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CBC radio recently aired an episode of “The Current” in which Theo Fleury guest hosted and spoke specifically about concussions in hockey. His guests included Robin Green, a neuroscientist in Toronto, Brad Madigan, a 19-year-old former hockey player directly affected by concussion, and Dr. Paul Echlin, a sports physician who recently authored a groundbreaking study on concussions in junior hockey.

What is a concussion? Concussion is a brain injury caused by traumatic forces*. At the moment of impact, the forces exerted on the head cause damage to the brain, in particular the neurons and axons, which are the cells that relay information from one part of the brain to another. This disrupts the ability of the brain to work properly, and causes it to go into an “energy crisis”.

Symptoms of concussion include: sensitivity to light, nausea, vertigo, problems with memory, and trouble concentrating just to name a few. The symptoms can vary in both intensity and duration, depending on the severity of the injury, and if it is managed appropriately. The symptoms may last a week or two, but in some instances may last up to a year or longer.

Rest is currently the most recommended treatment for concussion, but when is it safe to return to play? At this time, you are not considered safe to return to your sport until all your symptoms have resolved. There is still a great deal to be learned about concussions, and that is why we need to be careful, as we do not fully understand the long-term effects of mild concussions.

Dr. Paul Echlin did a study in which two hockey teams were followed for a season to monitor the incidence of concussion. The results were as follows: 21 concussions were diagnosed in 52 games. 67 players participated, and of these, 15 of the players were only able to play 5 games due to repetitive concussions. 69 percent of the concussions were from direct contact with the head, 80 percent of which were caused by purposeful contact to the head. 24 percent of the diagnosed concussions were from fights.

Concussions are serious, and need to be treated accordingly. The “Warrior Mentality” that some players feel they must live up to may lead to concussions not being reported, as the players feel they have to sacrifice their body. They feel like they can’t let the team down by sitting on the sidelines with a head injury. This can have very serious consequences if a concussion goes undiagnosed, or the player sustains a second concussion before fully recovering from the first. These consequences can range from the symptoms being prolonged, due to the body’s inability to rest and recover, or to Second Impact Syndrome, in which the brain basically shuts down due to trauma, causing death.

Concussion is not something that is exclusive to hockey. Head trauma may occur in any high velocity or contact sport. Downhill skiing, baseball, and football are just a few other sports that are affected. Anytime a direct contact or whiplash motion causes excess force to affect the brain, a concussion is possible. Any player who sustains this type of injury followed by problems concentrating, dizziness, nausea, or memory issues, should be evaluated by a medical professional.**

One concussion is too many. They are head injuries and should be taken seriously. Never continue your sport or activity if you are suffering from an acute concussion. Evaluation by a medical professional and proper management is essential to recovery. In the future, focus should not only center on concussion management, but prevention of such injuries, as they can have serious and lasting effects.

**This information was gathered from the February 11, 2011 episode of “The Current” on CBC radio. To listen to the whole broadcast online, follow the link.

http://www.cbc.ca/thecurrent/episode/2011/02/11/theo-fleury-guest-hosts/

*Definition from Wikipedia

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Acupuncture

Acupuncture is coming to Westman Evaluation and Rehab! Holly Weddall Bkin-AT CAT(C) will soon be offering acupuncture treatments, which will be available in early summer 2011. Acupuncture is an ancient form of Chinese medicine. It involves the insertion of fine needles into the skin at specific points to achieve a therapeutic effect. Acupuncture has been studied and used for over 2500 years. This therapy is used to address a number of conditions, some of which include encouraging healing, improving mood and energy, decreasing or relieving pain, and improving function.

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Barefoot?

Welcome to the home of Westman Rehab! Isn’t is great when common sense lines up with results of a study? In two separate studies going barefoot was analyzed. One study showed foot proprioception*  lessens with age due to the loss of tactile ( or touch sensitivity). Secondly, it showed that shoes impair proprioception in both young and old–due to the loss of plantar tactile sensitivity. For thousands of years we have used little to no support on our feet. Now we use huge heels, various arch supports, etc.
Runners in many other countries often run on their forefoot and don’t land hard on their heels. We have such great cushioned shoes that our running style usually involves a heel strike in front of us where the greatest amount collision forces occur. Another study showed that collision forces were much less in forefoot running as typically seen when running barefoot as opposed to running normally even when using a very cushioned heel.
Of course, there are cases where shoes are necessary and where arches are so fallen that they have to be supported. However, there are ways to strengthen the muscles that support the arch so that by slowly developing your strength, muscular awareness and endurance you may be able to have more freedom in what you have to wear on your feet.
Of course this January weather presents another problem!

*Proprioception – the body’s ability to sense the movements and positions of its parts

Robbins S,Waked E, McClaran J Proprioception and stability: foot position awareness as a function of age and footwear. Age Aging. 1995 Jan : 24(1):67-72

Lieberman DE et al Foot strike patterns and collision forces n habitually barefoot versus shod runners. Nature 2010 Jan 28:463(2780):531-5

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Welcome

Welcome the the home of Westman Rehab. Stay tuned for new information regarding myofascial stretching and the latest on footwear or lack thereof

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“… that the living organism is not a mere biomechanical machine, the traditional paradigm. A living organism is dynamic and fluid with all components in instant and continuous communication. This kind of instant, system-wide communication cannot be produced by the traditional view of solely physical and chemical interactions among molecules, genes, cells and organs. The speed with which activating processes spread throughout the body makes reliance on biochemistry alone insufficient. ” (John F. Barnes, physical therapist, author)


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