Concussion Action Plan
If your child is playing contact sports you should NOT be thinking “IF they get a concussion…” but rather “WHEN they suffer a concussion…” this is what I will do.
No matter what rules are established, no matter what equipment is created accidents will happen and being prepared with your own comprehensive program is key.
So the questions are:
- “What should I do NOW to prepare for a probable head trauma?”
- “How can I be proactive when it comes to concussions?”
- “If helmets are not the answer than what is?”
Dr. David Burns has provided his patients with expert advice and guidance on concussion management for over a decade.
Download a must read PDF on concussion management below and create a Concussion Action Plan for your child.
Avoiding the reality of sports and the potential consequences will not make the issue go away. Being proactive when it comes to their brain health is a step in the right direction.
“As such, I highly support and conquer with Dr. Burns’ recommendation that anyone involved in sports with the potential for head injury or concussion, should undergo comprehensive baseline testing. These assessments should be done BEFORE the injury happens, and should be comprehensive in nature, creating the necessary reference point, which would help in designing an effective treatment plan to enhance neurological recovery AFTER concussion.” Dr. Mark Piker, board-certified neurologist
Thanks to Dr. Burns, I was able to take my finals and complete my school work only one month into the summer, and I was able to return to play all summer resulting in college offers.
My name is Jacquelyn, and I want to share my experience with Dr. Burns. I have been a competitive athlete since I was 10 (club soccer, then lacrosse). I can’t imagine where I would be without sports.
In early May of my junior year, during a heated state playoff game, I took a direct hit to the back of my head from an opponent’s stick. I remained on the field for the final minutes of the game, but I have no memory of playing after the hit. Immediately following the game, I was unable to stand up on my own and felt nauseous. That’s when I knew something was wrong, and a teammate sent me to the our training room. Our athletic trainer put me through the standard tests, identified that I was having trouble with my vision, and that I had severe pain behind my eye. She had my mom take me to the ER for a CT scan. Everything went downhill from there. I don’t remember much after that other than the excruciating pain as well as my sensitivity to light and sound. I went home and slept and tried to avoid all light.
Three days later, I found myself at Dr. Burns’ office. We had been referred to him by my coach. I can’t say I recall too much of the first couple meetings other than the fact that I was unable to walk down the hall or stand with my eyes closed. I failed every single balance test and I was unable to track anything with my right eye. Dr. Burns immediately focused on fixing my eye/vision. I had peripheral vision for the first time in three days. My mom and I knew we had come to the right place. He explained to us how brain rehabilitation works and why you do it. “It’s like breaking your arm. If you just slap a cast on it without setting it, it won’t heal properly. It will just adjust to the new circumstance. If your brain gets hit and you just sleep it off and start working again when it doesn’t hut anymore, it never healed. It is just adjusting to the new normal. The point of brain rehabilitation is to not only get you back to the point you were at before the concussion, but to make you better than you were before.” Like physical therapy for the brain. Having been through multiple cycles of p/t for other injuries over the years, that made perfect sense. From day one, he knew everything that needed to be done and which exercises would benefit my recovery. Each day was different than the one before, building on that day’s improvements. The point of Dr. Burns’ treatment is to keep the brain active and continually do exercises that will fine-tune everything from eyesight to your awareness in space (balance). Although this was my first diagnosed concussion, Dr. B was able to uncover the effects of previous injuries from years of hard hits on the field that my body’s systems had been compensating for in various ways. Dr. Burns’ immense knowledge is incredible, and how seriously he takes brain health and performance is a testament to how hard he works with each of his patients. Everything done in his office and during the at-home exercises (including an iPhone app) is intentional and purposeful, resulting in daily improvement. I actually started to look forward to each appointment, because I could see measured improvements every single day.
If I had followed the ER doctor’s – or even my pediatrician’s – advice, I wouldn’t have played all summer and I wouldn’t have been able to finish out my junior year of school. Thanks to Dr. Burns, I was able to take my finals and complete my school work only one month into the summer, and I was able to return to play all summer resulting in college offers. Without Dr. Burns, none of that would have happened and my entire future would have been put on hold.
It is absolutely incredible how quickly Dr. B can take an injury, quickly and precisely identify what needs to be done, work it back into shape, and then even further improve it. I am forever grateful for his expertise and dedication. And on top of that, he’s a great guy! Every appointment had some laughter and was very relaxed. I have recommended him to all my teammates and anyone else who has suffered a concussion. He’s the best!
“Dr. David Burns is the highly qualified expert in the rapidly emerging field of concussions…”
As an actively practicing board-certified neurologist and the Medical Director of the Headache Clinic at the Valley Medical Center in Renton, WA, I have seen the debilitating and life-altering effects of concussions regardless of their intensity or whether there had been only one or numerous concussions.
Very frequently the effects of mild to moderate concussions are subtle and do not cause major obvious symptoms besides transient headache, blurred vision, imbalance, and just feeling “blah” for the rest of the day.
With the moderate to severe concussions, especially when someone loses consciousness for any amount of time, the concussion victim is frequently taken to the Urgent Care or the Emergency Department. The usual outcome of those visits boils down to:
- a negative head CT scan (“no head bleed”),
- a diagnosis of probable concussion or closed head injury,
- advice to take Tylenol or Advil for a couple of days,
- recommendations to sit out games or practices for a few days, rest, drink and eat well, watch for increasing headache, nausea, vomiting, blurred vision, imbalance, and so on,
- come back to the Urgent Care or the Emergency Department if anything acute happens,
- see the primary or family doctor in a few days for recheck and clearance to come back to the field.
Even though there is frequently no MACROscopic evidence of concussion (no bruises, normal head CT, MRI), the physical blow to the head of ANY intensity generates enough shearing force on the small nerve fibers and nerve cells deep inside the brain causing MICROscopic damage to those cells and their connections.
The subsequent disruption or loss of the proper signaling between neurons may lead to the anatomically based functional neurological deficit. The immediate symptoms of the concussions and their after-effects depend, to a large degree, on the severity and the location of this microscopic damage.
If not treated and healed properly, the microscopic damage to the certain brain centers may cause the longer-lasting effects of concussions, which may be much deeper and profound, and affect not only physical performance, but also emotional state, and mental and cognitive functioning.
Obviously, concussions affect different people in a different ways, and most of the people are doing just fine without any major ill effects plaguing their lives for months or years afterward. But this is truly the luck of the draw.
Therefore, beyond ensuring that there is no head bleed, the more detailed evaluation of the concussion victim is needed to establish whether there is an indirect evidence of microscopic damage to certain brain centers.
The detailed assessment helps localize the cause of functional neurological deficit anatomically. Finding the structures most affected by the concussion helps with designing the individualized functional neurological rehabilitation program. This treatment will put the brain through the unique “physical therapy” to help repair the injured nerve cells and their connections back to the pre-concussion functional capacity or as close to it as possible.
As the field of concussions and related complications gains publicity, more people than ever are becoming aware of potential long-term consequences and realize the importance of good POST-concussion assessments.
However, designing an individualized treatment plan depends greatly on pre-injury condition. Unfortunately, most people suffering from a concussion do not have objective measurements of their baseline neurological functioning before the concussion occurred.
In my professional opinion, having a measurable baseline of individual healthy PRE-concussion neurological functioning would serve as a good reference point, and the treatment plan would be geared to help recover to that point.
To put it in IT terms, baseline testing establishes a “back up” or a restore point of the healthy operating system. Thus, when the system malfunctions for whatever reasons, the steps are taken to restore the malfunctioning system to the pre-existing functional reference point.
Dr. David Burns is the highly qualified expert in the rapidly emerging field of concussions, whether related to sports or other injuries. He has an extensive hands-on experience in proper diagnosis of concussions and treatment of their after-effects. He utilizes the latest scientifically proven techniques and equipment available on the market.
I have witnessed first-hand the utility of Dr. Burns’ testing and treatment outcomes, as his individualized therapies have benefited a number of my and some of my colleagues’ patients.
As such, I highly support and conquer with Dr. Burns’ recommendation that anyone involved in sports with the potential for head injury or concussion, should undergo comprehensive baseline testing. These assessments should be done BEFORE the injury happens, and should be comprehensive in nature, creating the necessary reference point, which would help designing an effective treatment plan to enhance neurological recovery AFTER concussion.
Mark Piker, M.D.
Athletic Trainer’s Opinion
As a certified athletic trainer at a local high school, I have had experience with many concussions. Typically, most concussions are treated with physical and cognitive rest until symptoms subside. Dr. David Burns has been an amazing referral for athletes and parents who are interested in a more proactive approach to concussion management. I have seen vast improvements in the concussed athletes that David has worked with so far. It has been amazing to be able to refer these athletes to work with David because I know their rehabilitation will include more than just physical and cognitive rest. Dr. Burns’ approaches treatment and rehabilitation by utilizing objective brain function assessments to identify the parts of the brain that are affected by the concussion. Each treatment plan is specific to that individual’s deficits, and exercises are given to target and improve function in those areas. It is very difficult for athletes to be stagnant and I have noticed that when the athletes have exercises to work on and goals to strive for, their attitude towards recovery and their concussion in general is greatly improved. I definitely recommend Dr. Burns for any athletes/parents looking for comprehensive and innovative concussion management techniques.
-Kristen Slonski, ATC/L, MA
Certified Licensed Athletic Trainer
Dr. David Burns … my hero
When I received the call that Saturday night in December I remember the pit in my stomach and the ache in my heart. It was an athletic trainer at the Lacrosse tournament in Las Vegas. He had assessed my son and confirmed he had a concussion. Not just a concussion but for Blake it was his third. He was hundreds of miles from home and had little memory of the day’s events. I had that echoing phrase running through my mind, three and he’s done! Worried and scared, I was up all night racking my brain as to what we were going to do… I remembered after his second concussion a friend had given me the name of a Doctor. He said he specialized in concussions, his name was David Burns. I came to find out that was a big understatement. I emailed Dr Burns the next morning, Sunday. I received an email that day asking me to fill out some health history questions and to bring Blake in the next day. Shocked I would actually get a reply on a Sunday. Thinking wow impressive, is he for real?
The next day we saw David Burns in his private office, he ran several tests and assessments regarding the severity of Blake’s concussion and what part of the brain was affected, checked his balance, his memory, his strength. He also assured us that this was not the worst concussion he had ever seen and there was no reason he needed to quit playing his beloved sport. What followed was amazing. Blake worked with Dr Burns daily on brain rehab. Dr. Burns explained that the brain is like other areas of our body, i.e.: bones and muscles, if they get injured they need rehab. Yes brain rehab! Blake recovered in record time, compared to the previous two. Yes, I did have something to compare too. He missed only a small amount of school was able to take his sat tests as scheduled and get back in the game he loved so much. What I’m about to tell you is no short of a miracle….
Blake learned a lot about concussions. The previous treatments had been rest, quiet and more rest. Doing nothing for weeks, suffering with throbbing headaches and severe irritability. Dr. Burns takes a different more aggressive and proactive approach to concussion management. Just because Blake was cleared to play didn’t mean he was finished with rehab. He continued to work on his own rehab that Dr. Burns taught him to do daily and also worked weekly with Dr. Burns himself on brain skills, coordination, balance and memory. He became a better athlete and student because of this. He was quicker, faster, and had more focus on and off the field.
Unfortunately, He suffered another concussion in a very physical game. Number four. This is where the miracle comes to play…. Blake again lost his memory the night of the hit. The next day he was only groggy, the following day he said he felt OK a little off, he never had a headache, he only missed one day of school and was cleared to play in 10 days. He went on a special diet, took vitamins, got rid of sugar and sugared sports drinks, he was truly in top form. There is no way he could have recovered from that concussion that fast without the expertise of Dr. Burns. His brain was in peek condition and only momentarily had to re group. As a result he was one of the leading scorers on his team; he was made team captain and was written up in the paper as someone to watch. This was possible because of his work with Dr. Burns. He not only recovered he got better!
Honestly, I can’t not imagine Blake not playing sports, he is a true athlete, he lives and breaths the game. Dr. Burns has given us confidence that with proper rehab, and continued exercise of the brain muscle it will make Blake more resistant to injury. I wholeheartedly believe it. I know his work helped Blake get back in the game. To Dr. Burns, Blake is not just another patient with a number; he treats him as if he were his own. He emails, calls, follows up, holds accountable and has actually become a friend and mentor to Blake. I have never seen such dedication, passion and love for what someone does as much as David Burns.
In conclusion know that the secret to concussion management and prevention is to start with a healthy, strong, exercised brain. Start the brain work out before the injury. Would you ever consider running a marathon without training? Well same with the brain. It needs testing, training, pushing, stress, strain and limits to improve its function.
Now you can see why Dr David Burns is my hero. Thank you can not convey the gratitude I feel about what hope he has given us.
Melinda and Blake Lee
I have so much to be thankful for and finding Dr. Burns is high on the list! Thank you!
My 13 year old daughter suffered a fall while ice skating, resulting in a concussion. She was immediately dizzy, nauseous and experienced blurred vision. Within the hour we had her admitted into the emergency room for a CAT scan and waiting a diagnosis from the on-call physician.
While I was waiting for the doctor I realized my daughter wasn’t herself and that this was probably a bigger deal than I expected. As the doctor entered the room, he turned on the TV for my daughter to watch (NOT a good idea after a head injury). After speaking with the doctor about her injury and diagnosis, I inquired into my next steps. Should I monitor her during the night? No, he told me to let her sleep. When should I take her into her pediatrician for follow up and to be cleared of symptoms? He told me that was unnecessary. He then released my daughter to play soccer the following day, stating that soccer was probably a safe sport, just don’t head the ball. I did let him know that girls’ soccer has the second highest concussion rate among all sports, second only to football. The doctor was very surprised. He gave me several pieces of inaccurate information pertaining to my daughter’s injury. It was clear to me that this doctor didn’t know as much as he should about concussions and concussion treatment.
I took my daughter home and decided for myself to keep her in a darkened room, in her bed, with no stimulation. When she awoke the next day (Saturday) she was still very nauseous,had head pain, blurred vision, dizzy and was extremely lethargic and void of personality. I felt very uneasy and knew something was very wrong but I didn’t know where to turn.
One friend had told me to call Dr. David Burns; another had directed me to a well-known Hospital Concussion Clinic. My gut had told me to call Dr. Burns. Always follow your gut!I contacted him via e-mail Sunday evening and received a phone call from him about 20 minutes later. He could see us Monday morning.
When we arrived at Dr. Burns’ office he first observed my daughter walking down the hallway and we both could see obvious issues with this simple task. Throughout the next 2 hours his findings were mind boggling. He carefully performed several test, many I have seen before with my younger daughters neurologist, but I had never before seen Video Nystagmography to track eye movements or Posturography which measures vestibular deficiencies and balance. My daughter was having obvious struggles with her balance, coordination, eye tracking/movement and reaction time. She was a mess!
How could the ER doctor just send her home and tell her to play soccer? I don’t know! For 9 days she did nothing but lay in a dark room with no stimulation, and visit Dr. Burns. At day 11 our family was finally able to see our daughter emerging from this cocoon she had been trapped in. No sparkle in her eyes yet, but we could tell she was in there.
Each day we met with Dr. Burns he measured her improvement and pinpointed the sections of her brain that were affected. He has an amazing ability to understand what areas of the brain effect and control the parts of her body that were struggling. This was unlike anything I have ever seen.
My daughter worked with Dr. Burns not just until the symptoms resolved but until her function was restored and she regained everything that was damaged from her accident and she has emerged a confident, smart teenager with a stronger, quicker brain. Her personality is back and so are her A grades and soccer skills! I have so much to be thankful for and finding Dr. Burns is high on the list! Thank you!
I love that you are looking out for her in the long-term as well.
Dear Dr. Burns,
A Parent’s Full Endorsement – David Carpenter
A Brief Background with Concussions
I was forced to get interested in concussions and brain health when I was asked to put together the Zachary Lystedt Law consent forms for both Puget Sound Flight Basketball and Skyline Select Girls Basketball at tryouts this past year. The requirement to have each parent sign a consent form struck me as a bit reactive and burdensome at first. It seemed like just some additional paperwork and a formality, but I read more about it on sources like the NFL’s websiteand became more interested and concerned.
ISC Concussion Night
When the Issaquah Soccer Club offered up a night about concussion awareness I made sure I could go. There were two speakers there that night. One offered up the traditional warnings about how frequent concussions and other youth sports injuries are becoming, how serious they really are, and what sports they predominantly impact (football, wrestling, boys and girls soccer), but the 2nd speaker, Dr. David Burns, offered up a glimpse of a new approach: Baseline your kids now, so that in the event of a head-related injury, at least you’ll know how bad it is, and possibly even what part(s) of the brain were affected.
Mental Push Ups
David offered up this analogy: Let’s say the normal kid in America can do 8 mental push-ups, but your kid is capable of doing 15. They get injured and you take them to the hospital where they are primarily concerned with Acute Urgent Care (making sure your child is not internally bleeding or going into convulsions or about to die). They assess your kid and tell you, “Hey, your kid is fine. He/she can do 8 mental push ups just like everyone else.” If you didn’t have baseline data of what your son or daughter was capable of in their healthy state, that’s all the information you would have and you’d have to be content. But if you had the baseline data to suggest 15 mental push-ups was the norm for your child, you’d want a more thorough and comprehensive rehabilitation treatment plan.
Raising the Performance Ceiling
Then he went further to suggest that perhaps it is possible to raise that mental performance through training. What if your 15 mental push-up kid could be trained to do 20 or 25? What if he could train the brain to react quicker and more accurately? What if that improvement meant quicker reaction time on the field — that could possibly even avoid the next head on collision and prevent a brain injury or concussion? That brain performance improvement could lead to academic and athletic performance gains. I was a little skeptical, but intrigued enough to keep reading and asking questions over time.
Very Timely Comprehensive Baseline Testing
I discussed this idea with Gretchen, my wife, and a little bit to my surprise, she agreed and scheduled all three of our kids for the comprehensive, 3+ hour testing with David. Just nine (9) days after my daughter Marissa’s testing was completed, she took a hard charge on the basketball court, fell to the floor and stayed down. As a coach I was quick to get to her. Another coach came over and helped me run some initial tests of her memory, eyes, check for nausea, etc. My recent Lystedt Law education told me that she would have to come out of the game and see a Doctor and be cleared before returning to play.
Sunday Office Hours
Gretchen contacted David Burns, who agreed to meet us at his office on the way back from that tournament on a Sunday afternoon. He conducted some initial tests to compare to Marissa’s baseline tests, and within a half hour was able to diagnose a mild, vestibular concussion (affecting her center of balance). David went on to treat and train her for the following three weeks. Suffice to say she made remarkable progress regaining not only her balance function to where it was and getting cleared to play after three weeks… after five weeks she is now testing at levels above her original baseline test scores, indicating that she appears “better than new”, as David recently quipped.
Note: In subsequent conversations with David about his assessment that day he assured me that if he had seen signs of gross neurological deficit or critical condition, he would have immediately referred us to the hospital. The idea is that David is an easy check point between parents deciding to stay at home and potentially wait and see and going to hospital or urgent care unnecessarily.
Brain Performance translating to on court and on field performance
Marissa’s first weekend back at sports after her three-week rehab and resting period was the Seattle Youth Basketball TOC Last Chance Qualifier Tournament. In the semi final game, Marissa led all players with 14 points, 4 rebounds and 4 steals, and was named “The Beast” and “Da’ Boss” by her teammates for her effort. This is nearly 200% improvement in scoring over her best prior basketball performance, and roughly 500% improvement over her norm of 2-3 points per game.
As her Dad and coach, I attribute this greatly improved performance to the eye, balance and brain exercises and care she received from Dr. Burns, and to much needed rest and recuperation she needed after a long stretch of parallel soccer and basketball seasons. I was incredibly pleased she returned to play, safely, so quickly, but even more impressed at how her accuracy and decision making has improved in both soccer and basketball since her rehab.
And it’s not isolated to just Marissa. I’ve seen improvements in our youngest son, Ryan, on field as well. Ryan did the comprehensive testing, participated in an intense one week brain training boot camp during Spring break, then went out to have his finest soccer gamer to date and scored his first goal of the season from midfield. There are several other Gunners players I’m aware of who are working with David and seeing marked improvement in their on-field decision-making and reaction times to changing game conditions. (I’m also aware of a player who “attended” the same boot camp as Ryan, but did not put in the effort or take the training seriously, and as you would expect, did not realize any visible on field performance gains the following weekend.)
Our Full Endorsement
My wife, Gretchen, and I wholeheartedly recommend that parents at least take the first step: ImPACT training for sure, but also comprehensive baseline testing with Dr. Burns. If you have a kid who is in any competitive athletic program, whether it is football, basketball, LAX, soccer, wrestling or wherever head-to-head or head-to-floor contact is possible, you owe it to yourself to get the baseline information — just in case of the unfortunate event that your kiddo suffers a freak, split-second injury like Marissa did. David Burns has been entirely professional and a “team player” when it comes to working alongside others in the care of Marissa.
Sharpening the Saw
Steven Covey wrote in his book “The 7 Habits of Highly Effective People” Habit 7: “Sharpen the Saw”. In the author’s words, “It means having a balanced program for self-renewal in the four areas of your life: physical, social/emotional, mental, and spiritual.” For our kids, we’ve decided to invest in ongoing, weekly brain training with daily “brain homework” exercises that our kids work on and record their progress in a journal that they take back and share with David. You can certainly make your own determination if “brain training” is for you and your child after you’ve seen the baseline results and gotten to know David and his approach a bit more.
Feel free to contact me with questions about our experience with David Burns and Brain Centers NW.
-David Carpenter, david.carpenter [@] gmail.com
“… An entirely new aspect of performance”
MPT CEO, Owner
G4 Athlete, LLC
“… Impressed with the individual care my daughter is getting”
My daughter suffered a concussion on Mother’s Day weekend while going through the first day of soccer try-outs. We had heard Children’s Concussion Clinic had a great reputation and many of my daughter’s friends had been there, but we also had heard about Dr Burns. We decided to take our daughter to both places to compare treatment options. The drive to Children’s caused my daughter to become nauseated, the waiting room was over stimulating, and the hour wait to see the doctor was exhausting. The doctor was very nice as she gave our daughter the SCAT test. She also had her do some balance tests and visually assessed her. She told our daughter to “unplug”, go home and rest, and come back in a week. Then, the doctor said our daughter could try school when she was ready. When we left, we felt we had learned more from our friends who had children with concussions than we did from the doctor.
We drove straight from Children’s to see Dr. Burns. For a concussed person, two appointments back to back was probably not the best idea, but it was an excellent way to compare options with the prior one fresh in our minds. Dr. Burn’s office is less than 10 minutes from our house and the waiting room was quiet. His office is small with few distractions. The most interesting difference for us was the equipment to assess her. He had her stand on the CAPS force plate. Instead of relying on his visual judgment alone, he used technology to measure her balance and rate it as a percentile. He also put the VNG goggles on her to see how her eyes were tracking and then he had her take the ImPACT test. Children’s had mentioned giving her the ImPACT test, but they opted to wait until our next visit in a week or two. We were amazed at the tools Dr Burns was using to access our daughter’s condition, not just relying on his eyes alone. Before we made our decision to use Dr. Burns, we wanted to know what she should be doing for the next week. He urged our daughter to rest, that it was the most important thing for recovery, but gave her specifics what it meant. He also wanted to have daily email journals so he could see how she was truly “resting”. He said he would let us know when she was ready for school based on improvement of the test scores.
One week from the date of her concussion, her balance had gone from the 50 percentile to the 76 percentile. She is still unable to handle the stimulation of school, but his daily feedback and positive results kept her attitude up. She was feeling good, and decided to run up the stairs at home. She fell and caught herself, but fell none the less. To the naked eye, this was probably no big deal, but the CAPS force plate picked up the difference and her percentile dropped to 63. A week after her fall, she is now in the 81 percentile. It’s a measurable milestone.
She is going to 2 classes a day at school and we continue to journal and do the small exercises he is suggesting. Children’s hospital never called us to check in or to see why we didn’t come back. If we would have taken their advice, I know we would have tried to send my daughter back to school sooner and in the end, delayed her recovery even more. I have been impressed with the individual care my daughter is getting with Dr. Burns and most of all the measurable results. At two 1/2 weeks out, she is not fully recovered, but she is improving daily.
“We are forever thankful for all he has done to aid in the recovery of our daughter.”
Our 11 year old daughter suffered a second concussion in August 2011 playing soccer with the Gunners. We saw the sports medicine doctor, that we had used with her first concussion April 2010, a few days later and rest/brain rest was prescribed. Over the following months her symptoms not only persisted but worsened. We saw a number of specialists while trying to resolve her symptoms.
We were getting frustrated by her lack of improvement following the traditional medicine protocols. So by December when things were still not progressing from what seemed at first a simple concussion we were ready to try something new. I met Dr. Burns on sidelines of the soccer field that month.
I explained my daughter’s symptoms and he said, “That sounds like a vestibular problem.” He had her do one simple exercise on the sidelines and confirmed it. We had not heard it may be a vestibular issue in the previous 4 months. He said we would be proactive in resolving the problem instead of just allowing time to heal her. We loved this idea because as a parent it is heart wrenching to see your child in pain 24/7 for months and not be able to do anything to help.
Dr. Burns has spent countless hours with us trying different exercises to determine what we needed to do to help our daughter recover since we did not have baseline testing. At first we were seeing him daily, then a few times a week and now we are down to once a week. He works with us in the office then sends us home with exercises. We send him a daily journal email so he can monitor her progress through the week. He is extremely accessible to tweak the exercises between appointments.
He has such a passion for what he does and does not give up until he solves the problem. I truly believe our daughter’s recovery was personal to him as well. Our daughter is not yet to baseline but is closer everyday. We continue to work with Dr. Burns in order to establish a baseline for her.
We have another daughter who plays soccer and when the opportunity for comprehensive testing became available we jumped on it! I have learned through Dr Burns that there are little twitches that each of us have that determine a different course of action for full recovery.
I feel very fortunate to have met Dr. Burns on the sidelines that day. We are forever thankful for all he has done to aid in the recovery of our daughter.
“I was able to take objective tests that gave insight into how bad my concussion was.”
Hi my name is Jessie Oliver and I play for your local WPSL team. I wanted to share my experience with Dr. David Burns. Dr. Burns is an outstanding asset for our community and it is a privilege to have him available for our team. His expertise regarding the brain and how it functions is vital and should be embraced by ISC and other youth soccer programs.
After getting a concussion on June 15th I went to see a “normal” medical doctor. Although he could see I had a concussion I was not satisfied with the results of “rest and see how you feel”. “No heading the ball for a week and take a couple days off”, was all I was told. I left still not really knowing or having any way of assessing the severity and seriousness of my concussion. The general the doctors’ ideas were good, but he had no real data to support what the issue was. Yes I had a concussion, but that could mean a lot of different things.
When I found out I had to be signed back in to play again I asked to see a different doctor and Dr. David Burns was recommended by Howard Humbyrd and Dr. Justin Lee, both of whom are involved with ISC. The visit with Dr. Burns was quite different. I was able to take objective tests that gave insight into how bad my concussion was. One of the tests was called ImPACT. The ImPACT test measures speed of reaction, memory, and all sorts of things.
Luckily I had taken this test about a year ago which served as a baseline for comparison sake. On my original test, I scored in the 95% range on several of the tests. The test scores taken with Dr. Burns were significantly lower. I scored in the 16% and 33% range which was really low. The ImPACT test along with other diagnostics that objectively assessed my balance and my eye function, coupled with Dr. David Burns’ knowledge and “functional approach” has truly helped me see what needs to be done to achieve the fastest possible recovery. Also, these tests help ensure that I will not be sent back out on the soccer field to play too soon.
I feel so much better taken care of with Dr. Burns. It’s comforting to have the appropriate diagnostics and sensible approach that he provides. It’s so important that everyone understand the real urgency with getting these baseline tests done. As soon as you think you have time, you won’t and as soon as you think you are fine, you could have a head injury. I’m so thankful to have previously taken the ImPACT test, but I am more thankful to have found someone who can accurately tell me what is best for me rather than guessing.
Dr. David Burns not only works with traumatic brain injuries but helps player’s brains work at a higher level. He made a good point when he said “How do you get better at dribbling a ball, doing a scissor or kicking the ball? You practice dribbling, doing scissors or kicking the ball. How do you get better at striking a ball in the goal when there are several distractions, stress, and tons of things happening in your mind? You practice under those conditions.” Dr. Burns creates an environment for the mind that simulates the stress the brain is under during a game, but with seemingly simple exercises. Some of the exercises he has kids do may seem silly but they really do make sense. Trapping a small ball of a certain color that is thrown at you while counting backwards and spinning helps practice many fundamental skills. And his exercises would be hard for anybody, I mean tracking a ball, and turning all while doing math? Whew, that is difficult.
Our brains are incredibly important in sports and that’s why I think what Dr. Burns is doing needs to be recognized and taken seriously. I support him and I think if the ISC wants superior level teams, that they should invest and allow time to be set aside to work the minds of each player out there. It will only make the program stronger and more valuable. If professional players and the Marines are doing this stuff, why not start younger and give important skills to the kids who want and deserve it. Take a step towards a higher level of thinking which will in turn result in a higher level of playing.
Thank You for Your Time,
Jessie Oliver, WPSL
“Dr. Burns and his knowledge of the brain along with his tests and exercises that he performs should, without a doubt, be implemented into youth programs in all sports.”
Hi my name is Nasyir Rodriguez and I play for the North Sound Seawolves soccer club and I would like to share with you my experience with Dr. David Burns.
With this being my ﬁrst concussion, meeting with Dr. Burns was a completely new experience for me. At ﬁrst I thought it would just be a normal “doctor” visit, I thought he would just check my eyes, ask me how bad my head was hurting and then tell me to rest and check back with him at a later date. My thoughts were wrong. There were a number of objective tests that gave a complete understanding of how bad my concussion was. One test that I did was called the ImPACT test which measures verbal and visual memory, processing speed and reaction time.
Unfortunately for me I never did the test before which put me at a disadvantage because there were no previous results for me to compare my new ones with. This is why taking the ImPACT test is VERY IMPORTANT. Taking the test is a vital thing to do because it serves as a BASELINE which you can compare results to see before your concussion and after, which will give you an exact idea of the severity of your concussion.
My scores after doing the test were way below what it should of been, my lowest score was 10%. My eyes were a mess as well, I could not track a moving light smoothly and after doing it for too long I lost sight for a couple of seconds. After gathering all the results from my test, along with Dr. Burns vast amount of knowledge, he came up with the best solutions and exercises to get me back onto the field.
After doing exercises that Dr. Burns gave me to practice at home, I was amazed to see the difference it made when I went back and did the test over. I was able to track moving lights without any problems. My balance scores had gone up and my coordination was better.
What I liked about Dr. Burns approach was that we started in his ofﬁce where there was no stress factors and he broke everything down as simple as he could so that I could really understand what was going on with my head. Then as I improved we took it to the ﬁeld and made it more related to the sport I play. Which in my case is soccer. The main thing that intrigued me was how he joined in the soccer concepts into the brain training.
His exercises ranged from spinning while running, counting backwards and doing a ﬁgure 8 with your hand all at the same time. Spinning and then trapping a speciﬁc color ball while doing math. These exercises may not be what’s going to happen on a soccer ﬁeld but think of it like this. For me as a midﬁelder I constantly have to think of more than one thing at a time, I have to look over my shoulder to see whose behind me, while the ball is being played to me, where to go so the defender can’t get the ball and then where do I pass the ball next. All of these decision have to be made in seconds, which is why you can understand the importance of the exercises that Dr. Burns is doing.
Just like any other technique or skill you want to perfect, you practice it. These were just a few of the exercises that I got a chance to do, however there were a list of creative exercises that he mentioned that I could not wait to try. With these exercises some of the things that will improve is vision on the ﬁeld, coordination and timing, quicker thinking which results in quicker reactions. All skills that are fundamental to becoming better players.
Dr. Burns and his knowledge of the brain along with his tests and exercises that he performs should, without a doubt, be implemented into youth programs in all sports. My time with him was a deﬁnite eye opener and I am sure it would have the same effect on anyone who tries it.
I strongly recommend that time be set for Dr Burns to work with the children and get them involved with his program from as young as possible to give them the edge over other players that could only wish to get this kind of opportunity. This could be what makes AVERAGE players GOOD players and GOOD players GREAT players.
Comments from coaches, patients, colleagues on LinkedIn.
“I’ve known Dr. David Burns for a few years now, and the thing that I admire is his genuine commitment to patients. He simply loves his work that it’s not really a “job,” but a passion to work with a patient, which can be a rarity in our healthcare system today.” June 19, 2012
Michael Corsilles, Naturopath and Physician Assistant, Eastside Primary Care & Wellness
“After being hit head-on in a motor vehicle accident, I was referred to David for my injuries and broken bones. I found him to be extremely knowledgeable, had great “bedside manners” and I truly felt that I could feel confident in his abilities to get me back to good health, one step at a time.” June 13, 2012
Top qualities: Great Results, Expert, High Integrity
Penny Carey, hired David as a Chiropractic, deep tissue and pain in 2011, and hired David more than once
“Amazing work, I fully believe in the work David does, the baseline testing is an essential part of any childs education. I have witnessed first hand a dozen times in how his work does make a difference to the student/ players ability to get better.” May 22, 2012
Top qualities: Great Results, Expert, Creative
“David Burns and his brother Craig pioneered a unique health care offering in our area.
Integrated Health Center was an incredible value, and the best doctor’s office I’ve ever visited.
For the normal cost of a visit to the doctor’s office, a patient was able to see a ND, and a MD, and was actually able to talk to both of them at the same time, and for the full time you were billed for, (not just for 1 minute like at most doctor’s offices).
David is smart, thoughtful, patient, and willing to bring in other disciplines to solve a problem as a team. David was not condescending or aloof like many doctors, and none of his staff were either. He took a combined approach for a total solution to health problems. I’d recommend him to anyone.” May 17, 2012
Top qualities: Great Results, Personable, Creative
Ken Mizell hired David as a Doctor in 2008, and hired David more than once
“I have known and worked with David for over 5 years. Qualities which describe him are dedication, intelligence, empathy, kindness and compassion. Educated and qualified as both a naturopathic and chiropractic physician, David encourages his patients to become involved in their care. Following his interest and passion, he specializes in neurological conditions while treating the whole person. His expertise is a great addition to Seattle and the East Side.” May 10, 2012
Top qualities: Great Results, Expert, Creative
Jeff Puterman hired David as a Doctor in 2007, and hired David more than once
“David Burns and his staff provided expert, uniquely differentiated care. For a period of several years I relied on Dr. Burns and his staff to help me stabilize and improve several physical issues that were impacting my quality of life. His holistic approach, thoroughness in investigating root causes, and overall quality of care were superior to experiences I had with other care providers. I highly recommend.” May 4, 2012
Top qualities: Personable, Expert, High Integrity
David Ursino - hired David as a Doctor in 2009
“I have worked with Dr. David Burns, D.C., D.A.C.N.B. on several legal cases where he was the treating doctor and I was the attorney for his patient. Dr. Burns does a great workup on his patients. He does both diagnostics and treatment. He can explain his findings and defend his opinions when cross-examined. He made appropriate referrals to other specialists when appropriate. I feel confident recommending him to patients.” May 4, 2012
Top qualities: Great Results, Personable, Expert
Samuel Elder - hired David as a Doctor in 2005, and hired David more than once
“We were fortunate to get baseline testing done with Dr. Burns 9 days before our daughter received a vestibular concussion in a basketball game.
Having that baseline data was invaluable, as David was able to accurately assess and get her doing exercises that enabled her to return to sports and school in three weeks. Her academic performance has remained high, but her athletic performance has actually increased quite dramatically as a result of the training and rehabilitation process. My wife and I heartily recommend David to all parents who are interested in doing as much as they can to protect their kids in the event of athletic injury, and those who are interested in increasing performance on the court, on the field and in the classroom from quicker decision making, more mental focus and attention. His methods really do work.” May 3, 2012
Top qualities: Great Results, Expert, High Integrity
David Carpenter - hired David as a Doctor in 2012
David did a fabulous job assessing our 13-year-old when she got a concussion in soccer. Fortunately, we had done some initial pre-concussion testing with him and he was able to quickly diagnose the areas of impact and focus on exercises that would help her heal. He was vital in her recovery, and I strongly recommend him (athletes in particular). Thanks Dr. Burns!
David provided a level of care for my daughter that I was unable to find elsewhere. Instead of diagnosing a condition, David identified areas where my daughter was under performing and prescribed brain exercises to help her succeed. We are seeing improvement both in the classroom and on the soccer field. David’s dedication to children and his desire to help them perform at their best makes him a great doctor.
Owner, Pine Lake Construction
Brain Health – 4 Part Process
- Prevention: While healthy, establish a baseline of brain function and learn if you are at greater risk of injury.
- Trauma Evaluation: In the unfortunate event of brain injury (e.g. concussion) be able to quickly and accurately diagnose and identify the impact of the trauma. Don’t rely on symptoms to determine function.
- Health Management: Intelligently rehabilitate the area(s) of the brain that were affected (e.g. areas which scores lower than baseline assessment) and restore function to baseline / “healthy state”.
- Optimization: Increase the performance of the most valuable organ in the human body in a similar way to how we train our muscles in soccer, basketball, football, and as adults pay 100s of $$$’s for training at 24 hour fitness and Gold’s gym.
COMPREHENSIVE EXAM / BASELINE: $395
A comprehensive functional neurological evaluation or baseline testing assesses the strength and symmetry of all levels of the nervous system. Examining each level of the neural axis, comparing the symmetry of responses and putting the findings into the context of the whole network allows for pattern appreciation of what areas are weak and how you can be helped.
While disease management or symptom management is about uncovering or diagnosing a specific issue a comprehensive baseline evaluation is about finding your “weak links” or systems. Uncovering these asymmetries in function or relative weaknesses provides the opportunity to take a proactive approach to the health of your nervous system. If an area of your brain is not working very well and you injure that same area the outcome, in all probability will be much worse.
When it comes to sports and academics, we want to always be at the top of our game. Understanding what areas of brain function that you can improve, will provide you with the information and tools necessary for you to be on top.
Combining a functional neurological exam with diagnostics that test the strength of different brain “muscles” gives you a complete picture. If you were training your physical body would you evaluate half your muscles? Of course not. Our brain “muscles” work in concert with one another just like a body operates. An incomplete picture leaves us with assumptions about your present functional level.
Understanding where you are prior to a concussion or other neurological insult is important for returning you to your pre-injury status. Symptoms resolve well before pre-injury functional levels are reached. If symptoms rather than functional baseline levels are used to determine when you are once again “healthy” you will be short changed.
If you want an ideal approach to brain health management you need to establish a number of different baseline windows of your brain’s present function. The following diagnostics are used in addition to the neurological examination to ascertain the level of performance of various aspects of your brain / nervous system:
A) ImPACT testing measures multiple aspects of cognitive functioning including:
• Attention span
• Working memory
• Sustained and selective attention time
• Response variability
• Non-verbal problem solving
• Reaction time
B) Posturography is perfect for screening, assessing and diagnosing balance disorder/falls-risk patients. This testing gives us insight into areas of the nervous system associated with balance / vestibular function.
C) VNG equipment provides simultaneous subjective observation of the individual’s eye movements and objective collection and analysis of eye movement during both testing and rehabilitation.
D) Interactive Metronome (IM) is an assessment and treatment tool used in therapy to improve the neurological functions of motor planning, sequencing and processing.
BASIC BASELINE: $125
A) Posturography is perfect for screening, assessing and diagnosing balance disorder/falls-risk patients. This testing gives us insight into areas of the nervous system associated with balance / vestibular function.
Brain Training :
Once we understand what areas of your nervous system are the weak links, an individualized home program is created to strengthen these areas. If you can commit 15-30 min a day doing simple brain based therapies you can strengthen your brain and improve your academic performance and sports performance in ways you may not have dreamed possible.
Functional neurology emphasizes the nervous system as being the modulator of human expression and experience. The unique and complex responses of each individual’s nervous system to changes in their environment are central to the discipline of Functional Neurology.
New protocols in diagnosis and treatment are being developed everyday, and focus on neuro scientifically based interventions for brain injury prevention, concussion treatment as well as sports performance optimization.
Brain Centers NW offers affordable, integrated instrumentation for non-invasive brain baseline assessments, traumatic brain rehabilitation and functional optimization. Our equipment is designed for functional neurological and vestibular testing.
Our equipment and our detailed understanding of how information is shuttled through the nervous system allows us to develop and implement cutting edge, theory based therapies for concussion injuries and brain training exercises to enhance sports performance.
STEP 1 – Cognitive Baseline
Take the ImPACT Concussion Test today!
ImPACT takes approximately 30 minutes to complete. The program measures multiple aspects of cognitive functioning including:
- Attention span
- Working memory
- Sustained and selective attention time
- Response variability
- Non-verbal problem solving
- Reaction time
- Individual: $50 per test
- Team or Group* (8+ individuals): $25 per test
- Post Concussion follow up test: $50
* Team tests includes a parent / coach lecture on concussion management and functional approach to brain health and sports performance. Also included is a follow up Q and A to review results of the ImPACT testing. The team provides the facility for testing and the lecture.
- Measures player symptoms
- Measures verbal and visual memory, processing speed and reaction time
- Reaction time measured to 1/100th of second
- Assists clinicians and athletic trainers in making difficult return-to-play decisions
- Provides reliable baseline test information
- Produces comprehensive report of test results
- Results can be e-mailed or faxed for fast consultation by a neuropsychologist
- Automatically stores data from repeat testing
- Testing is administered online for individuals or groups
- Compatible with PC and MAC
The test battery consists of a near infinite number of alternate forms by randomly varying the stimulus array for each administration. This feature was built in to the program to minimize the “practice effects” that have limited the usefulness of more traditional neurocognitive tests.
More Info on ImPACT
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the first, most-widely used, and most scientifically validated computerized concussion evaluation system.
Developed in the early 1990′s by Drs. Mark Lovell and Joseph Maroon, ImPACT is a 20-minute test that has become a standard tool used in comprehensive clinical management of concussions for athletes of all ages. ImPACT Applications, Inc. was co-founded by Mark Lovell, PhD, Joseph Maroon, MD, and Michael (Micky) Collins, PhD.
Given the inherent difficulties in concussion management, it is important to manage concussions on an individualized basis and to implement baseline testing and/or post-injury neurocognitive testing. This type of concussion assessment can help to objectively evaluate the concussed athlete’s post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. In fact, neurocognitive testing has recently been called the “cornerstone” of proper concussion management by an international panel of sports medicine experts.
ImPACT can be administered by an athletic trainer, school nurse, athletic director, team doctor or psychologist, provided that they have completed training in the administration of the test. Post-concussion care and the management of concussion should only be administered by a trained medical professional. ImPACT assists doctors in making return-to-play decisions and should never be used as a stand-alone tool.
ImPACT is the most widely used computer-based testing program in the world and is implemented effectively across high school, collegiate, and professional levels of sport participation.
Read on to learn more about ImPACT Testing.
Learn about ImPACT testing as a component of a Comprehensive Functional Neurology Evaluation.
STEP 2 – Posturography is perfect for screening, assessing and diagnosing balance disorder/falls-risk patients. This testing gives us insight into areas of the nervous system associated with balance / vestibular function.
STEP 3 – VNG equipment provides simultaneous subjective observation of the individual’s eye movements and objective collection and analysis of eye movement during both testing and rehabilitation.
STEP 4 – Interactive Metronome (IM) is an assessment and treatment tool used in therapy to improve the neurological functions of motor planning, sequencing and processing.