The Importance of Unique Therapy with Matthew Campbell
Show Notes:
Many athletes are so fearful of being sidelined that they often lie to themselves, their coaches, and their doctors, undermining their recovery long term. In today’s episode, we speak with Matthew Campbell, Co-Founder and Clinical Director for the Midwest Concussion Clinic. Matthew is a certified athletic trainer and has advanced training and certifications in vestibular therapy and concussion management, allowing him to effectively evaluate and treat patients with acute concussions, vestibular impairments, and post-concussion syndrome symptoms. Matthew shares how he first experienced getting concussed while playing basketball and how, despite his circuitous career path, his interest in concussions only deepened leading him to his current vocation. In talking about his work, Matthew explains how his experience as an athlete, coach, and parent has helped him in treating concussion patients. Later Matthew speaks about why every concussion is different, making the treatment of any concussion a unique challenge. What works for one person, may not work for another. Listeners can expect to deepen their understanding of how formal treatment of concussions has drastically altered over the years, and why many doctors might prescribe the wrong treatment out of a desire to do no harm. For all this and more, join us today!
Key Points From This Episode:
● Meet our guest Matthew Campbell.
● Matthew shares how he first became interested in treating concussions.
● Some of the most recent changes in concussion management.
● Why the traditional therapy for concussions of sitting in a dark room is detrimental to recovery.
● How every patient’s experience with concussions and post-concussion symptoms is unique.
● How Matthew’s experience in different areas of concussion support, like being an athlete, patient, coach, and parent, has helped him better treat his patients.
● Common myths around concussion and how Matthew deals with his patients’ misconceptions.
● You don’t need to hit your head at all, or very hard to get a concussion, whiplash can also cause a concussion.
● Why athletes lie to themselves about injuries out of fear.
● The broader culture in sport needs to change so athletes can feel safer taking time off.
● How Matthew encourages athletes to take time off when they’ve had a concussion.
● Why Matthew spends the majority of the initial consultation with a patient educating them on concussions.
● How Matthew helps parents work through their fear when their children play sport or have had a concussion.
● How sports rules are slowly changing to help prevent concussion.
● Why coaches, parents, and everyone else involved need to be trained to recognize and report potential concussions.
● Why there is an increase in research on the psychological effects of concussions.
Connect with Our Guest:
Check out the Midwest Concussion Clinic on Social Media!
Instagram: @mwconcussion
Facebook: @mwconcussion
Twitter: @mwconcussion
Get in Contact with Matt by sending a message to mwconcussion@gmail.com
Transcript - Click to Read
[INTRODUCTION]
[0:00:05.3] BP: Hi, I’m your host Bella Paige and welcome to The Post Concussion Podcast. All about life after experiencing a concussion. Help us make the invisible injury become visible.
The Post Concussion Podcast is strictly an information podcast about concussions and post-concussion syndrome. It does not provide a substitute for professional medical advice diagnosis or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast. The opinions expressed in this podcast are simply intended to spark discussion about concussion and post-concussion syndrome.
[INTERVIEW]
[0:01:03.6] BP: Welcome to today’s episode of the Post Concussion Podcast with myself Bella Paige and today’s guest, Matt Campbell. Matt is a certified athletic trainer, cofounder and clinical director for the Midwest Concussion Clinic. He has advanced training and certifications in Vestibular therapy and concussion management that allow him to effectively evaluate and treat patients suffering from acute concussions, vestibular impairments and post-concussion syndrome symptoms. He is married to his beautiful wife, Ashley since 2015 and enjoys spending time with their daughter, two dogs and cats.
Welcome to the show, Matt.
[0:01:39.6] MC: Thanks for having me, I appreciate it.
[0:01:42.2] BP: To start, do you want to tell a little bit about your history and what led you to helping concussion survivors?
[0:01:48.9] MC: Yeah, absolutely. Like most your guest, I had a concussion as well, my concussion happened back in 2006 and now luckily I was one of the very few that really didn’t have a whole lot of lingering effects to it that I noticed even in my time here treating concussions and whatnot but I got my concussion playing basketball back in 2006, it was a follow-up with your athletic training when you get home, like most athletes, I didn’t and played with two different sized pupils for about a month and a half.
Knowing what I know now, I know how dumb that was and my job here really and why we kind of got into what we’re doing is number one, I don’t want other people to do what I did because I got lucky, the amount of things that could have gone wrong, the amount of things that could have happened to me, the amount of risk that I put myself, my family through by playing through it was something that really kind of resonates with me now and two, you know, when we sat down and started to look at the area of Indiana we’re in, we started to look at you know, how can we effect the overall treatment and overall sports medicine umbrella that happens in our area, one of the areas I would see so often was misjudged, misdiagnosed, mismanaged and mishandled throughout the entire healthcare system was concussions.
[0:03:04.8] BP: For sure.
[0:03:06.6] MC: When I was in school, it was looking at grad school, looking at what I want to do with my life, concussions have always been there, concussions has always been something that I’d been interested in. My first couple of jobs out of college took me away from the concussion world to an extent, I mean yeah, there’s still risk of concussions, working college football, working professional basketball, working at the high school saying, they’re all still there but when I finally sat down and looked at it, it was, how can I use my experience and my passion for concussions to benefit others around me.
[0:03:39.5] BP: Which is so important and I get the making the mistake and not wanting other people to make the same mistake because that’s my view, I’m trying to prevent people from doing what I did because I definitely handled it the wrong way. My concussion management skills were zero and terrible advice.
[0:04:00.3] MC: Right.
[0:04:02.2] BP: Things have changed a lot from when I started, especially you said, 2006. It’s changed in five years, let along 10. What do you find some of those recent changes in concussion management are?
[0:04:15.1] MC: The biggest change that’s kind of happened over the course of even the last – I mean, we’ll narrow it down, we started the clinic back in September 2019 and that’s when it was first kind of implemented that resting and sitting in a dark room is actually detrimental to health. Really, that’s the biggest change that we’ve seen of late is the implementation of aerobic exercise of vestibular therapy, of taking concussions instead of a sit and wait approach to see what happens.
It’s the big push for, let’s take your recovery into your hands, let’s start working with some of the impairments that you have and the sooner we can get working on them and the sooner we can help the brain kind of reconnect those neurons that are mismanaged and misfiring, the more likely, one, that we’re going to get better and two, we cut the duration of your symptoms severity and your symptom overall lingering symptoms and have three quarters, whatever it may be and three, we mitigate and eliminate the risk of re-injury that can happen. I can’t tell you how hard that is to kind of push and kind of get in the patient’s mind as our understanding of concussions is significantly changing.
[0:05:24.3] BP: It is, yeah.
[0:05:25.8] MC: It used to be 10 days you’ll be fine, okay? Even when we started, it was 10 to 21 days, you should be okay and now you're starting to look at more and more research that’s coming out. It’s 21 to 30 days, 34 to 60 days, 60 days to 90 days. I mean, the amount of understanding of the metabolic side of the injury, let alone persistent concussion symptoms and PCS but the metabolic side of the acute injury were starting to get a better understanding and we realized that returning it to place so early is not safe. Let alone something that we want to do as a clinic.
[0:06:03.7] BP: Yeah, that was the most common thing that I got told – I think every single hit, even the most recent one which is like four years ago now maybe and the most recent one I went to the hospital for actually. That’s because I had, yeah, I got put in the ambulance that time.
[0:06:23.4] MC: Right, you have a choice –
[0:06:24.3] BP: That was the same recommendation was still then, was that dark room and I had already known by then that that wasn’t correct.
[0:06:29.4] MC: Yeah, right.
[0:06:30.9] BP: The one I first started, that was going to dark room, go in the dark room and then the problem was, I ended up living in that room because I had gotten so adapted to it that trying to go out in the real world seems impossible.
[0:06:44.7] MC: Right.
[0:06:45.6] BP: It definitely slowed down my ability to get better.
[0:06:49.0] MC: I mean, even to today, we still get – I got a new referral this afternoon that is the emergency room said they didn’t have a concussion following a motor vehicle accident so they released him while they followed up with the emergency room a week later because their head was killing them and the emergency room said, “Okay, well we’ll send you to a neurologist” the neurologist says there’s nothing wrong with you and they just kind of said, okay, go home and wait and you’ll get better. I mean, the headaches will go away. If they don’t, they don’t.
[0:07:13.8] BP: Great.
[0:07:16.2] MC: It’s 2021. What can we do to help get that treatment plan and that cycle to stop, she’s over a month post-injury now and it’s like, you know, the only answer she keeps getting told is she’s fine, there’s nothing wrong.
[0:07:30.8] BP: Which is never the case, yeah. Everyone’s situation is so different. My biggest problem was my headaches and then my headaches kind of overclouded everything else because I was in so much pain, I didn’t realize all the other symptoms I was having because it was just the headache, It’s the only thing I ever talked about when I went to see anyone because it was my biggest issue was, I was always in pain. Because everyone’s situation is different, do you find that occurs in therapy as well, everyone needs to run kind of – like a different schedule or different therapy practices to help them get better even though it’s considered the same injury.
[0:08:12.1] MC: Yeah, the going phrase, the reoccurring phrase that happens in concussion management is once you’ve seen one concussion, you’ve seen one.
[0:08:20.1] BP: Yeah.
[0:08:21.7] MC: Even if it is the same patient to come back and it’s the exact same mechanism of injury, the exact same impact, the exact same place, the exact same date and time and weather outside and it’s a completely different injury each time. One of the things and the reason why I kind of got into concussions to begin with, is I’m really a competitive person like most athletic trainers like most athletes that are no longer athletes, were really competitive.
When I go through and evaluate a concussion patient or I focus on their brain injury itself, I start to sit there and say, “Okay, well, it’s now me versus your brain and it may take a while for me to win but I’m going to win.”
[0:09:00.4] BP: Yeah.
[0:09:02.1] MC: No offense to your brain, I’m going to win. It’s very unique, it’s very individualized, we have a grouper philosophy of exercises and kind of a small progression that I progressed most of our patients through. At the same time, it’s not a cookie cutter approach, what works for Bella may not work for Matt, what works for Matt may not work for Angela, what works for Angela doesn’t work for Bella but it may work for Tim.
It’s a really interesting way of going through this is you never know what you’re going to see and you’ll never know what you’re going to deal with and that’s what makes it exciting on my end of things. Now, it’s not [inaudible 0:09:37.9] for my patients because they don’t feel good and then it’s you know, they just kind of look at me and say, “Okay, yeah, great, what are we going to do about it?”
Okay, now we’ll talk about that but it’s exciting because you're new and it’s challenging to deal with.
[0:09:51.7] BP: Yeah, it’s a different perspective when you’re the one on the other side of the fence.
[0:09:56.1] MC: Right, that’s where you know, a little bit of having had the concussion, I see it.
[0:10:01.8] BP: For sure.
[0:10:03.4] MC: I see what happened to me even though it’s a long time ago now but I see what happened to me then, I know how I felt during, I know enough now of what I didn’t know back then. Here, the unique experience of being an athletic trainer that’s worked college football, professional basketball, high school, I get the athlete side of things. I get how the athletes feel, I get how the parents feel, being a parent, I get how the parents feel.
I’m a husband, I’m a father, I get the significant other side of things, I get the support system concern. I offer a unique kind of, in my opinion, now, everybody thinks they’re unique but I offer a unique kind of mindset because I’ve been in all the different areas of concussion support system, patient, athlete, coach, whatever you want to call it and it gives me an idea of how we can relate to each individual group and how you can communicate more effectively with them.
[0:11:01.6] BP: One that definitely helps, I know especially the athlete perspective that was a play that was missing from me a lot of the time when I went to, I saw a lot of neurologists and things. They’re like, “Well, why don’t you quit?” No, you can’t. I can’t quit or “Why don’t you just stop?” I’m like, “Well, I can’t just stop” there’s lots of that, lots of arguments or I saw lots of therapist once and never saw them again because their first answer was, “I think you just need to stop riding” but they didn’t say anything other than that and that wasn’t enough for me so I never saw them again.
[0:11:38.0] MC: Right. You have to know how to communicate with somebody. I mean, that’s life right there, that’s how life boils down, this is you know, the ability to communicate, the ability to relate. I don’t have all the answers, I don’t have my philosophy and my style, my personality does not work for everybody and I know that. Concussion management is the same way, if something’s not working for you, find somebody who is.
Everybody’s going to have a little bit of a different philosophy, I talk about it with patients all the time that you know, as much research is coming out, as much as we understand about concussions and concussion rehab, it’s really an art form when it comes to the treatment of it because we’ve got to sit there and we’ve got to feel [inaudible 0:12:16.0] okay. Science tells us ABC and D’s going to work.
A didn’t work, B worked a little bit, C made them worse, D, what are we going to do now? You got to pick and implement what’s going to work, the parameters for the exercises, the duration, the combination, everybody’s got a different philosophy so if it doesn’t work for you and you’re frustrated with somebody or you don’t listen to somebody or you don’t agree with them, find somebody else. Don’t feel like you're stuck there.
[0:12:42.9] BP: For sure and one of the hard things about concussions is that everyone is different but you don’t need one specialist to get better. It’s not like it’s a broken arm and you see one doctor and they heal your arm and then you leave. It’s not – there’s so many different aspects to therapy that you have to look at the whole picture the whole time.
As we mentioned, everyone’s situation is different, one of the things that a lot of people have trouble with is their accident seems so minor. They bump their head on something really hard or you know, they slipped and they fell but they got up and they felt okay. What are common myths you have to often explain to your patients who come in for help to kind of set them back in the right place?
[0:13:30.6] MC: The biggest myth to go on, it wasn’t a big impact, I hear it all the time as well, “Well, I didn’t hit my head” especially with motor vehicle accidents. “I don’t remember hitting my head. Yeah, the airbags went off but I don’t remember hitting my head” it’s like okay, myth number one right there is you don’t have to hit your head. A rapid whiplash movement, a rotational movement especially of the rapid movement to the head, the neck, the shoulders means –
Our understanding of the injury is so advanced from where I used to be where I was just, “I took a bump to the head and I got it all wrong and I’m now I’m not struggling” right? The biggest myth that we fight on a day-to-day basis is, “I didn’t hit my head. I hit my neck” or “I landed on my shoulder” or “The airbags didn’t even go off, it wasn’t that bad of a hit.” I talked to patients all the time about concussions and whiplash, right?
[0:14:20.3] BP: Yup.
[0:14:20.5] MC: Concussion symptoms mimic each other and whiplash symptoms kind of mimic each other one to one. Headache, dizziness, nausea. On the concussion side, headache, dizziness, nausea on the neck pain side. The amount of force required for a concussion is right around the 120 newtons of force to the brain, it’s only five newtons of force to the neck to get whiplash.
We start to look at, you know every concussion has whiplash but not every whiplash has a concussion. When we talk about that rapid movement, we differentiate between well, these symptoms coming from a disruption of the visual or the vestibular ocular reflex, visual system disruption or is it cervicogenic, is it a soft tissue injury, is it a ligamentous injury, is it upper cervical, is it cervical dysfunction or proprioception damage versus the actual brain injury itself.
The big myth of ‘you have to hit your head’ is number one and number two, the other myth that we fight is, the constant reminder that you just go sit in a dark room until you get better.
[0:15:17.2] BP: Yeah, that one’s brutal.
[0:15:19.0] MC: That one is so difficult to fight because if you look at the broad picture of the healthcare world in a healthcare system, take a pediatrician for example, how much information just came out on COVID-19? Over a year into this and how much information is still coming out? Think about that.
A pediatrician has to know about COVID, has to know about the flu, has to know about cold, diabetes, general medicine injuries, soft tissue injuries, muscular injuries, bone fractures and they have to know such a broad case load that a lot of times, their treatment of concussions is what they learned in school.
Okay, well, how many of these physicians just graduated med school? In all of formal medical training, I can tell you the same thing is what liability and litigation. Do things that aren’t going to hurt them. The rest isn’t going to hurt them so that was the treatment that was used to be thrown out there to sit and rest in a dark room.
Now you get anywhere from 40 to 60,000 research articles on concussions that come out every year to two years from now that they’re expecting. You expect a pediatrician to know 400 million articles on COVID, 200,000 articles on the cold and the flu and 60,000 articles on concussions. It’s impossible for that to actually happen.
[0:16:43.0] BP: Same thing as in the ER, people like all the ER doctor didn’t help me. Well, that’s not really – the ER doctor is to like assess and then send you somewhere else, they’re not there to treat your concussion to get everything better.
[0:16:56.8] MC: Yeah, they go through head to toe and look at it, is this going to kill me? Is this going to kill me, is this going to kill me? No, no, yes. Let’s fix this first and then you read through the discharge pack. Usually on like page 12 or 13, you’ll get a little small article that says, “Well, if you're still having headache systems, you may…”
[0:17:12.0] BP: To your physician, yeah.
[0:17:13.6] MC: You should follow-up with somebody.
[0:17:14.9] BP: Yeah.
[0:17:15.7] MC: It’s referred to the CDC website on concussion management.
[0:17:19.8] BP: Yeah, that’s usually it.
[0:17:21.9] MC: Yeah, in that scenario that we’re working on is trying to get into the emergency medicine departments and say, “Hey look, life’s all about liability, right?” You want to clear liability, you said somebody you suspect has a car accident, has a headache, send them here. We’ll take over liability evaluation and then if they don’t have anything, they don’t have anything.
[0:17:40.0] BP: US problems.
[0:17:42.2] MC: Yes.
[0:17:43.4] BP: It’s a lot different than Canada.
[0:17:46.0] MC: Very much so.
[0:17:47.9] BP: Yeah, okay, you don’t have to really think about that here, people just get mad that nothing happens. Anyways, you can follow the Midwest Concussion Clinic on Instagram or Facebook at MW Concussion which will also be available in today’s show notes but with that, let’s take a break.
[BREAK]
[0:18:09.2] BP: Want to create awareness for concussions? Want to support our podcast and website? Buy awareness clothing today on postconcussioninc.com and get 10% off using “listenin.” That’s “listenin” and be sure to tag Post Concussion Inc. in your photos. We’d love to see them.
[INTERVIEW CONTINUED]
[0:18:35.6] BP: Welcome back to the Post Concussion Podcast with myself, Bella Paige and today’s guest, Matt Campbell. What we’re going to get into now is more the athlete questions, because it relates to me and to you quite well. One thing that I did a lot when I started noticing the headaches and for quite a few years after was lie. I lied to my doctors, even to myself actually, because I’d tell myself I was better and I was better but I still had a headache every day, so that is not actually that much better. Why do you think athletes do this? Do you find it happens often with patients in your clinic?
[0:19:14.1] MC: Not so much when they come to us. The good thing is usually, when they’re to us, somebody has referred them to us. It’s doesn’t necessarily have to come from a physician but we work really well with some of the high schools, athletic juniors in the areas that when they get sent to us, they know that they’ve already been diagnosed in terms of like the high school and the collegiate, NCAA and things like that that they have to see somebody to get evaluated before they can go back to playing.
What we do see in terms of before I started the clinic out in, you know, out in the real world not in the sheltered world of therapist when they finally admitted something is wrong, there’s a couple of different reasons why athletes tend to tell us, that’s either they’re lying to themselves or they’re lying to us is one, they may not know. They may not know how to explain the way they feel. One of the things that I tell our patients all the time is, “I don’t know is a good answer” because with concussions, you know, they manifest so differently.
If you get some kid that’s been educated on concussions like here in the States and especially in Indiana, they have to go through the CDC’s ‘heads up’ training for coaching. The coaches give a speech at the beginning of each season like, “Hey, if you get a headache, if you get dizzy, you got to let somebody know. That’ll be great.” How many concussions actually happen versus the kid didn’t eat, the kid is dehydrated, that’s a huge one.
The kid hasn’t eaten breakfast this morning or ate too much breakfast this morning and now, he is coming over every other play saying, “Well, I’m dizzy” or “I don’t feel good, I’m nauseous” and it gets to a point where you know, one, the kid doesn’t know how to explain how they feel healthy, let alone if they think something’s wrong. I don’t necessarily know if it’s more their lying to doctors or if they’re trying to convince themselves that everything is okay.
[0:21:05.4] BP: Yeah, I did that.
[0:21:06.4] MC: Yeah and we see that a lot and especially early on in vestibular therapy. They come in, we do the initial evaluation, “How are you feeling?” “I’m fine, I’m fine, I’m fine” “Well, okay. First of all, your eyes don’t lie. No, you’re not. Second of all, I need you to be honest with me” and then the second time they come in, it’s like, “You know, I am doing okay” and then the third time they come in it’s, “I’m all right” and then the fourth time, “Yeah, I’m not good.” “Thank you” [inaudible 0:21:34.4] four times ago.
[0:21:36.2] BP: Yeah, I also had a lot of fear.
[0:21:38.5] MC: Yeah, with the athlete’s side of things, the fear is in my opinion, it comes from people in power are going to try to keep you out, right? I don’t go to athletic training when I rolled my ankle because they don’t want me to play. I don’t think something’s wrong because they don’t want me to play. Where in the coaches eyes, “Johnny just ran a terrible route. What is he doing? He’s coming off because he can’t figure it out.”
No, maybe he ran a bad route because he rolled his ankle and he doesn’t have the lateral stability in his ankle. You know, Amanda didn’t run that play correctly, she has to come sit it out. Well, maybe Amanda doesn’t know how to run the play correctly because she can’t think through the play because she got elbowed in the head two weeks ago and didn’t tell anybody because she doesn’t want to lose her starting spot.
With the athlete, a lot of times it’s the fear of especially the more and more research that comes out I think we’re going to have a problem with this in our area, is the more research that comes out that says it’s going from 10 to 21 days, to 21 to 34, to 34 to 60, you’re going to get those athletes that realize those numbers are out there and we’re going to start to sit there and say, “Oh 60 days is my entire wrestling season.”
[0:22:46.4] BP: Yeah, it’s a lot.
[0:22:47.2] MC: A lot of it has to do with the education side of things. We got to find a way to improve the overall education.
[0:22:54.1] BP: I agree.
[0:22:54.9] MC: The Internet is very dangerous and [inaudible 0:22:57.3]
[0:22:58.2] BP: Yeah, you think you’re done.
[0:22:59.1] MC: Very dangerous.
[0:22:59.7] BP: Actually, if you look up all the symptoms of your head injury.
[0:23:02.8] MC: Yeah, I mean I can find anything I want on the Internet in terms of concussions, right? I can find any research article that tells me that the headache that I have is not concussion related. It is more of a frontal lobe tumor or you know, a subdural hematoma but it is good when it is not a concussion, I’m fine but at the same time, I have a small headache because I’ve drink six ounces of water in the last three days and now all of a sudden I’m dying from cancer or lymphoma or a brain tumor and you know it’s –
[0:23:37.8] BP: Yeah, the Internet is scary.
[0:23:39.2] MC: Yeah, it’s a pretty scary place and that’s the majority of our first visit with our initial patients like our initial encounter visitor an hour to an hour and a half long because I spend 45 minutes going through the education on what concussions are, what you read versus what’s the truth, what to expect and it’s – there’s got to be a way to improve the education side of things and right now, I don’t have the answer don’t get me wrong.
[0:24:07.0] BP: That’s okay, most people don’t.
[0:24:08.4] MC: Yeah, I’m competitive. I am going to find a way to do it but I don’t have it yet.
[0:24:12.5] BP: Yeah, I find one of the things about the fear for me was like you would say that fear of taking time off. I didn’t – I never want to stop and the fear of my friends like it was a solo sport but them continuing on and me not and I had a horse to keep in shape and I really didn’t want anyone else doing it for me or if you’re in a team sport, you don’t want to let your team members down or if you’re being scouted for maybe college, like that’s a big deal and you don’t want to risk that.
It is really hard to take time off. I think it is really important that if we start encouraging it when you’re younger like I think if I’d taken off time as a kid when I got hit then when you’re a teenager and when you’re getting older, it’s like, “Oh this is normal. Okay, I have to take a few weeks off and rest and do therapy” because you’ve already done it so it’s not a big shocker, because when you’re a teenager you’re really stubborn so it’s like, “No way.”
[0:25:08.8] MC: Right.
[0:25:09.6] BP: Your brain setting is a lot different than when you’re a little kid, when someone is like, “Well, you just can’t play right now. You got to do something else.” Right, okay so how do you encourage some of your patients? I guess when they come to you it’s a little later but to take time off.
[0:25:25.5] MC: The easiest way to do it is if you don’t take time off now, you’re going to be forced to take time off when you don’t feel better. If you don’t take time off now, our two week recovery plan becomes six weeks, it becomes eight weeks, it becomes 12 weeks to where if you just listen to me right away, we’ll get things started and get things taken care of early. The hardest thing to sell is you know, taking time off and all of sports not just concussions, look at youth sports right now.
In the United States, it’s a multibillion dollar industry. That’s a problem, when you get a 12-year-old kid playing a 162 baseball games in the summer, 60 baseball games in the fall and 40 baseball games in the springtime, okay, major league players play a 162 games all year. In the basketball world, if LeBron James takes six months off after playing 82 games, your 15 year old needs to take more than two days off after playing a 100 games this [inaudible 0:26:23.0]
[0:26:23.0] BP: Yeah, I know. For sure.
[0:26:25.0] MC: That is part of the culture that needs to change in terms of sports in general. We’re starting to see a little bit of a shift on specialization and getting away from that but to bring it back into the concussion world, it’s really easy to tell somebody to take a break on my end of things because if they don’t, their symptoms get really bad and then I could sit here and say, “Well, first of all I told you that was going to happen. Now, let’s not happen again.”
We spend a lot of time educating them on if your symptoms get this bad, we’re not delaying our recovery because instead of the brain reconnecting the neurons and fixing that, it goes and fixes the problem that we’ve created to now come back and then get back to fixing the injury itself.
[0:27:10.9] BP: Yeah, you’re definitely setting things back. Speaking of sports and youth in sports and sports is everywhere I guess, some people are so involved and some people aren’t but I’ve been very involved. Something I found is parents are getting more nervous especially if they actually have an idea about concussions or maybe if they’ve had one themselves as an adult and they’re like, I’m definitely more paranoid.
[0:27:36.5] MC: Right.
[0:27:37.0] BP: Adults around kids, like I am definitely pro-sport but if the kid gets hurt, I’m like right there in two seconds. What are your thoughts on that fear and nervousness that people are having?
[0:27:48.6] MC: We see that with parents a bunch when they come in here. It’s not only the, “Yeah, the first thing is get healthy” and all of that and then it immediately reacts or changes to, “Well, now what? Do they still play football? What do they do? Are there helmets out there? Are there things out there that I can buy?” that are going to be crazy and it’s like well, I mean there are but they’re not.
One of the easy go-to’s for me when it comes to sports, I am still pro-sport, I mean football has a place, I don’t know if I am definitely not going to let my daughter play football but I don’t know with all of that, you know I highly doubt that I will encourage my son to play football and it is not the concussion risk, it’s the sub-concussive impacts that happen that I am more conscious now.
[0:28:35.6] BP: Concerned? Yeah.
[0:28:36.8] MC: Yeah, you know so my go-to argument for the same thing is for every football player that I’ve had, for every five concussions on the sports-related things, I’ve seen a motor vehicle accident, I’ve seen an elderly slip and fall. We had a patient about a year ago now that was making a bunk bed and stood up too fast, which is underneath and she hit the back of her head on the bunk bed. I've had people hit their heads on car doors. I mean concussion risk is there.
[0:29:05.2] BP: Yeah, one of our guests was at a party and someone threw a beer and it hit her because you know, somebody was who knows what and – like you can just get injured anywhere, which I also believe. Every time you get in that car, you could get a concussion so no one will live in that much fear where you’re not playing sports or being active. It is more just being cautious when those injuries do occur and not intentionally hitting your head.
[0:29:34.4] MC: Sports are changing in general, right? A lot of rules are changing to help mitigate some of the risk that happens. There is a big push for flag football, there is a big push for no hitting a soccer ball until you’re in high school. I mean there are a lot of things that are helping that are changing but at the same time, we have to be cognizant of educating everybody involved. Parents, coaches, athletes that when you notice something is wrong, you need to tell somebody.
Don’t jump to conclusions, don’t get nervous, don’t live in fear because if you’re living in fear or playing in fear, your risk for other injuries significantly increases, right? If I know I’ve got somebody I’m working with right now, second concussion, first concussion was almost a two year recovery. She says it all the time that she’s afraid to go back to playing her sport. She wants to be a division one athlete, she’s got division one potential and talent but she knows where she’s at right now even though she’s healthy.
She struggles to get back into playing because one, she says that, “When we’re doing return to play conditioning and things like that is I do an exercise and I just wait for my head to hurt and then it doesn’t and then I get nervous because my head doesn’t hurt because it hurt for two years.” It’s a slippery slope that she just has to be cautious and cognizant but at the same time, don’t live in fear. It is kind of that fine line between paranoid and crazy, you can’t live on both sides.
[0:31:04.9] BP: People have the fear of going out their door after a concussion, so it’s hard. I know myself, there were a couple of years where my headaches were really bad but I wouldn’t do anything. Well, I would ride because I was addicted but everything else, I wouldn’t go snowboarding with my friends. I won’t get on a snowmobile, I wouldn’t do anything that I thought I could possibly hit my head because I didn’t want the pain and I’ve also had the fear of when you hit your head again after a few concussions like it can be really overwhelming and terrifying.
I’ve had breakdowns over like small hits in the head because of the fear of symptoms coming back can be scary. Like it’s not the way to live but it is definitely really common. I know there was a while where the fear of me hitting my head or I ride a dirt bike now and I’m like in body armor like my boyfriend makes fun of me when I get dressed because I have the neck collar to help with the whiplash and I got all of the armor and then the normal dirt bike you’re on top, right?
He’s looking at me, I’m like, “It’s not going to prevent a concussion because that is not how this works but I just need to feel” it is more of a mental protection than a physical protection.
[0:32:24.2] MC: The psychological aspect of concussions is one of the areas that’s getting a lot more research to it and with that, I mean absolutely it should but just like that, like you’re saying, once you’re “healed and recovered” what psychological effect does it have? I mean, the patient I’m working with right now, it was a two year recovery. Her initial injury was before we started so we spent the initial almost two to three visits of just sitting there saying, “Okay, it would be a disservice to say this injury didn’t happen but you can’t compare these two injuries” right?
Because the more you sit there and say, “Well, it took two years, the more…” because you’re feeling better after four days, you’re now like, “Well, four days down, 685 more to go” you know what I mean?
[0:33:09.7] BP: Yeah, I know not a good way to think.
[0:33:11.1] MC: It’s tough and that’s where there’s a lot of the psychology and the psychological side of the injury is something that really interests me and it’s getting more and more of attraction in everyday life especially here in the States, you know, we have more of the big NBA players and more of the NFL people that are coming out and saying, “Hey, you know I battled with it too and I battle with mental health issues as well” so it is now starting to have that trickle down effect if you get public figures that announce it.
Then if you get Taylor Swift who comes out and says that she’s had some anxiety and depression issues and now it’s okay for a 13-year-old female to say, “Hey, I am not doing well. I’m struggling” it is beneficial in all cases, long-term recoveries, sports psychology, we partner with a couple of places that if we need behavioral therapy referrals we’ve got them that we can do.
[0:34:01.8] BP: My symptoms, I went to therapy and like I got forced into therapy and it was one of the things that helped a lot of my symptoms because all the psychological like I had real symptoms but I was making a lot of them worse, because I was so overwhelmed with the mental health side of things that I just couldn’t get out of that mental state. It was making it so much harder to get into that final step of being better because at that point, I was doing a ton better.
My headaches were way down, I wasn’t – I was doing school more normally than I was before and I was progressing with everything. I didn’t have a headache every day but I still wasn’t there yet and that therapy component of getting – improving my mental health made the next jump that I really needed that whole time.
[0:34:56.1] MC: It’s amazing like you look at the psychological side of things, there’s a physical manifestation to emotional stress and emotional trauma that exists in a lot of people. Now, you had a concussion where it is difficult to regulate our emotions, that happens too. Now, you also look at the sympathetic system, right? You’ve got your fight or flight mechanism. When we have a concussion, that fight or flight mechanism and that sympathetic system becomes heightened and we’re not actually able to convince our body to get out of that state because the brain is not functioning the way it should.
When the brain struggles to relax and struggles to go through and shut the sympathetic system down, the rest of the body goes, “Okay, we’re here. We’re going to fix this” and so it becomes kind of a vicious cycle that you have the emotional regulation, the physical manifestation of emotional demand and emotional injuries plus the inability to get out of that sympathetic system and that sympathetic triggered system and now it’s how do we help that into things, let alone the disruption of the vestibular ocular reflex.
[0:35:57.6] BP: Yeah, the physical aspect.
[0:35:59.0] MC: Yeah, the physical aspect of the injury itself and it’s tough.
[0:36:04.5] BP: That’s a lot.
[0:36:05.7] MC: That’s an area that’s a lot to deal with –
[0:36:07.2] BP: There is so much concussions, we haven’t even talked that long today and you could literally talk about concussions for hours and days and still not cover everything.
[0:36:17.8] MC: [inaudible 0:36:17.6] definitely and it’s like, “Oh I should have covered that” but I mean [inaudible 0:36:21.9]
[0:36:21.9] BP: Yeah, so with that is there anything else you would like to add before ending today’s episode?
[0:36:26.9] MC: I just want to say thank you. Me personally, I love what you’re doing. The more people that you can hear that are going through it, the better, right? Because it gives you that sense of you’re not in isolation anymore. The more people you can hear share their story, the more you can sit there and expand, you know, on both sides of the coin. “Yeah, mine is really not that bad” or “Hey, they got it just as bad as I do.” It’s good to have that support system in check. The more you can hear from other people, it’s amazing what you’re able to do.
[0:37:00.6] BP: Yeah, well thank you and thank you so much for joining and sharing your work and insights on concussion recovery.
[0:37:06.6] MC: Absolutely, thanks for having me.
[END OF INTERVIEW]
[0:37:10.8] BP: Has your life been affected by concussions? Join our podcast by getting in touch. Thank you so much for listening to The Post Concussion Podcast and be sure to help us educate the world about the reality of concussion by giving us a share and to learn more, don’t forget to subscribe.
[END]
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