In 1874, Andrew Taylor Still, MD, the founder of osteopathy recognized that health manifests itself when all parts of the body are in balance and function as a synchronized whole. He also knew that the body has the ability to heal itself. But there are circumstances, such as trauma from a car accident or sports injury when the body can become overwhelmed, causing a disruption in this self-healing capacity. As we will see with concussion, even small changes in the body can have big effects on health.
A concussion is a type of traumatic brain injury (TBI) caused by either a direct blow to the head or by indirect forces transmitted to the head by an impact to another region of the body. Sports related concussion is highly publicized, but other causes include vehicle related accidents, falls, assault, and explosive blasts or other combat injuries. An estimated 1.6 -3.8 million concussions occur in the U.S. each year.
Concussions can cause a broad range of physical and psychological effects. Some symptoms may appear immediately after the trauma, while others may be delayed, appearing days or weeks later. The effects of a concussion can impact the whole person, including school and work performance, the ability to complete everyday tasks and make decisions, as well as to interact socially and maintain healthy relationships.
Common Symptoms of Concussion |
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Note: The following warning signs and symptoms require immediate medical evaluation because they may indicate bleeding in the brain: increasing confusion or worsening headaches, double vision, unequal pupils, vomiting, seizures or drowsiness.
Diagnosis of Concussion
A concussion is diagnosed based on a patient’s history of injury and symptoms. Although there have been advances in technology, standard imaging studies available at most hospitals, such as CT scan and MRI cannot diagnose a concussion. The diagnosis of concussion is often delayed because the symptoms may not be immediately obvious and because it can be overshadowed by other injuries. When more than one area is injured, the most painful region or potentially worrisome issue usually receives the first and most attention. For example, a soccer player slams into the goal post with her outstretched leg and falls backwards onto the ground. She has what appears to be a possible fracture to her leg. She is taken to the emergency room where the focus is on diagnosing and treating the fracture. The next day she has a headache, feels foggy and dizzy. Another example is what can happen during a low speed fender bender. The driver of a car rear-ended by another vehicle declines medical attention at the accident scene because he wasn’t experiencing any pain. But later that day, he develops minor neck stiffness, followed by balance issues, trouble thinking clearly and a headache.
Treatment for Concussion
Cognitive rest
- Avoid texting, computer, TV and other activities that require focus & concentration. This allows your brain to rest and will help with recovery. Academic & workplace accommodations are often necessary, including excused absences.
Physical rest
- Avoid exertion until symptoms have fully resolved. It is unsafe to return to contact sports until cleared by a doctor and the person has completed a graduated exercise return to play protocol.
Osteopathic Manipulative Treatment
- Osteopathic philosophy recognizes that small alterations in structure and function can influence the whole. Traumatic forces can alter the intimate relationships of the cranial bones, cranial nerves, lymphatics, blood vessels and brain, causing this wide variety of symptoms. The role of a Doctor of Osteopathy (DO) is to remove restrictions, correct imbalances, and thus to restore health using Osteopathic Manipulative Treatment (OMT). OMT has been shown to reduce symptoms related to concussion including headache, fatigue, dizziness and balance issues.
- OMT can help facilitate recovery from concussion co-injuries such as sprains, strains, contusions, fractures as well alterations in endocrine, cardiac, vascular, respiratory, digestive and immune function. OMT helps to restore balance and helps facilitate the self-healing capacity of the body. As Dr A.T. Still noted in the late 19th century, a healthy state requires that all parts – bones, tissues and fluids move as a synchronized whole.
- At your visit an osteopathic physician will take a thorough history and perform a physical exam. A gentle hands-on approach will be used to address restricted tissues, bones and fluids. Most people find the treatments to be relaxing. Response to OMT for concussion related injuries can vary. Some patients experience immediate symptom relief, while others will require several treatments. The frequency of OMT is individualized and tailored to the patient’s response to each osteopathic treatment.
Recovery
Recovery from a concussion is highly variable. For some it takes days, while for others symptoms can last weeks, months or longer. Recovery is often prolonged in children and teenagers as well as people with a history of learning disorders, depression, migraine headaches, sleep disorders and those who have had a concussion in the past. After sustaining one concussion a person is more vulnerable to sustaining a subsequent concussion. OMT has been shown to reduce symptoms often associated with concussion which may allow a person to more rapidly return to their normal activities.
References
Centers for Disease Control and Prevention
Chappell C, Dodge, E, Dogbey, GY. Assessing the immediate effect of osteopathic manipulation on sports related concussion symptoms. Osteopathic Family Physician. 2015;7(4):30-35.
Rolle, GR, Pilot trial of osteopathic manipulative therapy for patients with frequent episodic tension type headache. J AM Osteopath Assoc. 2014;114(9):678-685.
Fraix M, Gordon A, Graham V, et al. A use of the SMART balance master to quantify the effects of osteopathic manipulative treatment in patients with dizziness. J Am Osteopath Assoc. 2011;113(5):394-403.
Lopez D, King H, Knebl J, Effects of comprehensive osteopathic manipulative treatment on balance in elderly patients: a pilot study. J Am Osteopath Assoc. 2011;111(6):382-388.