For the third installment of our concussion blog series, we’re debunking five common myths around concussions with a brief explanation of the better actions to take to aid in recovery and reduce long-term symptoms.

DISCLAIMER

These blogs are meant to give you some insight into concussion research and concussion rehabilitation. Concussion research is elaborate, and at times hard to understand. These blogs are meant to simplify the science around concussions, and provide helpful information for you to use whether you are experiencing a concussion, or, know someone who is. This is not a completely comprehensive look at concussions, there is a ton of research out there that we may not touch on. If you are someone who is experiencing a concussion, please seek medical attention. These blogs are meant to support you or a loved one in their concussion journey, not replace seeking individualized help.

MYTH 1: HELMETS PREVENT CONCUSSIONS

That's right, there is little evidence to support that helmets prevent concussions. Remember, concussions occur by the brain hitting the skull. Helmets can't eliminate the consequences of a powerful force generated by a direct or indirect blow to the head. HOWEVER, this doesn't mean you should stop wearing one! Helmets are valuable tools to help prevent impact type brain injuries, like a skull fracture, intracranial bleeding or lacerations.

MYTH 2: IF YOU DON’T LOSE CONSCIOUSNESS, YOU DON’T HAVE A CONCUSSION

Loss of consciousness is a pretty solid indicator that you have sustained some kind of brain injury. However, majority of concussions don't result in loss on consciousness. Research is investigating whether loss of consciousness is a predicting factor of prolonged recovery or Post Concussion Syndrome (PCS). PCS is a term used regarding people still experiencing symptoms three months post concussion. If someone has lost consciousness for over a minute or longer, it could indicate a more severe head injury and they should be monitored and seek medical attention.

MYTH 3: YOU HAVE TO WAKE SOMEONE UP EVERY FEW HOURS IF THEY’VE SUSTAINED A CONCUSSION

As previously mentioned in "Concussion Pathophysiology", when a concussion is sustained, the body goes into an energy crisis. This energy crisis leaves us feeling extremely fatigued. So what do we usually do when we're fatigued? SLEEEEEEEP. Sleep is such an important healing mechanism when it comes to concussions, especially early on. The whole idea behind waking someone up every few hours comes from the fear that the individual has sustained more of a severe head injury that could be fatal. You should seek medical attention right away if the person has:

increased confusion
unusual behaviour
reduced loss of consciousness
neck pain
repeated vomiting
seziure

If there are no alarming symptoms post impact, the best thing you can do is encourage rest and sleep!

MYTH 4: SIT IN A DARK ROOM AND WAIT IT OUT

Alas, this one is my favourite. Before I knew anything about concussions and concussion rehab, I to fell victim to this myth. When individuals experience concussions, they can be triggered by light, noise, reading, writing, socializing, driving, etc, etc, etc. So, what made sense at the time was 'well okay, let's avoid all of that and keep them in dark room. CURED. YARIKA!". Made sense at the time. What we now know is that we need that gradual exposure to our symptom triggers and activity in order to recover from a concussion. The brain needs exposure to build new neural pathways. As we know from "Concussion Pathophysiology", our neural pathways can be severely damaged and new ones need to be formed. "Waiting it out", can only prolong recovery. If you've just sustained a concussion (24-48 hours post), or you're incredibly symptomatic, sitting in a darker, quiet room can help promote rest, and contribute to the dissipation of symptoms. But remember, we NEED to expose ourselves to daily activities in order to build tolerance and recover.

MYTH 5: IF YOU DON’T HAVE SYMPTOMS IMMEDIATELY, YOU CAN GO ABOUT YOUR DAY NORMALLY

This is one of the trickier parts about concussions. Sometimes, symptoms don't show up for hours, days, or even weeks. There is no predictor as to when you'll experience symptoms. You might experience symptoms such as headache or dizziness initially, but symptoms such as sleep disturbances, depression/anxiety, and irritability can occur later on. Research is still investigating what causes the delay in symptoms. It could be due to prolonged pathophysiological change in the brain after a concussion, or it could be due to more psychological factors. Furthermore, people can be more genetically predisposed to certain symptoms which can impact their experience and recovery time. As mentioned in “Concussion Pathophysiology”, it can take weeks for the initial cellular damage to recover, even in the absence of symptoms (e.g. normal blood flow takes up to 14 days to recover!). Therefore, even if you feel fine, the best practice is seeking professional help and following the proper protocol for return to work and play. Remember, BRAINS ARE COMPLICATED AND WE STILL DON'T HAVE ALL THE ANSWERS.

There are lots of myths out there around concussions and concussion rehab. Get the facts! Talk to a healthcare provider about what the best practice is to help manage your concussion. Concussion rehab is continuously changing (gets better and better!), so it’s important to continue to ask questions and seek guidance if you suspect you’ve sustained a concussion.

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References

Elkington, L., & Hughes, D. (2016). Australian Institute of Sport and Australian Medical Association Concussion in Sport Position Statement. Australian Institute of Sport.
Harmon KG, Drezner JA, Gammons M, et al. (2013). American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med, 47, 15–26.
Ellis, M.J., Leddy, J., Willer, B. (2016). Multi-disciplinary Management of athletes with post-Concussion syndrome: an evolving pathophysiological approach. Frontiers in Neurology. 7: 136.
Alsalaheen, B.A., Mucha, A., Morris, O.L., et al. (2010). Vestibular Rehabilitation for Dizziness and Balance Disorders After Concussion. Neurology Section, APTA 34: 87-92.
Leddy, J.J., Baker, G.J., Willer, B. (2016). Active Rehabilitation of Concussion and Post-concussion Syndrome. Physical Medicine and Rehabilitation Clinics of North America. 437-454.