Concussions: Definition, Symptoms and How Osteopaths can Help.

By Thomas Nicolacopoulos

Concussions are defined as mild traumatic brain injuries (mTBI) caused by a blow to the head or body, resulting in an impulsive force transmitted to the brain, disrupting brain function. The force travelling up to

the brain causes stretching or shearing of white and grey brain matter, initiating a cascade of

neurotransmitter and metabolic changes, possible axonal injury (An axon is a part of a nerve cell that sends messages from one cell to another), blood flow changes, and inflammation affecting the brain. [1].

Concussions can occur in many situations, including sporting collisions, motor vehicle accidents, slips or falls, and workplace incidents. The symptoms can vary widely and may include loss of consciousness,

seizures, headache, dizziness, cognitive difficulties, and changes in balance or coordination.

Symptoms may appear immediately or develop over several minutes or hours. Most people recover within days, although some individuals experience longer-lasting effects [1].

In October 2024, I completed the Complete Concussions healthcare practitioner training to further develop my skills in assessing and supporting people with concussions. This additional education has allowed me to provide clearer guidance, more structured care and greater confidence when managing

concussion cases at Valued Health Osteopathy.

Osteopaths with additional training in concussion management are equipped to assess suspected concussions, identify red flags, and determine when further medical investigation or imaging is required

[1–3].

Once a concussion has been confirmed, osteopathic treatment can help address associated symptoms such as neck strain, headaches, visual or vestibular disturbances, and musculoskeletal tension [4–13].

Treatment and education can also support a safe and gradual return to school, work, or sport [1].

Osteopaths can perform neurocognitive and functional baseline testing before the start of a sports season, which provides a clear and accurate understanding of how an individual functions when healthy [1,14,15]. This baseline testing includes a range of cognitive and physical assessments completed prior to

any concussion.

If a concussion occurs, clinicians can compare the post-injury results with the original baseline to identify changes, monitor recovery, and make informed decisions about when it is safe to return to physical and

cognitive activity [14,15].

This process helps determine neurological recovery and forms a comprehensive and evidence-based approach to concussion management [1].

The Australian Institute of Sport emphasises the importance of neurocognitive baseline testing in its Concussion and Brain Health Position Statement (2024), recognising it as a key component of best-practice concussion care in Australian sport [16].

References:

1. Patricios, J., Schneider, K. J., Dvorak, J., et al. (2023). The Amsterdam International Consensus Statement on Concussion in Sport. British Journal of Sports Medicine, 57, 695–711.

2. , R., et al. (2023). SCAT6: Standardised Concussion Assessment Tool. British Journal of Sports Medicine.

3. Davis, G., et al. (2023). Child SCOAT6. British Journal of Sports Medicine.

4. Treleaven, J., et al. (2008). Sensorimotor and cervicogenic mechanisms contributing to post-concussion symptoms. Manual Therapy.

5. Cheever, K., et al. (2016). Cervical afferent dysfunction after concussion.

6. Register-Mihalik, J., et al. (2018). Cervical spine mechanisms and post-traumatic headache.

7. Gammons, M., et al. (2017). Headache evaluation following concussion.

8. Langer, L., et al. (2022). Revisiting ICHD-3 criteria for post-traumatic headache. Cephalalgia.

9. Santos, M., et al. (2020). Oculomotor rehabilitation and near-point convergence after mTBI. Journal of Sport Rehabilitation.

10. Barton, B., & Ranalli, P. (2020). Oculomotor dysfunction and vision therapy after concussion. Annals of Neurology.

11. Schneider, K. J., et al. (2014). Cervico-vestibular rehabilitation in concussion: RCT. British Journal of Sports Medicine.

12. Brown, D. (2019). Vestibular dysfunction following concussion.

13. Marcus, H., et al. (2019). Dizziness and imbalance in acute mild traumatic brain injury.

14. Kontos, A. P., et al. (2020). Time to presentation and recovery outcomes after concussion. JAMA Neurology.

15. , J., et al. (2020). Time to presentation as a predictor of prolonged recovery. Physician and Sports Medicine.

16. Australian Institute of Sport. (2024). Concussion and Brain Health Position Statement 2024. Australian Sports Commission.