The Center for Sports Neurology and Pain Medicine takes on a highly individualized
approach to concussion management. We believe this is important because,
while there are commonly experienced groups of signs and symptoms associated
with concussion, each individual presents with a different spectrum. Furthermore,
an individual with multiple concussions in their history might experience
completely different symptoms from one concussion to the next. This is
why a detailed history, validated concussion-specific clinical examination,
and focused interventions are particularly important with this population.
Our approach begins with
Cognitive Restructuring – educating patients and other stakeholders on state of the art
approaches and appropriate expectations regarding recovery. We believe
we can help everyone! We just need to find the appropriate intervention
for the individual we’re focused on at that time.
Search for Treatable Conditions in an effort to overcome symptoms and return the patient to baseline
or better than baseline, rather than the outdated and misguided approach of teaching compensation
strategies for a “new normal”.
And we utilize
Stratified Care philosophy – meaning we are aggressive with the intensity of our
interventions for severe and chronic symptoms, but reasonable and conservative
with milder sympotms that are resolving spontaneously. We have a wealth
of interventions and technologies at our disposal, But we maintain a common
Concussion symptoms typically fall into different categories of clinical
presentation, all of which require evaluation and management. Signs and
symptoms may include cognitive/thinking, affective/mood, vestibulo-ocular
(balance/vision), somatic (headache), cervicogenic (neck-related), and/or
cardiovascular/autonomic issues. Our multidisciplinary and interdisciplinary
team approach to concussion management ensures that each of these systems
are being identified, evaluated, and treated.
How Do We Treat Concussions?
- Consult with Sports Neurologist for expert and focused neurological assessment,
treatment, and “quarterbacking” the plan of care.
- Referral to appropriate specialist team member based on signs and symptoms
identified for individualized programs built based on clinical presentation.
We work closely with pain psychology, sports psychology, athletic trainer,
and concussion-focused physical therapist team members, as indicated,
to develop treatment plans and monitor recovery.
Provide education and communicate with patient, family, coaches, schools,
and involved healthcare practitioners regarding treatment plan and return
to activity. We believe STRONGLY in the power of education and effective
knowledge transfer. We want all stakeholders to understand what we’re
doing and why. We believe that kind of buy-in is crirtical to recovery.
Our goal is to return the athlete, injured worker, or military member in
better condition than they were prior to the injury!
What testing, interventions and rehabilitation techniques do we use to
help with Concussions?
- Diagnostic testing including traditional imaging (MRI), advanced imaging
(Qaunatitative MRI, DTI and fMRI), electrodiagnostic (EEG, QEEG, and Brain
Network Assessment), Advanced Visual and Balance Assessments, and Cognitive
Testing (Computerized and/or formal Pen and Paper Neuropsychological Assessments)
are used to evaluate every aspect of the patient’s signs and symptoms.
- A physical therapy/athletic training assessment is performed of vestibular,
visual, cervical spine, proprioceptive/balance, and cardiovascular systems
using iPad based program and clinical assessments.
- C3 Logix iPad based baseline/follow up assessments
- Vestibulo-ocular examination, including tests of vision, vestibulo-ocular
reflex, and oculomotor function
- Balance and/or gait assessment
- Cervical spine screen
- Cardiovascular assessment, including HR/BP monitoring and concussion treadmill testing
- Individualized programs are built, which may include:
- Visual and vestibular rehabilitation
- Head-eye-neck coordination exercises
- Balance exercises
- Dual tasking
- Cervical spine treatment
- Graded aerobic program
- Sports-specific training
- Expert pain management strategies ranging from topical and oral medications,
to interventioinal procedures (such as injections), to Neuromodulation
(with cryoablation, radiofrequency, Neueofeedback, and/or TransCranial
Magnetic Stimulation) are guided by our Sports Neurology staff.
- Behavioral Medicine consultations and management with Cognitive Therapy,
Autonomic Quieting, EMG/Thermal-Guided Biofeedback, Neurofeedback, and
Mindfulness Meditation techniques are available for non-pharmacologic
approaches to treating signs and symptoms.
- A number of state of the art technologies are available and utilized in
our beautifully designed Peak Performance, and Neurological Treatment/Testing spaces.
We are a full-service Center for Sports Neurology and Pain Medicine with
decades of expertise managing concussion in elite, professional, collegiate,
and high-school/youth athletes, as well as injured workers and weekend-warriors.
We have great success treating acute, sub-acute, and chronic Post-Concussion
Syndrome as well as chronic neurological impairment associated with multiple
concussions and sub-concussive blows. The combination of Sports Medicine
expertise and experience associated with Kerlan-Jobe, and the expanded
access to services and expertise associated with Cedars-Sinai place us
at the head of the pack when it comes to evaluating and managing head injury.