Concussion Risk Management

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Concussion management is ever changing and as research progresses, our understanding of concussions allows for more successful treatment options. Previously, in a post titled “What You Need To Know About Concussions,”  we explained what a concussion is, the signs and symptoms, and key objectives during recovery.  Key points included the seriousness of concussions, the importance of seeking medicare care, individuality in your treatment plan depending on your symptom presentation, evolving management plans, and the standard of care for concussions. It is important to remember that concussions can be a direct blow to the head or elsewhere on the body, but only about 10% of concussions result in loss of consciousness. Signs and symptoms can vary from patient to patient including neurological impairment, impaired brain function, and abnormal behaviors.

But what about managing the risk of a concussion from occurring?

Risk management of concussions has become a popular topic with researchers as well as medical health care professionals that work with individuals at risk for having been concussed. Here at Back to Function we understand that concussions cannot be eliminated, but our goal is to help our athletes manage their risk of being concussed. Below are three components of proper risk management of concussions that we provide for our athletes at Back to Function.

  1. Neck flexor endurance test and neck exercises

Research suggests increased strength and stiffness of the neck muscles reduces the risk of concussions during athlete impact. The authors theorized a greater neck strength can reduce the force of the head’s dynamic response to the external forces in all planes of motion, across all ages, and both genders (Honda, Chang & Kim, 2018). At Back to Function we implement the Neck Flexor Endurance Test (NFET) to evaluate muscle endurance of the cervical neck flexors. This test allows us to determine a baseline so that we can see progression as we utilize strength/endurance exercises.  One of the exercise tools we have found to be quite effective at increasing neck strength/endurance and girth is the Iron Neck. The Iron Neck allows us to build a protocol that will allow for stronger necks!

2. Correcting postural faults

According to Tiwari et al (2019), a common factor in concussed individuals includes poor posture.  More specifically, 90% of research participants were seen with forward head posture, scapular anterior tilt, and increase in thoracic kyphosis. A foundation of care provided at Back to Function is postural restoration. As credentialed professionals of the Postural Restoration Institute (PRI), we can recognize asymmetrical tendencies in posture and implement corrective exercises. Balancing muscle activity throughout the body with the PRI approach best positions multiple systems of the human body for proper posture. Corrective exercise for proper posture is a component of concussion risk management and implemented in post-concussion treatment as well.

3. Improving reaction time

Head impact severity is increased with decreasing anticipation of a collision.  The quicker reaction time allows for the athlete to react to impending head impacts on the field (Honda, Chang & Kim, 2018).  As Certified Strength and Conditioning Specialists, we provide reactive quickness drills that improve the ability to identify specific stimulus and to respond appropriately. These exercises include auditory, visual and sensory cues in order to execute each drill effectively (

Concussion Baseline Testing

It is important for all athletes to undergo a standardized test providing baseline measurements in the case that they are concussed. In the unfortunate circumstance of a concussion, we can use the baseline to help in the diagnosis and treatment plan. At Back to Function we utilize the SCAT5, a standardized tool for evaluating concussions in athletes aged 13 years and older and should be given within the first 72 hours after a suspected concussion.  The ImPACT neurocognitive battery is a computer based program for assessing neurological function and concussion symptoms. As an integrative health care practice, Back to Function works with local medical doctors who can provide the ImPACT battery as a baseline as well as a post-concussion test. We recommend all athletes complete both the SCAT5 and ImPACT battery prior to playing their sport.

What should you do next?

If you would like to manage your risk of concussions, please give us a call so that we can perform the proper testing and exercise protocols to help you. If you have had a concussion and need help with your recovery, we can also assist you. We can be reached at 310-534-1900 or by email at


Honda, J., Chang, S., Kim, K. (2018). The effects of vision training, neck musculature strength, and reaction time on concussions in an athletic population. Journal of Exercise Rehabilitation. 14(5). 706-712.

Tiwari, D., Goldberg, A., Yorke, A., Marchetti, G., Alsalaheen, B. (2019). Characterization of cervical spine impairments in children and adolescents post-concussion. The International Journal of Sports Physical Therapy. (14)2. 282-295.

National Strength & Conditioning Association website

Postural Restoration Institute website

Dr. Shelby Kloiber
About Dr. Shelby Kloiber

Dr. Shelby Kloiber is a Master's of Science, Exercise Physiology 2011 graduate from Texas Tech University. In 2009 she became a certified personal trainer with the American Council on Exercise and in 2014 became a Certified Exercise Physiologist with the American College of Sports Medicine. She was faculty at Texas Tech University in the Health, Exercise & Sport Sciences department until she entered the Doctor of Chiropractic program at Southern California University of Health Sciences. She currently practices in Fort Worth Texas.