Concussion

CONCUSSION, POST-CONCUSSION SYNDROME (PCS) and TRAUMATIC BRAIN INJURY

What is a concussion?

A concussion is a traumatic brain injury (TBI) caused by sudden movement to the head such as a blow, bump or jolt to the head that results in the head moving back and forth rather quickly. These types of sudden movements can cause the brain to bounce or twist within the skull. This results in neuro-metabolic chemical changes with the cells of the brain and potential over stretching within the axons of the nerves in the brain (most often micro trauma not seen on MRI).

Individuals with concussions suffer from these types of symptoms:

  • headaches
  • head pressure
  • neck pain
  • cognitive problems
  • blurry vision
  • Anxiety
  • fatigue
  • “fogginess”
  • dizziness, vertigo
  • sensitivity to light, noise and motion
  • fatigue
  • difficulty sleeping

What is post-concussion syndrome?

Post-concussion syndrome (PCS) is diagnosed when there is persistent concussion symptoms that last beyond the normal recovery time. The vast majority of concussion improve within two weeks and the majority heal in a month. When symptoms last longer than 30 days, it will be likely be diagnosed post-concussion syndrome.

What should I do if I think I have a concussion?

If you think you have a concussion you should get checked by a medical professional who is well versed in this field.

People should be assessed right away by a medical professional when concerning symptoms such as severe headaches or head pressure, change in behavior, nausea and vomiting, apathy, dizziness, drowsiness and extreme fatigue, confusion, and weakness.

Initial concussion assessment and management helps people understand what they are dealing with and what to do to improve optimally. The goal is optimal recovery, so get checked and follow instructions. Chiropractic Neurologists are extremely well trained to make this assessment and help people improve with many symptoms.

Who gets concussions?

Studies show that young athletes are at particular risk for this very serious injury. Kids involved in hockey, gymnastics, horseback riding and skiing/snowboarding sustain this injury more often. Women are more likely to be diagnosed with PCS.

Statistics page on specific sport related concussions in Canada amongst children and youth.

It should be noted that anyone can get a concussion – from a slip and fall, an automobile accident, or any other type of head trauma. You do not need to be rendered unconscious to have a concussion.

What is the current medical approach to concussion treatment?

The current medical approach to concussions is to rest and limit physical activity until concussion symptoms go away. In the event symptoms persist, patients are usually prescribed pharmaceutical drugs to help them cope. The patient is monitored and eased back into their usual activities.

How do Chiropractic Neurologists treat concussions?

Chiropractic Neurologists take the same approach as medical doctors in the early stages of concussion recovery. Absolute rest and limitations on physical activity will be often be recommended at the outset of treatment. Recent studies are showing that better outcomes with some levels of activity helps enhance the healing process. The chiropractic neurologist will make specific recommendations in order to keep the stimulation to the brain as effectively as possible during this period.
It should be noted, however, that current research suggests that some patients can begin rehabilitation therapy as soon as a few days post-injury.

Neural plasticity1,2 peaks within one to three months post-injury, which is an optimal time for patients consult with a chiropractic neurologist to access whether they can begin therapy.

Patients who are outside this “window of opportunity” will nevertheless benefit from seeing a chiropractic neurologist. Through our experience and scientific research, it is still possible to improve after years from these types of injuries as the brain and nervous system is shown to be adaptable.

Significant improvements can occur even at later stages, especially when rehabilitation combines task-specific training with therapies that activate neural plasticity.

Dr. Roch does not prescribe medications to mask the symptoms of concussion. He takes the time to assess which areas of the brain and/or neck have been affected by the trauma that led to the concussion and creates an individualized treatment program specific to your injury.

Dr. Roch’s concussion patients attend his office and he provides his patients with a series of individualized exercises to perform at home. A major part of the recovery process involves work done by the patient at home as learning takes repetition and time.

Treatment programs are based on individual injuries and needs to promote optimal recovery and function. These are tailored to the specific injury that the brain has sustained, and patient cooperation and compliance is necessary to achieve recovery.

The famous NHL player, Sidney Crosby, was sidelined for many months due to a serious concussion, and was only able to return to the ice after working with Chiropractic Neurologist Dr Ted Carrick.

See Article of Crosby and Dr Carrick in Macleans

1 Neural plasticity (also known as neuroplasticity, brain plasticity, cortical plasticity, and a variety of other names) is the changing of the structure, function, and organization of neurons in the brain in response to stimulus.

2 The Neurobiology of Brain Injury
By Marcela Pekna, M.D., Ph.D. and Milos Pekny, M.D., Ph.D.
July 30, 2012

“Dr. Roch gave me hope again, following a concussion in the Spring of 2013. It was my first head injury, and I was experiencing a series of frightening and severe systems, including disorientation and confusion (not knowing where I was), dizziness, vertigo, headaches, eye pain, as well as general problems concentrating. My emotional state was unstable, and I was having a difficult time functioning in day to day life, and wondering if I would recover.

Dr. Roch met with me, assessing my situation with a combination of professionalism, intelligence, and compassion. His expertise became evident quite quickly, as he assigned a series of eye tracking and brain strengthening tests with an overall plan for how to get me better. The professional medical advice he offered – a combination of rest, taking an appropriate amount of time off work, avoiding computer and smartphone screens, and reducing stress – helped me fully recover.

It took months for me to return to my old self, but with Dr. Roch’s assistance and knowledge I was able to fully regain the joys and fulfilment of my interpersonal relationships, my career, and life in general. Thank you, Dr. Roch.”

– Jason