Effective Neuroscience Therapies That Help Sport Concussion/TBI Recovery
Every so often, a startling news headline grabs our attention: a former athlete entangled in a case of domestic violence, or even more shockingly, involved in a murder. While such extreme cases are rare, a disturbing pattern emerges when we look closer—many of these athletes have a history in sports notorious for high risks of brain injury, like football and combat sports. But is there more than meets the eye? A groundbreaking 2010 study by Rao suggests a link between traumatic brain injuries (TBIs) and increased aggression. The consequences of untreated TBIs are vast and alarming, and often athletes, as well as active individuals, may not fully comprehend the severity of their concussions. The adage 'one concussion is one too many' rings especially true in the world of sports, where repeated head injuries are not uncommon. A head injury can cause more than just unusual aggression. It can cause a dysregulated nervous system, dizziness, and headaches, and trauma symptoms. This issue hits close to home for me too. Despite not being a professional athlete, I've experienced the lingering effects of a 'minor' concussion from a skiing accident, underscoring the hidden impacts these injuries can have on anyone.
Concussions in athletes are unfortunately extremely common. The Centers for Disease Control estimates that 5-10% of athletes will experience a concussion in any given sports season. There are about 3.8 million concussions that occur each year in the U.S. from sports-related injuries. Many of these injuries go unreported and undiagnosed. This leads to prolonged symptoms and long-term consequences.
It is CRUCIAL that one seeks early intervention for a concussion. The recovery rate seeking therapy is 80-85% in the first 21 days and 11.4-38.8% if someone waits for intervention.
Here are some more alarming statistics. When a child endures a traumatic brain injury (TBI), their cognitive stalls in crucial brain developmental years about teens to early 20’s. Many professional athletes start as young children. The consequences affect their school performance. They are 3 times more likely to be suspended, expelled, or quit. 32%-40% drop out of high school. Only 5-10% complete college.
When athletes endure a physical injury, their nervous system can be both in a hyperactive and hypoactive state. Hyperactive is the alert state (fight/flight) and the hypo is the depressive state (freeze). Many times athletes don’t realize they have a depressed nervous system. This can show up as anger, lack of focus, misuse of substances, loss of enjoyment in their sports, and other passions they used to have.
Physical therapy is not enough to recover from a TBI. As a certified Brainspotting Practioner and trauma therapist who has done athletic sports performance & injury training, I looked into innovative therapies that can tremendously help a TBI especially if treated early.
1.) Brainspotting
Besides a medical doctor visit and physical therapy, psychotherapy should be first line of defense in recovery treatment and done concurrently with physical therapy and a medical doctor. I’m not talking about a behavioral-based therapy such as CBT (cognitive behavioral therapy). Positive self-talk and reframing are all great but there needs to be effective trauma treatment involved. Trauma is a nervous system issue and it is stored in the deep brain. Therapies such as Brainspotting and EMDR access this region. The patient can release the trauma that is stuck utilizing this treatment. This may also relieve physical symptoms such as headaches and help with emotional regulation. Brainspotting is a relatively new form of treatment stemming from EMDR. Over time, Brainspotting can help create new neural pathways in the brain.
In a Brainspotting session, the patient will be asked to “Bodyspot” the area of the body that is injured. This will help stimulate a nociceptor in the brain that will help focus more on that part of the body (Roberts P., LCSW). Then the client will find a fixed eye position that will activate the trauma (with resources to prevent flooding) to help release the stuck trauma in the brain.
Brainspotting can help with recovery:
Help stimulate and strengthen the vagal nerve to increase gut motility to prevent SIBO (a gut condition called Small Intestinal Bacteria Overgrowth). There are a lot of nerves in the gut and a concussion can shut down brain-to-gut neurons causing a decrease in gut mobility (Roberts P, LCSW).
Regulate a dysregulated nervous system from the hyper/hypo state to a state of coherence by accessing deep brain parts.
Turning the brain’s unconscious scanning and monitoring itself for healing and repair of cells (Roberts P, LCSW).
Using the eye reflexes to decrease inflammation in the brain.
This is a modality I use as a practitioner to help patients recover from trauma including traumatic brain injury. Depending on the severity of the athlete’s symptoms, they may also require these other therapies listed below:
2.) Neuro Ocular Therapy
Between 69% and 82% of people who’ve experienced concussions report visual problems (Visual Symptoms Treatment Center 2022). This can cause many issues such as difficulty in sight (double vision or blurred), headaches, and dizziness. Head trauma causes the brain to move within the skull. Tjis can move cranial nerves and can cause damage in brain cells. A concussion can disrupt neuro pathways between the eyes and the brain.
Luckily the brain is maulable and we can help create new neuro pathways to help with this issue. Neuro-optometric therapy is a customized eye exercise program designed to rehabilitate visual skills.
Neuro-Optometric therapy can treat:
Double Vision
Tracking and scanning problems
Inability to sustain fixation or focus
loss of central vision
Strabismus
Convergence Insufficiency
Visual Field Loss
Visual Neglect (lack of response to stimuli in one half of one’s visual field).
Neuro Optmetry therapy not only helps with TBI and concussions but it can help with Cerebral Palsy, Parkinson’s disease, Autism, Multiple slerosis, and diabetic neuropathy.
Therapy usually is a 12-week duration with a once-a-week session.
3.) Vestibular Therapy
Vestibular therapy is a specialized physical therapy where therapists provides exercises to help improve gaze and stabilization. Concussions often affect the brain’s ability to tolerate head movements and eye movements. This can cause Dizziness, spinning sensation, balance problems, and difficulty reading.
Vestibular involves the inner ear where we get our balance. However, vestibular therapy helps not just the inner ear problem but helps improves the relationship between the inner ear, brain, eye, muscles, and nerves. This rehabilitation is recommended if dizziness and movement issues persist after a concussion.
Each patient’s treatment plan will be different but on average it is expected to be 4 to 8 weeks with sessions once per week. Therapy will consits of simple exercises to help focus on improving dizziness and tightness.
4.)Photobiomodulation (Red Light Therapy)
Red Light Therapy has been around for many decades but finally getting some traction in the mainstream. Most people know it as a beauty device used to create more collagen production. I have one of these expensive masks and it does help with my skin although I am not sure if it’s because of other products I use on top of it. Despite the skin benefits, It does much more than make your skin look more youthful!
The first known scientific findings of photobiomodulation was in 1967 by Budapest scientist by Professor Endre Mester when using it for rats to see if it would cause cancer (Look, I am not a fan of animal testing either…). He found that it did not cause cancer but induced hair growth. This started years of more research on photobiomodulation and its effects and there are now thousands of random controlled studies on this.
Red Light Therapy uses a low-level laser light that delivers red and near-infrared light to the areas of your body. This helps regenerate (grow back) cells, restore cell function, and help improve blood flow. The effects of this are reported to relieve pain, reduce muscle soreness, improve collagen production, wound healing, and better mood. This is a popular therapy for those in the biohacking community and athletic communities.
A photobiomodulation therapist would use one of these high-grade red light and infrared light decides on the scalp to penetrate certain parts of the skills to affect the health of the brain tissue. These wavelengths have antiinflammatory effects on specific brain cells called microglia. These cells are thought to play a role in mediating the immune response in the brain. This helps with energy production and blood flow to the brain which in return speeds up the recovery time of damaged neurons.
The results of this include improvement to working memory, mental flexibility, self-regulation, better sleep, learning, and attention.
Typical treatments range from 10-30 minutes with visits 3 to 6 weeks out of 18 visits.
You can purchase a medical-grade red light therapy yourself. They are expensive though and you have to do your research to find a legit one and not a knockoff. The ones for home are good for muscle soreness and skin. If you are looking for red light therapy for the brain it is best to go to a photobiomodulation therapist since they have the right tools for this.
5.) Neurofeedback
Neurofeedback is a form of biofeedback and is often referred as EEG-Biofeedback. Biofeedback measures and records physiological functions like heart rate variability and hand temperature. With neurofeedback, it measures, records, and displays back to the patient their brain activity. This helps enable the patient to improve brain function to a more coherent state. This improves performance and emotional health.
There are several types of Neurofeedback treatments. I will discuss a more common type called EEG Neurofeedback.
To understand how neurofeedback works, you have to know the different types of brainwaves (drake institute):
Delta Waves- slowest frequency in waves. Shows up in deep sleep.
Theta Waves- Occur at a slightly faster frequency but still slow. This shows up in daydreaming or drifting off. Excessive amounts show up in Attention Deficit/Hyperactivity Disorder.
Alpha Waves- Occurs predominantly in the posterior region (spatial attention and eye movement) of the brain. Shows up in a relaxation state or meditation.
Beta Waves- Occur at a higher frequency range in the brain. Shows up when we are actively engaging in focusing on tasks such as homework or job-related tasks.
Neurofeedback is like going to a brain gym. When the EEG detects that a patient’s brain wave activity has met the goals of treatment, the brain is rewarded with positive feedback. This could be a larger movie screen, a higher score on a video game, or pleasant audio feedback.
Typically there will be a noticeable response to treatment with 10-20 sessions but 30-40 sessions are generally needed for the brain to retain what it has learned.
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More types of therapies can help with brain health and improve concussion recovery. This includes other physical therapies and a good diet/nutrition plan. A good recovery plan involves a team of different specialists to help you in different areas. It is a good idea to always start with a medical doctor. I hope this article not only brings hope and knowledge to access better brain health within the sports community but also a reminder concussions are no joke and should not be ignored! I have more resources if this is an issue you are currently dealing with so feel free to reach out!
References:
Visualsymptomstreatmentcenter, Can your vision change after a concussion?, April 26, 2022
Paige Roberts LCSW Performance Neuro Training
Drakeinstitute, Neurofeedback Therapy for Traumatic Brain Injuries, 2024
University of Michigan, Brain Neurological Conditions,
