A Chiropractic Protocol for Examining and Healing Concussions in Exercise
This case study involves “Logan,” who was in sophomore high school in the spring of 2018. While playing college soccer, she was hit on the side of her head with the soccer ball and immediately went onto the field.
She did not pass out, but had a severe headache with dizziness and nausea. She was seen in the emergency room at the local hospital for a CT scan and was negative for any internal bleeding. The ambulance stated that she had a concussion and that it would take time and rest. If the symptoms persisted, she received follow-up care instructions from her family doctor.
Results of primary MD care
Two weeks later, Logan’s headache was still severe, made worse by exposure to light and noise. She had difficulties in school and had to go at different times of the day to go home and rest. The persistent symptoms caused her mother to take her to the family doctor.
The GP performed a thorough medical history and neurological exam on Logan. He stated that she still had concussion symptoms and that it would take rest and time before she felt better.
For the next month, despite not going to school or training for basketball or soccer, her symptoms did not go away. Her mother contacted the family doctor who referred her for a neurological consultation.
The neurologist performed a routine neurological exam that consisted of balance, muscle strength, and reflex tests. He told her again that the symptoms were remnants of the concussion and that she should stay in a dark and quiet room for most of the day and it would take time and rest for her brain to heal.
Logan spent the summer of 2018 in her bedroom where she turned off the lights and closed the curtains to keep out the sun that would aggravate her headache. She followed all instructions and slept for almost 18 hours a day. The headache, the imbalance, the sensitivity to light and sound persisted and school started in a week.
She was now very concerned about keeping her grade point average at 4.0 and the possibility of not being able to play basketball or soccer in her junior year.
Back to school
The fall semester of her junior year begins and in the first week of classes she has to leave by the third lesson because of the headache and sensitivity to light and sound.
The anxiety level rises and she no longer sleeps well and begins to get depressed. Her mother is very concerned because she sees her daughter slip away and become someone she no longer recognizes.
While shopping, the mother meets another mother whose daughter Lindsey had a concussion and did not recover from being given the recommendations for rest and time. Logan’s mom got my name because I successfully treated Lindsey for her concussion and was able to return her to play basketball and soccer during her busy season. Logan’s mother called and made an appointment that day.
Chiropractic concussion examination and care
I’m the Gaylord High School girls’ varsity basketball chiropractor, and I knew Logan before she got the concussion. She was an energetic defensive player who always had a smile on her face. The girl in front of me on that first visit wasn’t the person I knew. She sagged in the chair and looked totally defeated.
Examination of the cervical spine – During the cervical spine exam, she told me that no one had asked or done anything about her neck or upper back. She said her neck was sore and tense and she felt that she could not get a full breath because her upper back was very tight.
Her active and passive range of motion was severely restricted, with bilaterally exquisitely sensitive areas in the suboccipital muscles. Their balance with their feet together, standing on one foot and tandem with their eyes closed was terrible. Finger-to-nose tests showed bilateral overshooting of the nose.
Education and reassurance – Before bothering about it, I informed Logan and her mother about what had happened to the concussion and that she was now a patient with post-concussion syndrome. Assurance was given that she would feel better and that basketball season would be on for her. While I can’t measure it, I believe that by educating and reassuring them, the anxiety level decreased by 50%.
Treatment – The treatment consisted of long manipulations of the Y-axis distraction on C1 using the cervical headpiece on my table. I worked aggressively on the suboccipital muscles and with the application of heat and electrical muscle stimulation we saw improvement.
The most important aspect of our treatment approach was to straighten her up and get her moving. We ran a Buffalo treadmill test to see when her symptoms started and then based our active rehabilitation program on those results. I told Logan not to go into a dark room and to live again. All in moderation, but should be exposed to light and sound. Within two weeks, her headache was reduced by 50% and she was able to attend school all day.
At the end of a month of nursing, she got an A again and looked like the Logan I had originally known. The break-in was gone, the defeated gaze was replaced by a confident aura, and the thousand-meter-long gaze was missing.
Back to the competition
Logan could play basketball and soccer in her junior year and was a 4.0 student again. The day she was released from custody, her mother burst into tears and thanked me for bringing her daughter back to her.
Across the country there are many Logans in need of chiropractic care to immerse themselves in sports and symptoms of post-concussion syndrome. As the only neurological health profession, as chiropractors, we can improve the lives of these patients.
TED A. ARKFELD, DC, MS, graduated from Northwestern College of Chiropractic in 1988, where he also received his Bachelor of Science degree in human biology. He received his MSc in Biomechanical Trauma from Lynn University in Boca Raton, Florida. For the past 18 years, he has been a volunteer team chiropractor for soccer, basketball and soccer at Gaylord High School, treating numerous sports-related injuries and concussions. In December 2018, his clinic became the second chiropractic office in the country to receive certification in the diagnosis and treatment of concussion and post-concussion syndrome from Complete Concussion Management, Inc. He can be contacted at firstname.lastname@example.org