Concussions are becoming increasingly common, especially among
school-age athletes. It has been estimated that there are up to 3.8
million sports-related concussions in the United States each year.
Concussions are problematic as, by definition, a concussive injury
involves some degree of trauma to the brain. A concussion injury
literally jolts the brain, causing this precious organ to bounce against
the bony walls of the skull. The violence of the blow directly
determines the degree and extent of brain cell damage. Importantly, any
person can experience a concussion from having sustained a blow to the
head. Falls are commonly implicated in a concussion history, especially
in those who run or walk for exercise and may trip over a crack in the
sidewalk or a hidden tree root on a trail, as well as in the elderly.
In 2013, the American Academy of Neurology (AAN) issued its latest
update on the Evaluation and Management of Concussion in Sports. The
update, representing a summary of evidence-based guidelines, referenced
several standardized symptom checklists including the Standardized
Assessment of Concussion and the Post-Concussion Symptom Scale/Graded
Symptom Checklist, both of which had moderate to high sensitivity and
specificity in identifying sports-related concussions when administered
soon after a suspected concussion. In 2013, the AAN also published
Concussion During Sports Activities, a summary of evidence-based
guidelines for patients and their families. The AAN documents note that
concussion symptoms include headaches, dizziness, double vision,
confusion, sensitivity to light or sound, and nausea and vomiting. Signs
of a concussion that others can observe include slurred speech, changes
in balance and coordination, a blank stare, and behavior and
personality changes.
Concussion resolution may be evaluated by use of standardized
checklists and return to age-matched normative values regarding
cognitive performance and physiological function, as well as
neurocognitive testing. An athlete who has sustained a concussion should
not return to play/practice until her or his physician has assessed
that the athlete is asymptomatic, the concussion has resolved, and the
athlete is off medication.
Once a patient's concussion has resolved, chiropractic care can
provide substantial assistance. A blow to the head necessarily involves
trauma to the neck vertebras (cervical spine) and regional muscles,
tendons, and ligaments. As well, an injury significant enough to cause a
concussion can also cause damage to the spinal nerves in the neck. Such
trauma can cause nerve irritation and interfere with the normal motion
of the cervical spine. Spinal dysfunction and nerve
irritation/interference can then cause a range of pain symptoms and
altered physiological function, not only in the neck and shoulder region
but also in other locations and other systems such as the
gastrointestinal, immune, and endocrine systems.
By beginning or continuing regular chiropractic care once concussion
symptoms have resolved, a post-concussion patient can obtain treatment
that will help ensure that her or his spinal column and nerve system are
functioning at peak capacity. In this way, regular chiropractic care
helps post-concussion patients achieve and maintain optimal levels of
health and well-being.
- Broglio SP, et al: National Athletic Trainers’ Association Position
Statement: Management of Sport Concussion. J Athletic Train
49(2):245-265, 2014
- American Academy of Neurology: Update: Evaluation and Management of
Concussion in Sports, 2013 — https://www.aan.com/Guidelines/Home/GetGuidelineContent/583
- American Academy of Neurology: Concussion During Sports Activities:
Summary of Evidence-based Guidelines to Patients and Their Families,
2013 — https://www.aan.com/Guidelines/Home/GetGuidelineContent/586
