MILD TRAUMATIC BRAIN INJURIES

Proofed by Darren Bishop, MScPT

The brain is one of the body’s biggest organs, weighing in at around three pounds and consisting of over 100 billion nerve cells. It’s the boss don of our bodies, regulating everything from subconscious actions like breathing and digestion, to very conscious actions like fatty front boards down triple kinks. It’s responsible for language, art, and morality. It has helped us send a French cat named Felicette to space and lets Sage Kotsenburg get pretty damn close when he boosts on a hip. It’s generally resilient, as we’ve seen with Phineas Gage, an American railroad worker who lived after getting a large iron rod driven completely through his head, destroying his brain’s left frontal lobe. But, it can also be very sensitive, as I’ve experience with my friend Willy Schooler, who passed away in his sleep after hitting his head at a handrail in Golden.

The brain is a complex organ that isn’t fully understood. New discoveries are being made all the time, making it difficult to keep up with each new layer of understanding. However, this shouldn’t deter us from trying to understand. As boarders, we hit our heads so frequently that knowing a little more about the brain, and more specifically, concussions, wouldn’t hurt.

So, what is a concussion? As vaguely defined by the Concussion in Sport Group, during their 2016 international conference in Berlin, a concussion is “a traumatic brain injury induced by biomechanical forces” (Consensus Statement on Concussion in Sport, 2016, p. 2). This means, a concussion is the result of an impact that has moved your brain in an unnatural way, releasing chemicals into spaces of the brain where they do not belong. This chemical imbalance is what brings on the initial “excitatory phase” of the concussion, leading to symptoms like a headache, a feeling of pressure in the head, temporary loss of consciousness, confusion, brain fog, amnesia, dizziness, ringing in the ears, nausea, vomiting, slurred speech, delayed response to questions, light sensitivity, mood swings, or fatigue.

After the initial phase, your brain goes through a second phase called “spreading depression.” During this phase, your brain is in a state of energy deficiency because its chemicals are still out of whack. The spreading depression phase generally lasts for a couple of weeks, as your brain tries to repair itself from the bail you took.

Considering that a concussion is the result of an unnatural movement of the brain, it should be mentioned that a concussion is not always the result of a direct blow to the dome. A person can also get a concussion from a body blow or whiplash. This means that a gnarly butt check or ragdoll can cause any one of the symptoms explained above.

So, next time you feel off after ragdolling, know that it can be more than a little post-ragdoll haze. And, keep in mind that concussion symptoms are not always present immediately after an incident. Sometimes they can show up hours later, when you're already at home or at the bar. However, no matter when they appear, once symptoms are being experienced, go to the doctor! Your brain is nothing to play around with. And, if you are drinking—stop! Alcohol is not good for managing your concussion symptoms!

Apart from getting liquored, you also can't just walk off your symptoms. I know that in the past that's what people have done. If there wasn’t any blood, loss of consciousness, or immediately terrifying symptoms, "walk it off, son." In recent years, this approach has changed. As we have started learning more about the brain, people are becoming increasingly careful when treating concussions. Something called baseline testing is now being done, and it’s a solid test for anyone in a high-impact sport to get done. What the test does is measure a person’s average level of cognitive functioning before a mild traumatic brain injury. This information then provides doctors with data to compare a person’s brain before and after an injury. It's a precaution that helps reduce the chance of sending someone back to their sport too early, and risking secondary impact syndrome—which generally has more severe and longer lasting symptoms.

Getting a baseline test done is also helpful when a person is experiencing symptoms lasting more than 10-14 days, i.e. persistent post-concussive symptoms. If something like this is ever happening to you, go see your doctor again and get re-evaluated. Based on your symptoms, someone like a psychologist, physiotherapist, or neurologist can really help bring you back up to speed. Your G. P. is intelligent, but a specialist will be more suited for taking care of your needs.

When recovering from a concussion, it’s important to know that there are many factors that affect how you will recover. First and foremost, the best recovery position is face down in your pillow for 24-48 hours. After this acute recovery period, your doctor will probably tell you to gradually become more active, while staying below your cognitive and physical “symptom-exacerbation threshold” (Consensus Statement on Concussion in Sport, 2016, p. 5). That is, your doctor will tell you to putz around for awhile, making sure not to inflame any of your concussion symptoms. The exact duration of rest is not yet determined. The literature seems to suggest that each person should be treated subjectively because not all cases are the same: breaking your brain is not like breaking your arm. It’s not a six-week fix. But, even in the case of breaking your arm, you’re never encouraged just to hop back into your sport. You have to build up your muscles and tendons before jumping into a backside handplant. Your brain is no different.

On the topic of healing your body, not all persistent post-concussive symptoms are a result of ongoing physiological injury to the brain. Sometimes, post-concussion symptoms can be the result of what the Concussion Sport Group have called “a constellation of non-specific post-traumatic symptoms that may be linked to coexisting and/or cofounding factors” (Consensus Statement on Concussion in Sport, 2016, p. 5). That means, after getting a concussion, you may have lingering symptoms from other aspects of the slam. For example, you could still be experiencing headaches and vision problems because of tightness in your neck, not because of physiological issues with your brain. This is another reason why it’s important to follow-up with your doctor if experiencing persistent post-concussive symptoms.

Now, after laying that all out, I have to switch for a second from being a wannabe medical professional to a dad, and tell you that the best way to deflect head trauma is to wear a helmet. As explained by Dr. Jacqui Berg, in the article Concussion Awareness and Brain Injury Education, “Helmets will not [totally] prevent concussions, but they can lessen the severity of head injuries and prevent disastrous accidents. The use of protective equipment can significantly decrease the rate of head, neck, and facial injuries up to 43 percent, but it’s important the helmet fits correctly.”

Continuing with the dad archetype, I have to say, if you’re going to take anything from this article to heart, take these two things:

1. Wear a helmet properly. Sloppy, unbuckled, oversized, back-of-the-head helmets with 3 touques underneath will not do. Your helmet has to be fitted and on properly. People at your local shop should be trained on what a proper fit looks like.

2. Know the symptoms of a concussion and receive proper medical care. I didn’t learn the value of this until I had lingering symptoms from my fourth concussion. After eight months of experiencing symptoms off-and-on, I finally saw a physiotherapist who specialized in concussions. Within two weeks, some of my symptoms were resolving. It felt amazing. I wish I had seen a specialist much earlier, and gotten some baseline testing done prior to the concussion.

All and all, the brain is beautifully complex. And, subsequently, so are concussions. This article was written to inform you a little about both, but not to act as a medical opinion. As said earlier, if you have concussion symptoms—go see your doctor!

Back to blog