March 14, 2015
[01:31] About Dr. Kelly Ryder
[04:18] On Concussions
[05:37] Two Types of Concussions
[07:16] On Vestibular Cochlear Concussions
[12:02] On Testing Concussions
[14:00] On Imaging
[16:30] Treating Concussions
[24:17] On Brain Inflammation
[27:11] Other Healing Methods for Head Injuries
[30:27] Misdiagnosis in Concussions
[31:23] Using Ketosis During Concussions
[32:35] Preparing For Concussions
[37:27] End of the Podcast
In this episode of The Ben Greenfield Fitness Podcast:
“I see so many kids and they have been to the hospital, and they go on that traditional route where there’s urgent care. They've been to the pediatrician, they don't deal with concussions because it's so complex.” “I have an actual device in my office, its 35,000 dollar piece of equipment that test specifically for the vestibular cochlear concussion.” “A lot of these trainers are unaware of the actual balance examination and why that's important.” “We're forcing basically oxygen inside the cell to break down that toxic calcium, so therefore the kid recovers a lot quicker.” “We also do eye therapy which is where you have the person stare at the computer screen and the bars will either beat vertical or horizontal, and they have to follow a dot.”
Ben: Hey folks, it's Ben Greenfield, and if I think back to some of the worst injuries of my life, one of them that really stands out is a mountain bike crash that I had when I was 13 years old. I remember riding my bike down the driveway, I remember hitting some little bumps all in a row, and then I woke up at the hospital. Apparently I woke up two or three hours later at the hospital, and I had gotten a pretty significant concussion, just totally blacked out, forgot everything. I, of course, wasn't wearing my helmet, and from that point forward for the rest of my life including when I would do something as simple as climb a tree, my mom would have me wear a helmet. But probably with good cause because I did a good deal of head damage, and I've always wondered for myself and for my own kids if a concussion like that is something that I maybe could've or should've done more about when it came to follow up healing and making sure there wasn't lasting brain inflammation or damage or Lord knows what else may have happened to me that has made me a different person than I could've been.
Anyways, concussions are kind of mystery to a lot of people. It's like you get a head injury, and I have a client who, I'll keep them completely confidential, but their wife just had a pretty significant head injury, and they're waiting through this themselves. What do you do as far as healing, as far as diet, as far as testing to make sure there's not lasting damage, as far as the alternative medical remedies out there for concussions? What works, what doesn't, so when it comes to head injuries and it comes to concussions, I know this is a topic that's near and dear to many folks' hearts, whether you've had a concussion or whether you're concerned about your child who may play soccer or ride bikes or play football or something like that.
So I decided to get a guy on the call who knows a lot about concussions. He is in fact a concussion, health-certified provider. He's a sports chiropractic physician, he's an ART-certified provider. He's what's called an impact-certified provider which actually has to do with concussion management. His name is Dr. Kelly Ryder, and Dr. Kelly is an athlete himself. He was a long distance runner when he was 14, and he returned to the field to actually compete in the US Junior Olympic Track and Field after going through some injuries earlier in life, and now he helps a lot with athletes. He helps athletes get back to the competitive field after injury, and one of the things like I mentioned that he specializes in is concussions. So Dr. Kelly Ryder, thanks for coming on the call, man.
Dr. Ryder: Thank you, thanks for having me.
Ben: Well I guess we're going to test your knowledge right off the bat, man, 'cause I'm going to ask you the glaringly obvious question that is, what is a concussion?
Dr. Ryder: Concussion is nothing more than a violent shaking of the head, and when the brain actually hits you in the front part of the skull or the back part of the skull or the temple lobes to where your ears are located basically. It is a smashing effect, that actually causes toxic calcium. It's an extracellular substance to actually enter the cell, and the potassium then rushes out, so it causes this great imbalance of misfiring of the central nervous system, and so that's where people get really dizzy, they can't coordinate movement, they can't remember things, and it all depends upon which area of the brain has taken the damage, and so we called that a coup entry which is where the brain actually touches the skull and then counter-coup which is where the brain basically bounces of and it goes back in reverse and hits the opposite direction. So in other words if you take a front impact, your frontal lobe, the front part of your brain would actually hit the forehead, and then that would be a coup entry and then the head whipping back and the back part of your brain or the occipital lobe would actually get against the back part of your brain, the back part of your skull.
Ben: So when we're looking at the type of concussions where the brain is moving around like that, is that the only type of concussion that there is, or are there different types?
Dr. Kelly: There's two different types. That's correct.
Ben: And if I could interject real quick, I've heard about mild concussions where soccer balls hit a kid's head. To everything from me flying off a bike when I was a kid and probably getting a lot more impact than just a soccer ball hitting the head, so when you look at the different type of concussions, what are they?
Dr. Kelly: So there's the cerebral concussion which is how the brain actually functions, and then there's the vestibular cochlear concussion, and the cerebral concussion, you were talking about my impact certification is basically when a kid goes into a trainer's office in the school or even a doctor's office and they sit down in from of the computer, and they give them that test, that is actually testing the cerebral function. In other words, how the brain processes information, whether it can do mathematics or whether it can do number recall or whether it can do long term memory or short term memory tests.
Ben: So that test is what the ImPACT test is?
Dr. Ryder: That's what the ImPACT test is, and there's a lot of holes inside the ImPACT test, but we'll talk about that later. But then there's the vestibular cochlear concussion which is the inner ear, and this is often missed in the current model that we have in the United States, and this is the model where I see where I catch a lot of misdiagnosis and mismanaged concussions, and this is the one that has the longer term effects.
Ben: Can you explain what that is and why that would be a misdiagnosis?
Dr. Ryder: Yeah, a lot of times, the kid will take an actual head injury, but the side effects are actually coming from the vestibular cochlear meaning the inner ear, so that portion of the brain contains eye movements, head movements, how your body actually postures. It tells us where we are in space and how to function effectively, and so that has a lot more control over systems that control everything in our body, basically inside our inner ear. And we just don't realize how important that is until now where we actually have equipment that can actually test for that.
Ben: So when you're looking at a vestibular cochlear concussion versus this cerebral concussion which you say is the more common type of concussion, are there different kinds of injuries or sporting situations that would cause one versus the other?
Dr. Ryder: No not necessarily, it just all depends upon how the impact happens to the child or to the adult, and then what's their hydration level, what's their neck strength? There's a lot of factors that play into helping reduce our health or heard a concussion. That's why little girl soccer players are probably you’re most prone, head-injured patient that you'll actually see and practice.
Ben: So can you get tested to find out what kind of concussion you've actually had?
Dr. Ryder: Absolutely, yes. Like I said the cerebral will be done with the ImPACT test or computerized test, and the vestibular cochlear concussion, the testing goes about where you actually have to close your eyes and do a balance plate test on the VSR Sport is the equipment that I use, and basically it's the same equipment NASA uses on their astronauts when they come in from outer space to basically see if their brain and their tactile senses are actually working.
Ben: So we've talked about this on a podcast before about how your vestibular balance system is really one of the more crucial balances along with your visual and your somatic sensory system, and one of the reasons for that is the fluid that moves around in the ears that help you know where your body is in space. When somebody gets this vestibular cochlear concussion, is it actual damage to those structures or is there something else going on like pressure?
Dr. Ryder: Well, it could be from pressure to be from actual damage and what ends up happening is that could be blocked where that fluid cannot flow in there, and the body doesn't recognize. So then your eyes will have what they call nystagmus or shaking or movement, and so when you have the individual put the head shake test which is part of the vestibular cochlear concussion where they're moving their head left and right, trying to focus in at one point and then they move their head up and down and you see what their eyes will actually do, and a lot of times they'll get very disoriented and want to vomit and get really dizzy because they have lost the range of motion, and the device that I use in my clinic is actually objective data. We can actually put a form in front of a patient and tell them you can't rotate your head to the left. Your rotation velocity is 192 versus 222, so I know that if it's 192 on the left, that more than likely without asking them any questions about their concussion yet, I can tell them it's a left posterior injury. And they're like yeah, I fell down this way 'cause it tells me where the injury actually occurred and how the brain's not working.
Ben: So let's say that I get a concussion, or one of my kids gets a concussion, and I drive to the hospital or I drive to the urgent care center. I bring them in there and explain what happened about the head injury. When they actually run tests there in the hospital or in urgent care at the doctor's office, are they running the same kind of test that you run or is there a standardization for figuring out what kind of concussion has gotten.
Dr. Ryder: Has taken place? No, there's not. Unfortunately, we have people that are on the cutting edge, and then we have people that are just still in the 1920s when it comes to head trauma. Rub some dirt on it, you're going to be fine, you're going to be alright. Just go home and rest. In seven to ten days, you're going to be fine.
Well that would be in a perfect world, and unfortunately, I see so many kids that walk through my office and they have been to the hospital, and they go on that traditional route where the urgent care. They've been to the pediatrician. I have a pediatric neurologist in Dallas, Texas that says they don't deal with concussions because it's so complex. You have to really understand what's going on and being able to accurately diagnose these kids.
Ben: So what do you look for? If I bring my kid to the hospital and I walk in there, how do I know that the way that they're evaluating is correct?
Dr. Ryder: That's the million dollar question, so if you don't have a balance exam done with your kid when you're in the emergency room, if that's not part of the evaluation processes, please take your kid to somebody who is trained in concussions because the evaluation process of a true concussion should be that you're testing the balance and control, also along with the typical cerebral concussion type signs and symptoms because a lot of times, they will overlap, and you have to be intelligent enough to figure out which one is being the superior versus the inferior aspects.
Ben: When you're at the doctor's office or the hospital, that balance test, is that on a special piece of equipment or is that just a stand on one kind of thing?
Dr Ryder: Well they do it either way, they do what are called the old field method and then there's the technical method which is what I use now. I have an actual device in my office, it's 35,000 dollar piece of equipment that test specifically for the vestibular cochlear concussion, so it has the head movements, and then we have them stand up with their eyes closed on a firm surface doing three different tests, and then we have them doing the same thing on a foam, on top of the plate, and it records and it's very simple. It shows either a green bar or a red bar, and then you're tested. Your kids being tested against norms which are 12 to 24 years old, and basically it says your kid is either pass or fail, and it's very objective. So the kid has to perform the test, and I have two offices. I have one in Dallas and I have one in Baton Rouge. And the one in Dallas, there's a Presbyterian hospital in Dallas and the Ben Hogan Sports Institute in Fort Worth actually has a device that does the same exact thing as what I'm talking about right now.
Ben: Now what about imaging, like MRIs or things like that. What are you looking for as far as the imaging goes?
Dr. Ryder: So pretty typical deal with it, they're going to shoot a CT on your kid's brain or on your brain to see if there's any pressure that's building up from blood basically. If there's a skull fracture and if there's pressure building up in the brain causing the brain to shift and they'll naturally bring you to surgery right away, but I'm going to tell you. Honestly, I have never seen a skull fracture in a concussion, so I'm batting at a thousand percent. Now have I seen them in the books? Absolutely, you see them in the books all the time where somebody's gotten a skull fracture and they’re building up pressure, but for a lot of times the kid that actually bumps their head or takes a hard hit or a takes a soccer ball wrong to the head in their ear, takes a ball to their ear in their vestibular cochlear systems and turned upside down, that child will always image negative or that individual will always image negative. And so what we're using now is what they call the spec scan which is a single full ton emission technique where we can actually show where the inflammation and the damage is actually at in the brain.
Ben: That's called a SPECT scan?
Dr. Ryder: Yeah, SPECT scan. SPECT. Single, full time.
Ben: Gotcha, so you want to look for a practitioner whose doing a balance test. For imaging, you're looking for something like a SPECT scan. Now do you pretty much across the board for you or someone else who you brought in for a concussion, do you want to make sure that ImPACT test is done at that time, or is that test something you do later.
Dr. Ryder: Absolutely, you always want to check the cerebral function and making sure that your kids has a baseline of when their brain is working normally. Just like you know you would on your car, you have a baseline of where your car is at when you first buy it, right? You want that on your kid, and you also want a baseline balance exam. Because that way if the kid or the adult takes a hit to the head, then you have somewhere to compare when they actually do get injured. So what I see a lot of times is parent are unaware basically that they actually need to do a baseline balance exam, and so they go to the school because the school tells them that they need to go get an ImPACT test and they make them do an ImPACT test, but a lot of these trainers are unaware of the actual balance examination and why that's important also.
Ben: Gotcha, okay. So let's say that we find out that we've gotten a cerebral or one of these vestibular cochlear concussion, let's move into treatment. What do you do exactly? I mean as you're sitting there, it's like okay, we know you've got a concussion, what's next? And also as we talk about this, we have a lot of listeners who don't necessarily adhere to the idea of just popping a pill in modern medicine, so I'm curious about conventional and alternative treatment options.
Dr. Ryder: Right, so what I typically do inside my office is I use the balance therapy, so we do a lot of balance and coordination therapy. We use neurofeedback where they're having to play basically a video game with their brainwaves. We're using eye therapy which is we're having them go through movements with their eyes if they're having a nystagmus-type issue, and then we're also using mild hyperbaric oxygen therapy. The principle is that if we have toxic calcium on top of the mitochondria of the cell, and the way that we need to break that down is that we need to oxidize it. I'll tell people iron is iron, and when it starts to rust, what is that process known as? Oxidation, right? It breaks down, so we're forcing basically oxygen inside the cell to break down that toxic calcium, so therefore the kid recovers a lot quicker than if they would if their bodies just try to process it normally or naturally.
Ben: So we've got hyperbaric?
Dr. Ryder: Yeah, mild hyperbaric oxygen.
Ben: How often is that done and for how long after concussion?
Dr. Ryder: A pretty typical concussion on the kid with the research that I've done out of my office. I kid normally recovers after about 20 to 25 sessions, and so what we're able to do is take their baseline balance exam, have them go through it when they come in and they're all messed up, and then 20 to 25 sessions in, they're able to pass the test and they have no signs and symptoms of the concussion any longer.
Ben: Gotcha, so you do the hyperbaric oxygen, you do, did you say balance training?
Dr. Ryder: Yeah, balance training, so we're basically trying to tell the brain to kick start again. Call on the nucleus gracilis which is the main nerve tract that controls our feet and nucleus conatus which is the control of our hand and our shoulders, our upper extremity effectively, and we're trying to tell the brain to recognize those systems again because when the concussion happens, it tries to really focus in only on healing the brain, but we have to tell the brain that it's okay to work, and so that's why we use balance therapy.
Ben: Do you, when you're using balance therapy, also have recommendations for people for exercises that they do at home when they're not in the office? Is it simply just standing on one leg when you brush your teeth, or do you have special pieces of equipment that you like people to use?
Dr. Ryder: No, I mean I tell people like this it's pretty simple. You want to start of always on a hard floor, and then if you have some really soft carpet, get on the soft carpet and stand on one leg and look in different directions, and then I tell them you want to start maybe at the top left corner of your wall and maybe look down to the right corner and then look up to the top right and then look down to the lower left, and just cause your different eye movements while you're trying to balance, so that way, you can help heal yourself at home but you still need to come in and do therapy with us, but you can be helping me help you at home. So I try to really give the treatment option back to the patient and give them some control on recovering from this thing 'cause these things can last for a very long time.
Ben: Gotcha, okay. So we've got hyperbaric, we've got balance therapy, what are some other things that you do to help heal concussions faster?
Dr. Ryder: So we use neurofeedback which is when you can actually play video games basically with the brainwaves of your brain, which is the alpha, the beta, the theta and the delta waves, and we can simulate these guys out where they actually play computer games with their brainwaves. So you have no control in your hands, but you have it all in the brain. And so when you're activating and you're telling your brain I need to go up into the right, when you make that signal in your brain, that device moves your brain up into the right. So you can fly like an airplane through these different rings. You can surfboard through these different obstacles that you have to go through, and there's just different variations. It's pretty cool stuff. So that's an option we have for neurofeedback.
Ben: Now there are a lot of neurofeedback games, there are actually available for consumer purchase now like Muse is one I can think of off the top of my head where you attach the electrodes, you look at the screen and it helps you to meditate or to focus, did these thing work or have they been looked into as being something that could work for helping you to heal from a concussion faster?
Dr. Ryder: Yes, absolutely. The neurofeedback world has taken off really in the United States as far as concussion recovery because we know that's one segment of it, right? That's not going to be the only thing that fixes to your brain. That helps your brain heal, but that's not the only thing that you need to do with it, so neurofeedback works great in sports performance where you really got to get your focus in or you can turn that on and off 'cause sometimes, a lot of times great athletes are prepared but they're not prepared mentally, right? They lose focus, and so neurofeedback helps focus in that brain on trying to navigate a pathway through that concussion.
Ben: Interesting, so what other kinds of therapy in addition to hyperbaric therapy, balance therapy and neurofeedback are there for concussions?
Dr. Ryder: We also do eye therapy which is where you have the person stare at the computer screen and the bars will either beat vertical or horizontal, and they have to follow a dot while the bars are moving the opposite direction or maybe up and down, and this dot will actually go through vertical or horizontal movements or maybe diagonal movements where their eyes are being trained to follow that dot through a range of motion as if they were turning their head left and right or up and down while their head is actually staying still.
Ben: Now for these kinds of things, it also seems like there would be ways to do this at home.
Dr. Ryder: Absolutely, there's actually a small computer program that you can buy for like a hundred and fifty bucks where you can go through those different programs to do it at home.
Ben: What's the name of something like that, just in case I want to put it into the show notes for folks?
Dr. Ryder: Let me see, I have it in my computer in the back. I can't remember.
Ben: Well if you want to send it to me later after we record this episode, I can certainly put it in the show notes. And by the way if you're listening in, I'll put links to some of the things we talk about and Dr. Kelly's website over at bengreenfieldfitness.com/concussion. That's bengreenfieldfitness.com/concussion. So you've got this eye therapy that you do as well in addition to the hyperbaric, the neurofeedback, and the balance therapy, is there anything else when it comes to treatment options that you use?
Dr. Ryder: Yeah, you'll want to cut the inflammation out of these kids' diets, so I know you're a big fitness guru guy, so you'll appreciate this, but we really try to eliminate the sugars, and so we talked to the parents about removing the inflammation or any type of inflammatory response in the brain. So we put them on high doses of fish oil. We get them on glutathione, and then we also get them on Alcat testing which is a food sensitivity testing, so we want to make sure that if they're eating anything that their body can actually produce inflammation to, we want to remove that out of their dial, so we're really taking a true scientific approach and looking at the IGA and IGG antigens in the blood and figuring out what is causing an inflammatory response in these patients, so that way we can really heal them from the inside out, and if they can do something as simple as eating foods at home that are more productive for them to heal, then that's what we want them to do.
Ben: So when it comes to brain inflammation, when you use a word like that, is that pretty much the same as muscle inflammation in terms of there just being a bunch of inflammatory cytokines causing white blood cells and fluid to go into the area and cause swelling, or is there something else?
Dr. Ryder: Exactly, that is exactly what it boils down to is so your body knows in a concussion that your body's in mayhem right now, it's in confusion, and you have all this toxic calcium that's floating, that's not supposed to be where it's supposed to be at. It's supposed to be on the outside of the cell, but now it's on the inside. And your body's just constantly trying to ward that off, trying to protect your brain, and that's why the SPECT scan is so really cool because we can actually show you. If you go to google and you type in SPECT scan and ring of fire, you can actually see the images that the brain is highly lit up and red where the inflammation's at 'cause we use isotopes in the blood to actually show us where the inflammation's at. I mean, it's pretty cool stuff.
Ben: Can those type of tests also test, let's say someone hasn't had a concussion or head damage, and they just have other things that can cause brain inflammation. Let's throw some things out there like severe lack of sleep or a lot of stress or a poor diet, can you do that same kind of test just to see?
Dr. Ryder: Absolutely, you sure can. You can actually check brain function by either functional MRI too where you're actually seeing when a person sees a happy picture like what portion of the brain is actually excited. When they see something bad, where is that brain excited that and how much inflammation is actually in that area? So you're looking at a lot of post-traumatic stress disorders, people that take in mental and physical abuse, what portions of their brain are constantly inflamed, and you can even do it with gluten sensitivity type stuff too where you'll see the occipital lobe just blow. It looks like a big bright light coming out of the occipital lobe with a lot of gluten tolerance type stuff. So different portions of the brain actually light up in different areas on the SPECT scan.
Ben: So when you're doing that test, that's the same test as the SPECT scan, this test for brain inflammation?
Dr. Ryder: Absolutely, yes. Okay, so if someone wanted to find a test like that in their local area, how would they go about doing that?
Dr. Ryder: So you type in SPECT scans and type in your zip code. You're all in California, right? You're in California?
Ben: I'm up in Washington State, but our listeners are all over the freaking place.
Dr. Ryder: Yeah, so there's a clinic called the Amen Clinic, and they do a lot of SPECT scans, so they have a lot of clinics all over the United States. There's a lot of them in California and in San Francisco, Los Angeles area.
Ben: Got it. I actually see their website here, it’s amenclinics.com, I'll put a link to this in the show notes for folks.
Dr. Ryder: And they do a lot of psychological testing and a lot of imaging of the brain, so yeah. That's a good place to start, A as in Amen Clinic.
Ben: Now you talked a lot about omission in terms of getting rid of inflammatory sugars and getting rid of things that people might be allergic to after doing something like an Alcat test for food intolerances or allergies, you mentioned glutathione as one way to control brain inflammation. That's certainly one that we've talked about before on the show, but in addition to glutathione, are there other nutraceuticals or foods or supplements that you have found to be particularly effective for helping to heal head injuries faster?
Dr. Ryder: Yeah, you’re Omega-3s and 6 and 9s are always good. The good thing about those is you can't really overdose. If you overdose, you have to go to the restroom, and it's kind of messy, but you can never really overdo your brain. That's what I tell people is you take enough fish oil, you have to go use the restroom, and when your stool becomes a little runny, then you're going to stop for the day because your brain is constantly trying to absorb and trying to heal itself 'cause it is a central nervous system, so your creator, whoever your creator may be or whatever you may believe in, whoever is that higher being created that the brain knows exactly what it needs, and it will constantly thrive to get that. So Omegas is something that are really right for the brain to try to really get that inflammation down. It's a natural anti-inflammatory and Omega are fatty acids, your brain absorbs. I'm a big fan of the Omegas and use in a glutathione to get the mitochondria to actually function and properly work.
Ben: Have you ever looked into much of what Dr. Jack Kruse talks about. I don't know if you're familiar with him, but he's in a little bit about using cold thermogenesis, cold water splashed in the face or cold water immersion for things like concussions. Have you ever heard of something like that?
Dr. Ryder: Yeah, they're trying to use diver's reflex. Have you heard of diver's reflex?
Ben: Yeah, the Mammalian Dive Reflex?
Dr. Ryder: Yeah, and so what ends up happening is when cold water hits the face and the neck, the vagus nerve speeds up and slows down, so it's like a parasympathetic response to try to get the brain balanced. And so the vagus nerve a lot of times when you do the patient's blood work from a concussion, it'll actually show that they have a higher CO2 in their blood than they should, and that's because the vagus nerve isn't working and that travels with the sternocleidomastoid which is one of your major neck muscles that actually turns your head, so that's sort of down that same path. You have to make sure that vagus nerve is working, and using cold water on the face, using cold water on the back of the neck and occipital lobe actually helps that.
Ben: Interesting, so you're actually stimulating the vagus nerve when you splash cold water in your face and that's something that may help to almost reawaken the nervous system after you get through head injury.
Dr. Ryder: Exactly, yeah.
Ben: Very interesting.
Dr. Ryder: Yeah, it's a thing that they've used with the University of Miami. I think they used that one at, I don't know if you remember a few years back they had a player that took a major concussion, and they ended up putting him in a ton of cold water. They iced him down immediately and put him in a cold submersion bath. He ended up doing great with no problems.
Ben: So in terms of recover from concussion, are there any other remedies that you found to be particularly effective?
Dr. Ryder: Not necessarily, a lot of times what ends up happening is these people go unfortunately misdiagnosed and mismanaged. I mean I had a patient fly in from Baltimore, Maryland who got hit on her bicycle. She was a cyclist, competitive cyclist, PhD student, and she had been suffering for two years and just misdiagnosed, mismanaged. Two brain surgeries, they tried to cut out here lesser occipital nerve and her temple nerve to relieve her headache and didn't get any relief. Two hundred and fifty thousand dollars later, this girl had to drop out of school. She couldn't finish her PhD program until she started coming in and doing the therapy and the treatment with me. In about six months later, we were finally able to get her back on path where she's actually entered school again and now doing well.
Ben: That's fantastic, I didn't want to talk over you right there, but I did want to ask you another question. When it comes to kids like this or athletes or adults, the idea of using ketosis to manage inflammation, the brain, decrease glucose utilization, increase the ketones available and shutdown inflammation that way, have you ever experimented with that, with you or your patients or seen anybody get tested?
Dr. Ryder: No, I have not, and I've heard that there's been a big push towards exploring that idea. It would only make sense because of the physiological aspects of that, that makes total sense to me, I just never have went down that road of bringing somebody to a slight ketosis when they’re in a concussion state just because they've got so much going on. These people are really confused, and a lot of times the parents are going coming like wait, what is a vestibular cochlear concussion? I'm not understanding why my child's not recovering, so I try to keep the complicated process really simple for them. As talking with two working brains here, you and I and the audience that is listening, yes absolutely. If their parent can bring their child to a slight state of ketosis that would only make sense that the inflammation is being cut down because of the sugar being eliminated in the diet.
Ben: Yeah, and that leads me to another question, and that is when your child is heading out the door to go on a mountain bike ride or a soccer game or you are going to do something. Let's say anything from rock climbing to riding your bike to anything else that may have a risk of concussion, are there things that you could do before hand to ensure that if you get a concussion is not as bad or if you get a head impact that it's less likely to cause a concussion?
Dr. Ryder: Yeah, you want to make sure that you're well hydrated, and a big thing that we've noticed is that a lot of times their neck muscles need to be really, really, really strong and defined. That seems to stop the acceleration, deceleration of the head and neck, and when those neck muscles are really strong and you can prevent that head from really whipping that helps to basically eliminate and stop the effects of the concussion.
Ben: So how would you strengthen neck muscles, do you have certain exercises you like for that?
Dr. Ryder: A lot of extension, it's almost barbaric when you talk about the neck muscles being strengthen because it's the old high school method when you're actually taking about isometric exercises where you push your hand against your forehead and you press for seven to ten seconds or you push your hand against your left temple and you push left for seven to ten seconds. It's little isometric type exercises, and then you can actually get into where the neck muscle device which you see at the gym where you actually put five or ten pounds, and you actually go through flexion and extension and then lateral flexion and then rotation type stuff.
Ben: So either from the cords and the bands to the actual physical novice machine that actually has where you can actually build up neck muscles.
Dr. Ryder: So we've got hydration, training neck muscles, anything else that people can do?
Dr. Ryder: That's about it, and luck. Genetics and luck, man.
Ben: A hard head.
Dr. Ryder: Right, a hard head.
Ben: Now speaking of which, aren't they making special helmets now? Thinner helmets that can be worn even during things like soccer games?
Dr. Ryder: Yes, they are. The ones during soccer games are pretty bogus, the research shows. They're not as protective as they thought. I mean the whole idea of a helmet is to prevent the skull fracture. At the end of the day, that's what the helmet is for. The soft padded things that you put on top of kids' heads that the kids are running around there with that headband on and that little thin cap that they say that's going to prevent it, absolutely not. It's not going to prevent a concussion, it's a very good marketing might I say, but at the end of the day, you look at a company like ______ [35:13] Technologies out of Baltimore, Maryland. It think they're out of that actually have a cap that when a child puts on a football helmet actually tightens down and has these black knobby deals that are inside the helmet that actually cause a torque in the sheer forces to actually be reduced. Now that's cool stuff because you can actually test that. That actually does help their more safety rated helmets along the lines of football equipment them being the top one.
Ben: Yeah, and these helmets can actually tell you what's going on in terms of acceleration of the head during the actual sport, huh.
Dr. Ryder: Exactly, there some of them that are actually programmed with chips in there so that way, they can see what, I think Shaun and Rodale were doing some research studies on that. I think the kit costs $10,000, but you could monitor 60 kids at one time.
Ben: Wow, amazing. Well this has been really eye opening, I now have what I need to know as far as my kids go if they ever get a concussion or myself or my wife about what to look for, some of the ways to avoid that and then some of the things to include like eliminating sugar and introducing these things like glutathione and the fish oil for example to decrease the inflammation and also looking for a provider who does the balance test and the SPECT scan and things like the neurofeedback and the eye therapy. These are all things I wasn't aware of, and I think a lot of people also are not aware of these things. So this is good information. I'll put a link to everything that we talk about over at bengreenfieldfitness.com/concussion, and that'll also include a link over to your website too, Dr. Ryder, the Texas Sports Chiro Care 'cause you're in which town in Texas? Is it Dallas?
Dr. Ryder: I'm in Dallas, yeah, and I also have an office in Baton Rouge, Louisiana.
Ben: Okay, got it. So if you're listening in and you're in that area and you want to look up Dr. Ryder, then go for it. It sounds like people fly in to see you as well.
Dr. Ryder: Yeah, that's exactly right.
Ben: Cool. Alright, well folks, thanks for listening in, and again, everything's over at bengreenfieldfitness.com/concussion. Dr. Ryder, thanks for coming on the call today.
Dr. Ryder: Yeah, thank you guys for having me.
Ben: Alright folks, this is Ben Greenfield and Dr. Kelly Ryder signing out from bengreenfieldfitness.com.
One of the worst injuries of my life was a mountain bike crash when I was 13 years old. One moment I was bombing down the driveway with a big smile on my face (but no helmet on my head) and three hours later I woke up at the hospital.
I've always wondered if I was tested the right way when I was at the hospital, and if everything was done that should have been done when it came to optimizing the healing of my head damage and shutting down brain inflammation as quickly as possible.
I've also always wondered whether kids who get concussions might be getting missed diagnoses, improper treatments or lasting cognitive damage, and if there are ways to keep kids and sporting adults from getting concussions in the first place…
So in today's episode, I get Concussion Health Certified Provider, Certified Sports Chiropractic, ART Certified Provider
and ImPACT Certified Provider Dr. Kelly Ryder on the show, and we discuss:
-What a concussion really is…
-The different types of concussions, cerebral vs. vestibular cochlear concussions, and the kind of concussion that is often missed and not diagnosed…
-What the ImPACT test is…
-Why improper exams and the wrong imaging techniques are so often used in concussions…
-The one test you must ensure is done on you or your kids if you want to make sure you're being treated properly…
-Which alternative treatments really work for concussion healing, from hyperbaric therapy to neurofeedback to balance therapy and eye therapy…
-How a diet should be set up to reduce brain inflammation…
-How to decrease your risk of getting a concussion in the first place…
Resources we discuss in this episode: