SPORTS NEUROLOGY: APPROACH, TOOLS and SERVICES
Your brain can make you better
Most would agree that those individuals with the highest capacity for memory,
focus, and concentration tend to perform best in academic and professional
environments. In fact, in school we used to call those individuals “brainiacs”.
There was something about their brains that made them better. Sports and
athletics were considered…well, different. Physical attributes
seemed to predict success. While sports medicine and performance had traditionally
been associated with cardiovascular and musculoskeletal fitness for decades,
new information has developed, and approaches have evolved. Yes, Orthopaedic
and Musculoskeletal Medicine specialists have contributed greatly to the
development of best practices in treating injury, preventing injury, and
improving function. And the development of Peak Performance programs have
further advanced these foundational principles. But state of the art approaches
are uncovering a significant concept –
At every level of participation, Neurological function separates the average
from above average and the good from the great far more than physical
and musculoskeletal function. Sports Neurology is a new paradigm in Sports Medicine, poised to revolutionize
performance. Consider the following skills and performance characteristics
– all of which significantly improve and optimize sports performance
and all of which are Neurological in nature:
- Reaction and Prediction
- Speed of Mental Processing
- Control of Adrenaline
Whether an individual is a youth, high school, collegiate, elite, or professional
athlete, those with the most organized brains and highest level of neurological
functioning in these areas, will be the best and most productive at their
level of participation. There are typically minimal differences in cardiovascular
fitness, strength, and speed (with occasional outliers) within a specific
level of participation. And excelling in these areas won’t matter
nearly as much if the Neurological skills and performance characteristics
As with Orthopaedic and Musculoskeletal Medicine, lessons learned in the
evaluation and treatment of athletes can be extrapolated and applied to
non-athlete populations. Youth, adolescent, young-adult, middle-aged and
elderly individuals have long benefited from improved approaches to treating
bone and joint disorders, arthritis, and painful spinal conditions as
a result of advances in treating athletes through things like physical
therapy, biomechanics research, and arthroscopic surgery. Likewise, lessons
learned in the evaluation and training of the brain and nervous system
in athletes is beginning to pay dividends in other populations and contribute
greatly to improved neurological function and quality of life across the
What is increasingly obvious is that your healthiest brain is your best
path to success (athletic, academic, professional, and quality of life).
Our approach is unique and effective
There are two foundational principles that inform our approach to Sports
Neurology and Pain Medicine:
Neuroplasticity: The ability of the brain to form and reorganize synaptic connections.
Especially in response to learning or experience or following injury.
Neuromodulation: The alteration of nerve activity through targeted delivery of a stimulus,
such as electrical stimulation or chemical agents, to specific neurological
sites in the body.
There has been a paradigm shift in our understanding of Brain and Nervous
System function. In the old days, it was thought that these attributes
were fixed. If you were lucky, you were born with great vision and balance.
Or you were born “smart”, or “coordinated”. If
not, it was thought that you needed to find and focus on your strengths and
compensate for the shortcomings. Likewise, after an injury to the brain or nervous
system the focus was on teaching individuals to live with their “new
normal” – again, primarily through
compensation techniques. However, the concept and promise of Neuroplasticity assures us that the
brain and nervous system has the ability to reorganize synaptic connections.
And that learning activities assist in reorganization. Essentially,
Neuroplasticity shows us that the brain can be trained. This may seem to be a simple statement. But the concept has revolutionized
our approach to sports, academic, professional, and quality of life performance.
Just as exciting is the revolution in Neuromodulation that is currently
taking place. By stimulating the brain and nervous system in certain ways,
we can turn up, turn down, and/or turn off electrical signals and affect
sensory, motor, cognitive, and even behavioral function.
Neuromodulation shows us that we have equalizer-like control over certain
Brain and Nervous System activity. It’s early and there’s lots to learn. But this is revolutionizing
our approach to Neurological, Psychological, Psychiatric, Behavioral,
and Cognitive disorders as well as sports, academic, professional development/performance.
Our approach to Sports Neurology and Pain Medicine is grounded in these
principles, which are the most critical and groundbreaking to come along
We begin engagement with new patients and clients with an expert assessment.
This includes a history, physical examination, record review, and discussion
regarding goals and desired outcomes. Next, we attempt to educate our
patients and clients in a meaningful way. By education, we mean meaningful
knowledge transfer with an emphasis on gaining the buy-in needed to optimize
our outcomes. We know that knowledge and insight have physiological benefits.
Neurologically and physiologically, expectation has real, physical effects
on response to treatment. In some cases, our focus is on introducing new
language, constructs, and principles in ways that our patients and clients
understand. In other cases, we must begin with cognitive restructuring
– literally “unwinding” our patient’s and client’s
pre-existing and potentially misguided understanding and expectations,
then rebuilding with sound and accurate foundational principles. We know
this step is crucial to optimizing outcome.
Next, we institute appropriate testing and assessments, aimed at evaluating
Neurological anatomy and function. These may include combinations of physical
examination features, diagnostic imaging, electrodiagnostic tests, or
functional tests. We’re able to accomplish the great majority of
our assessments in-house (within the Center for Sports Neurology and Pain
Medicine), or within our Kerlan-Jobe/Cedars-Sinai network. The obvious
benefits are related to the quality of assessment and in negating the
need for outside referrals and cumbersome issues related to obtaining
test results or communicating with outside practitioners.
Finally, we employ state of the art treatments. Our goals are less dependent
on pills to “cover” symptoms or compensatory strategies to
“deal with” dysfunction. Rather, we search for opportunities
to intervene using Neuroplasticity and/or Neuromodulation techniques.
Our medical interventions, rehabilitation and therapy approaches depend
on our expertise with the Brain and Nervous System. Our ultimate goal
is to leverage our expertise and access to athletes and sports-related
performance to optimize Neurological Health across the lifespan.
We have a comprehensive menu and assortment of tools and services available
to achieve our goals. In addition to the expert application of traditional
approaches (medications, injections, and physical therapies), the following
tools and services are offered to optimize performance and quality of
life for our patients and clients:
ABOVE THE NECK AND BRAIN TRAINING
ADAPTIVE CONDITIONING POD
CONCUSSION MANAGEMENT AND REHABILITATION
EDUCATION AS MEDICINE
HF-10 SPINAL CORD STIMULATION FOR PAIN
MeRT℠ THERAPY FOR ATHLETES
NEUROMODULATION TECHNIQUES FOR PAIN
QUANTITATIVE ELECTROENCEPHALOGRAPHY AND BRAINWAVE NETWORK ACTIVATION
SPORTS/PAIN PSYCHOLOGY AND BEHAVIORAL THERAPIES
TRANSCRANIAL MAGNETIC STIMULATION