The Good Kind of Brain Drain

Recently, a fascinating article was published in The Atlantic about how the brain’s ability to process waste may impact its ability to recover after injury.  The article describes current research investigating whether damage to lymphatic vessels in the brain during head traumas like concussions may result in buildup in cellular and molecular waste.  It is hypothesized that when the brain cannot effectively drain this fluid, one of the consequences may be lingering concussion symptoms – things like “brain fog”, fatigue, dizziness, and headaches.

The article states that “ the existence of lymphatic vessels surrounding the brain was confirmed only recently—in 2015—but scientists have long known that they exist elsewhere in the body, mingled among the veins and arteries that supply oxygen and nutrients to tissues and organs. This network of tiny, thin-walled tubes acts as the body’s molecular trash-collection system. The vessels collect the clear fluid called lymph that leaks from the bloodstream; it’s filled with immune cells, as well as proteins and molecular debris. These are transported to lymph nodes: small structures throughout the body that filter out the harmful waste.”

One of the problems with lymph drainage that is most familiar to the general public is “Lymphedema”, which is the swelling in a limb that sometimes occurs after surgery or injury.  Many women struggle with lymphedema in an arm after breast cancer treatments.  Other men and women may develop lymphedema in an arm or a leg after a traumatic injury – often one that involves a “crushing” force that damages vessels in the limb.  Lymphedema can also be the result of long-standing problems with veins in the legs, or an after-effect of an infection that damages lymph nodes.

The Atlantic article talks about how scientists are looking for ways to “fix the faulty pipes” when damage occurs in the brain.  They are hopeful that they will be able to discover ways to promote the healing of lymph vessels in the brain.  This sort of treatment might help to prevent and treat the long-term symptoms that sometimes occur after a concussion injury.  Such treatments might also help with other inflammatory conditions of the brain, such as Alzheimer’s disease or other more generalized declines in cognitive functions such as memory, thought processing speed, and decision making skills.

To the physical therapist, this article is fascinating because it provides additional support for the currently accepted “best practices” for treating concussion injuries.  We have learned as a profession that early active treatment after a head injury is important – both to help patients to efficiently recover the ability to participate normally in all of their life activities and to decrease the risk of ongoing symptoms.  No longer should people be told to stop all activity and sit in a dark and quiet place for several weeks, hoping that waiting for time to pass will automatically make an injury go away.  Instead, it is best to proactively start working on recovering normal brain and body function by exercising gently in a prescribed and supervised manner and by correcting any mechanical problems in the head, neck, or the rest of the spine that may have occurred during injury.  Part of the rationale for these early treatments is to promote blood flow to the brain, so that the nutrients and oxygen in the circulating blood can help the injured brain tissue to heal.  The Atlantic article suggests that really, these treatments are also likely to be positively affecting the brain’s lymph drainage system – stimulating the “pipes” that clear waste to more efficiently drain the brain of inflammation.  Early intervention with these types of treatments – in addition to restoring normal head and neck movement – are also certainly helping to drain lymph vessels in the head, neck, & upper body too.

At Symmetry, we have been participating in the prevention and treatment of concussion injuries since 2016.  We continue to be fascinated with the rapid advancements that are currently occurring in the field of concussion research.  Each year, our staff attends a “Concussion Summit” that brings health practitioners from a variety of specialties together to share research and clinical expertise.  We are collectively learning that looking more closely at things like vision and balance and memory and mood enables us to design and implement much more effective treatment plans for patients than we were able to previously.   The perspective of physicians and therapists and teachers, as well as research neuroscientists and coaches and counselors is all valuable.  Our experience at Symmetry working with patients that are experiencing symptoms associated with concussion has also prompted us to realize that many of the same treatments that benefit these patients are also useful for other patients that have not had a specific head injury, but are having trouble with symptoms such as headaches, jaw and facial pain, balance, dizziness, and “brain fog”.  Maybe we’re treating the lymphatic system, whether we are intending to or not.  And maybe, providing more intentional care for this global body system moving forward for each of our patients will add further value to our treatments for patients with a variety of diagnoses and also provide larger-scale ongoing benefits to the overall health of bodies and brains.

If you are interested in further information about concussion care, feel free to reach out to us at Symmetry.  You might also be interested in reading some of our past blog posts on the subject.  If so, please check out the following articles: 

Four Important Things to Know About Concussions

Concussion:  Don’t Cocoon

Heads-Up:  3 Things You Might Not Know About Concussion