If you didn’t lose consciousness, you can’t have a concussion. We’ve all heard that refrain; it’s a common belief, but it’s false. Great progress has been made in driving awareness of concussions and what they are, but misconceptions persist. For our safety, athletes young and old need to educate themselves about this brain injury. You can start with some clarity around these common concussion myths.
MYTH: To sustain a concussion, it takes a hard blow to the head – like hitting the boards during hockey, being tackled on the football field or getting clocked by a baseball bat.
FACT: While this is true, a concussion can also happen after an indirect blow, such as a hit to the body that causes the head to whip back and forth. Says, athletic therapist Stewart Munroe, founder of Ken Val Rehab and Sports Injury Centre in Rothesay, NB, “even an athlete who stays conscious can suffer that kind of injury”.
MYTH: A CT or MRI scan will tell you if you have a concussion.
FACT: Right now, no imaging technology can make that diagnosis. “X-ray, CT scans, and MRIs do not show concussions,” says Munroe. Despite that, good test results often lead to unfounded optimism. “When a doctor holds up an x-ray and shows the athlete their broken bone or dislocated shoulder, they understand why they can’t play,” says Munroe. “When an athlete is told that their x-ray is clear and the CT scan was clear, all the athlete and parent hears is that there is no injury to the brain. We need to remember that a concussion is not diagnosed by one test or image. A proper assessment consists of numerous testing activities,” says Munroe.
Your health care practitioner will often test your memory, concentration and recall abilities, as well as evaluate your balance, coordination, hearing and more. “The results of all of the testing go into deciding whether or not a concussion was sustained,” says Munroe.
MYTH: After a concussion, a person should be woken up every 20 minutes.
FACT: According to the Concussion Institute in Montreal, “Complete rest remains the first step in the treatment of concussions.” They suggest that for the first 48 hours following injury that physical, intellectual and social activities are reduced. In fact, as much sleep as possible is recommended during this initial stage. Why? After a concussion, the brain consumes massive quantities of glucose as it tries to heal. Maintaining all energy reserves for that healing process is vital.
“The world we live in is full of external stimuli: visual, auditory, etc.,” says Munroe. “The more we can minimize the number of stimuli that the brain is trying to multi-task or comprehend at once, the easier it is for the brain to stay calm and heal.”
Munroe issues a caveat: “While you do not need to wake the athlete, it is still highly recommended to monitor them during this period. If any of the athlete’s symptoms have worsened or if they are starting to experience new symptoms the athlete should be taken to the emergency department for medical follow up.” This is also why it is recommended to not take any over the counter medications (unless prescribed by a medical physician) during this period as it can mask the worsening of symptoms.
MYTH: The most up-to-date equipment can prevent concussion.
FACT: Currently, there is “no equipment that will prevent a concussion from happening,” says Munroe. The brain sits in fluid within the skull, therefore no amount of protection around the skull is able to prevent the brain from shifting inside this fluid. Protective equipment is still important – for example, the helmet is worn to protect against facial and skull fractures or injuries. Bottom line: “Until they invent something that prevents the brain from shifting inside the skull, nothing will prevent concussions from happening.”
Instead, current research is focusing on new game rules and skill development strategies in practice in order to determine different ways of preventing the direct and indirect forces that cause the concussions from occurring in the first place. This research is ongoing, so no conclusive results have been released yet, but initial results seem promising.
A graduate from Acadia University in 1995 Sheridan College, Stewart has been working in private practice for the past 18 years. He and his wife own Ken Val Rehab and Sports Injury Centre in Rothesay NB. He is also the Rehab Consultant for Saint John SeaDogs of the QMJHL