Concussion and Chiropractic
It’s imperative that anyone suffering a concussion have regular assessment by a health practitioner in order to know when it’s safe to Return to Play. Chiropractic treatment is very effective for a concussion. I am often treating whiplash types of injuries which occur simultaneously with most concussions. Regardless, I always begin with a complete neurological assessment because treatment is always individual.
Let’s review what a concussion actually is.
A concussion is defined as a complex process that affects the brain, typically induced by trauma to the brain. It can be caused either by a direct blow to the head, or an indirect blow to the body, causing neurological impairments that may resolve spontaneously. Symptoms usually reflect a functional disturbance to the brain, and may include physical (e.g., headaches, nausea), cognitive (e.g., difficulty with concentration or memory), emotional (e.g., irritability, sadness), and ‘maintenance’ (e.g., sleep disturbances, changes in appetite or energy levels) symptoms. A concussion is considered a brain injury.
What happens to the brain during a Concussion?
The adult brain is a three pound organ that basically floats inside the skull. It is surrounded by cerebral spinal fluid, which acts as a shock absorber for minor impacts. When the brain moves rapidly inside the skull, a concussion has technically occurred. One common scenario that can lead to a concussion is a direct blow to the head or a whiplash effect to the body. The impact rapidly accelerates the head, causing the brain to strike the inner skull (i.e., the coup). When the head decelerates and stops its motion, the brain then hits the opposite side of the inner skull (i.e., the contrecoup). The second common scenario is a rotational concussion, in which the head rapidly rotates from one side to another causing shearing and straining of brain tissues. In either case, delicate neural pathways in the brain can become damaged, causing neurological disturbances.
Does age play a role in Concussion management?
There are distinct differences in age when it comes to managing sport related concussions. Recent research demonstrates that high school athletes not only take longer to recover after a concussion when compared to collegiate or professional athletes, but they also may experience greater severity of symptoms and more neurological disturbances as measured by neuropsychological and postural stability tests. It is also estimated that 53% of high school athletes have sustained a concussion before participation in high school sports, and 36% of collegiate athletes have a history of multiple concussions. Because the frontal lobes of the human brain continue to develop until age 25, it is vital to manage youth concussions very conservatively to ensure optimal neurological development and outcomes.
How do you determine when an athlete is OK to Return to Play?
This is so important!!! Various factors contribute to the decision of returning an athlete to play after sustaining a concussion. After a comprehensive interview, a full assessment of patient symptoms will take place. Because of the complex nature of concussions, a multi-factorial, multi-disciplinary approach must be taken to ensure the safety and well-being of the patient, and only after all these factors indicate that the athlete can safely participate in their sport will he or she be cleared for Returning to Play. Return to Play will also be a stepped approach making sure that the patient is symptom free at each level of activity before progressing to the next stage.
What are some long-term consequences of multiple concussions?
Long term effects of multiple concussions are currently being studied by researchers around the globe. Not only can multiple traumatic incidents contribute to the development of mild cognitive impairments (MCI’s), chronic traumatic encephalopathy (CTE), and other adverse outcomes, but a storied concussion history can also cause post-concussion syndrome (PCS). While we are still elucidating the causes of these long term effects, it is imperative that a person fully recover from one concussion before risking a subsequent one. Failing to do so adequately can lead to additional neurologic damage. Given this new understanding, managing concussions requires specialized, comprehensive approaches.
Concussion By the Numbers
- CDC estimates reveal that 1.6 million to 3.8 million concussions occur each year
- 5-10% of athletes will experience a concussion in any given sport season
- Fewer than 10% of sport related concussions involve a Loss of Consciousness (e.g., blacking out, seeing stars, etc.)
- Football is the most common sport with concussion risk for males (75% chance for concussion)
- Soccer is the most common sport with concussion risk for females (50% chance for concussion)
- 78% of concussions occur during games (as opposed to practices)
- Some studies suggest that females are twice as likely to sustain a concussion as males
- Headache (85%) and Dizziness (70-80%) are most commonly reported symptoms immediately following concussions for injured athletes
- Estimated 47% of athletes do not report feeling any symptoms after a concussive blow
- A professional football player will receive an estimated 900 to 1500 blows to the head during a season
- Impact speed of a professional boxers punch: 20mph
- Impact speed of a football player tackling a stationary player: 25mph
- Impact speed of a soccer ball being headed by a player: 70mph
Dr. Colin Leis, B.Sc., D.C.