Concussions and Head Injuries
I’ve had six concussions and countless additional hits to the head. My last concussion was the hardest to recover from, and opened my eyes to how challenging it is to find quality concussion care. Even though the science on concussions and concussion treatment has grown tremendously over the last few decades, many providers are stuck in the dark ages using outdated protocols. While concussed, I needed to start doing my own research to make progress on my recovery because the providers I was finding were a combination of useless and not good enough. Doing research when you have a concussion is NOT easy. I believe everyone should have a basic understanding of what to do to treat a concussion, and should know where to look for trusted help. While I am not a medical professional and nothing on this website should be misconstrued as medical advice, my goal is to share valuable basic information and resources and direct you to the real pros who can make a difference in your life.
What is a Concussion?
A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
Some medical providers may describe a concussion as “mild” if the patient didn’t lose consciousness. That doesn’t mean the concussion isn’t serious. Concussions are always serious.
Concussion Symptoms
Personality or behavior changes (e.g., increased irritability, feeling more overwhelmed than usual, feeling a lack of control over emotions, crying for seemingly no reason, feeling like you’re on an emotional rollercoaster, feeling like you’re vibrating inside, experiencing anxiety in a way that differs from your experience pre-concussion, struggling to feel motivated in a way that differs from your experience pre-concussion)
Confusion, memory issues, slow response to questions, repeating questions or statements
Forgetting events prior to or after the hit to the head
Dazed or stunned appearance, seeming “out of it”
Vision difficulties (e.g., headaches associated with reading and screens, difficulty looking at screens, double vision, blurred vision, eye strain, eye pressure, dizziness, difficulty remembering what you’ve read, difficulty with comprehension, difficulty focusing, bumping into things, increased startle response, feeling “slow” or “foggy,” issues with spatial awareness, light sensitivity, frontal headaches, headaches behind the eyes)
Autonomic nervous system dysfunction, including POTS symptoms, difficulties with vestibular function, temperature regulation, etc.
Neck pain, head feels heavy, head feels like it isn’t attached to the body, difficulty holding head up, jaw pain, dizziness when turning head
Forgetfulness, difficulty staying organized, difficulty focusing, brain fog, feeling cognitively “slow”
Trouble speaking, slurred speech
Trouble falling and staying asleep
Loss of consciousness
Clumsiness
When to go to the Emergency Room
Worsening headache or neck pain
Loss of consciousness, seizure
Vomiting
Fluid coming out of ears
Weakness or tingling in the arms or legs
Increased confusion or irritability
Trouble speaking, slurred speech, memory issues
Unequal pupils
What To Do
Complete physical and cognitive rest for 24-48hrs
No reading. No watching TV or movies. No phone. No computer. No e-reader. No podcasts. No audiobooks. No work.
Keep lights and sound to a minimum. Avoid anything stimulating.
Keep conversations to a minimum, especially complex conversations.
Don’t make any decisions.
If you’re bored and need an activity, consider playing a calm game of cards, go for a walk, color in coloring books.
Reduce inflammation of the head injury location using ice (wrap the icepack in fabric so the ice isn’t too cold or use a migraine ice hat). Consider using aloe vera and arnica gel, as well.
Eat an anti-inflammatory diet (check out my webpage on food) with healthy fats and protein.
Remove all sugar, alcohol, dairy, and gluten from your diet.
Prioritize getting quality sleep.
Wear noise-cancelling headphones to avoid overstimulation.
Look into:
Laser or low-level light therapy
Hyperbaric oxygen therapy
Neurofeedback
Neuro performance training, vision therapy, vestibular therapy, concussion rehab, cognitive rehab
Craniosacral therapy, spinal manipulation
Work with a practitioner to determine what, if any, supplements may be helpful for your recovery.
Some concussion experts recommend taking high doses (9g) of DHA and EPA (either fish oil or algae oil) the first week after a concussion, and then slowly titrating to a lower dose.
Other supportive supplements include: Curcumin, Glutathione, N-Acetyl-Cysteine, Glycine, Acetyl-L-Carnitine, Co-Q10, Resveratrol, Alpha Lipoic Acid, Phosphatidylserine, Phosphatidylcholine, vitamin C, vitamin B12, lion’s mane.
Gradually re-introduce activity to see how the brain tolerates it after 48 hours.
Stay below symptom exacerbation.
Studies suggest supervised physical activity can begin as soon as 4 days after concussion (not always!).
What NOT To Do
Rest until symptoms go away
Stay in a dark room
Have someone wake you up every 2 hours
Go back to “regular life” without professional guidance
Assume that all medical providers, even concussion “specialists,” are up to speed on the latest science on concussion and concussion treatment.
Assume that because you don’t have a brain bleed that there’s nothing to worry about or treat.
Consume sugar or alcohol
Excessive physical activity, strenuous mental activity
Driving too soon after injury
Take pain relievers (because they can mask worsening symptoms that are important to be aware of)
Look at screens (TV, phone, computer, tablet, etc.) in the first 48 hours
Concussion Care Team
Click here for a list of recommended practitioners*
Physical therapists, occupational therapists, chiropractors, osteopaths
Concussion-focused neurologists
Neuro performance trainer (Z-Health Performance trainers)
Neuro optometrist
Speech pathologist
Clinical counselor, psychologist, psychiatrist
General practitioners, primary care providers
Functional/integrative/naturopathic medicine doctors
*It can be incredibly challenging to find concussion specialists who are up-to-speed on modern concussion science - and as patients, it can be hard to know how to identify whether a provider is up to snuff and whether you can trust them. Here are a few tips:
Listen to your gut. If you have a nagging icky feeling about a provider, move on. You don’t owe them anything.
If a provider recommends you do any of the above listed under “What NOT To Do,” do a gut check and consider looking around for someone else.
If a provider wants to go straight to putting you on anti-depressants because you’re not feeling like yourself post concussion, consider looking elsewhere. Sometimes anti-depressants are necessary, but sometimes they just cover up an issue that needs to be more directly addressed.
If a provider reviews your neuro-psych report post concussion and isn’t concerned by your low scores, look elsewhere.