on Oct 17 in Health News posted balance, baseball, brain, children, concentration, Concussion, cranialsacral, dizziness, football, headache, injury, memory, soccer, sports, traumatic, youth by admin
My patients and friends know that I am obsessed with the sport of car racing, particularly Nascar racing and my favorite driver, Jimmie Johnson. After all, it was my husband’s racing career that indirectly led me to practice chiropractic. Several months ago, Synergy Integrative Health began focusing a treatment protocol on concussion syndrome, a condition that we are seeing an unusual increase in our practice. I have taken classes on treatment of, written a paper on and experienced one myself. My son even suffered from one after falling down the stairs! What concerns us as practitioners and parents is the hasty dismissal of the lingering but subtle effects of a concussion.
Thursday afternoon I listened to a reluctant Dale Earnhardt Jr., well known as Nascar’s favorite racer, admit to hiding the symptoms for six weeks after suffering a hard crash during an Aug. 29 test at Kansas. He admitted that for the sake of competing for a title, he pushed forward even though he knew something wasn’t right, even though side effects from the impact potentially put him and others at risk. Earnhardt finally did concede when he experienced another sheer concussion in last Sunday’s race at Talladega, which is commendable. “You know your body and you know when something is not quite right. And I knew as soon as it happened that I had re-injured myself, for lack of a better way to describe it. It was not even half of the impact that I had at Kansas. But it was enough to cause me some concern,” Earnhardt said. “So I went a couple of days, wondering how my body would react, sort of waiting for it to process what was happening. By Wednesday, I was still having some headaches.”Earnhardt said he plans to take time away from the track now “to let my brain rest”
But how many others have put themselves and others at risk in the past? NASCAR says there have been only nine concussions in the past five years, but that’s only what has been reported. The number seems far too low. The NFL conservative figures are around 180 a year; MLB is highest at 320 a year.
What is a concussion?
A concussion is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary, but can include problems with headache, concentration, memory, judgment, balance and coordination.
Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. This result is a sheering injury which can cause axonal (neural) and blood vessel damage. These injuries can cause a loss of consciousness and are the most damaging, but most concussions do not. Because of this, some people have concussions and don’t realize it.
Concussions are common, particularly if you play a contact sport, such as football and even cheer-leading. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Luckily, most concussive traumatic brain injuries are mild, and people usually recover fully.
Grade 1 concussion is the most common yet the most difficult type to recognize. The person is not rendered unconscious and suffers only momentary confusion. All athletes with Grade 1 concussion should be removed from a game and re-evaluated before returning. Return is mandated by rest and the elimination of all symptoms for 20 minutes. If a second Grade 1 concussion happens in the same day the athlete must be pulled from the entire game.
With a Grade 2 concussion the person is not unconscious but exhibits confusion with post- concussion amnesia. An athlete should be removed for the remainder of the game, rest and be monitored for 24 hours and seek a neurological evaluation before returning to the game. Return to play may be as early as one week if the athlete is asymptomatic at rest and exertion. If a headache or other symptoms worsen or last longer than one week return, should be contingent upon a CT or MRI and be deferred at least one month without any symptoms.
It is very easy to recognize Grade 3 concussion. The individual is unconscious for any period of time. The athlete may be lucid after he or she regains consciousness and over the next 20-30 minutes suddenly loses consciousness again. Grade 3 concussions are the most likely to be associated with intracranial hemorrhage which can be fatal. This treatment requires transport to the nearest hospital for neurological evaluation, CT or MRI scans. This period of time to return is at least one month free of symptoms.
Second Impact Syndrome is a second head injury occurring before the symptoms of the first have cleared. This has the potential to result in rapid onset of vascular congestion and cerebral edema, in other words Grade 3 concussion.
How do post concussion symptoms present?
Headaches, ringing in the ears, vomiting and nausea, delayed verbal/motor responses, difficulty concentrating, dizziness, depression, irritability, fatigue, disorientation, slurred or incoherent speech, photo-phobia, sensitivity to loud noises, impaired memory, sleep disturbances. These symptoms can persist for a prolonged time.
High School Sports at Risk:
Baseball, softball 3%
Field Hockey 1%
High Risk Sports include:
Skiing and Snowboarding
Motor Vehicle Accident (motorcycle, and boat as well)
Little League Baseball (baseball causes more fatalities than any other sport for ages 5-14; prevented now through the use of helmets, safety masks and soft-core balls)
How should concussions be addressed?
When diagnosed with a concussion the patient should be kept home from school with no brain activity-especially including electronics, texting etc. Cognitive test are important in the first 48 hours. The absence of light will help if the athlete has photo-phobia. The most important aspect is monitoring by an adult for digression in healing. Studies on professional athletes through the University of Boston’s School of Medicine have revealed brain damage in retired athletes that suffered multiple concussions. Each concurrent concussion takes longer to heal and may have more symptoms. An often overlooked component of concussion treatment is the neck and upper back injuries that frequently accompany the concussion. Untreated conditions of the cervical and thoracic spine will often linger in the same fashion as concussions and may impede recovery. Chiropractic physicians are well trained in concussion diagnosis. Chiropractic care and muscle therapy (specifically a Cranial Sacral Therapist) can also help re-balance the structure and function at any phase after a mild to moderate concussion. Rehabilitation therapy should be done in stages:
Stage 1- Light aerobics, swimming, walking, and stationary cycling
Stage 2- Sport specific exercise excluding head impact
Stage 3- Non contact training drills
Stage 4- Full contact practice
Stage 5- Return to play when there are absolutely no symptoms remaining!