RCCSS members are trained in sport injury, including concussions. They are also encouraged to con-stantly update their knowledge on concussion as new developments and information about this condition come out fairly frequently. There are a number of resources for chiropractors to get up to speed on concussion developments. The Con-cussion Consensus Statements, for example, is an international document that RCCSS members and many health practitioners use to find guid-ance around concussion diagnosis and management. The Concussion Con-sensus Statement is an evolving docu-ment, however, and has already seen its fourth update since the first version was released at the International Con-ference on Concussion in Sport held in Vienna in 2001. The last version was released in 2012. Familiarity with the concussion as-sessment tool SCAT 3 is also neces-sary, says Howitt. “These are common knowledge, common pieces if you’re working with sporting teams, where there are going to be concussions,” he says. While sports chiropractic specialists would likely have the knowledge to appropriately deal with potentially critical sports injuries, like a concus-sion, one cannot expect an average practitioner with no specialized train-ing to be able to handle these types of conditions. Collaboration with other health-care providers, therefore, is critical. Not all concussions are created equally, according to Howitt, and while most concussions resolve on their own with proper care, some will spiral into more serious and debilitat-ing PCS. It is when symptoms persist – even worsen – beyond the typical ten-day time frame that more careful and spe-cialized care is needed. “That’s where a multidisciplinary approach is likely applicable because that’s where we find that maybe, be-sides the fact this person has a concus-sion, they also have some whiplash injury or some sort of cervical spine injury that is contributing to the head-aches or to some of the symptoms described,” explains Howitt. www.canadianchiropractor.ca Chiropractors, as much as any other health-care practitioner, may be the first person to see a patient that comes in with a concussion. In the spotlight Perhaps one of the greatest publicities for chiropractic as a treatment for concussion symptoms happened when Canadian hockey hero Sidney Crosby attributed his recovery from a serious concussion – that kept him out of the game for several months – to Toron-to-born chiropractor Dr. Ted Carrick. Carrick, who specializes in chiro-practic neurology, had Crosby un-dergo vestibular stimulation with the help of a rotating chair called the GyroStim. In a Huffington Post article, pub-lished in November of 2011, Carrick explains: “The vestibular system is a powerful activator of brain function and its stimulation may be associated with an improvement of many func-tions with a decrease of symptoms including head pain, fogginess, con-centration, balance, gait and motor co-ordination. Vestibular stimulation in concert with eye exercises and other physical modalities affects central pathways in the brain. The brain is plastic in its function and activation of the brain may result in changes in structure and function.” Crosby’s infamous chiropractic ex-perience is only one of several recent developments supporting the value of chiropractic for alleviating the debili-tating symptoms of concussion and post-concussion syndrome. Recent studies are showing a con-nection between the cervical spine and concussion symptoms. One such study comes from the University of Calgary, where Kathryn Schneider, a researcher with the school’s Faculty of Kinesiol-ogy’s Sport Injury Prevention Re-search Centre, found cervical spine and vestibular therapy helped athletes with prolonged concussion symptoms return to play within eight weeks after their therapy. The study, published in the British Journal of Sports Medicine in the spring of 2014, was a randomised controlled trial involving 31 athletes, male and female, with persistent symptoms of dizziness, neck pain and/or headache following a sport-related concussion. Participants were divided into two: the control group and the intervention group. Both groups received weekly sessions with a physiotherapist for eight weeks or until the time of medi-cal clearance. Both groups received postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The inter-vention group additionally received cervical spine and vestibular rehabili-tation. The result revealed 73 per cent of the participants in the intervention group were medically cleared within eight weeks of initial treatment, com-pared to only seven per cent in the control group. Another recent study that is making the rounds in the chiropractic commu-nity comes from the University of Buffalo, which compares subjects with neck injuries and those with PCS. It found no difference between symp-toms of a neck injury and symptoms of PCS. “There is no change or different pattern of symptoms from concussion to neck injury,” says Dr. John Leddy, a sports medicine physician and pro-fessor of clinical orthopaedics at the University of Buffalo, who led the study. “You can get cognitive symp-toms with both – like trouble thinking, trouble concentrating, trouble remem-bering – you can get headaches from both, dizziness from both, emotional symptoms from both, trouble sleeping from both. So that if you try to go by symptoms alone, after any kind of December 2014 Canadian Chiropractor 29
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