Endurance Athletes and the Concussion

If you saw the 2011 Tour de France, you heard about RadioShack’s Chris Horner and his ridiculous 25k ride AFTER he crashed his bicycle. What a lot of us learned later was that he had suffered a severe concussion and did not even remember riding his bike. VeloNews published a story on 4/26 about concussions and cycling. On 4/25, I suffered my first concussion. For me, it re-assured what I was already planning to do — rest. Endurance athletes are a lot of type A personalities that do not like down time, it feels like a sign of weakness. The point of this post is to put things in perspective, educate, and to look at the bigger picture when it comes to your health.

Unfortunately, I do not have a grand and legendary story like Chris Horner. Details aside, I suffered my concussion in a doctor’s office. When I awoke from the smelling salts, I was welcomed by horrible pain. My equilibrium had been pummeled.

For the next couple hours the constant urge of vomiting was in the forefront of my mind, sometimes coming to fruition. There would be a rush of relief, but soon eradicated because I was dry heaving because there was no food in my stomach. My eyes were so sensitive to the light, it was torture trying to keep them open. I managed to tap out a text message for someone to drive me to the E.R.. The text message I was able to “type out” after many tries, “Call me immewnitalye. ERMERGNCYCY”

Severe light sensitivity
Severe nausea
Severe headache and throbbing
Severe fatigue

I was eventually was transported to the E.R. where they did a CT Scan and took X-Rays. I was told I didn’t fracture anything, but I had a severe concussion. After the x-rays I was finally given an IV with nausea reducing drugs and some liquid calories. When the bag dripped its last drop, it was time to go home. The moment I hit the pillow I was out like a light from 5:30pm to about 8:30am.

Severe headache & throbbing
Severe fatigue
Severe light sensitivity
Mild nausea (thanks drugs!)

Wednesday morning: Incident occurred
Wednesday post E.R.: Sleep. I was constantly moving my head position to find a comfortable non-throbbing location.
Thursday: I didn’t want to leave bed. Whenever I sat up, my head wanted to burst. I was not all together.
Friday: Head throbbed, concentration and focus were minimal. A lot of typos were in my typing.
Saturday: My black eye was coming in very nicely. My head had a dull throbbing and maintaining my focus was difficult.
Sunday: Did some errands, but was in my own little world.
Monday: The best I had felt, but there was still a slight throbbing. My conversation skills and thought process were struggling.

This went on for a 1-1.5 weeks. After the tangible symptoms went away, I still didn’t fee like exercising for 3-4 weeks.

I eventually eased back into working out and am now fine.

UPDATE: July — I feel fine and my season hasn’t been jeopardized. If anything, the forced downtime was helpful.

Information from the VeloNews article:

Even after going to the hospital and getting word from doctors that the blow to his head was so severe that he could not continue racing, Horner later recalled that, “I wanted to race the next day and start the stage at the Tour!” After all, he thought, “We crash so much; it’s just part of the job. Eventually you are going to hit your head; that’s why we wear a helmet.”

However, in the case of a crash like Horner’s, at the very moment the brain most needs energy to begin repairing itself, traumas elsewhere are compromising that energy-delivering blood flow. During and immediately after a head-injury-causing bike wreck, “our physiological capabilities have significantly decreased,” Freitag explained.

In turn, the brain enters a state of metabolic crisis, the symptoms of which the disoriented Horner displayed after crossing the finish line. “That’s what is happening in your brain when you are having the symptoms of headache, fatigue, fogginess, dizziness, balance problems, lethargy, upset stomach and vertigo. All those symptoms are due to that metabolic mismatch,” said Freitag.

And while dedicated cyclists’ impulses might be to get back on the bike and start training, especially if all their bones are intact, Freitag explained that for the brain to recover its equilibrium, it needs to rest. And this is perhaps the most surprising discovery for cyclists. By rest, research shows “that’s not only physical rest, but often times it’s also mental rest, cognitive rest,” he said.

Because the brain demands energy when concentrating on something, hopping on the bike and heading out into the input-rich, attention-demanding world of a traffic-filled training ride, or a criterium that demands utter focus and incessant, split-second judgment calls (can you squeeze through that gap?), riders can actually further delay recovery from a head injury, or even make it worse.

My take from this? Stay off the damn bike until you feel 100% better. If your brain cannot recover the right way, how is your body supposed? Training can wait. Your brain is the mastermind behind your body movements. Why risk further harm?


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