By Elizabeth M. Pieroth, PsyD, ABPP
Director, Concussion Care at Rush/Midwest Orthopaedics at Rush
This month instead of writing about a specific topic, I thought I would address the most common questions about concussions I hear from athletes and their parents.
Q: Do you have to lose consciousness (be “knocked out”) to have suffered a concussion?
A: No. Only 9-10% of concussions result in a loss of consciousness. Someone can absolutely have suffered a concussion without losing consciousness.
Q: I heard about a blood test for concussions. Is that true?
A: Unfortunately, it is not. Last year a new blood test was approved that may detect bleeding of the brain after a trauma but that is a different injury than concussion. Hopefully, some day we will have a test available that can reliably determine if a concussion has occurred but there are no tests commercially available at this time.
Q: Is there a “concussion-proof” helmet?
A: No, there is not! Helmets were designed to prevent skull fractures but cannot prevent the movement of the brain inside the skull. However, there has been improvements in the quality of hockey helmets. I recommend athletes and parents click here to review the Virginia Tech rating for hockey helmets.
Also, keep in mind that the fit of the helmet has been shown to be very important in concussion reduction. A poorly fitted helmet offers reduced protection and a helmet that pops off after an impact offers no protection. Before you purchase a helmet, always ask someone with experience fitting a helmet for assistance so you can get the highest rated helmet that best fits your child.
Q: What about mouthguards?
A: Mouthguards are important for the protection of the jaw and teeth but the research has shown they do not make a significant difference in reducing the frequency or severity of concussions.
Q: What do I do if I suspect my child has suffered a concussion?
A: First off, REMOVE THE ATHLETE FROM PLAY! Never allow an athlete with a suspected concussion to continue to play. If an athletic trainer or other properly trained medical professional is available, have the athlete examined to determine if a concussion has occurred. Do not allow non-medically trained coaches or parents to make this decision. Remember the adage, “When in doubt, sit them out.”
Second, watch closely for worsening of symptoms. There are “danger signs” that indicate the injured person should go immediately to the hospital. Please click here to view danger signs.
Third, contact your pediatrician, primary care physician or concussion specialist for additional guidance.
Q: What is the best treatment after a concussion?
A: There is no magical treatment for concussion. For the first 1-2 days, it is reduced activity. Get adequate sleep and avoid activities that risk another injury (don’t return to play until recovered!). There is no reason to rest in dark rooms or avoid all screens or other technology. However, if looking at the computer is increasing the symptoms, step away. After the first couple of days, increasing both physical and cognitive activity as tolerated is recommended. For more information on these recommendations, see my previous AHAI newsletter article “Rethinking the Recommendations after Concussion.”
Q: I have heard about vitamin supplements and other treatments for concussions. Do they work?
A: It depends. There is some preliminary evidence for the benefit for fish oil after a concussion but there is not universal agreement on its use. There are many other supplements that make claims of prevention or treatment for concussions, but these are not yet supported by good studies. Buyer beware! If you have any questions, ask your physician or a concussion specialist.
Q: How long does it take to recover from concussion?
A: Recovery is quite variable. The research tells us most people recover within 1-3 weeks, but it can be up to 4 weeks in kids. That does not mean every person is symptomatic for 3-4 weeks, but it also doesn’t mean someone should be returning to play within a few days. You really want to make sure the athlete has been evaluated by someone with the training and experience to judge recovery and/or make recommendations for additional treatments.
Please submit any additional questions you have to AHAI’s Communication Manager at firstname.lastname@example.org; I will address them in future newsletters.
Elizabeth M. Pieroth, PsyD, ABPP is a Board Certified Clinical Neuropsychologist and is the Director of the Concussion Program at Midwest Orthopaedics at Rush and Rush University Medical Center. She is the Head Injury/Concussion specialist for the Chicago Bears,
Blackhawks, White Sox, Fire, and the National Women’s Soccer League. Dr. Pieroth is the Co- Director of the NFL Neuropsychology Consulting Program. She is also on the Board of Directors of the Brain Injury Association of Illinois and is a member of the USA Football Heads Up Advisory Committee, the NFL Head, Neck and Spine Committee, the US Soccer Concussion Task Force, and the Amateur Hockey Association of Illinois Safety Committee. She has published on concussion management and neuropsychological assessment. Dr. Pieroth is currently working on her Masters in Public Health through the Medical College of Wisconsin.
Dr. Pieroth sees patients in Chicago, Naperville, Oak Brook and Oak Park and appointments can be scheduled by calling 877-632-6637. The orthopedic program at Rush University Medical Center continues its legacy of excellence with a 2020 ranking by U.S. News & World Report as No. 5 in the nation and as the top-ranked orthopedic program in Illinois and Indiana.