Sports-related concussion has gained widespread interest and media attention in recent years due to the potential dangers and long-term consequences. There remains a great deal of uncertainty surrounding these injuries, but it is important to take them seriously and comply with the recommendations from your doctor. Because concussion often involves direct force applied to the head and/or neck, it is a condition that chiropractors commonly see. Chiropractors can be instrumental to initial detection and diagnosis of concussion, leading patients to take the proper cautionary steps and get treatment they need.
What is a concussion?
Concussion is defined as: a brain injury leading to a complex pathophysiological process affecting the brain, induced by biomechanical forces. Concussion is caused by a direct blow to the head or to another body region causing the brain to slide back and forth forcefully against the inner walls of your skull due to sudden acceleration or deceleration. This typically results in the rapid onset of short-term impairment of neurological function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours.
During the acceleration or deceleration of the brain there is a stretching and shearing of neurons. The brief loss of consciousness that is occasionally seen after impact has been attributed to these shear forces causing a transient neuronal disruption at the level of the brainstem. The most current body of scientific evidence notes that, importantly, loss of consciousness is not required for a concussion to have occurred.
Although concussion is primarily a head injury, the initial concern following an extreme acceleration to the head is a cervical spine injury, hence why chiropractors are often the first medical providers diagnosing and treating patients post-concussive injury. Chiropractors are licensed to diagnose and treat patients as "portal of entry" health providers taking on a major role in evaluating, diagnosing, and treating concussions, particularly ones that affect the spine and related extremities. Chiropractors can help manage neuro-musculoskeletal conditions that patients experience after head injury such as headache, vertigo, neck pain, and back pain.
How to Identify a Concussion.
Concussion can present in many ways. While they do result in neuropathological changes, symptoms are usually indicative of a disturbance in function rather than physical, structural injury. This can make concussions difficult to detect as many symptoms are subjective such as dizziness and nausea, or difficult to measure such as moodiness, irritability, poor concentration, and photophobia. Concussions alter brain function, most commonly affecting memory and orientation.
In addition, neurological, physical, physiological, behavioral, and cognitive functions are effected differently, contributing to the variation in symptoms and the timeline in which the symptoms appear. Sometimes a person may experience concussion symptoms immediately after impact, but sometimes symptoms have delayed onset. Some may have a brief period of symptoms immediately after impact and then a disappearance, only to have the symptoms return several hours or even a few days later. Early detection and documentation, as well as sustained monitoring are important in successful concussion management.
How Might Concussions Occur?
Concussions are very common, with over 3 million cases per year reported in the USA. Common causes of concussion include:
Falling
Playing impact sports like football, hockey, and soccer
Motor vehicle collisions
There is some evidence to suggest that if the impact force is anticipated, the neck muscles can be activated which moderates the concussive force, resulting in no injury or more mild injury. For example, being hit on the football field carries a higher risk than heading a soccer ball, as most headers in soccer are intentional and anticipated.
How to treat a concussion.
Similar to treatment for other injuries, concussion recovery includes physical rest, and because it is a brain injury, concussions require mental rest as well. In the event of a head injury, always consult your doctor to determine the best course of recovery for you. Concussion recovery often includes what is called “relative rest” which simply means avoiding anything that requires deep thought or intense concentration as well as strenuous physical activity like sports and exercise, but does not require complete bed-rest. After a period of relative rest concussion patients can usually start to resume regular activities.
Chiropractic might be part of your treatment, and your doctor might also recommend acupuncture to treat some of the symptoms of concussion like irritability, insomnia, anxiety, headaches and light sensitivity. Acupuncture can help balance the autonomic nervous system and tip the scales towards less sympathetic activity and more parasympathetic activity, helping to alleviate these symptoms.
Because concussions differ based on person, cause, and symptom array, it’s important to consult your doctor for a treatment plan specific to you.