Published Mar 13, 2018
Harold Olson Michael Tunning Spencer Lindholm


Objective: The purpose of this case series is to describe chiropractic management and return-to-play of 3 student football players who had experienced concussion.Clinical Features: Three young football players (ages 16, 15, and 11) sought care within 3 days after sustaining a concussion.  Each athlete had neck pain accompanied by a headache.Intervention and Outcome: Manual therapies and therapeutic exercises were provided by a chiropractor to help treat cervical spine symptoms and dysfunction. Each patient was also taken through computerized neurocognitive testing during the evaluation of the return-to-play process. At the conclusion of the treatments, all symptoms had resolved including neck pain and headaches. Additionally, cervical spine dysfunction had resolved, the neurocognitive testing scores had improved and each person was returned to play.Conclusion Three football players with cervical spine symptoms, all having sustained a concussion, were managed and treated by a doctor of chiropractic. Manual therapies and therapeutic exercises were directed toward reducing cervical spine dysfunction, which appeared to have a beneficial effect on resolution of symptoms and return-to-play.
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Concussion, Sports Medicine

1. Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control 2010.
2. Marshall CM, Vernon H, Leddy JJ, Baldwin BA. The role of the cervical spine in post-concussion syndrome. The Physician and Sportsmedicine 2015; 43:3, 274-84.
3. McCrory P, Meeuwisse WH, Aubry M, et al. Consensus statement on concussion in sport: the 4th international conference on concussion in sport held in Zurich, November 2012. Br J Sports Med 2013; 47:250-258.
4. Hrysomallis. Neck muscular strength, training, performance and sport injury risk: a review. Sports Med 2016; Feb 9.
5. Collins CL, Fletcher EN, Fields SK, Kluchurosky L, Rohrkemper MK, Comstock RD, Cantu RC. Neck strength: a protective factor reducing risk for concussion in high school sports. J Prim Prev. 2014 Oct; 35(5):309-19.
6. Schneider K, Meeuwisse W, Nettel-Aguirre A, Barlow K, Boyd L, Kang J, Emery C. Cervicovestibular rehabilitation in sport-related concussion: a randomized controlled trial. Br J Sports Med 2014; 48: 1294-1298.
7. Halstead ME, Walter, KD. Sport-related concussion in children and adolescents. Pediatrics. 2010; 3:126.
8. Guskiewicz KM, Weaver NL, Padua DA, Garrett WE Jr. Epidemiology of concussion in colle.g.iate and high school football players. Am J Sports Med. 2000; 28(5):643-650.
9. Halstead ME, Walter KD. Council on Sports Medicine and Fitness. American Academy of Pediatrics: clinical report: sport-related concussion in children and adolescents. Pediatrics. 2010; 126(3):597-615.
10. Zuckerman SL, Lee YM, Odom MJ, Solomon GS, Forbes JA, Sills AK. Recovery from sports-related concussion: days to return to neurocognitive baseline in adolescents versus young adults. Surg Neurol Int. 2012; 3:130.
11. Allen BJ, Gfeller JD. The Immediate Post-Concussion Assessment and Cognitive Testing battery and traditional neuropsychological measures: a construct and concurrent validity study. Brain Inj. 2011; 25(2):179-191.
12. Grubenhoff JA, Deakyne SJ, Brou L, Bajaj L, Comstock RD, Kirkwood MW. Acute Concussion Symptom Severity and Delayed Symptom Resolution. Pediatrics 2014; 134:1, 54-62.
13. Ledd J, Baker J, Merchant A et. Al. Brain or Strain? Symptoms alone do not distinguish physiologic concussion from cervical/vestibular injury. Clin J Sports Med 2014 Jul 21.
14. Baker CS, Cinelli ME. Visuomotor deficits during locomotion in previously concussed athletes 30 or more days following return to play. Physiological Reports 2014 Dec 24; 2(12).
15. McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on concussion in sport: 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clin J Sport Med. 2009; 19(3):185-200.
16. Porcher NJ, Solecki TJ. A narrative review of sports-related concussion and return-to-play testing with asymptomatic athletes. Journal of Chiropractic Medicine 2013 Dec; 12(4): 260-8.
17. Lau B, Collins M, Lovell M. Sensitivity and specificity of subacute computerized neurocognitive testing and symptom evaluation in predicting outcomes after sports-related concussion. Am J Sports Med 2011 39(6) 1209-1216.
18. Schneider KJ, Iverson GL, Emery CA, McCrory P, Herring SA, Meeuwisse WH. The effects of rest and treatment following sport-related concussion: a systematic review of the literature. Br J Sports Med. 2013; 47(5):304-307.
19. Leddy JJ, Cox JL, Baker JG, et al. Exercise treatment for postconcussion syndrome: a pilot study of changes in functional magnetic resonance imaging activation, physiology, and symptoms. J Head Trauma Rehabil. 2013; 28(4):241-249.
20. Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013; 80(24):2250-2257.
21. Hugentobler JA. Physical therapy management of post-concussion syndrome. 4th Annual Ped Sports Phys Ther Conf. 2014.
22. Chaibi A, Russell MB. Manual therapies for cervicogenic headache: a systematic review. J Headache Pain, 2012; 13:351-359.
23. Alsalaheen BA, Whitney SL, Mucha A, Morris LO, Furman JM, Sparto PJ. Exercise Prescription Patterns in Patients treated with Vestibular Rehabilitation After Concussion. Physiother Res Int. 2012; 18(2): 100-108.
24. Kirkwood M, Yeates K, Wilson P. Pediatric sport-related concussion: a review of the clinical management of an oft-ne.g.lected population. Pediatrics 2006; 117:1359-71.
25. Treleaven J, Jull G, Atkinson L. Cervical musculoskeletal dysfunction in post-concussion headache. Cephalgia 1994; 14:273-9.
26. Bogduk N. The neck and headaches. Neurol Clin N Am 2004;22:151-71.
27. Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther 2009;39(5):364-377.
28. Treleaven J, Jull G, Sterling M. Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. J Rehabil Med 2003;35(1):36-43.
29. Endo K, Ichimaru K, Komagata M, Yamamoto K. Cervical vertigo and dizziness after whiplash injury. Eur Spine J 2006;15(6):886-890.
30. Hurwitz E, Carragee E, van der Velde G, et al. Treatment of neck pain: noninvasive interventions; results of the Bone and Joint Decade 2000-2010 Task Force of Neck Pain and Its Associated Disorders. Spine 2008; 15:S123-52.
31. Kat T, Gross A, Goldsmith C, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev 2005; (3): CD004250.
32. Bialosky J, Bishop M, Price D, et al. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive mode. Manual Therpy 2009;14:531-8.
33. Hartvigsen J, Boyle E, Cassidy JD, Carrol LJ. Mild traumatic brain injury after motor vehicle collisions: what are the symptoms and who treats them? A population-based 1-year inception
34. Wong JJ, Shearer HM, Jacobs C, et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the bone and joint decade task force on neck pain and its associated disorders by the optima collaboration. Spine J 2015 Dec 17. Pii:S1529-9430(15)01234-6.
35. Crowe L, Collie A, Hearps S. et al. Cognitive and physical symptoms of concussion injury in children: a detailed longitudinal recovery study. Br J Sports Med 2016;50:311-316
36. SCAT3. Br J Sports Med 2013; 47:259