Concussion Treatment via C.A.R.E.N

With sports being a huge part of many people’s lives all over the world, there has been a clear increase in sports related injuries. In fact, one of the most common injuries seen around the board is a concussion. This injury in particular is a traumatic brain injury that is caused when there is some kind of force trauma to the head. While the brain is covered by the skull and the fluid surrounding it, sometimes that is just not enough to prevent a concussion.

Concussions definitely occur more in athletes that participate in contact sports like football, soccer and rugby, but this injury can happen to the average person in everyday life. A person can develop a concussion by simply slipping and hitting their head. It really depends on how hard the impact was. That is why, besides athletes, children tend to experience concussions as well. Kids are always falling down, whether they are playing in the local park or just walking around the house.

In order to diagnose a head concussion, whether it is a mild concussion or one much more severe, the doctor must take a look at what kind of symptoms the patient is showing. Some concussion symptoms include not being able to think straight, a loss of consciousness, headaches, blurred vision, dizziness, trouble concentrating, loss of balance and nausea. While anyone can suffer from a head concussion, there are certain people who are much more prone to developing one. These individuals are people with balance disorders, epilepsy and vertigo. That is because these conditions tend to cause those who suffer from it to faint, causing them to hit their head in the process. However, concussion treatment can actually be tough at times because there are so many symptoms of concussions. Doctors usually have an easier time treating an individual who is only experiencing one symptom, as opposed to numerous concussion symptoms.

If a person ends up with a concussion more than one time, they could suffer from other neurological disorders, which have similar conditions to Alzheimer’s and Parkinson. In fact, there is a lot of research out that shows that athletes who experience a head concussion and then return to their sport too soon before entirely recovering are at least 5 times more likely to injure themselves again. That is why, whether a person has a mild concussion or a severe one, they must be completely treated before they head back out on the field to take part in sports again.

A lot of times when patients have gone through a concussion, they end up also suffering from post concussion syndrome, or “shell shock” as it is also known as. These symptoms vary in length. Sometimes they only last a few days, while other times it could happen sporadically for over a year. That is why usually a doctor will only diagnose a patient with post concussion syndrome if the symptoms of concussion last more than seven to ten days. This condition causes very similar symptoms found in concussions like headaches, nausea, difficulty concentrating and emotional disturbances. Dizziness is usually the most common symptom. However, for some of the more severe cases, there are concussion symptoms like amnesia and personality changes. In about 40 to 80% of these cases, though, the patient first experienced a mild concussion.

Unfortunately, it is very common for symptoms of post concussion syndrome to be completely brushed off by doctors, or even misdiagnosed. That is why the patient themselves must keep track of what they are feeling and experiencing in order to properly treat this condition, since there is no cure for it. Thankfully, though, this syndrome and its symptoms of concussion do go away on its own if the proper treatment is in place.

We here at NY Dynamic Neuromuscular Rehabilitation offer the very best treatment plans for anyone who has suffered from a concussion. For starters, with those that have experienced a severe case of post-concussion syndrome, we will employ behavioral therapy, such as stress reduction. That is because by simply eliminating stressful situations out of the patient’s life can reduce the risks brought upon by a concussion or post-concussion syndrome. While treatment is always important, it is especially vital for those that have encountered severe trauma. Plus, this treatment should be put into effect right away. When there is a delay in either diagnosis or treatment, the patient is now left with the chance of longer lasting symptoms of concussion.

Intracranial injuries are definitely becoming a growing concern for everyone alike, not just sport coaches and doctors. That is why there is always new studies being done on traumatic brain injuries. As research is continually coming in on what needs to be done to not only treat, but prevent these types of injuries, it is clear that Virtual Reality is currently the best rehabilitation method out today.

Today, there are not that many concussion treatment options available. However, as mentioned, there is Virtual Reality(VR) and that is one that has been proven to be both safe and effective. VR treatment for concussion was pioneered in the military where brain trauma is a common type of injury. Virtual Reality is a concussion treatment that specializes in brain injuries. It is by far one of the most successful methods that doctors, as well as us here at NY Dynamic Neuromuscular Rehabilitation, can offer to patients. It works by placing individuals in a virtual and immersive environment, so that they can start rehabbing without the potential of any more damage occurring. In other words, the patient feels, thinks and acts in present time, although he is actually in a computer stimulated setting. The treatment, in turn, measures how mild or severe the injury is without any more injury to the brain.

One of the most common, and effective, virtual reality models is the C.A.R.E.N, also known as the Computer Assisted Rehabilitation Environment. It works by having a patient stand on a platform that features 6 degrees of freedom. Then, that individual is immersed into a virtual environment, while a six meter semicircular screen is put in place with markers. These markers end up monitoring any and all movements and reactions made by the patient. The C.A.R.E.N is so realistic that the patient will actually feel like he is completing the assignment. As the doctor is watching these actions transpire, he will record and transcribe what’s happening, so that he can properly treat the patient on an individual level.

Again, when an individual is subject to some type of brain injury, it is best to be treated properly right away. This will ensure that the patient gets the help they require, so that concussion symptoms are eliminated and no further damage is done. From behavioral therapy to virtual reality, at NY Dynamic Neuromuscular Rehabilitation, we will make sure that patients receive the aid they need to be top shape again.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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