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Concussions - More Than Just a Headache

Everyone knows someone who has bumped their head or experienced a more serious impact at one time or another.

Parents of kids in sports have all had to learn the signs and symptoms of concussions and sign the waiver for their child to play. While we can all agree that hitting our heads is not something to take lightly, many people don’t realize that whiplash is a common and overlooked cause of concussions. During whiplash, the brain (an incredibly soft organ), sloshes back and forth within the hard protective skull and may hit more than two inner surfaces, thus bruising the brain and causing headaches, which is a hallmark of a concussion.

A list of symptoms besides a headache is called Post-Concussion Syndrome but unfortunately, Washington State Department of L&I does not recognize the list of symptoms as a legitimate condition due to concussion or whiplash-induced concussion because MRIs and CT-Scans often do not show the subtle damage to white matter and so the results do not validate the symptoms of the trauma, causing the injured person to experience frustration and depression because their symptoms are not recognized or treated as they would be with a traumatic head injury (TBI).

After a whiplash incident where a concussion is not considered, the injured person is only treated for neck injury and is expected to return to work, school, or home management without restrictions or consideration for the symptoms that continue to impact sleep, vision (light sensitivity), concentration, mood, and energy.

People with a TBI benefit from a multidisciplinary physical rehab team that includes, occupational, physical, and speech therapies to help the injured person with whole body, cognitive rehabilitation and emotional recovery.

BACKGROUND: The prevalence of Post-Concussion syndrome (PCS) in the first weeks after mild traumatic brain injury varies from 40% to 80%. However, as many as 50% of patients report symptoms for up to 3 months and 10% to 15% for more than a year. (https://www.ncbi.nlm.nih.gov/pubmed/20938266)

I have provided two lists for consideration when a concussion is suspected, and I highly urge that no symptom be disregarded out of fear of over-reaction. The longer a brain injury goes untreated, the more severe the consequences and the permanence of the disability.

Common Signs & Symptoms of a Concussion:

  • Headache: can be acute or persistent

  • Whole body: blackout, fatigue, or poor balance

  • Cognitive: amnesia, disorientation, or mental confusion

  • Sleep: sleep disturbances or sleepiness

  • Gastrointestinal: nausea or vomiting

  • Fatigue

Also common

  • irritability

  • mild depression

  • ringing in the ears

  • sensitivity to light

(from The Mayo Clinic)

Dangerous Signs & Symptoms of a Concussion – Should be taken seriously:

  • One pupil larger than the other.

  • Drowsiness, or inability to wake up

  • Headache that gets worse and does not go away

  • Slurred Speech

  • Weakness, Numbness, or Decreased Coordination

  • Repeated vomiting or nausea

  • Convulsions or seizures (shaking or twitching)

  • Unusual Behavior, restlessness or agitation

  • Increased confusion or disorientation to place and time

  • Loss of consciousness (passed out or knocked out) – even briefly

  • Intense sensitivity to light and/or sound

(from CDC.gov)

The commonly missed symptom of “Dizziness” on these lists IS COMMON. Dizziness is a sensation of spinning and often the reason why people get nauseous and vomit. Dizziness is known medically as vertigo, and is a symptom of a VESTIBULAR Disorder which is in the inner ear. I will address this further in this blog series next month. In this introduction, I will start with whiplash as the main contributor to many concussion cases.

When a person has sustained an injury from whiplash combined with concussion, they will often be referred to “physical therapy,” while others prefer to see a chiropractor. The allied health professions include Physical Therapy (PT), Occupational Therapy (OT), and Speech and Language Pathology (SLP) also known as Speech Therapy.

The patient will be assessed, treated, and educated by all three disciplines on supportive posture and body mechanics to protect the neck and given a set of home exercises to help the neck maintain full range of motion and strengthen the weakened muscles that support the weight of the head. Each discipline focuses on different but related aspects of the injury and how it affects mobility and function.

The focus of each discipline is going to be different for the purpose of mitigating pain and increasing function. OT is going to address how a concussion affects the ability to perform self-care and life roll tasks while experiencing symptoms of light and hearing sensitivities, headaches, dizziness, and impaired mental focus. OTs will address light sensitivity, fatigue, and mental clarity. The goal is to facilitate the return to work, school, or home life at pre-injury performance levels.

Alternative and complementary therapies such as Chiropractic, Acupuncture/Eastern Asian Medicine, and of course, Massage Therapy are all in the realm of “physical therapies” or rather, hands-on rehabilitation and are compatible when each practitioner sees themselves as a part of the healthcare team to accelerate the recovery of the injured person. Adjunct and complementary therapies may or may not be covered by your insurance plan but are well worth the investment for whole-person rehabilitation.

Acupuncture has been around for over 2000 years and is more than the use of fine point needles along a meridian. Acupuncturists are trained on other techniques such as Gua Sha (the original form of Instrument Assisted Soft Tissue Manipulation also known as "scraping"), cupping, functional nutrition, and physical agent modalities.

Deep tissue massage may be more effective in decreasing muscle spasms in some people, while in others, it will make the muscle resist the pressure and become more contracted and shortened vs the opposite state of relaxed muscle fibers which are long. There are several manual therapy techniques because everyone responds differently to touch. I recommend massage prior to spinal adjustments whenever possible.

The point of manual therapies or massage is to give the spine the room to relax and decompress naturally – especially the thinnest part of the vertebral column, the neck. When the muscles along and around the spine relax, then a skilled manual therapist or chiropractor can gently distract the compressed and misaligned vertebrae. It should feel like a relief and not forced into place. I highly caution against further cervical spine trauma by any practitioner. The neck has already experienced enough force. After whiplash and concussion, a gentler approach is what is needed as well as stability of the first two vertebrae that hold up the head.

The beauty of a team approach is that a person has every aspect of their injury and symptoms addressed so that the brain can recover more completely from a concussion, and quality of life has a greater potential for full restoration. The OT focus is on functional tasks of daily living and can include home safety assessments, fitness to drive, and adaptive equipment for work and home. PTs work with the injured person on walking, and SLP addresses higher cognitive functioning, swallowing and speech disorders resulting from the brain injury.

It takes more than just ONE approach to wellness after an injury or illness. The least expensive things can work better than the most elaborate devices. For example,

Voxx HPT (Human Potential Technology) socks are backed by science, are affordable, and can be purchased at my clinic or on my link: www.VoxxLife.com/IntegrativeBody. If you would like to experience the body's instant response to the Voxx HPT, you can make an appointment at Integrative Therapeutic Solutions in Gig Harbor or you can order directly online:

www.VoxxLife.com/IntegrativeBody - this link will connect you to me for online consults or recommendations.

I recommend Pulsed Electro-Magnetic Field therapy (PEMF) to my patients because this modality offers an impressive list of health benefits including acceleration of healing. Although I currently do not offer this treatment, I refer patients to my preferred acupuncture center, Gig Harbor Acupuncture & Holistic Health for BEMER ® PEMF treatments, which provide excellent results for improving wellness and accelerates healing. PEMF treatments not only address pain and improved circulation, it accelerates cell regeneration and mental clarity. When adding this treatment to the hands-on therapies mentioned, patients are able to return to full function in less time.

If you are in pain, not getting relief or improving with your current plan of care, it’s time to try something outside of the box. At INTEGRATIVE THERAPEUTIC SOLUTIONS, most insurance plans are accepted so call to get more information on how to get started on your best recovery treatment plan.

Prioritizing your well-being is important because HEALTH AND WELLNESS IS LIFE!

5775 Soundview Drive, Suite A-103

Gig Harbor  WA  98335

Phone: 253-514-6842     Fax: 253-514-6863