Concussions and What You Can Do

Concussions

TBI. Traumatic brain injury. Such a nice euphemism for a concussion, isn’t it? That’s what it is, after all. Someone’s brain was violently smashed against the inside of their skull which resulted in deep and, in many cases, permanent damage. One concussion is not all that bad; however, a second soon after the first can be crippling.

Additionally, after the first one, others come easier. The damage compounds upon itself over time even. Watch any interview with career boxers like Larry Holmes. By the end of his career he could barely form a sentence. As a veteran, myself, I can attest to the compounded damage and deterioration. Pay just a little attention to Veterans who have had a few concussions. You will see similar issues shared with professional athletes.

The Center for Disease Control says that between 500,000 and 3 million people in America are treated for concussions each year. Even on the low end, that is a huge amount a damage. Particularly when you consider how much work goes into trying to recover from the damage, to regain the skills lost, regain the physical functions that were basic non-issues just days prior to the injury.

Among the multitude of symptoms that can manifest after head trauma, the primary signs of a concussion to look for include:

·         Headache

·         Nausea/Vomiting

·         Dizziness/Balance Problems

·         Blurred Vision

·         Sensitivity to Light

·         Sensitivity to Noise

·         Numbness in any part of the Body

·         Can't Concentrate/Mental Fog

·         Can't Remember Events just before the injury

·         Can't Remember Events just after the injury

How does one recover from concussions? Does it just take time or is there something that can be done to strengthen the brain tissue itself? The good news is that, yes, there is something that can be done to assist in recovering from the damage. This practice can benefit the brain and body even if you have not had a concussion.

Tai Chi Chuan

Tai Chi translates to The Grand Ultimate. As a philosophy, it has existed for millennia in both India and China. The martial practice of Tai Chi Chuan around 1,000 to 1,500 years ago in China. Tai Chi Chuan means The Grand Ultimate Fist. For more information regarding the history of this art, there are several fantastic articles at YMAA.com, Yang’s Martial Arts Academy.

Practicing this art, as Catherine Kerr of Harvard Medical School (HMS) and many other studies have confirmed, is a unique culmination of physical and mental concentration and coordination. It brings together mindfulness meditation, light to moderate aerobics, and awareness of self and surroundings and one’s relation to them. It is a practice in moving mindfulness meditation.

Harvard scientists confirmed in 2011 that mindfulness meditation thickens the cortical structure in the hippocampus. This is the portion of the brain that governs learning and memory. By thickening the tissue here, essentially improving the function of the hippocampus, patients are able to learn new skills and improve in memory related tasks as opposed to patients with similar injuries who did not participate in tai chi chuan exercises. Due to this, the Veterans Administration has included Mindfulness Meditation exercises as part of its programs for Veterans dealing with traumatic brain injuries (TBI), PTSD, and anger and impulse control among other issues.

Practitioners also show improvements in up to eight regions of the brain (2). Regions associated with motor and executive functions are two important areas to consider. These benefits have been realized by hundreds of veterans through the SHARE Program at the Shephard Center in Atlanta, GA. As a veteran with TBIs, I started practicing tai chi chuan while at the SHARE program several years ago and still practice today. I continue to experience improvements and changes after five years of practice.

How Much Time is Needed?

As mentioned above, changes have been noted in several regions of the brain. This includes the lingual sulcus (LS). The LS encodes visual memories, logical order of events, and speech processing. Practice in amounts as small as 30 minutes per day twice a week have resulted in changes that are easily seen and tracked on a brain scanner.

One area changed is the Anterior Cingulate Cortex (ACC) behind the frontal lobe. This area is associated with self-regulatory processes. These include, but are not limited to, frustration tolerance, behavior inhibition, and self-regulation. Patients participating in studies of 24 weeks in length have shown improved affect in these characteristics (1).

The thickening of the matter in the prefrontal cortex and resultant tests from several studies show that sturdy participants showed improvements in the portions responsible for executive function and attention. Study participants demonstrated increased capacities to recall lists and tasks as well as complete said lists and tasks. There is also a corresponding increase in thickness of the cortical matter of the hippocampus. This part of the limbic system also governs learning and memory. It is also vulnerable to stress-induced injuries such as PTSD. Being able to repair damage to these tissues and regions is extremely hopeful for patients struggling with these issues.

More importantly than seeing these changes on a scanner, these changes are seen in how the practitioners improve in their ability to function in daily life. By thickening the tissue in the frontal cortex and in both the hippocampus and amygdala. These last two are part of the limbic system and are important to us in that they play a major role in memories, decision making, and emotional reactions. 

Conclussion

Both Tai Chi Chuan and mindfulness meditation have shown to increase tissue density in the frontal cortex, as mentioned already. Tai Chi Chuan increases tissue density in the limbic system. This thickening, as with increased tissue and activity in the frontal cortex, results in improved functions. Test subjects show improved memory recall and better emotional control and response to situations.

Outside of personal my experience and interviews along the way over the past several years, studies referenced include:

Ncbi.nim.nih.gov Tai Chi and Qigong for the Treatment and Prevention of Mental Disorders

Ncbi.nim.nih.gov Tai Chi Chuan Baduanjin practice modulates functional connectivity of the cognitive control network in older adults

a.      This is also applicable to younger patients who have sustained brain injuries

Journal.frontiersin.org Mild Traumatic Brain Injury and Delayed Alteration of Memory Processing

Bibliography

1.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294576/

2.      http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0061038

Preventing and Recovering From Shoulder Injuries

Protecting shoulders from injuries is of paramount importance. It has been for me since the late 90's. As a power lifter, my left shoulder came apart during a heavy bench press set. This piece is rather important to me in that it alleviates some of that pain. I also have a trick right shoulder that is now paying me back for all of those "trick" dislocations I enjoyed while younger.

First, let's understand exactly what we are talking about when we say “shoulder”::

• The humerus (upper arm bone), clavicle (collarbone), and scapula (shoulder blade).
• The scapulothoracic joint, which is located where the shoulder blade (the scapula) glides along the chest wall (the thorax).
• The two large muscles the subscapularis and the serratus. The subscapularis, attaches over the front of the scapula facing the ribs. The serratus anterior attaches along the edge of the scapula nearest the spine, passes in front of the scapula, wraps around the chest wall, and connects to the ribs on the front part of the chest.

That concludes that anatomy and physiology portion of this.

1. Scapular push up

This works your serratus anterior muscle helping to avoid 'winging' of your shoulder blade. It keeps your shoulder blade flat on your rib cage rather than sticking out like a wing.

Assume a pushup position, body straight, core tight. Now, keeping your arms straight lower your body so that only your shoulder blades come together, then push back up to spread your shoulder blades.

2. Shoulder rotations

Grab a towel or resistance band and hold so that your hands are slightly wider than shoulder width. Keep your elbows straight, lift your arms overhead and reach as far behind as possible/comfortable. Return to waist and repeat. Maintain constant tension on the towel.  

3. Ball to wall stabilization

Stand facing a wall at arms-length. Press a tennis ball against the wall at shoulder height. Using small movements start by drawing circles on the wall with the ball. Do this a few times with each hand. Then try a figure of eight or writing your name one letter at a time.

These two exercises will mobilize the small muscles (rotator cuffs) that control and stabilize the joint.

4. Circles 

You may remember these from school. Stand with your hands on your shoulders, elbows pointing out to the side and draw circles with your elbows. Start small and slowly get larger. Repeat in the opposite direction.

5. Symmetry

Push/Pull equally... the body NEEDS symmetry in strength of opposing muscle groups. When you do push-ups, do pull ups or pull downs. If you do shoulder presses then do upright rows. This can NOT be stressed enough.

Now, some stretches to finish with.

1. Maintain Full Shoulder Range of Motion.

Reach behind your neck with one hand while reaching behind your back with you other hand. Try to reach one hand with the other. Gently Pull with one hand and hold for 10 to 15 seconds for three sets. Now, switch hands and note any differences from one arm to the other.

 

Strengthen the Rotator Cuff Region

Internal Rotation:

Stand with your lifting arm closest to the cable machine, with your elbow flexed to 90-degrees. Rotate your hand from outside to inwards, bringing your hand towards your belly.

Or, kneel by a bench and lean over to one side. With your upper arm perpendicular to your body and your forearm perpendicular to your upper arm place a light weight (2 to 5 pounds to start) in your right hand. Allow the weight to bring your hand toward the bench and stretch just a little, touch the bench if you are able. Gently and smoothly raise your hand so that the weight is brought directly over your elbow. Now, repeat for 10-12 repetitions. Stop if there is pain or an unusual discomfort.

Sleeper Stretch instructions

Start the stretch by lying on your side, with your elbow at a 90-degree angle, directly across from your shoulder. Place your head on a pillow to keep your spine straight. While keeping your weight on your shoulder blade, gently lower your forearm with your opposite hand. You should feel a light stretch in the back of your shoulder. Hold for 30 seconds and repeat 3 times. Perform the Sleeper Stretch on your opposite side to compare tightness. Repeat the stretch 2-3 times per day until the right and left shoulders are equal.

Read more at http://www.philly.com/philly/blogs/sportsdoc/Stretching-to-prevent-shoulder-and-elbow-injuries.html#gtmud8c4ekRppbD0.9