An innovative concussion treatment that focuses on the inner ear and cervical spine puts youth and adult athletes back in the game more quickly than traditional treatment, researchers at the University of Calgary have found.
The study, published in the British Journal of Sports Medicine, concluded that athletes were four times more likely to return to their sport within eight weeks if their vestibular system (inner ear) and cervical spine (the vertebrae in the neck) were treated together. In the more traditional approaches, people are told it can take seven to 14 days to recover. That is the best-case scenario, and it does not apply to everyone.
Kathryn Schneider, a researcher with the Sport Injury Prevention Research Centre at U of C's Faculty of Kinesiology, spent more than a year chronicling people with prolonged post-concussion symptoms – dizziness, neck pain, headaches. As a sports physiotherapist, she treated symptoms in her patients' cervical spine then did a vestibular examination – balance is primarily controlled by the inner ear – to see if there was a problem that needed to be fixed. "This is the first study looking into this treatment," Dr. Schneider said. "There was a bit of excitement [when the results were tabulated]."
Fifty-eight people, all of them having suffered a sports-related concussion, were asked to be a part of the study. Thirty-one agreed (18 males, 13 females, all between the ages of 12 to 30). They were split into two groups. Some patients were given a postural education on how to sit and stand along with range-of-motion exercises and gradual exertion in their efforts to return to their sport as soon as possible. Others received vestibular rehabilitation plus cervical spine physiotherapy.
The results were utterly one-sided. Of the 15 patients who had the combination ear and neck therapy, 11 were medically cleared before or by eight weeks, a 73 per cent success rate. For patients who didn't receive the therapy, only four per cent were considered healthy enough to play again. "There are a variety of different techniques to help the brain compensate for problems in the vestibular system," Dr. Schneider explained. "[Patients] can be walking on different surfaces. Then we have them catching a ball while walking. If there's debris in the inner ear [wax, skin cells] we do a series of head positions to use gravity to help get the debris out."
Cameron Marshal led the U of Calgary study and his reaction was: "Finally." Dr. Marshall, president of Complete Concussion Management, has been "incorporating these treatments with our patients … and have been getting tremendous results." He said that in a large number of concussion patients, "we find that a staggering majority are due to neck dysfunctions that may have been the result of injury which happened concurrently to their concussion injury."
Olivia Mohtadi had suffered concussions before, but the worst one occurred in 2011 when she was playing soccer for the University of Wyoming. Her father, Nicholas Mohtadi, an orthopedic surgeon at the U of C Sports Medicine Centre, recommended a visit with Dr. Schneider.
"Kathryn put me through a series of tests," said Ms. Mohtadi, who was dealing with a constant headache. "She checked my vestibular system and my neck then had me tracking objects and noticed there was a lapse in my eyes [an indication she was having trouble following a moving object]. She had me do exercises for my neck muscles, exercises for my eyes. It's a six to eight week process, but I could feel things happening pretty quickly."
Ms. Mohtadi sat out a year before she returned to Wyoming, played two seasons and graduated with a degree in kinesiology. She now works for Dr. Schneider as a physiotherapist.