07 Oct One Unique Way Sports DCs Can Help Athletes Reduce Concussion Risk
On August 30, 2019, The American Journal of Sports Medicine published a study that involved a survey of almost 3,500 former NFL players. After analyzing their responses, researchers learned that, for every 5 seasons of play, players had a 9 percent increased risk of depression.
Additionally, players in positions other than kicker, punter, and quarterback had the highest depression risk and tended to suffer more with higher levels of anxiety and lower cognition-related quality of life.
Worse yet, those who reported concussion symptoms had noticeable effects in all of these areas not only short term, but also 20 years after they’d hung up their cleats.
Long-Lasting Concussion Effects
This is partially what makes the topic of concussions so important in football says Dr. Michael K. Bagnell, DC, DACNB, FABBIR.
“We are blessed with a marvelous capacity of our brain to compensate and have neuroplastic changes,” says Dr. Bagnell, a Fellow of the American Board of Brain Injury and Rehabilitation. “Yet, eventually, compensation typically comes apart in my experience, later in life, with the additional demands of human life (stress), dietary changes that are suboptimal, and immune alterations.”
Research conducted by the University of California, San Francisco confirms that even mild concussions can create long-term effects. Among these effects are reduced neurological function, which increases the potential development of cognitive diseases such as dementia and neurogenerative disorders like Parkinson’s.
Though many of the NFL’s rules are created to reduce the risk of injury to the brain—such as declaring it a personal foul for a player to lower his head to initiate contact with his helmet—there is one thing that some healthcare professionals say that players are continuing to do that puts both them and their teammates at greater risk of suffering mild head trauma.
Here’s a hint: It involves an action they often take when celebrating an amazing play.
When Celebrating a Play Can Increase Concussion Risk
This action involves making contact with the head of a player, even when that player helmeted, and usually involves head butting or slapping of the helmet says Spencer Baron, DC, DACBSP®, president of NeuroSport Elite, PC. “It is probably one of the most profound or most obvious actions that can be controlled,” he says.
Dr. Baron goes on to explain that this type of celebratory action is also one that happens primarily in football. “If you notice, it does not happen in other sports,” says Dr. Baron. Why? “You’re less likely to smack someone in the back of the head or head butt them when you’re not wearing a helmet,” he says.
But isn’t the player adequately protected by his helmet? Not necessarily.
“Even though you’re protected, it’s still projecting vibration,” says Dr. Baron. And when Dr. Bagnell was asked if he felt players are increasing their own risk of concussions by engaging in these same behaviors, he agreed, adding that repeated low level impacts “may add a cumulative effect compounding the problem for the brain.”
An Issue Along All Ranges of Sport
What is particularly troubling is that head butting and helmet slapping isn’t just something you see in the pros. “That’s college, that’s high school,” says Dr. Baron, further stating that it is the latter—high school—where you usually see a majority of these types of offenses.
In fact, Dr. Bagnell reports that he generally sees patients “who have sustained a concussion or are suffering with post-concussion syndrome” every single week. Additionally, while speaking around the country about this very subject, he has conducted informal polls on attendees and would estimate that approximately 50 percent of the doctors in the conferences reported they believe they have sustained at least one concussion in their history, either during sports or other activities. “The issue of mTBI may be more pervasive than estimated,” he says.
Knowing this, sports DCs can play an active role in helping their athletic patients stop this potentially life-changing behavior. What can you do?
Helping Football Athletes Reduce Concussion Risk
“There’s many things we can do for the athlete,” says Dr. Baron, “but one of the most important things from the start is to do a great physical exam.” For instance, he recently examined a 17-year-old female athlete who, while playing soccer, had a kicked ball bounce off the back of her head.
“Her complaints were photophobia and headaches that were pulsatile,” he says. “I’m not saying she didn’t sustain a mild, traumatic brain injury, but on examination, the headache portion of it was coming from the neck. Guess what? I can treat that. I can strip some of those symptoms away.”
Dr. Baron adds that, had she gone to any other doctor, the patient would’ve likely been told that she couldn’t play and her best solution would be to sit in a dark room for the next week. “What I did was I worked on the neck muscles and I adjusted and it helped relieve some of the headache,” he says. “We’re talking instantly. More than instantly. The moment I put my fingers on the back of her skull when she was in the supine position, she felt relief.”
Another action you can take as a sports DC to help concussed players is to “get them to do light, no impact aerobics such as cycling or an elliptical machine,” says Dr. Baron. This helps resolve the concussion by improving blood flow.
Tips for Caregivers
You can also help reduce these effects by providing proper guidance to caregivers, parents, and legal guardians of a child who has just concussed. For instance, one of the first things these individuals do when their child has been injured is to ask whether they’re hungry, says Dr. Baron. And if they say yes, the response is typically to stop for something to eat from a nearby fast food drive thru.
“A lot of the neurotransmitters for the brain are created in the stomach after you eat and those are the worst quality neurotransmitters,” warns Dr. Baron. Plus, studies are just now finding that a ketogenic diet offers a number of cognitive benefits. This means educating caregivers to feed concussed children meals that contain high-quality proteins and fats. “Do that for several days,” says Dr. Baron, as this helps with the way the body gets rid of unneeded, damaged, or abnormal cells.
Continuing Your Concussion Training
Dr. Bagnell adds that, “We know neck strength and vision training, as well as proper cervical spine biomechanics are correlated with better outcomes for injury prevention.” Therefore, he recommends that DC’s consider taking the HEADS UP to Youth Sports online training offered by the CDC for increased concussion understanding.
Dr. Bagnell also suggests attending CE courses that give hands-on training and improve observation and rehabilitation skills to help become better qualified with regard to effective diagnosis and treatment options for mild traumatic brain injury and concussions.
“Chiropractic plays an enormous role in the understanding or the treatment of concussion,” says Dr. Baron. It’s up to you how that role is filled.
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