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A lot has been made over the last decade about the hazards of concussions (and rightfully so). When the brain smacks into the skull with force, it should be obvious that this isn’t a good thing and it needs to be taken seriously. Most of the attention around concussions has been dedicated to chronic traumatic encephalopathy (CTE). If you’ve watched Will Smith’s movie “Concussion” or followed the NFL over the past few years, you’ve definitely heard of it, (that's not what this article is about).  In CTE a protein called Tau slowly builds clusters in the brain, killing brain cells. It’s been linked to cognitive problems, personality changes, and behavioral changes like aggression and depression. But the development of CTE is a long term process. And for us human beings, it’s harder to make decisions that are best for our long term health and well-being (just think about how much discipline it takes to routinely put money aside in retirement savings, knowing you could go on a tropical vacation with it instead…) So let’s talk about the short term risks with concussions - the ones that haven’t been featured in a movie or talked about on Sportscenter. If you’re only focused on the here and now versus what your brain looks like 30 years from now (what’s wrong with you anyways?? Take your brain health seriously!), these are the risks that will matter to you. Even though they can completely DERAIL an athletic career or workout regimen, they aren’t getting the same attention as CTE. So what is it? Those who suffer a concussion are at least 38% more likely to suffer a lower extremity injury within the next year [1]. And some studies have concluded the risk is even higher (up to nearly 3x more likely to suffer a lower extremity injury! [2,3]).
What’s this mean? That a concussion can have lingering effects LONG AFTER the initial symptoms are gone and you’ve been cleared by your physician or athletic training staff for return to activity.
And that these effects can keep you off the field or out of the gym for significant lengths of time. In many cases, those who return to activity after concussions continue to have decreased dynamic postural control, motor control, balance, and ability to effectively coordinate movement [2]. The differences are so subtle that often times it’s not even noticeable, but they are there, and pose a risk for future injury. We see this retrospectively all the time at Premier. A client comes in reporting an extensive history of injuries (they just keep getting hurt time and time again…) or chronic pain that won’t go away no matter what they do. After thoroughly talking through the client's injury history, this question is eventually asked: “Have you ever experienced a head or neck injury?” In many cases, the answer is something along the lines of: “Well, there was this one time that caused a lot of concussion symptoms, but it wasn’t that serious and went away after a few days.” When the client compares the date of the concussion with when the string of injuries or chronic pain started, it becomes clear that the concussion may have been much more significant than originally thought. From there, our unique neurological communication assessments reveal that the significance of the concussion is even more apparent – those who have suffered a concussion often fail to pass the most basic assessments. So what does all this mean? 1. Take concussions seriously! They not only impact your long term brain health, but short term ability to stay on the field and in the gym. 2. A proper concussion rehabilitation program needs to go beyond just rest and passing a cognitive test. It should incorporate functional movement and dynamic postural control testing as well. 3. If you’re someone who keeps getting hurt, has an injury that won’t go away, or suffers from chronic pain AND have a history of head/neck trauma, it’s likely neurological communication issues will need to be addressed to put an end to your cycle of frustration. . If you have questions regarding concussion rehabilitation protocol or how a previous head/neck injury may be affecting your life, feel free to shoot me an email at: support@premierneurotherapy.com References:
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There’s a common misconception out there that a person experiencing lower back pain must have a core that is “unstable.” It’s a thought process that intuitively makes a little bit of sense, but if you dig a bit deeper below the surface, you’ll find it’s rarely the case. Study after study has shown that core exercises are no more effective than general exercise when it comes to addressing lower back pain. Before we get into several reasons why lower back pain doesn’t always equal an unstable core, let’s look at the theory behind it. When most people refer to “core stability,” they are referring to the muscles that lie deep within the torso (think the muscles around the abdomen). Muscles generally accepted in this group are: the diaphragm, lumbar mutlifidus, transverse abdominis and the muscles of the pelvic floor, which link most closely to the spine.  Because these muscles act most immediately on the spine, the surface level thought is that they must not be working properly in people with lower back pain… or they must not be providing the proper stability to the spine. This is a far too oversimplified way of thinking about the body, and would be similar to assuming the wheels on your car don’t turn because the axel isn’t strong enough. Yes, it’s possible, but there are hundreds or even thousands of other variables that may be going on that contribute to the wheels on the car not turning. The same can be said about lower back pain and core stability. Pain is complex. Movement is complex – we need to go deeper than the surface to find meaningful (and productive) solutions. Unfortunately, this means that we can’t just point to the simplest possible answer (core instability) and say it’s why you’re having lower back issues. Let’s look at the assumption a little more closely, and we’ll see how wrong it can be…
The core stabilizers are meant to do just that, provide stability. In a general sense, they’re meant to absorb tiny forces around the spine to maintain balance. Just think about the exercises and tools we use to isolate these muscles… bosu balls, physioballs, and balance boards.
We’re not moving tremendous amounts of weight or moving with high velocities when we’re isolating these muscles, because that’s not what they’re designed to do. Now, let’s think about the muscles that we DO train with heavy weight and high velocities. These would be ‘mover’ muscles like the calves, hamstrings, quads, and glutes. They help to create and absorb tremendous amounts of force – not only in the gym, but in our day to day lives. They are the main drivers for movements like bending over to pick something up, walking, jumping, and climbing the stairs. Looking at it this way, if either of these types of muscles (the smaller core muscles or larger ‘mover’ muscles) were unable to absorb force properly throughout the day, which do you think would contribute more to additional stresses on the spine (and possibly lower back pain). I think the answer’s obvious – you would expect any dysfunction in the larger ‘mover’ muscles to play a much larger role in keeping stresses off the spine.. and it matches what we find with nearly all of our clients with lower back pain. Rarely does our assessment process indicate any need to improve core strength. This is just one great example of the many myths out there about lower back pain (and rehabilitation in general). If we look at problems within the body at the surface, you’ll get surface level solutions. I encourage you to take a step back, whether you’re dealing with back pain or another issue, and dig at least 1 level deeper to find more meaningful (and hopefully productive) solutions. This week's post highlights the story of a Premier Family member, Kelly. I share these stories with hopes that you can relate - it's likely that you know someone who's living with pain and would jump at the opportunity to find out if Neuro Therapy can help live life without limitation. (Click here to refer a friend or family member).
Kelly came to us after hearing about her husband's positive experience working with Premier Neuro Therapy. She had lived with chronic sciatic pain for all of her adult life, over 20 years. Secondary to the sciatic pain, she was experiencing 1-3 migraine headaches/week. The sciatic problem was bothering her throughout everyday life, including when she sat for long periods of time at work, in the car, or in restaurants. Like many people who come to Premier, she had tried a number of other options first, including seeing multiple specialists, chiropractors, and physical therapists. No one was able to offer her a direct solution. Her goal was to have pain free days, and we're happy to say that through several weeks of hard work (as you'll see in the video below) and dedication, Kelly has achieved that goal! If you're interested in finding out if there's a chance Neuro Therapy can help you, click the blue button below to schedule a time to chat with a member of our team. For a sneak peek of one of Kelly's Neuro Therapy sessions, check out the video below:
There are between 150,000 – 200,000 ACL tears every year in the US, and nearly 100,000 ACL reconstruction surgeries performed. Out of all the data available with regards to these surgeries, there is one piece of information that is most telling about the future health of the affected knee. This data point is so telling that one group of researchers drew the conclusion that people who don’t hit this target would have been better off if they hadn't gone through the ACL reconstruction surgery at all. So what is it? After ACL reconstruction surgery, one of the primary focuses of rehabilitation is restoring full extension of the knee (or being able to completely straighten the knee). If full extension is not restored to within 5 degrees of being straight, those who undergo ACL reconstruction surgery will be 2x more likely to develop osteoarthritis in the knee. A loss of 5 degrees of extension is also tied to:
All of these consequences make it very unlikely that the patient will be able to return to a high activity lifestyle. Without full extension, even every day activities like walking, climbing the stairs, and bending over to pick things up can become difficult. It goes without saying that restoring full knee extension range of motion after surgery must be one of the top priorities in a successful ACL reconstruction rehabilitation. And the sooner the better. One research group found that range of motion in the knee at 4 weeks was strongly correlated with range of motion in the knee at 12 weeks. In other words, if you’re behind in restoring range of motion 4 weeks after surgery, it’s likely you will still be behind 8 weeks later. When you hit the 12 week mark, the likelihood of restoring ROM becomes less and less. In a recent case study with one of our clients, Bobbie, she started Neuro Therapy protocols 4 weeks after surgery. At the time she started, her knee lacked 5 degrees in extension, which could have been problematic if it remained that way. In many cases, it takes months to restore the range of motion with traditional therapy. However, within just 1 week of work, Bobbie’s knee extension range of motion was restored, drastically decreasing her chances of developing osteoarthritis in the affected knee. Neuro Therapy protocols have consistently delivered these types of results for ACL Reconstruction Rehab, as is evidenced by Cameron and Naja’s words on the rehab process below (both returned to their sports at a high level).
Neuro Therapy can yield these types for a variety of ACL reconstruction clients, including the following:
Just click the link below, fill out the form, and we’ll have someone get in touch as soon as we can. go.premierneurotherapy.com/talk
Sources:
Noll S, Garrison JC, Bothwell J, Conway JE. Knee Extension Range of Motion at 4 Weeks Is Related to Knee Extension Loss at 12 Weeks After Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med. 2015;3(5):2325967115583632. Published 2015 May 4. doi:10.1177/2325967115583632 Shelbourne KD, Urch SE, Gray T, Freeman H. Loss of normal knee motion after anterior cruciate ligament reconstruction is associated with radiographic arthritic changes after surgery. Am J Sports Med. 2012;40:108–113 |
About the AuthorEvan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility. 
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Physical Therapists Learn More Here
Premier Neuro Therapy LLC
support@premierneurotherapy.com
(410) 929-0642
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