A chiropractor is using questionable diagnostic and therapeutic measures to return athletes to play sooner after a concussion. Not a good idea.
A science teacher contacted me with concerns about a story he saw on his local TV news. It featured a chiropractor in his area who is treating athletes with concussions. He claims that with dynamic compression therapy and the BrainTap device, these athletes can return to their sport weeks early. Are other chiropractors doing this? Are any medical doctors doing it? Is there any evidence that these treatments work? Are patients being endangered by a premature return to play? Should chiropractors be treating concussions?
Concussion is the most common type of traumatic brain injury (TBI). It is usually caused by a blow to the head, but there may be no external signs of head trauma, and it may or may not involve a loss of consciousness. There is a temporary loss of normal brain function, often with loss of memory, confusion, and other deficits. There can be microscopic damage that doesn’t show up on a CT scan. A post-concussive syndrome with symptoms like headache, dizziness, and difficulty concentrating can persist, sometimes for months or even years.
Concussions are common in football, soccer, and other contact sports. 34% of college football players have had one concussion; 20% have had multiple concussions. After a first concussion, athletes are four to six times more likely to suffer a second concussion. In second-impact syndrome, when a second concussion occurs before the patient has completely recovered from the first, acute brain swelling and increased intracranial pressure can occur and may be fatal.
Effects are cumulative, and with repeated concussions there is an increased risk of depression, Alzheimer’s, memory deficits, and the “punch drunk” syndrome first noted in boxers.
In recognition of the potentially serious consequences, guidelines for return to play after a concussion have been developed by numerous organizations. There is no treatment that will speed recovery. Rest is the first step, followed by a graded return to activity and clearance for sports only after full recovery.
Chiropractors want to be team doctors. There is even an American Chiropractic Board of Sports Physicians. Chiropractic is not a science. It is more like a cult. The majority of chiropractors still accept the subluxation myth, and a large percentage of them discourage immunizations and practice applied kinesiology (bogus muscle testing) and ineffective treatments. In my opinion, patients (especially patients with concussion) would be better served by science-based medical doctors.
Dynamic compression therapy
While I found some information ondynamic compression therapy, I couldn’t find anything on its use for concussion. Dynamic compression therapy is used to speed recovery after exercise by providing “peristaltic” pulsed pressures to the lower extremities, basically a form of mechanical leg massage. It seems to be offered mainly by chiropractors. It is said to “flush out toxins”. The toxins are not specified. I looked for supporting scientific studies and didn’t find any.
BrainTap is a gimmick that allegedly “turns your brainwaves into a symphony,” entraining your brain waves witha proprietary neuro-algorithm using sound and light, with binaural beats, guided visualization, 10-cycle holographic music, isochronic tones, and pulsing lights that “travel through the retina and ear meridians.” The company website has a tab for “The Science Behind BrainTap” but it consists of pseudoscientific gobbledygook rather than scientific studies.
Canary concussion test
The same chiropractor is using the Canary concussion test in his role as team chiropractor for a high school. It asks the usual questions but uses new technology to analyze the patient’s voice before and after an injury and supposedly can tell if it has changed due to a concussion. He thinks it can also be used to determine when recovery is complete. The same voice recognition technology is being used to test for everything from Parkinson’s to dementia. I couldn’t find any supporting scientific studies. The test doesn’t seem to have been validated in any way.
Conclusion: not a better way to treat concussions
There is very little information available, and what there is smacks of a non-science-based chiropractor’s typical enthusiasm for jumping on the bandwagon for anything new. There is certainly no evidence that he has found a better way to diagnose concussions or speed athletes’ return to play. Medical doctors have established guidelines to protect patients, and it seems to me it would be foolish to replace mainstream practices without having any evidence that the new practices are better or even equivalent. I hope this silliness will not catch on. Patients could be harmed.
This article was originally published in the Science-Based Medicine Blog.