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While concussions may be common, knowing what to do for one isn’t common knowledge. Maybe you’ve seen a favorite athlete taken out of the game after sustaining a concussion, or you’ve read scary headlines about chronic traumatic encephalopathy, aka CTE, which may be associated with repeated head impacts over many years.
But the truth is, these examples don’t really represent what it’s like for an average person to get a concussion.
“Media attention focuses on sports-related concussion, but most concussions don’t actually happen in a sports setting, which means the information that gets put out about them might not be accurate for all patients,” says Stanley Herring, MD, a physiatrist, co-founder of The Sports Institute at UW Medicine, and co-medical director of the UW Medicine Sports Concussion Program. He previously served as a team physician for the Seahawks and Mariners for many years.
We asked Herring and his colleague Orli Shulein, MS, a speech-language pathologist working toward her doctorate degree in the UW Department of Rehabilitation Medicine, to debunk some concussion myths they hear the most. Both experts regularly treat patients who have concussions.
Real quick: What is a concussion, exactly?
It’s a type of traumatic brain injury, which, we know, sounds pretty ominous. What exactly happens during a concussion is still a bit of a mystery, though doctors have some ideas based on years and years of research.
A concussion causes disturbance to brain cells, particularly axons, which are long, delicate fibers that transmit messages between cells. This disturbance affects how the axons function and, in some cases, may also be associated with microscopic cell damage. The chemical balance of the affected cells is disrupted, and it takes time and energy to restore normal brain function.
Falls, car accidents and physical violence are some main causes of concussions. You can also get a concussion from injuries such as whiplash, which may force your brain to move rapidly forward and backward. Symptoms vary depending on the location and severity of the blow, but often include headache, nausea or vomiting, fatigue, dizziness, vision problems, and trouble with thinking, walking, sleeping and remembering. Loss of consciousness is actually uncommon, and if it occurs, it is brief.
As scary as concussions sound, most people fully recover from them, though some people may have symptoms that linger beyond the standard one-month recovery time.
Myth 1: I should sit in a dark room and wait until my concussion symptoms go away.
Please, don’t do this. It can actually do more harm than good. While it’s fine to take a day or two to rest right after a concussion, being bedridden for a week is not helpful.
Brains (even injured brains) need stimulation, and your body needs to move a little. Take things slowly at first. A walk around the block, as long as you aren’t too dizzy? Totally fine. Getting back on your mountain bike? Absolutely not.
“Especially in young athletes, there can be rare but catastrophic consequences — including death — if you get back in the game right away,” Herring says. “Don’t do anything while you’re still healing that will put you at risk for another concussion.” Even if the consequences are not life-threatening, mismanaging a concussion in young athletes can prolong recovery, affecting not only sports participation but also school and other academic and social activities.
So, take a couple of days off and gradually build up how much you do. If you play sports, don’t start playing again until your doctor says it’s OK.
Myth 2: It’s dangerous to fall asleep after a concussion.
Another common misconception is that you shouldn’t let someone fall asleep after they hit their head because they might die.
The truth is that, once someone is medically evaluated and a doctor determines they don’t have any worrisome symptoms or test results, it’s OK for that person to sleep. In fact, sleep helps your brain heal, which is extra important after a concussion. You don’t want to sleep the entire day — as mentioned above, some movement and brain stimulation is a good thing — but you also don’t want to keep yourself awake because you’re afraid to doze off. Stick to a consistent sleep schedule as best you can, while understanding that your normal sleep pattern may be disrupted for a few days after a concussion.
After a concussion, it’s important to have someone stay with you for a day or two. They can look out for signs that something more serious is going on, like if you don’t fully wake up or wake up confused. Other signs to watch for are slurred speech, weakness on one side of the face or body, or seizures. These are signs that your brain injury is more severe, and the person with you should call 911.
Myth 3: All I can do for a concussion is wait it out.
Doctors and other healthcare providers can help your recovery in a variety of ways, including educating you and your family members about expected signs and symptoms of concussions, returning to school or work, and getting back to physical activity. Referral to rehabilitation specialists, diagnostic testing and medication use may be options. Mental health specialists can help if you’re feeling anxious or stressed out by the concussion and its symptoms.
Herring recommends looking for a physiatrist, a doctor who specializes in physical medicine and rehabilitation; a neurologist; or a sports medicine specialist if you sustained a concussion. Some primary care doctors or physician assistants may be comfortable treating concussions, too.
There are also things you can do for yourself, like noticing what triggers your symptoms and making an effort to avoid those things for the time being. You may find you feel better during a certain time of day, which is when you can get those need-to-do chores done. Sticking to a daily routine may be helpful. Taking breaks is also a good idea, even if it seems like you shouldn’t have to. Be patient with yourself while your brain is healing.
Myth 4: I used my brain too much and reinjured it.
“When you’re first injured, your capacity to do things is lower, and the amount of energy it takes to do those things is higher. Sometimes people expect they can dive right back into things, but when that backfires, it can make them more symptomatic or anxious,” says Shulein.
Don’t mistake a temporary recurrence or increase in symptoms as re-injury to your brain, though. You can’t hurt your brain just by staring at a screen for too long or getting tired after cooking a meal. (And yes, it’s OK to watch TV or scroll on your phone — just limit how much time you’re looking at screens. Playing that video game for hours could make your symptoms worse.)
So instead of stopping all activities, try cognitive pacing, a technique Shulein regularly uses with patients.
“It involves helping someone find their activity threshold and learning how to work just below it. They learn when to engage and when to put the brakes on,” Shulein says.
Once you’re able to do something without getting too tired, you can try slowly increasing your activity levels over time to see how you handle it. If things get difficult again, pull back a bit and wait a while, then try again. As you heal, your activity threshold should slowly increase.
Myth 5: The concussion I got a month ago is still causing symptoms and will affect me for the rest of my life.
It is not true that everyone who gets a concussion will develop long-term brain damage. In fact, most people who get concussions will fully recover.
It’s also not true that any new symptoms you start experiencing after a concussion are automatically related to the concussion. If you have new symptoms or your symptoms aren’t gone after a month, follow up with your healthcare provider. They may recommend specialized rehabilitation to get you back on your feet.
And if your symptoms do linger, it doesn’t mean you won’t heal. Things like migraines, anxiety, depression or a stressful time in life can make healing take longer.
“Even if a concussion is considered mild in the media, it won’t feel mild to you. It can be a huge disruption to your life,” says Shulein. “Many people think they’ll feel better in a week or so, but it can take longer, even up to a month or more. Be patient with yourself and don’t give up hope — you won’t have concussion symptoms forever.”
