By: Dr. Ciro Errico and Dr. Terry Weyman
Concussions
are a big part of every sport. Being on the sidelines of different sports, I
see many injuries including concussions. But, what exactly is a concussion?
Before
I begin to explain concussions, let me cross out the myth about a concussion
being only a direct trauma or hit to the head, and/or a complete loss of
consciousness. Another big myth is that a concussion is a bruise to the brain. Both
statements are incorrect.
A concussion is a physiological
change in the brain induced by a biomechanical force. A force can be applied anywhere on the body causing an ‘impulsive’
force transmitted to the head. This transmitted
‘impulse’ to the head causes a short lived impairment of neurological functions
that can resolve spontaneously, but some neurological functions can come on
immediately, after several minutes, or hours after a trauma.[1]
Signs
and symptoms of a concussion that often go unnoticed are: feeling ‘foggy’, headaches, feeling overly emotional, unexplained sadness,
irritability, forgetfulness, slow reaction time, sleepy, and insomnia. When someone is having one of these
symptoms (and there is a mechanism of injury that could dictate the reasons), a
concussion must be suspected and a proper assessment must be made by a MD, DO
or DC. On the sidelines, an ATC or medic can also evaluate an athlete.
What
if the symptoms get worse? If a headache becomes worse, if slurred speech
occurs, seizure or convulsion, decrease in coordination - the patient should
receive immediate medical attention due to the possibility of a deeper cerebral
injury.
The
reason for the athlete to rest more and
be reevaluated is due to the dangers of a possible second concussion also known
as Second Impact Syndrome, which is highly dangerous. Here is why: When
someone suffers a first concussion, there is a physiological change occurring
in the brain that does not allow proper signaling between the synapses. When a second concussion occurs, the brain may
lose the ability to properly regulate blood flow causing the brain to swell due
to increase pooling in brain. The pooling does not allow the blood to drain
causing pressure build-up in the brain ultimately resulting in brain damage
and/or death.
So,
how do we prevent concussions? Preventing a concussion is hard. There is no
real way to prevent a concussion predominantly due to the fact that a
concussion does not need to be a direct blow to the head. Concussions can be
caused by shoulder charges in soccer, tackling in football, bumping your head
on a cabinet door, getting rear-ended in a motor vehicle accident, or even
texting while walking and walking into a lamp pole. Concussions, again, are physiological changes in the brain. Headgear
and helmets are great for general protection against skull fractures. Mouth
guards are also good for preventing an athlete to bite off his tongue, however
be aware that when wearing mouth guards, they can cause an athlete to clench
his jaw allowing the muscles in the neck and head to tighten up before an
impact. This allows less chance of a neck sprain/ strain, but because a
concussion is a physiological change in the brain, an athlete may still suffer
a concussion. All studies, and including the International Conference on
Concussions in Sports, show there are no studies conclusive against protection
for concussion.
When
managing a concussion, first thing first: parents, coaches, teachers, and
teammates need to be aware of the symptoms and get the person properly
evaluated. Concussions are difficult to manage due to the severity and, more
importantly, due to the physiological changes that occur in the brain. First
of all, the athlete or patient
should rest. Rest is going to be the
key to begin the healing process: this includes resting from training and
playing. For young adults, teens, and children resting also means staying home
and/or limiting school activities; the information can cause the brain to
overwork and as a result decrease healing. Another rest is from technology
including video games, TV, computer, phones, and texting because the stimuli
that the brain needs to function can overwork the brain resulting in decrease
healing time. Secondly, water! Drink plenty of water. Drinking water
allows an athlete to stay hydrated, and allows the body to increase healing
potential.
What
else is available for management? Chiropractic care and adjustments are
great with concussions. When someone suffers a concussion there is also a
whiplash injury that occurs simultaneously at the upper cervical (neck) area.
This causes a physiological change in the muscles surrounding the spine often
times causes tightens. It’s putting an extra strain on the neck which in turn
will put an extra strain on the healing process for the concussion. Getting
adjusted allows less interference on the central nervous system which helps the
body change physiologically back to its normal state. Mild Hyperbaric
Chamber is another great tool that can be utilized. The hyperbaric chamber
increases the oxygen, and pressurizes the body allowing the oxygen to absorb in
the body to allow healing to happen at a faster pace.
Concussions
affect everyone from the parent to the athlete. For proper healing, it is imperative
to understand the first steps to recovery which are understanding what a
concussion is and being knowledgable of the best ways for a concussion to heal.
When a concussion occurs, it becomes a full effort by everyone to help the
athlete reach full recovery.
Dr.
Ciro Errico is the Team Chiropractor for California State University-Channel
Islands (CSUCI) Lacrosse Team and Newbury Park HighSchool Lacrosse. He is also
the Team Chiropractor for Club Sports at California State University-Northridge
(CSUN). He is a treating Chiropractor at Chiropractic Sports Institute (CSI)
Dr.
Terry Weyman is the Chiropractor for Pepperdine University
More
info on CSI visit their website www.gotcsi.com
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