Concussions are a hot topic these days, with professional sports leagues and even Hollywood starting to take a keen interest. However, there remains a lot of myths and misinformation regarding proper concussion management. I want to delve into some of the more common misconceptions out there in this post, and outline the current evidence-based concussion management practices in a follow-up post.
Below I’ve outlined a few common concussion myths, and then I’ve attempted to provide the facts, or at least what we know so far as fact:
1. If you didn’t hit your head, you can’t get a concussion.
- Wrong. A concussion occurs as a result of the brain moving within the skull. The motion causes shearing of the brain’s axons and cellular structures, and this can occur with any impact that transmits force to the head – think a body check in hockey where no head contact was made.
2. Nothing showed up on my MRI or CT scan, so I’m good to go.
- Inaccurate. A concussion is a functional injury, not a structural one. There is currently no imaging modality that can rule out a concussion. It is a diagnosis based on the patient’s history, and physical examination. If you’ve suffered a trauma, you may well receive imaging of the head and neck, but they would be assessing for things like fractures or hemorrhages, not concussions.
3. If you’ve suffered a concussion, don’t fall asleep.
- A concussion is a brain injury, and the best way to manage almost any injury in the body is by getting sufficient sleep, and progressively challenging the injured structure. We’ll talk more about the rehab involved later, but for now know that sleep is an essential part of the process. During sleep is when a significant portion of the healing occurs. Provided a more serious injury has been ruled out (like a hemorrhage), sleep should be encouraged when the patient feels tired.
4. You need to rest in a dark room.
- Wrong. This was standard practice not too long ago, but we now know that this can delay the recovery from a concussion. In much the same way that we rehab injuries to other parts of the body, it is important that we provide controlled stress to the injured brain. This may include progressive balance exercises, visual exercises, mobilizations and strengthening of the neck musculature, and moderate aerobic activity. It is okay to rest immediately following a concussion, but no more than 48-72 hours before you begin challenging the brain.
5. I was told that treatment X can cure my concussion.
- False. Ask yourself this: Do you really think if there was a silver bullet that could cure someone’s concussion, you’d just be hearing about it now? If you consider how many professional athletes, in football, hockey, basketball, soccer, etc miss games due to concussions, and the millions of dollars that represents to their respective franchises, don’t you think they’d also know about this “cure”? Be skeptical, and if something sounds too good to be true, it more than likely is. If someone tells you they can cure your concussion, run away. There are no treatments available that are curative for concussions. We hear stories of people who receive any number of treatments that were promised to “cure” their concussions. Things like manipulation of cranial bones (which in an adult, isn’t plausible anyway due to fusion of the fissures between the various bones comprising the skull), to hyperbaric chambers where you are subjected to pressures that exceed atmospheric pressures. However, according to the large and growing body of scientific literature, these things simply don't work.
If you have a question about concussions feel free to get in touch. Leave a comment, email us, or call the clinic. We’re always happy to chat. Remember, concussion research is rapidly evolving, and best practices can change. But also remember to use your judgment, and apply some healthy skepticism when you hear fantastic claims about the latest "cure" for concussions, or any other ailment for that matter.
Thanks for reading!
Dr. Lee Brotherston