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Dr Cassandra Fairest, chiropractor and spokesperson for the New Zealand Chiropractors’ Association explains: `Many people affected by concussion don’t understand the neck and spine are also traumatised. They also don’t realise the link between upper neck dysfunction as a possible cause of headaches and dizziness which often gets passed off as coming from the mild traumatic brain injury but responds well to chiropractic care¹’.

`It is paramount the spine, and in particular the cervical spine and nervous system, are checked with any such injury to the head. We know that concussions occur in all contact sports with the highest incidence in rugby, soccer, hockey and basketball, and that youth athletes may have a more prolonged recovery and are more susceptible to a concussion accompanied by a catastrophic injury^[2]. The greater number, severity and duration of symptoms after a concussion are predictors of a prolonged recovery.’

The uppermost part of the neck protects the brainstem at the top of the spinal cord, and injury to this delicate area from whiplash-type injuries and/or knocks to the head can produce symptoms that are similar to a traumatic brain injury^[3],^[4].

Dr Fairest adds: `Although neck strengthening makes perfect sense after an injury to the neck or head, if joint function is compromised then neck strength is only one part of the very complex nature of concussive or sub-concussive injuries and whiplash.’

Mild traumatic brain injury, occurs from a blow to the head or violent shaking, with approximately 24,000 cases in New Zealand every year^[5]. It is a common injury in sport, with most individuals recovering in 7–10 days but some have persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.

Dr Fairest notes: `Research looking at a combination of cervical and vestibular therapy by chiropractors with post-graduate sports training, demonstrated earlier recovery by patients who underwent chiropractic care. Youths and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion were also able to return to sports sooner following chiropractic care^[6].’

She adds: `Chiropractors commonly encounter concussed athletes in clinical practice and we encourage our members to understand the importance of using standardised concussion assessment tools and current concussion guidelines.

‘Athletes should be aware that chiropractic care to restore the proper function of the spine and nervous system can help in the post-concussive situation and also in the maintenance of spinal function and optimum athletic performance’.

A new study by Dr Heidi Haavik and her team at the Centre for Chiropractic Research at the New Zealand College of Chiropractic^[7] showed large increases in the maximum output of the target muscle after a chiropractic adjustment session, which suggests that chiropractic care may help athletes’ brains to more efficiently produce greater outputs in sports performance, including muscle recruitment and recovery times.

^[1] Leddy J, Baker J, Merchant A et al. Brain or Strain? Symptoms alone do not distinguish physiologic concussion from cervical/vestibular injury. Clinical Journal of Sports Medicine. 2015 May; 25(3): 237-242

^[2] http://bjsm.bmj.com

^[3] Marshall C, Vernon H, Leddy J, Baldwin B. The role of the cervical spine in post-concussion syndrome. Physician Sportsmedicine. 2015 Jul; 43(3): 274-284.

^[4] Ellis M, Leddy J, Willer B. Physiological, vestibulo-ocular, and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Injury. 2015; 29(2): 238-248.

^[5] http://www.brain-injury.org.nz

^[6] http://bjsm.bmj.com

^[7] Haavik H, Niazi IK, Jochumsen M, Sherwin D, Flavel S, Türker KS. (2017) Impact of spinal manipulation on cortical drive to upper and lower limb muscles. Brain Sciences. In Press

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