A concussion is defined as a physiologic disruption of brain function resulting from traumatic forces transmitted to the head. Forces transmitted to the head does not necessarily mean direct forces to the head. Any trauma could be the cause; including whiplash, a fall on the tailbone, or a force to another part of your body. Signs and symptoms of concussion include but are not limited to nausea, seeing stars, vomiting, memory loss, confusion, headache, feeling of pressure in the head, fatigue, feeling of being dazed, changes in speech, ringing in the ears, mood changes, irritability, sleep disturbances, trouble concentrating, cognitive changes, motor coordination changes, dizziness, in addition to sensitivity to light, loud noises and stimuli. An important thing to remember is that a loss of consciousness is not required to be diagnosed with a concussion.
For many, their concussion symptoms resolve within a couple weeks enabling them to safely return to work or sport. The body is that amazing☺ For some, around 10-15%, they still experience symptoms a year after injury. These ongoing symptoms can include headaches, sleep disturbance, dizziness, mood changes, balance problems, cognitive impairments, and fatigue. Many of the symptoms overlap with depression, anxiety and post-traumatic stress disorder.
Treatment options
Treatment of the concussion begins immediately following impact or noticing any of the above signs and/or symptoms by removing yourself, your athlete or your worker from either the field of play or the workplace. Being checked out by a physician can be beneficial to rule out fractures, brain bleeds or any other neurological red flags. Red flags to look for include loss of consciousness, fluid leaking from nose and/or ears, changes in pupil size or dilation, unresponsiveness, seizures or slurred speech in addition to symptoms that are worsening. Any of these red flags should be cause for concern and require immediate attention either with a call to 911 or a trip to the emergency room.
Removal from play or work if there is a suspected concussion is a must. The risk of a second impact if left in the game, activity or workplace can be detrimental and can lead to second impact syndrome.
Rest is key for concussion rehabilitation. This means from all activities that increase blood flow to the brain in addition avoid all activities that stimulate the brain. This includes all sport related activities, running, swimming, biking, walking fast, lifting weights, spin class, bar class, pilates and even yoga. Do I need to go on Vancouver!?? Rest also means cognitive rest, aka. no brain stimuli. No reading, no screen time, yes that means your phone, tablet, ipad, tv, and computer. A major part of rehabilitation involves staying within your symptom free zone as each time symptoms spike, this prolongs the inflammatory process in the body and can increase your healing time.
Ananta Wellness & Osteopathy and HeadCheck Health
Our clinicians at Ananta Wellness & Osteopathy have partnered with HeadCheck Health to bring standardized concussion testing to local athletes and help improve the level of concussion care they receive.
With HeadCheck’s technology, our clinicians can perform research supported concussion tests aimed to assess symptoms including balance, motor coordination, vision and neurocognitive function. The tests are conducted using an intuitive mobile app that leads to more reliable results and data driven decisions regarding your health and return to play.
Return to work or return to play timelines
How do you know when you’re ready to return to play? At minimum, a week of being symptom free, then you can start your gradual return to play timeline. This doesn’t mean you jump right back into full practice or a full workday. For return to activity, this means you try a 10 minute bike ride. If you are still symptom free in 24 hours, you move to a 15-20 min bike ride. After another 24 hours of being symptom free, you progress from there. A therapist at Ananta Wellness & Osteopathy can help guide you through the remainder of your concussion protocol guidelines.
How can osteopathic treatment help with your concussion rehabilitation?
Osteopathic manual therapy techniques can include spinal mobilization, visceral manipulation and treating the cranio-sacral unit including the brain and the spinal cord. An important component of the rehabilitation process is ensuring the traumatic imprint which led to the concussion is removed from the tissues in addition to ensuring circulation and fluid flow throughout the body all the while respecting your healing timelines.
If the concussion was the result of a direct blow to the cranium, this can result in somatic dysfunction to the cranial bones themselves, and over time, can result in compensatory mechanisms in the rest of the body, including the cervical, thoracic, lumbar spine, and the pelvic and sacral regions. This can lead to ongoing symptoms and pain. We posted an Instagram post at the end of summer about the dura, which can also be impacted by concussions, whiplash and falls on the tailbones, not to mention toxins.
New research is being completed that demonstrates there is actually a physiological change in the brain tissue that occurs during a concussion. These changes are noted to have metabolic qualities that alter blood flow and can lead to neuro toxic by-products being produced in addition to changes within the neurons. Glymphatics is a term you’ll start to hear about in the coming years, but it is currently understood to facilitate the clearance of cerebrospinal fluid (CSF), interstitial fluid and interstitial solutes from the brain. CSF clears the brain of toxins, cellular debris and proteins in addition to metabolic proteins and osteopathic treatment can help to ensure the CSF is free flowing.
I took a post graduate course in August, Endocranial Spasm 1 or traumatic spasms. I’ve been waiting six years to take this course! There are other levels of spasms but those will come later. We learnt that a traumatic spasm is a density in the brain tissue, it literally feels like a piece of driftwood, resulting from a direct blow, or an indirect shock to the body, or a blow to the head, or resulting from either stretching or compressive forces to the body. These are areas where there is no vitality or motility and they aren’t living like the rest of the body. Areas like these can lead to an increase in inflammation and a decrease in resilience and neuroplasticity. So why is it important to treat areas like this? Well, Chronic Traumatic Encephalopathy (CTE) is degeneration in the brain and has been shown in people with repetitive brain trauma, including athletes and military veterans. CTE is linked with inflammation, brain atrophy, decreased venous drainage, decreased atrial flow, decreased cerebrospinal fluid and decreased neuron conduction and is demonstrated by dementia like symptoms. Osteopathically, by removing these spasms we can restore circulation, blood flow, venous drainage, cerebrospinal fluid flow in addition to the brain and spinal cord biomechanics. The goal is to not only decrease the symptoms resulting from concussions or whiplash, but to work towards preventing further chronic deterioration. Going back for Endocranial Spasm II in December, stay tuned for an update in the New Year!
Get in touch if you have any questions!