The Concussion Confusion

Katy Teasdale,
Registered Osteopath, explores.

A concussion is a mild traumatic brain injury (TBI) often caused by an impact to the head or body, with or without loss of
consciousness.

It is one of the most significant issues facing sports medicine and one of the most common injuries in sailing.

This article
provides clarity around
this issue and explains why:

TBI should be prevented at all costs;

Treatment is essential to address immediate and long-term issues
surrounding TBI, head injury,
impact trauma and concussion;

Osteopathic treatment can help prevent
long-term symptoms* such as:

On-going headache,
headache with exertion,
dizziness, fatigue, irritability, impaired memory, decreased concentration, loss of
balance/coordination, lying motionless.

*Due to post-traumatic altered
neurotransmitter function.

Sport-related concussion is
generally not a major source of concern as it is categorised as a ‘mild head
injury’. While most concussion injuries don’t result in long-term damage to the
brain, temporary disruption to brain function
can occur and last for weeks. A recent study
revealed almost half of
people who suffer a sports-related TBI are still experiencing physical symptoms
after six months.

Action: In the event of a head injury, recognise and remove

If an individual displays
any symptoms of a concussion, with or without
loss of consciousness, your main priority must be bringing them back to shore.

This will protect
them from further
harm whilst reducing
any potential risks
to others.

Remove them from racing and do not return to sail/play that
day;

Keep them
warm;

Avoid alcohol/stimulants;

See a physician
for examination, diagnosis, and treatment.

Restriction from competition of
any athlete with persistent symptoms should always be accepted. Return to contact sports should only be allowed
after the athlete
is asymptomatic, both at rest and
with exertion (to avoid second-impact syndrome).

If the
following symptoms are observed
and a physician is not
available, call 999:

Neck pain or tenderness;

severe or increasing headache;

double vision;

weakness or tingling/ burning in arms or legs;

seizure or convulsion;

loss of consciousness;

deteriorating conscious state;

vomiting;

restlessness;

agitation or combativeness.

Prevention of Injury:

Experience, familiarity with the boat and equipment, complexity of the boat’s systems,
weather conditions and type of sailing are all important in assessing
the impact of each risk;

Clear, calm, agreed communication in the boat;

Follow your instinct and trust your intuition. An art once essential to survival,
training yourself to listen to your intuition
can be invaluable mentally, physically, and emotionally.

Wear a helmet: A helmet can dissipate the force that
causes translational movement and traumatic brain injury, significantly
reducing the risk of skull fractures and bleeding inside the skull –
intracranial bleeding. (A helmet doesn’t prevent the translational
or rotational movements of the brain within the skull during an impact and so cannot prevent
concussion). Choose a light,
well-fitting helmet that does not affect visibility and is suitable for water
sports.

Bodywork: Osteopathy

How osteopathy can help and why it’s essential for immediate and long-term
restoration of health:

Osteopaths are primary healthcare practitioners qualified to examine, diagnose
and treat patients presenting with any medical
condition.

A skilled
practitioner will take a full medical history
and carry out a physical
examination. They will assess the body and anatomy
in a particular way, forming
a precise and unique diagnosis of the patient’s
dysfunctional pattern.

Less is more, with treatment engaging
the body’s own innate drive towards normal
function.

The body has the inherent capacity to heal itself

Dysfunction in any area will impact all other
areas of the body, directly and indirectly, via different types of connective tissue,
such as fascia,
bone, the nervous
and cardiovascular systems,
as well as the Primary
Respiratory Mechanism (PRM)**.

**The
physiologic centres that control and regulate pulmonary respiration,
circulation, digestion and elimination and depend on the function of the central
nervous system. Consequently, treatment affects the entire body.

Cranial Osteopathy is
the study and treatment of the intricate
‘bony armour’ that protects the brain
and spinal cord to restore the body as an integrated machine, each part in
working relationship with every other part.

Trauma is by far the primary
cause of disruption and malfunction of the PRM.

The force may, for example, be from a fall and
transmitted from the feet or sitting bones upward through the body into the
base of the skull. A skilled practitioner can feel and address
the vector of force established through the body or head. Trauma
to the PRM can also occur from mild, sustained force, such as from orthodontic
appliances (braces) on the teeth.

The goals of osteopathic treatment

Normalise the nervous
system;

Counteract stress-producing factors by normalising the function of the HPA axis;***

Normalise circulation of blood and veinous and lymphatic drainage;

Release tensions in membranous tissues;

Correct strains in cranial mechanism;

Modify gross whole-body structural posture patterns.

*** controls
reactions to stress and regulates
many body processes, including digestion, immune responses,
mood and emotions, sexual activity, and energy storage and expenditure.

Osteopathy restores
structure and function

Restrictions develop in the musculoskeletal system as a result of daily life,
responding to the force of gravity, trauma, infection,
and repetitive action. An athlete’s
ability to adapt is additionally challenged by the particular demands of his
sport.

Osteopathy is key to restoring the balance of structure and function. Then,
neuromuscular training can occur.

Osteopaths have unique palpatory skills. This is very useful
in determining if there is a somatic (anatomical/bodily) component
to a patient’s medical condition
or a restriction that may lead to an overuse injury.

Example:

Consider an asthmatic patient with upper
thoracic (chest/spine) and rib dysfunction. Reflexes from the organ to the body (viscero-somatic) give the
clinician useful information regarding management and sports participation and,
most usefully, treatment to enhance respiratory capacity and, therefore,
physical performance.

Osteopaths use their
hands to diagnose, treat and prevent illness or injury

Other considerations:

Gain an edge: How to enhance your performance

Use the
whole body, engaging large muscles such as the abdominal diaphragm and
glutes.  This protects smaller muscles,
peripheral joints and connective tissue from injury.

Train to
improve balance, energy transfer and functional strength (static strength is
unimportant without balance).

Improve
athletic ability through flexibility, proprioception, strength and practice
movement patterns -> better neuromuscular coordination.

Nutrition

Nutrition is one of the most
important contributing factors to enhancing athletic performance. Deficiency of key nutrients
will impair performance. The most overlooked nutrient is water. Athletes
must consume more water than the general population to replace sweat losses.
Fruits and vegetables are essential for minerals and vitamins and, therefore,
antioxidants to overcome free radicals. Eat plant-based fats as well as
slow-release grains rather than refined carbohydrates.

Psychology

Mental discipline is a significant factor
in predicting athletic
success. This includes
relaxation techniques.

Practice mindfulness: https://www.dhamma.org/en/about/mini_anapana -
observation of the natural breath.

Recovery

Human growth hormone is produced during
sleep. It increases the transport of amino acids
into tissue and stimulates the mobilisation of fat as an energy source.

Note that caffeine
as a stimulant can cause
gut intolerance, dehydration, cardiac arrhythmia,
tremor and headaches.

Avoid ergolytic substances such as drugs and alcohol,
which limit neuroplasticity.

Conclusion

It can be seen here that concussion is a severe injury and that
increased awareness of prevention can help to avoid accidents
occurring.

Osteopathic treatment improves
neuromuscular coordination by
removing restrictions in the spine as well as posture and muscle imbalances and
addresses existing issues, thereby preventing the long-term effects of existing
trauma.

Osteopaths see a variety of patients complaining of many problems, including but not limited to:

low back and neck pain;

repetitive work-related injuries or strain;

effects of trauma,
such as whiplash;

asthma and other breathing problems;

colic and irritable bowel syndrome;

postoperative
pain and adhesion
problems;

back, joint and soft tissue
pain during pregnancy;

postpartum pelvic problems, including pelvic floor injuries;

headaches and TMJ (jaw)
pain;

ENT (ear, nose, throat) problems;

developmental, feeding, sleeping and other problems
in babies and children.

U.K. Registered Osteopaths are Allied Health
Professionals.

Osteopaths are Primary Care Professionals who provide general
medical care and are responsible for overall care, including
coordinating medical specialists and supportive care.

Quick reference Concussion Recognition Tool for display
at sailing venues and events: https://www.sailing.org/tools/documents/CRT5WSEditionv5.13-%5B26452%5D.pdf 

Katy Teasdale
BSc (Hons) PsySc.,
BSc (Hons) Ost., DO, DPO Registered Osteopath

Consultant Paediatric Osteopath specialising in the treatment of babies, children, adolescents and
perinatal issues.

Lymington, Hampshire www.katyteasdale.com