By Shannon Vander Doelen, HBSc, ND

Concussions are an injury that we hear a lot about due to their prevalence amongst NHL and NFL stars. Despite the fact that it is one of the most common neurological disorders in athletes and non-athletes alike, little research has been done in the field of non-sport concussions, and this is why physicians often have difficulty treating people with these injuries. The good news is that we can take sport related concussion research and “return-to-play” protocols and adapt it for proper management of non-sport related concussions.

Maybe you fell off your bike, slipped on some ice, tripped when you were walking, were playing a sport with your friends or kids, or even fainted – if you hit your head, you might have had a concussion. And if you’ve had a concussion, it’s likely that you will experience some undesirable symptoms, and perhaps you’ll need a “return-to-life” protocol before you can start to feel better.

A concussion, or a mild traumatic brain injury (mTBI), is defined as a complex pathophysiological process that affects the brain due to some type of biomechanical force (either a direct blow to the head, face, or neck, or to another part of the body with an “impulsive” force that gets transmitted to the head). In more simple terms, a concussion is an injury that causes the brain to shake in the skull and results in symptoms that are related to the disruption of normal brain function, and are not necessarily due to any structural injury of the brain.
Once your medical doctor has ruled out any complications, such as bleeding or fracture, you may be wondering what the next steps are in terms of managing your injury. It is estimated that 80-90% of patients who get a concussion recover in 7-10 days. However, that means 10-20% of these people will have persistent post-concussion symptoms for weeks or even months.
After a concussion there may be many physiological processes and reactions that are not functioning normally. This can be due to inflammation, disruptions to our neurotransmitters that are responsible for how we think and react, oxidative stress that may lead to cellular damage, “excitotoxicity” or excessive neuron stimulation, and mitochondrial dysfunction leading to decreased energy produced for brain cells. Additionally, there may be post-traumatic deficiency of certain vitamins, minerals and nutrients due to their increased use by the body after the injury. Ultimately, all of these factors can contribute to any number of symptoms that are associated with concussions, including:
Headache
Dizziness
Nausea/vomiting
Light or noise sensitivity
Ringing in the ears (tinnitus)
Visual disturbance (blurring, stars)
Difficulty with balance
Fatigue
Depression or anxiety
Difficulty with sleep (too much or too little)
Difficulty concentrating
Brain Fog, or just not feeling like yourself
Neck and shoulder pain or stiffness

I’m still not feeling right, what should I do??

Naturopathic medicine focuses on treating the cause of your symptoms. Though nothing can reverse your head injury, figuring out what physiological processes are contributing to your symptoms is critical. With this knowledge, an evidence-based treatment plan can be developed that will help you to return-to-life symptom free.

Lifestyle Modifications

Think of your brain injury like a broken bone. In order to heal, it needs rest. Immediately after a concussion you need complete physical and cognitive rest. If you are still having symptoms after a few days, it is likely a sign that you are doing too much too soon. You need a step-by-step protocol in place where you don’t move on to the next step until you are symptom free. You may require strategies to help you get back to work or school, manage stress or anxiety, get adequate sleep, and modify your exercise plan to promote optimal brain health and recovery. An important habit to adopt if experiencing symptoms is to limit your screen time to an absolute minimum (TV, cell phone, tablets, and computers). Not only are screens incredibly stimulating to our brain, they can contribute to headaches, visual disturbances, light sensitivity and sleep issues that result from concussions.

Diet?

Changing our diet is one of the best ways to mitigate inflammation. It is helpful to adopt a diet where you avoid foods that promote inflammation like red meat, sugar and dairy, and add foods that decrease inflammation such as herbs, spices, fruits and vegetables. Additionally, if you have any food sensitivities, consuming those foods may result in additional inflammation for you. This may include eggs, gluten, or certain fruits and vegetables.
Did you know that your brain is surrounded by fluid? So remember to also stay hydrated, drinking at least 1.5-2L of water per day to keep the environment around your brain as healthy as possible.

Supplementation

Though diet and lifestyle changes are often profound in their effect, supplementation is also important to correct for any deficiencies and address some of the dysfunctional processes that are occurring in our brain. Fish oil has been show to be very important for brain health and recovery after a concussion. Antioxidants like curcumin and resveratrol can be supplemented in concentrated doses to help counteract oxidative stress. Certain vitamins and minerals may also help to correct any faulty physiological reactions. Vitamin D and magnesium have been shown to help decrease inflammation and decrease neuron excitability respectively.

Acupuncture?

Acupuncture is incredibly effective at treating the nervous system, and helping to calm down any neurological “excitability” that may be present. It is helpful for sleep disturbances, headaches and anxiety. Furthermore, certain acupuncture points increase blood flow to specific areas of the brain. When the brain gets adequate blood flow, there is proper delivery of nutrients for repair and removal of waste products that will help to decrease inflammation.

Soft-Tissue Therapy

After any injury our soft tissue structures like muscles, tendons and ligaments may react by tightening up or by under-performing. If you are experiencing headaches, neck or shoulder pain and stiffness, seeking out additional physical therapy from a chiropractor, registered massage therapist or osteopath may help to correct any soft-tissue dysfunction.
Suffering from a concussion can be very difficult both physically and emotionally. It is important for your long term brain health that you manage this correctly! Your naturopathic doctor can make specific and individualized recommendations along with monitoring your progress so that you can feel better and return-to-life symptom free.

References
Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L. Clinical practice guidelines for mild traumatic brain injury and persistent symptoms. Can Fam Physician 2012;58:257-67.
McCrory P, et al. Consensus Statement on Concussion in Sport – the 4th International Conference on Concussion in Sport. Clin J Sport Med 2013;23:89–117.
Maroon JC, Blaylock R, Bost J, LePere D. Post Concussion Syndrome – Pathophysiology and Non-Pharmacological Approaches to Treatment. 2011;1-23.
Cernkovich Barrett E, McBurney MI, Ciappio ED. Omega 3 Fatty Acid Supplementation as a Potential Therapeutic Aid for the Recovery from Mild Traumatic Brain Injury/Concussion. Adv. Nutr. S 2014;5:268-277.

Shannon will work with you to help you live your healthiest and happiest life. Since this means something different to everyone, she is excited about exploring your individual needs and working with you to create a treatment plan that is unique and sustainable for you and your busy lifestyle. Shannon is passionate about health and happiness and believes that the two go hand-in-hand.

Clinically, Shannon practices functional medicine. She maintains a general family practice, with a special interest in managing fatigue, stress, anxiety, and depression; digestive health; skin health; irregular or painful menstruation; and endocrine/hormonal disorders.
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