00:01
Concussion is another common presentation
for pediatric even adolescent population.
00:08
So concussion is a form of mild traumatic
brain injury following a biomechanical force.
00:13
It results in a rapid onset of
impairment of neurologic function.
00:18
You don't necessarily have to have full
loss of consciousness to have a concussion.
00:24
The CDC actually says that about 3.8 million sports
related traumatic brain injuries occur annually.
00:32
So concussion results from a
rapid stretch of the brain
where the neurons are stretched and that shear
causes changes to the brain neurochemistry.
00:42
Usually there's neuronal depolarization,
there's local lactic acid accumulation
and then that causes decreased
cerebral blood flow
with the mismatch of cerebral
glucose supply and demand.
00:54
So there's generally not a lot of different
treatments available for concussion.
00:59
Usually, the recommendation is for people who
are concussed, with mild concussion to rest
not return to activity until
they are free of symptoms.
01:08
A lot of different return to
play protocols are out there.
01:12
But, there is a role for potentially
integrating osteopathic manipulation
to the treatment of concussion.
01:19
And so, again concussion is usually due to
some sort of severe force or blow to the body.
01:25
That force usually causes
musculoskeletal restrictions.
01:29
A lot of times, patients after concussion
may have headache, issues with their neck
And so, applying OMT to improve
circulation and lymphatic flow
can also help with decreasing inflammation
and allow patients to heal better.
01:46
So, we want to start by treating the thoracic
inlet, apply balanced membranous tension
to treat the cranial strain patterns,
make sure the cranial base
is released by treating
the OA and the OM.
02:00
There is a technique called the
venous sinus drainage technique
which helps to improve circulatory
flow throughout the venous sinuses
and recently they found that the
lymphatic system which helps to
drain lymphatic fluid from the brain
actually lies within that venous sinus.
02:18
So utilizing this technique
may potentially help patients
to heal quicker and
reduce the inflammation.
02:24
Also remember that you need to take a
look and address the sacrum and pelvis.
02:28
There is a core link, dural
attachment from the frame and magnum
to C2, C3 all the way
down to the sacrum.
02:36
And so, I've had patients that
had concussion-like symptoms
from a really severe sit down fall unto the tail
bone because they were so jar and shocking
that it went and stretched all the
different neurons in the brain.
02:48
So again, each patient
is different.
02:51
You want to listen to the history and physical and
address somatic dysfunctions that you may find.
02:55
But these are some key areas
that you could integrate
into your treatment
for patients with concussion.
03:01
So in general, following the neurologic,
biomechanical and the circulatory lymphatic model,
you could look at different
pediatric presentations
and put them together to develop a
good treatment plan to help address
our pediatric patients and get
them to heal quicker and better.