotherapy can help to:
  • Improve balance and walking
  • Improve ability to move in bed, sit and stand
  • Reduce muscle spasm
  • Increase strength
  • Increase function of affected limbs
  • Decrease pain and stiffness
  • Retrain normal movement patterns
  • Decrease risk of falls
Our physiotherapists understand that following a TBI you may find previously simple tasks are a struggle for you and are there to advise you and your family on the use of walking aids, splints, supports and home equipment to make things easier.

What would physiotherapy treatment for TBI involve?

Treatment for TBI will always begin with a full assessment with one of our specialist neurological physiotherapists in order to examine your movement, tone and balance so that we can develop a rehabilitation programme specific to your personal physical and emotional needs.

A treatment programme is generally designed to take you through a structured, progressive rehabilitation scheme to increase your mobility and muscle control through use of functional exercises. In order to maximise your rehabilitation, our physiotherapists may also teach you and your family or carers exercises to continue at home between sessions.

A rehabilitation programme may involve:
  • Functional activities to encourage normal movement patterns and increase independence
  • Stretching and strengthening exercises
  • Balance re-education
  • Hydrotherapy
  • Positioning therapy to normalise muscle tone
  • Training sessions for family or carers to teach positioning and handling techniques to ensure your comfort at home
  • Provision of equipment
  • Provision of legal reports as required
If you would prefer to be treated by our specialist physiotherapists in the comfort of your own home this can also be arranged.

How do I arrange a physiotherapy assessment following TBI?

If you would like to arrange an assessment with one of our neurological physiotherapists, please email us at or call the team on 0151 558 0077.


A traumatic brain injury is damage to the brain caused by a trauma to the head. Injury can range from mild to severe and the resulting symptoms can vary greatly dependent upon the severity and the area of the brain damaged.

A TBI can be a life changing event for you and your loved ones and recovery can be a long process. Our expert physiotherapists are able to help you through this by creating a personalised rehabilitation programme to help you reach your potential and regain your independence.

If you would like to make the first step and arrange an assessment with a specialist, please email on call our team on 0151 558 0077.

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