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head to head trauma

Second impact syndrome: winning the game isn’t worth losing your head.

Getting a concussion is bad. But getting more than one can be significantly worse. Doctors use the term second impact syndrome to describe the aftereffects of multiple concussions in a short period of time. It can be deadly. 
Concussion happens when the brain moves beyond its normal limits. With a blow or jolt to the head or body, the head and brain move back and forth rapidly. These sudden movements can make the brain bounce or twist inside the skull.  It’s also known as mild traumatic brain injury. The new name came from recent efforts to make it sound as serious as it actually is.

Two can be way worse than one

Whatever you call it, concussion is definitely something to be taken seriously—especially in multiple episodes. Second impact syndrome—SIS—describes getting a second concussion within hours, days or even weeks of the first. Neither has to be severe, even two mild concussions in close proximity can cause it. 

Hidden trauma: improving long-term problems after concussion

SIS is extremely dangerous. In confirmed cases of SIS, half the victims die. Those that survive are at risk for long-term effects, like coma, paralysis, epilepsy, muscle spasms, mental impairment and emotional problems. It also contributes to 

chronic traumatic encephalopathy (CTE), the type of brain damage that can cause long-term deficits in athletes, most often associated with football players and boxers.

Many other athletes are at risk. Without proper supervision and medical advice, it’s easy for an athlete to have his “bell rung,” and return to play, way too soon. We have known football and soccer players, for example, sustaining dozens of concussions when they and their coaches were unaware of the warning signs.

Prevention, the only medicine

Because the brain is in an injured state when the second trauma happens, bleeding and rapid swelling can result, doing significant damage. It can come very quickly, often within minutes—too fast for medical attention to make a difference. Education is the best way to get ahead if it. Fortunately, thanks in part to the publicity around concussions in the NFL, things are definitely moving in the right direction. 

We are much more aware of both the warning signs of concussion and the dangers of SIS. A number of standardized sideline screening tests have been developed, along with much stricter return-to-play guidelines. Word is getting out to coaches and trainers around the world. But concussion and SIS remain a serious threat every athlete and parent should be aware of.

Chiropractic can help

No amount of medical care can reverse the damage SIS causes. But the right kind of chiropractic care can support healing after a normal concussion. The standard treatment is to reduce sensory input. That’s why the doctor will order strict limits on activity and screen time. In an ideal world, we’d lock the concussion survivor in a dark, quiet room until the brain has time to heal. This is impractical, but limiting stimulation remains very important, especially in the early stage. Even just watching a movie can be too much for the injured brain.

I would not recommend traditional chiropractic for concussion survivors, as the old-school techniques can themselves be very stimulating. My colleagues and I at Mark Kemenosh and Associates are trained in ART—Active Release Techniques—which is very different. ART targets the fascia, the tissue that supports and contains muscles. It doesn’t involve sudden movements or “cracking” joints. Since tension and pain caused by the concussion are also stimulating, ART can support healing by relieving it. We have helped many young athletes recovering from concussion, paying special attention to the head, neck, jaw and upper back.

Learn more about concussion prevention and treatment at the CDC’s Heads Up web portal.