So I’ve managed to sustain yet another concussion whilst out on the bike on Saturday. This is my fourth in about 8 years, with the previous one 13 months prior (I’m 31 by the way):

1. 2012 – came off my road bike and hit my head against the tarmac – saw stars, but remained conscious – concussion diagnosed by doctor several days later
2. 2016 – crashed my bike on a jump – knocked out cold – ended up in hospital for a CT scan
3. Oct 2019 – high speed crash on trail – vision/speech/cognition impaired for about an hour – ended up in hospital for CT scan
4. Nov 2020 – hit head against tarmac on icy corner – fairly mild concussion, but still feeling foggy after 4 days – doctor diagnosed concussion today

Despite spending several weeks off my bike after each incident to allow for recovery, I’m becoming increasingly worried that my concussion tally is mounting and that I may eventually be left with some long-term after-effects (watching the film ‘Concussion’ last night probably didn’t help my anxiety…). Despite advances in the understanding of concussions, it seems to me that the field remains pretty poorly understood, especially when it comes to evaluating the severity of a concussion, recovery time and future risk profile. I really hope that this doesn’t lead to me having to give up riding 🙁

Any thoughts?

Any thoughts?

Only repetitive ones.

Any thoughts?

Try to stop falling off your bike?

On a more serious note, speaking with someone like the Dr @ 5:18 would be very informative.

Any thoughts?

Try to stop falling off your bike?

Well, I can’t argue with that advice XD

Not a doctor! Story time. I had a bad fall (road bike) in June 2017, lost consciousness briefly and lost my memory of the day completely, even now. As best as I can surmise I took most of the impact on my chin/face. Mate took me to A&E, had a scan and some stitches in my chin, sent home with a concussion. Minimal other injuries, just a few scrapes. Head was all over the place for a couple of weeks, short term memory and concentration were shot. Once that passed I felt fine until some time in August when I started getting episodes of numbness on one side of my face/right arm, thought I was having a stroke. After the 3rd episode went back to A&E, where after a night in and some more scans, they found a slow brain bleed (chronic subdural hematoma) that had been putting pressure on my brain and causing the numbness, in the intervening two months. A speedy minor brain op and within 24hrs I was back home. Luckily no further symptoms and a full recovery (bar slight problems with numb hands which has since resolved in the last 2 years). Very glad I went back to A&E and I was certainly helped by my age.
Not trying to put the fear in you, but my take away from what happened to me was to keep a close eye on symptoms, even further down the line and take a good break from anything that could potentially cause another head injury in the short term.
Longer term I guess it comes down to personal choice on how much risk you’re willing to take with potential further concussions versus giving up something you love. I will say that my accident was on an innocuous bit of road where I wasn’t taking any particularly big or out of the ordinary risks, I got unlucky hitting a pot hole or speedy bump weirdly and off I came, shit happens. I was wearing a helmet at the time, which I think helped, and I always wear one, that’s another argument though. I was back on the bike 6 weeks after the op and although thoughts of it occasionally pop into my head while riding, it hasn’t changed how I ride either on or off road. Like you though, I share concerns about the unknowns of further concussions.

Best of luck to you with your recovery.

Edit: I’m 25 now so not too dissimilar in age.

I really hope that this doesn’t lead to me having to give up riding

Perhaps it would just require you to dial it down a bit rather than giving up.

Very interesting story @jakd95. Glad that you came back for the scans – sounds scary. I think I will take a month or two off riding to let my brain heal up and then I’ll get back into it.

@slowoldman, I agree that I should probably dial it down, but that is often easier said than done. It’s very easy to get into the heat of the moment in mountain biking. Moreover, I feel that if I consciously dial it down, I’d be prone to becoming a less confident and more hesitant rider – I think that’s dangerous in it’s own right. On top of all that, it’s probably worth highlighting that most of my head injuries actually took place on less challenging bits of trail/road.

Right, I don’t want to add to your stress/worry, but you did ask!
Within the scientific literature ‘concussion’ is an increasingly outmoded term. We should be calling it what it is: mild traumatic brain injury.

The research is still evolving. The trajectory seems to be more in line of ‘people should be aware of an concerned about the cumulative effects of mild traumatic brain injuries’ rather than treating each as isolated incidents with no connection.

You are doing the right thing by resting. Also, bear in mind that a second mTBI soon after a first can have a bigger impact. Time of the bike is good in that regard also.

No one knows for sure, the data isn’t there yet, and it’s a very contentious field of study. Of course in the individual case there’s no way of knowing. You may be absolutely fine knocking yourself out repeatedly, whilst your mate doing the same may run into problems later in life.

I’m not giving up riding anytime soon. If I knocked myself out more than a couple of times I’d be giving it all careful consideration though.

And get a MIPS type helmet if you’ve not got one already!

Not an expert but have first-hand experience.

I’m up to 9 (yes, nine) since 1993. 7 from bike incidents and 2 from DIY issues – a Mini to the head when the axle stand punched through the sill and an Audi bonnet tried the same trick when the support strut decided to go into auto-close mode. Add in brain trauma from CO poisoning and a full blackout due to oxygen starvation form choking on my lunch and it’s guaranteed I have some brain damage. Actually I know I do as I can’t drink anymore (even half a shandy gives me a massive migraine for a few days) and I cannot remember anything in any detail from 2003 to 2005. I also struggle in large groups to keep calm and follow what’s going on, making me even more of a social outcast than I was.

The ones that did the most damage was a bike crash at Afan in February 2009 that knocked me out for 45 minutes and did lots of damage to me physically. Dislocated shoulder, broken jaw, hairline crack to my eye socket, broken nose, cracked tooth, lower back pain and an exploded bottom lip. Managed to get back to the car and even drive home but went into shock on the M4 near home, pulled over to calm down then got home. Called a friend to take me to A&E and apparently I was completely out of it. Docs kept me in for a few days for observation then I was let out and told to avoid any further bumps for a few months. Didn’t ride my bikes until August and even then stuck to safe trails that I knew well. Fast forward to September and I was still suffering with after-effects and was having monthly check-ups that could see some small memory effects. I was in work eating a roast chicken dinner a customer had given me when a chunk went down the wrong way and I started choking. The issue was I was in an armoured cash van and couldn’t concentrate enough to work the locks and get out!
Raised the alarm via the tracking control room on the phone and waited for the ambulance crew to arrive. They arrived as I blacked out and collapsed on the floor, I’d somehow got out of the van just as they were arriving. The rest I only know from the notes I saw afterwards. They did multiple rounds of Heimlich manoeuvres and back slaps and were ready to do a tracheostomy when the medic grabbed me and basically threw me in the back of the ambulance, thankfully dislodging the chicken. I still wasn’t breathing so had mouth-to-mouth and thankfully started breathing again.

This further brain trauma is what did the damage, most likely on top of previous damage that had gone undetected. Strangely I don’t notice most of my symptoms but people who knew me before certainly do. They say I’m prone to just pausing in the middle of a group conversation for minute or so then carrying on again a minute later. I also sometimes need to find somewhere quiet and let my brain calm down regularly, both of which I have no real idea I’m doing!

The medical specialists I now see annually define my condition as Chronic Traumatic Encephalopathy (CTE) which leads me to have a higher risk of developing dementia or other brain-damaging issues in my old age. they can’t say for definite as the only way to be sure I have it is to cut my brain open and look for dead zones! Any more concussions could be my last or could do no more damage. Still doesn’t stop me riding my bikes as much as I can, I’m just a wuss when it comes to jumps and drops.

So my advice is this: get friends and family you trust to point out to you if you’re acting strange, you may not realise it. Also follow the medical advice, avoid any more traumas and take things easy. I find exercise really helps calm down any issues I suffer from to the point that if I don’t ride my bike for a few days I can end up going into a vey dark hole rather quickly. I have asked about being prescribed a bike as therapy but I’ve still got to pay for them myself.

If you can I’d recommend watching a documentary called The Crash Reel about Kevin Pearce, a snowboarder who suffered nasty head injuries. Lots of information in it and helps et an understanding about the effects too. It’s on Prime Video for 99p if you struggle to find it elsewhere.

I’ve had a few, probably 3 or 4 in the last couple of years, reality is that after bad ones i’ve had scans and so on, i get the all clear i’m happy and don’t think about it much, as with most things though, you’ll get signs if it’s not right, be that headaches, forgetfulness, change in habits, etc, so just monitor and if in doubt, ask the GP, they tend to be the best to allay any fears, or put you in the right direction for further analysis.

blimey reluctantjumper, that’s quite a story. Hope you manage to avoid any further incidents.

3 in the past 10 years here and definitely a background worry. First one a huge MTB crash just over 6 yrs ago, out for a few minutes, ambulanced, smashed up face, broken nose and intercostal damage, a few days in hospital and 40 plus internal facial stitches with plastic surgery to reattach chin etc. I did get my mugshot into MBR though 😂. All the scans and tests and all ok.

Next one 8 weeks to the day later, recovery riding in the velodrome and taken out by a passing rider. Ambulanced and CT scan, all good and back riding within a week.

Last one October 19, solo MTB ride same venue as crash 1 (Cathkin is now my nemesis) and also first ride on a new ebike. Simple front wheel washout and life changing injuries with a wrecked shoulder. I got myself home and wife took me to hospital. Wasn’t aware I’d hit my head as totally consumed by wrecked shoulder, however fuzzy head a few days later led to me checking my helmet and seeing it was fully split, trip to GP, a few more days fuzzy head, concussion confirmed by GP.

The only upside was GP checkups after crash 1 led to early diagnosis of Prostate Cancer which led to surgery which has left me cancer free for now..

I suffered a severe head injury last year, hit a 10ft crest blind and at high speed (25mph according to garmin watch gps) unbeknownst to me had a 10ft drop the other side which also had concrete steps as a feature! I probably would of got away with it if I had not landed on the steep non graduated steps!

Knocked out for a few minutes and taken to hospital by ambulance

Ended up with an intraventricular hemorrhage and a weeks stay in hospital and an 8month driving ban courtesy of the dvla.

Doctors say the helmet saved my life or prevented severe brain damage

At the time I thought my memory was fine, but speaking to people now it’s very apparent I have big gaps in my memory and to say that week in hospital was a blur is an understatement!

I definitely have issues with my memory now, I have always been brilliant at visualising a place I have been and identifying it, now I can visualise but struggle to name the place, when I know that I know it!

Maybe just old age and no relation to the injury! (34)

But as mentioned above there are not enough studies into head injuries and effects in later life

I definitely look before I leap these days!

Had two in the last 5 years, first one I slid the bike off the top of a berm and used my face as a brake, was in a race and apparently told the guy behind me I was OK and rode the next lap, remembered were I was half way through but couldn’remember how to get back to transition so followed the course slowly and had a mate drive me home, left me feeling woozy for a few days and time off work. The more major one I think I washed out the front wheel in a drainage ditch coming down a fire road, don’t remember that, the ambulence trip or the week in hospital (also broke vertebrae and occipital condyle). I think that one ahs effected my memory, not helped by watching my dad go through dementia in his mid 70’s. I do worry about it but the best way to keep going is to try to stay healthy and avoid lifestyle choices that lead to increased risk of dementia (diet, excessive boozing, lack of exersise etc)

Seem like these days they think that you can reduce the long term damage by treating a concussion like you would an ankle sprain. After my last one, which wasn’t s particularly bad one, it was no reading, no tv, no laptop, phone, etc. No radio, no loud sounds or strong visual stimulation including bright lights/sunlight. No exercise. Basically sit in a semi dark room for 2 weeks and do nothing. If they could get away with sticking you in a sensory deprivation tank for w weeks without you going mad, they would.

No personal experience but the Manchester Institute for Health and Performance has a specialist concussion clinic.
Barbara Kreijtz MTBtraining.nl gave a talk on Post concussion syndrome on the recent Training Peaks Summit symposium. She recommended the Queensland Brain Institute for online information (has a downloadable PDF ‘The Brain’ Issue one Concussion), anything written by Norman Doidge and brainhq.com for brain training. She herself had had good results with treatment by a Functional Neurologist (I’m not sure if that is a recognised qualification/profession in the UK).

This is a topic close to home for me after a mild brain injury in about 2011. I took about 9 months to feel myself and even now I don’t handle stress or multiple complex tasks as well as I used to. I was much worse for the first 3 months. Brain fog, tiredness, irritability, terrible short term memory, disorganised, disinhibited impulses. I’m lucky its only a minor degradation of my executive functions in the long term. The worst thing is conversation in busy places. I can’t filter it out. I also have an exaggerated startle response to noise, and certain noises that others find annoying I just can’t deal with at all.

As has been said the latest research is evolving at a rapid rate. The focus is now on cumulative effects of sub-concussive head blows. As is typical the yanks are leading the way.

One of the specialists involved with the NFL says that measurable effects on the brain can be identified with as few as 4000 discrete head hits.

How many have you accumulated in your life? It’s why I won’t let my boy play headers in football and why the FA ban headers for under 11s, although the age limit appears to be arbitrarily selected.

I’m pretty interested in this. I’ve experienced quite a few ‘concussions’ back to primary school – getting dropped on my head in a playground, kicked in the head playing football multiple times, multiple rugby incidents in my teenage years and early 20s (having to ask which team you’re on and being refused substitution isn’t great, but the worst I think was driving down the motorway to meet friends after a rugby match and thinking that I was in the car overtaking me … which appeared to be the same car that I was driving!)
As a teenager I also fell off an outside staircase backwards whilst inebriated and landed on the back of my head on concrete.
If i had a football ‘specialism’ i’d say it was heading. I got real enjoyment from it, actual pleasure from doing it well and never had any pain, but it’s not looking like such a good idea now apparently.

Fortunately, i don’t recall bike accidents contributing!

I haven no idea if it’s affected me. I was prone to mild depression when i was younger – but was it related to other things (alcohol, drugs, parental divorce), i couldn’t say – there’s been mental health issues in my family just like everyone.

My concentration isn’t as good as i’d like it to be … but what would be good enough?
What happens next as I get older may be interesting. In his 60s my Dad had a benign tumor the size of a lemon removed from his head that he traced back to a motorbike accident when he was around 18.

A local to me research institute is apparently looking into adolescent concussions.

https://www.mja.com.au/podcast/211/5/mja-podcasts-2019-episode-37-adolescent-concussions-dr-amanda-clacy (disclaimer: I haven’t listened to this yet)

Thank you all very much for sharing your thoughts and experiences – really appreciate it!

I’d just like to add that it’s interesting to hear others experiences too, I can’t say that I know anyone in real life who’s had a head injury/concussion from cycling, so it’s reassuring to hear experiences that are similar to mine to some degree or other. It’s something that I think of fairly regularly while riding and the potential for a future further head injury is a worry at times.

I am by no means a professional in the field, but some logical guidelines that I will personally go by from now on are:

1) If you hit your head and think you might have a concussion, go see a doctor
2) Rest and take it easy until ALL of your symptoms have disappeared
3) DO NOT get back on your bike until AT LEAST a month after your symptoms have disappeared (or longer if advised by your doctor)
4) Ride in the best helmet that you can afford, preferably with MIPS, or similar