Concussion Recovery: What I learned through my own experience
Concussion Recovery – A personal experience..
In January of this year, I was at a one-on-one wheelchair practice performing sideline repeats at max speed. I had been training consistently for the past few months and finally started to learn to use my hips to turn the chair (an advantage as an able-bodied player that I was not utilizing) however I still had a bad habit of turning the chair with my hand. On the second turn, I turned with my hips but over-feathered with my hand resulting in fishtailing and spinning out. See the video here
I had hit my head hard. After taking a second, I checked my neck and ruled out a spinal injury, and then unstrapped myself and slowly got up. I felt a little off, but nothing too serious. I ended up deciding to go home and rest.
The next morning I felt like I was hit by a truck. Pounding headache, I couldn’t even lift my head off my pillow, my eyes felt weird (blurred vision, trouble focusing), I had a huge sensitivity to light and noise that even my husband talking to me set things off in a way I had never experienced. I was tired all the time, sleeping hours in the afternoon, and then lying awake at night. I didn’t know what to do with myself – I was still under the mindset that rest was best and although I felt better when I was working (treating), I felt like I needed to avoid anything that might aggravate things so I ended up doing a lot of nothing! Not the best choice.. for my body or my mind!
I was overwhelmed in grocery stores, got extremely behind on emails and charting as the computer bothered me, which stressed me out even more, I had no motivation to cook or clean leading to poor meal choices. My energy was low, anxiety high – I had also just gone through a huge career change with a lot of unknowns for the future, no needless to say there was a lot impacting my recovery.
After the 10-day mark, I knew I wasn’t following the typical recovery of a concussion so I called up a fellow Athletic Therapist, Kim Oslund, to help me out. Not only is she way smarter than me – and happened to do her Masters in concussion management -even us as health care practitioners can benefit from someone else leading our rehab, especially with something as multifactorial as a concussion.
From my assessments with Kim, we determined that I had cervical (neck), ocular (visual), cognitive, post-traumatic headache, and psychological (anxiety and mood) components of a concussion. That’s a lot going on! I expanded my support team: I went to my family doctor (who happens to be a sports medicine physician who works in high level contact sport), my optometrist, a sports psychologist and also got some much needed manual therapy to help my neck injury so I wasn’t always treating myself.
Here are some of the concussion recovery strategies that helped me. You can read all about the classifications of concussions here.
I was experiencing a lot of visual symptoms, sensitivity to light, trouble focusing, blurred vision. I had a prescription change a few months before my concussion but kept the same frames – we determined that there wasn’t enough space for my prescription in the old frames, making it more challenging to switch from near to distance. I got new glasses made with a deeper frame which made a world of difference while rehabilitating my vision.
I had a lot of trouble with focus on the computer and reading so I used a coloured film over my screen to decrease the contrast, which helped tremendously. I also struggled with short-term memory so I started using reminders and notes on my phone more.
I also used Neurotracker, which is a cognitive training tool designed to enhance neurocognitive abilities. Learn more here
I worked with an amazing sports psychologist, Dr. Bruce Pinel, who not only had experience in dealing with concussions, but also was very familiar with working in high performance sport as an Integrated Support Team member. For me, it was the perfect combination of healing as an athlete while navigating my way after moving away from working in high performance sport myself.
Avoid the fluorescents! I was already sensitive to light prior to my concussion due to my cataract surgery in 2009, but was amplified post-injury. I utilized hats and sunglasses wherever I could and used dimmed lighting or natural light when available.
I’ve never been a fan of loud music, but post-concussion I couldn’t have any background noise, meaning I avoided places with multiple stimuli like restaurants. Ear plugs definitely helped to soften the noise when busy places were unavoidable.
I believe a lot of my symptoms were neck-driven. I treated myself however I could, including performing Functional Release® to my deep cervical flexors and facial muscles, but also received manual therapy from one of my mentors, Sue Lott. I had regular acupuncture from Ian Abbott, which not only helped my cervicogenic headaches but also my mood.
Cervical Rehab: I led my own neck rehab, pulling in concepts I have learned from Functional Range Conditioning®, starting with neck CARS (Controlled Articular Rotations) and pain-free isometrics and also incorporating abdominal breathing and core stabilization using concepts from DNS (Dynamic Neuromuscular Stabilization). As my range of motion and control improved, I progressed these exercises by challenging the position, and then implementing them into sport-specific scenarios.
Vestibular – In addition to hand-eye coordination exercises and balance training, I worked on exercises that changed levels. For example I started at a half kneeling hip hinge and progressed to astanding hip hinge
I started sub-symptom threshold activity on a bike. Using a heart rate monitor and RPE scale (Rate of Perceived Exertion), I determined my symptom threshold and then worked below that on a cycle ergometer.
I also started meditating. Who knew someone as Type A personality as me could learn the art of mindfulness! It’s still a learning experience and I need lots of practice as I often lose focus, but it made a huge difference in managing my symptoms and improving my concentration and focus. Check out the Calm App for guided mindfulness exercises.
Once my symptoms had resolved and I had reached a plateau on the Neurotracker (signifying baseline measures), I started my 6-step return to play protocol, which concluded with an extremely difficult cycling and plyometric test. Kim wrote a summary of my recovery, which I took to my physician for final clearance. I competing in Wheelchair Basketball Provincials within a few days and then was selected to represent BC at the Women’s Wheelchair Basketball National Championships a few weeks later.
I am so grateful so the incredible team that I had supporting me every step of the way of my concussion recovery. It was a challenging process, but the lessons I’ve learned from the experience myself and the practitioners I worked with will undoubtedly help me as I continue to help other athletes through their concussion recovery.
Concussion recovery and return to work and play should always be guided by a qualified health practitioner. To learn more about what a concussion is and how a Certified Athletic Therapist can help, check out the blog post Concussions: What we know now