If you train at any type of contact sport, you probably have witnessed or have suffered from a concussion. The CDC (Centers for Disease Control and Prevention) estimates that the incidence of concussion ranges from 1.6 to 3.8 million annually in the USA alone. A large part of those are sport-related concussions and it has dramatically increased in the past few years, especially among children and teenagers. So why is it on the rise? Is sport practice getting more brutal? Are we simply more aware of it?
What is a concussion?
When the head is subject to an impact or a rapid change of direction such as during a whiplash, the brain, which is very soft, is actually colliding against the skull. This will cause a local bruising of the brain, but that is not all. Your head is mounted on top of your spine, just like a pivot. During a rapid movement the momentum will cause shearing forces within the brain structure, which can cause tearing of the nerve fibers along with bleeding. If the tearing is minimal it won’t necessarily be seen on a brain MRI but does not mean that there is no damage.
Here are some important facts about concussion:
- You don’t necessarily have to lose consciousness to have a concussion
- The severity of the impact is not proportionate with the severity of the brain damage
- A mouth guard does not protect from a concussion
- You don’t have to actually hit your head to have a concussion
- Prolonged resting might help but does not necessarily mean full recovery.
The majority of symptoms of a concussion (such as headaches, nausea, dizziness, visual disturbance, brain fog,…) will usually self-resolve within about a week. However, research suggests that about 15% of people who have endured a concussion will sustain prolonged symptoms. Those will typically impact the cognitive, emotional, physical, or autonomic functions and are for the most part non-specific, meaning that it varies with each individual. Sustaining a prolonged cluster of symptoms is known as post-concussive syndrome.
Most commonly people suffering from a post-concussive syndrome will report pressure in the head, light or noise sensitivity, fatigue, poor ability to focus, memory loss, disrupted sleep, poor appetite or digestion, increased irritability or sadness, and the list goes on….
Why did it get so bad?
Post-concussive syndrome has been responsible for ending numerous careers among professional athletes. But when it affects teenagers or children, it can lead to severe difficulties to perform in school and therefore can affect their future. As I mentioned earlier, the number of reported post-concussive syndromes has significantly increased in recent years regarding teens and children. If this is partly due to an increase in awareness, there are other factors contributing to this rise.
A recent scientific article published by Morley and Seneff, two researchers from the MIT has hypothesized that environmental toxicity, and nutritional deficiencies due to poor diet habits lead our brains to be less resistant to a physical impact.
Diminished resiliency
In their brilliant article, the authors explain that the brain is under normal circumstances capable to restore proper function after a trauma. However, the past recent years have shown a dramatic increase in toxicity in the environment, due to overuse of chemicals, pollution, pesticides… Adding that to a diet poor in nutritional values and rich in saturated fat and sugar, and you have the perfect combination for an inflamed, poor functioning brain. They called it diminished brain resiliency. This is the reason why diet and environmental factors play such an important role in our neural function. Too many people think that they can have a unhealthy diet and if they “sweat if out” with an intense training it will be without adverse consequences.
Unfortunately it seems to be wrong, and more and more evidences are showing that a poor lifestyle has a direct negative effect on the brain, which has a direct effect on our body performance and our ability to recover from an injury.
And this does not only affect the ability of our brains to heal after a head trauma. This also explain why there is now such a high prevalence in obesity, diabetes, autoimmune and degenerative disease. Let’s put it that way, if we wanted to give ourselves Parkinson’s disease, we couldn’t a better job than what we are doing right now.
What can be done?
Even though it is impossible to remove all risk of concussion, there are a few points that can be done in order to minimize the risk of post-concussive syndrome.
1. Recognize the first symptoms of a concussion
When you suspect someone is having a concussion, immediately remove him/her from the field and place that person in a safe area. A few easy questions can be asked (What day are we today? , What is your name? ,…) to see any alteration in the level of consciousness. Eye movement abnormality has been shown to be a good assessment tool but it requires good clinical observation skills. You will want to work with a neurologist, a chiropractic neurologist or any other practitioner well trained to identify and manage brain injuries.
2. Rest
Back in the days we used to treat someone with a concussion by having him/her rest on a bad in complete dark for several days. We have now realized that it is not necessarily useful, however it is still recommended to allow an initial period of rest with reduced exposure to light, TV and computer screens, loud sounds and bright light, and physical or mental activities.
3. Clean your diet and your environment
Eat organic, avoid processed food, sweets, alcohol. Promote neuro-protective food such as high fat low carb, or paleo diet. Avoid chemicals or toxic metals exposure.
4. Test for any co-infection or toxicity in your body
This includes bacterial infections, viral infections, mycotoxins, food allergies, heavy metals and chemical toxicities. At a normal state, your central nervous system is strong enough to fight those co-infections and toxicities, but once your brain has been hurt and is not able to regulate your immune system as it should, it is not uncommon to see those pathogens being more of a problem and slow down your recovery. Make sure to consult a specialist in functional medicine to help you in heal quicker.
5. Actively rehabilitate the brain
Just like after an ACL surgery or any muscular injury, if you don’t properly rehabilitate your brain, it might sustains deficits that will affect its proper function. Vestibular and neuromuscular exercises that specifically target the area of deficits of the nervous system can help. Vision therapy & specific eyes movement exercises have shown to speed up recovery. Hyperbaric oxygen therapy has shown some increase in blood flow in the brain, which is vital for proper recovery of neurological function. Again, make sure to consult a concussion specialist for guidance.
Sources:
– Wendy A. Morley, Stephanie Seneff. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration. Surg Neurol Int. 2014; 5: 97
–Maroon JC, Lepere DB, Blaylock RL, Bost JW. Postconcussion syndrome: a review of pathophysiology and potential nonpharmacological approaches to treatment. Phys Sportsmed. 2012 Nov;40(4):73-87.
–Pearson BC, Armitage KR, Horner CW, Carpenter RH. Saccadometry: the possible application of latency distribution measurement for monitoring concussion.Br J Sports Med. 2007 Sep;41(9):610-2.
–Cifu DX, Wares JR, Hoke KW, Wetzel PA, Gitchel G, Carne W. Differential eye movements in mild traumatic brain injury versus normal controls. J Head Trauma Rehabil. 2015 Jan-Feb;30(1):21-8.
–Gallaway M, Scheiman M, Mitchell GL. Vision Therapy for Post-Concussion Vision Disorders. Optom Vis Sci. 2016 Aug 8.
–Larrabee GJ. Neuropsychological Outcome, Post Concussion Symptoms, and Forensic Considerations in Mild Closed Head Trauma. Semin Clin Neuropsychiatry. 1997;2(3):196–206
–Boussi-Gross R, Golan H, Fishlev G, Bechor Y, Volkov O, Bergan J, Friedman M, Hoofien D, Shlamkovitch N, Ben-Jacob E, Efrati S. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury – randomized prospective trial. PLoS One. 2013 Nov 15;8(11):e79995.
–Tal S, Hadanny A, Berkovitz N, Sasson E, Ben-Jacob E, Efrati S.Hyperbaric oxygen may induce angiogenesis in patients suffering from prolonged post-concussion syndrome due to traumatic brain injury. Restor Neurol Neurosci. 2015;33(6):943-51.