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Injury and Rehabilitation

7 Common Concussion Myths

Author: Steven Zonner, D.O.
Family Medicine

A doctor holding her fingers up for a child to look at

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
  • Headache
  • Dizziness
  • 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:

  • Falls
  • Motor vehicle-related injury
  • Being struck by or against an object (accidental)
  • Assaults

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 (concussion).

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.

Visit the 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.”