Concussion Myths: Facts Straight From the Experts

1. You can only get a concussion from a hit to the head – A concussion is caused when the brain begins to shift back and forth within the skull leading to axon shearing, also known as an acceleration injury. In many cases, a strong impact to the body can transmit enough force to the head, directly resulting in a concussion.
2. Helmets will prevent concussions in contact sports – Helmets have not been proven to reduce the incident rate of a concussion due to the mechanism of the injury. They are designed to protect against skull fractures and lacerations, therefore, should still always be worn in high-impact sports that are associated more commonly with injury.
3. Mouthguards can prevent concussions from occurring – Mouthguards can reduce oral and dental injuries, but like helmets, there is limited research or evidence to support that they can prevent concussions.
4. Concussions only happen in high contact sports – While there are a significant number of concussions in contact sports such as rugby, hockey and football, concussions in other “non-contact” sports frequently happen. Sources show that head injuries commonly occur in sports such as soccer, cycling, skiing, basketball, baseball, dance and gymnastics.
5. After a concussion, it is best to isolate yourself in a dark room – Strict rest was once a common way to manage a concussion, but recent research recommends a short period of symptom-limited rest (24 to 48 hours). Following this period, a graded return to activity is advised. If someone is experiencing sensitivity to light, vision therapy or vestibular therapy may help aid in recovery.
6. A concussion is when the brain becomes bruised – There are no objective findings on imaging (CT scan, MRI, X-ray, etc.) because there is no structural damage or injury to the outer grey matter. A concussion is a functional injury within the white matter, which leads to a metabolic energy crisis and cellular dysregulation.
7. It’s important not to go to sleep after getting a concussion – This idea stemmed from precautions with those who have had a brain bleed. It is difficult to assess a person’s symptoms or if there has been a regression while asleep so recommendations are to wake every hour to check. These types of injuries will show red flag symptoms within 3-6 hours. If there is no concern for this, the individual may sleep. If there is a concern or uncertainty, the individual should be taken to the emergency department.
8. Concussions cause long-term memory loss or Chronic Traumatic Encephalopathy (CTE) – Scientific studies linking concussions and long-term effects are still in the early stages and no definitive conclusions can be made. There are a great number of other factors which are poorly covered in the media.
9. Concussions treatments and recovery times are all the same – No two concussions are identical. There are 6 different clinical trajectories – visual, cervical, vestibular, physiologic, migraine, and mood – for a concussion but each patient presents differently due to other factors unique to the injury.
10. To be classified as a real concussion, there needs to be a loss of consciousness – It is estimated that more than 90% of concussions do not result in a loss of consciousness.
11. Having one concussion places you at increased risk for future concussions – Proper clinical management is the best form of prevention; recovery from one should not put an athlete at risk for another.

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