Sometimes a blow to the head could be substantial enough that in addition to a concussion, it can cause a skull fracture, and lead to the leakage of the cerebral spinal fluid through the nasal cavity. In this case, patients could feel a very salty taste in their mouths. Sometimes the fracture/ fissuring is so minimal that the leakage of cerebral spinal fluid will not be noticeable.

However, when the drainage of cerebral spinal fluid is increased, sometimes, fluid could drain through the nasal cavity, and a patient experiences a salty taste in a mouth. Practically, after each concussion intracranial pressure is increasing, and at the time of manual acceleration of the cerebral spinal fluid drainage, the fluid can start draining through the nasal cavity, and a patient could feel salty taste in the mouth. In either case this phenomenon shouldn’t be viewed as a something negative. Usually during the first few procedures, this leakage will be stopped. There is an opinion that in cases of non-significant fractures/fissuring, the leakage at the time of application of the acceleration techniques actually helps this fracture to heal naturally.

In 1964 professor Dembo of the Leningrad Medical School proposed a biomarker to diagnose concussions and to assess normality of brain functions. In addition he proposed a hands-on protocol for rehabilitation from post-concussion encephalopathies.  This discovery was preceded by somewhat tragic event.  In 1963 one very famous boxer, two time Olympic Champion, Valeri Popenchenko, 24 hours after winning the Soviet Union championship, lost consciousness.  What, probably, triggered the loss of consciousness was a graduate buildup of cerebral-spinal fluid that created a significant pressure.  At the moment, the “rest and time” cure was also accepted in the Soviet medicine and neurology. So Valeri was prescribed a two week rest, after which his immediate concussion symptoms disappeared.  Notably, Valeri was not only an excellent boxer, but also a PHD physicist.  He noticed that while coming back to the laboratory, he couldn’t focus. He related this complaint to his physician, who at the time happened to be Professor Dembo.

Professor Dembo was not only Valeri’s physician, but also a famous academician, an authority in sports medicine, neurology and massage therapy.  He started investigating further this complaint and attributed Valeri’s condition to the consequences of his post- concussion brain dysfunction.

After substantial research, Professor Dembo’s team discovered that the biomarker to diagnose the process of development of encephalopathies, after disappearance of immediate concussion symptoms. Such biomarker was irregularities of autonomic activities. These irregularities were expressed in jumping blood pressure, irregular heartbeat, etc. These irregularities were established with the series of tests.

Once professor Dembo made this discovery, he stopped Valeri’s training regimen and started the treatment.  Little by little, within the six month from that moment, the protocol for a post-concussion rehabilitation was established.  Having underwent the treatment protocol, Valeri Popenchenko condition has improved tremendously.  His focus was restored and he could successfully come back to both boxing and scientific work.

As Boris pointed this out in the video, in addition to releasing different neurotransmitters, and post brain trauma cellular derangement, the reason for having concussion symptoms is the accumulation of excessive amount of cerebral spinal fluid. It is over abundantly secreted by ventricles of the brain, immediately after a concussion has taken place.  Since the drainage of cerebra-spinal fluid is a natural process, when a person lies down after the concussion, little by little, usually within the course of two weeks, the excessive amounts of liquid would be drained and, to a degree, intra-cranium quantities would be restored and a person would feel better.

However, it is important to understand that “to a degree” doesn’t mean “completely.”  Even after two weeks the brain will continue producing some excessive amounts of cerebral-spinal fluid.  It wouldn’t be as much as it would produce immediately after the concussion, but, certainly, more than during the pre-concussion stage.

Therefore, it is crucially important to initiate the acceleration of cerebral-spinal fluid drainage as soon as possible after a concussion has taken place.  As Boris mentioned in the video, during the course of first five sessions, which should be performed within the first five days after the concussion, most of the excessive amount of cerebral spinal fluid would be removed and an individual, sustaining a concussion, would feel much better.  This improvement would not only be the result of release of pressure, but also due to increase of blood supply.

Equally as important to reiterate that the excessive amounts of cerebral-spinal fluid in the intra-cranium causes a disruption of blood supply. Decrease of blood supply causes both the immediate concussion symptoms and becomes a precursor of possible long-term brain damage.   Insufficient supply of glucose and oxygen, delivered by the blood, causes the automatic “programmed cell dead” (PCD) regime in the brain to turn on.  As a result of brain functioning in this regime, some of the neurons enter “hibernation stage,” that is they will consume less glucose and oxygen, just so the other cells could survive in the situation of sharply reduced blood supply.

The sooner the blood supply is restored, the sooner the “red alert” or PCD regime could be turned off by the brain, which would offer a better chance to those PCD cells to recuperate.  Conversely, the long-lasting insufficient blood supply (the difference in its demand and availability) would increase the likeliness of some hibernated cells becoming permanently dysfunctional, which is the major reason of encephalopathies, or brain degenerative diseases.

The massage protocol offered in the video is directed toward reinstating the blood supply to the brain, improving the damaged function of the neck that suffered as a result of a concussion. This is the main reason why it has to be implemented as soon as possible after the concussion has taken place.  That’s why the difference between letting the “rest and time” to take its natural course and performing the protocol could be responsible for the difference in the speed of recovery – disappearing of immediate concussion symptoms.  More importantly, the timely performance of massage protocol could mean the difference between a long-lasting or irreversible brain dysfunctions and brain function being restored.

Does this mean that the recommended post-concussion protocol is only effective immediately after concussion? No. It just gives us a better opportunity to restore the full brain function, without receding.

It is generally accepted that the cell in hibernated stage could come back to life within 90 days.  Boris’ practice shows that the cells could come back to somewhat normal functions even after a longer period of hibernation, due to treatments that balance autonomic activities. Therefore, as people in the first line of defense, a massage therapists should perform the post-concussion protocol even when between concussion and the moment when a client attended the therapist, some time has passed, as long as the client exhibits symptoms of brain dysfunction. According to Boris’ clinical observations, in many clinical cases, the protocol has shown improvement in the well-being of the client, even when the time gap between the moment of the brain injury and the time of arriving in his office existed.

As Boris pointed this out in the video, the reason for having these symptoms in the first place is the excessive amount of cerebra-spinal fluid that is over abundantly secreted by brain immediately after the concussion has taken place.  Since the drainage of cerebra-spinal fluid is a natural process, when a person lies down after the concussion, little by little, usually within the course of two weeks, the excessive amounts of liquid would be drained and, to a degree, its circulation in the brain would be restored and a person would feel better.

However, it is important to understand that “to a degree” doesn’t mean “completely.”  Even after two weeks the brain will continue producing excessive amounts of cerebral-spinal fluid.  It wouldn’t be as much as immediately after the concussion, but, certainly, more than during pre-concussion.

Therefore, it is crucially important to initiate the acceleration of cerebral-spinal fluid drainage immediately after concussion has taken place.  As Boris mentioned this in the video, within first five sessions, which should be administered within first five days after the concussion, all excessive amount of spinal fluid would be removed and an individual, sustaining a concussion, would feel much better.

Equally as important to reiterate that the excessive amounts of cerebral-spinal fluid in the brain causes a disruption of blood supply and the resulting lack to blood supply is causing both the immediate concussion symptoms and becomes a precursor of possible long-term brain damage.   The lack of glucose and oxygen, delivered by the blood, causes the automatic “programmed cell dead” (PCD) regime in the brain to turn on.  As a result of brain functioning in this regime, some of the neurons enter “hibernation stage,” that is they don’t consume glucose and oxygen, just so the other cells could survive in the situation of sharply reduced blood supply.

The sooner the blood supply is restored, the sooner the “red alert” or PCD regime could be turned off by the brain, which would offer a better chance to those PCD cells to recuperate.  Conversely, the long-lasting lack of proper blood supply would increase the likeliness of hibernated cells to die, which is the major reason of encephalopathies, or brain degenerative diseases.

The massage protocol offered in the video, is directed toward reinstating the blood supply to the brain, to improve the damaged function of the neck that suffered as a result of a concussion and this is the main reason why it has to be implemented immediately after the concussion has taken place.  That’s why the difference between letting the “rest and time” take its natural course and performing the protocol could be the speed of recovery – disappearing of immediate concussion symptoms.  More importantly, the timely performance of massage protocol could mean the difference between a long-lasting or irreversible brain dysfunctions and brain function restored.

Does this mean that the recommended post-concussion protocol is only effective immediately after the concussion? No.

It is generally accepted that the cell in hibernated state could come back to life from 90 days to 9 month.  Boris’ practice shows that the cells could come back to normal functions even after a longer period of hibernation.  Therefore, as people in the first line of defense, a massage therapists should perform the post-concussion protocol even when between concussion and the moment when a client attended the therapist, some time has passed, as long as the client exhibits symptoms of concussion.  In many clinical cases, the protocol has shown improvement in the well-being of the client, even when the time gap between the moment of the concussion and the time of arriving in the therapist office existed.

For a successful treatment, it is important to understand the mechanism of concussions. When we running, jumping, even walking, neuronal and axonal membranes are stretched in the normal physiological range.

A mechanical significant blow to the head, producing sudden not physiological sprain of neuronal and axonal membranes. This sprain initiates release of many different neurotransmitters, and post-traumatic cellular derangement, increasing excessive amount of cerebral spinal fluid secretion, leading to inadequate blood supply to the brain, resulting inflammatory condition becomes an obstacle to a blood supply for normal brain function and much-needed extra blood supply to repair damages.

Insufficient blood supply along with dysfunctional mitochondria – intracellular source of reactive oxygen species, if will be not addressed, little by little leads to degenerative encephalopathy. With time, it can lead to movement disorders, dementia, psychiatric behavior disorders, chronic headaches etc.

From a neurological perspective, when there is a concussion, which is a head injury causing head trauma, brain cells are in the mode called “stunned brain.” This is also known as “hibernating brain cells.” This is a mode the cells go into in order to avoid massive apoptosis or necrosis. Apoptosis is also known as “programmed cell death,” describes the state when some brain cells go into the programmed cell death in order to allow other neighboring cells to survive. The only way to prevent neurons from going into hibernation is to increase cerebral circulation. Again the purpose of hibernation is to decrease cellular function to the point when fewer resources, blood, oxygen, glucose, are required for cell function and allows the neighboring cells a chance to survive heal/recover.

Immediately after a concussion and sometime later on, when concussion symptoms disappear, secretion of cerebral spinal fluid will be increased. However with time, as far as few years later, during a post-concussion period, a significant insufficiency of the natural drainage is observed. In other word, a stagnation of the cerebral spinal fluid occurs. This CSF stagnation, significantly disturbs a blood supply, and fuels encephalopathies developments.

An acceleration of the lymphatic and the cerebral spinal fluid drainage techniques, is equally important when an excessive amount of cerebral spinal fluid produced, as well as in the case of stagnation of the cerebral spinal fluid.

It is acceptable to think that during the nine months after a concussion, Programmed Cell Death can be reversed. From my personal clinical observations, when the obvious symptoms of brain dysfunctions start such as initial symptoms of dementia, Alzheimer disease or movement disorders, the acceleration of lymphatic and cerebral spinal fluid drainage techniques help to promote blood supply to the brain, and patients demonstrate improvement.

In my blog http://medicalmassage-edu.com/european-cranio-sacral-therapy/  I’m explaining the general concept on subject of encephalopathies, and the importance of acceleration of lymphatic and cerebral spinal fluid drainage techniques, as well as the importance of massage therapy in balancing sympathetic and parasympathetic activities.

In the clinical and scientific world, there are scientifically established facts, which in most cases are fundamental facts. However, sometimes clinical observations supported by clinical outcome suggest differently. In this case, after nine months, supposedly organic not reversible changes should develop, but I personally observed significant improvements, years later. We should not confuse encephalopathies due to post concussions, and encephalopathies due to different other causes. Dementia is dementia, and in early stages its developments can be stopped and reversed. For example, if a football player who have sustained a concussion, two years after the occurrence starts demonstrating and experiencing symptoms of dementia, the post-concussion protocol still can make a difference.

The physical methods of treatments proposed by former Soviet sports medicine experts are directed toward stimulation of blood supply to the brain, which in turn is the prevention of hibernation/apoptosis and/or necrosis.

As an instructor I often witness quite a curious phenomenon. Many massage therapists expect me to disclose some “deep and dark secrets” of mine; some “magic” spot on the client’s body where they can press and relief clients from suffering. When I am faced with such an idiosyncrasy, I always experience a feeling of peace and power. These practitioners seek truth about massage and it is very easy to teach them that truth about power of massage. It is easy for me to share with them and give a detailed explanation of “secrets” and clinical results that came to me through my over 40 years of clinical experience and through experiences of my teachers and students. To summarize these “secrets” in a couple of words in order to acquire a healing power a practitioner should:

Below is the content of my book ”Simple approach to massage therapy.  Part 1” In my book I’m sharing you the “secrets” of massage therapy in great details. This book is the ultimate guideline for those therapists who are driven by passion for our occupation.

Boris Prilutsky