Common misconceptions about concussions

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by Dave Hawken, MScPT

Concussions have been a hot topic of discussion over the past several years, and with many popular professional athletes missing time due to this injury, we never seem to stop talking about them completely. Certainly this has led to a greater awareness about concussions in general, and more thoughtful decision-making when it comes to returning to sports, school, or work. However, despite more concussion information being available than ever before, misconceptions about this injury still exist. Here are some of the most common misconceptions about concussions:

“You have to be knocked unconscious to have a concussion”: This is simply untrue. In fact, in 90% of concussions, there is no loss of consciousness whatsoever.

“Concussions are when your brain gets bruised…”, or “Concussions are when your brain bounces around the inside of your skull, hitting one side then the other…”: A concussion occurs when the brain tissue get accelerated, or decelerated with sufficient force, which quickly stretches the brain cells or neurons. This causes a sudden electrical storm to take place in your brain leading to the typical concussion symptoms. However, with imaging such as an MRI, there is no structural damage that will show up. If there is a more serious injury, an MRI or CT scan may reveal a brain bleed, but this would be considered to be more than a concussion.

“You have to directly hit your head to have a concussion.”: This is also false. Again, all that is required for a concussion is for the brain tissue to be accelerated or decelerated with enough force. This can happen if the head and neck are whipped back suddenly, like with a whiplash injury, or with a sudden, forceful impact to the body.

“Helmets can prevent a concussion.”: Unfortunately this is false. Helmets are very important, as they prevent skull fractures in sports like hockey, football, cycling, and baseball. However, they do not stop the brain tissue from accelerating or decelerating within the skull. Think of the brain as being somewhat like the consistency of Jello. Now, if you put that Jello in a nice, hard container, it provides some protection for the Jello. But if you suddenly shake the container, it will not stop the Jello from being shifted around inside.

“If you sustain a concussion, you must sit in a dark room and rest for up to 2 weeks.”: This is no longer the widely accepted approach to take when someone has a concussion. It is important to rule out a more serious injury such as a brain bleed, but once this has been done, a gradual return to activities is encouraged as soon as possible, provided it does not worsen symptoms. This may be limited at first, but an effort should still be made to start to resume the normal day to day routine as symptoms allow.

Baseline testing BEFORE getting a concussion is a big advantage. Cognitive testing, balance and reflexes are all part of determining when someone can return to sport after a concussion. Without baseline testing, test scores can only be compared to average scores for a particular age group. Comparing to your own baseline scores is much more accurate and gives you a much better idea of how you are healing.

A healthcare provider who is trained in concussion assessment and rehabilitation, such as a physiotherapist, can help guide someone with a concussion to safely return to school, work, or sports.There is plenty of information out there about concussions, and it is always changing as research into this complex topic continues to occur. Although concussions won’t be eliminated any time soon, we continue to know more and more about how to deal with them.

So, before you hit the soccer pitch or the football field this spring, get a baseline concussion test done. Kemptville Physiotherapy Centre can test individuals or teams, let us help you keep your head on straight!

Kemptville Physiotherapy Centre, 613-258-7661.

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