A particular interest of mine, especially with athletes.
Explore Conditions
Concussion recovery is an area I’m especially interested in working on, particularly with athletes. I use Nasal Release Technique (NRT) and Cranial Facial Release (CFR) — two names for closely related endonasal techniques — alongside Afferentology as part of my approach with this population.
Important: An acute concussion needs to be evaluated and managed medically first — that includes a proper diagnosis, monitoring for red-flag symptoms, and a graded return-to-play protocol overseen by a qualified provider. Cranial adjusting isn’t a substitute for that process, and I don’t use it as a first step immediately after a head injury. My interest is primarily in athletes who’ve already been through appropriate medical evaluation and are dealing with ongoing, persistent symptoms.
Why I look at the cranium after a concussion
A concussion is a functional injury to the brain, but the forces involved can also affect the surrounding cranial structures. When I evaluate an athlete with a history of concussion, I’m interested in whether cranial findings — restrictions, asymmetry, or changes in muscle testing — appear relevant to their ongoing presentation, alongside everything else in a full history and exam.
NRT and CFR for this population
NRT is taught through Cynthia Stein, PT, M.Ed. and her Conquer Concussion training program, and is marketed specifically toward concussion and post-concussion recovery. CFR is the flagship technique in my broader cranial approach. Both are endonasal techniques from the same historical family — see the full history — and I use them as tools within a larger assessment, not as a stand-alone protocol.
What the evidence shows
Manual and chiropractic approaches to post-concussion symptoms do have some support in the literature, but it’s worth being specific about what that support actually covers. Most of the chiropractic and manual-therapy research on concussion focuses on the cervical spine — addressing neck-related dizziness, headache and joint-position problems that commonly follow a concussion — rather than on cranial bones specifically. A 2025 scoping review of manual therapy for traumatic brain injury found that the scope of supporting evidence remains unclear, and most of the available chiropractic literature on concussion consists of individual case reports and small case series rather than controlled trials.
I haven’t found dedicated peer-reviewed research evaluating NRT or CFR specifically for concussion or post-concussion syndrome. The interventions with the strongest evidence base for persistent post-concussion symptoms are things like graded return to physical activity, vestibular rehabilitation, cognitive-behavioral therapy and psychoeducation — approaches I’d expect to be part of a well-rounded recovery plan alongside anything I do.
I don’t present cranial work as a replacement for the standard, evidence-based components of concussion recovery. I see it as one additional tool I can offer, particularly for athletes who still have symptoms after the usual course of care.
Who this is for
I’m particularly interested in working with athletes — at any level — who have a documented history of concussion and are dealing with persistent symptoms after appropriate medical evaluation and management. That can include ongoing headaches, dizziness, difficulty with focus, or other symptoms that haven’t fully resolved.
A related case
See multiple head injuries and chronic lower-back and pelvis pain for a real example involving a patient with a history of several concussions, among other head trauma.
Related reading
Read about cranial adjusting after head or facial injury, see the techniques I use, or read real patient cases.