6 Concussion Myths
Over the last decade and a half, concussions have become the most hotly researched and discussed injury in sports. This is due to the increased number of health issues arising later in life following repeated concussions. The NHL, NFL and WWE have accelerated our understanding and management of concussions.
While I’m grateful for the increased focus and attention given to concussion management – not all advice is equal. In my previous job, concussions, particularly persistent post-concussion syndrome cases, accounted for 20-40% of the people I saw on a day to day basis. Through this time, I’ve joked around that everyone who is an NFL/NHL fan is a concussion expert which leads to a lot of inappropriate advice and recommendations.
Therefore, the aim of this blog is to discuss some common myths about concussions
For more detail, I recommend checking out this Masterclass by Mike Studer on Concussions: Assessment and Treatment.
MYTH #1: Imaging of the head is required to diagnose concussion
Many people stress out about getting CTs and MRIs of their head after having a concussion, thinking that it will reveal what’s going on and how to cure it.
However, CTs and MRIs are almost always normal in people with concussions unless there is a major associated injury such as a skull fracture or a brain bleed.
Some recent focus has been given to developing imaging methods that can look at concussions on a more microscopic scale – but for the time being CTs and MRIs won’t do much to show an isolated concussion (1).
MYTH #2: People with concussions need to stay in a dark room and avoid screens for long periods
Concussion care has progressed quite a bit from these beliefs – but some old school doctors and lay people still believe that you need to stay in a dark room, wear sunglasses, and keep away from screens for a long time period after a concussion.
This is fine for the first few days – but research supports that the benefits (aside from more symptomatic cases) only last for less than 2 weeks (2).
Over time the goal is to very gradually expose yourself to screens and brighter environments. Working with an occupational therapist or a physiotherapist who is very thoroughly trained in concussion management and pacing can help with this.
MYTH #3: ‘’I’m fine to play’’
Some athletes will do anything to get back into the game after a concussion. I heard a story of a kid and her mother who went to 6 different ER doctors before finding one that would clear the kid to play. When I played rugby 15 years ago, many of my teammates would get hit hard and then resume playing in a few minutes.
The problem with this is that you’re at higher risk of developing a condition called Second Impact Syndrome (SIS). SIS occurs when a second concussion is sustained within a few weeks of having an initial concussion. It is rare but can cause the brain to considerably swell and is fatal.
Bottom line – if you suspect you or one of your athletes have a concussion don’t send them back to play right away.
MYTH #4: Helmets prevent concussions
When I discuss concussions, or hear of someone getting a concussion, in sports the most common reply I hear is “well they should be wearing their helmet.” The research (3) doesn’t support this and shows that helmets don’t affect the incidence or severity of concussions.
Side note: before anyone takes this the wrong way – contact sport athletes and people riding bicycles should still wear helmets for the sake of protecting their skulls.
That said, there is some early developmental research in the works to determine if different styles of helmets may affect concussion risks.
MYTH #5: You need to be hit in the head to get a concussion
This is a common one. Unfortunately, trauma anywhere on the body that transmits force to the head can result in concussions as well as whiplash.
MYTH #6: All I need is a generic rehab program off the internet
With the rise in awareness of concussions comes a concurrent rise in people trying to make money off of concussions by creating generic “brain treatment” programs.
Concussions are by far the most heterogenous condition I treat. Some cases are aggravated by strenuous cardiovascular exercise. Some only have a bit of light sensitivity. Some have cognitive (i.e. memory, concentration, multitasking) or psychological issues (i.e. stress, depression). Some have a mixture of everything.
A generic program likely won’t work very well – unless you fall in the group of cases that recover with very little treatment. Some require physiotherapy, occupational therapy, psychology, kinesiology or a combination of the above depending on what the issues are.
A combination of the following may be needed:
- Physiotherapy/Kinesiology: for graded cardiovascular, strength, balance, vestibular and/or oculomotor exercise
- Physio/Chiro/Massage/Osteopath: for neck treatment
- Dietitian or Naturopath: for nutrition (and the latter for sleep)
- Mental health professionals (i.e. psychology, psychotherapy, psychiatry)
- Occupational Therapy: to help with pacing and reintegration into activity as well as cognitive domains (i.e. attention, memory, multitasking).
If you work with athletes who are at risk of concussion, I hope this information was useful. If you’d like to learn more about the assessment and treatment of concussions, check out this Masterclass by Mike Studer.
Thanks for reading.
Want to become a pro at managing concussions?
Mike Studer has done a Masterclass lecture series for us on:
“Concussion: Assessment and Treatment”
You can try Masterclass for FREE now with our 7-day trial!
- McCullough, B.J., Jarvik, J.G. (2011). Diagnosis of concussion: the role of imaging now and in the future. Phys Med Rehabil Clin N Am,22(4),635-652
- Silverberg, N.D., Iverson, G.L. (2013). Is rest after concussion “the best medicine?”: recommendations for activity resumption following concussion in athletes, civilians, and military service members. J Head Trauma Rehabil,28(4),250-259.
- Sone, J.Y., Kondziolka, D., Huang, J.H., Samadani, U. (2017). Helmet efficacy against concussion and traumatic brain injury: a review,126(3),768-781.
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