Management of concussion symptoms utilizing Mechanical Diagnosis and Therapy: a case series

ABSTRACT

Objective

Concussions are a common condition in athletes leading to symptoms including headache, dizziness, and sometimes vestibular deficits. Concussion management typically involves rest and a gradual return to activity among other interventions. This case series includes three patients who were evaluated using Mechanical Diagnosis and Therapy (MDT) after sport-related injuries involving concussion-like symptoms. MDT is a system of evaluating patients using repeated movements and sustained positions to assess symptomatic and mechanical changes.

Results

Patients in this case series demonstrated rapid reduction of symptoms using variations of repeated cervical movements and sustained positions, which enabled them to return to play with a lasting resolution of symptoms.

Discussion/Conclusion

This highlights the importance of a classification system for the appropriate treatment of these cases who did not require management using concussion protocol, as they were classified as cervical derangement.

KEYWORDS:

• Concussion
• derangement
• directional preference
• McKenzie method

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10669817.2024.2368923

Additional information

Notes on contributors

David J Pleva

David J Pleva is a practicing physical therapist who specializes in the treatment of orthopedic spine and extremity disorders. He has received advanced training in Mechanical Diagnosis and Therapy (McKenzie) and is diplomaed through the McKenzie Institute International. In addition, David has been a member of the McKenzie Institute USA branch faculty since 2003. He earned his board certification in orthopedics in 2019. David treats patient in a private clinic on a daily basis. He has also consulted with numerous industries on the prevention of back pain and ergonomics. David has also provided educational seminars to industry on injury prevention. In addition, David has been an invited speaker to various spine symposiums as well as other professional groups including the American Dental Association, Chicago Dental Association and Illinois Society for Advanced Practice Nursing.

Jared C. Hanson

Jared C. Hanson is a certified athletic trainer who graduated from the University of Nebraska at Kearney in 2002 with a Bachelor of Science degree in Exercise Science with an emphasis in Athletic Training. Jared was introduced to the McKenzie Method in 2008 while working at ARC Physical Therapy+. In January 2012 he passed the McKenzie Credentialing Examination. During his career Jared has worked in both the clinical and secondary education setting as an athletic trainer. He has spent the past 11 years working at Liberty North High School where he utilizes the McKenzie Method on the athletes he works with and treats on a daily basis. Jared is also the Supervisor of Athletic Training Services for Liberty Hospital Sports Medicine. Liberty Hospital Sports Medicine employs over 20 athletic trainers providing athletic training services for collegiate and secondary education level athletics in the Kansas City, MO metro area.

Brian Greer

Brian Greer is a McKenzie Diplomat practicing in Glastonbury, Connecticut. He participated in McKenzie Parts A and B during his clinical rotation at Maccio Physical Therapy in Troy, NY and graduated from Springfield College in 2016 with his doctorate in physical therapy. He went on to become McKenzie Certified in 2017, and became a McKenzie Diplomat in 2019 after completing his Diploma training in Austin, TX. He opened his McKenzie Certified clinic in Connecticut in April 2021. He went on to publish a case report in February 2022 titled “Flexion Directional Preference in a Patient With Low Back Pain, Utilizing Mechanical Diagnosis and Therapy: A Case Report.”