A new client came into my office who had been struggling profoundly with many aspects of life for over a year, as a result of ongoing symptoms from diagnosed post-concussion syndrome. The following is shared and printed with his permission. He had trouble following directions at work and struggled to put his thoughts together and communicate them in a coherent way. Organization was very difficult, which made planning his route for the day as delivery person particularly challenging. He felt in a mental fog all the time and had difficulty concentrating at work and at home. Nausea was an ongoing symptom resulting in very little appetite. He experienced pressure in the front of his head and a pain behind his eyes, combined with a sensitivity to light and sound. Leaving his apartment after work and during the weekend felt like too much, and he had trouble talking on the phone or having conversations in person. As a result, he felt very socially isolated from friends and family. He had trouble sleeping and had very little energy. The least provocation made him irritable, and he felt angry and sad a lot of the time.
Over the course of a few months of weekly Bowen Therapy sessions, he steadily but surely regained himself - his clarity, his sense of humour, his friendships, his ability to work and his enthusiasm. As he said during the process, he was “emerging from the fog.” What a pleasure and an honour to be part of his journey.
What is a concussion and how can Bowen Therapy help
A concussion is a type of traumatic brain injury (TBI) that is defined as:
a change in brain function following a force to the head which may or may not be accompanied by a temporary loss of consciousness, and is identified with measures of cognitive and neurologic dysfunction.
The diagnosis of a concussion can be challenging as;
- physical and cognitive exams can be normal, and MRI's, CT scans and blood tests are also usually normal as well. Concussion symptoms can be immediate and/or delayed onset and balance testing can normalize more quickly than other symptoms often complicating diagnosis.
Recovery from concussion occurs in 80 - 85% of cases within 7 - 21 days. But according to the Centre for Disease Control (CDC) up to 15% of people diagnosed with concussion will have ongoing persistent symptoms, classified as Post Concussion Syndrome. Adolescents under 15 years old are 45% more at risk for a concussion than adults because their brains are physiologically still developing, resulting in greater volume of water and blood in their brains, a lower degree of myelination, changing skull geometry and less neck strength.
What are the symptoms of a concussion or post concussion syndrome?
Concussion symptoms fall into four categories and can include any of the following and more:
Sleep Change Symptoms
Sustaining a concussions can be extremely distressing, debilitating and lifealtering no matter the age, interests, or stage of life of the individual suffering from the injury. If the symptoms of a concussion are ongoing this can be extremely concerning.
- Students may have difficulties remembering things with implications for taking in and retaining information for exams.
- Athletes may not feel 'right' and be unclear about the Return To Play protocols.
- Employees may find that they are having difficulties with instructions and the ability to complete projects, with stressful implications for job security.
- Relationships may be affected due to changes in memory, concentration and mood and the physical effects of the concussion. Intimacy with a partner may be affected. The ability to interact with family members also may be affected.
- The elderly may find memory loss and balance issues to be extremely concerning.
- Sleep deprivation – can magnify all of these already challenging life changes.
What is the physiological nature of a concussion?
During a concussion there is a physiological cascade of events that happens in the brain. Initially, there is a mismatch between glucose supply and demand in the brain, resulting in an energy crisis as the brain tries to regain homeostasis. During this time, cellular metabolism is stretched to the limit, leaving brain cells vulnerable and much less able to respond to further brain injury. Post concussion cognitive and physical rest become essential.
During a concussion there is an initial release of neurotransmitters and particularly glutamate. This leads to an imbalance of calcium and potassium ions which results in changes in cellular physiology. The sodium/potassium pump works extra hard to try to restore balance in the cells during this time, requiring extra ATP, which in turn requires extra glucose, resulting in a hyper-metabolic state.
This increased need for glucose and blood flow happens at a time when the brain is experiencing a decrease in blood flow resulting from the head trauma. This mismatch between glucose supply and demand results in an energy crisis in the brain as it attempts to regain homeostasis. During this time, cellular metabolism is stretched to its limit, leaving brain cells more vulnerable to further injury. Post-concussion cognitive and physical rest are essential.
The above simplified view of the of the initial cascade of events is followed by the brain going into a period of slower than normal glucose metabolism, and can also be followed by an increase in lactic acid, free radical production, and inflammation, a decrease in intra-cellular magnesium, and altered neurotransmission.
How can Bowen Therapy help?
Bowen Therapy is a wonderful whole-body technique. Some people may have heard of Bowen Therapy but may not be aware that it can also help concussions.
Bowen Therapy helps to rebalance the Autonomic Nervous System, which is extremely important after a concussion and helps to initiate the healing process. Bowen Therapy also increases blood, nerve and lymph flow, all critical in concussion recovery. A recent study has shown that lymph flows in the brain which was not previously known. Bowen Therapy involves a rebalancing of the lower and upper body and neck. This is very important in the concussion recovery process, as the body may have begun to take on some compensating patterns, and the neck may have sustained a strong flexion or extension force, which is particularly true in the case of whiplash injuries.
The TMJ may also may have been affected in a concussion injury. Bowen Therapy is very helpful in rebalancing the TMJ, which is important in increasing blood supply and rebalancing the vestibular system or balance system after a concussion. The TMJ is closely related to the trigeminal nerve which controls most of the blood supply to the anterior part of the brain. Bowen Therapy work on the TMJ is at the core of addressing the trigeminal nerve.
When the body's innate healing process has been stalled due to a head trauma, this can result in a slow recovery. In cases of post concussion syndrome, Bowen Therapy can be very helpful in restarting a stalled healing process. It's a bit like providing the spark plug to the engine. Bowen Therapy encourages the body to remember how to heal and return to it's original blueprint or homeostasis which is the body's most efficient recovery process. In effect Bowen is helping to override the slow stalled recovery process. It can also help to speed up the healing in cases where the concussion would have resolved on it's own.
The number of sessions required to help resolve symptoms depends on how long it has been since the concussion. The sooner a concussion is addressed, generally the fewer the number of sessions required. The most optimal time to start Bowen Therapy is 24 - 48 hours after a concussion. There can be a delay in symptom onset, and this gives time for symptoms to fully surface. Acute concussions sustained within a few days to weeks will likely require 2 - 4 sessions. Medium to long term concussion symptoms will likely require weekly sessions ranging from approximately 5 up to a few months.
Return to Work and Return to Play protocols as outlined by a primary care physician or physical trainer can be begin once symptoms are no longer present.
 Cognitive Rest May be Crucial After Concussion; Neurology Reviews. 2014.
 M. McClincy, “Recovery from sport's concussions in high school and collegiate athletes”, Brain Injury. 2006
 Human Anatomy and Physiology 7th Edition, Pearson International Edition
 F. Paparo. “Anatomic Relationship between trigeminal nerve and temporomandibular joint”, European Review for Medical and Pharmacological Sciences. 2008.
 R. Lang, “Neurogenic control of cerebral blood supply”, Experimental Neurology. 1974