Concussion Treatment and Prevention Part 1


Chronic Headaches is a common lingering symptom from concussion.

Chronic Headaches is a common lingering symptom from concussion.

Concussions and there lingering symptoms can often last for for months or longer. I have had patients come into the office with symptoms like daily headaches, inability to concentrate and poor sleep that have lasted over a year or more. In the medical community there does not seem to have a unified consensus on how to best heal from  concussion. Most of the advice seems like common sense: rest, reduce computer and television screen time, reduce homework or work load, exercise to tolerance and return to play when you are symptom free. Concussion prevention advice is even weaker.  Athletes are told to buy better equipment and and get a base line neurological assessment so that they can detect a concussion earlier.  It is often pointed out that a previous concussion is predictive of future concussions. It seems to avoid concussion, the advice is don’t get one in the first place. How is that prevention?  To me this is a very passive and defensive way to both prevent and heal from a concussion.

Concussion Treatment

I have treated patients with acute and chronic post concussion syndrome. The approach that gets results is usually involves cranial adjusting, leveling the head and neck and treating other injuries in the body that can affect gait.

The sutures of the skull actually move rhythmically.  These joints are often become stuck with trauma.

The sutures of the skull actually move rhythmically. These joints are often become stuck with trauma.

The cranial bones of the skull move in a rhythmic fashion with the rest of the spine and pelvis and can be accentuated by your breath. These ideas were discover by William Sutherland, D.O. a century ago. The movement occurs along joints called sutures which you can see as the squiggly lines on the picture of the skull.  Cranial motion moves cerebral spinal fluid around the spinal chord and even out to the ends of the nerves coming form the spinal column. Here is a cool video of CSF flow under MRI. The cerebral spinal fluid is critical to healing because it brings nutrients to the tissues of the brain and nerves as well as helps move waste out. Increased CSF fluid pressure, which can result from poor flow, can can disrupt blood flow in the brain as well. With direct trauma there is more waste to move out and a desperate need for nutrition as the brain heals.  Compromised CSF flow and blood flow is a very bad thing for people are trying to heal their brain. Physicians generally do not know you skull moves and fail to consider restoring its mobility from a blow to the head. Damage and pressure on the brain of course can affect the function of any part of the body.  There is no more important chiropractic adjustment that can be done to affect the brain directly than cranials.  I use Applied Kinesiology to locate which bones are no moving and with gentle rhythmic pressure restore motion.  The relief from symptoms is sometimes immediate and sometimes takes a month or two as we treat the body. It all depends on a person’s state of health before the concussion.  I usually tell the patient that when their skull starts moving its like the first day of the healing process. When their skull is locked it is like healing has been suspended until the cerebral spinal fluid starts circulating again.  Looking for a practitioner who uses cranial techniques can drastically cut the time it takes to heal form a concussion.

As a chiropractor my primary focus is to help restore function to nervous system.  A nervous system that can receive information from the body, process it appropriately and send the correct output is healthy. Injuries tend to interrupt your body’s ability to communicate with itself. Concussions usually come with other trauma especially with blows to the head.  A foot ball player may suffer a concussion from a helmet to helmet collision but there will be an accompanying whiplash from the head going one way and the body another.


The upper trap and SCM are visualized on the side of the neck in this illustration.

The upper trap and SCM are visualized on the side of the neck in this illustration.

Whiplash is usually more than a sprain of the spine. There is usually strain and lingering inhibition of some of the muscles like the scalenes, upper trap or sternocleidomastoid. These traumatized muscles may not be painful after a few days but often remain dysfunctional. If for example the the SCM and upper trap are inhibited from the trauma on the right the muscle on the left will begin to pull the head to the left. This may result in pain pain the left side of the neck as those muscle become tight. What is just a significant about this example is that the eyes will not let the head tilt that far to the left during the day. It is however, exhausting for the brain to not let you fall over all day long. The brain is constantly and unconsciously trying to keep the head level by assessing combining all the information from the eyes, ears and body. When all the information is not making sense the brain cannot integrate the information well enough to give appropriate out-put.  The result can be dysfunction elsewhere in the body. What if the neck wasn’t the only injury? Those injuries and even past injuries need to be to treated as well so that more effective integration of the nervous system is possible. That is a short statement but very important.

Once the cranial bones have been freed up and function has started to be restored to the rest of the body. You have to move the body to help connect the brain back to the injured areas and the rest of the body. I have used simple cross crawl exercises in the past to activate the whole body and synchronize the brain until I found something that I liked better. Power Kinetics developed by Dr. Eugene Charles is like cross-crawl for Superman! This is a challenging workout but I really like the way he integrates movement of the entire body and brain while reducing the risk of injury.


Spark by John Ratey, MD

Spark by John Ratey, MD

With a functioning body and normally moving skull additional aerobic exercise can be added at low intensities at first.  Aerobic exercise delivers much needed blood flow to the brain for bringing healing nutrients which also removes metabolic wastes. If you are running or even walking you get the benefit of moving your body in a cross crawl pattern that helps integrate your nervous system. In the book, Spark: The Revolutionary New Science of Exercise and the Brain, John Ratey, MD convincingly lays out study after study showing that shows exercise is better than medication for depression, ADHD/ADD, managing stress, addiction and for anti-aging. Aerobic exercise builds neural connections so your brain can literally rewire itself and levels out neurotransmitters which can be responsible for a persons sense of well-being. This is a massive topic but for now this is just more proof that exercise is good for your brain especially when healing form concussion.


Concussion Prevention


Stay tuned for Part 2 of this post where I will cover some strategies for concussion prevention.


Fatigue: Iron Deficiency, Folic Acid and B-12

Anemia could be the cause of your fatigue.

Anemia could be the cause of your fatigue.

Fatigue: Iron Deficiency, Folic Acid and B-12

Fatigue is a common complaint that brings people into my office. People complain they cannot make it through the day or can only be half as active as they used to be. Common causes of fatigue are lack of sleep, poor diet, hypothyroid, adrenal insufficiency, chronic infections, food allergies and the classic anemia.  I am going to focus on anemia because though it is often overlooked as the potential root of a patient’s fatigue. We always have to remember the basics when dealing with a patient. A great example came into the office several weeks ago:

A 70 year old female came to the office with 5 months of fatigue that came on slowly. She was forcing herself through the day and working out but felt like she was just getting old. I almost never buy the “getting old” argument. She was having cramping at night in both her calves and pain in the low back and into the left hip especially. Her diet is very good with eating mostly whole foods with only occasional indulgences, although she tended to intermittent digestive issues. She was getting a good amount of sleep each night. She had a history of thyroid issues, but recent blood testing showed no changes. Generally, in this type of patient, I find some type of chronic infection that is causing the immune system to slowly drain a person’s energy as it fights the infection. I could not find any sign.  She did test negatively to wheat and dairy so those foods were restricted. My testing showed stress in her cardiovascular circuits and an inability to make repeated muscle contractions without causing weakness.  This type of testing called aerobic testing, can reveal if there is a problem with the bodies ability to use fat for energy or its ability to deliver oxygen to the cells so the can produce energy. We tested her aerobic ability again after exposing her to nutrients such as iron, folic acid, B12 and chlorophyll. All strengthened her muscles and made her pass the aerobic function muscle testing. Within one week her energy started to return and 2 weeks later she felt much more like herself making it through the day with full energy and even being able to exercise again! Also the nightly calf cramping stopped. Clearly, her circulation was improving.  Why did this happen? We usually find this out as treatment progresses but mostly likely her impaired digestion or food intolerances (which may not be permanent) slowly caused a poor absorption of these nutrients.  Sometimes, straight forward nutrient support for formation of healthy functional red blood cells is all that is need to change a person fatigue for the better.  Muscle testing often can find a problem before it shows up on a blood test which is what happened in this case.

Red blood cells carry oxygen which allows your body to make energy.

Red blood cells carry oxygen which allows      your body to make energy.

If a person’s the ability to produce energy at the cellular level is impaired they can have a lengthy list of symptoms besides fatigue, such as brain fog, confusion, suppressed immune system, systemic body pain or fibromyalgia. Nerve cells, muscle cells, intestinal cells, cardiac cells, immune cells, all need energy to function. Anemia, especially the iron deficiency type, starts to break down the ability of the body to produce energy.  Energy production in the cells is dependent on red blood cells delivering oxygen so that a series of chemical reactions can take place that create energy (ATP) inside the cells(mitochondria).  Anything that is necessary for those reactions to take place or for the delivery of oxygen to happen must be present or it all grinds to a halt.  The most common nutrients are Iron, folic acid, B-12, B-6, B-1, B-2, B-3, B-5, magnesium, manganese, phosphorus, molybdenum, and copper.  Finding the specific nutrients a patient needs through muscle testing can narrow down what that person really needs the most.

What Makes People Like Tennis Star Novak Djokovic Gluten Intolerant

The US open of Tennis is about to start. As world number 1, Novak Djokovic, takes the court one of the great stories in sports will be told again and again. If you are unfamiliar with his story, here it is. Up to 2011 Djokovic was an excellent player, yet he was not considered to be one of the elite tennis stars. Why was this? After all, he won the Australian Open in 2008. Although he was obviously very skilled in every aspect of the game, he had a habit of collapsing in the heat and during long extended matches. Djokovic would blame it on asthma and seasonal allergies. He appeared out of shape to most of his opponents and even television announcers. This accusation was despite Djokovic’s regimented training schedule, which consumed most of his waking hours. Then in 2011 he won 3 Grand Slam tournaments, 10 Titles, and 43 consecutive matches on his way to becoming the world’s number 1 tennis player. He was so dominant that year there are few achievements in the history of sports that can even compare. What does he credit this dramatic turn around to? Are you ready for this? It’s so simple yet so epic. He changed his diet! He simply stopped eating gluten, dairy and reduced his sugar significantly. How did he know what dietary changes he needed to make? Someone used muscle testing on him to figure it out! When his body no longer had to fight through the inflammation created by consuming these foods, he was able to maintain his skills even during the longest matches. The tennis world did not see him coming.

Djokovic’s story is like many others I know. Maybe they do not become the world number one in tennis, but their lives are changed for the better in major ways when they give up foods their bodies are reacting to. Often their chronic symptoms go away and other problems go away as well-the ones they don’t tell me about. Patients often ask why and how did this happen? They say, “I used to be able to eat those foods without any trouble. Why can’t I now?” The answer can often be found in their patient history. I ask, “What was happening in your life around the time that this started?” It usually takes a moment or two of reflection before they say something like, ”I was going through a divorce,” “I was taking care of my terminally ill father,” “My child was in the hospital,” “I was working long hours at a job I hated,” or “I had just had my 3rd baby in 3 years.” You get the idea. A significant life event generally precedes the onset of their chronic symptoms. There is almost always a timeline that fits.

Stress is insidious and it destroys your body slowly. People think they are thriving on stress, but that is never the case. When they think they are ”thriving” they are really adapting. The body will eventually run out of reserves and can no longer adapt. When it does, the person has a health crisis that was sometimes years in the making. Hans Selye, in his classic book The Stress of Life, found that stress causes intestinal ulcers, suppresses the immune system, and increases the size of the adrenal glands (reason you can adapt to stress at all). We know that the cells that line the intestine are connected with something called tight junctions. Tight junctions function to keep out undigested food particles, toxins and microorganisms that naturally live in our gut. Under stress the tight junctions can start to break down allowing food, toxins and microorganisms to cross the intestinal lining. This can happen even before the classic ulcer is present. These cracks in the intestinal linings make the immune system go crazy. The immune system begins to fight this steady stream of invaders. When you have a cold or flu some of the symptoms of fatigue, headache, achiness are simply due to your body’s immune system working so hard. Mobilizing the immune system requires tremendous energy. This is some of why when you are sick you feel so bad. Symptoms are reasonable for the 1-2 weeks a cold might last, but what if you felt like that all the time. Many people do feel like that all the time, and it often it comes from their immune system battling their leaky gut.

Whole books are devoted to the subject of leaky gut, but here are some of the basics that answer our question of “How did this start?” Something causes a disturbance in the gut such as prolonged stress, poor diet, excessive alcohol, antibiotics, toxic chemical exposure, or pathogenic organisms like bacteria or yeasts. The lining of the intestines becomes compromised affecting the immune system as well as the cells that line your intestine directly. These cells called enterocytes, and their finger like projections called microvilli, are where digestion and absorption occurs. Depending on the level of damage to the intestinal lining different enzymes will no longer be produced or work effectively. It could be enzymes specific to lactose (a type of sugar many people cannot digest), dairy protein, gluten, other wheat proteins or starches to name a few. If this goes on for long periods of time the immune system begins to attack more and more strongly. If it goes on long enough, the body can even begin to attack itself. You are one of these people if you have an auto immune disorder, joint pain, thyroid problem, skin problem or any other body issue that goes away when you take specific foods out of your diet. I have seen it time and again as I work with patients to try and reverse this damage to the gut.

Why did the detrimental affects of intestinal damage start with tennis star Novak Djokovic? I am going to speculate wildly here. A patient of mine gave me a book that Djokovic wrote, Serve to Win, where he tells his tennis story and talks about how important diet is to athletic performance. There is a chapter early in the book that talks about a part of his childhood that was horrific. No child should have to endure such trauma. Djokovic grew up in Belgrade, Serbia during the War of Kosovo. He recounts a time when he was running to a bomb shelter when he tripped and was separated from his family in the darkness. When he was on the ground he looked up to see 2 laser-guided bombs blow up a building in front of him. For 78 nights at 8pm, the siren would blow and they would head for the bomb shelter as the city was bombed. “The feeling of helplessness dominated our lives,” he said. One of the worst forms of stress is feeling like you will not be able to control the situation you are in. Imagine that level of stress on a child. Not knowing day to day if he would see his family again. I think this stressful time period in his life may have started the cascade of events that led eventually to his inability to digest gluten and dairy. Of course, there easily could have been other factors involved over the years as well. There could have been compounding events such as the stress of being bombed and taking a round of antibiotics, which could create an imbalance of bacteria in the intestines; both acting together to result in intestinal damage. I do not know for sure, but I bet the start of Djokovic’s problems could be linked to the time after living through airstikes.

If you have chronic health issues think back to when it all started. What was happening in your life before the symptoms began? Using applied kinesiology and muscle testing we can quickly determine if the health problems you may be experiencing are related to your intestines. Knowing if you have to avoid a certain food makes your life easier and healthier. Using targeted herbs, supplements and lifestyle modification we often restore intestinal balance, which reduces he number of foods one needs to avoid. It is worth the effort of changing your diet because often it is the only way you will recover your health.