Crashes happen. Sometimes, the only evidence is a few scrapes and bruises, but other times, the injuries are unfortunately much worse. If your head hit the ground on impact, you could have a concussion.

We talked to clinical neuropsychologist, Alicia Sufrinko, and Christopher Giza, the director of UCLA’s Steve Tisch BrainSPORT Program, to lay out the basics of concussions and what you should do if you suspect you have one.

What Is a Concussion?

A concussion is a mild traumatic brain injury (or TBI) caused by a direct or indirect hit to your head or body, Sufrinko says. When your head takes a hit, your brain gets jerked around inside your skull, causing damage to your brain cells. Most concussions resolve in a couple weeks to couple months.

Concussions are common in all sports, but unfortunately, they’re very common among cyclists.

What makes concussions tricky is that there’s no specific amount of force that causes a concussion, Sufrinko says. Sometimes big hits don’t result in concussions, but smaller ones do. It simply depends on your brain, and everyone’s is different, which is why even a small fall or a seemingly harmless bump should be taken seriously.

A few concussions in a lifetime probably won’t lead to any long-term brain damage, Sufrinko says, but it all comes down to how you handle them. “Appropriate management of injury is linked to better outcomes in the weeks and months immediately following concussion, and although speculative, I believe it to be linked to better outcomes long term,” she says.

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Genetics and age at injury may also factor into your risk of long-term damage, Giza says. Some people are more susceptible to experiencing problems down the road, while others aren’t. That said, multiple moderate or severe TBIs can result in neurological, cognitive, or behavioral problems long-term, Giza says.

If you experience a crash in which you hit your head – whether in a race, out on the trails, or even on a group ride – it’s important to proceed with caution as Sufrinko warns that riding through a concussion and not taking adequate time off is linked to recurrent injury, more severe injury, and longer recovery overall.

Concussion Symptoms

According to Sufrinko, there are over 20 symptoms of concussions that fall under four categories: physical, cognitive, emotional, and sleep.

Physical symptoms include headaches – with over 80 percent of people reporting them in the first week after sustaining their head injury – dizziness and trouble balancing, nausea, fatigue, and sensitivity to light and noise.

Cognitive symptoms include feeling foggy and slowed down, and having difficulty concentrating and remembering things. Emotional symptoms will show up as irritability, sadness, and anxiety, while sleep-related symptoms include either insomnia or sleeping way more than normal. More serious symptoms include total amnesia or losing consciousness.

Concussion Treatment

If you hit your head in a crash, it’s common to experience some level of shock or even demand that you’re okay. But if you’re experiencing any of the symptoms above, it’s best not to get back on your bike and keep riding. Instead, figure out how to get out of the situation safely, whether it be calling for a ride home or to the hospital.

“Reaction time, balance, and thinking can be impaired, and you could have a higher risk to crash again,” Giza says.

It’s never a bad idea to get checked out by a medical professional. Since concussions are so different from person to person, a customised evaluation and treatment plan can really help. Your doctor will ask about your injury – how it happened and what symptoms and impairments you’re experiencing – as well as past history of prior head injuries, migraines, cognitive problems, anxiety, or depression, Giza explains. Afterward, he or she will test your memory, attention span, vision, balance, and coordination, as well as physically examine your scalp, head, and neck for injuries.

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Most patients won’t need a CT scan or MRI, but if there are “red-flag” symptoms like amnesia, loss of vision or consciousness, repeated vomitting, paralysis, seizure, or general unresponsiveness, one may be ordered. This could signal a more severe TBI.

Only after you’ve been cleared by your doctor should you resume any high-risk activities like cycling, skiing, climbing, or contact sports.

Concussion Prevention

Plain and simple, wearing a helmet is the number one, most important way to prevent a TBI. Doing so can slash your risk of head injury by 85 percent. And while helmets can’t always prevent a concussion, they do protect against more severe injuries like brain bleeds, says Sufrinko.

Look for a helmet with the Consumer Product Safety Committee (CPSC) sticker inside. This ensures it underwent rigorous testing and will provide protection against skull fractures and other traumatic brain injuries.

Otherwise, Sufrinko says being aware of your surroundings on your ride is just as important as wearing a helmet. Watch out for cars, other cyclists, and obstacles like roots, rocks, twigs, and trees.

“Cycling can be a very healthy alternative to driving, and regular aerobic activity is one of the best ways to maintain long-term brain health and fitness,” Giza says. “But many cyclists have limited knowledge about traumatic brain injuries and concussions. We just [need to] do a few things to be safe and avoid injury.”

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