Chiropractic Management of Musculoskeletal Symptoms in a 14-Year-Old Hockey Player With Postconcussion Symptoms: A Case Report

Abstract

Objective

The purpose of this study is to describe the chiropractic management of a student athlete with postconcussion syndrome.

Clinical Features

A 14-year-old male hockey player presented to a chiropractic clinic with postconcussion symptoms 13 days after his initial injury. He experienced an occipital headache with a pain rating of 8/10, upset stomach, blurry vision, nausea, dizziness, balance problems, a “foggy feeling,” difficulty with concentration, difficulty with memory, fatigue, confusion, drowsiness, and irritability. Prior to seeing the doctor of chiropractic, the patient was monitored by a medical doctor, and the care he had been receiving was in accordance with current concussion guidelines. At the time of presentation to the chiropractic clinic, he had failed to progress toward return to play, and his computerized neurocognitive testing scores had not improved.

Intervention and Outcome

Chiropractic manipulative therapy, myofascial release, instrument-assisted soft tissue technique, and therapeutic exercises were provided over 5 treatments spanning a 20-day period. The patient followed up each treatment with ImPACT testing. At the conclusion of the treatments, the patient’s computerized neurocognitive testing scores had improved, and the patient was returned to play.

Conclusion

This case demonstrates the improvement of postconcussion syndrome in a 14-year-old male hockey player under chiropractic management.

Introduction

Concussion is a subset of a traumatic brain injury (TBI) and is often classified as a mild traumatic brain injury (mTBI). Concussion is a brain injury resulting from a low-velocity force in which the brain is shaken, resulting in clinical symptoms which are not necessarily related to a pathological injury. It is a complex pathophysiological process leading to a wide array of symptoms.¹ It is the common result of a direct blow to the head in contact sports; however, it can be a consequence of collisions and falls. It can also be the result of a whiplash-type injury without a direct blow to the head.² With the growing concern of TBIs in athletics, the balance between athletes maintaining a competitive edge in a sport and participant safety has become gray. The balancing between this has been left up to coaches, doctors, players, team trainers, and even parents. The role of the health care provider is the rapid assessment of the injured athlete and the guidance toward a safe return to play.

At present, there are very few case reports describing the chiropractic management of a patient with concussion and return to play. Therefore, the purpose of this case report is to describe the chiropractic management of a student athlete with postconcussion syndrome (PCS).