Concussion – After Injury Care

Most cases of concussion resolve spontaneously over time, we have had discussions on here that vary from 72 hours to 6 months or longer – however, people/researchers are trying to find a way to help along recovery.  Most of this is an inexact science, to say the least, it is almost the ol’ adage of “throw crap on the wall and see if it sticks.”

Lindsay Barton wrote a great summation of current ideas for therapy for lingering effects of concussion, in some cases being classified as PCS, or post concussion syndrome, for Mom’s Team.  I do like his list which includes;

  • Craniosacral therapy
  • Chiropractic Neurology
  • Vestibular Rehabilitation
  • Amantadine
  • “Buffalo Protocol”
  • Epsom Salts

The first three are very “hands on” by a practitioner and may just alleviate the symptoms, making life generally better.  If there is a neck or musculature etiology the first two would definitely be of great help.  If there is an inner ear or balance issue the vestibular rehab would be a great avenue.

The third and fifth on Barton’s list is where a lot of people are putting their time.  Just like the “American Way” we want a magic bullet to fix the issue and fast, however this has not been the case.  Both Amantadine and Epsom salts have worked for people, but without clinical trials it is EXACTLY throwing crap at the wall.  This approach may not be a bad idea, it only becomes an issue if there are side effects or unintended consequences of your crap throwing.  We have used this approach for our Omega 3/Fish Oil and Reversitol regimen for concussions (with full parent consent mind you).

As for the “Buffalo Protocol” it is actually sound advice and not nearly as controversial as people make it out to be.  If after an event you are symptom free why not try to get back into the “saddle” once again.  What makes theirs more palatable and effective is that there is a team of people monitoring each individual.  This protocol may work in colleges and pros, but it is less likely to work in younger ages because of the lack of resources/time.

The general take on this information is: It is good to know that some things show effectiveness.  However, just like we harp on the neurocognitive testing, each individual is different, and each recovery approach must be tailored to each situation.  I still believe that no matter the individual removal from all physical and cognitive activity is the best idea, for s certain amount of time.

5 thoughts on “Concussion – After Injury Care

  1. joe bloggs March 5, 2012 / 11:45

    Cranio Therapy is not supported by evidence.

    Chiropractory is mainstream but remains questionable medicine. It is only supported for use in brain injury. Outside of back injuries it has very little support. Furthermore, chiropractory has risks that are seldom discussed.

    Vestibular Rehab has basis in science. Although, it unclear what the suitable protocol should be.

    Amantadine and other substances do no have established treatment window and will require much more research before reaching conclusions regarding sports-type concussion treatment. It has demonstrated utility in deep coma patients.

    Buffalo protocol needs more support but has science behind it.

    Epsom salts and chelation is crap.

    I realize there are doctors selling all kinds of drivel from high potency vitamins, magic imaging technology, supplements and super fish oil. Be cautious, check qualifications and verify all claims.

    I realize many people believe alternative medicine has its place. It does, in patent medicine shows. It is just a good way to separate desperate people from the hard earned
    money. Always remember Steve Jobs, smart man, who died unnecessarily because of unregulated and unquestioned nonsense.

  2. A Concerned Mom March 6, 2012 / 07:49

    I chose to add fish and omega 3 supplements to my son’s diet based on information found on this blog and on MomsTeam (two videos/one from their nutritionist & one from Dr. Meehan … I believe he referenced a study in rats … he noted that rats obviously aren’t humans). I didn’t view fish oil as a magic tonic, but rather thought that since the modern diet tends to be low in omega 3’s anyways, it wouldn’t hurt. (I made sure the supplements were tested for mercury & PCBs, and didn’t go overboard on the fish.)

    In general, I took a do no harm approach. As long as there seemed to be some basis for the therapy, and as long as it didn’t seem to be able to harm him in any way, I was willing to give it a try. I would be cautious about neck manipulation … there are some scary stories out there about neck cracking. As with any medical condition, it’s important to run things by the doctor. We didn’t start the moderate slowly increasing daily walking regiment until the sports specialist suggested it (at that point we were more than a month post injury and he had somewhat mild symptoms that just seemed to be lingering). A few weeks prior to that point, walking too many laps during gym actually provoked a headache, so I do see a need to be careful about introducing walking too early or by attempting to do too much at once.

  3. Jake Benford March 6, 2012 / 19:08

    Concerned Mom

    Your approach is wise. Until we have some good studies to validate some of these therapies, I would also recomend the no harm approach. A lot of the supplements (fish oil, magnesium) show promise and have some animal data, but not a lot of human data. If taken correctly, these would meet the no harm criteria.

    Their are some other therapies that are being studies right now. The Protect study is a phase III study being conducted across the US right now. We are participating in that study. It is looking at progesterone in head injuries. If proven effective for more serious head injuries, I am hoping it will be studied for concussion.

  4. kara December 28, 2012 / 13:38

    At age 14, a concussion caused me to suffer from an inner ear problem – dizziness and vomiting. A neurologist recommended rest, keeping my eyes closed, until swelling went away and my sense of balance returned. I was lucky that it only took a week. but was quite weak from a week without much activity. Had a couple dizzy spells in the following month, and was not in gym classes that year.

    Now recovering from an inner ear virus, without dizziness. Have some loss of hearing. Steroid inner ear injections restored some hearing. Using a quality EPA/DHA helped with quieting the hearing loss/noise. I started using the fish oil without knowing it would help my ears, but it appears to help.

  5. Gretchen November 10, 2013 / 20:31

    Gretchen from NY here. 8 years post concussion from a fall on black ice on a cracked cement driveway. Time knocked out: 45 minutes. I had another concussion incident within 2 months after the first. NO symptoms from either concussion until four months AFTER. Barometric pressure changes give me migraines. Still have residual issues with brightness & sound, not all the time. Bi-weekly chiropractor visits. Found Holistic medicines with multi B vitamins a must. Enrolled in college, found that I have problems (no pun intended) with math, specifically-simple math. Initially, it took 3 years to balance my body enough to walk normally at a slow pace. Still have issues with one eye dilating more than the other. Cannot talk & drive, I tend to miss simple things (like stop signs). I do yoga to relieve muscle stress, but it doesn’t always help. There are days when fast movement is not good, & days when I refuse to drive, because I don’t want to hurt anyone else. My doctors have told me several times, that they wish more of their patients would do that.

    I wish that M.D.’s would co-operate with chiropractors and massage therapists. I’ve learned alot over these last 8 years. One of the biggest problems is that medical doctors don’t like chiropractors. Why? Send your client to a massage therapist & then directly to a chiropractor. That way, all the muscles are relaxed and the bones can be put back into place with less stress. Give them something to relax a little more so that the residuals from this the next day won’t be so bad. It worked for me, but I had to beg my doctor to allow the chiropractor visits. It was my thought to go for the massage therapy prior, & she actually drove me to the chiropractor when done.

    Just remember this…everyone is different, and everyone should be treated individually. What works for one, may not work for you. 🙂 I’m applying for the University of Buffalo post concussion study. I hope I get accepted. Good luck everyone! 🙂

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