Understanding The Silent Injury

You’ve heard the term: “I got my bell rung.” 

It’s an old saying in football used when a player suffers a blow to the head and hears a ringing sound. In football, concussions are common – the National Football League reported 219 concussions in 2023 – and ringing in the ears is a concussion symptom.

But concussions don’t just take place in professional football. This traumatic brain injury can happen to anyone at any age and be from motor vehicle accidents, falls and sports injuries.

The Long-Term Effects of a Concussion  

People at greater risk for concussion include older people and children ages 4 and under (from falls), adolescents (from bike accidents and sports injuries) and military personnel (from explosives). 

According to the Centers for Disease Control and Prevention (CDC), symptoms include:

• Headaches
• Memory problems
• Nausea
• Blurry vision
• Ringing in the ears
• Feeling dazed
• Trouble with concentration
• Balance
• Mood
• Disrupted sleep.

The effects can last days, weeks, or sometimes longer. Concussions can cause slurred speech in the short term, and difficulty organizing language or thinking of words in the long term.

“No brain injury is created equal,” says Meredith Bushey, a speech language pathologist at UVM Medical Center. “Symptoms vary from person to person as every brain injury is different.” 

Adults and children who have already suffered a concussion are at greater risk for subsequent concussions, which can be particularly worrisome. Studies show that repeated concussions can lead to mental health challenges and devastating brain diseases or disorders like Alzheimer’s disease and chronic traumatic encephalopathy (CTE).

Concussions and Youth Sports  

Any sport that involves physical contact can result in a concussion. Girls’ soccer has the second highest rate of high school sports concussions after boys’ football, according to the Journal of Pediatrics. 

For children, most concussions happen on the playground, while bike riding, or when playing sports such as football, soccer, ice hockey, basketball or wrestling. 

“There's always that risk associated with playing contact sports,” says Alina VanRuff, an occupational therapist at UVM Medical Center. “But there are ways to mitigate the risks. You can do that by having rules in place for tackling and coming into contact with other players.”

A concussion can be caused by a bump, jolt or blow to the head. You can also get a concussion from a hit to your body that causes your head and brain to move quickly back and forth.

That rapid back-and-forth movement can cause the brain to bob around or twist in the skull, creating chemical changes in the brain – sometimes stretching and damaging brain cells. 

Concussions can be challenging to diagnose. Still, if you suspect that you or a loved one has a concussion, see a doctor immediately. 

“A concussion is not going to show up on imaging from an MRI or CT scan,” VanRuff says. “With a concussion, there’s no bleeding in the brain. It's more of a grouping of symptoms that comes with diagnosing a concussion.” 

Helmets and Concussion Prevention  

Wearing a helmet while skiing, biking and playing football is always a good idea because they will help prevent skull fractures and severe brain injuries in a crash or fall. Unfortunately, they aren’t as effective at preventing concussions. 

To prevent concussions in youth sports, the most important thing to do is to avoid using your head or helmet to come into contact with another athlete, according to the CDC. That’s why doing so is often considered illegal contact. 

Concussions in Adults

For older adults, falls and car crashes are the two most common causes of concussions.

Even if you’re in a minor car crash that doesn’t involve you hitting your head, whiplash can cause a concussion. 

“Whiplash is very common in motor vehicle accidents,” VanRuff says. “Let’s say you’re stopped at a red light, and someone driving 10 miles an hour rear-ends your car. Your head is still going to snap forward.” 

If you're 60 years old or older and experience a fall or are involved in a car accident, it’s important to seek medical attention, especially if you’re taking blood thinners. Blood thinners can increase the risk of bleeding in the brain following an injury, leading to prolonged recovery or potentially even death. 

Recovering from a Concussion  

Experts say balancing rest with gradual exposure to activities and stimuli – like running, screens, light and noise – is key to recovery.

VanRuff explains that computer screens require a combination of eye skills and movement, which are often impacted after a concussion. Also, a computer emits blue light, which is naturally found in sunlight.

“If someone is light sensitive, there is a good chance the light from a computer or cell phone will also be difficult for them to tolerate,” she says, adding that someone might also feel sensitive to noise after a concussion.

Resting in a quiet room with your eyes closed will help you feel better, but it won’t necessarily speed up recovery, VanRuff says.

“If you continue to isolate from the things that trigger symptoms, you create a greater intolerance to those things,” she explains.

About 90% of concussion symptoms typically resolve within 10 to 14 days. However, symptoms may linger for weeks. Persistent post-concussive syndrome happens when symptoms persist beyond three months. 

Recovery may be slower among older adults. People who have had a brain injury in the past may also find that it takes longer to recover.

VanRuff says to think of a concussion as an injury that needs time for rest and rebuilding strength.

“Give your brain time to mend,” VanRuff says. “It’s all about gradual exposure and a return to prior activities based on how you’re feeling. It’s a matter of finding that balance of doing things a little bit at a time.” 

To learn more, visit the CDC website’s Heads Up section for more information.