Sports Chiropractic Care for Athletes with Vertigo

Sports Chiropractic Care for Athletes with Vertigo Blog

Vertigo is a feeling of dizziness and a sensation of being off balance. In athletes, vertigo is a common side effect of concussion. While vertigo often resolves itself over time, persistent symptoms may need medical intervention. If you are an athlete suffering from vertigo, sports chiropractic care may offer the best solution.

Balance and Sports Trauma

Balance is defined as your ability to maintain your body’s center of mass over its base of support when standing or moving. Balance is a key component in any sport, protecting your from falls and injury while on the playing field. Sports trauma can affect the systems responsible for achieving and maintaining balance, leading to vertigo.

Three systems interact to help you achieve and maintain balance: The proprioceptors located in your muscles and tendons; the vestibular system located in your inner ear; and your brain’s cerebellum.

Your Proprioceptive System

Information about your body’s position in space is continually being sent to your brain from proprioceptors in your muscles and tendons. Proprioceptors are specialized receptors, located on nerve endings throughout your body, found in tendons, joint capsules, muscles, and in your inner ear, that provide feedback about your body’s position relative to gravity.

During physical activity, proprioceptors detect changes in muscle tension, body position and force production, helping your brain make adjustments to maintain equilibrium.

There are three types of proprioceptors:

  • Golgi Tendon Organ (GTO); Located in tendons at the ends of muscle fiber, GTOs are sensitive to changes in muscle tension. During exercise, the GTO provides feedback about how much force your muscles are producing. When muscle tension becomes too great, the GTO blocks further force production, protecting you from ruptures and injury.
  • Muscle Spindle: A muscle spindle is a stretch receptor that senses changes in muscle length, providing feedback about muscles as they are stretched. Muscle spindles let your brain know when a muscle has reached its longest length, invoking a stretch reflex that causes the muscle to contract, a protective mechanism to prevent tearing.
  • Pacinian Corpuscles: These mechanoreceptors are found on your skin, in joint capsules, and in the mesenteries of the gut. They detect vibration and pressure, and are responsive to rapid changes in joint position.

Your Vestibular System

The vestibular system provides feedback about spacial orientation, motion and equilibrium via sensory receptors in your inner ear. When combined with visual feedback, the vestibular system helps you make adjustments to maintain balance. Without visual input, balance becomes more difficult.

During sports, your vestibular system kicks into high gear, giving specific feedback about acceleration, deceleration, and vertical movement when jumping or bounding. Without vestibular feedback, you would be unable to perform as an athlete.

Dizziness originates deep within the inner ear, where three fluid-filled canals (utricles) and two sac-like structures (saccules) interact. Within the canals, hair-like structures connected to nerves respond to fluid flowing past, relaying information about body position and motion. Tiny stones in the saccules move the hairlike structures when the body is in motion.

When you take a hard fall or collide with another player, the stones can become dislodged from the saccules and move into the canals, creating an eddy that changes the fluid flow across the hairs, resulting in misinformation to the brain and causing vertigo.

Your Cerebellum

When your proprioceptors and vestibular system respond to changes in equilibrium, that information is sorted in your brainstem at the top of your spinal column, and sent to your cerebellum, where balance, posture and movement are coordinated and regulated. When signals are confused, as is the case with vertigo, balance is disrupted as your brain struggles to resolve the conflicting information.

How Sports Chiropractic Care Can Help Restore Equilibrium

Imagine if you became dizzy every time you made a sudden move during play. This can occur after a concussion, setting you up for a serious injury. A sports chiropractor works with you to help restore balance and reestablish spacial awareness.

Benign paroxysmal positional vertigo (BPPV) is the most common type of concussion, related to brainstem trauma. You may feel dizzy when turning your head or changing body positions.

At NYDNR, a sports chiropractor can help you overcome BPPV through exercises designed to move the tiny stones of your vestibular system out of the canals and back into the saccules, thus restoring balance. We use a combination of exercises and spinal adjustments to eliminate vertig. We also use C.A.R.E.N (computer assisted rehabilitation environment) to improve vestibular feedback and restore equilibrium.

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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)

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Complete tear of rectus femoris
with large hematoma (blood)

image

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

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