If a concussion happens and it’s not on the ice, does it still count?
When Sidney Crosby misses a game due to a concussion, it’s national news. He is assessed by team doctors, and a protocol is followed to help him recover before returning to play.
When the average Canadian gets a concussion in every day life, the path forward is less clear.
The 180’s Kathryn Marlow knows this well — she fell and hit her head in May 2015, and is still dealing with the effects— so she set out to discover if there’s a difference between a sport concussion and an every day one.
A concussion is a form of mild traumatic brain injury, which occurs when your brain sloshes around in your skull. This can happen when you hit your head, but it can also be caused by a jolt to the body (like a tackle), or any sudden movement of the head (like whiplash).
The effect is not actual structural damage to the brain, but a “disturbance in brain function,” according to Keith Yeates of the University of Calgary.
That disturbance can cause symptoms like: headache, dizziness, nausea, confusion and difficulty concentrating, fatigue, irritability, depression, and anxiety.
After a concussion, most people (80 to 85 percent) will recover within a few weeks. But in order to be one of those people, it’s important to take care of yourself as soon as the concussion happens.
And that’s where the challenge can come for non-athletes.
What does it feel like to have a concussion?
For me, it meant daily headaches, sensitivity to light and noise, and fatigue. I also dealt with depression and anxiety, and had a hard time handling even simple stress. In my job, I need to be able to multi-task and work in an environment with a lot of stimulus. My concussion made this almost impossible: merely having to switch tasks quickly, or trying to concentrate while there were conversations going on around me, triggered anxiety attacks that would have me weeping openly (and I’m not a crier).
It can also be hard to process information. Sometimes, I would be in the middle of a conversation and I would completely lose the thread. It felt like the conversation was an island floating in the sky, and I had fallen off the island: I was plummeting down, reaching desperately to try and grasp some little thread, but to no avail.
-Kathryn Marlow, The 180
In terms of what’s happening in the brain, no. But some research shows that athletes recover better than regular folk, because they are generally healthier, and because they are motivated to get better so that they can get back into play.
And, athletes often have better support. While a coach, trainer, or even parent may have been trained to recognize and react to concussions, not all family doctors have been.
Keith Yeates, the neuropsychologist who leads the integrated concussion research team at the U of C, says there are a few reasons why athletes are better served when it comes to concussions.
“One just has to do with the fact that a lot of physicians who are interested in this injury are sport medicine physicians. So their professional training runs around
sport-related injury, and concussion is a natural outgrowth of that. So that’s part of the reason. There’s also a financial reason.”
There’s profit to be made in concussions, Yeates says.
“If you can get whole teams to buy in to the idea of baseline testing and other things, there’s a lot of money at stake in concussion, unfortunately or fortunately, depending how you look at it. So people are looking at market share. It’s little bit harder to market your clinic to the average Joe or Jane who falls off their bike, or has an accident in the park.”
There’s a lot of money at stake in concussion, unfortunately or fortunately, depending how you look at it. So people are looking at market share. It’s little bit harder to market your clinic to the average Joe or Jane who falls off their bike, or has an accident in the park.– Keith Yeates, University of Calgary
Different provinces have public resources in place to help with concussion management, generally for people whose symptoms persist past three to six months, but many require referrals and have long waiting lists.
Unfortunately, Yeates says, patients are often left to do their own research and advocate for themselves.
Concussion researchers are pleased that injuries like Sidney Crosby’s have us all talking about brain injury.
But it’s not all good.
“There has been increased awareness that concussion is actually affecting the brain, but then there are instances where, when we’re watching the news, we see that one person has a concussion and then is sent back into the game to play,” says Naznin Virji-Babul, a professor in the Department of Physical Therapy at UBC.
“I think this raises a lot of questions for the public: is this really a serious issue, because why is this very high profile player now going back in, when they’ve just said that he’s got a concussion, right? So there’s a lot of mixed messages out there that I think that, because of that, the real seriousness of this injury is being downplayed a little bit.”
There has been increased awareness that concussion is actually affecting the brain, but then there are instances where, when we’re watching the news, we see that one person has a concussion and then is sent back into the game to play.– Naznin Virji-Babul. UBC
For Keith Yeates, there is also a concern that the dramatic coverage of sport concussions, especially when it comes to the NFL and chronic traumatic encephalopathy, makes concussions seem scarier than they are. He cautions there is still a lot to be learned about CTE and its connection to mild traumatic brain injury, and points out that while concussions must be taken seriously, most people recover completely. He says fear of concussions should not stop us from being active.
Much of the research into concussions happens in sport, partly because athletes and teams make easy control groups. But the lessons learned can be applied to everyone. Lessons like the value of rest, but not total shut-down.
“The idea of rest is really important. The idea of isolation, dark rooms, is not.,” says Brittany Jamieson, an occupational therapist in Calgary.
“What we know about neuroplasticity is that if you give the brain no stimulation, the brain gets used to no stimulation, you add in stimulation and it’s really provocative. So, while you’re resting, we need to incorporate things like noise. So listening to an audio book is an example of rest, in a room with normal lighting.”
The current guidelines for rest come from the Consensus Statement on Concussion in Sport. Every few years, concussion experts meet at an international conference, and they issue a new statement. The next conference is October 27 to 28, 2016 in Berlin.
There is still a lot we don’t know about concussions, and it fits into two main categories: diagnosis and treatment. Right now, mild traumatic brain injury is diagnosed mainly from symptom reporting, but there are hopes that new imaging or blood tests will be developed. There’s also no clear way to determine recovery, so even when athletes are sent back into play based on “concussion protocols,” there’s no black-and-white way of knowing if they’re ready.
Sport research could find new diagnostic tools, better treatments, and ways to scientifically demonstrate recovery.
And that would help everyone, not just athletes.
Does this story bring to mind your experience with concussion? Share your story in the comments below, or send and email to The 180.