It’s Serious: Running and Concussions

DizzyEarly last Saturday morning, I woke up after a late night and decided that a run would boost my energy for the day. So, instead of heading back to bed, I headed out for a quick eight mile tempo, which is exactly what I needed. I felt great, maintaining a consistent 7-7:24 pace before heading toward home on the main roads.

About a mile out I ran past a construction site and suddenly found myself sliding on the ground, my chin bearing the brunt of a dramatic flying fall. Somehow, I’d managed to trip on a firehose that was almost invisible, the same color as the sidewalk. I got up and paused my GPS (obviously) and did a quick assessment. No bones sticking out, legs held my weight just fine, so I slowly jogged home, blood dripping from my chin, assuring the construction guys working outside my loft that it was “just a flesh wound.”

But, as it turned out, it was so much more; I got a concussion from running.

When I told my mom, a nurse, what happened she said I not only needed to get the obvious chin injury looked at, but I also needed to make sure I didn’t have a concussion. While a cut on my face was disconcerting because I’d rather not have a big scary scar, a possible concussion concerned me much more. I didn’t want to break my brain! Even so, I felt fine. No way I had a concussion. I ran home, for goodness’ sake! Of course, I was wrong. I went to the ER and they confirmed I suffered a mild concussion.

What are the symptoms of a concussion?

After I got home from the ER, I learned that adrenaline must have masked my symptoms. While my symptoms were some of the milder ones on this list, here are all the possible symptoms of a concussion according to the Mayo Clinic:

  • Headache or a feeling of pressure in the head
  • Temporary loss of consciousness
  • Confusion or feeling as if in a fog
  • Amnesia surrounding the traumatic event
  • Dizziness or “seeing stars”
  • Ringing in the ears
  • Nausea
  • Vomiting
  • Slurred speech
  • Delayed response to questions
  • Appearing dazed
  • Fatigue

Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

  • Concentration and memory complaints
  • Irritability and other personality changes
  • Sensitivity to light and noise
  • Sleep disturbances
  • Psychological adjustment problems and depression
  • Disorders of taste and smell

How do you confirm it’s a concussion if you think you might have one?

Only a doctor can diagnose you, so seek medical treatment the moment you’re concerned you might have a concussion. I went to the ER, despite the expense, but many doctors’ offices and urgent care clinics don’t have the equipment to measure whether or not a concussion is serious. Plus, if a concussion is getting worse, the ER is the best place to assess that and get you into treatment that could save your life or your brain.

I didn’t think I had a concussion, so I felt kind of dumb being there. However, the doctor in the ER assured me that it was good for me to come in and rushed me to get a CT scan. He also assessed my symptoms.

What’s the prognosis if you have a concussion?

Depending on the severity of your concussion, your treatment will vary, but all concussions require some degree of rest from both physical and mental activities, like studying, reading, or even watching TV. As runners, no matter how severe, any concussion will necessitate a break. If a concussion is mild, low impact activities like walking may be allowed before you can return to running. The more severe the concussion the less you can do during your recovery period and the more time off you will need.

Because my concussion was mild, the doc said to take a few days off from running and then, if I had no symptoms, I could slowly return to running, beginning with 30 minutes. In the meantime, he said I was fine to do low impact exercise, like walking and stairs. All of this, of course, was to be accompanied by close monitoring of how I felt, stepping back if I felt dizzy or had trouble focusing and returning to the ER if any symptoms persisted or got worse. And that’s exactly what I am doing. No race is worth permanent brain damage.

Why shouldn’t you hop back into running after a mild concussion?

So we’re stubborn and most of us believe doctors tend to be overly cautious when they tell us to back off running. But in the case of a concussion, it’s best to listen. A concussion occurs when your brain bangs against the inside of your skull, damaging your brain tissue. Any repeated jarring, such as from running, very well might exacerbate the damage and can hinder healing. This would not only prolong recovery, but could cause a second concussion that could lead to a more serious brain injury. And brain injuries aren’t something one should fool around with.

While concussions, mild and severe, can lead to headaches, dizziness, vision problems, anxiety, trouble sleeping, and nausea (to name a few), not taking care of a concussion can lead to brain trauma that results in long-term problems with memory, concentration, cognition, and life-threatening conditions. This is serious stuff.

On the Internet, of course, is an array of pseudo-science and anecdotal reports of how different people recovered from their concussions, but the bottom line is that each concussion case and individual is different. The only way to know for sure that you are cleared for exercise, however moderate, is to talk to your doctor and, if they can’t seem to give you a definitive plan to ease back into running, see a neurologist.

Runners like to pick and choose what doctor’s advice we want to take, and if I’d broken my ankle, I’d probably have been on the rowing machine Monday morning trying to keep my fitness up while my lower body was out of commission. But this isn’t my ankle, it’s my brain. I only get one and I’m willing to gain a few pounds or lose a little fitness to keep it safe and healthy.

If you can’t run what CAN you do if you have a concussion?

That being said, some research suggests that a little exercise can be helpful in concussion recovery, so the key is to find a balance between low-impact exercise, rest, and brain recovery. It’s tricky, and frankly, hard to define even for someone who is hyper-aware of her body. With this in mind, ask your doctor and listen to what she says.

Since mine said I could do low-impact stuff for a few days, here’s what I did. Day 1, the day after my concussion, I rested completely. On Day 2 I was feeling better, so I drove to the gym to do some stairs (which seemed similar to walking but not as boring). I was fine for 30 minutes on the stairs and then switched over to the elliptical, but the elliptical was too bouncy, despite being low-impact, and within five minutes I started to not feel right. I backed off immediately and headed home. All that day I had general brain fog and nausea, a clear sign that the elliptical had been pushing things too far. I rested completely on Day 3 and by the evening felt a-symptomatic.

Great, but when can you run again?!

Whoa, girl. This is not the time to be a shero on Strava. Did I mention you need to talk to your doctor? Your doctor might have specific instructions for you,  but mine said – again ,with a mild concussion – I could start back with a very short and easy run a “few days” after my concussion if my symptoms were gone.

To make your brain happy again, it might mean no running for a little while. That's ok.
To make your brain happy again, it might mean no running for a little while. That’s ok.

On Day 4, I woke up feeling fine so I headed out for a very slow three miles. My body and brain handled that well, so I decided to double the time and distance on Day 5, for a six mile run. Again, I felt fine, so I headed out for an eight mile run on Day 6. This was tricky, though, because I woke up Friday morning with a headache. This is where the anxiety comes in. Headaches are not something I am unfamiliar with – I’d say, in general, I live with a headache most days, with varying degrees of severity. What kind of headache was this? I struggled all week and still am struggling with trying to figure out if I was nauseous because I hadn’t eaten or if it was a concussion symptom. Is this headache a concussion headache or a caffeine headache? Did I run into the edge of my desk because I have a concussion or because I am, as a general rule, exceptionally klutzy? I don’t have an answer, even for myself.

Since my headache got better with caffeine and breakfast, I still decided to run. This could have been a risky decision, but since running had, in both cases, made me feel much better during and after, I felt like another slow run wasn’t risking my brain and might improve my mental health. The run went fine, but after, as the mild headache persisted and I felt pressure behind my eyes, I started to worry about all of the potential concussion concerning symptoms, and headed back to the ER for my own peace of mind. Turns out, I’m fine, but I’m glad I went.

***

Have a concussion? Don’t take it lightly. Follow your doctor’s orders, no matter what Runner X said he did on a LetsRun forum. Whatever you do, when you feel like you are 100%, ease back slowly into running again. While my concussion was very mild, yours might necessitate a week, two weeks, or more off from running. It sucks, but it’s better to take the time now than suffer the lifelong consequences. Listen to your medical professionals even if you don’t like what they have to say. This isn’t a strained hamstring, it’s your brain, and it’s pretty important.

Have you ever returned to running after suffering a concussion?

Ultrarunner, yoga teacher, academic, and feminist. I write about ultrarunning, feminism, and the intersection of running and life.

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13 comments

  1. I did a face plant last Nov 1 while trail running. Had a nasty cut on my forehead, ended up with whiplash and a concussion. I also was fueled by adrenaline the whole day, drove home from Boston doing conf calls and ended up crashing into bed by 6pm. It took me 3-4 weeks of lots of extra rest before I was back to being fully engaged at work and starting to run again. The brain is not something to mess around with….

    1. Yes! This is so true! I was feeling really embarrassed about my fall until I started talking to people and everyone had a concussion story (and many had a concussion+running story). It’s way more common and nothing to mess around with!

  2. I’ve never thought about this, but I think it occurs more often than you think… especially during icy conditions. I know friends who have slipped on ice and hit their heads. This is something you certainly need to be aware of and treat properly.

  3. So sorry you had to have this personal experience, but thanks for sharing it with everyone! I’ve fallen a lot and seem to have injured everything but my head that way so far (knock on wood). One of my runner friends had a concussion a few years ago and his doctor actually advised him to include running as part of his recovery – something about the linear motion visually (?) was supposed to be therapeutic. I’m not sure how long after his incident he was encouraged to do this, though. Hope you’re feeling better soon.

    1. I’d love to hear more about this – I know it helps me mentally to run, but I’d love to back that up with some linear motion science! So glad you’ve never banged up your brain like this!

  4. I did a full faceplant into concrete (including slamming L side of head – ear, jaw, chin, cheekbone) 10 days ago now. I didn’t get checked out because I didn’t lose consciousness and seemed ok. I’ve started running again. Had and have some of the symptoms – but some I’ve had before (occasional sensitivity to light – migraines, fatigue, , some are likely due to allergies, etc. The bad headache went away, the fatigue has gone back to normal levels. So I seem to be doing ok. I ran Th/F/Sat on my tmill (took 3 days off), and again today. Not the greatest runs but no worse than normal probably.

    How does one know if you need to get checked this far after? How long from the event is too long to get checked out? Is an ER/CT scan the only option? Yeesh, I don’t really want to do that and my DH has an away race this weekend and we’re both slammed at work.

    1. Oof! First, I’m so sorry about your fall – that sounds terrible! Did your face get pretty scratched up too?

      So, I’m not a medical doctor but I would recommend that you go into the ER to get at least a CT scan. I know it sounds extreme, but it’s your brain! I wonder if your GP could even get it scheduled for you – but I wouldn’t let this go. Did you see the movie about concussions in the NFL? This stuff is serious! If I were you, even though you are crazy busy, I’d make time for your brain. You need it!

  5. i hit some softball equipment during an interval workout in college. My two teammates in front of me were just 1/2″ shorter and made it through in front of me but I nailed it (you know, late fall xc workouts, sun’s setting…you’re in the zone…) I tried to gather myself and finish but my best friend was right next to me (and an inch taller) and was like “no! stop running!”

  6. That sounds horribly painful! Ugh! Did you get it checked out by a doctor? So good that your friend was there to tell you to stop running. I’ve heard a few stories where someone continued to run and it took months to recover because of the additional damage.