Concussions Are a Lot Trickier Than You Might Think

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Provided by Novant Health UVA Health System

Christopher Frymoyer, M.D.

Christopher Frymoyer, M.D., a sports and family medicine physician with Novant Health UVA Health System Bull Run Family Medicine – Linton Hall, often deals with misconceptions about concussions among athletes and weekend warriors.

Here are six key points to keep in mind.

You don’t have to lose consciousness to have a concussion

Most concussions occur without getting knocked out. What’s important is to identify symptoms.

“Many athletes will look dazed or confused immediately following an injury,” Frymoyer said. “Sometimes it may seem like they don’t remember what to do on the field. Common complaints you may hear from an athlete are headache, dizziness, and feeling ‘out of it.’”

Concussions are no longer graded.

“Sometimes athletes will come into a doctor’s office saying that they were told they have a mild concussion,” Frymoyer said. “But concussions are not graded. From a clinician’s standpoint, the determination is whether an athlete has a concussion or not.”

Until a few years ago, concussions were identified as grade 1 (mild), grade 2 (moderate) or grade 3 (severe). However, there were several classification systems, and none was determined to be more effective than the others. That practice is no longer used.

You don’t need imaging to diagnose a concussion

“Many athletes will have been seen in the emergency room prior to coming to their doctor’s office and are disappointed that they did not have a CT scan performed,” Frymoyer said. “However, a concussion does not show up on a CT scan or MRI. It is a clinical diagnosis. A CT scan is used to rule out other serious injuries like skull fractures or brain bleeds.”

Helmets don’t prevent concussions

Yes, they’re vital, but don’t let helmets lull you into a sense of invincibility. “Helmets help prevent skull fractures,” Frymoyer added. The brain, despite being encased in a protective helmet, can be concussed from a blow to the head or violent shaking of the head or body.

Concussions aren’t limited to football

Athletes suffer concussions in every sport. Concussions can occur anywhere, from an automobile accident to a school recess mishap to a simple misstep and fall during routine activities.

You can’t “play through” a concussion

There’s a common culture that you’ve got to be tough and shake off a big blow. That should never apply to concussions. If you haven’t fully recovered from a concussion and you receive a second one, the repercussions can be serious.

Dr. Frymoyer’s advice to young people and parents

To young athletes: “It’s really important that you pay attention to your own symptoms. Your coach can’t watch everyone all the time. The (athletic) trainer can’t watch everyone. If you hit your head on another player, the ground, equipment, etc. and feel like you may have a concussion, you should remove yourself from the practice or game and let a coach or athletic trainer know.”

To parents: “If you see symptoms and think your child may have a concussion, seek out an athletic trainer or another person qualified to diagnose concussions. Call your pediatrician and they can determine whether your child should be seen in the office or if they should go to the emergency room. If you have any concern that your child may have a concussion, they should not return to play the same day. When in doubt, sit them out.”

To make an appointment with Dr. Frymoyer or learn more about sports medicine specialists at Novant Health UVA Health System, visit


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