Concussion Management
Have you ever had a concussion? I know many of you have had one.
I recently had my very first one. I hope it is my last!
However, concussions are not new in our household. My husband has had many in his lifetime. Keeping our heads safe is our primary mission objective!
Here are some things I have learned or validated during my recovery experience:
The first 48 hours are critical. Rest in darkness and stay off any screens. Give your body this time to begin healing. Your body will thank you. I spent my first 24 hours in emergency rooms and the next 24 in my own bedroom with the lights off. It paid off.
I followed the 2019 concussion guidelines for return to activity and return to sport. There are other guidelines for returning to work and school as well. All resources are available at https://cattonline.com/. These are based on the research of Dr. Noah Silverberg from UBC. I am grateful to our friend Tobin Copley who shared those resources with us at the onset of my recovery.
I found a concussion management specialist — someone who tested my range of movement and vestibular responses. I thought about this as setting my baseline so they could test my progress over the next few weeks. There are options to consider. I saw Tony Macri at Fit to Train in Vancouver. Tony encouraged me to use a Concussion Management app to track my progress and to run some tests myself. He also used IMS treatment on the muscles giving me the most grief as well as gentle massage on my neck. He then gave me some exercises to help strengthen my hips.
None of my health practitioners nor my concussion management specialist recommended any other practitioner — they only focused on their area of expertise (except for the neurosurgeon who recommended seeing my family physician but only if my symptoms continued past 4 weeks) or any other guidelines for return to activity. I was disappointed — I had hoped there would be some indication of who else might be helpful to me in my recovery. So I needed to focus on self-preservation.
Sport concussions are often accompanied by musculoskeletal injuries. So I knew I needed additional support to help me like a chiropractor, an osteopath, a physiotherapist and massage therapists. My friend called this “my personal health team”. Unfortunately, this level of support is not part of our BC Medical Services Plan so I had to pay for this myself. Luckily I have access to employer-paid benefits through my husband’s plan. If I was a Cycling BC member, I could have had accident coverage though. When I was diagnosed with a concussion by a neurosurgeon, I also had bleeding on the brain, a chipped pelvic bone and some serious musculoskeletal issues with my right hip which impacted my ability to walk as well as sore ribs. For my own recovery, I first went to the physiotherapist who was a concussion specialist. Then by chance I had a massage at a spa which released a lot of tension and nerve pain in my thighs. I went back to the physiotherapist for another set of concussion tests and a gentle neck massage which was needed. I then went to a chiropractor who tested my range of movement and confirmed I had a bruised rib and sore muscles and ligaments underneath. I then had another massage – greatly needed as my muscles around my hips were still tight and not releasing. My last appointment with my physio included more IMS treatment on my hips and glutes. I am going to see my osteopath today.
Since my concussion came from a crash, chiro and/or osteopath appointments are a must in our household — as soon as we are able to allow for this. When we crash, our bones are often malaligned which can cause additional pain and headaches. A chiro or osteo can help make the adjustments needed. Now my friend who is a retired professor and family physician will tell you there is no research to support this or the use of massage therapy. I will tell you though: I don’t need a body of research to confirm what I know from our collective experience :) Both my husband and I have experienced the joy and relief of having such an adjustment from Zain Mohammed from Catalyst Kinetics. I actually gave myself a gentle adjustment by just stretching one night when a bone shifted. The end result was an immediate removal of my brain fog and most of my hip pain. A visit to the chiro made a couple more small adjustments which also helped. My husband had a similar experience after months of debilitating headaches, brain fog, serious noise sensitivities, short term memory loss, and balance issues, and he spent thousands of dollars at a concussion management clinic. One visit to the chiro and symptoms were immediately relieved except for the balance issues which took 4-6 weeks to return. Life changing to say the least. Oddly enough on the same day, I met the author of The Malalignment Syndrome: Diagnosing and Treating a Common Cause of Acute and Chronic Pelvic, Limb and Back Pain. Dr. Wolf Schamberger told me of his frustration that day as physicians were not paying attention to this very important point: “Although the symptoms are familiar to those working in the field they are often treated independently and their collective cause goes unrecognised. In this book the author presents the evidence for looking at the group of symptoms involved and treating them as a single syndrome with a single cause - biomechanical malalignment.”
Our mental health is also incredibly important. I was lucky enough not to have any mental health issues related to my crash during my recovery. I am an introvert and enjoy my time alone which helped me heal and my brain froze my memory of the crash as well as my emotions. However, FOMO was alive and well every time I saw my husband leave for a ride or anyone else for that matter. This probably helps explain my reduced time on social media. Having said that, I started waking up regularly feeling incredibly anxious in the middle of the night ever since I felt fully recovered. It was taking a long time to settle down without intervention. This was unusual so I am paying attention to this. I started a new bedtime routine which includes restorative yoga, meditation, journaling and reading a book I can hold in my hand — no screens. Breathing exercises help immensely in the middle of the night. We are making progress. If you are experiencing any impact on your mental health, please seek help. Here are some local resources: https://www.healthlinkbc.ca/mental-health-substance-use/resources.
We all experience concussions differently. Sometimes it is because of what part of our brain is injured or damaged and sometimes it seems to be based on pre-existing conditions. So I can’t assume my concussion is going to be exactly like your concussion. For example, my husband experienced light and noise sensitivity whereas I didn’t struggle with that at all – other than dealing with my pre-existing noise sensitivity #introvertedlife :)
When I reflect on my concussion experience, I would love our country to move to a team-based care approach for concussions (among everything else). For example, Catalyst Kinetics takes a more holistic integrated approach with a team including physiotherapists, chiropractors, a vision therapist, naturopathic doctors, and kinesiologists. However, when I think about the mental health aspect and the importance of registered massage therapists, there is room to expand our vision of what team-based care could be for the benefit of all of us. Maybe consider it as taking a village to keep us healthy.
Photo: William Semrau
