Pain

By: Allison M. Payne

Sourced from Massage Magazine

The word concussion typically comes to mind when you think of traumatic events such as car accidents.

But for professional athletes, especially those who play football, concussion can be part of a normal day’s work—and according to NFL injury statistics released for the 2017 season, this type of head injury is becoming more common, with 281 reported this past year. That’s an increase of more than 13 percent from the previous year.

The effects of concussion often extend far beyond the acute stage of injury, and athletes seek out many forms of treatment to deal with them.

One complementary health intervention that shows promise in the addressing of post-concussion symptoms is CranioSacral Therapy (CST).

“[CST] is perfect for football players,” said Ricky Williams, a former NFL running back who also played a season in the Canadian Football League.

Williams, who trained in CST through the Upledger Institute International (UII) and is currently studying Chinese medicine in Los Angeles, partnered with UII in 2014 and 2015 to offer two intensive therapy programs to football players with post-concussion symptoms.

The programs produced a pilot study on the effects of the therapy on this type of injury,

published in 2017 in the journal Medical Acupuncture, “CranioSacral Therapy and Visceral Manipulation: A New Treatment Intervention for Concussion Recovery,” found that 10 sessions of specific CST, visceral manipulation and neural manipulation resulted in statistically greater improvements in pain intensity, range of motion, memory, cognition, and sleep in concussed patients.

What is CranioSacral Therapy?

CST, according to a definition on UII’s website, is a “gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance.”

The modality targets the membranes and fluid surrounding the brain and spinal cord. Injuries to any part of the body, CST practitioners say, can manifest in the central nervous system, so releasing restrictions there can facilitate self-healing in other areas of the body.

Williams first discovered CST when he was playing football for the Toronto Argonauts. He noted that many of the team’s trainers knew the technique and offered it routinely to players.

“I noticed in our training room, after practice sometimes, guys would be laying on the table, and their trainers would have their hands underneath the guys’ heads,” Williams told MASSAGE Magazine.

Intrigued, he tried it out one day and then started receiving CST weekly; soon he was taking courses in it through UII.

Later, in 2009, he received CST through one of UII’s intensive programs. In his subsequent season, playing for the Miami Dolphins, he rushed more than 1,000 yards, breaking an NFL record.

“It changed my life,” he said of his CST sessions. “I had a great season, and I attribute a lot of it to the work that I did at [UII].”

What Is Concussion?

Football players can suffer concussions in any number of ways during practice or games. A concussion, also known as a mild traumatic brain injury (MTBI), typically occurs after a blow to the head or violent movement of the head or body, and might or might not make you lose consciousness, according to the Mayo Clinic’s website.

A concussion may cause symptoms such as headache, memory loss, ringing in the ears, or even nausea, vomiting and slurred speech. These effects usually resolve in a matter of hours or days, but in some cases concussion can have longer-term effects.

Repeated head trauma, such as that experienced in combat or in rough sports like football, can cause permanent and debilitating problems, called post-concussion syndrome, or even develop into what is now known as chronic traumatic encephalopathy (CTE).

CTE symptoms, according to the Mayo Clinic, can include cognitive problems, poor impulse control, memory loss, aggression or dementia, among others.

March is the Brain Injury Association of America’s Brain Injury Awareness Month; massage therapists and clients can learn more about concussion and CTE from the association.

Another article published recently on this topic was “CranioSacral Therapy, Brain Injury, and American Football: Time for a Convergence,” by Eric Leskowitz, MD, published in The Journal of Alternative and Complementary Medicine.)

Concussions and CTE

Most people with concussions make full recoveries, but much attention has been paid lately to the prevalence of this injury in football at all levels—professional, college, high school and Pop Warner.

The NFL has faced criticism for not taking action to address the prevalence of concussion and CTE, and many athletes now retired from the game are discovering the long-term health effects of repeated head-and-body trauma.

“All these injuries accumulate,” said Chas Perry, PhD, CSTD, one of the organizers of UII’s concussion programs. “So you have a lot of head injury, you have a lot of injuries in various parts of the body, and over time that takes a toll on people.”

Williams, as a football player himself, has long been aware of how repetitive trauma can affect the body. While he believes it’s important to work on prevention of concussion and cte, he also advocates for investigating new techniques for counteracting these effects, including those outside the realm of conventional medicine.

“I’ve realized that almost every square inch of my body has been traumatized at some point in time over my football career, whether it’s from being hit, being tackled [or] being fallen on,” said Williams.

“Going through healing sessions where I’m receiving work and feeling energy and life force, mobility, blood flow, come back into these areas of my body, it’s really mind-blowing,” he said.

Positive Outcomes

UII’s concussion program, held in 2014 and again in 2015, conducted research involving 11 ex-football players diagnosed with post-concussive syndrome. The research excluded those suffering from recent head trauma, in order to specifically study the long-term effects of concussion. (Another program is planned for late 2018.)

Each time, athletes participated in a week of intensive therapy in West Palm Beach, Florida, performed by a team of health care professionals; therapies given twice daily for two hours per session included CST, visceral manipulation and neural manipulation.

Outcomes were measured before treatment, after treatment and three months post-treatment, and included the effects on cognitive tasks, quality of life, headaches, dizziness, pain, range of motion, balance and sleep, among others.

Statistically significant outcomes, according to the study’s abstract, existed in measures of pain intensity, cognition, memory, sleep and range of motion.

Anecdotally, many of the participants in these studies reported rapid, dramatic results. In addition to improvements in pain and other physical complaints, many also reported positive changes in cognition and emotion.

For example, said Perry, some former football players who have suffered head trauma have trouble modulating strong emotions, such as anger and aggression; others might develop depression, experience irrational fears or have trouble concentrating.

“You have a lot of very unusual phenomena that can be uniquely individual, but they’re all basically kind of brain trauma related,” Perry said.

“During the intensive, the therapists used persistent but gentle hand pressure at various contact points and areas on my body. Sometimes I questioned if anything was actually happening, but at the end of each session I felt noticeably better,” wrote Clarence Vaughn, a former member of the Washington Redskins, in a testimonial about the program. “By the end of the week I was a new man. The pain in my neck, shoulders and hips was gone!”

Eric Williams, a former member of the Washington Redskins and Detroit Lions, also wrote a testimonial to the therapies’ positive effects. “My mood, my emotions and body had such a drastic change, it’s really hard to put into words. My chronic pain was drastically reduced and my range of motion on 99 percent of my body parts increased significantly,” he wrote. “I can’t explain what they did or how they did it. All I know is, I’d do it again in [a] heartbeat.”

The results of the UII study are encouraging,  but more research is needed to advance the acceptance of this therapy, said Ron Radawiec, PT,  who has worked with many traumatic brain injury clients and also worked hands-on with these athletes. Yet, he acknowledged the strength of the anecdotal evidence for these therapies’ effectiveness and said the changes can be profound at the physical, emotional and cognitive levels.

“I highly recommend Upledger CranioSacral Therapy to anyone who has played football,” wrote David Meggyesy, a program participant who played for the St. Louis Cardinals in the 1960s, in a testimonial.

“CranioSacral was a revelation — what a gift.”

Neurohacking is all the buzz these days for improving mental performance and enhancing recovery time. If you’re curious, and start looking into Neurofeedback and Brain Balancing programs, you may quickly become overwhelmed by all of the options that are available to you.  And, it can be confusing to understand the similarities and differences between the different options. One type of treatment that several of our clients have tried and/or asked us about, is TMS, Transcranial Magnetic Stimulation, and how it compares to our Neurofeedback System, NeurOptimal®. Fortunately, our very own NeurOptimal® Associate has had firsthand experience working with patients as a technician for both of these modalities. We asked her to share her knowledge and experience working with clients using both systems and here’s what she had to say.

Neurofeedback and TMS are two modalities that I’d heard of, but never had first hand experience with – until recently. Both are noninvasive treatments to help influence the brain, and throughout the past year I’ve had the opportunity to observe the effects of each. In my short time working with TMS patients and neurofeedback clients, it’s been incredible to see the impact of both systems on individuals receiving them. Having helped operate both, here’s my honest review of the two. 

I worked for a mental health clinic in Denver last year, and there I became certified as a TMS technician. TMS stands for Transcranial Magnetic Stimulation, and it uses magnetic fields to influence brain activity. TMS operates using a magnetic coil to transfer electromagnetic pulses to help stimulate the brain cells. The electrical pulses are repetitive, and TMS has mainly been used to help treat depression. The vast majority of TMS patients suffer from one form of clinically diagnosed mental illness, such as depression, anxiety, bipolar disorder, etc; although TMS has been shown to successfully help treat these and other mental disorders. 

Though I found the process of TMS fascinating, I did have some skepticism as to its effectiveness. Out of all the patients I administered treatments to over a period of six months, a handful had significant success at the completion of their sessions. Not only is the process of receiving TMS daunting, there are hoops and hurdles to get through in qualifying with insurance companies. Depending on a person’s deductible having been met or not, the cost of their treatment could range anywhere from free to a few thousand dollars. So not only do you have to qualify through insurance to see if you can even receive TMS, but you could spend anywhere from five grand or more, for a treatment that may or may not give you the results you are hoping for.

TMS also comes with multiple side effects. The vast majority of clients receive headaches during the first few days for up to a week through their sessions, though with time these typically lessen or go away. They may also experience insomnia, increased anxiety, and dizziness during the process. The pulsing from the coil is uncomfortable and can sometimes cause calluses on the scalp, and can be described as painful for some individuals. A severe side effect can be seizure, however this is extremely rare and luckily I never had a client have one. TMS is also very demanding on a person’s schedule, for they typically need to show up 3-5 days a week for a couple months until their treatment is complete, or until their insurance date expires. Most folks have to take time off work or school, and typically insurance companies only allow a few months window of time to complete it. A treatment option like this is not always the most efficient or sustainable for a full-time student or a person without a flexible work schedule. 

There’s also the dip: a timeframe during treatment where patients’ mental health may regress or become worse than it previously was when they first came in. During my training we were initially told to disclose this information during initial appointments, however it never sat well with me. Essentially telling someone “Oh, by the way, during your TMS journey you may start to feel even worse than when you previously started” was already setting up a person for failure in my opinion. Most of these folks continuously have crippling depression and anxiety, and telling them on day one they’ll get even worse doesn’t exactly invoke a spark of confidence to them that it will ultimately work. Of course, I understood the reasoning behind telling them, if their dip were to occur they wouldn’t be blindsided nor possibly be as easy to doubt or regret the progress TMS has made up to that point. I’m a big believer in the placebo effect, and I noticed right away once patients were told they could get worse, they were never fully trustworthy of TMS from start to finish, as opposed to other patients who weren’t immediately told about the dip, their approach and outlook looked different. I get it, no one wants to be told something they’re paying a lot of money for and investing a lot of time in may not work right upfront. If I was receiving TMS, I wouldn’t want to hear that either. 

Despite all my criticisms of TMS, I have seen its positive attributes and believe in some cases it can be incredibly beneficial. I had one patient who quit using marijuana, had easier ways to cope with his anxiety, was no longer taking antidepressant medication, and got out of his shell and comfort level faster after TMS. He described it to be ‘life-changing’ for him. It can be the right treatment for some people, and I applaud those who take time out of their busy lives and money out of their pockets to invest in it, for it is an unnerving ordeal. It takes a lot of bravery and courage to seek out treatment. But in my mind and heart, working in direct correlation with massive pharmaceutical corporations, health insurance companies and psychiatrists who prescribe medication after medication, I knew there was another more holistic path to wellness that I was meant to embark on to help heal people. 

I have that opportunity now,  through Recovery Lounge and Spa here in Denver. As I mentioned before, neurofeedback was a concept I’ve heard of, but soon became familiar with their NeurOptimal® system and am now a Certified NeurOptimal® Trainer. Neurofeedback is another brain training tool that has similarities to TMS, yet is also vastly different. 

NeurOptimal® is Dynamical Neurofeedback, a type of brain training or biofeedback for your brain. NeurOptimal provides a person’s brain with feedback in real time by monitoring shifts in the person’s brain activity and mirroring or interrupting those patterns in the central nervous system through music and sound. NeurOptimal® trains a person’s brain to help their nervous system become more resilient and malleable. With NeurOptimal®, folks are hooked up to sensors on their ears and scalp with a type of paste that conducts EEG signals, while listening to an audio playlist. As the music is playing, there will occasionally be ‘scratches’ or ‘blips’ during the audio when the software is temporarily being interrupted and cuing your brain. These interruptions in the music are designed to give your brain information to help it self-correct and operate in a more efficient manner. Over time, people who use NeurOptimal® consistently tend to see significant changes or shifts and they typically see those changes or shifts at or around 20 sessions. So for NeurOptimal, 20 sessions at 1-2 sessions a week is the optimal target for more lasting results. 

A common type of neurofeedback known as linear or classical neurofeedback provides brain mapping, EEG’s, and requires monitoring to steer the brain in a specific direction with a targeted goal of balancing the brain. It also requires a diagnosis, which, unlike its NeurOptimal® counterpart, does not. NeurOptimal® is known as dynamical neurofeedback, where a person is receiving feedback in real-time rather than a pre-set program. It does not require a diagnosis or something to be ‘wrong’ with them in order to receive it. With NeurOptimal® there is no brain mapping and nothing is being taken out of or put into the brain and there are no programming decisions being made by a technician to force the brain to be trained in a specific direction. You simply put on your headphones, we place the sensors on, and your brain does its thing. 

With NeurOptimal® there’s no need to go through a lengthy process with your insurance company to qualify. There’s no need to have trialed multiple medications and no need for a formal diagnosis. What makes NeurOptimal® stand out is its ease of application, minimal to no side effects, and the benefit for many populations ranging from people suffering from TBIs including concussion, people looking to help improve their performance, sleep or memory, children with ADHD or lack of concentration in school, and people with mental health disorders.  

I’ve seen continual progress from clients I’ve worked with in NeurOptimal® and they all tell me the same thing: they’ve noticed something happening. They’re getting more sleep, their memory is better, they’re less anxious, they’re not getting headaches or migraines as frequently, their mood has improved. Subtle changes or shifts in concerns they had coming in for the first time, to people receiving regular maintenance can tell there is something to it. NeurOptimal® is also typically less pricier than TMS, and are only 33 minute sessions. Through Recovery Lounge and Spa, we also offer NeurOptimal® home rentals, so a person can still receive all the brain benefits in the comfort of their own home. There are no time constraints, no ticking countdown or an ‘end date’ to when you need to finish, for NeurOptimal® can always be started and stopped, used continuously or occasionally, to whatever needs fit someone the most. There’s no pain or discomfort, and no one is told right away “you’ll get worse before you get better.” 

The pros of NeurOptimal® seemingly outweigh any possible cons of TMS I’ve seen and experienced as a technician for both. Though I do not believe there is a ‘one size fits all’ when it comes to treatment or therapy or healing of any kind, I have seen more of a positive influence working with neurofeedback clients and their results from NeurOptimal®. They aren’t being told what to do and aren’t being told a problem cannot be solved or an issue cannot be fixed. Anyone can come and receive NeurOptimal® and do not need to completely break their wallet to do so. I’ll take small sensors on my scalp over a pulsing magnetic coil on it any day. I have no doubt either TMS or neurofeedback couldn’t work for one person or another, and these systems are being more widespread and becoming more mainstream which is encouraging to the masses, but to me, there’s less risk with NeurOptimal® and more hope and opportunity for real change consistently over time, versus a slightly more dramatic (possible) short boost of improvement.

To learn more about NeurOptimal® Dynamical Neurofeedback, check out this Explainer Video or schedule a FREE Virtual Consultation with one of our NeurOptimal® Trainers.