Perhaps the biggest misunderstanding we’ve had about concussion is how the brain is actually injured. For years, concussion was viewed as the result of the brain hitting the inside of the skull, leading to brain bruising. We now know that concussion occurs when the cells of the brain are stretched, disrupting the ability of the brain cell to transmit the electrical signals required for proper brain function. So, a blow to the head is not necessarily required to suffer a concussion. A violent shake to the head, neck or upper body that creates an impulsive force to the head can potentially cause concussion, as well.
How to tell if it is a concussion
Concussion affects different people in different ways. Typically, symptoms appear immediately and suddenly, and are short-lived. But sometimes symptoms gradually evolve over minutes to hours after the trauma. Some people could exhibit headache, dizziness, even loss of consciousness and amnesia. Others may exhibit no symptoms at all. Symptoms can also be cognitive, for example feeling like you’re in a fog and slowed reaction times, and/or emotional symptoms, like lability. There can be behavioural changes, too, including irritability and sleep disturbance.
When can I return to regular activity?
80-90% of concussions will resolve in 7-10 days if managed properly. This means allowing for complete rest and NO activity requiring physical or mental exertion for that time period. It may take slightly longer for children and adolescents.
It takes that long for brain cells to fully recover from the traumatic stretch and to function properly. Even if there are no noticeable symptoms, returning to play too early will increase the risk of cumulative concussions. Second Impact Syndrome or Post-Concussive Syndrome both have more severe, longer lasting and potentially devastating effects.
The role of the neck in concussion
If a patient is still suffering concussive symptoms after the normal 10–day recovery period despite proper rest, a simultaneous neck injury could be the cause. Recent research has shown that the acceleration force required to cause concussion is 60-120 G (G = force of gravity), whereas a mild neck sprain/strain injury occurs at an acceleration of 4.5 G. In many cases of concussion, it’s reasonable to assume some injury to the neck has also taken place. Another study comparing symptoms of neck injury and symptoms of concussion found no differences between the two lists of symptoms. This information supports treatment of the neck in cases of concussion, especially those where symptoms do not resolve within 10 days.
Better safe than sorry
If you think you may have suffered a concussion, please visit a health care professional such as your chiropractor, physiotherapist or general practitioner for proper assessment and diagnosis.
Please call us at the clinic – 1-902-404-3668 – with your questions about concussion.
by Dr. Erin Kempt-Sutherland, DC, Chiropractor