This article was co-authored by Des Moines University students Brittney England, D.P.T.’21 and Jordan Wachter, D.P.T.’21.
Concussions are a hot topic in our society that affects children, athletes, and adults of all ages. Understanding the best care and treatment is important for optimal recovery. Unfortunately, many myths about concussions still exist. Let’s take a look at some of these myths and what the research says.
Myth #1: Concussions Only Occur from Directly Hitting Your Head
As stated above, concussions are not limited to sports and can happen to any person at any age. A concussion can occur from any force that impacts the head, neck or body. Many injuries come with a bruise or scratch that is visible on the skin, however, a concussion injury is not always visible because injury occurs to the brain inside the skull. Concussions can occur in sports, where people most commonly think of them, but can also occur during car accidents, falls within or outside of the home, or being hit by an object. In these situations, the force of the body can cause rapid movement of the head and injury to the brain without the head hitting an object.
Myth #2: Concussions Must Involve a Loss of Consciousness
While losing consciousness can be helpful for a medical professional to know when diagnosing someone with a concussion, they cannot use a lack of losing consciousness to rule out a concussion. In fact, the University of Pittsburg Medical Center found that only about 10% of those who sustain a concussion actually lose consciousness. The brain is a very complex organ, with different areas controlling different bodily functions. Depending on the area of the brain injured in the concussion, the effects may be different. Some may experience dizziness and loss of concentration, while others may have a headache and prolonged fatigue. To say that everyone that sustains a concussion must lose consciousness is simply not true.
Myth #3: You Can’t Sleep for more than Two Hours with a Concussion
Maybe you heard only an hour or 30 minutes, was all that was safe for someone with a concussion. Regardless of the time frame, the main idea behind this myth was that checking on someone at regular intervals was necessary to prevent something worse from happening by catching any decline in their mental or health status as early as possible. According to Dr. Richard Figler with the Cleveland Clinic, this myth is counterproductive to healing from a concussion, because sleep is crucial for recovery. However, the potential decline in mental or health status following concussion emphasizes the importance of receiving a thorough examination by a medical professional so that severe conditions can be ruled out. Such an examination can ensure that a person receives the appropriate level of care, including a proper recovery and rehabilitation program.
Myth #4: Mouth guards Prevent Concussions
Sports are one of the leading causes of concussion, and the focus on creating a safer environment in sport participation through protective equipment and rules has greatly increased in the past decade. As a result, numerous changes in both policies and the effectiveness of equipment have been made. While these policies and equipment improvements have helped to make sports such as football and hockey safer, it is often assumed that these newer pieces of equipment, such as mouth guards, are able to prevent concussions. Since a mouth guard or helmet helps absorb external forces during sport, the idea that they help reduce the amount of force the head endures during a game also makes sense. And while there is research supporting effectiveness at preventing facial and mouth injuries, a systematic review of several studies involving mouthguard use and concussion risk concluded that mouth guards had “little impact on reducing the incidence of concussions.” So, while mouth guards are very important to wear, it is important to know that concussions can still occur when worn.
Myth #5: Complete Rest is the Best Treatment
Rest following concussion is an important part of recovery. On the other hand, doing absolutely nothing is not necessary and can prolong recovery. Following a concussion, physical and sensory stimuli should be limited, including staying in a dark, quiet room with limited physical activity and screen time. Research shows that balancing rest with gradual exposure to activities and stimuli (screens, light, noise) while monitoring symptoms is important for recovery. One study found that children who did not participate in any level of activity within seven days of a concussion experienced more concussion symptoms after a month than children who did return to some sort of physical activity within seven days. Although the physical activity ranged from light aerobic activity to returning to full competition, activities that bring on concussion symptoms should be avoided. A medical professional trained in concussion management, such as a physical therapist, can help guide a patient through the rehabilitation program and to progress them appropriately. Physical therapists at the Des Moines University Physical Therapy Clinic can develop rehabilitation programs for injuries like concussions and guide the recovery process.
Myth #6: If an Athlete Doesn’t Show Signs of a Concussion, they Can Return to Play
No parent or coach wants to see an athlete sit on the bench, especially as a senior in a playoff game. But no one wants to see that same athlete in a coma or pass away from a high school game. Concussions are serious injuries and are not to be taken lightly. Although an athlete may state that they feel fine after sustaining a severe head injury, some concussions may take up to a week to show up. According to the International Concussion Society, concussions can present with various levels of symptoms based on the severity of the injury. Early symptoms can include confusion, headache, dizziness, or memory loss; delayed symptoms can include light and sound sensitivity, irritability, difficulty sleeping, fatigue, and depression. Although the athlete feels fine, returning to play increases their risk of developing much more severe complications, such as post-traumatic headaches or second-impact syndrome. It’s important to have the athlete cleared by a medical professional prior to returning to play.
Myth #7: All Concussions are the Same for Everyone
Everyone is different! Just as different people respond to illness differently, the body will respond to concussions differently too. The University of Pittsburg Medical Center identified 6 different trajectories that concussions can take depending on the mechanism, location of injury and severity. These trajectories include cognitive/fatigue, vestibular (balance), ocular (vision), post-traumatic migraine, cervical and anxiety/mood. Dr. Michael Collins, PhD at UPMC states that even among these trajectories, symptoms can overlap and present differently in patients he sees. Every brain needs to be rested after a serious injury, but any lingering symptoms related to balance, vision, headaches, or depression can be addressed by a trained medical professional. At the DMU Physical Therapy clinic, therapists trained in concussion management can assist with management of concussion symptoms including dizziness, lightheadedness, and difficulty with balance, working with you to develop the best treatment plan to get you back to feeling like yourself.
If you suspect you or your child has a concussion, or one has been diagnosed and needs treatment, our exceptional physical therapists at the Des Moines University Clinic and the Des Moines University Clinic Physical Therapy and Sports Performance Center in the RecPlex can help. We are currently offering in-clinic and virtual appointments for patients. Visit the DMU Clinic website or call 515-271-1717 to learn more.