A recent injury suffered by NHL’s hockey star Sidney Crosby of the Pittsburgh Penguins has brought public attention to the link between soft tissue injuries of the spine and to concussions, a form of mild brain injury. Mr. Crosby sought treatment for concussion-like symptoms after a game in which he suffered a blow. However, after nearly 13 months of persistent concussion-like symptoms his condition remained unchanged. Consultations with multiple medical providers in California have revealed that he is suffering from swelling of the C1-2 joint of his neck. He has been diagnosed with a cervical soft tissue injury and has began a course of treatment. This injury has impacted Mr. Crosby, his team and the thousands of fans as he continues to be sidelined from the game while he recovers.
While the injury of this well-known NHL player is bringing public attention to the link between soft tissue spinal injury and the brain, many victims of auto-collisions have been seeking medical treatment in an attempt to heal from these same types of injuries.
At times, those in auto accidents will state they suffered from whiplash. While some may use the term ‘whiplash’ as a medical diagnosis, this word actually is meant describe the mechanism of injury. Upon impact, the vehicle that was rear-ended and its occupants, are quickly accelerated forward and backward. It is this cervical acceleration-deceleration that leads to cervical (neck) injury and concussions.
Why do concussions occur in those who experience soft tissue spinal injuries? Well, first one should take into consideration the make-up of the brain. It is a small, weighing approximately two and a half pounds and its substance or density is gel-like. The brain is then encased within a bony structure (the skull) that rests on the spinal column. The spinal cord is also a delicate structure. The spinal cord itself is long and tubular made up of sensitive nervous tissues and cells. Together, the spinal cord and brain, make up the central nervous system.
During an auto impact, these delicate structures are then forced to endure the blow of moving vehicles whose weight is anywhere from 2,000 to 3,000 pounds. Besides the weight of the vehicles, auto collisions typically occur when one of those vehicles were traveling at high rates of speed prior to impact and then they collide with another vehicle that was, as is true in many cases, at a complete stop. Complicating matters is that the weight of vehicles is going up. A study in 2004 indicated that vehicles made in the U.S. were averaging a weight of 4,021 pounds.
In 2000, a study was published entitled ‘Is there a relationship between whiplash-associated disorders and concussion in hockey?‘ The 183 hockey players used for the study were from 20 different teams. The authors stated that ‘the athletes studied in this investigation experienced symptoms of both WAD [whiplash associated disorder] and concussion after a head and/or neck complex acceleration/deceleration injury. However, the number of concussion symptoms they experienced did not associate with an increased severity of WAD [whiplash associated disorder] grading…Based on the observed prevalence of symptoms of both WAD [whiplash associated disorder] and concussion irrespective of the mechanism of injury, it is important for the clinician treating a patient or athlete for WAD [whiplash associated disorder] to evaluate for symptoms of concussion and…to be cognizant of conducting a thorough cervical evaluation when dealing with concussed.’
This study, while focused on hockey players, is useful for anyone suffering from soft tissue spinal injuries and those medical providers treating them. It clearly demonstrates that symptoms of a brain injury such as concussions can overlap with cervical spine injury. As seen with NHL player, Sidney Crosby, this is of particular concern for those patients who are not recovering from their symptoms.