It takes 90-100 grams of force to cause a concussion but only around 5 grams of force to cause a whiplash injury. I would argue that you would be hard pressed to find someone who suffered a concussion that did not also sustain a neck injury. An injury to the neck can also cause headaches and dizziness – the top 2 symptoms reported after concussion. Many times, the neck is overlooked because the person may not have neck pain. If you feel dizzy and have a headache most of the time, you may not notice pain elsewhere. Even if you are 100% sure that you don’t have neck pain, you still need a comprehensive screen to rule out the neck as a cause of your symptoms.

What should this screen include?

1. Cervical Active Range of Motion
   1. Your physical therapist should measure your motion to check to see if it is normal and symmetrical. You should also note if any direction feels stiff or painful.
2. Ligamentous Testing
   1. Your physical therapist should check the ligaments in the upper cervical spine to make sure they are intact. If there are any concerns, your doctor may order additional imaging.
3. Cervical Joint Glides
   1. Your physical therapist should press on different parts of your neck to make sure the joints are moving easily and painlessly. They should focus on the upper part of your neck.
4. Cervical Muscles
   1. Your physical therapist should apply pressure to several muscles on your neck to determine if they are excessively tight and to see any symptoms are re-created.
5. Cervical Proprioception/Kinesthesia
   1. Your physical therapist should check to see if the your neck muscles are sending appropriate sensory information to your brain. This can be assessed through several tests that look a joint sense and neck motor control.

These 5 areas should be assessed at a minimum to screen the cervical spine. There are more detailed tests and examination procedures that can be done to fully evaluate the neck so that a individualized treatment plan, if needed, can be developed. By screening these 5 areas, your evaluating clinician will know whether you will need a more comprehensive assessment.

 

ABOUT THE AUTHOR

Dr. Etheredge is a physical therapist who specializes in treating patients with headaches, neck pain and dizziness. Many of her patients have multiple diagnoses and complex needs. Dr. Etheredge is certified and dry needling and has been using this modality for years to assist her patients in achieving their goals. Learn more about Dr. Etheredge here .