According to the Centre for Disease Control, an estimated 2.7 million children (0-19 years of age) were treated annually in emergency departments for sports and recreation-related injuries. Approximately 6.5%, or 173,285, of these injuries, were traumatic brain injuries (TBIs), including concussion.
There are approximately 67,000 diagnosed concussions in high school football every year.
As part of my physiotherapy practice I treat both adults and children who have suffered from a concussion. Although, there has been a lot more attention and awareness give to concussions recently, I still see many misconceptions that still exist and am surprised at some of the incorrect advice given to people who are recovering from a concussion. Research is still working on determining the efficacy of treatment protocols, and best practice guidelines for patients suffering from a concussion, which speaks to the complexity of the injury. In this blog, I will attempt to share with you some of the common misconceptions I hear from patients in clinic. It is critical that we share what is known about concussions, so we educate others to be able to properly seek treatment, manage their symptoms, and receive proper care.
MISCONCEPTION: A Concussion is ONLY caused by a Direct Hit to the Head
A concussion is a mild traumatic brain injury (mTBI) and is caused from an acceleration/deceleration force to the brain. This force can be from a direct hit to the head, which is most common, but it can also be from an indirect hit to the body. Any movement which causes the head to move back and forth, or the brain to “shake” in the skull, can cause a concussion.
MISCONCEPTION: Helmets Prevent Concussions
Currently there is no evidence that demonstrate helmets prevent concussions or reduce incident rates. There is evidence to show that helmets do prevent skull fractures and cuts, and thus it is important to wear them and ensure they properly fit. The skull acts as a protective shield around the brain. The brain almost floats inside the skull. A helmet does not prevent the back and forth movement of the brain in the skull, which is the action which causes a concussion.
MISCONCEPTION: Rest is Considered the BEST Treatment for a Concussion
In the past, a widely prescribed treatment for a concussion was to rest in a dark room for 7-10 days. Currently there is insufficient evidence and prolonged rest can even be detrimental to recovery. The most recent International Conference on Concussion in sport held in Berlin, October 2016 recommends the following:
“After a brief period of rest during the acute phase (24–48 hours) after injury, patients can be encouraged to become gradually and progressively more active while staying below their cognitive and physical symptom-exacerbation thresholds (ie, activity level should not bring on or worsen their symptoms)”
Current studies are showing that prolonged rest is maladaptive to recovery, and many studies now are focusing on heart rate-based exercise as a rehabilitation strategy for patients with a concussion.
MISCONCEPTION: There is NO Treatment for a Concussion
Since rest is no longer considered the best intervention for a concussion, early interventions can help to fully and quickly resolve a concussion. Health care professionals with specific training in concussion management can assist in returning individuals to school, work and physical activity. Concussion treatment may include exercise therapy, manual therapy to the neck for headaches or whiplash injuries that accompany a concussion, visual and vestibular therapy to address dizziness, balance or visual disturbances.
MISCONCEPTION: Symptom Resolution Means Full Recovery from a Concussion
Typically, 7-10 days after a concussion injury, symptoms begin to resolve. Individuals may be asymptomatic and feel that they have completely recovered, but research shows that the metabolic recovery of the brain takes at least 3 – 4 weeks (or more). During this time when individuals are asymptomatic, but the brain is still recovery, a second impact can cause severe and irreversible damage to the brain. Before returning to sports, clearance from a trained professional in concussion management should be obtained.
If you or a loved one has sustained a concussion or suspected concussion, and would like to book a Physiotherapy Concussion Assessment please click here.
By Jennifer Harvey