Dr. Podell says concussions are treatable. I have traditionally heard you do not treat a concussion, instead you manage it.

Join Dr. Podell for a discussion live from the Trinity University Sports medicine Workshop 2020.

Cervical Strain is Treatable – 3 min

Neck issues can play a big role in prolonged headaches.

Location of headaches may correlate to the c-spine that has been affected.

Role of Myodural connection – 5 minutes

“Effect of the Suboccipital Musculature on Symptom Severity and Recovery after Mild Traumatic Brain Injury”: http://www.ajnr.org/content/37/8/1556

Study done in 2016 on myodural bridge and its connection to post-concussive symptoms, may suggest that treating suboccipital musculature early on may reduce post-concussive headaches and/or other symptoms.

Neck strengthening and conditioning – 6-9 min

Neck girth and strength = reduced impact to the head and neck

Strength exercises must be done in all planes!

“The effects of rest and treatment following sport-related concussion: a systematic review of the literature”  

https://bjsm.bmj.com/content/47/5/304.long

Studies revealed that those who reported pre-season baseline symptoms had an increased risk for concussions during the season.

“Sex Differences in Head Acceleration During Heading While Wearing Soccer Headgear”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582549/

The study revealed that soccer females wearing headgear had greater head acceleration compared to males who had a slight decrease in head acceleration. This suggests that headgear may not be appropriate for all athletes.

Measuring Neck Strength – 10 min

“Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports”

https://link.springer.com/article/10.1007/s10935-014-0355-2

This study showed that “smaller mean neck circumference, smaller mean neck to head circumference ratio, and weaker mean overall neck strength were significantly associated with concussion.”

Vestibular balance is also treatable – 15 min

BESS/ Sway app / Force plate

Balance work = decreased risk of lower body injuries relating to prior concussions

Vestibular-ocular – 17 minutes

“Does it feel unstable to you?” “Rocky boat” 

Are they experiencing vertigo?

Increased s/s if they were previously experiencing motion sickness

Vestibular-ocular issues are a “major source of fatigue, headaches, and cognitive problems

Vestibular Ocular Motor Screen (VOMS); 

smooth pursuits, horizontal and vertical saccades, horizontal vestibulo-ocular reflex, near point convergence, visual motion sensitivity

Home exercises; Eply/Brandt-Daroff exercises and gaze stabilization

Beginning vestibular therapy at two weeks will greatly impact and help during post concussion recovery

Training for professionals in vestibular rehab techniques is available

CAUTION!