Back Clinic Whiplash Chiropractic Physical Therapy Team. Whiplash is a collective term used to describe injuries to the cervical spine (neck). This condition often results from an automobile crash, which suddenly forces the neck and head to whip back and forth (hyperflexion/hyperextension). Almost 3 million Americans are hurt and suffer from whiplash annually. Most of those injuries come from auto accidents, but there are other ways to endure a whiplash injury.
The symptoms of whiplash may include neck pain, tenderness and stiffness, headache, dizziness, nausea, shoulder or arm pain, paresthesias (numbness/tingling), blurred vision, and in rare instances difficulty swallowing. Soon after it happens at the acute phase the chiropractor will focus on reducing neck inflammation utilizing various therapy modalities (eg, ultrasound).
They might also use gentle stretching and manual therapy techniques (eg, muscle energy therapy, a type of stretching). A chiropractor may also recommend you apply an ice pack in your neck and/or light neck support to use for a short time period. As your neck gets less inflamed and the pain diminishes, your chiropractor will execute spinal manipulation or other techniques to restore normal movement to your neck’s spinal joints.
Physical therapy involves both passive and active treatments and�is an effective treatment for whiplash, especially combined with other treatments, like bracing and chiropractic. Whiplash causes the soft tissues in your neck to get damaged. A physical therapist can work with you to restore proper function and movement of those tissues.
Passive treatments help to relax tension in the muscle tissues brought on during the accident in the neck and body. It is considered a passive treatment because the patient does not actively participate. Fresh from the injury acute pain sets in, therefore passive treatment is usually the first type of therapy used as your body begins to heal and adjusts to the symptoms.
The primary goal of physical therapy is to get the patient actively participating in active treatment until they can do the exercises on their own. The therapeutic exercises that physical therapists teach to a patient are for strengthening your entire body to ensure that your spine is optimally supported.
Passive Treatment
Deep Tissue Massage
This technique focuses on tight muscle tension that develops from the injury. Direct pressure is applied and massaged to release the tension in the soft tissues like the:
Ligaments
Tendons
Muscles
This will help these tissues heal quicker and keep them loose.
Hot/Cold Therapy
Heat therapy is used by physical therapists to circulate more blood to the injured area. Increased blood flow allows more oxygen, and nutrients to the area. Blood also removes the waste products created by muscle spasms.
Cold therapy slows the blood’s circulation, which helps to reduce inflammation, muscle spasms, and pain. Physical therapists alternate between hot and cold therapy depending on the patient’s condition.
Whether in a car accident or other type of trauma hot and cold therapy can be used at home. Ice should be used first to bring down the inflammation. After 24 to 48 hours, switch between ice and heat. The heat helps relax tense muscles and increases blood circulation to the injured area. Never put ice or heat directly on the skin, wrap in a towel then apply.
Ultrasound
Ultrasound helps reduce muscle:
Cramping
Pain
Spasms
Stiffness
Swelling
Sound waves are sent deep into the muscle tissues and create a gentle heat that circulates the blood that optimizes the healing process.
Active Treatment
When the active part of the therapy begins, the therapist will teach/train you a variety of exercises to work on strength and range of motion or how the joints move with ease or not. Each physical therapy program is customized to each patient’s condition, health, and medical history.
Some exercises might not be appropriate for someone else with a whiplash injury as they could worsen their symptoms and exacerbate the injury. Learning how to correct your posture and utilizing ergonomics into your regular daily activities is part of the therapy program. Once recovered this posture work will continue to help because of the training/exercising you can prevent other forms of neck pain that develop from regular life.
Physical therapy for whiplash patients helps reduce muscle spasms, increase blood circulation, and promote healing of the neck tissues.
Spinal Bracing Another Treatment Option
Whiplash is very treatable, another option is using a cervical brace or cervical collar. The brace provides support to the neck while the soft tissues heal. The soft tissue’s job is to support your neck, but when they’re injured, they can’t do their job. That’s where the brace comes in.
Cervical devices limit the neck’s movement and support your head, which takes the weight off the neck.
This allows the muscles to rest while they heal. Your doctor will inform you of how long you need to wear the brace. Generally, it is worn for two to three weeks. The doctor will explain how to wear the collar, which means how long to weary it each day, caring for the collar, handling daily activities like showering, sitting, sleeping, etc. Symptoms usually subside in two to three weeks. However, if there is still pain, soreness, or other symptoms, you may have to try other treatments.
Whiplash Massage Therapy El Paso, TX Chiropractor
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After a car accident, you may notice neck pain.�It could be a�slight soreness that you think is nothing but take care more than likely you have whiplash.�And that�little soreness can turn into a lifetime of chronic neck pain�if only treated with pain meds and not�treated at the source.
Neck pain caused by a whiplash injury definitely warrants a visit to a chiropractic whiplash specialist that can provide non-surgical treatment and pain relief.
Whiplash is an injury to the neck muscles from a rapid forward and backward motion of the neck caused by trauma from a car accident, sports injury, slip and fall accident or even just turning one’s head but doing it with a fast whipping motion that causes the neck/spine muscles to become swollen and irritated. It can cause acute short-term neck pain and restricted movement.
How a Whiplash Injury Is Diagnosed
A chiropractor evaluates the spine in its entirety. If you go to a chiropractic clinic with neck pain following trauma. The chiropractor will examine the whole spine because the other areas of the spine could be affected and not just the neck region.
The chiropractor locates the areas where motion is restricted if there are any disc injuries, muscle spasms, and ligament injuries. They will first apply motion and staticpalpation diagnostic techniques where they feel and touch the various areas where the pain is present, as well as where there is no pain. A chiropractor will also feel for:
Tenderness
Tightness
How well the spinal joints move
They will also analyze the patient’s walk noting their posture and if there is possible spinal misalignment. This will help the chiropractor understand the patient’s body’s mechanics and what their spine is doing to compensate for the injury. This can mean:
Leaning to one side
Getting up in a very careful way so as to avoid pain
Hunching over
Only turning in one direction
In addition to the evaluation, they will also order an x-ray or an MRI to evaluate any deteriorating changes that could have existed before the whiplash injury. The images and physical and neurological evaluation resultsare compared to figure out and develop the best treatment plan.
Whiplash Treatment Stages
After a whiplash injury happens a chiropractor works to reduce neck inflammation with various therapies like:
Massage
Ultrasound
Light stretching
Soft manual therapy techniques
They may also recommend applying an ice pack on the neck and light neck support for a short time. As the inflammation and pain decrease the chiropractor will begin applying gentle spinal manipulation along with other techniques to restore the normal motion to the neck’s facet joints.
Chiropractic Whiplash Injury Treatment
A treatment plan depends on the severity of the whiplash injury. Some manipulation techniques used are:
Flexion-distraction technique
This is a gentle non-thrusting type of spinal manipulation that helps treat herniated discs. A whiplash injury can cause an aggravated bulging or herniated disc. If this happens a chiropractor uses a slow palm pump action on the disc rather than direct thrusting force.
Instrument-assisted manipulation
This technique also non-thrusting utilizes a hand-held instrument. A chiropractor generates force without thrusting directly into the spine. This therapy is great for older patients who may have degenerative joint syndrome.
Specific spinal manipulation
Spinal joints that are restricted or have abnormal motion are identified. Then the chiropractor restores motion to the joint with a gentle thrust. This stretches the soft tissue and stimulates the nervous system to bring back normal motion.
Along with these spinal therapies/techniques, a chiropractor also uses manual therapy to treat the soft tissues like the ligaments and muscles. Some examples of manual techniques are:
Instrument-assisted soft tissue therapy is where a chiropractor uses an instrument/s like the Graston technique, that gently treats any injured soft tissues. They will gently apply the instrument along the injured area with repeated strokes.
Manual joint stretching and resistance therapy is a form of manual therapy that uses the muscle’s own energy to create isometric contractions that help relax the muscles, and help lengthen the muscles.
Therapeutic massage is where a chiropractor or physical therapist performs massage to ease and relax muscle tension in the neck.
Trigger point therapy identifies specific tight painful points/areas of muscle by applying direct pressure with the hands or fingers on these points to alleviate the muscle tension.
Interferential electrical stimulation This technique uses low-frequency electrical current to stimulate the muscles and reduce inflammation.
Ultrasound increases blood circulation and helps reduce muscle spasms, stiffness, and pain. This happens by sending sound waves deep into the muscle’s tissue which generates low heat and increases circulation.
Therapeutic exercises to restore normal spinal motion and reduce whiplash symptoms.
Chiropractic medicine looks at the whole person and not just the symptoms. Neck pain is different for everyone, so chiropractors don�t just focus on the pain because the whiplash injury could have affected other areas that the patient doesn’t feel pain or anything.
But as the spine is a complex structure that works as a unit, a problem in one area can slowly or quickly start to create problems in other areas of the spine much like falling dominoes.
With these techniques, a chiropractor will help increase a patient’s daily activities back to normal as quickly as they can, depending on the severity of the injury. They will work as hard as they can to address any added spinal or nerve-related causes/injuries stemming from the original whiplash injury and treat them as well until normal movement is restored and there is no longer pain.
Remember that prevention is the key to optimal long-term health!
Our team has taken great pride in bringing our families and injured patients only clinically proved treatment protocols. �By teaching complete holistic wellness as a lifestyle, we also change not only our patient�s lives but their families as well.� We do this so that we may reach as many El Pasoans who need us, no matter the affordability issues.
El Paso, TX Chiropractic Neck Pain Treatment
NCBI Resources
Often,�people with whiplash don�t experience any effects until a day, or even two, after. The key is to stay ahead of the pain and take measures sooner rather than later to relieve it and keep it at bay. It also provides documentation should other issues arise, and you need the information for legal purposes.
If you are in an accident, especially if you get rear-ended, and experience whiplash, see a doctor that day ��even if you don�t feel much pain. The sooner you visit a chiropractic clinic, the sooner you can begin treatment should a problem develop.
Rheumatoid arthritis, or RA, is a chronic health issue which affects approximately 1 percent of the population in the United States. RA is an autoimmune disorder that causes the inflammation and degeneration of the synovial tissue, specific cells and tissue which form the lining of the joints within the human body. Rheumatoid arthritis may and generally does affect every joint in the body, especially as people get older. RA commonly develops in the joints of the hands and feet, severely restricting an individual’s ability to move, however, those with significant disease in the spine are at risk of damage like paraplegia. Rheumatoid arthritis of the spine is frequent in three areas, causing different clinical problems.
The first is basilar invagination, also referred to as cranial settling or superior migration of the odontoid, a health issue where degeneration from rheumatoid arthritis at the base of the skull causes the it to “settle” into the spinal column, causing the compression or impingement of the spinal cord between the skull and the 1st cervical nerves. The second health issue, and also the most frequent, is atlanto-axial instability. A synovitis and erosion of the ligaments and joints connecting the 1st (atlas) and the 2nd (axis) cervical vertebrae causes instability of the joint, which may ultimately result in dislocation and spinal cord compression. In addition, a pannus, or localized mass/swelling of rheumatoid synovial tissue, can also form in this region, causing further spinal cord compression. The third health issues is a subaxial subluxation which causes the degeneration of the cervical vertebrae (C3-C7) and often results in other problems like spinal stenosis.
Imaging studies are crucial to properly diagnose patients with rheumatoid arthritis of the cervical spine. X-rays will demonstrate the alignment of the spine, and if there is obvious cranial settling or instability. It can also be difficult to demonstrate the anatomy at the bottom of the skull, therefore, computed tomography scanning, or CT scan, with an injection of dye within the thecal sac is arranged. Magnetic resonance imaging, or MRI, is beneficial to assess the severity of nerve compression or spinal cord injury, and allows visualization of structures, including the nerves, muscles, and soft tissues. Flexion/extension x-rays of the cervical spine are usually obtained to evaluate for signs of ligamentous instability. These imaging studies entails a plain lateral x-ray being taken with the patient bending forward and the other lateral x-ray being taken with the individual extending the neck backwards.�The scope of our information is limited to chiropractic, spinal injuries, and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Neck Pain and Auto Injury
Whiplash is one of the most common causes of neck pain after an automobile accident. A whiplash-associated disorder occurs when a person’s head and neck moves abruptly back-and-forth, in any direction, due to the force of an impact. Although whiplash most commonly occurs following a rear-end car crash, it can also result from sports injuries. During an auto accident, the sudden motion of the human body can cause the muscles, ligaments, and other soft tissues of the neck to extend beyond their natural range of motion, causing damage or injury to the complex structures surrounding the cervical spine. While whiplash-associated disorders are considered to be relatively mild health issues, these can cause long-term pain and discomfort if left untreated. Diagnosis is essential.
You are sitting in your car, stopped at a traffic light. Suddenly, a vehicle traveling at low-speed rear-ends your car. The impact isn�t hard although it is unexpected. You take a look at your car and see that there is minor damage, or no damage at all, to either vehicle. The bumpers absorbed the bulk of the energy from the crash, so they protected the car. You feel a little pain in your neck, and upper back, perhaps a little dizzy or you have a headache, but you shrug it off, reasoning that it is from the unexpected jolt. After all, they didn�t hit you that hard. You exchange information with the other driver and go on your way.
The next morning is a different story. Your neck is painful and stiff. You have pain in your shoulders and back as well. A visit to the doctor reveals a diagnosis of whiplash.
Is Whiplash Real?
Some people will tell you that whiplash is a made-up injury that people use to get more money in a settlement stemming from an accident. They do not believe it is possible in a low-speed rear-end accident and see it as a legitimate injury claim, mainly because there are no visible marks.
Some insurance experts claim that about a third of whiplash cases are fraudulent, but that leaves two-thirds of the cases legitimate. There is also a great deal of research that supports the claim that low-speed accidents can indeed cause whiplash � and it is very, very real. Some patients suffer from the pain and immobility the rest of their lives.
The Mechanics of Whiplash
When a person is sitting in their vehicle, they are usually upright with their head directly over their shoulders, and the neck as the support. The key to whiplash is that it is unexpected. The vehicle gets struck, the torso of the person in the first car gets thrust forward. However, the head does not immediately follow but instead falls backward, behind the body for a split second. In this position, the neck is hyperextended for the first time (to the rear).
As the torso snaps back against the back of the seat, the person�s head falls forward but is quickly yanked back as it follows the movement of the chest � then passes it. The second time the neck is hyperextended (to the front). The effects of this movement that lasts only a few seconds can cause debilitating pain and immobility. It gets compounded when the headrests are set too far back and are too low so that they do not provide adequate support.
What To Do If You Are In A�Low-Speed Rear End Collision
If you are in an accident, especially if you get rear-ended, and experience whiplash, see a doctor that day � even if you don�t feel much pain. The sooner you get into a doctor, the sooner you can begin treatment should a problem develop.
Often, people with whiplash don�t experience any effects until a day, or even two, later. The key is to stay ahead of the pain and take measures sooner rather than later to relieve it and keep it at bay. It also provides documentation should other issues arise, and you need the information for legal purposes.
Seeing your chiropractor soon after your accident can help you heal faster and manage your pain more effectively. With techniques like gentle manipulation and deep tissue massage, your neck can begin to improve almost immediately. Then you can get back to life a lot faster.
I got into a car accident, I was rear-ended on Valentine’s Day and things weren’t quite right in my body, the aches and pains started coming. So after I visited another chiropractor and talked to my client, they told me about this place and when I came I was like, okay, I’m not going back to the other place. And that’s how I head about him (Dr. Alex Jimenez) and I’m so grateful. – Terry Peoples
Based on information referenced by the National Highway Traffic Safety Administration, or NHTSA, approximately more than three million individuals are injured annually in automobile accidents throughout the United States alone. While the unique conditions of every car crash can ultimately result in a wide variety of injuries, some types of automobile accident injuries are more common than others.
Fortunately, a majority of automobile accident injuries may resolve on their own without the need for treatment, however, more significant health issues caused by the auto collision may require some amount of treatment and/or rehabilitation and others may unfortunately become permanent if left untreated. It’s fundamental for the victim of an automobile accident to seek immediate medical attention in order for them to receive a proper diagnosis for their motor vehicle injuries before proceeding with the most appropriate treatment option for them.
Prior to following any necessary medical procedure, understanding some of the most common automobile accident injuries can help you become aware of the steps you can take to ensure that you are getting the proper care for your health issues. Furthermore, the type and severity of motor vehicle accidents suffered by the victims involved in a car crash may largely depend on several variables, including:
Was the individual wearing a seat belt?
Did the person’s car get hit from the back, side or front?
Was the occupant facing straight ahead in the seat? Or was the person’s head or body turned in a particular direction?
Was the incident a low-speed collision or a high-speed crash?
Did the car have airbags?
There are two broad categories of automobile accident injuries: impact injuries and penetrating injuries. Impact injuries are generally characterized as those caused when a portion of the individual’s body hits some part of the interior of the car. Frequently, this can be a knee hitting a dashboard or the head hitting the seat rest or the side window during an auto collision. Penetrating injuries are generally characterized as open wounds, cuts and scrapes. Shattering glass or loose items flying inside the car on impact can often cause these types of automobile accident injuries. Below, we will discuss the most common automobile accident injuries and describe them in detail.
Soft Tissue Injuries
Soft tissue injuries are some of the most common types of automobile accident injuries. A soft tissue injury is typically characterized as trauma, damage or injury to the body’s connective tissue, including tendons, ligaments and muscles. Soft tissue injuries can vary depending on the type of connective tissue it affects as well as on the grade and severity of the harm. Because soft tissue injuries do not involve open wounds, it may be challenging to diagnose these type of automobile accident injuries.
A whiplash-associated disorder, most frequently referred to as a whiplash injury to the neck and upper back, is a type of soft tissue injury. In this form of harm, the muscles, tendons and ligaments are stretched beyond their natural range due to the abrupt movements imposed on the neck and head from the force of the impact at the point of collision. These same mechanisms may additionally cause soft tissue injuries in other regions of the body, such as the back. Automobile accidents can also often cause mid-back and low-back muscle sprains, and at times, these may cause severe back injuries and even aggravate underlying conditions due to the sheer force from the impact on the spine.
Cuts and Scrapes from Automobile Accident Injuries
During an auto collision, any loose objects inside the car can immediately become projectiles which can be thrown about the vehicle’s interior. This includes cell phones, coffee glasses, eyeglasses, purses, books, dash-mounted GPS systems, etc.. If one of these objects strikes your body at the time of the incident, they can easily cause cuts and scrapes as well as cause additional trauma, damage or injuries.
Occasionally, these cuts and scrapes are relatively minor and require no immediate medical attention. More severe cases of these type of automobile accident injuries, however, could create a relatively large open wound and may require stitches to prevent blood loss. Cuts or scrapes can also occur when your airbag deploys from the auto collision.
Head Injuries
Head injuries in the form of automobile accident injuries can take a number of forms, where some can be considered comparatively minor and others can virtually be quite severe. The sudden stop or shift in direction by a motor vehicle during an car crash can cause an individual’s head and neck to jolt or jerk abruptly and unnaturally in any direction, overstretching the complex structures of the cervical spine beyond their normal range, leading to muscle strains and whiplash-associated disorders.
The head itself can also be injured during an auto accident. Impact with a side window or with the steering wheel may cause cuts, scrapes and bruises to the head, as well as even deeper lacerations. More severe collision impacts can cause a closed head injury. In that circumstance, the fluid and tissue inside the skull are damaged due to the abrupt movement or impact of the head. Less acute closed head injuries often result in concussions, while the most severe head injuries can cause brain damage.
Chest Injuries
Chest injuries are also common auto accident injuries. These type of injuries are usually identified as contusions or bruises, however, these can also take the form of much more severe injuries, like fractured ribs or internal injuries. Drivers often experience chest injuries due to their position behind the steering wheel, which offers very little space to move before the torso collides with the steering wheel. If an individual’s body is thrown forward during a motor vehicle collision, even if their chest doesn’t impact the steering wheel or dashboard, the torso will experience tremendously high amounts of force, specifically against the shoulder harness or seat belt, which may cause severe bruising.
Arm and Leg Injuries
The very same sheer forces which unexpectedly throw a person’s head and neck back-and-forth during a car crash can behave similarly on arms and legs. If your vehicle experiences a side impact, your arms and legs may be tossed hard against the door. In addition, if you’re a passenger, your legs typically have very little room to move. As a result, automobile accidents often cause an occupant’s knees to strike the dashboard or even chairs in front of them.
Based on the circumstance of the auto collision, automobile accident injuries to your arms and legs may include bruises, scrapes and cuts, however, sprains and even fractures in both the upper and lower extremities can happen. Keep in mind that some injuries aren’t apparent following a car accident. It may take days, weeks, or even months for symptoms to manifest. Therefore, if you’ve been involved in an automobile accident, it is best to seek immediate medical attention.
Dr. Alex Jimenez’s Insight
After being involved in an auto accident, it may sometimes take days, weeks, even months for symptoms to manifest completely. For your own health and wellness, it’s essential to seek immediate medical attention following the car crash. While many types of injuries can occur, there are several common automobile accident injuries which can develop due to the sheer force of the impact, such as whiplash-associated disorders. Whiplash is a prevalent auto accident injury which is characterized as a type of neck injury which happens when the complex structures surrounding the cervical spine are stretched far beyond their natural range of motion. Chiropractic care is a safe and effective treatment option which can treat a variety of auto accident injuries.
Chiropractic Care After an Automobile Accident
Many healthcare professionals are qualified and experienced�in the treatment of a variety of automobile accident injuries, especially chiropractors. Chiropractic care is a well-known, alternative treatment option which focuses on the diagnosis, treatment and prevention of numerous injuries and/or conditions associated with the musculoskeletal and nervous system. If you’ve been involved in an auto collision, chiropractic care can offer substantial benefits towards your current well-being, supporting your recovery process.
After a car collision, you may experience pain and discomfort, decreased range of motion, stiffness or soreness. Remember that these symptoms may not always manifest immediately after a motor vehicle accident. Through the use of spinal adjustments and manual manipulations, chiropractic care will help you manage painful symptoms, as well as help enhance flexibility, increase strength and improve mobility, promoting a faster recovery. In addition, it can prevent long-term symptoms from developing, such as migraines and chronic pain. The sooner you get chiropractic care after a car wreck, the more likely you are to recover fully.
By carefully restoring the original alignment of the spine, chiropractic care helps reduce pain and other painful symptoms. Furthermore, a chiropractor can recommend a series of exercises and physical activities to help pump oxygen, blood and nutrients to the injury site and enhance recovery. A doctor of chiropractic will develop a personalized treatment program targeted to your specific automobile accident injuries. Chiropractic care also makes it possible to avoid the need for surgical interventions. It strengthens ligaments, tendons and muscles, which shield the body’s structures. It’s also a far more cost-effective solution.
Chiropractic care can also restore function in patients with older vehicle collision injuries. You are still able to benefit from chiropractic care even if you had an accident years back. Employing spinal adjustments and manual manipulations, as well as rehabilitation techniques, it helps relieve old pain and improve function. Additionally, it is a non-invasive treatment option, and you won’t end up needing to rely on pain drugs and/or medications for relief of your symptoms.
Chiropractors can even treat vertigo resulting from a car crash. In as little as one treatment, they could fix a dysfunction in the vestibular system. Other types of chiropractic care treatment techniques include massage, ultrasound, ice and cold treatment, specific exercises and physical activities, and even nutritional advice. Chiropractic care is a safe and effective treatment approach which can help treat automobile accident injuries without the need for drugs and/or medications as well as surgery.
If you suffered a car accident injury, don’t delay any longer. Contact a chiropractor and allow them to help you follow the best treatment path. Chiropractors can provide you a consultation to perform a comprehensive evaluation and make a treatment strategy targeted to your injuries.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Concussions are traumatic brain injuries that affect brain function. Effects from these injuries are often temporary but can include headaches, problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head or violent shaking of the head and upper body. Some concussions cause loss of consciousness, but most do not. And it is possible to have a concussion and not realize it. Concussions are common in contact sports, such as football. However, most people gain a full recovery after a concussion.
Can also happen due to excessive shaking of the head or acceleration/deceleration
Mild injuries (mTBI/concussions) are the most common type of brain injury
Glasgow Coma Scale
Common Causes Of Concussion
Motor vehicle collisions
Falls
Sports injuries
Assault
Accidental or intentional discharge of weapons
Impact with objects
Prevention
Prevention of concussive injuries can be paramount
Encourage Patients To Wear Helmets
Competitive sports, especially boxing, hokey, football and baseball
Horseback riding
Riding bicycles, motorcycles, ATVs, etc.
High elevation activates such as rock climbing, zip lining
Skiing, snowboarding
Encourage Patients To Wear Seatbelts
Discuss the importance of wearing seatbelts at all times in vehicles with all of your patients
Also encourage use of appropriate booster or car seats for children to ensure adequate fit and function of seat belts.
Driving Safely
Patients should never drive while under the influence of drugs, including certain medications or alcohol
Never text and drive
Make Spaces Safer For Children
Install baby gates and window latches in the home
May in areas with shock-absorbing material, such as hardwood mulch or sand
Supervise children carefully, especially when they�re near water
Prevent Falls
Clearing tripping hazards such as loose rugs, uneven flooring or walkway clutter
Using nonslip mats in the bathtub and on shower floors, and installing grab bars next to the toilet, tub and shower
Ensure appropriate footwear
Installing handrails on both sides of stairways
Improving lighting throughout the home
Balance training exercises
Balance Training
Single leg balance
Bosu ball training
Core strengthening
Brain balancing exercises
Concussion Verbiage
Concussion vs. mTBI (mild traumatic brain injury)
mTBI is the term being used more commonly in medical settings, but concussion is a more largely recognized term in the community by sports coaches, etc.
The two terms describe the same basic thing, mTBI is a better term to use in your charting
Evaluating Concussion
Remember that there does not always have to be loss of consciousness for there to be a concussion
Post-Concussion Syndrome can occur without LOC as well
Symptoms of concussion may not be immediate and could take days to develop
Monitor for 48 post head injury watching for red flags
Blurred eyesight or other vision problems, such as dilated or uneven pupils
Confusion
Dizziness
Ringing in the ears
Nausea or vomiting
Slurred speech
Delayed response to questions
Memory loss
Fatigue
Trouble concentrating
Continued or persistent memory loss
Irritability and other personality changes
Sensitivity to light and noise
Sleep problems
Mood swings, stress, anxiety or depression
Disorders of taste and smell
Mental/Behavioral Changes
Verbal outbursts
Physical outbursts
Poor judgment
Impulsive behavior
Negativity
Intolerance
Apathy
Egocentricity
Rigidity and inflexibility
Risky behavior
Lack of empathy
Lack of motivation or initiative
Depression or anxiety
Symptoms In Children
Concussions can present differently in children
Excessive crying
Loss of appetite
Loss of interest in favorite toys or activities
Sleep issues
Vomiting
Irritability
Unsteadiness while standing
Amnesia
Memory loss and failure to form new memories
Retrograde Amnesia
Inability to remember things that happened before the injury
Due to failure in recall
Anterograde Amnesia
Inability to remember things that happened after the injury
Due to failure to formulate new memories
Even short memory losses can be predictive of outcome
Amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute)
Return To Play Progression
Baseline: No Symptoms
As the baseline step of the Return to Play Progression, the athlete needs to have completed physical and cognitive rest and not be experiencing concussion symptoms for a minimum of 48 hours. Keep in mind, the younger the athlete, the more conservative the treatment.
Step 1: Light Aerobic Activity
The Goal: Only to increase an athlete�s heart rate.
The Time: 5 to 10 minutes.
The Activities: Exercise bike, walking, or light jogging.
Absolutely no weight lifting, jumping or hard running.
Step 2: Moderate activity
The Goal: Limited body and head movement.
The Time: Reduced from typical routine.
The Activities: Moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting
Step 3: Heavy, non-contact activity
The Goal: More intense but non-contact
The Time: Close to typical routine
The Activities: Running, high-intensity stationary biking, the player�s regular weightlifting routine, and non- contact sport-specific drills. This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2.
Step 4: Practice & full contact
The Goal: Reintegrate in full contact practice.
Step 5: Competition
The Goal: Return to competition.
Microglial Priming
After head trauma microglial cells are primed and can become over active
To combat this, you must mediate the inflammation cascade
Prevent repeated head trauma
Due to priming of the foam cells, response to follow-up trauma may be far more severe and damaging
What Is Post-Concussion Syndrome (PCS)?
Symptoms following head trauma or mild traumatic brain injury, that can last weeks, months or years after injury
Symptoms persist longer than expected after initial concussion
More common in women and persons of advanced age who suffer head trauma
Severity of PCS often does not correlate to severity of head injury
PCS Symptoms
Headaches
Dizziness
Fatigue
Irritability
Anxiety
Insomnia
Loss of concentration and memory
Ringing in the ears
Blurry vision
Noise and light sensitivity
Rarely, decreases in taste and smell
Concussion Associated Risk Factors
Early symptoms of headache after injury
Mental changes such as amnesia or fogginess
Fatigue
Prior history of headaches
Evaluation Of PCS
PCS is a diagnosis of exclusion
If patient presents with symptoms after head injury, and other possible causes have been ruled out => PCS
Use appropriate testing and imaging studies to rule out other causes of symptoms
Headaches In PCS
Often �tension� type headache
Treat as you would for tension headache
Reduce stress
Improve stress coping skills
MSK treatment of the cervical and thoracic regions
Constitutional hydrotherapy
Adrenal supportive/adaptogenic herbs
Can be migraine, especially in people who had pre-existing migraine conditions prior to injury
Reduce inflammatory load
Consider management with supplements and or medications
Reduce light and sound exposure if there is sensitivity
Dizziness In PCS
After head trauma, always assess for BPPV, as this is the most common type of vertigo after trauma
Dix-Hallpike maneuver to diagnose
Epley�s maneuver for treatment
Light & Sound Sensitivity
Hypersensitivity to light and sound is common in PCS and typically exacerbates other symptoms such as headache and anxiety
Management of excess mesencephalon stimulation is crucial in such cases
Sunglasses
Other light blocking glasses
Earplugs
Cotton in ears
Treatment Of PCS
Manage each symptom individually as you otherwise would
Manage CNS inflammation
Curcumin
Boswelia
Fish oil/Omega-3s � (***after r/o bleed)
Cognitive behavioral therapy
Mindfulness & relaxation training
Acupuncture
Brain balancing physical therapy exercises
Refer for psychological evaluation/treatment
Refer to mTBI specialist
mTBI Specialists
mTBI is difficult to treat and is an entire specialty both in the allopathic and complementary medicine
Primary objective is to recognize and refer for appropriate care
Pursue training in mTBI or plan to refer to TBI specialists
Sources
�A Head for the Future.� DVBIC, 4 Apr. 2017, dvbic.dcoe.mil/aheadforthefuture.
Alexander G. Reeves, A. & Swenson, R. Disorders of the Nervous System. Dartmouth, 2004.
�Heads Up to Health Care Providers.� Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Feb. 2015, www.cdc.gov/headsup/providers/.
�Post-Concussion Syndrome.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 July 2017, www.mayoclinic.org/diseases-conditions/post- concussion-syndrome/symptoms-causes/syc-20353352.
Whiplash Massage: Sandra Rubio describes how whiplash-associated disorders resulting from an automobile accident can cause symptoms of neck pain. An injury to the cervical spine can damage the complex structures of the neck, including vertebrae, intervertebral discs and soft tissues like tendons, ligaments and muscles. Dr. Alex Jimenez, doctor of chiropractic, is a non surgical choice which provides several treatment methods, such as deep-tissue massage, which can help improve neck pain associated with whiplash from an auto accident.
Massage therapy�is the evaluation and manipulation of cells and joints of the human body to effect a curative response in the�prevention and treatment of physical dysfunction. It may be curative or preventative, helping to rehabilitate, to preserve, strengthen bodily function or relieve pain. Massage therapy has established its function as it achieves outcomes that were undeniable, as a wellness option used to alleviate an assortment of physical discomforts.
Massage helps alleviate the soft tissue discomfort associated with everyday stress, muscular overuse and lots of chronic pain syndromes. Massage treatment can decrease the development of painful muscular patterning if used early enough after accidents involving trauma and injury.
Whiplash Massage Therapy
Neck pain can come from various structures in the neck including: vascular, nerve, airway, digestive, and musculature or it can originate from other areas of the human body. Although the causes are many, most are easily rectified by either assistance or using self help suggestions and techniques. Treatment of neck pain is dependent upon the reason. For the vast majority of individuals, neck pain may be treated conservatively. Recommendations in conservative treatment include applying cold or heat. Other frequent treatments could include chiropractic care, physical therapy, body mechanics training, reform that is ergonomic, and drugs and/or medication.
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