<p><a href="https://peterattiamd.com/mickycollins/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230724-pod-mickycollins&utm_content=230724-pod-mickycollins-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230724-pod-mickycollins&utm_content=230724-pod-mickycollins-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230724-pod-mickycollins&utm_content=230724-pod-mickycollins-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Michael "Micky" Collins is an internationally renowned expert in sports-related concussions and a consultant for multiple professional sports organizations. In this episode, Mickey first explains the definition and diagnosis of a concussion, as well as the diverse signs and symptoms associated with different types of concussions. He discusses the risk factors that contribute to increased susceptibility and/or severity of concussions in certain individuals, emphasizes the significance of prompt treatment, and uses case studies to illustrate the latest in treatment protocols and recovery process. Additionally, Mickey provides insight into the evolving field of concussion treatments, including the exploration of hyperbaric oxygen and synthetic ketones. He gives advice to parents of kids who play sports and discusses the promising prospects in the realm of concussion management.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Micky's interest in concussion and how he started the first concussion clinic [3:15];</li> <li>Concussion: definition, pathophysiology, and risk factors making someone more susceptible [9:45];</li> <li>Symptoms of concussion, predictors of severity, and the importance of early and effective treatment [20:00];</li> <li>The six types of concussion, the effectiveness of treatment, and factors that impact recovery [25:45];</li> <li>The importance of seeing a specialist and the prognosis for recovery [30:00];</li> <li>Case study of a racecar driver who suffered a vestibular concussion [32:15];</li> <li>Why vestibular concussions are particularly problematic [42:45];</li> <li>A treatment plan for the racecar driver, possible use of medications, and how to address the root cause [45:45];</li> <li>Exploring alternative treatments: hyperbaric oxygen, synthetic ketones, and more [52:00];</li> <li>The natural history of a concussion if untreated and the effect, if any, of concussion on subsequent risk of brain disease [57:15];</li> <li>Chronic traumatic encephalopathy (CTE) [1:01:45];</li> <li>Advice for parents of kids who play sports: when and where to seek treatment for a possible concussion [1:04:45];</li> <li>Is there any evidence that the APOE4 genotype increases susceptibility to concussion or TBI? [1:10:15];</li> <li>The increased risk of concussions in older adults and a case study of a 90-year-old patient who suffered a head injury in a fall [1:11:15];</li> <li>Funding for concussion research and fellowship programs to train concussion specialists [1:15:30]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
If a head injury occurs with concussion symptoms (like dizziness or fogginess), immediately remove the individual from play or activity, as continuing to play for even 15 minutes can significantly prolong recovery.
2. Seek Early Specialist Care
For any suspected concussion, seek evaluation from a concussion specialist within seven days of the injury, as early intervention is the best predictor of quicker recovery and prevents secondary problems.
3. Embrace Active Rehabilitation
Contrary to common belief, active and targeted rehabilitation, including exertion therapy and specific physical therapy, is crucial for concussion recovery, rather than prolonged rest which can worsen symptoms.
4. Follow Targeted Exercise Program
Engage in specific vestibular exercises (e.g., Russian twists, planks with head turns, lateral shuffles, burpees) and a daily exercise program, such as a 45-minute morning walk and a 45-60 minute rigorous afternoon workout, to retrain affected brain systems and increase parasympathetic nervous system arousal.
5. Regulate Sleep Schedule
Establish and maintain a consistent sleep schedule by going to bed and waking up at the same time daily, and avoid napping, to support nervous system regulation and recovery from concussion.
6. Engage in Environmental Exposure
Actively expose yourself to busy environments like grocery stores, restaurants, and parties, and engage in external activities to challenge and retrain the brain, avoiding rumination and social isolation which can worsen symptoms.
7. Treat Chronic Concussion Symptoms
Even if concussion symptoms have persisted for years, seeking specialist care can lead to significant improvement and recovery, as the injury is treatable and not irreversible.
8. Prioritize Behavioral Treatment
Initially focus on behavioral interventions, such as exercise, sleep regulation, and exposure therapy, before considering medication, as these often address the root cause of concussion symptoms.
9. Avoid Hyperbaric Oxygen Therapy
Do not pursue hyperbaric oxygen treatment for concussion, as there is no compelling data to support its effectiveness, and it may lead to unproductive searching for solutions and increased anxiety.
10. Educate on Concussion Symptoms
Parents and individuals should be aware of subtle concussion symptoms like dizziness and fogginess, which are strong predictors of longer recovery, and understand the importance of reporting them immediately.
11. Avoid Re-Injury During Recovery
Be vigilant to prevent another head injury while recovering from a concussion, as subsequent impacts during this vulnerable period can lead to more severe outcomes and prolong recovery.
12. Seek Concussion Specialists
When seeking medical attention for a concussion, prioritize clinics or specialists with specific expertise in concussion management, as general neurologists or neurosurgeons may not be up-to-date on the latest science and treatment protocols.
13. Consider Neck Strengthening
Recognize that neck strength can play a role in concussion susceptibility, implying that strengthening the neck may be a proactive measure, especially for athletes, to potentially reduce risk.