In recent years, there has been increased public attention to concussion injuries and the potential long-term effects of sustaining a concussion. This attention has led to positive changes in attitudes about concussions and improvements in how concussions are managed. Despite these improvements, several myths about concussions persist.
1. MYTH: “So you got your ‘bell-rung’. It’s no big deal.”
FACT: Concussion is classified as a type of traumatic brain injury.1 Most concussions resolve in 7-10 days, though recovery time may be longer for children and teenagers.1 However, as many as one third of children and people recovering from non-sport related concussions experience persistent symptoms2 lasting weeks or even months. Poor post-concussion management can result in long-lasting problems.
Also, a history of concussion also increases the risk of future concussions.2 In other words, concussions ARE a big deal.
2. MYTH: You need to experience a blow to the head to have a concussion.
FACT: A concussion occurs when the brain moves within the skull in a sudden, forceful way. A concussion can occur from a direct blow to the head or may be the result of a blow to the body in which the force is transferred to the head, such as a whiplash injury.
3. MYTH: Helmets can prevent concussion.
FACT: Helmets are essential equipment for many sports, helping to protect against skull fractures and other serious head injuries. Helmets DO NOT protect against concussion, as they can’t prevent the movement between the brain and the skull that happens in this type of injury.
4. MYTH: You need to be knocked out to have a concussion.
FACT: People do not always “black out” or lose consciousness when they experience a concussion.1,2 Loss of consciousness is not a requirement for the diagnosis of a concussion,1 and in fact, some research suggests that only 10% of concussions result in a loss of consciousness.2
A concussion is diagnosed when a person reports a history of injury and one or more of the following symptoms:2,3,4
Difficulty thinking clearly or concentrating
Feeling “slowed down”
Difficulty remembering new information
Nausea or vomiting
Balance and dizziness
Sensitivity to light and noise
More or less than usual
Difficulty falling asleep
5. MYTH: Only children experience concussions.
FACT: Concussions can be common in youth due to sport-related injuries; however, concussions are also common among adults. In adults, concussions can be caused by sport related injuries, motor vehicle accidents, falls, occupational injuries, and assault.2
It is hard to estimate the exact number of people who have a concussion each year, as not everyone with a concussion seeks medical treatment. It’s also thought that these estimates may be inaccurate due to different terms used to label these injuries, (concussion, traumatic brain injury, and mild traumatic brain injury), making it difficult to sort out the exact number of each type of injury.
However, between 2009 and 2010 (the last year this data is available), at least 94,000 Canadians aged 12 or older experienced a concussion.2
6. MYTH: If you think you have had a concussion, you should have a CT Scan or an MRI.
FACT: At present, CTs and MRIs cannot reliably “show” or diagnose a concussion. Concussions are often referred to as an invisible injury as these types of tests do not show changes to the brain structures. When a person sustains a head injury, their doctor may order a CT or MRI; however, this is done to rule other head injuries such as a skull fracture, not to diagnose a concussion.1,2
7. MYTH: The person who has been injured will identify that they have a concussion and will limit their activities appropriately.
FACT: People often minimize, or attempt to “push through” their symptoms rather than limiting their activities. Among athletes and youth there can also be pressure to compete, even when injured. Over time these attitudes are changing, especially as awareness of concussions increases and stories from high-profile players become known, but there is still work to be done to help make sure that individuals who experience an injury are properly screened and that the mantra “if in doubt, sit them out”4 is fully adopted in sport and elsewhere.
8. MYTH: Once concussion symptoms go away, people are safe to resume usual activities, including work, school, and sport activities.
FACT: As symptoms begin to resolve, experts recommend a gradual return to activities, while monitoring the individual and ensuring that symptoms do not return as activity levels increase. The basic principle is that activity is increased in stages while symptoms are monitored. Activity is only increased to the next level when the person has been symptom-free at their current activity level for 24 hours.2,5
9. MYTH: The only treatment for concussion is to rest in a dark, silent room until the symptoms go away. (Sometimes referred to as complete cognitive (brain) rest).
FACT: Originally a common treatment for people recovering from a concussion, the advice to rest in a silent, dark room for extended periods in now being questioned. Current research suggests that both “under-activity and over-activity might be counterproductive,” and that after a brief period of rest, low-level exercise that does not aggravate symptoms may be of benefit for those who are slow to recover.2,6
Physiotherapy can also help to treat the symptoms of a concussion, including dizziness, balance problems, headache, neck pain and stiffness, and other symptoms.2,6 The first step is to have an assessment by a physiotherapist who is skilled in the management of concussions.
McCrory P, Meeuwisse WH, Aubry M et al. Consensus statement on concussion in sport: The 4th International conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine 2013; 47:250-258.
Physiotherapy Alberta. Concussion management: A toolkit for physiotherapists. 2016. Available at: https://www.physiotherapyalberta.ca/files/concussion_toolkit.pdf. Accessed on May 27, 2017.
Centers for Disease Control and Injury Prevention. Traumatic Brain Injury & Concussion: What are the signs and symptoms of concussion. Available at: https://www.cdc.gov/traumaticbraininjury/symptoms.html. Accessed on May 27, 2017.
SCAT3. British Journal of Sports Medicine 2013; 47:259.
BC Injury Research and Prevention Unit. Concussion Awareness and Training Tool Return to Learn/Play Flip Card. Available at: http://physicians.cattonline.com/resources/files/catt-flip.pdf. Accessed on May 27, 2017.
Schneider KJ, Iverson GL, Emery CA, McCrory P, Herring SA, Meeuwisse WH. The effects of rest and treatment following sport-related concussion: A systematic review of the literature. British Journal of Sports Medicine 2013; 47:304-307.