Today I want to provide you some information on what a concussion is and give you some brief tips to share with anyone you may know who has had an impact to their body/neck/head and may have recently suffered this type of brain injury. There are several common myths that exist and my goal is to provide
some updated truths from the latest research to guide you, or someone you know, who has sustained this
type of injury. Seeking proper assessment and treatment, as close to the injury as possible, by a qualified
health care professional who is up to date on the latest research and rehab modalities, is imperative. Early
assessment and treatment of concussion can expedite your healing time.

What is a Concussion?

By definition, concussion is defined as, “A subtype of mild Traumatic Brain Injury
(mTBI)…A reversible neurological dysfunction…may be caused by either a direct blow to the head, face,
neck or elsewhere on the body with an impulsive force transmitted to the head…which may result in
neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional
disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural
neuroimaging studies.” (1) It is a metabolic, physiological, microstructural injury to the brain. The force
of the head and neck being jarred forward and back (and in some incidences which also include rotational
forces) cause a shearing of the white and gray matter in the brain (which are different densities) and can
lead to injury of the axons and nerve transmission pathways. This then causes disruption to the function
of the pathways in the brain, or “messaging highways” that allow our brains and bodies to coordinate
certain functions such as balance, vision, hearing, moving, and so forth leaving you to feel symptoms
either physically, emotionally, cognitively, or even affecting sleep and wake cycles. So, in other words,
although there is structural injury to the axons, this damage is unable to be detected and causes a
disruption in function. There does NOT have to be a loss of consciousness involved to sustain a
concussion.

Myths vs Truths

Myth: Wake someone with an acute concussion every 2 hours
Truth: A concussion can evolve over a period of 4-6 hours. You do not want to let someone sleep for this
initial time frame after a concussion so you can monitor for worsening symptoms, decreasing
consciousness, speech issues etc. (also known as “red flags” in the medical field). If “red flags” are
present, or if you have concerns, visit your nearest Emergency Room for evaluation, neurological testing
and imaging, if warranted. After that initial window of 4-6 hours with no red flags, sleep is important for
recovery - so in those first few days… let them sleep.

Myth: Rest is best
Truth: Rest is required for the first 24-48 hours and then slow/gentle re-introduction of activity coupled
with a sub-threshold aerobic program is required. Qualified healthcare professionals with training in brain
injury can guide you.

Myth: Stay in a dark room until symptoms go away (especially if symptoms involve light sensitivity)
Truth: This can, in fact, make things worse. Staying in a dark room decreases all sensory input to the
brain and over a prolonged period of time is not beneficial to healing

Myth: Concussion symptoms are permanent
Truth: Extremely Incorrect

Myth: All you can do is wait / It just takes time
Truth: Yes, recovery and healing take time. However, connecting with a knowledgeable provider to guide
you appropriately and begin active rehabilitation sooner, will increase your speed of recovery

Myth: Recovery is complete or “you're as good as you’re going to get” at [insert time frame]
Truth: Our brain is plastic and healing can happen at any point over a lifetime

Myth: You need to push through your symptoms
Truth: Pushing through your symptoms will not help you in recovery, and in fact can worsen them. Instead, when you begin to feel symptoms elevate, or feel overwhelmed, stop and take a break from what
you are doing and remember to breathe!

Myth: Once symptoms settle your brain has recovered
Truth: Symptom resolution is a fabulous step - however we know in the acute phase that symptoms can
resolve in 7-10 days but the brain continues to heal for up to 30 days.

References:
1. McCrory P, et al. Consensus Statement on Concussion in Sport-the 5th International Conference
on Concussion in Sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun;51(11):838-847.
doi: 10.1136/bjsports-2017-097699. Epub 2017 Apr 26. PMID: 28446457.
2. Leddy JJ, Baker JG, Willer B. Active Rehabilitation of Concussion and Post-concussion
Syndrome. Phys Med Rehabil Clin N Am. 2016 May;27(2):437-54. doi:
10.1016/j.pmr.2015.12.003. PMID: 27154855.
3. Leddy JJ, Haider MN, Noble JM, Rieger B, Flanagan S, McPherson JI, Shubin-Stein K, Saleem
GT, Corsaro L, Willer B. Management of Concussion and Persistent Post-Concussive Symptoms
for Neurologists. Curr Neurol Neurosci Rep. 2021 Nov 24;21(12):72. doi: 10.1007/s11910-021-
01160-9. PMID: 34817719.
4. Ken, TK, Neary JP. Cerebrovascular Pathophysiology following mild traumatic brain injury,
Clin. Physiol. Funct. Imaging (2011) 31 pp85-93. Doi:10.1111/j.1475-097X.2010.00990.