Not Just Sports and Car Crashes: Five Myths About Traumatic Brain Injury Debunked

A Hidden Epidemic

Traumatic brain injury, commonly abbreviated as TBI, is one of the most prevalent and consequential health conditions in New Zealand, yet it remains widely misunderstood. An average of 110 people sustain a traumatic brain injury every day in Aotearoa, translating to approximately 40,000 cases annually and a population rate of 852 per 100,000 residents. Despite these staggering numbers, public awareness of the condition is clouded by persistent misconceptions about who is affected, how injuries occur, and whether anything can be done to prevent them.

Researchers have now systematically addressed five of the most common myths surrounding TBI, using epidemiological data and clinical evidence to replace popular assumptions with facts. Their analysis paints a picture of a condition that is far more complex, widespread, and preventable than most people realize.

Myth One: Most Traumatic Brain Injuries Are Severe

When people think of traumatic brain injury, they tend to imagine dramatic scenarios: a devastating car accident, a boxing knockout, a catastrophic fall from height. These images create the impression that TBI is primarily a severe, life-altering event. The reality is dramatically different.

Data shows that approximately 93 percent of all traumatic brain injuries in New Zealand are classified as mild, a category that includes concussions. While the word mild might suggest these injuries are trivial, that characterization is misleading. Even mild TBIs can produce symptoms lasting weeks or months, including headaches, cognitive difficulties, mood changes, and sensitivity to light and noise. Some patients experience persistent post-concussive symptoms that significantly affect their ability to work, study, and maintain relationships.

The overwhelming prevalence of mild TBI means that the condition touches far more lives than the public generally appreciates. It is not primarily a catastrophic injury affecting a small number of people but rather a common medical event affecting tens of thousands of New Zealanders every year.

Myth Two: Sports and Car Crashes Are the Main Causes

Public discourse about TBI is heavily dominated by discussions of contact sports and motor vehicle accidents. Rugby injuries, boxing concussions, and high-speed collisions dominate media coverage and public awareness campaigns. While these are legitimate and important causes of brain injury, they do not represent the primary mechanism.

Falls account for nearly half of all traumatic brain injuries in New Zealand. Moreover, a substantial proportion of these falls occur in domestic settings rather than on playing fields or roads. Slipping in the shower, tripping on stairs, falling from a ladder while doing household maintenance, or stumbling on uneven surfaces at home are all common scenarios leading to TBI.

This finding has significant implications for prevention efforts. While sports safety protocols and road safety campaigns are valuable, they address only a portion of the problem. A comprehensive approach to reducing TBI must also focus on fall prevention in homes and communities, particularly for populations at highest risk.

Myth Three: Only Young People Are Vulnerable

The popular association between TBI and youth sports creates an impression that brain injury is primarily a young person's problem. In reality, the demographic most affected by traumatic brain injury in New Zealand today is adults aged 65 and older.

Older adults now represent the largest share of TBI cases, with falls accounting for approximately 39 percent of injuries in this age group. As New Zealand's population continues to age, this trend is expected to intensify, placing growing pressure on healthcare systems and rehabilitation services.

The reasons older adults are particularly vulnerable include:

• Age-related changes in balance, coordination, and reaction time increase fall risk
• Medications commonly prescribed to older adults, including blood thinners, sedatives, and blood pressure medications, can increase both fall risk and injury severity
• The aging brain is more susceptible to damage from mechanical forces, and recovery from injury tends to be slower and less complete
• Osteoporosis and reduced muscle mass reduce the body's ability to absorb impact forces

Recognizing that older adults are the most affected demographic is essential for directing public health resources where they can have the greatest impact.

Myth Four: Risk Is Uniform Across Populations

A fourth misconception holds that traumatic brain injury affects all segments of the population equally. Epidemiological evidence tells a different story. In New Zealand, TBI rates are significantly higher among males than females, and Maori communities experience disproportionately elevated rates compared to other ethnic groups.

These disparities reflect deeper systemic factors including income inequality, differential access to healthcare, housing quality, occupational hazards, and the social determinants of health more broadly. People in lower socioeconomic brackets are more likely to live in environments with fall hazards, work in occupations with higher injury risk, and face barriers to accessing prompt medical care after an injury.

The researchers also noted a troubling trend during the COVID-19 pandemic: assault-related traumatic brain injuries increased among women aged 15 to 64. This finding aligns with broader evidence of rising domestic violence during lockdown periods and highlights how TBI intersects with social issues beyond the medical sphere.

Myth Five: These Injuries Are Unavoidable

Perhaps the most damaging myth is the fatalistic belief that traumatic brain injuries are simply an inevitable consequence of living an active life. While it is true that accidents will always occur, a substantial proportion of TBIs are preventable through targeted interventions.

For older adults, evidence-based fall prevention programs have demonstrated meaningful reductions in fall rates. These include community exercise and strength-building classes that improve balance and coordination, home safety assessments that identify and mitigate hazards such as loose rugs, poor lighting, and slippery surfaces, and medication reviews to reduce the use of drugs that increase fall risk.

For younger populations, continued investment in sports safety protocols, protective equipment standards, road safety infrastructure, and workplace safety regulations all contribute to reducing TBI incidence. Public education campaigns that accurately represent who is at risk and how injuries occur can help shift behavior at both individual and community levels.

Implications for Policy and Practice

The debunking of these five myths carries clear implications for how New Zealand allocates resources and designs public health interventions. Current prevention efforts that focus predominantly on sports and road safety, while important, are insufficient to address the full scope of the problem.

A comprehensive national strategy for TBI prevention and management would need to incorporate fall prevention programs for older adults as a central pillar, address socioeconomic and ethnic disparities in injury rates, expand rehabilitation services to meet the needs of the large population experiencing mild TBI, and invest in public awareness campaigns that accurately communicate who is at risk and why.

With 110 people affected every day, traumatic brain injury is not a rare condition reserved for athletes and accident victims. It is a pervasive public health challenge that touches communities across the country, and addressing it effectively requires moving beyond the myths that have long shaped public understanding.

This article is based on reporting by Medical Xpress. Read the original article.