Photo credit: Sven Martin
Each time another friend eats dust and admits that they hit their head, I experience an internal struggle. There's the mountain biker in me, competitive, familiar with head injury, and aware that they'll probably be fine if they just take it a little easy and drive on. And there's the clinician in me that understands that concussion is a multi-faceted, complex neuropsychiatric phenomenon that can have long-lasting sequelae and put its victims at immediate risk for further injury. Lastly, there's the scholar in me, who knows that there is SO MUCH that we have yet to understand about concussion, traumatic brain injury (TBI) and chronic traumatic encephalopathy (CTE). So I usually end up giving my friends some convoluted and tangential recommendations about how to treat themselves.
So here's exactly how to know, 100%, without a doubt, if you have a concussion. Yeah right.
1. Did you hit your head? [Yes] [No] [Not Sure]
Sadly, any answer to this question may or may not lead to a concussion. It turns out you don't have to hit your head to experience brain trauma. Energy can distribute through the body, after an impact to the back or some other body part and lead to movement inside the skull that causes the neurometabolic cascade of concussion. In so many of the high speed crashes that we have all experienced, we're left wondering if we did actually hit our head. Or we may not even think about the noggin because our ribs or back or pinkie finger are causing so much pain that it is distracting us from our most precious and fragile of organs.
1. Did you hit your head? [Yes] [No] [Not Sure]
Sadly, any answer to this question may or may not lead to a concussion. It turns out you don't have to hit your head to experience brain trauma. Energy can distribute through the body, after an impact to the back or some other body part and lead to movement inside the skull that causes the neurometabolic cascade of concussion. In so many of the high speed crashes that we have all experienced, we're left wondering if we did actually hit our head. Or we may not even think about the noggin because our ribs or back or pinkie finger are causing so much pain that it is distracting us from our most precious and fragile of organs.
2. Is your helmet MIPs certified and free of previous crashes? A full face or a half shell? Black, pink or camouflage? Have you inspected it for damage? Were you not even wearing a helmet?
Guess what, doesn't matter. See #1- you don't even have to hit your head to experience a concussion. That said, helmets are amazing at preventing skull fractures and can certainly do wonderful things for reducing the risk of very serious TBIs like subdural, epidural and intracranial hemorrhage and hematoma, (which are all much more dangerous than concussion and potentially life-threatening). So if you answered that you weren't wearing a helmet, you might be an idiot. Please take an inteligence test immediatley. That said, helmet technology leaves a lot to be desired when it comes to concussion. So just because the pretty helmet is still intact and unscathed, doesn't really tell us what's going on inside your pretty brain.
Guess what, doesn't matter. See #1- you don't even have to hit your head to experience a concussion. That said, helmets are amazing at preventing skull fractures and can certainly do wonderful things for reducing the risk of very serious TBIs like subdural, epidural and intracranial hemorrhage and hematoma, (which are all much more dangerous than concussion and potentially life-threatening). So if you answered that you weren't wearing a helmet, you might be an idiot. Please take an inteligence test immediatley. That said, helmet technology leaves a lot to be desired when it comes to concussion. So just because the pretty helmet is still intact and unscathed, doesn't really tell us what's going on inside your pretty brain.
Photo credit: Sean Ryan 3. How do you feel? Dizzy, Foggy, Tired, Giddy, Sad, Angry, Headache, Nausea, Memory difficulty, Fatigue, Sensitive to light, Sensitive to sound, Balance problems, Trouble sleeping, Sleeping too much.
Above is a list of some potential concussion symptoms. This is not a comprehensive list. You do not need to have any of these symptoms to meet the criteria for concusion. And to further muddy the water, if you are suffering from a recent TBI, odds are that your judgement is impaired and it may be really hard to detect any symptoms.
Above is a list of some potential concussion symptoms. This is not a comprehensive list. You do not need to have any of these symptoms to meet the criteria for concusion. And to further muddy the water, if you are suffering from a recent TBI, odds are that your judgement is impaired and it may be really hard to detect any symptoms.
So you may have already figured this one out, but if you suspect you have a concussion, then you probably have a concussion. There is no test for a concussion.** We have great tests for bleeding in your brain and fractures in your skull and one day, there may be something groovy like a genetic blood test to predict how susceptible you are to getting a concussion. But today, this doesn't exist. So, when in doubt, sit it out. There is no amount of sick trail or a podium high enough to be worth damaging your brain.
I started writing this post about a month ago and I almost didn't post it as I've seen numerous articles pop up about the subject and I thought we might be saturated with head injury articles. But then I was at the BME Finals this weekend in Crested Butte where I watched no fewer than 3 racers go over the bars right in front of me. In a small section of just 1 stage of a multi-day enduro. I thought a short, easy to read, write up could be helpful for those of us who like to self-diagnose. Here are links to Pinkbike and Outside magazine's more lengthly articles if you want to read more about how TBI can cause long term symptoms and how CTE is slowly killing athletes.
I started writing this post about a month ago and I almost didn't post it as I've seen numerous articles pop up about the subject and I thought we might be saturated with head injury articles. But then I was at the BME Finals this weekend in Crested Butte where I watched no fewer than 3 racers go over the bars right in front of me. In a small section of just 1 stage of a multi-day enduro. I thought a short, easy to read, write up could be helpful for those of us who like to self-diagnose. Here are links to Pinkbike and Outside magazine's more lengthly articles if you want to read more about how TBI can cause long term symptoms and how CTE is slowly killing athletes.
** Although there is no test for concussion, there is actually a great tool that some medical providers can use to help evaluate patients after concussion called ImPACT. It is a computer-based neurocognitive test that checks things like reaction time and memory and can help guide recovery. Although ImPACT cannot tell us whether or not someone has had a concussion, it can be very helpful in guiding recovery and was just FDA approved for concussion management.
