Neck ache after concussion? (Sarah Etheridge, PT)

Neck ache after concussion? (Sarah Etheridge, PT)

Table of Contents

Neck ache after concussion is a quite common symptom. In the event you endure from neck ache, studying concerning the muscle mass and nerves which may be inflicting the ache on this episode could also be very useful for you. Nonetheless, should you don’t have any neck ache, or simply minor complaints like stiffness, there should still be one thing occurring with the muscle mass and nerves in your neck. That’s the reason, PT Sarah Etheridge says, it’s at all times necessary to verify the neck after concussion. 

Desk of content material

02:04 International Brain Injury Association conference
03:34 Neck pain after concussion
04:25 Muscles to check after concussion
06:17 Nerves to check after concussion
09:03 Occipital neuralgia

Concussion Tales podcast introduction

[00:00 Melanie] If I say there may be hope for full restoration for folks with a concussion, you say…?

[00:07 Professor McCrea] 100%!

[00:08 Professor Maas] And in reality, you didn’t solely really feel it: you have been outdoors the common medical system, as a result of they weren’t thinking about you.

[00:16 Professor Sitskoorn] Neuroplasticity really opens you as much as the world. It makes it attainable to develop; it makes it attainable to rehabilitate.

[00:25 Professor Wilson] Traumatic brain injury has been known as a silent epidemic for that cause, as a result of it consists of adjustments and disabilities that aren’t apparent to different folks.

[00:35 Dr. Zasler] If, as a doctor, you felt you had nothing to supply a affected person, then I feel ethically, it is advisable to say] “I don’t assume there’s something I can give you. Possibly it’s best to see Dr. M.”

[00:48 Professor Diaz-Arrastia] Traditionally, we’ve got known as this stuff gentle traumatic mind accidents, which suggests that, nicely… It might be a brain injury, nevertheless it’s not going to have nice penalties, proper? And that’s frankly not true.

Concerning the Concussion Tales podcast

[01:05 Melanie] Welcome to Concussion Tales, a Lifeyana podcast sequence full of hope. I’m right here to let you understand that you’re not alone in your post-concussion restoration journey. My identify is Melanie and I spent six and a half years studying, experimenting, and coaching with a purpose to discover a option to heal myself from post-concussion syndrome.

After making a full restoration by the top of 2018, I launched into this mission to make the restoration journey simpler for you. This is the reason I began this podcast, wrote detailed blog post and downloadable guides, provide coaching and likewise the course that I want I had again after I was recovering — educating you all the things that I wanted to know with a purpose to make my restoration occur.

On Concussion Tales, we dig deep whereas discussing hopeful tales of restoration in addition to the exhausting stuff within the messy center. Let’s dive proper in!

Worldwide Mind Harm Affiliation convention

[02:04] Welcome to one in every of many episodes overlaying my go to to the International brain injury conference by the International Brain Injury Association that occurred in Dublin across the begin of April 2023. It’s been my honor to attend and document displays given by many outstanding researchers and practitioners within the subject of brain injury.

Concussion analysis insights

I discovered issues that I didn’t but know, and spoke with folks I used to be actually trying ahead to assembly sometime. Now, I need to share all the things that I discovered, noticed, and heard with you, so that you’ve entry to the latest insights, instantly from the highest brain injury researchers and docs who discovered them. Let’s get began with at present’s episode. 

Concussion Care Heart of Virginia

On the primary day of the convention in Dublin, I went to a seminar by the Concussion Care Center of Virginia. You could bear in mind the clinic’s founder, Dr. Zasler, from season one in every of Concussion Tales (Dr. Zasler on post-concussion rehabilitation and on post-concussion headaches). Because the identify implies, the middle makes a speciality of post-concussion care and has a selected concentrate on treating the neck (amongst others neck ache) and eyes with a purpose to heal lingering concussion signs.

Concussion PT: Sarah Etheridge

[03:12] On this first episode, you’ll get to know Sarah Etheridge, the clinic’s bodily therapist, or PT. In her expertise, quite a lot of concussion signs really come from neck issues, not at all times leading to neck ache. This is the reason, she says, it’s so necessary for docs to verify the neck in sufferers with concussion. Let’s hear it instantly from Sarah.

Neck ache after concussion

Neck pain after concussion

[03:34 Sarah Etheridge] In a cohort the place they checked out these with concussion and people with concussion plus cervical impairments, within the group that had neck impairments, nearly 30 p.c had zero complaints of neck ache or stiffness. So if we’re simply asking the affected person: do you’ve gotten neck ache? And so they’re like: yeah, it’s a bit stiff, however no, that’s probably not what’s bothering me – we’re going to miss them. 

So perhaps these with concussion and neck damage have extra complaints about neck ache or have extra complaints about dizziness versus those who simply have a concussion? Possibly they simply complain extra about temper adjustments or sleep disturbances? That isn’t the case. 

Examine the neck after concussion

These signs are evenly distributed between these two affected person populations: these with concussion and people with concussion plus cervical impairments. So we’ve got to be checking the neck, even when sufferers don’t complain about neck ache

So the sufferers who come see us, they’re those who aren’t getting higher. Properly, the literature additionally reveals that these are those who usually tend to be having cervical impairments. In the event you deal with these impairments, they really feel higher. 

Muscle tissues to verify after concussion

Muscles to check after concussion

Sarah continues to level out the muscle mass and nerves which will trigger particular complications. In the event you’re not already watching this episode over on or YouTube, you may wanna go there with a purpose to see the slides and the palpation actions Sarah makes together with her arms.

Trapezius and sternocleidomastoid

[04:59] The upper trapezius is frequent to come back proper into the temple space. It should have type of a ramphorn distribution, and is often concerned. The SCM (sternocleidomastoid) can also be one that may contribute to not simply complications, but in addition tinnitus. So sufferers generally will say: hey, I really feel fullness in my ear or cotton in my ear.

Suboccipital muscle mass and occipital neuralgia

The suboccipital muscles are nearly at all times concerned to some extent – particularly if sufferers have occipital neuralgia occurring. However this one may give quite a lot of retro orbital ache. That is undoubtedly in these sufferers who sit with that ahead head who’re workplace staff which might be on screens and are doing that higher cervical extension. 

Semispinalis and splenius muscle mass

The semispinalis and splenius muscle teams refer up into the top, and are necessary to verify. 

These are the nerve teams that I at all times verify on my sufferers which might be complaining about headache. What concerning the occipital nerves? 50 p.c of sufferers which have occipital neuralgia additionally complain about dizziness.

Nerves to verify after concussion

Nerves to check after concussion

[06:17] So in case your affected person’s complaining a few actually intense headache – it may be transient, it may be persistent, it may be retro orbital, and they’re additionally having dizziness, and they struck the again of their head or they’ve had signs for a very long time: please, please, please verify the next nerves. 

Supratrochlear and supraorbital nerves

The supratrochlear and supraorbital nerves run within the entrance, they’re branches off the trigeminal nerve. I don’t discover these as generally concerned until the affected person has struck their brow or they’ve a migraine part to their headache and so they have been having complications for some time. Once more, as a result of these are branches off the trigeminal nerve, there are neuromodulation gadgets on the market like cephaly that may be a noninvasive method to assist these sufferers.

Occipital nerves

To palpate the occipital nerves (the anatomy is a bit totally different on all people), I’m going and I discover the mastoid course of, which is the bone proper behind the ear. Then I discover the exterior occipital protuberance, which is the bony knot on the base of the cranium, and I run my fingers proper by way of there.

[07:26] A couple of third of the best way in on that diagonal line is your lesser occipital nerve, and it tends to run in a bit little bit of a trough. So generally I’ll run my finger, I’ll discover the groove after which I’ll palpate alongside it. A couple of third of the best way in from the exterior occipital protuberance, must be your better occipital nerve. And once more, I type of discover the little trough that it runs in. Not all people can really feel it, however some folks have that divot, as a result of nerves are inclined to run in a groove. After which I’ll palpate alongside the traces of that.

Ache sensitization

When it’s sizzling and irritable, it’s actually apparent. One of many issues that I feel is tough, particularly if any person has been in ache for some time: they will have some peripheral sensitization and a few central sensitization, so they’re a bit bit tender all over the place.

However what I’m actually in search of is that one who’s like: yikes! And they’re attempting to leap off my desk and are like: thanks, good to fulfill you, I gotta go, bye. That’s the form of response I’m in search of. 

If they’re a bit bit tender after which they’ve this delayed response the place they then, throughout the subsequent minute, say: ooh, I’ve bought that headache occurring. Then I begin to assume: okay, perhaps it’s irritable, however perhaps it’s not the first driver of their ache and nonetheless one thing to handle. We might attempt them on one thing like an icing program that’s a really benign remedy that doesn’t have quite a lot of unintended effects. 

Occipital neuralgia

Occipital neuralgia

[09:03 Dr. Zasler] Sarah, might I simply make a fast remark? One caveat I might add: once you discover individuals who have occipital neuralgia, they usually even have involvement of suboccipital musculature. In the event you attempt to inject to deal with the occipital neuralgia earlier than treating the myofascial dysfunction, the occipital neuralgia will possible simply come again. 

Injections or neuromodulation

So it is advisable to deal with the muscular part first, after which usually the occipital neuralgia will abate. If it doesn’t, at that time, you possibly can think about injection or neuromodulation, which we’ve got been utilizing for various years with good success with Cephaly, in addition to a tool known as Relevion that may additionally do occipital nerve stimulation externally.

Icing nerves

[10:00 Jacqueline Theis] And ice. Whereas they’re ready to see one in every of them, I inform them to ice. 

[10:04 Sarah Etheridge] Ice tends to work nicely. The nerves are actually superficial, so if they’re actually infected. It may possibly get a bit dicey if they’ve had ache for some time and have some central sensitization. They will have a bit little bit of hyperalgesia in direction of chilly, particularly.

However 10 to fifteen minutes of icing a day is what I inform my sufferers to do, whether or not it’s a great day or a nasty day. I get them began on that as a result of it’s very easy to implement, and so they can often inform me: sure, that makes a distinction for me or no, it doesn’t. Then that may lead us down the observe of neuromodulation, or injections whereas I’m engaged on their suboccipital muscle mass. It may possibly assist information remedy. Ice is straightforward, it’s low-cost, so why not? 

Share your ideas with me?

[11:00 Melanie]  Now, I might love to listen to from you. What do you are taking away from this episode? Is there one thing that you could apply to your life straight away? Head on over to and depart your remark now.

And if you wish to hear and skim extra Concussion Tales, actionable steps and inspiration, you’ll want to subscribe to the Lifeyana e-mail record whilst you’re there, so that you simply by no means miss out on new supplies we consistently make for you.

If you wish to assist this podcast, head on over to Thanks for listening to this concussion tales episode by Lifeyana. Might you can be nicely and should you be blissful.

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