Concussions- Can More be Done?

A concussion is defined as a type of traumatic brain injury (TBI) that may be caused by a bump, blow, or jolt to the head or by a hit to the body that leads to the head and brain move rapidly back and forth or side to side.


Manual physicians, such as chiropractors and physical therapists address the whiplash component quite easily. We understand and have modalities that help treat the ligament, fascia, disc, and muscle injuries from a physiological and mechanical approach. What then can be done for the brain?


This past weekend I spent 8 hours in a course reviewing how to assess and treat some of the symptoms that occur from the neuronal damage of a concussion. The most affected area of the brain by the force of a concussion is the midbrain, which is the upper most part of the brainstem. This area is affected if there is a lot of damage to the capillary flow following the events of a concussion. The force from a concussion can also cause disruption in neuronal connections, which can lead to delayed responses by the neurons involved. Common symptoms that present are dizziness, nausea, change in personality, irritability, delayed response, and headaches. The patient may also present with abnormal tone of the neck musculature and facial muscles or altered sensation to the face and neck. On field assessments and protocols for return to play are present and commonly used by athletic trainers and physicians, but what happens after the athlete is pulled from play? What should treatment look like?


I use the current recommendations of a graduated return to play based on a slow reintroduction to both cognitive and physical activity. This protocol typically places the athlete on a 7-10 day hold (although longer in some cases) from full athletic participation before returning to the activity. Treatment involves chiropractic adjustments when warranted, soft tissue rehabilitation, and a monitoring of symptom. After the training this weekend and the continual training I will be taking, it will also involve a neurological examination of both eye movements and motor control that will further help me evaluate whether the athlete should return to play. Through these techniques, I will also be more able to help the athlete’s brain heal itself, thus returning the brain to a more stable state and preventing any other long-lasting effects that may have otherwise developed.


As I have stated many times before and in our clinic’s mission statement, I not only want to be able to educate those that entrust me with their care, but also take continual education courses that will bring better care and a different approach for my patients, both current and future. The brain and body are amazing self-healing, dynamic, and ever changing anatomical wonders. Let me help you release their potential. Please, if you know anyone with long standing headaches, migraines, personality changes, or other symptoms that persisted post-concussiono or know someone that has recently sustained a concussion, please send them our way. We would love for them to experience our different approach.


Hope your day is a good one,

Cindy VanSickler, DC, CCSP, Cert. MDT

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