10 Concussion Myths To Boot to the Curb: Advice from a Concussion Physiotherapist
Over the last 10 to 15 years there has been a huge increase in awareness of, and treatment for concussions. As a physical therapist who treats concussions, I have heard too many stories of people with persistent post-concussion symptoms who were told to sit and rest in a dark room until their symptoms resolved. Lack of exposure to anything that would aggravate their symptoms led their brains to continue to be sensitive to these stimuli, and never fully recover.
This is a scenario we hope to stop from happening by spreading increased awareness around current best practices for concussion recovery. With that said, here are 10 common myths about concussions and concussion recovery from your local concussion physiotherapist in Fernie, BC.
MYTH #1: Rest in a dark room until symptoms resolve
This used to be best practice about 10 years ago. Updated evidence informs us that complete rest should only last between 24-48 hours after a concussion. After this, slow exposure to mental and physical activity should take place to optimize recovery.
MYTH #2: A Concussion Requires Losing Consciousness
Many people think you need to lose consciousness to have a concussion. This is not true. In fact, 90-95% of concussions do not result in a loss of consciousness. Any hard hit to the head or whiplash of the head where you feel you got your “bell rung” is likely a concussion.
MYTH #3: Wake Up a Person every 30 minutes if you suspect a concussion
After a concussion, sleep is essential to recovery. Let them sleep through the night!
MYTH #4: Avoid All Screen Time Post Concussion
Old-school recovery strategies involved full avoidance of screens. As evidence has evolved, we now know that full avoidance of screens is not best practice in concussion recovery. We need slow exposure to screens and brighter environments for optimal concussion recovery.
If screens are irritating to your concussion symptoms, you can reduce screen time or make other modifications such as putting a blue blocker on like f.lux, turning the brightness down, or using a bigger screen. Slow exposure to aggravating activities is essential to concussion recovery. A physiotherapist who has concussion-specific training can support you with management and pacing around this.
MYTH #5: Symptoms Present Immediately
Symptoms can take up to a week to present post-concussion. If you suspect a concussion at all, it is best to sit out to ensure no concussion symptoms present themselves. Going back to sport early puts you at risk of a second concussion and can have extremely detrimental effects on your recovery.
MYTH #6: Concussions can only be diagnosed via a CT or MRI
Many people stress about getting imaging after a concussion. They think it will be able to tell them what is wrong and how to cure it. Fun Fact: MOST concussions cannot be diagnosed by an MRI or CT. The main reason imaging is occasionally performed after a concussion is to double-check there are no skull fractures or bleeding inside the brain. Most concussions cannot be seen on imaging and are diagnosed solely by symptom presentation. Symptom presentation and your response to certain tests in the clinic determine if a concussion has occurred, what areas have been affected, and directions for treatment.
MYTH #7: Concussions are only caused by direct hits to the head
Concussions are the result of the brain moving quickly inside the skull. When the brain moves quickly it can hit the inside of the skull, injuring cells in the brain. The brain can also twist and shear axons (a part of our brain cells) along the way. These actions can happen during quick movements to the head, such as a whiplash injury. A direct hit to the head is not required to injure healthy brain tissue.
MYTH #8: I feel fine, so “I am fine to play”
Often athletes feel they can return to play after a hit to the head as they do not feel any symptoms. As we talked about before, it can take up to a week for concussion symptoms to present themselves. Additionally, the adrenaline pumping through the body during a competition or practice can mask concussion symptoms. If you suspect a concussion at all, even if you feel no symptoms, DO NOT return to play. Returning to play before full recovery takes place can put you at risk for developing a condition called Second Impact Syndrome (SIS). SIS occurs when a second concussion occurs within a few weeks of the first concussion. This can cause significant setbacks in recovery times and dramatically increases the chance of persistent post-concussion symptoms. In rare cases, it can cause the brain to swell considerably, and can be fatal.
The Bottom line: If you suspect there is a chance of concussion for you or one of your athletes, do not return to play that day.
MYTH #9: Concussions only happen in high-contact sports
Concussions can happen anywhere, to any type of person. It can happen due to a fall from standing where you hit your head on the ground. It can happen in a car accident during a whiplash injury. It can happen during a fight with a hit to the head or jaw. While sport is the most common cause of concussions, it is by no means the only cause.
MYTH #10: After a concussion, I should only be seeing a doctor
Although we highly recommend seeing your doctor after a concussion, they are not the only healthcare practitioner you should be seeing! A doctor can help diagnose a concussion, and can refer you to imaging if needed, but they are not the ones that will work with you to provide individualized treatment during your recovery. A physiotherapist who has specialized training in concussion care can work with you to assess which parts of the brain were affected and help develop a treatment plan that will help you recover from your brain injury. Every brain injury is different and will have a slightly different presentation.
An Occupational Therapist (OT) who specializes in concussion care can also be an amazing asset to the team. OT’s can help with planning and pacing so you don’t overdo it and flare your symptoms, as well as help deal with symptoms such as issues with memory loss, concentration, attention and problem-solving.
Your doctor, physiotherapist, and occupational therapist are often the core members of your team. Depending on your symptoms and severity, other practitioners may also be involved. Other practitioners you may be referred to are neuro-optometrists, ophthalmologists, social workers, psychologists, chiropractors, osteopaths, kinesiologists, dieticians or massage therapists. Often these individuals will be added to your recovery plan on an as-needed basis.
Conclusion
Best Practice for concussion care has evolved a lot in recent years, and for the better! At Ridgeline Physio, we are happy to be able to support our community with evidence-based concussion rehabilitation both in-person and virtually. If you have any questions please call us, email us or book online. We look forward to working with you!
