Concussions, No longer just rest!

It is often sparked by a high-profile athlete getting a concussion (Ravens quarterback Lamar Jackson) to stir the buzz word “Concussion” around the sports and often non-sports worlds. For the longest of time, and as most recent as 2013, complete rest was the suggestion of many health care professionals, myself included. While this was a safe method, it often did not address some of the underlying pathologies associated with sport related concussion/ post-concussion syndrome. I want to highlight some of the actions I have taken for my athletes and patients that have been a better step in the right direction versus “just rest”

Cognitive Rest – We live in a very stimulating world. Our lifestyle is often conducive for recovery. Between our phones/computers/tablets/tv’s we are in a constant state of stimulation of noise, sounds and lights. This would be one of the only pieces of the original recommendations of rest that I find extremely important. Your daily cognitive load cannot make your symptoms worse if you are struggling with post-concussion symptoms. Anyone remember when Texas Tech Coach Mike Leach was fired over locking a player in a dark shed? (If not here you go: https://abcnews.go.com/US/texas-tech-university-football-coach-mike-leach-fired/story?id=9449169) As an outsider to the situation were his intentions good? Maybe. But definitely went about it the wrong way. So turn that phone on night mode, pick up a pair of blue-light blocking glasses if you must work on your computer for extended periods of time. Finally, talk to your health care provider about accommodating your current work or academic schedule so that you can take steps forward and not back.

GET ACTIVE – The last paragraph ends where I would say “Old School meets New School”. Exercise is a must and an early application to the recovery. The Buffalo Concussion Treadmill Test (BCTT) has become a front runner in safe return to exercise with concussion/post-concussion symptoms. More information on the BCTT can be found here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492460/

Vestibulo-Ocular Dysfunction – This is not my expertise. This is not an area I am thoroughly trained to evaluate and treat. Like all health care workers it is important for me to recognize when my patients are not improving. This could be the very reason. Patients struggling from this following a concussion will have trouble with visual acuity, double vision, fogginess, motion sensitivity, difficulty concentrating or focusing. If these symptoms do not subside it is beneficial to seek care from someone who specializes in their treatment: vestibular physical therapist, neuro-opthalmologist, neuro-optometrist.

Cervical Spine Dysfunction – Let’s call this my wheel house. This is an area I see the most success with my athletes and patients when it comes to concussions and post-concussion. A study performed in Canada in spring of 2019 of 266 pediatric sport related concussions, the authors found that 32.5% of the patients also suffered from cervical spine dysfunction (CSD). The authors then concluded that those that had CSD in addition to their concussion were 3.95 times more likely to have a delayed recovery versus those that didn’t have CSD (28.5 days vs 17 days). Link to the study below. This is pretty telling how powerful and important the head on neck, neck on body relationship is. If there is limitations in the motion or function of the neck it plays directly into how the brain is able to function and recover.

I did a previous piece on breathing and its importance to our overall health status, which can be found here: https://drbrianregan.com/2019/11/13/take-a-deep-breath/. For connecting some dots, I want to include some of that writing now. The fluid surrounding your brain, cerebrospinal fluid (CSF), plays a vital role in our daily function by providing nutrition and waste removal for the brain. It was at one point believed that its primary function was to balance the pressure within the skull. As the pulse of blood entered the skull, the skull could not compress or expand. The CSF would then pulse just the same and exit the skull, maintaining equilibrium, or balancing the system.

Advances in MRI imaging have completely changed our interpretation of this lifeblood. We are now able to measure the fluid and its movement throughout the body without sticking a needle in the spine, or opening up the skull. Researchers have determined that respiration is a major component, if not the most important component, in your bodies ability to effectively move CSF. Anecdotally if we are able to stimulate the flow of CSF through the brain, could we accelerate the brain’s ability to recover. Or uncork the plug that may be limiting the brains recovery in the first place. We know that with concussions the brain cell’s metabolism essentially has gone “haywire”. If we could provide that cell with appropriate nutrition and waste reduction, we could in turn help it recover.

Parasympathetic Stimulation- There is an additional benefit to the deep breathing techniques. We know that deep breathing will help stimulate our parasympathetic nervous system. This is also more commonly known as our “Rest-and-Digest” portion of our nervous system. Amplifying the “Rest-and-Digest” portion of your nervous system will help you have better sleep and recover better during that sleep. I recommend all of my patients to perform slow and deep diaphragmatic breaths while they are lying in bed to help “down regulate” and slow their body down prior to sleeping. This is also a tactic that can be used when performing an activity that is aggravating post-concussion symptoms to halt those symptoms from getting worse.

Magnesium- What started as a cue from Ben Greenfield from his book Boundless (https://www.amazon.com/Boundless-Upgrade-Brain-Optimize-Aging/dp/1628603976) has now gained traction in the concussion research. Ben originally wrote about magnesium being able to attenuate blood brain barrier permeability. Now double blinded research has surfaced supporting the application of magnesium during the acute stage of concussions. High dose IV supplementation has been found to be neuroprotective in severe cases of traumatic brain injuries. Authors of this study (https://www.ajemjournal.com/article/S0735-6757(20)30348-X/fulltext) believe that magnesium will decrease symptoms sooner and allow a faster return to baseline.

Complexity- At this point I hope you have assumed the complexity that can be brought on with concussions and how 1-sized fits all management is not always ideal. Whether you are a health care provider or a patient, please seek the appropriate health care provider to help guide you or your patients to recovery. Let’s not sit back and say “it’ll be get better with time”

Algorithm for diagnosis of physiological post-concussion syndrome (PCS) and different post-traumatic disorders (PTDs, image adapted from Ellis, Michael J., Leddy, John J., and Willer, Barry S. “Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment.” Brain injury 29.2 (2015): 238-248).

Disclaimer: This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. It is extremely important if you are struggling with a concussion or the aftermath of a concussion to find a health professional that is experienced in treating and managing concussions. It is paramount for you to find someone that can help jumpstart your recovery.

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306465/
https://pubmed.ncbi.nlm.nih.gov/32318012/
https://pubmed.ncbi.nlm.nih.gov/29393810/
https://pubmed.ncbi.nlm.nih.gov/30045221/
https://cdn-links.lww.com/permalink/jsm/a/jsm_2020_01_28_haider_19-313_sdc1.pdf
https://pubmed.ncbi.nlm.nih.gov/28152239
https://www.jneurosci.org/content/jneuro/35/6/2485.full.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089233/pdf/nihms976674.pdf

Crush being a Student Athlete

High school athletics are unique and dynamic. The experiences and challenges that I had growing up playing sports are not the same of today’s high school, or even college athletes. Even since I have been working in the high school setting, things have changed dramatically. Social media went from “what is that?” to giving every student and fan a way to voice their opinion – both good and bad. There have been a few mainstays that I think will always be the forefront of a successful student athlete.

Photo for comic relief. My Brother and I, Spring 2004

Humility – The ultimate learning point of sports is getting put in a public light, under scrutiny, and expecting to perform to perfection. How well you respond to negative emotion and positive emotion, says a lot about your character and person. This is something that as a student athlete, I definitely struggled with. retrospectively, there were plenty of situations where I lost my cool and where I could’ve done better. It would’ve allowed me to be more open to coaching and allowed me to see and understand the game better.

This is where social media becomes a huge challenge for student athletes of today. Everyone has an opportunity to let you know how you played. How you process that information is 100% up to you. Allow yourself to be coached, take that negative feedback, watch the game film and become a better athlete every time you step out on the floor or the field.

Strength and Conditioning – What a time to be alive in the strength and conditioning world of sports. There isn’t a team/coach/athlete out there that doesn’t know that they would be better if they spent more time in the weight room. I hold this close to my heart because I see day in and day out, the athletes that spent time in preparation during the off season are not only more successful, they are also less injured. Don’t get lost in philosophical battles of training techniques, just go in lift more weight than you did on a previous workout and keep getting stronger.

Find the time! This is the largest excuse I hear from student athletes. I know its difficult to balance school, sports and often work. 20-30 minutes after school can be a huge benefit to you and your performance. Young and inexperienced lifters (regardless of your age), don’t be embarrassed to ask questions or get help/advice. You didn’t learn to swing a bat or shoot a basketball without someone’s help. Strength training is no different. You will excel with guidance.

Sleep- As a student athlete you need to love your sleep. During sleep is when your body will recover and rejuvenate after those long days of mental and physical activity. Turn your phone off and shut down for the night. Get off social media, it will be there in the morning. Forget about the technology, you will know if you are well rested enough, don’t rely on some app. If you wake up in the morning and you are still sore from the day before, you are not getting enough sleep.
Here’s a routine I often recommend to athletes and patients to help down regulate and get ready for bed:

Child’s pose with feet tucked under your butt, feet flat on the ground so to stretch the front of the ankle/shin – 10 deep diaphragmatic breaths with the stomach expanding down
Child’s pose with feet tucked under your butt, toes up on the ground so to stretch feet and deep flexors of the ankle – 10 deep diaphragmatic breaths with the stomach expanding down
5- 10 minutes of foam rolling the major muscle groups of the legs/hips
1-2 minutes of foam rolling the back and upper trapezius muscles

I believe these three things have stood the test of time and will forever. They will help your energy, intellect and performance. There will always be a “better athlete” out there in your sport, but you can be the one that decides who is going to work harder. Crush your competition.

Exercise Less

The first full work week following “New Year, New Me”, January 1, 2020. How are those activity resolutions working out? I enjoy utilizing the start of a new year as a restart for some people a start to a healthier, more active lifestyle. I myself have changed up my regular routine to include different forms of exercise. Whatever you have decided for your new years resolution, Don’t Stop!

A few years back I read a book authored by Katy Bowman, Move Your DNA: Restore your Health through Natural Movement. Amazon Link to follow: (https://www.amazon.com/gp/product/1943370109/ref=dbs_a_def_rwt_bibl_vppi_i0) A wonderful and entertaining read with a great message. The one phrase that still to this day sticks out in my mind from listening to the audiobook (paraphrasing because its been a few years): “We need to exercise less, and start moving more”

I apologize to Ms. Bowman, if I terribly slaughtered that statement but I want to roll with it. Often times our new years resolutions can overwhelming and difficult to maintain. But let’s go back to that statement. Let’s exercise less, and start moving more. WOAH the guy who has a master’s degree in exercise science just said to exercise less! Yea, I guess I did. But that’s not the kicker. I don’t care about your exercise, as long as you are doing it. I want you to focus on the second half of that. “Start moving more.”

Start moving more: Take the Steps

Start moving more: walk/bike to work if you can, park a block away so you walk into the building instead of parking close

Start moving more: Stand at work instead of sit

Start moving more: Take a quick 1 minute lap around the office every 20 minutes. (Someone has had to have done a study on the productivity of active workers. I am just not gonna spend the time to look for it 🙂

Start moving more: Take the dog around the block for a walk, even if it’s cold outside. If you don’t have a dog, take yourself around the block for a walk, even if it’s cold outside.

Start moving more: (Insert your own adaptation of what you already do during your daily life)

Movement is our life, its what we were made to do.

When we stop moving, that is when problems begin. When we move and breathe we push and pull fluids through our body. Our pressure in our lungs helps pull fluid around the brain. When we move our legs, the muscle pump helps return blood in the venous system back to the heart. Movement is our life. Don’t get caught up in “having to exercise to be healthy”, get caught up in moving more.

Also: Read Katy Bowman’s book. Here’s the link again: https://www.amazon.com/gp/product/1943370109/ref=dbs_a_def_rwt_bibl_vppi_i0
Or you can subscribe to her podcast: https://podcasts.apple.com/us/podcast/move-your-dna-with-katy-bowman/id894200695

Yours in Health
Dr. Brian Regan

Attacking the “Fight-Or-Flight” Response

I recently had a great conversation with a patient who described to me their body’s interpretation of the fight-or-flight response. Agitation, restlessness, heightened respiratory rate, unable to “settle down”. How often do we find ourselves in such a difficult situation? Likely way more than we should be. Our bodies are inherently wired to enhance such feelings when we are situations of danger. We used to rely on this primitive system for survival, but in our current day and age, it can do more harm than good. Especially if we can’t find out way out of it.

Our sympathetic branch of our autonomic nervous system (ANS) is responsible for an increased heart rate you get when someone jumps out and scares you. It once helped us in times of danger to fight off enemies or animals as we developed. The parasympathetic branch of the ANS is also called the “rest-and-digest” response. It was once believed that these two systems operated independently, but we now appreciate that they work in a unique balance to help us regulate our bodies through out the day.

Often times we don’t focus enough on amplifying our rest-and-digest parasympathetics to counter our fight-or-flight sympathetics. We enhance our fight-or-flight all day long, starting with the morning cup of coffee we drink. Or maintain forward head posture through the day, which tightens the muscles of anterior neck creating unnecessary tension. Finally as we sit with a forward slouched position, it becomes difficult for us to take a deep breathe. Short and shallow breaths are typically sympathetic amplifiers, while deep prolonged breaths stimulate the parasympathetic nervous system.

Amplifying your rest-and-digest portion of your nervous system will help you have better sleep and recover better during that sleep. I recommend all of my patients to perform slow and deep diaphragmatic breaths while they are laying in bed to help “down regulate” and slow their body down prior to sleeping.

For those of you who have ever gotten a massage, you can attest to the relaxation effect that comes over you. That is your parasympathetic nervous system at work. Another recommendation I often make is to foam roll the major muscles of your legs prior to sleeping. This not only will help relax those hard and tense muscles, it could (in theory, can’t find a publication on it) boost that parasympathetic system.

The toughest recommendation to make because I know how much people love their morning coffee! Carefully monitor the amount of caffeine you are consuming through the day. If you wake up every morning and crave a cup of your favorite stimulant, it may be a sign that you are not getting thorough enough sleep at night. It can be a negative cycle to consume caffeine products to counter your tiredness, when those same drinks will trash your sleep quality.

Structural chiropractic treatment can be used to combat the postural distortions we put our body through all day long. Research is collecting on the benefit of chiropractic treatment and its effect on the parasympathetic nervous system. One major downfall about the collection is how and what is measured. What we can focus on is how well we are able to maintain our ability to move fully and breathe deeply so we are not putting undue mechanical stress on our bodies.

Sucking Air

Asthma is no joke. The spasms that make it difficult to breath can send someone into a full on fight-or-flight response in seconds. I regularly work with athletes who need to be quickly coached through diaphragmatic breathing techniques because they have forgotten their rescue inhaler during a game or match. But what if there was an option besides waiting for an asthma episode to come on and hoping the inhaler will stop the spasm.

Exercise induced asthma will come on as chest tightness, possible wheezing, shortness of breath during or shortly after heavy exercise. Better understanding of the mechanism of breathing, anatomy of the diaphragm, will give us some cues into possible treatment methods.

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The above picture is the major muscle of respiration: the diaphragm. We are looking at it from an inferior to superior view (from hips to ribs). I want to point out some very important parts of the muscle that play a huge role in its function or dysfunction.

Focus on how the fibers of 15, 14, and 13 run into the fibers of the spine and muscles of the hip. When there is dysfunction in the core muscles, the diaphragm gets taken along of the ride. Often the diaphragm will stop working primarily as a muscle of respiration in an attempt to create tension through the muscles of the pelvis. All in desperation to create lumbopelvic stability. This can be seen in people that when they stand, their ribs “flare” out. Their lower ribs will be more prominent and stick out. This is a last chance effort to create tension in the hip flexor and lumbar spine, by stretching the diaphragm.

If someone with a dysfunctional core has been running or exercising for a period of time, it makes sense that they would have difficulty breathing. The diaphragm has stepped in as a core control muscle during the activity. The action of breathing becomes labored without help of the diaphragm.

Now lets talk posture. As we start to adopt a forward head posture our overall vital capacity becomes mechanically restricted. The muscles surrounding the ribs will tighten, the ribs move in an inferior position and taking a full breath becomes more difficult. Pair this posture with dysfunctional core control and we have a recipe for disaster. The diaphragm struggles to work as a muscle of respiration, while the ribs are limited in their ability to elevate. Taking a deep breath, especially during any sort of increased activity, can feel impossible.

So what’s to be done about it? A systematic review of three randomized control trials found that there was moderate evidence to support diaphragmatic breathing training in individuals with asthma found both short-term and long-term improvement of their quality of life. Another study performed a 16-week muscular retraining program and found a significant reduction in pharmacologic intervention and symptom severity.

If one can treat the mechanical restriction caused by postural distortions and retrain the diaphragm to be a muscle of respiration, patients should find relief from exercise induced asthma.

Sources:

Ledford DK, Lockey RF, World Allergy Organization. Asthma : Comorbidities, Coexisting Conditions, and Differential Diagnosis. Oxford: Oxford University Press; 2014
https://www.ncbi.nlm.nih.gov/pubmed/1642520
https://www.ncbi.nlm.nih.gov/pubmed/23088703

Looking out for #1

Ever hear that men are too stubborn to go to the doctor until it is “too late” -insert your own definition. Turns out when it comes to headache and back pain there are not gender biases as to when someone would consult a primary care doctor, according to a study of the journal of health services research and policy. Good on you gentlemen and a good point of emphasis for this weeks blog. (Heres that study if your interested in reading more https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104816/)

Self care is the best care. You are the only one that initiate care when it is needed. You are the only one that knows when your body isn’t working “as it should” or “as it used to”. I believe we as humans are ingrained to think that as we get older that we shouldn’t move like we once did. Yes, there are definitely changes in our hormones. Yes, it is true our metabolism “slows” down. But that is largely because we start slowing down our own movement and activity.

I want to challenge the thought that we should slow down as we get older. I think you should go out for that half mile walk, a 20-minute run, or go lift some weights. There will be moments of soreness, moments of where you may not be interested in what you are doing. But it is the best way to stay young and vibrant. Challenge yourself to do something that you haven’t in the last year. Let it establish a goal for you for the coming year. Set your standard of activity and break it.

It can be a vicious cycle when you add a sedentary lifestyle and injury from trauma or accidents. Arthritis sets in when an injury happens and no intervention is performed. Arthritis can be an overwhelming diagnosis, but it doesn’t need to be. What I hope to get across is aging and arthritis are not synonyms, but often they are seen that way. You can regain function, to an extent of your severity. Your body is resilient and with the right tools, you can start to move and feel better.

Take the next few weeks to reflect on how your feeling and how you are moving. If you’re happy where you are at, great! If you’re not, only you can take the steps you need to get moving and feeling better.

Protection Plan

Tis the season (Of icee surfaces)! Nothing worse than spending the holidays in pain due to an accident, fall, or slip. Mobility and core strength are key in protecting your back, hips and extremities. Our bodies interpretation of where we are in space, proprioception, is determined by the receptors in our joints and muscles. When there becomes restriction in range of motion, we create an altered sense of proprioception. We lose the ability to truly sense the ground underneath our feet.

What??? Of course you can feel the ground under your foot. But can your brain sense when you make contact with the ground. Ever hear someone tell you that they have “terrible ankles because they get sprained all the time!”? That is not due to weak ligaments or muscles in the ankle itself. It could be due to a global loss of sense in that limb, thats putting that ankle in a position to constantly roll or sprain.

We can put our bodies through a lot of punishment before our brain says “stop”. We are fortunate that our bodies are extremely resilient. If not, we would be in constant state of pain for even the littlest of activity. Our brains will interpret pain when the stimulus becomes too strong to ignore. It becomes difficult to say then, that presence or absence of pain is the equivalent of being healthy or not.

Ever take your car into the shop and wonder what will be covered under its warranty? What if you drop your phone and the screen cracks, who will cover the cost. But when it comes to your health and body, it is your individual responsibility.

Noticing your body has begun limitations in range of motion can be the first step in your personal Protection Plan. Can you look over both shoulders equally? Can you reach both of your arms overhead? Are both of your knees able to bend fully so that your lower leg touches your upper leg?

As the body moves and oscillates from left to right and right to left, you are pumping fluids and nutrients throughout, helping your body heal and function optimally. When there is restriction in a joint that oscillation and fluid movement can be effected. Restrictions in one joint can be detrimental to the structures above and below, creating problems in other parts of the body.

We are designed to move and to live. If you want to use your Protection Plan on your health, make sure to do just that.

Grab the ice, its swollen!

Words that kind of make my skin crawl: “He needs to put ice on that.” or “that ankle is going to swell up if you don’t put ice on it!” I usually bite my tongue. Sometimes I’ll voice my opinion. But there is one major component of our physiology that is totally misunderstood: INFLAMMATION.

Inflammation is the first step in our body’s healing cascade. Inflammation is also a vital step. The body sends fluid and cells to an injury to clean up dead tissue. It will naturally splint the area to limit motion while its healing. I hear people damning inflammation as the worst thing that can happen to us. Inflammation is a sign that there is something awry. But inflammation is natural and we need it.

All too often I hear patients and athletes say “I’ve been icing and taking an anti-inflammatory meds and its not getting any better”. BINGO – you’ve not allowed your body to heal by disrupting the inflammation cascade. Both icing and anti-inflammatory medication will make you feel good for a short while, but largely do nothing to fix the issue in the first place.

Slide326.jpeg 8-14-19

The structure of your body dictates your function. When we have trauma – physical, emotional, chemical – it changes the structure of our bodies which in turn effects our function. When we have a change in our structure, our bodies will set off inflammation in an attempt to heal. If we do nothing to change the underlying structural issue, the inflammation will continue to no avail.

We have a tremendous ability to heal as long as we don’t get in the way. So save the ice for the summertime lemonade. Move and breathe to the best of your ability. If you have limitations in your function, don’t put a “band-aid” on it. You need to address the structure.

Don’t Become an “Emma”

I wish this was something out of a Halloween store. Meet Emma:

https://apps.fellowes.com/promos/work-colleague-of-the-future/

Emma is the portrayal of what office workers will look like in twenty years, if we don’t accommodate better postural positions. Emma is the product of a team of ergonomists and occupational health experts put together by Fellowes. While this life sized doll might come off just as scare tactics, this team put together a pretty thorough report. You can find the full report here: https://assets.fellowes.com/skins/fellowes/responsive/gb/en/resources/work-colleague-of-the-future/download/WCOF_Report_EU.pdf

Let me elaborate on some of their findings:

Weaker Muscles – “Don’t use it, you lose it” In the world of muscle that is 100% the case. When we sit for prolonged periods of time, our bodies will stop using postural muscles to maintain our shape. We will always assume a position that requires the least amount of energy and effort. When our core weakens because we don’t need it when we sit all day, once we do start to move we create muscle imbalances. These imbalances will lead to over use injuries.
Posture and Pain – Maintaining a forward head position, rounded shoulder position and collapsed thoracic cavity is a recipe for pain. As the head and shoulders come forward, it will become more and more difficult to fully fill your lungs. The decrease in vital capacity has a major influence on your daily life. Make sure your workspace is fit to your body and not the other way around. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499997/
Mental (Brain) Health – Blood flow can play a major contributor to your brain health. Sitting for prolonged periods of time, decreases the overall amount of blood that is being pumped into and out of your skull. Researchers found that regular walking breaks can combat this decrease in flow and potentially increase productivity. https://www.physiology.org/doi/full/10.1152/japplphysiol.00310.2018
Screen Time – Increased screen time is thought to have an association with increased risk of migraine in young adults. https://www.ncbi.nlm.nih.gov/pubmed/26634831

While there sometimes can be kick back from employers about workstations. It is however, in their best interest to help keep you healthy. Healthy employees are productive employees. There often can be little tweaks to your station or daily routine that have huge impacts on your body. If you are suffering from aches and pains seek intervention to help protect your body and your well being. Before little aches and pains become major issues.

Take a Deep Breath

How many times have you heard in your life “Take a deep breath, it’ll be fine”? While in the moment it may have been an infuriating statement. Little did you know that request of oxygen could actually have a major influence on your life.

The fluid surrounding your brain, cerebrospinal fluid (CSF), plays a vital role in our daily function by providing nutrition and waste removal for the brain. It was at one point believed that its primary function was to balance the pressure within the skull. As the pulse of blood entered the skull, the skull could not compress or expand. The CSF would then pulse just the same and exit the skull, maintaining equilibrium, or balancing the system.

-Quantifying the influence of respiration and cardiac pulsations on cerebrospinal fluid dynamics using real-time phase-contrast MRI. https://www.ncbi.nlm.nih.gov/pubmed/28152239

So what’s the big deal with this small amount of fluid in our bodies? Its major ability to remove waste from the brain. The next article paints a picture.

A study of eight patients with Multiple Sclerosis (MS) and seven healthy patients was performed, evaluating the flow of their CSF through their brain. All of the patients with MS evaluated in this study described a history of head and neck trauma. The authors note that trauma induced blockages of CSF may result in increased pressures, which in turn causes CSF to leak its contents into the surrounding brain tissue. If the CSF is blocked, it becomes unable to perform its primary function and becomes detrimental to the health of the brain. -The Possible Role of Craniocervical Trauma and abnormal Cerebrospinal Fluid Hydrodynamics in the Genesis of Multiple Sclerosis and the Craniocervical Syndrome. https://www.ncbi.nlm.nih.gov/pubmed/21970155

Now here is where it hits home for my life of chiropractic and athletic training. In a study performed on 266 pediatric patients aged 6-19 y/o with sport related concussions, 32.5% had associated cervical spine dysfunction. Those with a neck injury in conjunction of their concussion took almost 4 times the recovery time of those with a concussion, but without a neck injury. Young athletes need to seek professionals who can efficiently evaluate and treat their necks in conjunction with their concussion. -Cervical Spine Dysfunction Following Pediatric Sports-Related Head Trauma https://www.ncbi.nlm.nih.gov/pubmed/30045221

Keep taking deep breaths, it’ll be ok. Please don’t leave neck injuries untreated. Keep that cerebrospinal fluid moving around your brain to keep it functioning optimally and effectively.