If you read my blog about how to tell if you have a concussion, you know that it is really easy to diagnose yourself with concussion and you'll never have a hard time knowing what is and isn't a concussion. Yeah right.
It's actually quite complicated and not always black and white, but in general, When in doubt, sit it out. Step 1 is really removing one's self from any further risk of harm. In a head-injured state, your balance, judgment and stamina are all compromised. Continuing to ride and (God forbid), compete, are a pretty good recipe for more serious injury.
Step 2: Rest.
Easy peasy. A couple days off, in the thick of the summer, when all your friends are going to shuttle that ride. You know, the one we've been waiting for and the conditions are finally just right and so-and-so's girlfriend is going to drive. You get it: it can be hard to rest. Luckily, the latest research supports a graduated approach to rest as opposed to the concussion treatment of yester-year when we told athletes to sit in a dark room with no tv, cell phone or stimulation. Sound depressing? Well, depression can be a symptom of concussion and "cocooning" in a dark room is likely to make it worse.
I recommend to my concussion patients that they:
- Avoid any contact prone activity. This includes mountain biking, but does not include a gentle spin on a stationary trainer or a walk on the rec path. Google "second impact syndrome" if you're questioning the recommendation to avoid contact prone activities.
- Don't do the things that make it worse. If spinning on a stationary trainer makes the whole room spin, don't do it. If going to work and staring at a computer screen all day makes your head throb, don't do it (talk to your boss about perhaps modifying your duties, if possible, or just use some sick time).
- Have a good routine. Get a consistent (hopefully about 8 hours) amount of sleep every night. Eat regular, balanced meals and get consistent amounts of mild physical activity daily, like a gentle spin or a hike.
This is the tricky bit that science hasn't quite figured out (but its getting better, I swear!). Compared to how to help your brain recover from concussion, diagnosing concussion is a piece of cake. Most medical providers don't have a lot to offer to the typical concussion patient. I recommend catching up on those non-bike related hobbies (click here if you need any ideas) and using a step-wise approach to getting back in the saddle. There is absolutely no way to predict how long recovery from concussion might take for any particular person. That said, as a general rule of thumb, if you are not feeling mostly back to 100% two weeks after your head injury, its probably time to get help.
STEP 4: Know when to say help.
If you go to your doctor for a concussion that isn't getting better, there's a good chance you might meet a provider who is not aware of all the resources available to help manage head injury these days. Don't be afraid to speak up and ask for a referral to a concussion specialty clinic. Or ask if there is a specialist who can help with rehab in your particular area of need. More and more physical therapists and occupational therapists are helping with concussion recovery in areas like balance and memory. Behavioral health therapists can help with symptoms of depression. Optometrists and ophthalmologists can help with visual deficits. Don't be afraid to ask your primary care provider for a referral if they seem to be at their wits end and are telling you that you just need to rest and wait it out after many weeks of continued concussion symptoms.
Feel free to contact me or post a comment if you have questions about concussion, ImPACT testing or recovery.
Ride bikes and be well!