A Bruised Brain Deserves Better: The Case for Cranial Therapy in Concussion Care
Canberra Concussion Therapy
Concussions are more than just minor head knocks—they’re brain injuries. Despite this, the standard post-concussion care protocol rarely includes direct cranial treatment. Most physiotherapists, general practitioners, sports physicians, and even neurologists focus on rest, gradual return to activity, and symptom management. But what if the root of the problem—the brain and cranial system—isn’t being addressed at all?
CranioSacral Therapy (CST), a gentle, hands-on approach that targets the craniosacral system, and acupuncture, a modality from traditional Chinese medicine that stimulates healing through targeted needling, offer novel, body-based strategies for supporting recovery from post-concussion syndrome (PCS). While both remain controversial in mainstream healthcare, a growing body of research and case studies suggests these approaches may offer relief to individuals suffering persistent symptoms.
What Happens to Your Brain When You Get a Concussion
According to research shared by the Concussion Alliance, a concussion results in a complex cascade of metabolic, ionic, and inflammatory events in the brain [6]. During the impact, the brain can twist or bounce within the skull, leading to cell damage, axonal shearing, and a disruption of normal neurotransmission. The injury sets off a neurometabolic crisis, which affects energy supply, blood flow, and neurochemical balance. This disruption makes the brain particularly vulnerable in the hours and days following a concussion, underscoring the importance of appropriate care that addresses the brain directly.
Why the Cranial System is Overlooked
The prevailing skepticism toward cranial therapy stems from outdated anatomical beliefs and a lack of large-scale randomized controlled trials. Many clinicians believe adult cranial bones do not move and are therefore resistant to the foundational principles of CST and cranial osteopathy. Additionally, medical training generally omits manual therapies targeting the cranium, creating a knowledge gap that reinforces this skepticism.
This means that post-concussion treatment often bypasses the actual site of injury—the brain and its surrounding tissues.
Understanding CranioSacral Therapy (CST)
CST was developed by osteopathic physician John Upledger and involves light-touch manipulations of the skull, sacrum, and spine to influence the flow of cerebrospinal fluid (CSF) and release restrictions in the craniosacral system. The goal is to restore balance to the central nervous system and improve the body's natural healing processes.
According to the Concussion Alliance, CST has helped many patients relieve persistent PCS symptoms, including headaches, dizziness, anxiety, brain fog, and sleep disruption.
Acupuncture for Concussion Recovery
Acupuncture, rooted in Traditional Chinese Medicine (TCM), involves the insertion of fine needles into specific points to stimulate healing, modulate pain, and restore balance. Research suggests acupuncture may help regulate autonomic function, reduce inflammation, and alleviate symptoms such as headache, insomnia, and emotional dysregulation—common in PCS.
A randomized controlled trial published in 2013 showed that acupuncture significantly reduced post-concussive symptoms and improved cognitive function in patients with mild TBI [4]. Additionally, a 2020 review concluded that acupuncture has potential neuroprotective effects post-TBI and may assist in reducing secondary brain injury markers [5].
Pros and Cons of CST and Acupuncture
Pros:
Non-invasive and low risk
Targets cranial tension and CSF flow (CST)
Regulates nervous system and reduces inflammation (Acupuncture)
Supported by patient case studies and early research
Cons:
Limited large-scale, peer-reviewed studies
Skepticism among mainstream providers
Requires experienced practitioners for effectiveness
What the Evidence Says
Wheeling University Pilot Study: A collaboration with the Simkovich Cranial Institute revealed significant improvements in blood flow, CSF circulation, and PCS symptoms in patients undergoing cranial movement therapy [1].
Case Report on Manual Therapies: A collegiate athlete with an 18-month history of PCS showed an 87% symptom reduction following CST and related manual therapies [2].
Acupuncture RCT: A study demonstrated that acupuncture significantly improved symptoms in patients with post-concussion syndrome, including headache and memory issues [4].
Acupuncture Systematic Review: Findings showed acupuncture to have neuroprotective and anti-inflammatory effects in TBI models [5].
Patient Testimonials: The Concussion Alliance features multiple first-hand accounts of dramatic symptom improvements following CST and acupuncture, often after months or years of ineffective standard treatments [3].
Self-Care After a Concussion
Self-care plays a vital role in concussion recovery. The Concussion Alliance offers a comprehensive overview of effective strategies [7], including:
Pacing & Rest: Avoid overstimulation and balance activity with rest to prevent symptom flare-ups.
Nutrition & Hydration: Anti-inflammatory diets and proper hydration support brain repair.
Sleep Hygiene: Restorative sleep is essential for neuroplastic recovery.
Mindfulness & Stress Reduction: Techniques such as breathing exercises and meditation help regulate the autonomic nervous system.
Low-Intensity Aerobic Exercise: When appropriate, light movement like walking can support brain recovery by improving circulation.
Incorporating these self-care practices alongside manual and integrative therapies can significantly enhance the healing trajectory.
The Case for Including Cranial Therapy and Acupuncture
Post-concussion syndrome is notoriously difficult to treat. It’s multifactorial—affecting the musculoskeletal, vestibular, visual, emotional, and neurological systems. Ignoring the cranial system entirely, or dismissing integrative approaches like acupuncture, could mean missing a vital piece of the healing puzzle.
Manual cranial therapies and acupuncture may help by:
Enhancing CSF circulation
Reducing dural and fascial tension
Modulating inflammation and autonomic function
Supporting neuroplastic recovery processes
Even if CST and acupuncture are not cure-alls, their inclusion in a multidisciplinary approach may accelerate healing and provide relief to those who feel they’ve run out of options.
Conclusion: A Call for Open-Minded Integration
Current concussion care is robust in some areas, but lacking in cranial-focused intervention and integrative therapies. While CST and acupuncture may not yet have the weight of large-scale clinical endorsement, their low-risk profiles and promising outcomes warrant serious consideration.
A bruised brain deserves better. And that might mean going beyond convention—to the cranium, the fascia, and the meridian.
ReferencesWheeling University. Researchers at Wheeling University collaborate with Simkovich Cranial Institute to study a novel technique of cranial movement therapy for individuals suffering post-concussion symptoms [Internet]. 2019 [cited 2025 Mar 23]. Available from: https://wheeling.edu/wu-news/news-home-researchers-at-wheeling-university-collaborate-studies-of-cranial-movement-therapy-for-individuals-suffering-post-concussion-symptoms/Rubenstein L. Integrative Manual Therapy Case Report: 87% reduction in post-concussion symptoms. J Am Osteopath Assoc. 2021;121(4):e1-e4.Concussion Alliance. Craniosacral therapy [Internet]. [cited 2025 Mar 23]. Available from: https://www.concussionalliance.org/craniosacral-therapyWang Y, Zhang R, Liu J, Yang Y, Chen P. Acupuncture in the treatment of post-concussion syndrome: a randomized controlled trial. Chin J Integr Med. 2013;19(11):820–4.Zhang L, Wang T, Shen Y, Liu Y. Neuroprotective effects of acupuncture in traumatic brain injury: a review. Am J Chin Med. 2020;48(1):1–18.Concussion Alliance. What Happens to Your Brain When You Get a Concussion: A Deeper Dive [Internet]. [cited 2025 Mar 23]. Available from: https://www.concussionalliance.org/what-happens-to-your-brain-a-deeper-diveConcussion Alliance. Overview of Self-Care [Internet]. [cited 2025 Mar 23]. Available from: https://www.concussionalliance.org/overview-of-selfcare
