Concussions, often termed mild traumatic brain injuries, have long been the focus of medical attention due to their potential short- and long-term consequences. While the brain is undoubtedly the primary site of injury, recent research sheds light on the intricate relationship between the neck and concussion symptoms, unveiling a crucial link that demands understanding and consideration in post-concussion management. In this article, we explore the findings of a systematic review titled "The Role of Cervical Symptoms in Post-concussion Management" by Kelly Cheever et al., offering insights into the indispensable role of the neck in concussion recovery and symptomatology.

Understanding the Link: Neck and Concussion Symptoms

Concussions occur when the brain experiences rapid acceleration and deceleration within the skull, leading to neurological disturbances. While the brain bears the brunt of the impact, the neck, comprising muscles, ligaments, and cervical vertebrae, is intricately connected to the head and central nervous system. Consequently, any trauma affecting the head can also impact the neck, giving rise to a myriad of symptoms that often overlap with those of concussion.

The Systematic Review by Kelly Cheever et al.

Through their systematic review, Cheever et al. offer valuable insights into the significance of cervical symptoms in post-concussion care. Their analysis of current literature aimed to shed light on the frequency and consequences of neck-related symptoms following concussions. The results emphasize the notable link between neck issues and prolonged post-concussion symptoms, emphasizing the importance of a thorough cervical evaluation and treatment of any cervical dysfunction with special attention to the upper cervical spine. This should be done in all individuals with concussions that present symptomatic clinically, even in the absence of complaints of neck pain or stiffness.

Implications for Post-concussion Care

The findings of Cheever et al.'s review have profound implications for post-concussion care and rehabilitation. Recognizing the role of the neck in symptomatology can guide healthcare providers in developing tailored treatment plans that address both the neurological and musculoskeletal aspects of concussion recovery. Integrating neck-specific interventions, such as manual therapy, therapeutic exercises, and cervical spine proprioception exercises, may contribute to more effective symptom resolution and improved patient outcomes.

Comprehensive Concussion Management Strategy

Focusing on the holistic management of concussions highlights the interrelation of different bodily systems and stresses the need to address each aspect thoroughly. Recognizing the impact of neck issues on concussion symptoms allows healthcare professionals to implement a multidisciplinary strategy involving neurology, orthopedics, and physical therapy. Through collaborative endeavors to optimize neck function and mitigate related symptoms, the overall standard of care for individuals with concussions can be significantly improved.

Common Treatment strategies

A structured physical therapy program tailored to the individual's specific needs can help improve range of motion, strengthen neck muscles, and restore function. Techniques such as manual therapy, therapeutic exercises, and cervical proprioception exercises can be tremendously helpful in the treatment of whiplash-associated disorder (WAD) that is commonly associated with concussion injuries.

· Manual Therapy: Hands-on techniques performed by a qualified healthcare provider, such as spinal manipulation, mobilization, dry needling, and soft tissue mobilization, can help improve joint mobility, reduce muscle tension, and alleviate pain in the cervical spine. When it comes to dizziness, headaches, and visual changes if all Red Flags have been ruled out these symptoms are commonly associated with an upper cervical dysfunction, C1-3.

· Deep neck flexor activation/endurance: Plays a crucial role in the management of cervical pain and dysfunction. These muscles, including the longus colli and longus capitis, provide stability and support to the cervical spine, contributing to proper posture, movement, and function.

· Cervical proprioception: The body's sense of neck position and movement, is crucial in treating whiplash injury post-concussion. It helps with sensory integration, neuromuscular control, vestibular rehabilitation, and functional recovery. By targeting cervical proprioception through specific exercises and techniques, healthcare providers can alleviate symptoms, improve neck function, and enhance overall rehabilitation outcomes for individuals recovering from a whiplash injury/concussion. Below are some examples of tools to assist with assessing and treating cervical proprioception deficits. The first is the SenMoCOR™ System which can be found HERE. The SenMoCOR™ System is very good and inexpensive and will do the job.

Another great option is Motion Guidance, which, like The SenMoCOR™ System, offers visual feedback with a laser. However, Motion Guidance steps it up by adding wall-mounted targets that can be activated with the laser, creating a more interactive rehabilitation environment. Motion Guidance offers products for clinicians and home exercise packs for patients, helping to improve movement control, coordination, and performance through real-time feedback.

If you want to go to the next level with a more accurate and detailed assessment and interactive treatment you can look to NECKCARE™, which is a patented technology that was founded in Iceland and has recently made its way to North America

Conclusion

This article emphasizes the important relationship between the neck and the symptoms of concussion. Healthcare providers need to expand their approach to post-concussion care by thoroughly evaluating the cervical spine. By acknowledging and treating neck-related issues in concussion patients, clinicians can deliver more tailored and efficient care, leading to smoother recovery and decreased persistent symptoms. Continued research and innovation in this area will further advance our comprehension of the neck's impact on concussive injuries and contribute to enhanced treatment methods.

Reference Article:

Cheever, K., McDevitt, J., Phillips, J., & Kawata, K. (2021). The Role of Cervical Symptoms in Post-concussion Management: A Systematic Review. Sports Medicine, 1–15. https://doi.org/10.1007/s40279-021-01469-y

The Role of the Neck in Concussion Symptoms: Understanding the Link