CONCUSSIONS AND CHIROPRACTIC

For the last few years, the healthcare community has begun formulating better assessments and care protocols for patients who have suffered mild traumatic brain injuries (MBTI) or more commonly known as concussions. This has been brought to the public light because of the movie “Concussion” which brings awareness to the struggles of post-concussion symptoms that have led to increase violence, depression, anxiety and even suicide in NFL players. This has also led to the awareness of being more cautious with young athletes who may have a higher risk for head injury because of a higher head to body weight ratio then adults. Children also have been shown to take longer to recover from concussions.

SO WHAT IS A CONCUSSION?

As stated above, “concussion” is the more common term for mild traumatic brain injury, a longer term but explains the injury much better. These injuries have mostly been talked about with involvement in sports (mostly football) but physical sports have been estimated to account for only around 25% of all concussions. Concussions more commonly occur in falls and motor vehicle accidents. Our brains don’t completely cover the whole space inside of our skulls for a couple of important reasons. One, our brains pump somewhat like our hearts do to push cerebrospinal fluid in and out of it so there needs to be space for it to expand slightly. Also, a little space gives the brain extra protection for when you hit your head so it doesn’t take the full force of the hit. In a concussion however, this extra space causes your brain to move from one side of your skull and then slam into the other side of your skull with a quick whiplash motion of your neck. This is why you do not need to necessarily be hit directly in the head to get a concussion.

WHAT IS THE USUAL PROTOCOL FOR CARE OF CONCUSSIONS?

Most patients who suffer concussions and head to the ER are first examined to see if they had a concussion using assessments to test concentration, focus and present time awareness. There are also physical examinations performed. MRI or CTs of the brain are most of the time indicated to make sure there is no bleeding or more severe injuries sustained to the brain. MBTIs don’t usually show up on MRIs or CTs so if the films are negative for more serious injuries the patient may be given medication for headaches and/or dizziness and then told to rest and avoid bright lights. They may be taken out of school or work for a few days and discontinue play from sport until dizziness and headaches have subsided.  It’s important to note that while we as a society are getting better at catching concussions, some still go undiagnosed.

SO WHAT CAN CHIROPRACTIC DO FOR CONCUSSIONS?

First off, chiropractors can be and are primary care providers for many patients around the country and are qualified to diagnose and manage concussions in patients. Management would primarily be deciding how long a patient should wait before returning to a sport and/or other restrictions in daily life until the patient is healed, and also if the case warrants further testing such as a CT, MRI, etc.

After determining that there is no serious complication that warrants immediate intervention, chiropractors can do their usual exams to determine if the spine needs to be adjusted as concurrent care for this patient. Because our heads are connected to our cervical spines, there is a great chance that if your head was hit you have sustained some spinal damages in the joints and ligaments that can become chronic issues if not dealt with appropriately. The chiropractor will adjust the specific offending joints and then give the body time for the ligaments to heal properly and get that athlete back on the field or for the weekend warrior to get back to working 8 hour days without blinding headaches in the office cubicle.

Chiropractic is a conservative option for the management of concussions and getting back to feeling and functioning like normal. If you or a loved one think that you may have suffered a concussion, get in to get checked out as soon as possible to reduce the risk of further injury and complications.

References

• Johnson, C. D., Green, B. N., Nelson, R. C., Moreau, B., & Nabhan, D. (2013, December). Chiropractic and concussion in sport: A narrative review of the literature. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24396325
• Shane, E. R., Pierce, K. M., Gonzalez, J. K., & Campbell, N. J. (2013, December). Sports chiropractic management of concussions using the Sport Concussion Assessment Tool 2 symptom scoring, serial examinations, and graded return to play protocol: A retrospective case series. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24396327
• Kazemi, M., Bogumil, M. E., & Vora, K. (2017, December). Concussion knowledge among Sport Chiropractic Fellows from the Royal College of Chiropractic Sports Sciences (Canada). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799842/