Ten Concussion Myths that Need Correcting

The medical profession’s understanding of concussion and the best way to treat these common injuries has changed in recent years. Yet misinformation and outdated thinking remain. Christine Greiss, D.O., Medical Director of the JFK Johnson Rehabilitation Institute Center for Brain Injuries, provides answers and updates:

• You need to lose consciousness, even for a moment, to suffer a concussion.

No. Even people who do not lose consciousness can experience concussion.

• The best way to recover from a concussion is to stay quiet in a dark room with no sound for an extended time.

No. That approach is outdated. Today, we advise a gradual return to activity, including cognitive activity. That might mean going back to school or work, but with a limited schedule, and getting out for walks but perhaps not running.

• A concussion cannot impact a person’s hormones.

Wrong. The brain houses the pituitary gland and concussion can impact hormone levels. At the JFK Johnson Concussion Program, we often conduct blood tests on concussion patients, both men and women, to determine if the brain injury has impacted their hormone levels, such as levels cortisone and testosterone levels. Women can experience menstrual changes. Hormone changes can affect sleep cycles, mood, weight gain, and fatigue. Brain injury specialists can help patients address these changes.

• Time is the only way to heal a concussion.

Most concussions will heal without intervention. And it is true that fully healing a concussion can take time. But treatment and rehabilitation can make an extraordinary difference for people whose concussions do not heal on their own. Medications and injections for migraine/headache, strategic vitamins, as well medications for hormone imbalances can help. Also important is rehabilitation to address balance and visual, cognitive, and physical symptoms.

• Athletes can play through the pain.

Continuing to play through pain can delay recovery or cause longer-term consequences. The quickest way to get better is to take care of the concussion right away.

• Children bounce back from concussions faster than adults.

Children, especially adolescents and young teenagers, may need longer recovery times than adults.

• Imaging tests such as MRIs or Ct scans can pinpoint concussion.

No, you cannot see a concussion on brain imaging tests. We diagnose and treat concussion based on how our patient’s function — on their symptoms and how concussion has impacted their daily lives.

• A neurologist is the only specialized medical professional that treats concussion.

No. Physicians trained in rehabilitation medicine with brain injury certification also provide comprehensive treatment for concussion and other traumatic brain injuries. Rehabilitation medicine physicians look at the function of the brain and the ways concussion impacts how patients move, see, hear, balance, and function overall. These specialists work closely with specialized therapists who provide physical, occupational, vestibular, cognitive, and other specialized therapies for concussion patients.

• Patients should avoid all screens, such as cellphones and computers, after a concussion.

Completely avoiding all screens is not necessary. Patients can have limited screen time, depending on their symptoms, if they want and feel comfortable on phones, computers, etc.

• Once injured, the brain cannot heal.

Our brains are neuroplastic. Neuroplasticity is the brain’s ability to rewire neural connections, enabling the brain to adapt and function in new ways. Physical, occupational, and cognitive rehabilitation can enhance this process and help the brain heal.

Dr. Greiss is a member of the physician committee created by the Commission on Accreditation of Rehabilitation Facilities (CARF) to advise concussion programs nationwide.