Surprising concussion myths and facts

"There was a time when it was considered life-threatening to let someone suffering from a concussion to fall asleep," said Chris Hummel, a certified athletic trainer and clinical associate professor in Ithaca College's Department of Exercise and Sport Sciences. "But current research shows that sleeping is actually the best thing for a concussed player. Getting physical and mental rest helps an athlete recover from a concussion. But athletes should not be left alone the first night and should be seen by the sports medicine staff the next day."

Concussion management, Hummel added, is very complicated and should only be undertaken by athletic trainers, sports medicine physicians and others with specialized concussion training. Still, it's important for coaches, parents and athletes to know the difference between fact and fiction when applied to concussion basics.

Fictions

•A normal CT scan rules out a concussion. "A concussion results from a neuro-metabolic event brought on by the trauma," Hummel said. "Simply put, there is an imbalance of the needed chemicals or fuel that helps the brain function when an athlete is concussed. That's not a structural injury, so a CT scan won't pick it up. CT scans can only view structural damage."

•A player who has been knocked unconscious will suffer a worse concussion than a player who didn't lose consciousness. "A player doesn't have to be knocked out to sustain a serious concussion," Hummel said. "In some cases, individuals who are knocked out may suffer less severe trauma. In either case, the severity of the concussion might not be known for days or weeks."

•Male athletes sustain more concussions than female ones. "Male athletes sustain concussions at similar rates as female ones," Hummel said. "However, recent studies have shown that symptoms might vary by gender, as males with concussions experience more physiological issues such as balance problems while females experience more psychosocial issues such as fatigue or low energy."

•A grade-one concussion is less serious than one that's a grade-three. "We used to grade concussions during the initial diagnosis, but we no longer do that because we now know it's difficult to accurately assess the severity of a concussion right away," Hummel said. "We have to wait and see how the symptoms resolve over time before we can determine how significant the concussion is or is not."

•The harder someone is hit, the worse the concussion. "It doesn't always take a big hit to produce a concussion," Hummel said. "Any contact to the head or body that causes rapid head movement can cause a concussion. It's also important to point out that several lower impacts over time might be more serious than a single collision of great force. For example, offensive linemen in football, who experience contact on almost every play, could be more at risk for permanent brain damage than a wide receiver who absorbs a single hard hit once or twice a game."

•Athletes can soldier through a concussion. "No," Hummel said. "Typically, it takes one to two weeks for concussion symptoms to resolve and for the brain to begin operating back at full capacity. Just because an athlete states his or her head has cleared, it's no indication that he or she should go back into the game. It is not safe to go back on the field the same day after experiencing concussion-like symptoms."

•Concussions are the same for adults and adolescents. "Adolescent brains are still developing," Hummel said. "The effects of a concussion on young athletes are more dynamic than on mature ones and may take longer to recover from."

•Helmets prevent concussions. "Helmets are designed to prevent skull fractures, not concussions," Hummel said. "If a helmet is fitted properly, it might reduce the risk or severity of concussions, but no one helmet is capable of preventing a concussion, yet!"

Facts

•An athlete who has had one concussion is more likely to have another than an athlete who hasn't been concussed. "Once an athlete has experienced one concussion, the threshold for sustaining another concussion can be diminished. Also, if a player sustains another blow before he or she is fully recovered, the resultant symptoms can be worsened and result in a prolonged recovery. There is also a rare phenomenon called Second Impact Syndrome that can cause impaired brain blood flow or even death if an athlete suffers another trauma before fully recovering."

•Concussions should be treated and managed on an individual basis. "The brain is an incredibly complex organ, and so are the neurochemical processes that govern it," Hummel said. "No two concussions are exactly alike anymore than the brains of any two individuals are identical. Concussion management begins by obtaining individual baseline (pre-injury) testing for each athlete. Once a concussion occurs you will then know what is 'normal' for that athlete. Once the athlete has become symptom-free and is back to his or her baseline test scores, a progressive return to play plan should be followed. This progression should consist of rest, light exercise, noncontact drills and then full practice before returning to game competition. Each level of recovery should take 24 hours. An athlete has to continue being symptom-free to proceed to the next level."

•If you suspect a student-athlete of having a concussion, assume it's a concussion. "If an athlete describes having a headache or dizziness, shows signs of balance problems, or difficulty remembering, assume that player is concussed and have him or her evaluated by an athletic trainer or a physician trained in sports medicine," Hummel said.