Doctors share common misconceptions about concussions

An injured hockey player is attended to on the ice by the team doctor.

Medical professionals estimate that about 50 per cent of concussions go unreported. Concussion experts say this is due to the many misconceptions about concussions, especially among young athletes.

According to the Government of Canada, 39 per cent of head injuries in 10- to 18-year-olds were diagnosed as concussions, while 24 per cent were considered as possible concussions.

Children and youth in that same age group, especially in sports like football, soccer and hockey, have all seen at least a 40 per cent increase in rates of reported head injuries between 2004 and 2014.

If concussions seem to be so common in sports, then why are so many of concussions going unreported?

Dr. Cameron Marshall, a chiropractor and a graduate of a post-doctorate residency in Sports Sciences, believes athletes either ignore their symptoms or they’re unaware of the real damage they can cause — citing it as a “culture of sport issue.”

CamMarshall doctor
Dr. Cameron Marshall has a chiropractic degree and a post-doctorate residency in Sports Sciences. He has received specialized training, which has allowed him to diagnose and manage sports-related injuries. Photo courtesy of Complete Concussion Management

Marshall says it comes down to two factors: “It is [either] athletes withholding it or they’re unaware.”

The most common response he hears is that the person believed their injury was not “bad enough to even say anything to anyone or go to see a doctor.”
A pediatrician and passionate cyclist, Dr. Rob Meeder agrees that athletes may ignore the symptoms of a concussion.

Meeder believes the reason that concussions are under-reported is due to the types of pressure on young athletes.

“The more higher-end sports, the more pressure there is to stay uninjured,” says Meeder. “I think there is a lot of under-reporting that is going on — kids are trying to make the team, they’re trying to make playoffs and they don’t see the long-term consequences and risks.”

A lot of the risk for young athletes is due to the fact that they are more prone to suffering concussions. Meeder’s thought process is that young people’s bodies have not developed to receive such injuries, and they do not have the right skills and reaction time to protect themselves.

“If you’re a child and you’re six and you’ve never been hit before, you’re not ready for it. You don’t know how to take a hit. Definitely more of a factor in a kid.”

There are many misconceptions, not only in terms of what a concussion is, but in how to treat and recover from one.

Marshall believes there have been many advances in concussion research over the course of the past few years.

“The old [thinking] was rest until your symptoms go away and then gradually reintroduce activities. And there have been some recent studies over the past three to five years that have come out saying that people fair much better when they have activity earlier on in the recovery.

“Some studies have come out saying that rest can become detrimental beyond a three- to five-day period. So, people who have been told to constantly rest, rest, rest are faring much worse than people who got active earlier. This has lead to a whole new explosion of research that the benefits of activity for people with concussions.”

Subsequently, many medical professionals are advising people to remain active when having a concussion.

“We prefer kids to become a bit more active as opposed to sitting in a dark room. Especially athletes, they tend to use activities as an outlet. If you cut them out from that for too long, it could actually become more detrimental than helpful,” says Meeder.

Doctors Marshall and Meeder are members of Complete Concussion Management (CCM) Medical Advisory Board, which provides Canadians with information and services about concussion management and treatment.

Both medical specialists also say research is developing and that new information is always surfacing. Although they advise people to remain active after a concussion, they warn people to not strain their symptoms and avoid activity that puts individuals at risk of receiving another concussion.

Another common misconception is that protective equipment will help prevent injuries. Both Meeder and Marshall believe it is important to recognize that a concussion can occur even without direct contact to the head.

RobMeeder doctor
Dr. Rob Meeder is a staff pediatrician at Orillia Soldiers’ Memorial Hospital. His focus is primarily on developmental and behavioural pediatrics, which has led him to further study concussion education and treatment, especially post-concussion syndrome. Photo courtesy of Complete Concussion Management

“I think sometimes we put the pads on and we’re fine. Well you, got a helmet on your head … but your head still speeds up and slows down just as much with helmet on versus with it off. You have to be careful that just because you have a helmet on doesn’t mean that you can’t get a concussion,” warns Meeder.

In order to prevent concussions in sports like hockey, Meeder asks, “Can we redefine hockey with no contact? That is probably the best way to reduce concussions with no contact until you’ve developed — when the reaction time is there and when the skills are there.”

But, he adds, even without contact concussions still won’t be fully eliminated from sport. Meeder warns that concussions can even happen when falling with nobody around you — as long as there is that acceleration and deceleration of the head.

“There will always be risks to sports. But, the benefits of playing sports outweighs the risks.”