Winter is upon us and with it, the season of slip-and-falls, both accidental and sports-based, and therefore, also “concussion season”. How do you know if you have sustained a concussion? Who can help you figure out if you have one? How do you know when you can go back to work or sport? Why is dictating your own “recovery period” potentially very dangerous? Read on and find out…
A concussion is not a brain bruise
The most current understanding for the mechanism of concussion is that rapid acceleration and deceleration of the brain leads to a stretching and “shearing” injury. Think of two different materials rubbing back and forth together quickly, like getting a friction burn on our skin. Our brain has two main tissue layers of different densities - white matter and grey matter. When the brain rapidly accelerates and decelerates, these differing tissue layers do not move at the same rate so the connections between the layers get stretched and “sheared” and cause a temporary disturbance in the cells. A cascade of events leads to an imbalance between energy supply and demand within the body and the onset of various symptoms of concussion [2,5].
Why "feeling better" is not sufficient data to clear return to work or play
This is why so many concussion patients say they felt a lot better in a few days so they decided to try going back to full-time work, school, or sport and then felt a lot worse shortly thereafter. They basically asked their still-recovering brain to work at normal, high levels, which takes a lot of cellular energy, when their brain was still in a state of energy-deficit. This mistake can contribute to delayed recovery, persistent symptoms, increased risk of musculoskeletal injury, more severe physiological dysfunction, cumulative concussion injury through a secondary impact, and increased risk for neurodegenerative disease [4,5].
Why you should never "wait and see" after a slip, fall or impact
Thorough assessment is key (it might not be a concussion) let us diagnose you properly!
Finally, some of the small muscles at the back of the head/neck have the highest number of neurological connections neurons providing feedback to our brain regarding our eyes and our vestibular/balance systems, which can have a big impact in concussion management . The affected muscles and joints of the neck/upper back are treatable, especially by manual practitioners such as chiropractors, physiotherapists, and registered massage therapists through a combination of soft tissue therapy, joint mobilization/manipulation, rehabilitation exercises, and patient education. This is where “The Choice Difference” has an impact – we work together as a team to assess and treat all of the symptoms of concussion to help optimize your recovery.
Not all health care providers are equally as educated in concussion assessment
Concussion research is rapidly evolving and those of us staying abreast of that research know so much more today about the effects of concussions on the body and brain than we did even in the past decade! We are here to apply that knowledge to help you recover safely and optimally.
1. McRory P, Meeuwisse W, Dvořák J, et al. Consensus statement on concussion in sport – the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51:838-847.
2. Complete Concussion Management Inc. (2019). Complete Concussion Management: Online Practitioner Certification Course [Course notes]. Retrieved from www.completeconcussions.com.
3. McCrea M, Guskiewicz K, Randolph C, et al. Jan 2013. J Int Neuropsychol Soc. 2013;19(1):22-33.
4. Kamins J, Bigler E, Covassin T, et al. What is the physiological time to recovery after concussion? Systematic review, 28 April 2017. Br J Sports Med. 2017;0:1-7.
5. Signoretti S, Lazzarino G, Tavazzi B, Vagnozzi R. The pathophysiology of concussion, October 2011. American Academy of Physical Medicine and Rehabiliation. 2011;3:S359-S368.
6. McRory P, Feddermann-Demont N, Dvořák J, et al. What is the definition of sports-related concussion: a systematic review, June 2017. Br J Sports Med. 2017;51(11):877-887.