When was the last time you fell while mountain biking? For most of us, it’s a matter of a few weeks since our last “crash”. These falls/crashes can be varied, but needless to say, the incidence of coming off your bike while mountain biking is rather frequent compared to other cycling genres. Most often a crash leads to a scrape on the shin, or abrasion on your shoulder from cutting a corner a little too hard, ploughing your shoulder into a tree at the apex. But what about when you take a real tumble and hit your head, either directly or indirectly. Has it happened to you?
For most the answer is a resounding “Yes” if you’ve been in the sport for more than a year. Often the results are mild or innocent. But do you know for sure you haven’t had a concussion? Do you know what the symptoms are of a concussion? And how quickly were you back on your biking doing the same thing, unaware of the high risk you were putting your brain at?
Concussions are classified as Mild Traumatic Brain Injuries. What this means is that there is no structural damage done to the brain during your impact or following. The symptoms of a concussion can be mild to severe, but no matter the severity should be taken seriously. If ever you hit your head, whether you break your helmet or not the following list of symptoms should be considered. This is not an exhaustive list of all the symptoms that a concussion can cause, but they are the most easily identifiable for the average person, causing concern where further medical help should be sought out.
- New Headache – different than you have had before – following hit on the head.
- Increase in Nausea/Headache with brain stress – TV, Phone, Reading, Driving, Homework etc.
- Exercise Induced Headache/Nausea – walking, running, cycling…any exercise where your heart rate elevates.
- Irritability and Difficulty Sleeping – providing this is abnormal for you.
Again not an exhaustive list, but these tend to be the simplest symptoms noticed by an individual or spouse. If you experience any of the above after a significant crash, or after hitting your head in a crash, then you very well may have a concussion and should seek the advice and diagnosis of a professional. Preferably someone with further training in concussion diagnosis and treatment. Concussions diagnosis and management is a new area, and one where not all treatments are created equal. The landscape is forever changing as new research is released.
If you have any of these symptoms, the last thing you want to do is to try and “work through” the pain and discomfort in the hope that it will magically get better. If you have a concussion then certain limitations need to be placed on an individual. Most concussions take four weeks to fully resolve. The scary part is that most people start to feel better by day 8. This point is actually the most vulnerable point in recovery from a concussion, and if you go back to your activity too early and happen to hit your head a second time, a mild traumatic brain injury can turn into a severe traumatic brain injury. It is not something to be taken lightly.
Concussion management has changed in the last few years as more research and long term follow up studies are done. The old adage of sit in a dark room till you feel better is no longer advised via research. Slowly getting active within the framework of a clinician guided rehab has shown to be more beneficial and get patients better faster. The key to this approach is that every patient is different and there is no cookie cutter approach. The best option for any mountain biker if they happen to have any of the above mentioned symptoms after a crash to get in to see a qualified practitioner and NOT continue to ride until they have been properly cleared, following rehab and recovery protocol.
Take any type of crash seriously. Be honest with yourself about how you feel, and if there is any question, getting the opinion of a professional is always the best option.
Dr. Adam Wade
Dr. Adam Wade 