How can a neck injury lead to you feeling dizzy? If you have read one of our articles before you have probably learned how there are 3 important systems that all contribute specific information to the brain that allow us to know where we are located in space. These three systems consist of the inner ear (vestibular system), neck (proprioceptive system), and the eyes (visual system). Knowing where we are in space is crucial to us as humans because humans are designed to move. It's the same as when you get into your car to head to a place you’ve never been and you put the destination in your GPS. Your GPS has to know what your current location is otherwise you will never end up at the correct destination. These three systems need to work in unison and relay the same information to the brain so that we can properly navigate this world. When one system becomes damaged the other two must work harder in order to make up for the loss of information. Just like being at a job where each person has a specific task that needs to be completed. If one person is slacking and not holding up their end of the deal, that task will either not be completed or it will get done by another individual.
The neck is an important and often overlooked component of concussion recovery and even prevention. "Overall neck strength was found to be a significant predictor of concussion. For every one pound increase in neck strength, odds of concussion decreased by 5 %." (2) "The upper cervical spine is particularly vulnerable to trauma because it is the most mobile part of the vertebral column, with a complex proprioceptive system that has connections to the vestibular and visual systems. Cervical vertigo or dizziness after whiplash injury can mimic the symptoms of post-concussion syndrome." (3)
When it comes to experiencing a concussion any one of these systems could get damaged as well as a few others not mentioned in this article leading you to experience a whole host of different symptoms. Each system has its more characteristic symptoms and since this article is talking about neck injuries lets discuss more of what you might find when you injure your neck. When someone injures there neck they may notice an increase in visual motion sensitivity where busy environments make them feel dizzy, they may notice feeling off or out of it when they rotate their neck, they may feel off balance when they rotate their neck, or their neck may be extremely tight leading to headaches, etc. These are some of the most common complaints after a neck injury but as we know, each person is uniquely different and with that I may see a patient tomorrow that will come in with a complaint of something completely different that is also stemming from the neck. Every patient that walks through the door is a learning experience and as we continue to see more patients and the research keeps broadening our understanding we will only continue to serve each patient better and see results quicker than we have in the past.
A recent study showed that a significantly higher proportion of individuals who were treated with cervical spine physiotherapy and vestibular rehabilitation were medically cleared to return to sport within 8 weeks of initiating treatment after sports related concussion. 31 patients exhibiting persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion were split into 2 groups. Both groups received weekly sessions with a physiotherapist for 8 weeks or until the time of medical clearance consisting of postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. One group also received cervical spine and vestibular rehabilitation. 73% of the group that received the additional cervical spine and vestibular rehabilitation were medically cleared within 8 weeks after the initiation of treatment whereas only 7% of the treatment group was cleared within the same time frame. (1)
When you come into Peak Brain Performance Centers for an initial exam you will undergo a full battery of testing and challenges so that the doctor can accurately diagnose the root source of your complaint as well as make an accurate recommendation for treatment. An example of how we can isolate the neck during the exam is called the smooth pursuit neck torsion test. During this test the patient will be performing a smooth pursuit (following an object from one side to another with their eyes) sitting in a neutral position, and then they turn their head 45 degrees to the right and to the left. The doctor will then observe for noticeable differences in the speed and how smooth the eyes were able to track the target in each position. “The smooth pursuit neck torsion test seems to be useful for diagnosing cervical dizziness, because it has a high sensitivity and specificity.” (4)
Hopefully this article was able to demonstrate to you why it is important to find a provider who is adequately trained in concussion rehab when seeking relief for your post concussion syptoms because once you’ve seen one concussion, you’ve seen one concussion. No two injuries are the same and therefore no two treatment programs should be the same. If you or someone you love is struggling with a concussion or concussion like symptoms feel free to give us a call by clicking the contact us button at the top of the page and scheduling a complimentary phone consult with the doctor. We believe there are answers to why you are continuing to struggle and we are here to help.
1. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. British Journal of Sports Medicine. 2014.
2. Neck Strength: A protective factor reducing risk for concussion in high school sports. The Journal of Primary Prevention. 2014.
3. Rehabilitation of Concussion and Post-concussion Syndrome. Orthopaedic Surgery. 2012.
4. Smooth Pursuit Neck Torsion Test: A specific test for cervical dizziness. The American Journal of Otology. 1998.