7 Common Concussion Myths
Steven Zonner, D.O.
Simply put, a concussion is a type of brain injury caused by a bump, blow
or jolt to the head or a hit to the body that causes the head—and
the brain—to move rapidly back and forth. Essentially a concussion
produces a whiplash effect through the brain inside the skull.
While our understanding of concussion has improved a lot over the years,
there are a lot of myths surrounding this type of injury that still exist.
Here are some of the most common concussion misconceptions:
MYTH: Concussion usually causes a loss of consciousness.
One of the biggest myths surrounding concussion is that you have to lose
consciousness to have suffered a concussion. Most people immediately think
of a football player who has to be carted off the field after receiving
a major blow. The reality is that the symptoms displayed after a concussion
are a lot more subtle and a lot less dramatic than one would imagine.
More often, people who have received a concussion experience:
- Nausea and vomiting
- Double or blurry vision
- Sensitivity to light or noise
- Feeling “off” or foggy
- Difficulty concentrating or remembering
MYTH: If you think someone has a concussion, don’t let them fall asleep.
The most common myth I hear about concussions is one that, if followed,
can actually delay recovery. People still believe that a concussed person
should not be allowed to sleep for fear that they will slip into a coma.
Research has now shown that “cocoon therapy” – remaining
in a dark room without any visual or auditory stimuli – will actually
result in a considerable delay in recovery or worse, lead to prolonged
months of post-concussion symptoms. It has now been shown that getting
regular sleep – not excessive napping – helps the brain heal.
Furthermore, it has now been substantiated in research in just the last
4 years that starting to move around and even beginning a gradual return
to aerobic exercise (that does not worsen symptoms) will promote faster
recovery. Since dizziness and nausea frequently accompany concussion,
limiting movement of the head by using a stationary bike is a very safe
and effective option. In fact, it is established that over 80% of concussions
can completely recover within 7-10 days – IF treated appropriately.
In other words, concussion is a reversible injury.
MYTH: Doctors can tell if you’ve had a concussion based on MRI or
CAT scan readings.
Standard CT or MRI scanning of the head and brain can NOT detect a concussion
and are usually performed in the ER to rule out more serious conditions
such as a skull fracture or intra-cranial bleeding. Again, research has
shown that with mTBI (Mild traumatic brain injury), only the most sophisticated
imaging devices utilized in research (e.g., diffuse tensor imaging or
DTI) can reveal the electrical and chemical imbalances of a concussion.
These devices are not ready for prime time yet and the public needs to
be aware that a CT of the brain gives an amount of radiation that is 20
times that of one chest x-ray. While the risk of developing a brain tumor
is extremely low, it has been estimated that in children under the age
of 15 years, the summary effects of radiation from 2-3 CT brain scans
nearly triple the risk.
MYTH: Athletes are the only people who need to worry about concussion.
The CDC estimates that there are between
1.6 and 3.8 million sports and recreation-related concussions each year in the U.S. However, it’s not the only cause of concussion.
Other leading causes include:
- Motor vehicle-related injury
- Being struck by or against an object (accidental)
MYTH: Concussions are only caused by being hit in the head.
You can get a concussion without receiving a strong blow to the head; it
can also be caused by whiplash or rotational injuries. In fact, around
80 percent of the people we see from motor vehicle accidents have had
a concussion because of this whiplash effect. Regardless of where you’re
hit, when the head or body receives an impact with enough force, it can
cause forces within the brain to result in stretching and damaging of neurons.
MYTH: Everyone is at the same risk for concussion.
While they can happen to anyone, there are some groups that are especially
prone to concussion. We tend to see more concussions in teenagers and
women. Teenagers tend to be more active and involved in sports, and are
less risk-averse than other groups. As for women, they generally have
less developed neck muscles to stabilize the head during impact. In addition,
women have a more developed structure within the brain called the corpus
callosum than men. This is a connective pathway between the left and right
sides of the brain that is responsible for the functions that make multitasking
possible, like coordination and complex problem-solving. These connections
are especially susceptible to the type of shearing damage that can cause
the broad symptom complex known as mTBI or mild traumatic brain injury
It is now generally understood that concussion is an extremely common and
treatable condition. In children and teenagers especially, it’s
important to know the signs of concussion and seek appropriate treatment
to reduce the risk of long-term cognitive effects. With adequate rest
and rehabilitation, concussion doesn’t have to have a lasting impact
on your – or your student-athlete’s – quality of life.
Washington Hospital Healthcare System website to learn more about concussion diagnosis, treatment and rehabilitation
services available through the
Washington Sports Medicine Program and the
Washington Outpatient Rehabilitation Center.
Posted August, 2019
About Steven Zonner, D.O.
Dr. Steven Zonner is board certified by the American Osteopathic Board
of Family Practice and has over 30 years of experience in the fields of
primary care, occupational and sports medicine. In his family medicine
practice, Dr. Zonner promotes physical fitness to prevent disease and
assists his patients to make educated decisions with regard to their health
care. As an expert on concussions, Dr. Zonner currently serves as the
Concussion Program Director of the Tri-Valley and Golden State Elite Youth
Ice Hockey Programs in Dublin, CA as well as Medical Consultant for the
Concussion Committee of the California Amateur Hockey Association.
Dr. Zonner completed the majority of his medical training in Chicago starting
with his Doctor of Osteopathic Medicine degree (DO) from the Chicago College
of Osteopathic Medicine. After finishing his Family Medicine internship
and residency at Botsford General Hospital in Michigan, he returned to
Chicago to complete his primary care sports medicine fellowship at Rush-Presbyterian-St.
Luke’s Medical Center. In 1990, he went on to become the head team
physician for Arizona State University and has been invited to work at
the US Olympic Training Center in Colorado Springs. He has been treating
people of all ages and athletic abilities in the San Francisco Bay Area
since 2004. Dr. Zonner is also fluent in Spanish.
“My philosophy is to provide the same quality and coordination of
medical care that I would provide to my own family and friends. Too often
in today’s medical world, physicians do not have the time to explain
the details of your care nor do they have the time to speak with other
providers involved. I will work with other members of your medical care
team (e.g., radiologists, physical therapists, specialists, chiropractors)
to coordinate your care and provide optimal treatment.”