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Post Concussion Syndrome

~~A Little Bit About Sports-Related Concussions

According to the most recent research, Crosby is not alone: (1, 2, 3)

3.8 million sports-related traumatic brain injuries (TBIs) occur annually.
• 173,285 occur among children and adolescents, from birth to 19 years.
• Children and teens are more likely to get a concussion and take longer to recover than adults.
• Typical sports-related concussions resolve rapidly, with complete symptom resolution in 10 days or less.
• Some atypical concussions leave an individual with prolonged symptoms.

Diagnosing a concussion can be a little tricky, however, which makes some experts question this data. Concussion symptoms depend on the person and the injury, and they may not be noticeable for hours or even days. Nonetheless, global authorities advise that these symptoms are relatively common: (4)

• Balance problems or dizziness
• Being bothered by light or noise
• Confusion
• Double or blurry vision
• Difficulty remembering or paying attention
• Feeling sluggish, hazy, foggy, or groggy
• Feeling irritable, more emotional, or “down”
• Headaches
• Nausea or vomiting
• Slowed reaction time
• Sleep problems
• Loss of consciousness

Concussion symptoms depend on the person and the injury so may not be noticeable for hours or days.

Anyone who has recently experienced one or more of these symptoms after hitting their head or falling should contact their medical doctor or chiropractor immediately.

The Problem

Unfortunately, concussion and concussion-related symptoms continue to confuse health care professionals. According to an article in the Journal of Chiropractic Medicine,
• “Despite high levels of publicity and advances in research regarding concussion, the care and management plans for concussion are transitional.” Meaning, they are not consistent and are not universally accepted by all doctors.
• Subsequently, “An evidence-based ‘criterion standard’ for concussion management has yet to be defined and accepted,” which basically gives doctors free range to conduct their concussion protocol in the manner in which they deem necessary.
• “Although the appropriate approach to management continues to be developed, a focus on concussion awareness and education has been emphasized as a way to protect athletes from mismanagement and prevention of catastrophic and long-term injury.” (5)

This is why it is critical for patients and parents of children who have suffered from concussions to be as involved as possible in the care and management protocol their doctor recommends. Provide input and feedback. Read articles like this one. Do your homework.

~~~~Chiropractors Can Help

One piece of the puzzle that you may want to consider is having your MD co-manage concussion care with a chiropractor.

First off, chiropractors with specific post-graduate coursework are very well suited to care for concussion patients. (5)
1.As a rule of thumb, Doctors of Chiropractic (DC’s) may evaluate, diagnose, and manage concussion patients. The pre-requisite management skills for a concussed athlete can be supported by additional education.
2.For example, DC’s who have sought post-graduate certification within sports health care (sometimes, but not always identified by a DACBSP or CCSP), have taken particular interest in the management of sports injuries including concussions.
3.Because the area of injury in the case of a concussion is at the skull and/or upper cervical spine, chiropractors who utilize precise X-ray analysis of the occiput and cervical vertebrae, and work to specifically reduce misalignments in this area, should also be incorporated into the health care management of any concussion patient.

“It appears that some neurological deficits persist beyond the current return-to-play standards and that discrepancy exists between common practices of returning athletes to competition and new standards of published research.” (5)

Essentially, what this is saying is that most medical interventions generally have a limiting effect on concussion patients, which suggests that alternative methods should be considered.

The Research

A recent review of chiropractic and concussion literature offers some promising hope for people, especially those that suffer from the residual effects of concussions as mentioned above. It is important to note that, according to the scientific literature, no articles report adverse outcomes of chiropractic management of an athlete with concussion. (6) Additionally, several case studies have shown that gentle, specific chiropractic adjustments can offer a great deal of help for athletes suffering from concussion symptoms and residual effects:
• Dr. Elster wrote up a report in 2003 of a 23-year-old profession ice skater that experienced unbelievable results after chiropractic care. After sustaining a concussion when she hit her head against the ice, the skater experienced unrelenting headaches for over 12 years.  Using pain medications to help cope with the pain, she gave up hope that her life could ever be pain free. Thankfully, she visited a chiropractor and after 3 months, all of her symptoms were gone. (7)
• In 2011, a report was published of a 16-year-old male athlete with post-concussion neck pain and daily headaches. After just two adjustments, the young man experienced “significant relief,” and complete resolution of his symptoms just 5 visits later. To his delight, he was back on the field afterwards and returned to play full games … symptom free! (8)
• Beyond headaches, these types of cases can be found with post-concussion patients with positional vertigo as well. (9)
• Dr. Sweat reported that a 76-year-old woman with post-concussion seizures that lasted 10 years presented into his office with visual disturbances, fluctuating blood pressure, decreased hearing, and abnormal walking patterns. Unfortunately, her medical doctors couldn’t help and, after suffering for many years, finally decided to visit an upper cervical Atlas Orthogonal chiropractor. These DC’s are some of many who specialize in correcting vertebral misalignments (subluxations) of the top bone in the spine (the “atlas”). (This is just one of the many approaches chiropractors can take to manage concussion patients.) According to the study, “Immediately after the first adjustment the patient experienced a more normal gait and resolution of her altered walking pattern. The patient was managed for a duration of two months and reported complete recovery from seizures, altered walking pattern, blood pressure stability and improved hearing.” (10)
• The next year, Dr. Sweat reported a similar story, but with a 75-year old woman who had a history of concussions and experienced a wide variety of symptoms including: fatigue, gait ataxia (staggered walking), strabismus (crossed-eye syndrome), and migraines. After not too long, “The patient’s symptoms were quickly and painlessly reduced and/or resolved.” (11)

No one knows for certain why chiropractic adjustments work so well with concussion patients, but it’s encouraging to know that help (and hope) isn’t too far away.

I explain it to patients this way:

Clearly, there are cervical spine subluxation which can produce many of the same symptoms as can the rattling of the brain incurred during a concussion. If there’s enough physical trauma to agitate the brain, there’s definitely enough to subluxate the spine. Don’t assume that every symptom you have post-trauma is a result of the concussion … In fact, a good number could be as a result of the subluxation of the neck.

Not every symptom is a result of the concussion. A good number result from neck subluxation

If you or a loved-one have suffered a concussion or think that you many have based off of the symptoms above, contact our office immediately. The sooner they receive Chiropractic Care the better and faster the results.

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