Concussions: what every parent, coach, and healthcare provider needs to know- by Dr. Nathan Servey,
You’ve probably heard a lot of talk recently about concussions… and for good reason. Our understanding of concussions has changed rapidly over the past decade and new research is coming out all the time which is why it’s important to clear-up any confusion or misconceptions. For example, it was once thought that concussions only occurred in athletes (not true), or that you had to lose consciousness to have a concussion (nope… but if you do you’ve probably had one), or even that there’s nothing you can do if you’ve had a concussion (definitely false).
In this article I’d like to walk you through the mechanics of a concussion, how to identify if you or a loved one has had a concussion, concussion treatment options, and how to prevent future concussions. I’ll also shared the story of a friend who had a concussion and why proper diagnosis and immediate management is so important.
What is a Concussion?
Concussions are traditionally described as a “brain bruise” or injury which occurs during a sudden impact when the brain collides with the inside of the skull, damaging brain tissue. These sudden impacts are often associated with sports, motor vehicle accidents, and falls. While concussions are a concern among athletes, a lot is unknown about the prevalence of concussions in the general population due to low diagnosis and misdiagnosis.
In general, older individuals are at an increased risk of concussion because brain tissue “shrinks” as we age creating more room for movement of the brain within the skull.
Older individuals who fall or hit their head should always be evaluated for concussion. New research has questioned whether the traditional “brain bruise” model is entirely accurate suggesting that there is also a significant whiplash-like neck and spinal cord traction injury. After all, any sudden impact forceful enough to send the brain “sloshing around” in the skull will certainly result in neck injury as well. Furthermore, the signs and symptoms of a concussion and those of whiplash are almost identical.
How to Identify Signs and Symptoms of a concussion
If you think you, your child, a spouse, family member, etc. may have had a concussion, you should get them evaluated by a neurologist and then a chiropractor as soon as possible. They may order an MRI and/or x-ray to look for brain bleeding and neck injury. Obviously in emergency situations, call 911.
According to the Centers for Disease Control and Prevention (CDC) the signs and symptoms of a concussion include slowed thinking, personality changes, exhaustion, mood swings, and trouble sleeping. Other symptoms may include headaches, neck pain, change in vision, memory loss, difficulty concentrating, brain fog, depression, anxiety, and more, depending on the area of the brain affected.
Signs of a concussion vary widely between individuals both in type as well as severity with some individuals exhibiting only minor or vague symptoms.
Failure to properly diagnosis and treat a concussion can result in permanent brain damage, coma, and death.
Concussion treatment has changed a lot over the past few years and it’s important to stay up-to-date with the latest treatment options. There aren’t any routine drugs, injections, or surgery options for concussion sufferers and so most medical advice for concussions today is limited to the “rest and relax” prescription. This, in my opinion, is due to the ignorance of many practitioners to the research behind supplemental nutrition, diet, exercise, chiropractic, laser, and other modalities which have been shown to be effective for concussion management and should be considered in EVERY concussion case.
Furthermore, current treatment for concussions virtually ignore the neck which can delay recovery and result in permanent damage.
A study conducted by the University of Buffalo found that many patients who were previously diagnosed with a concussion were actually likely suffering from a neck injury. This is why all concussion sufferers should consult a chiropractor to determine whether chiropractic care is right for them. Proper training, education, and coordination by medical professionals can improve patient outcomes and lower the risk of ongoing complications.Perhaps the biggest news out of concussion management has revolved around the brain-gut dysfunction after a concussion.
Within as little as three hours of someone having a concussion, there is evidence of leaky-gut syndrome.
This is due to the close relationship between the brain and gut via the Vagus nerve. Left untreated, the gut will continue to be inflamed and unbakanced and slow (or even prevent) brain and overall recovery. A diet and nutritional program aimed at healing the gut should be incorporated into every concussion recovery.
Concussion prevention depends largely on a person’s daily activities. Athletes should ensure they are correctly wearing and properly maintaining equipment including helmets, face-masks, and shoulder pads. Limit or avoid contact with your head/neck and sports equipment (volleyballs, soccer balls, etc.) and other players. Take care to avoid contact with the neck and head of other players and educate players and staff on concussion signs and symptoms and correct protocols.
Everyone can take precautions against concussions by wearing a helmet when on a bike, snowmobile, motorcycle, and ATV and by taking steps to avoid falls, especially in the elderly.
Furthermore, research has shown that strengthening the muscles in the neck can decrease the incidence of concussion and neck injury should a sudden impact occur.
A Concussion Case-study
I was recently confronted with how dangerous concussions can be and why aggressive treatment is so important when a close friend of mine injured his head when he rolled his four-wheeler and hit his head. He was a little sore but didn’t think much of it. Two weeks later he slipped on the ice and hit his head again. He went to the ER and had an MRI which found no evidence of brain bleeding. They sent him home with instructions to “rest and relax”, however he had travel plans for work for the next two weeks. He figured he’d rest a little after his trip. He came back from his trip with a constant headache and shoulder and neck pain.
Over the next week he continued to decline. He lost the ability to walk or even stand by himself. He lost most motor- control on the left side of his body. His speech became slurred and slow.
He went to the ER again, concerned about a possible stroke and they ordered another MRI and a CT-scan. Again, no evidence of an aneurysm, stroke, or other bleeding. They were at a loss as to what was going on. They referred him to a neurologist who prescribed pain killers and muscle relaxers and suggested he go home and “rest and relax”.
By this time, he had called me for my opinion and I told him it was likely something referred to as 6-week post-concussion dementia, a condition that can result in cases of untreated or severe concussions.
In his case I recommended chiropractic care, a strict elimination diet, and a tailored nutritional program, balance/core/eye exercises IN ADDITION to rest and relaxation. He was also seeing a massage therapist, acupuncturist, and a physical therapist. Within one week he was 50% better. After a month, he was almost back to normal.
His case was a wake-up call to me about the inconsistency of concussion knowledge and care between different providers. If you or someone you know has had a concussion and hasn’t had their neck and spine evaluated by a chiropractor, they should do so. If you’re in the Victoria area you can do so with me by calling 952-443-9000. For those interested in learning more about nutrition and concussion, you can read more here.