Concussion
My treatment of concussions ranges from immediate on-field assessment as a Certified Athletic Trainer(ATC) to managing chronic issues from a complex case.
My treatment centers on the neuromusculoskeletal system, which can help many aspects of the post-concussive symptom cluster. The direct trauma can result in injury to the head neck and jaw, all of which can generate local pain, radiating pain and headaches. I include asssessment of the jaw and scalp into my evaluation due to dysfunction due to bruising of the head at the contact point of the collision.
When indicated I refer and cotreat with visual and vestibular specialists to resolve visual problems, dizziness and vertigo. I integrate visual and balance patterns into my rehabilitation to combine the weakness/tightness treatment with the neurological retraining aspects of eye movements and body coordination to give a combined effect. The multiple systems of the neurological system crossover and “talk” to each other, so depending on the severity we may have to challenge them separately or combined to get a therapeutic effect, too little or too much difficulty will result in poor results.
Due to the neurological nature of the injury, the body can start to deviate into a fairly typical pattern of tightness and weakness most closely following the upper and lower cross patterns of Janda along with the stability and control tests of DNS(Dynamic Neuromuscular Stabilization) Lack of body balance and coordination is common after concussion, the part of the brain which controls muscular coordination and reaction time can be injured along with the parts of the brain responsible for memory, reading, balance and mood. Many evaluations focus more on the direct visual and vestibular(balance) portions of the brain, but fail to fully assess body coordination and motor control. The DNS system directly evaluates this, their system is based on the neurological development and maturation of body’s control systems, making it ideal for assessing persistent pain and injury after a concussion. This ties into my one-on-one treatment and more qualitative approach to rehabilitation, without the individual attention and modifications, full recovery is more difficult to attain.
Some articles on persistent injury after concussion
http://www.sportsmedres.org/2016/02/concussed-athletes-face-tough-odds.html
http://www.sportsmedres.org/2015/07/increased-risk-of-acute-lower-extremity-after-concussion.html