Here are the most common questions received by Dr. Mark:
Click on any of the questions below to be taken to an answer.
Acute Concussion & Sports Concussion
Persistent Post-Concussion Symptoms
About Dr. Mark & The Practice
What is a concussion?
A concussion is a mild traumatic brain injury. There is no such thing as a “mild concussion.” You either sustain a concussion, or you don’t. The damage in concussion is considered functional and temporary, as there is nothing found on MRI/CT imaging and many individuals go on to recover within 30 days.
Is a concussion permanent?
A concussion is a temporary, functional brain injury. In most cases, symptoms will peak (be at their worst) in the first 3-5 days after injury, will have symptoms go away in 7-10 days, and will be metabolically recovered in 21-30 days. Symptom recovery is not the same as metabolic recovery.
It’s estimated that ~20-30% of patients who do not receive treatment for their concussion will experience persistent concussion symptoms (PCS; also called Post-Concussion Syndrome). This is when symptoms last longer than 14 days in adults and longer than 30 days in children.
Should I rest after a concussion?
”Rest is best” is an outdated and possibly harmful recommendation in concussion recovery. Rest is recommended for the first 24-48hrs after injury; however, symptom-limited activity is recommended as early as 48-72hrs after injury.
Additionally, research is beginning to support sub-symptom threshold exercise to accelerate recovery times overwhelmingly. The standard testing for this is the Buffalo Concussion Treadmill (or Bike) Test.
Can I take Ibuprofen after a concussion?
There are two general rules around medications (particularly NSAIDs) and concussion:
First, do not take a NEW medication for NEW symptoms in the first 24-72hrs after a concussion. You do not want to mask life-threatening symptoms. Severe or worsening headache can be an urgent sign that CT imaging is needed.
Second, concussion or not, it is not recommended to take an NSAID (e.g., Ibuprofen) for more than 10 days in a row. That’s actually written into medical standards of care, though you may not know it by how we pop OTC pills for pains.
Is it safe to exercise after a concussion?
Not only is it safe, but the appropriate dose of exercise can be integral to your timely recovery.
Steady-state, low-intensity aerobic exercise is recommended in the acute stages following a concussion. This is called “Sub-Symptom Threshold Exercise (SSTE),” and it is strongly recommended in the acute stages of concussion recovery. A Buffalo Concussion Treadmill Test (BCTT) is typically performed by your doctor/therapist to find your specific “dose” (sub-symptom heart rate) of exercise following a concussion.
Resistance, circuit, and high-intensity aerobic or interval training are NOT recommended in the acute stages of recovery. Once you have successfully passed your BCTT, you can talk with your provider about the safest way to reintegrate into higher intensity and more dynamic activity.
What are persistent post-concussion symptoms (PPCS)?
Previously called “Post-Concussion Syndrome,” researchers and clinicians are moving to Persistent Concussion Symptoms (PCS). This term provides a bit more clarity into the condition.
Persistent post-concussion symptoms are precisely what they sound like; symptoms that persist long after your concussion. This diagnosis is considered when your symptoms:
Last longer than 14 days (adults)
Last longer than 30 days (children)
What causes PPCS?
There are typically five reasons your symptoms may not have gone away. These are the five “roadblocks” in PPCS, and they include:
Physiologic/Autonomic (“Blood Flow”) Dysregulation
Metabolic/Hormonal Dysregulation
Visual/Vestibular Dysfunction
Cervical Spine Injury
Psychological Distress (or Mental/Emotional Trauma)
A visit with a concussion specialist can help you to find and address your roadblock(s).
What is a naturopathic doctor?
Dr. Mark Heisig is a naturopathic doctor (ND) licensed in both Arizona and Washington state. Naturopathic doctors can be thought of as the “original functional medicine” doctors. Requiring four years of accredited, graduate, medical education following an undergraduate degree, naturopathic doctors are trained as primary care providers with advanced training in nutrition, botanicals, physical, and behavioral medicine. With basic sciences, clinical sciences, on-site clinical rotations, and licensing exams; NDs are real doctors. Scope and licensure for NDs vary from state-to-state.
*Licensed naturopathic doctors are not “naturopaths.” Often, folks who use the term “naturopath” are unlicensed, online-trained, and did not attend a nationally accredited program. When looking for a naturopathic doctor, look for a licensed ND that graduated from an accredited naturopathic medical school.
Where did Dr. Mark receive concussion training?
Dr. Mark has received post-graduate concussion training from Complete Concussion Management (CCMI) and is a subscribing member of the CCMI research updates. (*Currently not listed as a certified CCMI clinic/practitioner, Dr. Mark may attempt to pursue this clinic distinction shortly.)
Dr. Mark also receives journal notifications for up-to-date concussion research publications and stays as current and evidence-based as possible. Additionally, he has completed hundreds of hours of applied clinical neuroscience training from The Carrick Institute.
Concussion/PPCS is always evolving. Research is exploding. Education never ends.
How much do Dr. Mark’s services cost?
Dr. Mark prioritizes providing top-notch, evidence-based, integrative concussion/PCS care at affordable prices. Because every head injury is as unique as the individual who sustains them, each individual's recovery timeline will be unique. Because of this, Dr. Mark offers single-session and multi-week package options to accommodate varying timelines. Session and package rates range from $275-$2,600. All packages include an EQ Brain Performance subscription and discounts on supplement recommendations. All in-person packages include in-house autonomic/exercise testing and BTrackS Force Plate assessment. In-person and virtual packages may include blood work and interpretation. Learn more about packages here.
Concussion Cost Notes: The average concussion (mTBI) "out-patient" in the United States spends $4,185 to $4,207 on their concussion in the first 12-months after injury. The median cost per patient is approximately $1,900 in 12 months. Dr. Mark aims to stay below the average while providing far superior care. Compare this to the minimum fee of $3,500 (up to $25,000) seen at many specialty concussion clinics (e.g., Amen).
Does Dr. Mark take insurance?
Dr. Mark is not currently contracted with any insurance companies. However, upon request, Dr. Mark will provide a Superbill for you to submit to your insurance company for reimbursement.
Insurance currently dictates far too much of how doctors practice. From what labs/imaging can be ordered, which therapies will be covered, how many sessions will be allowed, etc... This is why your doctor can only spend 5-7 minutes with you, and is overworked from patient volume. This system doesn't allow clinicians to provide you the best care possible and is why many providers, both conventional and integrative, are stepping away from insurance.
Have more questions?
Dr. Mark will love to chat with you one-on-one if you have more questions about concussion care or recovery for yourself or a loved one.