Friday, December 18, 2015

CONCUSSION - Increase Neck Strength To Reduce Risk of Concussion

Strengthen Your Neck – Reduce Your Risk For Concussion

With Will Smith’s new movie CONCUSSION coming out, parents concern for their children’s safety in high impact sports is growing. As their concern grows, fear grows in the NFL that this movie and the condition it’s named after could have serious impact on the sport of football and open up a can of liability worms that they wanted to keep covered up. But there is good news.

According to several studies, increasing the strength of your neck can reduce the risk of concussion. One study specifically states for every one pound increase in neck strength, odds of concussion decreased by 5% 1.   Concussion can occur from a direct blow to the head or due to a phenomenon called “contre-coup”.  A direct blow causing direct impact and inflammation or the contrecoup where the body takes a hit and the head lags behind the momentum-striking one side of the skull, then after momentum shifts the other way, the brain rebounds and strikes the other side of the skull.  

A direct blow is more obvious. A boxer strikes his opponent in the head causing the injury to the brain or a football player takes a direct blow to the head. However in the contrecoup, the concussion is less obvious to those unfamiliar. The athlete takes a blow to the body, the body suddenly changes direction while the head and neck lag behind. This is when the first brain-to-skull impact occurs. The brain strikes the inside of the head because the body just shifted direction and the brain is literally floating inside the skull. Then, as the momentum catches up to the change in motion, the brain strikes the opposite side of the skull as the whipping motion stops. This can occur when one player collides into the body another, it can happen if you slip and fall or if you get into a car accident.

Think about shaking a walnut in the shell. Every time the walnut hits the inside of the shell-think about your brain hitting the inside of your skull. With each strike, the brain gets bruised and inflamed. The more inflammation-the more damage.

Increased muscle strength plays an important role in slowing down the momentum of the head/neck caused by the impact trauma. Stronger necks = less severe concussion.  Why? Because the stronger the neck muscles are the more they resist the contrecoup whipping motion.  This is why evaluating neck strength should be a part of every child’s pre-season assessment and neck strengthening should be part of every coach’s pre-season strength and conditioning program.

The question is, how do you strengthen your neck? There are numerous ways. First, get an examination of the neck to make sure it is stable and there are no underlying issues. Next, complete a baseline SCAT (Sports Concussion Assessment Tool) evaluation. It’s important to have a SCAT completed pre-season in case  a concussion occurs during the season, there is a baseline to compare it to so the athletic trainer or team physician can make appropriate decisions on the athlete's behalf.

In my opinion, neck strengthening should consist of base strength (just get those muscles strong) and functional strength. Functional strength is increasing muscle strength and coordination in such a way as those muscles are used in real life.  These are programs I do with my athlete patients as well as those patients with post whiplash trauma, recovering from neck surgery rehab patients and anyone suffering from the effects of herniated or bulging discs. Neck strength and stability can go a long way to aid your recovery. And, in light of recent research, to help mitigate the effects of a concussion.

Feel free to contact me to discuss a neck strengthening program that’s right for you.

Dr. Todd Narson
Diplomate of the American Chiropractic Board of Sports Physicians


1.     Neck strength: a protective factor reducing risk for concussion in high school sports. Collins CL, Fletcher EN, Fields SK, Kluchurosky L, Rohrkemper MK, Comstock RD, Cantu RC. J Prim Prev. 2014 Oct;35(5):309-19. doi: 10.1007/s10935-014-0355-2.

2.     The influence of cervical muscle characteristics on head impact biomechanics in football. Schmidt JD, Guskiewicz KM, Blackburn JT, Mihalik JP, Siegmund GP, Marshall SW. Am J Sports Med. 2014 Sep;42(9):2056-66. doi: 10.1177/0363546514536685. Epub 2014 Jun 13.

3.     Effect of neck muscle strength and anticipatory cervical muscle activation on the kinematic response of the head to impulsive loads. Eckner JT, Oh YK, Joshi MS, Richardson JK, Ashton-Miller JA. Am J Sports Med. 2014 Mar;42(3):566-76. doi: 10.1177/0363546513517869. Epub 2014 Jan 31.

4.     What are the most effective risk-reduction strategies in sportconcussion?Benson BW, McIntosh AS, Maddocks D, Herring SA, Raftery M, Dvorák J. Br J Sports Med. 2013 Apr;47(5):321-6. doi: 10.1136/bjsports-2013-092216. Review


Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

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