Head injuries and concussion are not unusual in the world of cycling. Even the most careful cyclist or the most protected mountain biker can suffer this condition if the blow to the head they receive, through accidents or crashes, is hard enough. While it's common, it's also sometimes overlooked and misunderstood, and proper diagnosis, treatment and recovery is essential to prevent complications down the line. You only have one brain, so make sure you look after it.
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We spoke to UK-based charity Headway about what concussion is, what to do if you encounter someone who has a head injury, and how to recover after a concussion. Headway is a brain injury association that runs awareness campaigns and provides advice and guidance around head injuries, concussion and related conditions.
What is concussion?
According to Headway, concussion is "a temporary disturbance in the brain’s functioning that occurs when the brain gets shaken around in the skull following an impact. It’s also often referred to as a minor head injury or minor traumatic brain injury.”
In sports that often result in crashes, which certainly includes cycling and mountain biking in particular, impacts to the head are not unusual. So being aware of concussion, its symptoms and what to do if you encounter someone with a head injury or suffer one yourself, is very important.
What to do if you suspect someone has concussion
If the person is unconscious, you need to call for help immediately. Notify the emergency services of the location of the injured person, either using street names, GPS locations, map grid references or trail markers, and let them know what condition they are in. Do not move them or remove a helmet or neck brace if they are wearing one, as you may unintentionally injure them further .
If the person is conscious, and only around 10 percent of concussions involve a loss of consciousness, it's worth being aware that they may still have a minor head injury.
If they are bleeding, you may need to perform first aid if you have the training, equipment and confidence to do so. The Red Cross has a guide to treating head injuries that may be helpful and it's never a waste of time to get some first aid training.
Try to keep the injured person still. They may display a range of symptoms including dizziness, nausea, confusion, sensitivity to light, or an inability to process or retain information. They may ask you repeated questions or be unable to answer your questions clearly, and they may be in some distress so try to keep them calm.
Do not leave the person unattended, particularly because concussion is, as Headway describes, an "evolving injury" and symptoms may not present themselves immediately.
If the injured person suspects that they may be concussed they should seek medical attention as soon as possible. While in the majority of cases there is no long-term damage caused by concussion (if the person is treated appropriately), occasionally complications can arise, states Headway.
Because head injuries can impair cognition, the injured person may not be the best judge of how well they are. They may, for example, insist they are okay and attempt to continue to ride. If there is any doubt at all you should encourage them to rest and seek medical attention. Headway recommends the "if in doubt, sit it out" approach.
How to recover from a concussion
If you’ve ever broken a bone or fallen ill, you’ll know that adequate rest is crucial to an effective recovery. The same is true of head injuries, but it’s obviously much harder to rest the brain.
It’s important to take things easy and not to try and force the recovery because you’ll risk further injury or longer-term symptoms if you return to activity too quickly.
The person suffering a concussion should not be left alone for the 48 hours after the injury occurs, because — as we’ve mentioned above — further symptoms may present themselves.
Plenty of rest with as little stimulation as possible is essential, and that includes avoiding screens such as laptops, phones and televisions, and no reading. Avoid drinking alcohol too.
Headway recommends not returning to strenuous activity such as cycling for at least three weeks without consulting your doctor first. As any regular cyclist knows, cycling requires mental focus and acuity as well as physical ability, which puts a strain on the brain, so it’s worth returning to cycling gradually by doing some short easy routes and seeing how you feel rather than going in hard and risking further injury.
The risks of longer term damage and of lingering symptoms increase with subsequent concussions, particularly if the brain hasn’t had sufficient time to heal, so take care and don’t risk your health by returning too quickly.
Finally, if your symptoms persist, get worse, or change, you should revisit your doctor to seek further advice and help.