What a Headache!

Headaches are extremely common. Most people will suffer from a headache at some point in their lives.  And they can result in pain in the head, neck and face. 

There are over 300 different types of headaches described in medical literature, including:

  • Migraine
  • Tension Headaches
  • Silent Headaches
  • Menstrual Headaches
  • Cervicogenic Headaches and these can be split into two categories:
    • Primary headaches – “just come on” headaches, these headaches aren’t caused by an injury or other illness.
    • Secondary headaches – these headaches are caused by an underlying pathological or health condition. 

What to look out for?

Most headaches aren’t serious, however there are some important “Red Flags” that we as Osteopaths look out for:

  • A new headache as an adult over 40 years of age
  • Abrupt onset of a headache that is unusually severe
  • A “different” headache from previous ones
  • Progressive headache over days or weeks
  • Headache associated with nausea and vomiting or fever that can’t be explained by another illness or condition, for example the flu.

What causes a Headache?

There has been a huge amount of research over the years about the causes of headaches.

More recently, studies have concluded that a large percentage of headaches are caused by a dysfunction in the neck. 

The head and face share some neurological structures with the upper 3 segments in your neck, therefore they have a great effect on each other.  Dysfunction or a problem in one will influence the other. 

What can your osteopath do?

If you suffer from headaches seeing an Osteopath may help.

During an osteopathic session we will take a detailed history to rule out the nasty red flags.  We also will perform a thorough examination including testing and stressing structures within the neck.

Osteopathic treatment aims to address any problems in the neck, therefore decreasing the intensity or frequency of the headaches.  As Osteopaths we may also recommend some exercises and advise you on strategies to decrease the likelihood of headaches. 

Thanks for reading along!

Reference:

Watson, Dean (2016) Cervical Afferents and Primary Headache: An investigation of the potential role of cervical nociceptors in sensitising the trigemino-cervical nucleus in primary headache. PhD thesis, Murdoch University.

Footy season is almost upon us – this injury cannot be ignored!

With football season fast approaching, concussion is a topic that can’t be talked about enough. In the “old days” concussions used to be brushed off with a “he’ll be right” or “he wasn’t unconscious so he’s fine”.  Unfortunately it’s not that simple….

 

What is a Concussion?

Concussion is defined as a traumatic brain injury (TBI). A Mild traumatic brain injury, also known as a concussion, which can either knock you out for 30 minutes or less, or doesn’t have to knock you unconscious at all.  Short-term symptoms often appear at the time of the injury, but can develop days or even weeks later.

 

How Does it Occur?

The brain is suspended in the skull and can move within it. Any sudden movement of the head and or neck can and will cause the brain to move within the skull and potentially bounce off the inner surfaces. Think of the mixing ball in a protein shaker or the metal balls on your favourite nail polish, they get quite a beating. This movement causes trauma to the brain, bleeding, bruising and disruption to the cells and their function.

 

Signs and Symptoms

Concussion can present itself in many ways – some much more obvious than others.

Main symptoms include:

  • Loss of consciousness
  • Headaches
  • Nausea and Vomiting
  • Visual Change, blurriness, seeing spots, different colours
  • Unbalanced
  • Change in mental or emotional state, often people can become aggressive
  • Inability to sleep
  • Overly tired

 

Management

Like any other injury in order to recover the brain needs to rest. This is the part that tends to fall short and when concussion can become very dangerous. Unfortunately due to lack of education, pressure from coaches, teammates and or parents players often return to sport too early.  It is in these instances the chances of another concussion are significantly higher and it’s these cases that can turn into fatalities.

 

What is Being Done?

Many codes and sporting organisations are starting to implement procedures to manage concussion in order to keep their players and athletes as safe as possible. The British Journal of Sport Medicine is now up to their 5th SCAT (Sports concussion assessment Tool) which helps teams and their first aid/trainers/osteopaths/physiotherapists and doctors monitor their players progress.  There is also loads of information at the Australian government website “Concussion in Sport

 

The Australian Rugby Union (ARU) has introduced the “Blue Card” Australia wide for amateur and junior competitions. This program is overseen by the ARU chief medical officer and allows concussions to be monitored and addressed across the life of a player.

 

What are the Long Term Consequences of Concussion?

Unfortunately we are still unsure of many long term consequences of concussion which means we need to treat it with even greater care. The movie “Concussion” starring Will Smith tells the story of a doctor in the US who discovered the neurological condition called CTE, which was present in retired NFL players.

  • Chronic traumatic encephalopathy (CTE) is a brain condition associated with repeated blows to the head. It is also associated with the development of dementia. Potential signs of CTE are problems with thinking and memory, personality changes, and behavioural changes including aggression and depression. People may not experience potential signs of CTE until years or decades after brain injuries occur. A definitive diagnosis of CTE can only be made after death, when an autopsy can reveal whether the known brain changes of CTE are present.

 

What Can You Do if you Suspect Someone is Suffering From Concussion?

So as a Parent, Friend, Partner or Practitioner here are some things to keep in mind:

  • Watch for symptoms, note them down and if they change/get worse, seek advice
  • Seeing an Osteopath, Allied health professional or Doctor with experience in up-to-date management of concussion, who may then refer on as needed to a Neurologist or Sports medicine Doctor
  • The hardest part about concussion is you can only treat and manage the symptoms that you can see
  • Whenever unsure seek advice

Thanks for reading this article.  Please share it with those involved at sporting clubs or those who have children playing sport.  It may just help to save a life, or a permanent head injury!  If you have any questions regarding concussion, or if you would like a copy of our “Signs & Symptoms of Concussion” Infographic for you, or your club please feel free to email me at leora@pakenhamosteopathy.com.au

MY PAINFUL EXPERIENCE – LEORA DOBIA

As an osteopath, I am often asked “should I have the surgery or not? What would YOU do?” Normally my advice is this: look at all your options and make an informed decision.  As someone who has thankfully never been under the knife, that is a very easy line to rattle off.

Now however the tables are turned….

While on holidays in New Zealand last week I had a nasty fall and injured my ankle quite significantly (please refer to my previous blog for the full story here).  While I was sitting on the couch with my very fat, very sore ankle trying to hold back tears all I was asked was, “what do you think you’ve done? Is it bad?” As a practitioner I was running through every possibility in my head and I think I was more anxious because I have medical knowledge, and because in my gut I knew it was more than just a sprained ankle.

I am lucky that within 12 hours of returning to Melbourne I had an MRI with the report stating “significant syndesmosis”.  There are two ways of managing this diagnosis: conservative or surgical.

I began my information gathering.  In the space of 2 weeks I saw 2 surgeons, a sports physiotherapist, a sports medicine physician, consulted with my mum who is a GP, not to mention my esteemed colleagues and friends…. Everyone had slightly different advice!

Weight-bear as tolerated, don’t weight bare – allow it to rest longer, take anti inflammatories for pain and to bring the swelling down, don’t take anti inflammatories they slow the healing process, sleep in the moon boot, don’t sleep in the moon boot….

One surgeon advised conservative management – moon boot for 6 weeks, non weight bearing/driving for another 2 weeks and reassess in a month.  The other said “well you’ve done a good job” and after examining and going through my MRI recommended that I have surgery within the week.

Now this is where it really got hard – which advice do I take?  Is one surgeon being too conservative and is the other “knife happy”?  What will be the quicker recovery time? How quickly can I return to work?  When can I drive? How much is it going to cost? The Pros and Cons list was growing!  Ultimately you know when something feels right or not. I decided to go with the advice that gave me the most confidence, and with the surgeon who I had more trust in to get the result I wanted.

I ended up having surgery 2 days after the consult with the second surgeon.  I didn’t want to drag out the process any longer, and possibly lengthen my recovery time.  

When the surgeon came to see me after surgery he said “It was more unstable than we thought, your fibula was moving all over the place, any more and we would have needed to put the screw in too and not just the tightrope”.  Ultimately I had a high level grade 2 sprain. Luckily it wasn’t a grade 3 which would have required the bolt and a second surgery.

So my advice is, GO WITH YOUR GUT!  Every body is an individual and has different wants and needs, and are in different circumstances.  Unfortunately there is no cookie cutter answer, but ultimately do what feels right for YOU.

I am now 4 weeks post surgery and I’ve been working the last 2 weeks.  I am back in the gym and I have 2 weeks left in the moon boot. I am almost pain free and I feel stable.  I believe surgery was the right decision for me considering my current circumstances but again, there is no “one-size fits all” when it comes to these types of decisions.  Information is power so arm yourself with the best!