Insane in the Membrane: Recovering from Head Injuries

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Minor falls happen and most of the injuries you may get are apparent from the bruised knees and knuckles and ripped garments they leave behind. But there’s one injury you might not even know you have which is far more serious: concussion. When you fall, there’s always a chance that your brain has hit the side of your skull, bruising it. Obviously, we cannot see people’s brains. And it appears impossible to see these bruises even with an MRI or CAT scan. So its important to look for the signs.

CJ and Brendan demonstrating proper helmet fit. (Image Credit, Brendan Patrick.)

First, I know you were wearing your helmet. (If not, read my blog entries on the important of helmets.)

Second, if the helmet is cracked or seriously scratched, it means that you hit your head.

Third, If you face or head is bruised or bleeding, it means you hit your head.

Fourth, if you have any lapse in memory, for however short a time, it means you hit your head. (And if your helmet is cracked or you have injuries to your face or head and can’t remember them, you definitely hit your head.)

Fifth, if you feel disoriented, confused, or just plain weird, you probably hit your head.

You can also test yourself, if you want to purchase expensive software of iPhone apps, or you can and should see your doctor as soon after the incident as possible. If you’re on an organized ride, go to the medical tent at the next rest stop!

This stuff happens to us regular riders and to pros. Here’s professional cyclist Jade Wilcoxson’s description of her crash:

A girl in front of me decided to ride into a space that didn’t exist, then hit a car and ricocheted into the peloton in front of me. I don’t remember the next five minutes. I’d gone down hard and took the brunt of the fall on the back of my head. My helmet did its job and shattered in the process. I can’t imagine what my skull would look like if I didn’t have a helmet on. I suspect it would have been a life-changing (or life-ending) crash.

My mechanic found me and held my bike while I tried to get back on it. I apparently fell down three times in the process, but when director Jack drove up I told him I could still race (adrenaline = bad decision making). He took one look at me and told me to get in the car. I think my eyes may have been pointing in different directions.

(Bicycling Magazine, “To Ride or Not Ride.”)

She goes on to describe her symptoms and how they prevented her form exercise, “I spent the next 48 hours feeling like I was rocking on a small boat….” She tried to get back on her bike, but even moderate exercise left her, “foggy, exhausted, and ready for a two-hour nap.”

Worse than just affecting your workout, exercise after concussion can slow recovery:

[R]esearchers tracked the medical records and activity levels of 95 student athletes … who had suffered concussions in school sports. The students were evaluated using cognitive tests immediately after the concussion and in follow-up visits. The data showed that athletes who engaged in the highest level of activity soon after the initial injury tended to demonstrate the worst neurocognitive scores and slowest reaction times. Students fared better if they didn’t return immediately to their sport but instead simply engaged in normal school and home activities.

(New York Time Sports blog, “Sports Activity after Concussion Slows Recovery.”)

There’s no bandaid you can put on your brain. Recovery takes time and rest. Doctors have developed a recovery plan for after brain injuries:

  1. Become symptom-free at rest;
  2. Become symptom-free with light activity — meaning walking, jogging, or training on a stationary bike;
  3. Become symptom-free with “light practice” — meaning for cyclists, short, flat, semi-strenuous rides;
  4. Become symptom-free during regular practice with no contact or while being “yellow-shirted” — meaning for cyclists, a regular training ride but at a reduced pace;
  5. Become symptom-free during regular practice — meaning a regular training ride at a nearly regular pace;
  6. Become symptom-free while participating in an event — meaning regular riding at full pace.

Once you reach one stage, you get to move on to the next stage. If you fail the next stage, you have to drop back until you’re ready to move on. This process takes 4 to 6 weeks, for most people. See the video, below, for an explanation:

But make sure you’re doing this under the supervision of a doctor. The take away is: give yourself time to recover. Your heath is much more important, and besides, overtraining will only delay your recovery.

Your Bear


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