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Hi Wellingtonians!

​This is Diego here, and today I am writing ​about Concussion, which can be one of the most limiting injuries affecting a persons quality of life.

Currently, it is one of the most researched subjects in the scientific world. What we understand about it has been changing in the last few years and the approach for assessment and treatment is constantly being updated.

One of the most common misunderstandings regarding concussion is its cause.

We used to think until recently, that it was caused by a direct trauma to the head, which caused the brain to ‘bang’ against the skull causing a sort of bruise on it. We know now this is not true. What really happens is a fast stretch in the brain cells secondary to a movement of acceleration and deceleration of the brain tissue, with or without direct head trauma. This means that you can have a concussion, even without hitting your head. This can occur during the movement of a neck whiplash, for instance.

Another common mistake is rest prescription for concussed patients. We now know that rest should be only prescribed in very specific circumstances and for a very limited time. On the other hand, research shows that controlled and specific prescribed exercises by a capacitated health professional are much more beneficial, even in the early stages of concussion.

Nevertheless, many health professionals keep prescribing only rest for their patients. For most people, concussion lasts around 30 days. During this period, the initial phase causes a reduction in the ATP levels in the brain. ATP is our energy molecule, and concussion can result in a 20% deficit in our energy storage. This is what causes most of the concussion symptoms, like fatigue, dizziness, brain fog, headaches, nausea, light and noise sensitivity, sleep issues, etc.

​If the concussion is well managed, the energy storage will be back to its regular level within the 30 days and the person will be fine. The proper management for acute concussion includes mainly an assessment for fitness to exercise, controlled prescribed exercise and proper advice and strategies aiming at recovery and gradual return to work/school/driving/sports’ practice. It is important to know that concussion does not cause any visible damage to brain tissue and cells. This is why there are no changes in the image exams, like a CT scan. The biggest problem is that usually most of the symptoms resolve in the first 2 weeks after concussion, however, full recovery has not occurred and if a second concussion happens before the proper recovery (and this is extremely common). Then there is a cumulative effect which may result in

irreversible brain damage and cell death, and this is what makes the recovery much more difficult. While most people recover in a month, research shows that up to 40% develop Persistent Concussion Symptom (PCS), also known as Post-Concussion Syndrome, which can last for months, or even years.

At CityOsteopaths, we use the most up-to-date scientific evidence-based method of concussion assessment and treatment, which reduces this possibility to no more than 15%. Now, many conditions can cause PCS, this includes reduced blood flow, reduced oxygenation, chronic inflammation, vision, vestibular and neck issues, also mental state can play a part. In our methodology of concussion management, we have the best tools and approach to identify if any of these issues are happening and to provide the best strategies to handle them, through proper advice, specific exercises to address the affected systems, and hands-on treatment. Research data confirms that 1.15% of the worlds population suffers from concussion annually. This corresponds to almost 54,000 people in New Zealand per year, with over 6,000 concussions in the Wellington region. And this is not only related to sports’ activities.

​A great portion of concussions occur in motor vehicle accidents, at work, home, and during leisure activities. Among these people, 15-24% will not be back to work after 6 months. Luckily, research also indicates that the number one strategy to prevent that happening, is seeing a health professional who actually knows what they are doing, who is up to date with the best scientific evidence and will use the proper tools and treatment strategies to help you with your concussion, as soon as possible. Our mission at City Osteopaths is to provide the best current evidence based care for post- concussion treatment to help Wellingtonians back to health. So, if you have suffered a concussion or know someone who is suffering from concussion symptoms, come and see us as quickly as possible. We will help you to feel yourself again!