In this episode of Ask Concussion Doc, Dr. Cameron Marshall, DC, discusses the history and mission of Complete Concussion Management; the potential role of mouth guards in concussion prevention; and vestibular rehabilitation in concussion care.
Mouth Guards and Concussion
Currently, there are no studies that fully support mouth guards as a preventative measure for concussion injuries. There are some studies that show mouth guards may protect against concussions and others that show the opposite. In fact, Hockey Canada states that “their role in preventing or reducing the severity of concussions has not been scientifically proven.”
That said, athletes should wear a mouth guard, and we believe it should be mandatory in sports. It’s unclear if what you put in your mouth or around your skull will not change the forces acting on the brain. Ultimately, there is a need for additional research.
Importantly, a mouthguard is proven to help prevent jaw and dental injuries. So, we recommend wearing one. But, we must understand that a mouth guard will not prevent or limit your risk for concussion. Dr. Marshall discusses in detail in this episode.
Vestibular Rehabilitation in Concussion Care
There are a number of studies that look at vestibular rehabilitation for sports-related concussion where return to play is an outcome measure. In fact, one of the better studies was based out of the University of Calgary and published in the British Journal of Sports Medicine. The study concluded that patients that received multimodal physical therapy treatment “were more likely to achieve medical clearance before 8 weeks when compared with rest in individuals with persistent symptoms” following sport related concussion.
Is rest the best approach to concussion care? Definitely not.
In this episode, Dr. Marshall discusses the pros and cons of some of these studies as well as the benefits of a comprehensive, multidisciplinary approach to concussion care. Vestibular rehabilitation is often one component of concussion management. Other strategies may include manual therapy of the neck, cervical spine rehabilitation and vision therapy, for example.
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 Facts and Prevention. Hockey Canada. Available at: www.hockeycanada.ca/en-ca/hockey-programs/safety/concussions/facts-and-prevention.
 , et al Cervico-vestibular physiotherapy in the treatment of individuals with persistent symptoms following sport related concussion: a randomised controlled trial.
 Reneker JC, Hassen A, Phillips RS, Moughiman MC, Donaldson M, and Moughiman J. Feasibility of early physical therapy for dizziness after a sports-related concussion: A randomized clinical trial. Scand J Med Sci Sports. 2017;27:2009–2018. https://doi.org/10.1111/sms.12827
Dizziness after sports-related concussion: Can physiotherapists offer better treatment than just ‘physical and cognitive rest’?