HighCountryBike

I crashed on my road bike about a month ago and sustained a concussion, though no permanent brain damage or bruising according to the scans. The neurologist told me to stay off the bike for two months. But a month out, I'm not feeling symptoms from the concussion anymore - and the cyclists I know who've had concussions did not have to stay off the bike this long.

Asking this feels dumb, since obviously the neurologist is the expert. But what do you all think? I'm itching to get back out there!

datlas 

Ride the trainer for another month. Listen to the neurologist.

shelbyfv

Yes.

DXchulo

First, just because you aren't feeling symptoms may not necessarily mean you're out of the woods. You know all those crappy, bumpy roads out there? Who's to say those won't be an issue for you? What if your decision making is still a little messed up or your reaction time is a little slower? That could lead to a crash. I'm guessing a crash right now would be worse for you than the same crash before the concussion.


Second, it's not always good to compare yourself to others. I'm willing to bet that no 2 concussions are the same. Even if they were and you just have a more conservative doctor or something, it still makes sense to listen. There's just so much we don't know about concussions. It's not like a broken bone where you can kind of feel it out and try to listen to your body. Your mind, even in its most healthy state, can play all kinds of tricks on you.


Trying to save a month now could cost you extra months in the future. That's the way I'd try to look at it. (Easier said than done, I know.)

pvillemasher

I'd probably wait, oh I dunno, maybe a couple of months.

bbattle

Ask Saul Raisin.

https://en.wikipedia.org/wiki/Saul_Raisin

seedsbelize 

I stayed off for 5 weeks, after my recent concussion, without advice from the neurologist. It's a tricky thing, and I agree with datlas, do the trainer for awhile. When I first got back on, I couldn't get my heartrate up without getting a headache emanating from the contact point.

kraftwerk 

I suffered a concussion a few years ago. Was knocked out, ALL THE WAY out. I don't remember the accident or several days following. A whole week of my life is gone, besides about five or ten minutes of being in the hospital. I slept a lot. My G/f tells me when I woke up I would ask the Doctors where my bike was and if my dog could come visit me. Since severity of head injuries differ from person to person, (duh) no one can answer this question for you, a good neurologist will usually err on the side of safety. I felt that particular recovery, head injury, comes really slowly, slower even than a broken bone but actually you can't even compare such things. I would rather break ANY bone than break my head I can tell you that. I remember when I drove for the first time 2.5 hrs and it was really difficult to maintain concentration. I Thought I was fully recovered but wasn't. Earlier, on my first bike ride after getting out of the hospital I was punched in the face by an angry driver. ( I am juts lucky that way.)
So, go really easy at first and maybe don't ride where traffic is a concern. That's the best advice I can give you. Oh yeah, and wear a helmet, a brand new one.

Ramona_W

Holy cow! I hope things went better on your next ride and the ones after that. Did getting punched have to do with riding after your concussion?

kraftwerk 

Ramona. Yeah, ever single ride after that has been great and continues to be, thankfully.

I did make a thread about that incident way back when:
https://www.bikeforums.net/road-cycli...oing-okay.html

3alarmer 

...pfffft, doctors. What do they know ?

3alarmer 

...you need to broaden your exercise options, man. There's a whole world of other aerobic adventure just waiting for you.

Fox Farm

I had a very very minor one where I did not hit my head (not a scratch on the helmet) but the side of my chin. Sort of like getting punched in the face hard. Front wheel caught a tram track and I went down fast and hard. Got up, bike was ok and started to ride. About 5 minutes later I was not sure where I was, which direction I was suppose to ride, etc. Got off of the bike and realized that this was new territory! So I started to walk in what I thought was the direction of home with the bike (this was in the city) and within 5 minutes it all came back to me - where and how the crash took place. I had no dizziness or head ache or typical symptoms. I stayed off the bike for about one or two weeks. For the OP, if you close your eyes and shake your head quickly, do you feel at all dizzy? If so, that is a good reason to take as much time as you need to heal.

Maelochs

My doctor told me that to test if I had recovered from a concussion I should shake my head as violently and forcefully as possible.

If afterwards I felt a lot of pain and nausea and a desire to sleep, I still had a concussion

Campag4life

Because most of us are qualified doctors on the internet, my advice is...if seeing more than double, either cover one eye or stay on the sidewalk. Keep in mind, many believe bicycles are toys and shouldn't be on the road with cars.
Feel better soon.

ReneV

It may be worth mentioning that the possible effects of overdoing it before your brain has recovered include life-long headaches and a chronic inability to concentrate fully.

Campag4life

True which plays into my advice about covering one eye if seeing double. Instinctively we ride slower and exert ourselves less if we don't see fully. Win/win.

Jakedatc

Going back to activity can definitely cause symptoms to return.. you need to ramp up slow.

When I was an athletic trainer this is the protocol we would follow from the NCAA:

" Once a concussed student-athlete has returned to baseline level of symptoms, cognitive function and balance, then the return-to-play progression can be initiated, as follows in this general outline:

Light aerobic exercise such as walking, swimming or riding a stationary bike. No resistance training.

If asymptomatic with light aerobic exercise, then;
Sport-specific activity with no head impact.

If asymptomatic with sport-specific activity, then;
Non-contact sport drills and resumption of progressive resistance training.

If asymptomatic with non-contact drills and resistance training, then;
Unrestricted training.

If asymptomatic with unrestricted training, then;
Return-to-competition. Medical clearance will be determined by the team physician/physician designee, or athletic trainer in consultation with a team physician.

At any point, if the student-athlete becomes symptomatic (i.e., more symptomatic than baseline), or scores on clinical/cognitive measures decline, the team physician should be notified and the student-athlete should be returned to the previous level of activity. "

Concussion Diagnosis and Management Best Practices | NCAA.org - The Official Site of the NCAA

motosonic

Having been in this position before, I know what you're going through. I worked with my PcP to ensure I was ready to even attempt to ride again. Luckily my crash happened at the end of the riding season here, so it gave me time to recover and get well. It was only a couple of months, but the doc ran some simple tests on me and then told me to start slowly and move up from there. The important thing was for my PcP to be sure there were no lingering symptoms, so if you go this route, be honest with your PcP about anything you're feeling, headaches, dizziness, blurred vision, etc.

Ilbiker

Listen to your neurologist, he's the expert. Still baffled why folks continue to seek medical advice online from a bunch of strangers. Doesn't matter what I or anyone would do, this is all about what's best for you. Plus, you answered your own question. I have back problems and follow my orthopedist's course of treatment, not what anyone else thinks I should do.

seedsbelize 

After reading the rest of the thread....I took me quite a while to realize I couldn't treat the concussion like just another injury--a minor inconvenience. It is a long, slow healing process.

a1penguin

^^^ This. A coworker had a bad motorcyle accident. He didn't remember anything and the police report was terrifying. He was lucky and only got a broken wrist and a concussion. It was 2-3 months before he got the nod to exercise again, but he can't have alcohol for a year!

Given all the recent news about concussions and how little is known, I would err on the side of caution to avoid any lifelong issues. Penny wise, pound foolish!

canklecat

This -- what @Jakedatc wrote.

My primary sports experience was boxing and I've seen a lot of concussions. There are telltale signs, but it helps to have an independent, preferably object and independent observer.

If you decide to ride sooner than recommended stick to smooth pavement and avoid rough stuff like chipseal and striated concrete that jostle the head and neck. Watch for little things like losing concentration, missing turns on familiar routes, forgetting to set your phone or bike computer if you usually use cycling apps/devices, etc.

Those seemingly little things can too-easily lead to near misses or collisions in traffic. If your concentration and focus aren't 100%, take more time to recover. Train at home or in the gym.

Also watch for dizziness, unusual drowsiness, nausea, headaches, etc. All the same stuff your medical pros already mentioned. Ditto, even if this occurs during indoor training at home or in the gym. If these symptoms persist get to an ER ASAP. Don't shrug it off claiming "I'm okay, I'll be fine" etc. If you're irritable or unreasonable, your family/friends show know that's a sure sign of risk and should override your protestations. That's what happened after actress Natasha Richardson (wife of actor Liam Neeson) had a seemingly minor fall and head impact while skiing. She died of epidural hematoma at age 45.

diphthong

concussions are like children. they're all a little different. if i had listened to
my neurologist 10 years ago, i'd be sitting on the couch watching netflix or the like the rest of my life. some people just aren't geared towards/don't understand active vs a passive life. both have their risk/reward. what's your choice? mine is an active life.