Concussion Recovery: Cervicogenic (Neck) Subset

Jun 9th, 2022

Concussion - Cervicogenic (Neck) Subset 

Written by Brittany Emary and Fausta Ferzoco 

Not sure if you have a concussion? Scroll down to see a list of typical signs, symptoms and treatments related to concussions or learn more here

What is the Cervicogenic Subset of a Concussion? 

The cervicogenic subset is a subset of concussion where structures in the neck contribute to concussion symptoms. It is caused by a direct or indirect hit to the neck or another part of the body that causes the brain to move inside the skull. 

What are the common treatments for the Cervicogenic Concussion Subset? 

  • Practitioners will monitor symptoms and create a recovery plan tailored to the patients' needs to ensure a safe return to daily activities. 
  • If the neck or spine is affected by the injury that caused the concussion, a physiotherapist can help to strengthen the neck muscles. Physiotherapists will utilize manual therapy and myofascial release techniques to ensure the joints and tissue are moving well.  
  • Our Physiotherapists at HPC will create a personalized treatment plan. This may involve the use of advanced manual therapy skills and exercises to treat symptoms associated with the neck and vestibular system and restore strength in the affected areas of the body. 
  • Manual therapy can be used to massage and manipulate damaged soft tissue which allows the muscles to relax and increases blood flow to that area. This technique takes the pressure off nerves which can alleviate pain. 
  • Isometric neck strengthening can be incorporated into the treatment plans that physiotherapists create for their patients. Increased neck strength has proven to decrease the incidence of injury and decrease the risk of future concussions. Exercises should be performed in sets of 8-15 twice a week for 8 weeks minimum. 
  • Flexion exercises can help the neck recover.
    • For these exercises, the patient will stand or sit in line with a sturdy object that a resistance band can be attached to. The resistance band is then fixed across the forehead. The patient is instructed to bring their chin down toward their chest to lengthen the back of the neck and then slowly return to neutral. 
    • For side flexion, the resistance band goes across the head while the patient stands towards the wall. The patient is then instructed to slowly bring the head towards their shoulder and then back into neutral. 
  • Similarly, extension exercises can be used. For extension, use the same setup as outlined above with the resistance band, but instead, the patient will be instructed to face the attachment point and tilt the head back to look up at the ceiling then slowly return to neutral.
  • The patient should gradually return to work, school, and/or sports as symptoms allow. It is recommended that patients slowly increase their daily activity levels to prevent symptoms from worsening. Medications that can mask symptoms are not recommended as it is important that individuals know their body’s limits following a concussion. 

What are the Signs and Symptoms of Concussions? 

Symptoms can involve the body, cognition, emotions, and sleep. 

Body-related symptoms: 

  • Dizziness 
  • Headache 
  • Neck pain 
  • Trouble balancing 
  • Sensitivity to light or noise 
  • Blurred vision 

Cognitive symptoms:  

  • Confusion 
  • Fatigue 
  • Disturbances in memory and concentration 

Emotional symptoms: 

  • Irritable 
  • Nervous 
  • Anxious 
  • Sad 

Sleep-related symptoms: 

  • Difficulty falling asleep 
  • Trouble staying asleep  
  • Sleeping too much 

How is a Concussion Diagnosed? 

The first part of diagnosis involves medical assessment in which the practitioner considers the mechanism of injury, risk factors for prolonged recovery, medical history, and symptom presentation. For concussions of neck origin, a neck examination is often conducted. 

The Sport Concussion Assessment Tool – 5th Edition (SCAT5) is a concussion assessment tool commonly used in diagnosis to evaluate consciousness, memory, symptoms, balance, and coordination.  

Concussion patients can be discharged from the hospital right away if it is determined that they have normal mental status, no indication of a need for a CT scan, and no other clinical indicators for prolonged hospital observation. 

Concussions are classified as brain injuries and should not be taken lightly. As a specialized concussion clinic, our practitioners at the Health and Performance Centre use their expertise to effectively treat concussions and ensure that the brain and other impacted body parts recover properly. For more information on our unique approach to concussion management, give us a call.  

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About the HPC Student Volunteer Program: 

Each year, approximately 30 University of Guelph students are selected following a competitive application process to take part in the “HPC Volunteer Program.” This program provides an opportunity for U of G student volunteers to translate their academic knowledge into practice, while gaining first-hand experience and mentorship from the team of certified physiotherapists and chiropractors at the University of Guelph’s Health and Performance Centre. As a result of this exceptional partnership between the University of Guelph and the HPC practitioners, students can gain valuable insight on evidence-based practice prior to graduating from their respective programs. Click here for more information on co-curricular experiential learning opportunities at the University of Guelph. This article was written by members of the 2021-22 HPC Student Volunteer Program. 

References: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264559/ 

https://www.canada.ca/en/public-health/services/diseases/concussion-signsymptoms.html 

https://eramosaphysio.com/conditions/concussion-management/ 

http://concussionsontario.org/healthcareprofessionals/standards/standards-for-highquality-post-concussion-services-and-concussion-clinics/standard-1/ 

https://www.physio-pedia.com/Concussion