Beyond Concussion: What If It’s Just a Head Injury?
“My daughter fell on the playground at school. The ER says there is no concussion. She took a pretty good hit in the face. Should we come in?”
Each year, nearly 200,000 children, ages 14 and under, require emergency room treatment due to playground falls.
- The most severe playground-related injuries are due to falls.
- More than half of all playground-related injuries occur in children ages 5 to 9.
- Children ages 4 and under tend to suffer injuries to the face and head from playground-related injuries, while older children are more likely to injure arms or hands.
Panic. Fear. You spring into action to make sure your child is ok. If not, off to the ER or Urgent Care you go. Once assured that things are ok, you still observe. Is everything ok? Sometimes, not.
For example, we just met a kindergartner at the end of the summer related to an on-going elbow issue. A few weeks later an unexpected call from Mom came in; the day before her daughter had had a playground accident. Mom was worried that the impact to her head was a concern. She was right. More of this story follows.
During October, I am focused on different scenarios of head injury and how the Kinetic Konnections’ unique perspective addresses overlooked aspects which are essential to recovery.
These four head injury scenarios will be discussed this month:
- Cleared, but still struggling (read here)
- Not a concussion, just a head injury (this week)
- Lost my balance again
- The unsuspected head trauma
Putting Humpty Dumpty back together
It happens. Children need to explore and take risks. Playgrounds provide a great environment for this, but kids will be kids whether they horse around or bump into each other. (Bunk beds are also ripe for the same unintended injuries.)
When playing at the park so much can happen — falls, being bopped by equipment, or even bumped into by other children at the park. Most of the time some ice, a colorful bandage and a kiss will do the trick. When all is not ok, a visit to urgent care may be in the cards.
Once the injuries are cleared by a physician, Kinetic Konnections is ready to put head and body back together in working order.
Let’s consider a different perspective
At Kinetic Konnections we look at a completely different aspect of an injury. We take your entire history into account looking at how your head, core, and limbs currently work together compared to how they are naturally supposed to work together.
Some of the unique information we gather and use in our problem-solving includes:
- What exactly occurred in the injury event? (and what else occurred that you don’t recall based on the logistics of the event.)
- Which of the fundamental head and body movement relationships were impacted?
- How was the integration of key sensory systems affected? (Vision and vestibular/balance)
- What prior injuries also impacted the foundational head and core movement relationships?
- Were the head/body relationships compromised from early developmental factors?
While these questions may seem unrelated, the answers are important. Answers to these questions lead us to the missing piece of your puzzle of why your child still feels off.
The case of the kindergarten playground fall — the details
What exactly occurred?
Our young student was balancing on the short piers which make up a balance section of the playground scape. Another child bumped into her, throwing her off-balance. Falling to her right side, the platform of the play structure broke her fall. Her jaw and front teeth impacted the platform leaving blood everywhere along with two loose baby teeth. With such impact to the face Mom was called and off to the ER they went.
Mom called the next day wanting to know if she should just wait until the scheduled follow-up appointment in November or come in sooner. Experience tells us the upward impact to the chin should be checked out for less obvious consequences. She was able to come in about three weeks after the fall, enough time for the mouth injury to heal.
Which of the foundational movements were impacted?
Two aspects of the fall become key — the momentum of the fall was off to the right side so there was a torque upon impact. The second insight is the head to core relationships thrown out of sync in more than one dimension. The head stopped at the platform but the upper body kept going. Momentum from the fall ended up stressing two places–her upper jaw compressed upward, and her neck/upper back elongated forward.
- A key job of the muscles and bones is to absorb impact. This event was not the sort of impact our muscles are designed for. We reconstructed the positions of what happened supporting her body in the way it landed. We then re-organized her body-head relationships back to baseline.
- In order to re-establish the head/torso movement relationships, we got creative. We rested her body on a soft peanut-shaped ball while we supported her jaw at an angle similar to impact. As we supported the positions of impact we lightly oscillated her shoulders until the muscle relationships between the head and body were are able to match up again. Everything suddenly felt lighter!
Are there Sensory System Integration Issues?
Yes! Testing her balance relationships revealed the sway control (ability to keep oneself safe when off balance) was gone awry. This left her primed for future falls because her poor reactions would not keep her safe. The loss of balance control was the most significant remnant of the entire event.
A significant part of the session was spent on restoring the synchronous reactions between her feet, core and head. For these essential balancing movements the body and brain should sense when we are off-center, react, and self-correct. The body is amazing at reconstructing these relationships given some support and guidance. Going through the process of reintegration looked like we were making her dance.
There had been prior elbow injuries. Because she had been in for an appointment the month before, these were not a factor with the current injury.
How correct were the head/body relationships to begin with?
There was an indication that arm relationships were not 100% with the first visit. (Three elbows injuries at earlier ages.) Something wasn’t transitioning well at the elbow. Because this was addressed in the initial session it did not seem to be a factor in the current injury.
She left looking more in control with her movement and with a calmer demeanor. Her integration of balance and motor skills looked great! She will check in again later this fall.
A unique five-step process to get you back to better function
Our first step is gather injury information and assess key aspects of stability, balance, symmetry and visual-motor function.
Step two is to re-center the movements of the body and of the head, and link the arms and legs. We use the gentle Bridging technique movements to do this, and often begin from a position of reconstructing the event. Essentially, we back-up the body’s structural relationships to the point before they got off track and help erase the way the forces and torques changed them.
Step three is to refresh all the correct relationships so the body remembers how it is structurally supposed to work. Restoring muscle memory is one way to think of this.
Step four is to refine the relationships of the body, head, eyes and balance system. Sometimes this falls into place just by centering the head and body.
Step five when needed, is a more complex step to account for skewed movements from early years of development, and/or prior injuries. This is a critical step that we uniquely consider at Kinetic Konnections and it makes a difference!
In our FB videos I share a more detailed explanation of how we resolve head injury issues using the Bridging technique. (You do not need a FB account to watch)
Typical concussion recovery steps are outlined in this article.
Statistics about playground injuries.
A study of injury prevalence by type of playground equipment. (The merry-go-round is not the bad apple we thought it to be!)