#115 - Inside the Athlete’s Brain - Understanding Concussions and Neurofeedback with Dr. Kevin Butterfield, Part 1

Welcome to The Factor Podcast, where we talk about the stuff they didn't teach you in school. How to grow your practice, refine your clinical skills, and get better results for your patients. We're here to help you navigate the real-world challenges of being a healthcare provider, from delivering top-notch patient care to running a business that doesn't run you into the ground. Whether you're fresh out of school or scaling your practice, we're diving into effective cutting-edge treatments to get patients better faster. We'll also talk about business strategies and tactics to help you work smarter and not harder, and the mindset shifts required to thrive as a top performer in your field so you can build a career you love without burning out. If you're ready to learn what works and what doesn't from leading experts, industry innovators, and respected clinicians across a wide range of specialties, you're in the right place, my friend. Let's dive in. Welcome back to the Factor Podcast, where we explore the science, systems, and strategies that push human performance forward. My name is Jessica Riddle. I'm your host. Welcome, and thank you for listening. If you've been one of our listeners for a while, you might remember episode 112, The Future of Sports Medicine: Brain Training with Neurofeedback, with Dr. Kevin Butterfield. That episode quickly became one of our most streamed shows, and the feedback has been incredible. So we invited Dr. Butterfield back to take the conversation even deeper. In this new 2-part series, we're unpacking what really happens inside the athlete's brain, how concussions and trauma disrupt neural communication, and how neurofeedback is changing everything we thought we knew about recovery, focus, and performance. In today's episode, part 1, Dr. Butterfield breaks down what neurofeedback actually is, why traditional imaging often misses the mark, and how clinicians can begin integrating brain-based training into sports medicine and rehab practice. Let's dive in.

Today we're going to talk about neurofeedback in sports. I've been eyeball deep in sports from professional level all the way down to youth level. And as you can see by this picture, this impact is going to hurt probably both of them. This is— helmets were never, were never designed to prevent concussions. Their sole purpose is to prevent skull fractures, and for the most part, they do that. I was born in the area of Evel Knievel, so I used to ride bike— BMX bikes with my friends down these steep hills trying to jump garbage cans. And obviously, if you didn't make it and you crash and you got knocked out, we just move them on the side so we can continue jumping. Things have come a long way since then. I mean, with youth sports especially, If you get knocked out cold on the field, they come out with smelling salts, get you back to the sideline to count fingers. How many fingers am I holding up? And the kid says, all of them. He says, close enough, and I'll get back in there. That is a bad choice, that— but that's all we knew what to do. Now it's a little different as far as technology has advanced so much in 50 years. We know exactly what's going on in the brain and where. Where it struggles, where the concussion is affecting it. So that's what we're going to go over today. Here's a disclaimer for you. I'm not going to read it all verbatim, but this is just for educational purposes only. We're not offering medical advice or diagnosing anything. That's it in a nutshell. You guys can read that at your leisure. Now, the takeaways of this— I want you guys to be able to recognize and explain the long-term neurologic effects of concussions and the impact that it has on athletes well beyond the initial injury. Which could be months or years afterwards, you could still be suffering. Most people say in the Western medicine area say that concussions usually go away. The initial symptoms usually do go away, but you're always left feeling different. Something's off, whether it be brain fog or anger, or if you're in school, your grades go down. And I'll explain why that happens here. And then you're going to learn how to interpret and apply the qEEG brain mapping data to detect concussion patterns and guide individualized treatment. And then finally, how to integrate neurofeedback into concussion management protocols to accelerate recovery and support cognitive and performance outcomes. So how do we recognize the long-term effects of concussions that impact the athletes long afterwards? When they get in a collision like this soccer head-to-head, or if they get in a football helmet-to-helmet, or if they fall on their back playing basketball and they hit the back of their skull, That has initial effects of the brain, whereas you jiggle all the insides of your brain— your brain's electronic, so the electronics are like misfiring. Now you get swelling in your brain, you get stretching and tearing of the brain tissues in there. All this leads to brainwave dysregulation. And again, you don't have to be knocked out cold to have a concussion. I mean, it could be like a jolt, like in a car accident, like Maybe just falling down on your knees and hitting your head on something. I mean, there's different ways you can get a concussion. It does not have to be knocked out cold, kind of. The immediate depends on how bad the impact is. The shearing forces that damage the neurons and glial cells in the brain, that's immediate. Your blood-brain barrier may be compromised, and you got injuries that are often microscopic and too small to see on traditional scans. That's for sure. And the contrecoup injury is if, like, let's say both football players— we use that for an example— as soon as the helmets collide, immediately the skulls stop. They're not moving anywhere. We're talking milliseconds. But the brain is still inside the brain, floating in the cerebral spinal fluid. It's got 1 to 3 millimeters before it impacts inside of your skull. Once it does that, you're moving back already, so you accelerate the brain moving back to smack on the opposite side of where the impact was. It's never usually front to back, left to right kind of thing, because there's always twisting and torsion of the brain. Depends on where your impact hits you. But again, so it's like a double injury. It hurts the front of the side of your brain where the impact is, and it hurts it on the opposite side. That's the contrecoup effect. Okay, so once you have a concussion, obviously, unless there's a skull fracture or bleeder, Something like that, you're going to look fine. So they usually pull you on the sidelines and do some functional assessment stuff like the sway test, the impact test. They do some different cognitive tests to see if you're okay to go back in. It's never okay to go back in if you've had a concussion or suspected to have one without getting some mitigation strategies in place, because the secondary concussion is a very bad thing because your brain's not done healing from the first one. Now you have another one. And I'll explain that later, why that's not a good thing. Obviously, you get neurologic disruption because that is— your brain is electronic fuse box of your body, right? So your brain is you. So what happens when you get a concussion? You got all these electrical storms in your brain. All the networks are not communicating as well as they should. Stuff that you can see on a brain map. If you go to get the golden standard, which is an MRI or CAT scan, of your brain after a concussion. If they suspect a bleeder or a skull fracture, that's the only thing I would ever want done to me because it, it actually does detect that. But usually a bad concussion, you'll come back and I've seen this in race car drivers and pro football players. They have a bad concussion, they've been knocked out, they go get their MRI or CAT scan and it comes back as normal. Well, we know it's not normal. So MRI or CAT scans will take the electronic or the, the physical slices of your brain and look at it. We take with the qEEG, we take an electronic slice of the brain. So we know electronically how it's functioning, where it's struggling. Yeah, and this is, this is the rest. This is the standardized protocols after concussion. Everything in black is the Western medicine way, which is fine. I don't see a problem with those that they mentioned, but I added the red is what we do or what we would recommend. Okay, right away you start with the inflammation supplementation for your body and your brain to get that calmed down, right? And a week after your concussion, you get a brain map. So let's see what's going on where. And after that, you train the brain back to where it should be. So, and again, I'll explain that as we go further on down here. But that's a pretty standard approach, except for the red stuff. That should be standard, standardized at once sometime. The lingering effects after a Concussion. If you have a concussion, the options you have to do are do nothing, go to your medical doctor, and they'll prescribe you probably some medications to help with the headache, to help you sleep, aches and pains, whatever. Go to a chiropractor, they'll take care of the soft tissue issues. That's great. I mean, chiropractor— I, that's— I was a chiropractor, but I would always treat from the neck down. No matter what kind of injury you had. And I always neglected from the neck up for some reason. And we'll get into that, why I changed, at the very end of this presentation. But there's a lot of problems with the memory loss, cognitive decline. You can have issues where it can lead to CTE, but it doesn't have to all be that way. Because if you get a concussion baseline, not a subjective baseline like the impact or sway or all the other tests, If you get an objective baseline, which is what the brain mapping does, you know where they start with. And with the Peak Performance Brain Training, you can essentially scrub out the concussion signature in their brain so they don't have all these problems that are listed here. And they've— this is why when you get a concussion, it automatically throws you into leaky gut syndrome. A lot of people don't know that. Your brain and gut are connected with the vagus nerve, and that's your, your gut-brain axis. So once you get a concussion and you're in fight-or-flight mode right away, that suppresses the vagus nerve activity, and that leads to slowed digestion, reduced enzyme production, and impaired gut motility. That is a big thing. So we have a double, dual-issue approach here. You got to address the brain and you got to address the gut after you've had a concussion. And that's why. More detail on that one. It triggers a systemic inflammatory response. We know that gets up into the brain. Inflammatory cytokines circulate and affect the intestinal lining, increases the gut permeability. So you got free-flowing junk in and out of the bloodstream, which is not good. So that's why that has to be addressed, and it's a key component to concussion recovery. And again, same thing here. It's a vicious cycle. Your gut will send inflammatory signals back up to the brain to keep your brain in a state of inflammation. The inflammatory response, you have to break that loop, and you do that with the supplements for the gut stuff. And, and the hormones that are made for the brain are made in your gut, your neurotransmitters. So if you have a problem with the gut, you're not sending the best neurotransmitters up to your brain after the fact, after the impact. And again, here's another example of the gut-brain axis. You got all these extra symptoms associated with the concussion that probably show up after you've had the concussion. If you've had these before the concussion, it's worse. Yeah, so there's, there's targeted supplements you can take to get rid of the neuroinflammation and to take care of your gut as well. I just listed a few of them here and why you should take those. But that should be like the first level of approach. Once you get a concussion, you should be taking these supplements right away. I mean, I wouldn't delay on that at any time. All right, so here's why the CAT scans and MRIs are not that effective to check for concussions. Because again, they don't look at anything electronically in the brain. So the CAT scan has 10 to 20% effectiveness and sensitivity to detect a mild traumatic brain injury. That's not very much. But again, that's best for detecting skull fractures, bleeding, and swelling. There's nothing else that's, that, that's going to pick that up. The brain map is not going to pick that up. The MRI is about the same success rate, 30%, unless you do more advanced studies. But they're looking for functional and structural damage. Electronic damage of the brain is, is also a very big thing because that's going to change your life from that point on to some extent. Of course, some people just Feel like they are in a brain fog. They have brain fog. They get angry when they shouldn't be. Just stuff like that happens after a concussion. And it's tricky with kids, with youth athletes, if they are different after a game. Some parents say, well, that could just be the hormones growing up. Well, no, it's not the hormones. It was that impact that changed their brain, and now it's firing and talking to itself. And I'll go give you a case study on that in a second. There you go. The qEEG is 90 to 95%— has a 90 to 95% sensitivity rate of detecting changes from a concussion. The electronic signatures are off. The brainwave patterns are different. They have enough studies, normal brain databases now that know what an unconcussed brain looks like and what a concussed brain looks like. So if you could look at a concussed brain, We know the treatment protocols to get that back to where it looks like an unconcussed brain. Again, that's scrubbing that concussion away. Still don't have any lingering effects later in life. This is the one I was talking about here. All right, so I'm going to explain this one as best as I can. I hope you guys can see this. This kid came in to me for a brain map, and his history is a year and a half earlier. He was a soccer prodigy, soccer star. He collided with another player, got a concussion really bad. He got a lot of soft tissue injuries. So he went to his chiropractor and physical therapist and they treated from the neck down. They got all that stuff working great. But he didn't— his parents noticed his attitude changed. He'd get kicked out of school all the time. His mom would drop him off at the front of the school in the morning and just wait in the parking lot because she knew the principal was going to call a couple of minutes later and say, come get your kid. He's acting up again. Which is exactly what they did. So they said, maybe it's hormones. They didn't even think about maybe it was a concussion that started this cascade. So they took him to talk therapy. Let's go to a counselor to work on your anger issues. So they did that for a while. That didn't work. So then they came and went the medical route. Let's medicate it for his depression, for his sleep problems, for all this other stuff. They did that route and that didn't work. We're not anti-talk therapy, we're not anti-medicine. There's a time and place for everything. I firmly believe that. So if you look at this map here, I'm just going to show you from the— this represents the top of the head looking down. The nose is up here, ears are on the sides. This is the back of the head, this is the side of the head, the eyeballs about here, they're looking this way. Okay, now when we put the brain map cap on their head, there's 19 sensors around the head.

Right.

If you got a brain map from me or the hospital, the sensors are in the same place because they have to be standardized. So what we do is the hospitals— well, the hospitals take a look at the raw signal under every sensor. So do we. We take that a step further. We take every raw signal and break it down into 9 frequencies, and then we put that in a box. We compare that box of electricity to somebody your age and your gender. If there's too much or too little electrical activity in that box, it could be a problem. But not with one box. So we put 6,800 around your whole brain to get a 3D model of it. This is the 3D model of it. Those are all the 6,800 boxes. So there should be no colors in these 3 boxes. If there is a color, what color is it? That's going to be light blue to dark blue. The darker the blue, the more that part of the brain is asleep electronically. Conversely, if it's yellow, orange, or red, red means there's way too much electrical activity in the area. And whatever area that electrical storm is over, that part of the brain is not going to function as well as it could unless you remove the, the storm there. So we know exactly what frequency and where there's a problem. And this actually tells us what brain area that is, what function of the brain does. And what symptoms they may or may not have because of that. And I tell people that this is not your specific list. This is a list of the brain area. So if you see yourself in there, fine. If you don't, that's also fine. Of course, this mother said, yep, that's him. Yep, yep, yep, yep. All the way down, all the way down the whole list. Because this kid was— he had a tough way to go. What we also do is we do a concussion assessment report. Our reports that we do from our brain maps are about 300 pages in total. 45 of them are looking for concussion signatures, and we know what those are. So this report tells us what's the probability of that concussion— 85% right there. That's highly probable that all the stuff we were looking at was from a concussion that did not resolve, that he's still suffering with. Now that we know that it is highly probable it is a concussion, how bad is it? This is the next page on the report. This is where they fall in.

Right.

It's moderate. So again, he had this 2 years later, year and a half later, he still got it. So that's what he was still suffering with. So I think if that, like, the chiropractor, the physical therapist, or whatever had stuff to treat the neck up, they could have cleared this out just like he cleared out the soft tissue injuries from the neck down. So what we got here, when we look at these brain maps, this is another thing that we look at. This is all the delta frequency here, theta frequency here, and so on. This represents the top of your head looking down. Your nose is up there. There's your ears. Black dots are the sensors. These top 2 rows should be gray, no color. If it's blue, that's a sign of brain inflammation. You got to get that out of there. And this line down here, the phase coherence line, your brain has to share information from one network to the other. And it has to be— and it— and this is the phase lag, is what is the timing of that? Is it too fast or too slow? Red is too fast, blue is too slow. The information sharing, if it's blue, is you're not sharing enough information from one network to the other one. Okay, so this scenario here, it's like the mailman's driving through your neighborhood at 100 miles an hour, not touching the brakes, just chucking the mail out hoping it gets in the box. And a lot of it's not getting in the box. The brain is not communicating with itself. There's an asymmetric sharing of information. It's all scattered. He made it through the day. He's making it through life, but he could be making it through a lot better if he had this all regulated, which is what neurofeedback does. It gets that back to where it should be. Okay, so this is what we look at when we do a brain map. We have all this data to look at and to go through, right? We know where the struggles in the brain are. We know where the brain is working great, right? But we also know where the concussion effects are getting them. So we go ahead and attack those. I had a couple people walk into my office one day wearing suits. And of course, after I asked them if they were feds and they said no, I said, how can I help you? And they said, well, we need your help because we have a— They had a hospital. It's the biggest hospital in the state of Indiana. They had a concussion and sports center. And I said, okay, how can I help you? And they said, well, we want you to work on our concussions. And I said, isn't that in your name? Aren't you guys supposed to handle that? And yeah, but we don't know really how to do it. And I said, I know why, right? It's like the difference between what I do and what you do. It's like a concussion is like when you walk in your garage and you hit your fuse box with a sledgehammer. All the lights on the inside inside start flickering. They still light, but they start flickering. And you guys run in the front door trying to change all the light bulbs, hoping that fixes the problem. And I'm in the fuse box working on that to get the wiring back where it should be. Because that's right. Here's but we'll gladly take all your orthopedic injuries. So I mean okay. So they changed their name now to Sports Performance Center. They took concussion right out of it. So yeah, we help those guys. So. Again, there's a time and place for all these different professions to help. I mean, the more the merrier, they get on there. So this is like, again, all the brainwaves that we look at are over here on the left. And like, let's say a concussion caused too much or too little of these frequencies to get out of whack, out of sync, get the timing off in your brain. It could lead to these if you have too little of that frequency in a certain area of the brain, or it could lead to this if you got too much of it. So we can pretty much pinpoint exactly where your problem is. Our brain map shows 6,800 boxes. If your concussion caused 200 boxes to fall asleep or be too overactive, I'm going to shut off all the boxes except for 200 and work on the 200. That's targeting right there. So this is what we do— peak performance brain training. It's brain training, not treatment. We help the brain Get its balance back. We help the brain from the left side of the brain to the right side of the brain, front and back talking nice to each other again. Then we get all the networks working the way they should. You're sharing just enough information at just the right speed so you can process it all. It eases up on your stress, your anxiety, your brain fog, whatever you got going on there. If you can see it and you can measure it, you can change it. And that's what all this data we get from brain mapping. So once you get the concussion management protocols, what we do is we do the brain map first. We find out if they got a concussion signature, what brain waves are disrupted, and then the treatment protocols are all set for the areas of the brain and the networks of the brain. And we balance the autonomic nervous system in the brain once we clear it and scrub it all out of there. But if you don't, again, the long-term effects are Could be debilitating. So this is like a before brain map up here. This is like an after the neurofeedback sessions. Again, it could take 30 times of doing this, 20 minutes twice a week in the office. That doesn't take up a lot of space. They sit in a comfortable chair, put headphones on, and they hear tones at specific times. And I think I'll flip over that in a second. But once you— like I said, people or practitioners that want to add this into their practice, You're doing a great favor for your community because now you're addressing from the head to toe, the complete body, including the brain, which is very important. I mean, you can't neglect that part. You got a kid like I had— this is okay. So this is the kid before that had a concussion. Remember I said these 2 rows should be gray? This is what he came in looking like in his first brain map. So anything from the center here this way, if it's red, yellow, or orange, that means they're stuck in fight or flight. And he was like, he's sitting at the— is sitting in a chair looking at the front door ready for some monster to come in that's not coming in. I can't tell him it's not because his brain tells him it is. So he was on the edge of his seat on high alert at all times, and that's from the concussion. Anything from this point to the left, these are your healing frequencies, right? There's too much of an electrical storm for his brain to rejuvenate itself. To heal itself or get unstuck from this. So he's pretty stuck. I mean, since he's in such fight-or-flight mode, you tell this kid to clean up or do your homework, he's going ballistic because he doesn't have the bandwidth for that. He's waiting for a monster to come in. And again, if you look down here at how there shouldn't be this many colors or lines in any of these, he has excessive amounts. So his brain is not communicating well. That's why his anger got going. That's why he couldn't shut his brain off. That's why he couldn't sleep. That's why his grades tanked terrible. He was on the honor roll before all this stuff happened. And again, this is after 30 sessions. Is this— that's what it should look like. Anyway, needless to say, he's great today. He comes in periodically now for college classes before he has a big test or come in to get a boost, a training. Okay. And this is why everyone needs a brain map, because everyone's brain is unique. And we see— I haven't seen the same brain ever. I mean, as far as what protocols they need, how we go in there and get it. How you train them is— I'll try to do this with my hands. When we put the headphones on and the sensors on their head, this is after the brain map. We know what target to go after. We're going after 200 boxes, let's say, that are in the front of his head that caused— that is giving him his concussion effects. So when you watch the screen, his brainwave should be represented like a nice smooth line like this. Most people after a concussion, their brainwaves are so scattered it's going like this. So it's like it's walking around a dark room and it does not know where the exit is, and it will continue going through its whole life not knowing where the exit is until somebody tells them where it is. That's what our protocols and neurofeedback does. So every time it goes up and down like this in those 200 boxes, you He's gonna hear a beep. It'll go beep and stop. Come back down, it'll go beep and stop again. And after 3 to 5 minutes, you'll see that brainwave go like this, right where it should be, right in the zone. And it'll stay there. You just got to reset everything. I mean, that's why I said it could take 30 sessions to do it. But once you get it where it should be, the brain tends to want to stay there because the brain has a lot of neuroplasticity, can make new run— new pathways, new connections in the brain throughout its whole life. So that's why you need to get the neurofeedback on there as quick as you can after post-concussion to help with that.

That wraps up part 1 of our 2-part series with Dr. Kevin Butterfield of Hippocampus Labs, a continuation of our wildly popular episode 112 on neurofeedback. Here are a few key takeaways from today's discussion. Concussion doesn't just affect structure, it disrupts the brain's electrical communication. We also learned today that the brain and gut are deeply interconnected and healing the brain often starts in the gut. And then we discussed how neurofeedback gives practitioners the ability to see and retrain dysfunctional brainwave patterns for lasting results. Be sure to join us next time for part 2, where we'll explore how Dr. Butterfield uses brain mapping to help athletes, military veterans, and even young children enhance focus, recovery, and cognitive performance. We'll also hear how healthcare providers can bring neurofeedback into their own clinics and expand their ability to better serve patients. Stay tuned, you won't want to miss it. Part 2 drops in 2 weeks. To To learn more about the incredible work of Dr. Butterfield and his team at Hippocampus Labs, be sure to check out the link in our show notes. Also, be sure to mark your calendars for our next Factor Monthly webinar planned for November 18th at 1:00 PM Central, 2:00 PM Eastern, where we'll be featuring guest instructor Matthew McKay for part 2 in his Durability Over Dominance series. Register for free by visiting the link in our show notes. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-R-store.com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on FACTOR Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates. Coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.