Concussion Protocols: What providers should know to recognize and serve this group

Millions of Americans sustain concussions per year, yet as many as half go

unreported, and thus untreated. Attention on concussions is rising, particularly

among athletes, with new protocols and assessments in place for sports like

football, soccer, and hockey. There is still much work to do.

Many in the general public don’t realize that concussions can occur outside of

athletics or without a blow to the head. 

Even with increased societal awareness, my work with patients who have been

seen by other providers before coming to me highlights that outdated methods

for concussion treatment, some of which actually hinder proper recovery, are still

used.

As someone who sees a lot of these patients in a clinical setting, here are five things providers should know about

concussions.

1. Concussions aren’t just a bump on the head. A concussion is a functional

injury to your most precious organ, the brain.  This sets off a “domino effect” of

inflammation in the brain and body, and can affect other systems like the

digestive system, the mental state, hormonal system, and blood flow regulation

(just to name a few).  

This means that treatment for recovery should be multifaceted, incorporating

diet, graded exercises, manual rehab, comprehensive testing, and potentially

psychological support.  Your patients aren’t crazy, and they certainly aren’t

making their symptoms up!  They just need somebody to listen with an informed

perspective. 

2. Concussions aren’t just a head injury; they’re a neck injury too. A whiplash

injury that creates enough force to cause a concussion is also guaranteed to cause

a cervical spine (neck) injury. With a jolt to the body that creates a whip-like

motion of the head or neck, you can sustain a concussion even without hitting

your head. I’d argue that treating the neck is likely the most overlooked

component of concussion rehab - and research has caught up with this as well. 

This makes incorporating neck rehabilitation after a concussion that much more

important. Nevertheless, rehabilitation of the neck is hard for providers to

objectively measure. That’s why new innovative systems like NeckCare are being

introduced to the market, because there is a need for objective measures. We can

now objectively look at the impact concussions have on the cervical spine, joint

position sense, oculomotor control, and confirm the efficacy of our treatment and

the patient's progress. 

3. Only resting in the dark won’t cut it. "Resting in the dark with no screen time

until symptoms go away" is likely to do more harm than good. Guidelines show

that there is no benefit from this past 24-48 hours after the concussion. There is

evidence that shows light exercise helps restore proper nervous system

regulation. So, rest for a day or two, but then implement exercise that doesn't

aggravate your symptoms too much, doing just a little more each day as your

symptoms permit. 

4. Eating right matters. A whole food diet is extremely important in the days and

weeks after a concussion in order to give the brain and body the fuel it needs,

while cutting down on the load of inflammation. Focusing on high quality

proteins, fats, and carbohydrates – along with hydration – exponentially improves

your experience after the concussion and decreases the chances of lingering post-

concussion symptoms. 

5. Time to treatment matters. Only 20-30% of those who suffer a concussion will

have symptoms that last past 30 days – something we call post-concussion

syndrome. However, the number one indicator of whether or not you will develop

post-concussion syndrome is the amount of time that passes from the time of the

concussion to seeing a trained provider – one who is up to date on the research

and capable of testing and treating with updated protocols.

With continued attention to concussions both in wider society and in the medical

community, as well as continued research of and advancement in treatment

protocols, we can do our part to provide patients with better recoveries and

higher quality of life post-injury.

About the author:

Dr. Al Cobb is a certified chiropractor in Lubbock, Texas, where he specializes in

treating kids, athletes, and those experiencing concussions or post-concussion

syndrome, dysautonomia, and various forms of headaches. 

As a former college football athlete, Dr. Cobb was exposed to high-speed

collisions and understands the role upper cervical chiropractic care can play in

rehabilitating the brain and neck. Through additional post-graduate training in

concussion care, neurological rehabilitation techniques, and utilization of the

NeckCare system for objective testing and rehabilitation, he has seen countless

individuals heal from their concussion and live full lives once again.