Still Not Yourself
After a Concussion?

A concussion happens when a blow or a sudden jolt makes the brain move rapidly inside the skull. Most people recover within a few weeks. A meaningful minority do not, and are left with symptoms that interfere with work, school, driving and sleep long after their scans came back normal.

The forces that cause a concussion do not stop at the skull. Your head weighs roughly ten to twelve pounds and sits on top of the atlas and axis, the two most mobile vertebrae in your spine. The same whip of acceleration and deceleration that injures the brain also strains the ligaments, joints and small muscles of the upper neck.

That matters because an injured upper neck can produce many of the same symptoms as a concussion: headaches that start at the base of the skull, dizziness and unsteadiness, visual strain, and difficulty concentrating because of constant pain. Sports medicine researchers now recognize that persistent post-concussion symptoms often have a cervical component, and that addressing the neck can be part of recovery.

One reason post-concussion symptoms are hard to sort out is that the brain and the upper neck share wiring. Nerves from the top three neck segments connect with the brainstem pathways that process head pain and balance. The joints of the upper neck are packed with position sensors that tell your brain where your head is in space, and when those joints are injured the signal gets noisy.

The result is a set of symptoms that can come from the brain, the neck, or both at once. A headache that sits at the back of the head and gets worse with neck movement, or dizziness that comes on when you turn your head rather than when you stand up, points us toward the neck. Researchers increasingly describe whiplash and mild traumatic brain injury as overlapping conditions rather than separate ones.

Every concussion is different, and recovery is rarely a straight line. Early in care we usually see patients more often while we stabilize the correction. As the atlas holds its position longer, visits are spaced out. We re-examine regularly so both of us can see objectively whether things are changing.

Many patients notice neck-driven headaches and dizziness change first. Fatigue, concentration and exercise tolerance tend to improve more gradually and often depend on sleep, a graded return to activity, and help from other providers. We will tell you honestly if your progress suggests the neck is not the main driver, and point you toward the care that fits better.