Post Concussion Syndrome

Andrea Mohrle, MSPT, JSCC Release! Manual Therapy
Olympia, Washington


Post Concussion Syndrome (PCS) occurs following a traumatic injury to the brain. This is often the result of a blow to the head, but can also occur without physical impact, for example, by means of a whiplash. Bones and ligaments, blood vessels, nerves, fascial support tissues of the brain as well as the brain itself are injured in such cases. Symptoms include headaches, dizziness, nausea or vomiting, distorted vision, balance problems, impaired memory, difficulty with concentration and thinking, problems sleeping, and mood or personality changes. In most people, these symptoms are worst in the first seven to ten days after the injury and then subside over time. They can last a few months to a year or longer. Researchers have not yet been able to determine why some people who have had concussions develop persistent PCS symptoms and others do not. The severity of the injury does not seem to play a significant role in whether or not PCS symptoms persist.


Currently, treatment following a brain injury consists of rest, time, medication and therapy. Therapy addresses memory and thinking problems as well as emotional and behavioral issues. The treatments are generally focused on symptom presentation. Is this really all that can be done? In response to a traumatic brain injury, fascia making up the outer layer of arteries, veins, and nerves, as well as the supporting tissues within the cranium (Dura), will go into a protective spasm just like in other parts of the body. In the case of arteries and veins, a spasm in the outer layer (adventitia) means that the vessel is tightened, which decreases the amount of blood that can flow through it. Thus, arterial blood is not able to get to brain tissue as efficiently as before the injury, which can starve the brain cells, slow healing, and impair function. In the case of venous blood, it is not able to drain as well. Over time, this will cause a backlog of blood and increase pressure onto the tissue that surrounds the vein. This will also interfere with healing and function of those tissues. The reflexive, protective spasm will persist unless it is released. When the brain is under pressure from spasms in the dura and nerves and is compromised in blood flow to and from the tissues, it is not able to heal well or function like it should. Fascial Counterstrain (FCS) does not ignore these effects of the trauma. Once initial healing of any associated fractures or soft tissue injury has taken place, treatment can begin. Your FCS practitioner will carefully assess which structures are being affected by protective reflexes. Gentle compression and tissue glides will mechanically shorten the structure in spasm, putting it into a state of optimal relaxation, thereby releasing the neurological reflex which perpetuates this protective spasm. Once this release has taken place and excess tension in the fascia is removed, blood flow to and from the injured tissue is restored, and the body will be able to heal itself much more effectively. This will allow for more complete healing of the injury and enable persistent symptoms to resolve.

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