You don't need to play football in the NFL to suffer a concussion — or the long-term effects.
Millions of people turn up in emergency rooms every year with concussions, and only a small portion play football at any level.
Here's what we all need to know about concussions, from Dr. Martha Grimm, an emergency medicine physician and medical director of the Texas Health Ben Hogan Concussion Center Plano.
It doesn't take a hard whack on the head to get a concussion.
"Most people are surprised to learn that it doesn't necessarily take much of a hit to get a concussion," Grimm says. Some of the most serious cases she has treated occurred in relatively mundane ways, like the patient who knocked her head while reaching under a table to pick up something.
You don't need to lose consciousness to have a concussion.
"That was the hallmark for so many years, but not anymore," Grimm says. A concussion is diagnosed by symptoms, which can include headaches, nausea, dizziness, inability to remember, irritability, insomnia or sensitivity to light or noise.
You don't even have to hit your head.
Any impact that gives the brain inside the skull a good shake, such as a blow to the chest, can cause a concussion.
Some people seem to be genetically more susceptible to concussions.
Why can one NFL player play football for years and be fine, while others end up with concussions and long-term problems like Chronic Traumatic Encephalopathy? There's some compelling evidence suggesting that a genetic component makes some more vulnerable. Researchers studying the brains of football players (who died at a young age or committed suicide) found that more than 80 percent had a genetic variant that's commonly called the Alzheimer's gene.
You can take a genetic test, such as the one offered by 23andme.com, to find out if you have it.
"We need more research in this area, but if it pans out, the thought is that people who have the gene would be guided toward sports that are less likely to involve head trauma, like tennis and golf, instead of football or hockey," Grimm says.
Eighty percent of concussions aren't sports-related.
The No. 1 cause: falls, where a person falls and hits his or her head. Other causes, in order of frequency: car accidents, a blow from an object falling onto the head and assaults. "Keep in mind, this data is based on head injuries presented in emergency rooms, and many players with head injuries on the field don't go to the ER, so it's a little bit of a skewed database," Grimm says.
The Centers for Disease Control and Prevention has proposed a National Concussion Surveillance System to help collect better data on this.
Head injuries and migraines may be related.
A number of factors, including hormones and vascular conditions, can contribute to migraines. "But there may be some subset of migraines that are due to concussions or other head injuries, and not necessarily traumatic ones," Grimm says.
Women are more susceptible to concussions than men.
Among NCAA athletes, women's soccer is the biggest source of concussions. "We don't know why, but one theory is that women's necks are less muscular, thus the head is less stable and more prone to injury," Grimm says. Muscles in the neck have testosterone receptors, making it more difficult for women to build muscle. Hormonal differences may also play a role.
Adolescents are particularly prone to concussions.
Again, doctors aren't sure exactly why. Hormone levels are higher at this age, and adolescents may simply be more likely to engage in high-risk activities. "We also know that, up until age 24, the brain is still growing and takes longer to heal," Grimm says. With much younger children, under age 6, there may be some neuroprotective factor in play. "They can hit their head and not always have injuries in the way an older child might," she says.
Doctors can't diagnose a concussion with a CT scan, MRI or X-ray.
Currently, a concussion is diagnosed by way of symptoms and an exam, but Grimm is hopeful a more exact diagnostic tool is in the pipeline. "There is a lot of research working toward a blood test that would indicate either, yes, you've had a concussion, or no, based on how much of a certain blood protein is present," she says. "That's still several years away but it's very promising."
The only treatment for concussion is rest.
"Physical rest is important, but more recently we've learned that mental or cognitive rest is also important, maybe even more so," Grimm says. Cognitive rest means refraining from reading, thinking or attempting anything that is stimulating or requires concentration, like math homework. And it usually takes more than a day or two. "About 80 percent of patients with concussions will get better with seven to 21 days of rest; about 20 percent take longer to heal," Grimm says.
Mary Jacobs is a Plano freelance writer.