How this Athletic Therapist Manages Concussions?

Concussion management is a hot topic these days and as an Athletic Therapist I have had my share of challenges in managing concussions.

I have interviewed an Athletic Therapist who has dealt with many concussions over the course of her career.

She is an active member in concussion management and is very passionate about spreading the awareness of managing this very serious sport injury to athletes, coaches parents and health providers.

Find out how this Athletic Therapist manages concussions as she gives her insight with a step by step process:

For Complimentary Access to the interview and MP3 Download (valued at $47) click on the link below:



Concussions and Manual Therapy??

Concussions have gained alot of attention in the media
these days and is one of the most challenging injuries
to manage in sport today.

It is not uncommon for the Athletic Therapist, Sport Physician
and the Neuropsychologist
to lead and supervise the management
of concussions.

Certainly in my clinical practice I have also seen an
increase of athletes sustaining concussions and seeking
help for it. 

My role as a clinical therapist in managing concussions
has surrounded the associated neck dysfunction that I have
noticed to accompany these mild head injuries.  Since the
mechanism of injury typically involves some sort of head
trauma with associated cervical spine whiplash, it certainly
makes sense that there would be some upper cervical joint
dysfunction following a concussion. 

It is quite plausible that some of the headaches that athletes
complain about post-concussion could be stemming from upper cervical
spine facet joint dysfunction.  Lately, I have treated 3 athletes who
are post-concussive and have neck related pain and restriction of movement.

I have noted that in all 3 of these athletes the OA joint and
C2-3 facet joint were involved as areas of joint dysfunction.  

This is where I think manual therapy techniques have a role
in helping to manage concussions.  After appropriate
mobilisation techniques were performed to restore the
movement restrictions in my 3 athletes, they reported
improved mobility and less headaches and pain.  They still
reported headaches due to the concussion itslef.

The only research that I have been able to find on this specific
topic was a study done by J Treleaven, G Jull, L Atkinson on
Cervical Musculoskeletal Dysfunction in Post-Concussional Headache.
Cephalalgia August 1994 14: 273-279.

Their results suggest that a “high proportion of post-concussion headache
sufferers have physical signs of cervical musculoskeletal dysfunction,
particularly in the upper three cervical joints, and support the need
for a precise and sensitive physical examination of the cervical spine
in patients complaining of persisting post-concussion headaches.”

Has anyone else observed this?

Have you found any research to support this clinical observation
that I am witnessing??

Please post a comment and share your insights!

Low Back Pain and the Hip Joint

Happy New Year!

I hope 2011 brings you health and happiness…

So I wanted to write a post about a client who
came to see me for low back pain.

Quick History:
57 year old female with chronic nagging low back pain,
hyperlordosis and an avid golfer who especially complains
of pain with walking.

I treated her lumbar spine for segmental flexion restriction
using manual therapy techniques, specifically unilateral
flexion mobilisation of the right L4-5 and L5-S1 facet joints.

Also treated her for a presenting right sacroiliac upslip
using long leg distraction manipulation of
the right sacroiliac joint.

Her lumbar spine mobility and sacroiliac joint function both
improved however she still continued to report lumbar pain
especially after any walking activites.

This prompted me to look more closely at her gait pattern as
this is when she complained of her pain. I noticed that she
had a decreased left stride length and decreased left hip
extension on the right.

So I looked at her hip joint more closely and found her to
have restricted hip extension and external rotation. Manual
therapy assessment of her hip joint revealed anterior capsular
restriction with inhibited gluteals.

Manual therapy treatment of her hip consisted of an anterior glide
joint mobilsation in an extension and external rotation quadrant.
I have included a picture below for your visual benefit.

After three treatments in this manner and supplimenting with
gluteal activation through a bridging exercise and
external rotation stretching, her back pain dissappeared.

The Lesson of this post:
Sometimes low back pain is secondary to a hip extension restriction.
The low back pain is due to the lumbar spine hyperextending
for the lack of hip extension during gait.
So look for it!

To Your Manual Therapy Success!