With the popular movie Concussion and a Public Broadcasting System documentary of the same topic there is substantial national attention on sports related traumatic brain injury and its consequences.
In the United States the prevalence of mild traumatic brain injury, also known as concussion, is estimated at 3.8 million per year. 85% of people sustaining a concussion will have symptoms resolve within 7 to 10 days. The remaining 15%, however will exhibit persisting symptoms lasting weeks, months or even years after their injury. In those suffering, lingering symptoms persisting longer than 4 to 12 weeks the condition is considered to be chronic and is known as post-concussion syndrome.
Many healthcare professionals consider post-concussion syndrome to be purely an injury isolated to the brain. However, recent research shows that another etiology, other than the brain, may be responsible for ongoing, chronic symptomatology.
Those experiencing mild traumatic brain injury tend to have symptoms of headache, dizziness, neck pain, visual problems, concentration problems, hearing disturbances and emotional irregularities. Not coincidentally, these are also findings that occur with neck injuries, like whiplash, as well.
Injuries to the neck can occur from many types of trauma. The classic whiplash of an automobile accident is one with which many can identify. Of course, sports injuries occurring in football can also cause problems with the neck. But many other sports such as falls occurring in cheerleading, heading a ball in soccer, collisions of players in lacrosse, divers landing awkwardly in a swimming pool and anyone striking their head on a gym floor or playing field can lead to trauma to the neck.
Trauma research has revealed the range of linear impact accelerations causing concussion is between 60-160 G’s of force with the peak occurring at 96 G’s. Whiplash associated traumas can occur at accelerations of only 4.5 G’s. From this it is seen that individuals who experience force is strong enough to sustain a concussion will also experience cervical spine injury. In fact, it seems virtually certain that someone having traumatic force causing a concussion will also suffer injury to the soft tissues of the cervical spine.
In a research study evaluating hockey players suffering trauma published in Brain Injury in 2006 it was noted “there is a strong association between whiplash induced neck injuries and the symptoms of concussion in hockey injuries.” The researchers went on to say that athletes/patients should be evaluated for both traumatic brain injury and cervical/whiplash type trauma.
Current thinking is that those suffering from post-concussion syndrome have most certainly also had injury to the neck or cervical spine. Some are terming it Post-concussion Syndrome and associated Cervicogenic trauma. “Cervicogenic” means “from the neck”.
In another study published in the journal Cephalgia in 1990 researchers evaluated patients who had sustained head trauma and who were still suffering from headaches one year later. These patients entered a clinical course of specific manual therapy of the neck, such as chiropractors utilize, to help headache problems. The results were the group treated with manual therapy showed over 50% improvement of their headache pain index compared with the pretreatment level. The researchers stated: “Manual therapy used in this study seems to have a specific effect in reducing post-traumatic headache.”
Chiropractors have extensive training and experience in evaluating injuries of the neck or cervical spine. If there is an abnormality of misalignment or improper movement of the vertebrae of the spine, strain of the muscles and ligamentous sprain, chiropractors have safe, proven methods to treat these injuries.
A 2015 study in the journal The Physician and Sports Medicine quotes “Management of persistent post- concussion symptoms through ongoing brain rest is outdated and demonstrates limited evidence of effectiveness in these patients.” They add further “instead there is evidence that skilled manual therapy related assessment and rehabilitation of the cervical spine dysfunction should be considered for chronic symptoms following concussion injuries.”
When considering this type of information it would be wise for all patients suffering from post-concussion syndrome to be referred to a chiropractor for cervical spine evaluation and treatment.