Traumatic Neck Pain and Concussion

Course Synopsis

Patients frequently seek the help of chiropractors, osteopaths, physiotherapists, and other manual therapy specialists after sustaining a head or neck injury. Frequently the main focus is on the biomechanical dysfunction of the neck; the true extent of the injury often remains unexplored, undocumented and frequently untreated. The cervicogenic component is just one potential contributor to post-concussion syndrome. Six other components have been described (Craton et al., 2017*) and will each be discussed in detail. Whether you treat athletes involved in contact sports or mostly the ‘bread and butter patients’, this seminar will help you to better understand the acute and chronic bony, soft tissue and neurological injuries that can occur through a traumatic head and/or neck injury and will provide you with the knowledge and tools to effectively treat these injuries to the best possible extent.

* Craton, N., Ali, H., & Lenoski, S. (2017). COACH CV: The Seven Clinical Phenotypes of Concussion. Brain sciences, 7(9), 119. Full text available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615260/

Course Schedule

Seven clinical phenotypes of whiplash and concussion will be discussed – Cervical, Vestibular, Autonomic, Headache, Cognitive, Affective (Emotional), and Oculomotor

Saturday

9am – 10.45am:

• Soft tissue injury and alteration of spinal biomechanics after whiplash and mild traumatic brain injury.

• Assessment and treatment of neurological manifestations of cervical spine injury.

10:45am – 11am: break

11am – 1pm:

• Vestibular and cerebellar assessment and rehabilitation.

1pm – 2pm: lunch

2pm – 3:45pm

• Autonomic / cardiovascular manifestations associated with concussion, including exercise intolerance, altered heart rate variability, postural orthostatic tachycardia syndrome (POTS), tachycardia and arrhythmia.

• Brief discussion of headache disorders in post-concussion syndrome and how to manage these.

3:45pm – 4pm: break

4pm – 5.30pm

• Cognitive dysfunction after head/neck injuries and the wide range of symptoms associated with this.

Sunday

9am – 10:45am

• How to assess and rehabilitate cortical dysfunction, focusing especially on the frontal and prefrontal cortex.

• Why emotional / affective disturbances frequently occur in concussion and how these are influenced by altered functional connectivity in other areas of the nervous system, followed by discussion of neuro-rehab and co-management strategies.

10:45am – 11am: break

11am – 1pm:

• Abnormalities in the near point of convergence, saccadic eye movements, visual pursuit and screen viewing are common after head/neck injury, as is photophobia. We will discuss oculomotor dysfunction, assessment and rehabilitation, and how eye exercises can also be used to stimulate many parts of the nervous system that suffer functional disconnect after concussion.

• Management of acute concussion.