Concussed. Nate from @thebikecompany discusses symptoms and recovery

Cracked Helmet

The failure crack seen after removing the padding.

My left grip touched the ground and I knew what was happening, I felt its beginnings and I understood its end.  My bike, my left hip and my left bar found the dirt at speed – my upper body was cocked to the right and I braced for the inevitable.

The next day I wasn’t too concerned.  My body hurt as bad as my head and perhaps that caused the issues.  It was the day after and the day after that I began to realize what was going on.

We were riding fast that Sunday.  Not steep, not technical, not sketchy.  A cross country connector trail between drops, really only one step down which I grossly overshot. The bike didn’t slide – it dug.  Cliché as it sounds it was slow motion.  I hit, bike and body stopped too quickly and I knew my upper body was about to whip my head into the ground. 

It wasn’t my first concussion. I grew up playing competitive ice hockey and I have had a couple previous.  It was my first in my mid-thirties, first with a wife, with a mortgage, nieces, and nephews – my first with responsibilities. 

Tucking my chin kept my face off the trail.  My helmet struck the ground about 5 inches directly above my left eye.  I was told I was on my feet by the time the rest of the group got there.  The inevitable if I’m standing I’m ok reflex.  We eased our way to the next clearing where I did an inventory.  Helmet cracked, headache, left eye blurry, cuts, soon to be bruises, internally conscious this was bad, but articulating to the group I was fine. I would “take it easy” the rest of the day.  I continued the ride climbing the next trail.  On our way up I fought with my motor skills and vision.  Five extra miles uphill on trail wasn’t my best idea of the day – skipping the remaining descends and heading home may have been.

Concussion awareness has never been more focused.  Daily there are reports of athletes across every sport dealing with the repercussions of head injuries.  Professional athletes are expected to be able to endure and perform at superhuman levels.  The “it” factor that takes someone from good to great is nearly entirely psychological.  Compartmentalizing anything that doesn’t help confidence – tucking it away – dealing with it later is a job requirement for a professional athlete.  Pros can’t unlock their psyche, their “it” for the world.  It may expose weakness or it may give away the secret of success.  So we read so and so suffered a concussion and will return at some date.  Headaches or sensitivity to light are published and society at large feels free to make their own judgment on toughness.

I am not a professional athlete and my concussion was much more than a headache and sensitivity to light.  This was my experience, my pain and my fears from this concussion.     

I am the general manager of The Bike Company (BikeCo.com).  Our business sells sport to pro level mountain bikes, we work with manufacturers on product development and co-marketing projects, we produce content for various MTB media resources.  It is my job to develop markets for top tier product, to help riders take their experiences to the next level, to create positive excitement for mountain bike riders.  I debated for some time about publishing this experience.  How would I relate what happened into positive content for our sport?  I decided it was a major event in my riding year and I wanted to share it with the community.

Rachel Burns, a speech-language pathologist, points out that the location of a head injury directly relates to later symptoms. “In this case, it is important to note the left side of the brain houses the two primary centers for language and speech – Wernicke’s area in the temporal lobe, and Broca’s area in the frontal lobe. Injuries to Wernicke’s area are most likely to affect the comprehension of written or spoken language, while insults affecting Broca’s area impact the physical production of speech, resulting in the feeling that the patient knows what he or she wants to say and is aware – and frustrated – that it is coming out wrong.”

After the crash I wrote off the Sunday evening and Monday symptoms– no one is 100% when they can barely move.  I had a concussion, a pair of ribs dislocated from the cartilage and was bruised from shoulder to knee.  Of course my patience was short, yes I forgot a couple things, sure my thoughts and speech were jumping around – I had ton on my mind and I hurt! I felt agitated that everyone would point out the obvious.

“Emotional changes and mood swings are commonly related to head injuries as well, and should be reported to the patient’s physician,” Burns reported.

Waking Tuesday morning I had a serious reality check.

After my crash the first three and a half days I fought nausea, severe pressure on the rear of my left eye, and bright blue flashes in the peripheral of my vision.  These were the least offensive symptoms.

For two weeks I was accompanied by a severe headache and the most disconcerting side effect – speech and cognitive issues.  I would inverse words, not in my thoughts, but as they came out my mouth.  As Rachel Burns indicated I had symptoms of a Broca impact.  I would become stuck looking for words or even synonyms.  I developed a stutter.  Internally I was aware my thoughts weren’t coming out right.  At times I felt two internal and separate thought processes.  Speaking became unbelievably tiring.  As I fatigued from conversation my logic and speech would loop.  I would hang up on a point and as I attempted to transition to the next I would loop back.  The secondary thought process would become aware that I was in a loop and become frustrated but with no recourse to stop it.  I found myself being understated or silent to minimize attention if I stumbled in speech or logic.

Rachel Burns noted that the injured individual or family members may want to request a speech-language consultation or screening following a head injury, and most hospitals will have appropriate personnel on staff available to complete one.

The more focused I became on the issue the worse it manifested.  The ultimate advice was to slow down, take an extra breath, to relax.  When I was able to do this it helped – however it is hard advice to take when already frustrated.  Wondering if this was permanent became a constant question.  Week two and into week three the symptoms started to decrease and I began to grasp normality would return eventually.  That’s when I began to wonder about it happening again.

“The human brain has a remarkable ability to repair itself,” stated Burns. “However, persistent speech-language or cognitive struggles should be evaluated as there may be therapeutic approaches to rehabilitate the injured individual or teach him or her and the family how to compensate for these changes.”

Doctors instructed me a second hit without being healed would create problems at an exponential level.  They cautioned to wait at least 1 week after the headache subsided.  It took nearly three weeks for my headache to go away.  Getting onto the trail became half therapeutic and half intimidating. 

Has it kept me off the bike?  No.  Do I think about it?  Yes, a lot actually.  I think about it before rides.  I think about it climbing.  It leaves my mind descending, when I’m really riding the bike.  The most likely scenario for me to repeat the problem is about the only time I put it out of my mind.  The world runs on irony.

Nearly two months after my patience is still short, I can still feel the rectangle of contact on my skull, pressure on my left eye comes and goes, alcohol consumption affects seem quite varied, motivation is sometimes hard to find, depression ebbs and flows, and the incident hasn’t really left my mind when I think about riding.

So how did this experience shape my riding year?  It showed me that occasionally things happen you don’t expect.  No one wakes up and says today I’m going to wreck myself.  I was riding within my skill set and had an anomaly.  It has helped me realize I can find speed by riding more in control, maximizing corner apex, becoming a more technical rider pumping terrain, working to add strength to get a quicker pedal in out of the corner to get back to speed quicker. 

It illustrated the importance of safety equipment.  I ride in top tier helmets and I replace them often.  I hesitate to think about what could have been with a lesser helmet (don’t even speak to me about riding with no helmet).  My helmet was about a season old and something was beginning to feel off about it. It was on my radar to replace it prior to my crash.  Helmet manufacturers have a hard dance in our litigious society.  Listing an exact lifespan opens manufacturers up to issues if an accident occurs prior to their safety date.  Manufacturers have been accused of setting lifespan dates to sell more helmets.  Ask me and I will tell you that even with better than average insurance the co-pays from my concussion would have bought me two quality helmets.  I will tell you about missed hours at work, stress at home and physical pain – and I will publish thanks to the engineers of my helmet.  It could have been much worse.  I don’t care to debate helmet lifespan.  There is no debate.  Foam exposed to UV and sweat ages.  Period.  Helmets are designed to absorb only so much.  Typically one severe impact.  Replace your helmet if you have ANY doubts.  Riders who tell me they’ve had the same helmet for 3, 5 years because they’ve never had an issue are missing it.  Remember fit is critical – try a handful on.  You will find some fit you much better than others.  Fit is critical so the helmet stays in place to function.  A helmet that slides out of place will expose vulnerable areas.  The helmet needs to stay in place in case your crash results in multiple head hits.

My injuries illustrated the tough guy persona “I don’t need a hospital” has a price.  I spent the critical first hours (and days) avoiding the obvious.  Those around me paid the price wondering how badly I was hurt.  I wondered how bad it was too. I was unaware of the coping and therapeutic techniques available.  It showed me how serious and personal even a “minor” brain injury feels.  How alone you can feel wondering if you are understood.

Each of us has reasons for riding.  I am a happier person when I ride.  I ride to enjoy nature, to escape the paved concrete tilt up world.  I ride to spend time with my brother and good friends.  Turning my brain off over a single feature cost more than a dozen rides as I healed.  A dozen adventures, a dozen stories shared. 

I hope my experience illustrates the importance of riding within your skill set and with proper equipment.  If you have suffered something similar I hope that you will utilize your resources to find recovery.  There are professionals (a surprising amount who ride) with therapeutic techniques that pay dividends.  If this is the first time actual concussion symptoms in detail have hit your radar I hope you reflect on your riding safety as well as the safety of those you ride with. 

Experienced riders need to help dictate appropriate riding decorum.  If you have a rider in your group riding well above their skill level articulate the dangers, help them learn needed skills, teach them it’s better to be the slowest on the trail then the fastest on the couch.

See you on the trails – Nate@BikeCo.com

 

Comments

  1. Your Hemet did its job and live to ride another day

  2. yup. better than the other options…

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