Case Study Highlight: Accelerating Adolescent Concussion Recovery with OMT

Background
Concussions are common in adolescents, with traumatic brain injury ranking among the leading causes of disability in young people. While most patients recover within 7–10 days, about 11% experience prolonged symptoms—even with rest and standard therapies.

The Case
A 16-year-old girl, with a history of three head injuries, presented with persistent post-concussive symptoms. Her complaints included severe, pressure-type headaches, vertigo, dizziness, neck and back pain, photophobia, phonophobia, and cognitive challenges. Despite initial treatment with activity restrictions, physical therapy, and vestibular rehabilitation, her symptoms continued to impact her daily life and academic performance.

Clinical Findings
At her initial visit to our Osteopathic Manipulative Medicine (OMM) Clinic (5 weeks post-injury), our evaluation revealed:

• Cranial Dysfunction: Diminished cranial rhythmic impulse with restricted movement in the cranial sutures—particularly in the temporal bone—likely contributing to her balance issues and vertigo.
• Cervical and Musculoskeletal Restrictions: Hypertonicity in the cervical musculature, occipitoatlantal dysfunction, and thoracic inlet restrictions that were contributing to her headache and neck pain.

OMT Intervention
The patient underwent a series of six weekly OMT sessions. The treatment plan was customized to address her somatic dysfunctions through:

• Cranial Techniques: Including sphenobasilar synchondrosis decompression and restricted suture release to improve cranial mobility and enhance cerebrospinal fluid dynamics.
• Cervical and Musculoskeletal Techniques: Muscle energy, myofascial release, and articulatory methods were applied to reduce hypertonicity and restore normal alignment.
• Fluid Dynamics Enhancement: Techniques aimed at promoting lymphatic and glymphatic drainage to clear neurotoxic byproducts and reduce inflammation.

Outcomes

• Immediate Relief: The patient reported significant headache relief immediately after her first treatment.
• Progressive Improvement: Follow-up assessments showed a remarkable decrease in her Concussion Symptom Score (CSS), from 53 initially to 22 after early sessions, and ultimately to 0 by the end of the six-week course.
• Functional Recovery: With symptom resolution, she was able to resume normal school activities, extracurricular pursuits, and overall daily functioning.

This case underscores the potential benefits of incorporating OMT into a multidisciplinary concussion management strategy for adolescents. By addressing the underlying cranial and cervical somatic dysfunctions, OMT helped accelerate her recovery and substantially improved her quality of life. While further research is needed, this case offers promising evidence that OMT may be a valuable tool in managing prolonged concussion symptoms.

References

Castillo I, Wolf K, Rakowsky A. Concussions and Osteopathic Manipulative Treatment: An Adolescent Case Presentation. J Am Osteopath Assoc. 2016 Mar;116(3):178-81. doi: 10.7556/jaoa.2016.034. PMID: 26927911.