Since neck injuries often occur with concussions, both can and should be treated at the same time by a concussion rehab expert in Midtown.
This is what what we specialize in and we encourage you to take the time to read on so you are well-informed about concussion rehabilitation.
In the second article of our three-part concussion series, we broke down what goes into the assessment of determining if a concussion has occurred and why treatment should be structured around these results. This thorough evaluation can indicate to a medical professional—like a physical therapist—if each patient’s symptoms are more closely related to a dysfunction of the vestibular system, visual system, or the neck, which will also help them decide what course of action is best. In this article, we explain why the neck is injured so frequently in the course of a concussion and how to best treat these neck-related issues.
Concussions are complex injuries that often affect many different regions and systems of the body at once. This is one of the primary reasons that every concussion is unique, and why one patient may experience a particular set of symptoms and another could have an entirely different experience and set of symptoms altogether.
The connection between neck and head means both are subject to the same damage – and that’s what our concussion rehab experts in Midtown will look for…
Injury or dysfunction of the neck has been shown to cause a wide range of symptoms, which may include headache, dizziness, loss of balance, nausea, vision and hearing-related issues, and even reduced overall brain function. If these symptoms sound familiar, it’s because they are also some of the most common symptoms reported after concussions. With this in mind, one study compared patients with concussions injuries against those with whiplash, which is a neck injury due to forceful, rapid back-and-forth movement of the neck. When compared alongside one another, they found that there were absolutely no differences in the symptoms that were reported between the two groups.
So why is it that injuries to the neck and the brain lead to nearly identical symptoms? It may be as simple as this: in order for a force to get to the brain, it has to go through the neck.
Both concussions and whiplash occur as a result of acceleration or deceleration forces. Concussions result from acceleration and deceleration that moves the brain within the skull, while whiplash is due to the same types of forces affecting the neck. It only takes 4.5 Gs of acceleration to result in a strain of the neck, but most concussions occur with anywhere from 60-120 Gs. So as you can see, every concussion likely has some degree of associated neck injury, because the force that causes the concussion can easily damage the neck in the process. The neck is also the most mobile part of the spine, which makes it particularly vulnerable to the trauma involved in most concussions.
The result of all this is that after a patient withstands a hit to the head or a similar trauma, it can be extremely difficult to tell if they have experienced a concussion or a neck injury—or both—because the mechanism of injury and symptoms are usually identical. It’s therefore essential that these patients undergo a thorough neck examination during the assessment by a medical professional trained in concussion management to identify and treat any neck-related dysfunction that may be contributing to these symptoms.
Assume it’s a concussion until proven otherwise
As we explained above, after a blow to the head, it’s nearly impossible to distinguish between a concussion injury and a neck injury. That’s why in these cases, it’s best to err on the side of caution and assume that a concussion has occurred until proven otherwise. So if a patient experiences an injury that could be either a concussion or a neck injury and displays symptoms that are associated with both, the doctor or physical therapist will usually play it safe by diagnosing the injury as a concussion.
The benefit of this approach is that it addresses issues related to the neck—regardless of the cause—while also acknowledging that there may be other problems related to the concussion as well. Concussion experts like certain physical therapists focus on improving the impairments of the neck first when they deem these issues to be most central the patient’s symptoms, and in the process, they may wind up treating both the concussion and the neck injury.
There are many interventions that may be used to manage neck-related dysfunction and symptoms, and the treatment course will depend on the type and severity of the concussion, as well as the patient’s physical abilities and limits. But some of the most effective treatments that are commonly used by physical therapists to address neck-related impairments after concussion include the following:
- Hot and cold therapy: depending on the stage of the injury, either hot or cold therapies may be applied directly to the neck to alleviate pain
- Cervical range of motion exercises: these types of exercises aim to improve the flexibility of the neck by having the patient move and stretch the head and neck in various directions
- One simple but effective stretch is to tilt the head from the left to right in slow, smooth movements and hold it for 20 seconds
- Other examples include the chin tuck, neck rotation, and neck flexion and extension exercises
- Proprioceptive neuromuscular facilitation: a specific type of stretching exercise that involves a series of contractions and relaxations, with enforced stretching during the relaxation phase; these exercises are usually performed with the therapist, but can also be completed individually by the patient
- Manual therapy: the term manual therapy describes a number of different interventions that are applied to the patient by the hands of the therapist, including:
- Deep tissue massage: applies a measured amount of pressure to the muscles and other soft tissues of the neck
- Mobilization: uses slow, measured movements to twist, pull, or push bones and joints; this can target the neck (cervical) or upper back (thoracic) region of the spine, depending on the patient’s condition
- Sustained natural apophyseal glides (SNAGS), which combine a mobilization from the therapist with movement from the patient, are particularly effective for neck injuries related to concussions
- Manipulation: applies a careful, controlled amount of force to various joints, which can range from gentle to strong, and from slow to rapid; while the spine is usually the focus, sometimes other joints of the body are also worked on to help treat neck issues
- Cervical traction: in this maneuver, your physical therapist will pull your head away from your neck to create expansion and eliminate compression, with the goal of mobilizing the spine to reduce pain and increase function
Getting the concussion care in Midtown you need at Dynamic Sports Physical Therapy
When a concussion occurs, the only way to ensure that the patient receives the treatment he or she needs in order to recover completely is by placed in the hands of concussion experts who understand the many nuances of managing these injuries. One location that patients can count on for this type of care is the Hospital for Special Surgery (HSS). HSS offers a concussion program, which is an active recovery clinic dedicated to providing expert, timely, and comprehensive care to patients with concussions. Peter Schultz, DPT, co-owner of Dynamic Sports Physical Therapy, is a board-certified orthopedic specialist and member of the concussion team at HSS. He, along with other medical professionals, rehabilitation specialists, and trainers, work together to properly diagnose all concussions and direct patients to the appropriate course of treatment.
Here at Dynamic Sports Physical Therapy, we also pride ourselves on offering the latest and most effective techniques in concussion management. With our team of concussions specialists, which includes Peter, physical therapists Alan Ng, DPT and Bridget Dungan, DPT, and acupuncturist Mila Mintsis, LAc, we work together to carefully identify all symptoms that may be caused by the injury in order to determine what areas or systems of the body have been impacted. From here, we decide which interventions are best for the particular concussion, and then get the patient started immediately on their treatment path to a complete recovery.
Contact Us Today – Time is of the Essence When it Comes to Concussion Rehabilitation
So if you or your child experiences an injury to the head that could be a concussion, we strongly encourage you to contact Dynamic Sports Physical Therapy at (212) 317-8303 to schedule an appointment as soon as possible. Since time is of the essence, doing so will get the ball rolling on a comprehensive treatment program right away and reduce the chances of dealing with any concussion-related complications in the process.