The media’s narrative on concussion has been pretty consistent for the last five years. Concussion equals controversy, possible catastrophe, and an inevitable diagnosis of CTE — that’s chronic traumatic encephalopathy.
Late last month, they were all over a study out of St. Michael’s Hospital in Toronto. There, researcher Jane Topolovec-Vranic, PhD, reported that nearly half of homeless men have suffered at least one head injury. Dr. Topolovec-Vranic therefore concluded that head injury was a risk factor for homelessness.
Meanwhile, former Secretary of State Hillary Clinton, by her husband’s own admission last week, needed six months to recover from a December 2012 concussion. The reaction from most political pundits along the New York/Washington DC axis? ”Nothing to see here. Move along.”
So where’s the truth here?
Certainly, the former first lady is not on the verge of living on the streets. Nor are the vast majority of athletes – and others – who suffer a concussion.
The coverage of the Toronto findings highlighted that 40% of the homeless had suffered a head injury prior to losing their addresses. Still, it entirely missed other studies – actually cited by Topolovec-Vranic – which show over 30 percent of similarly-aged members of the general public have needed medical care for a head injury.
The fact is that, rather than head injury being a risk factor for homelessness, homelessness is a risk factor for head injury.
As for Mrs. Clinton, her experience with concussion should be — in hindsight — instructive. (Too bad she, her staff, and family had not been more forthcoming up until last week.)
As Mrs. Clinton demonstrated, concussions can and do happen outside sports: industrial accidents, car wrecks, personal violence, and — as was the case with Mrs. Clinton — falls at home. And most people ultimately get over concussion, if properly managed, with no long-term side effects.
While we know plenty about how concussions turn out among teenagers and young adults, there is very little data about older adults.
Many commentators have said it was unfair for Republican strategist Karl Rove to have suggested that Mrs. Clinton suffered a traumatic brain injury or that she experienced brain damage. Unfair perhaps, but Rove’s overall characterization was correct. A concussion is a traumatic brain injury that involves microscopic damage. A case can actually be made for Mrs. Clinton having suffered something more serious. She ended up with a blood clot on her brain.
While the average young adult takes two weeks to return to normal and teenagers take slightly longer, we don’t know entirely the whys and wherefores of concussion recovery. Do the injured cells make a complete comeback or are some lost only to be replaced by those that had been previously inactive?
That replacement process, evident in more serious head injuries, is known as neuro-plasticity. As one ages, the brain gradually loses its neuro-plasticity, leading to longer and less complete recoveries from more serious brain injuries. Consequently, it makes perfect sense for Mrs. Clinton to have taken months instead of weeks.
Nonetheless, recovered she very much seems to be. And if a concussion that occurred 18 months ago is all the Republicans have in their anticipated campaign against Hillary Clinton in 2016, then they don’t have much. But neither do the media when it comes to most concussions in sports.
John Doherty is a licensed athletic trainer and physical therapist. This column reflects solely his opinion. Reach him at firstname.lastname@example.org. Follow him on Twitter @JDohertyATCPT.