April 25, 2017

Concussions: Myth vs. Fact – Six Common Misconceptions about Prevention and Treatment

By Brent Fisher, MD

As we enter warmer months and outdoor activities increase, risks of injuries and accidents related to sporting activities increases as well, including a likely increase in head injuries. And while football has been heavily scrutinized for the impact of head trauma, including concussions on current and former players over the last several years, it is not alone. Also prevalent are a fair amount of concussions in rugby, lacrosse and soccer, to name a few; nor are mountain bikers, road cyclists and kayakers immune to concussions and head injury either.

The Centers for Disease Control and Prevention (CDC) estimates about 2 million children each year suffer a concussion — a direct blow to the head or indirect blow to the body that causes the brain to literally shift in the skull. While most concussions are mild, they are serious injuries that require medical treatment.

That said, let’s review some of the common misconceptions of concussions.

Myth #1 – Helmets and mouth guards help prevent concussions.

Fact – There is no current evidence to support the use of either to prevent concussions, but they are very helpful in preventing other serious injuries, including skull and dental fractures.

Myth #2 – If my child has a concussion, I need to wake him/her up every 2 hours to check on him/her. 

Fact – Concussed athletes require rest. Waking them repeatedly is not needed. Checking to make sure they aren’t breathing abnormally, vomiting or crying out in pain (signs of a possibly more serious head injury) is still warranted, but the child does not need to be awakened to do this.

Myth #3 – An MRI or CT scan is required to diagnose a concussion.

Fact – Concussions are diagnosed clinically and will not show up with traditional imaging.

Myth #4 – It is necessary to go to the ER for a concussion.

Fact – Most concussions can be evaluated and managed by physicians trained to treat concussions. However, patients with suspected concussion should be evaluated promptly to rule out other life-threatening head injuries.

Myth #5 – All doctors are trained to treat concussions and are familiar with state laws regarding return to activity. 

Fact – Most physicians receive little to no training regarding concussion management, and many don’t keep up with regulations, which vary by state. While there are certainly family physicians, internists, pediatricians, ER physicians, neurologists and providers of other specialties that are up to date on management, most do not seek out the additional training that would make one proficient. When in doubt, a sports medicine professional or certified athletic trainer would be best to seek out for initial evaluation and management.

Myth #6 – To suffer a concussion, one must hit their head on the ground, another player or object. 

Fact – While head impact with another player, ground or other object is often the cause of a concussion, a rapid rotation or snap of the head, without hitting the head on anything, can also cause a concussion.

Concussions are serious injuries and rightfully in the public spotlight. When in doubt about whether you or your child have suffered a concussion, its best to be evaluated by a trained healthcare professional to help decide the best individual treatment plan.

Brent Fisher, MD, is a fellowship-trained primary care sports medicine physician with Asheville Orthopaedic Associates.

He is welcoming new patients, and cares for athletes and active people of all kinds at the Mission Orthopedic and Sports Medicine AOA Walk-In Clinic near Biltmore Park, Monday-Friday, 7:30 am – 4:30 pm, with a concussion clinic on Friday afternoons. Learn more at missionhealth.org/orthopedics.