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Do I have a Concussion?
Concussions are scary. We have all heard about how dangerous they can be, how much damage repetitive concussions have caused professional athletes, or how much your friend has suffered from them. But how do you know if YOU have a concussion?
In this article, I break down what a concussion is, how to know if you have one, and what to do if you think you have one.
The content in this post is intended for educational purposes only. No information in this post is to be interpreted as medical advice, recommendations, or prescription. If you think you have a concussion, are concerned about your symptoms, or have further questions, make an appointment here, give us an email here: drmurdoch@basecampclinic.com, or contact your medical provider.
Picture this…
You’re speeding down a single track. You have run this same route three times today and you are really feeling the flow. Only two more turns until you are done this run. Wait. Was that root there last run?
Next thing you know, you are looking up at the sky, plenty of dirt on your forearms, and a fern leaf or two shoved up your sleeve.
You think you are ok. Nothing feels broken. A bit of blood, but that is to be expected. Your neck hurts and you have a mild headache, but other than that, everything feels ok. You don’t think you hit your head, but you can’t be sure. Then you think to yourself... ‘Do I have a concussion?’
What this article covers:
What are the symptoms of a concussion
How do I know if I have a concussion?
How long does it take to recover? Will I have symptoms forever?
What is a concussion?
What to do if I think I have a concussion?
What are the symptoms of a concussion and how do I know if I have a concussion?
Concussion Symptoms:
Headache
Dizziness and balance changes
Difficulty with concentration
Trouble with Sleep
Mood changes including anxiety and depression
Forgetfulness
Fatigue
Loss of consciousness
Light or Noise sensitivity
The list of the signs of concussion can seem endless and vague. One aspect of concussions that makes them so hard to deal with is that you are unlikely to have all of the symptoms, and just because you DO NOT have any of these symptoms does not necessarily mean that you are concussion-free. This can be confusing for medical professionals, let alone an athlete or weekend warrior who suspects they might have a concussion. Part of the problem is that symptoms may not show up immediately, but instead take 24-48 hours to appear. (1)
With this in mind… How do you know if you have a concussion? How does a Chiropractor or a Physical Therapist in Vernon, BC test you for a concussion? This can be a nuanced question, but there are a few rules that you can follow. Let’s talk about how to tell if you have a concussion.
How do you know if you have a concussion?
SHORT VERSION: If you experience an injury and have ANY of the symptoms listed above, you likely have a concussion. It is recommended that you seek an evaluation by a qualified professional within 72 hours of the initial injury. If you are unsure who to see in your area, please reach out to me at drmurdoch@basecampclinic.com and I will help you find someone.
“I have a headache and some trouble with sleep! Does that automatically mean that I have a concussion?” The short answer is No. In general, to get a concussion you need to have a mechanism of injury. In other words, concussions need to have some sort of event that causes them.
These injuries usually involve some combination of the following:
Moderate to high speeds
Sudden changes in direction
Head or body impact
Like the symptoms, we do not need to have all of these factors in order to get a concussion. One common question is “do you need to hit your head to get a concussion?” and the definitive answer is NO. You can experience a concussion without hitting your head. If after a fall, car accident, sports collision or unexpected impact you have any of the symptoms above, you most likely have a concussion. (1)
How does my Dr. know that I have a concussion?
The diagnosis of a concussion is primarily based on a thorough history (what happened) and a symptom inventory (see above list of symptoms). As a clinician, we then used the physical exam to rule out anything that might be more serious (e.g. broken bones or more serious brain injury) and determine the most probable cause of the symptoms you are experiencing. (1)
In short, if you have a mechanism of injury consistent with concussions and any of the above symptoms, you likely have a concussion and should get an evaluation.
Recovery after a Concussion
How long does it take to recover from a concussion?
The good news about concussions is that most people fully recover from them completely and in a relatively short amount of time. The tricky part about concussions though, is that you will typically feel better before your brain has healed, which puts you at risk of a second injury with more serious consequences. Every person who experiences a concussion recovers somewhat differently, however, there are a few rules we can use to predict recovery. (2)
Concussion symptoms usually last 7-14 days following the injury
Symptoms often get worse 24-72 hours following a concussion
Those with less severe concussion symptoms are more likely to recover quickly
Symptoms resolve before the brain has recovered
When can I get back to doing what I love?
Despite feeling better within a relatively short amount of time, returning to the activity that caused the concussion in the first place is dangerous. The brain heals slowly and takes about 30 days to recover to baseline for most concussions. (2) As long as your symptoms do not persist or return, in general, you can return to your activity at about 30 days after a concussion without increased risk or permanent or lasting damage. It is, however, recommended that you return to your activity gradually, rather than back to 100% on day one (I am looking at you single track riders).
Will I have symptoms forever?
Most people who experience a concussion fully recover with no residual injuries. If you are experiencing symptoms that last longer than 2 weeks then you need to get a thorough evaluation by someone who knows what they are doing. If you receive proper treatment then most people who have persistent symptoms still experience full recovery. A portion of patients have persistent symptoms that do not resolve. These people can still experience significant relief with treatment.
When should I go see someone if I think I have a concussion?
So… you went over your handlebars. What now? When should you see someone if you think you have a concussion? I recommend seeing a qualified clinician as soon as possible following an injury if you think you have a concussion. Not only will this help you rule out anything more severe, it will also help you recover FASTER because early interventions with concussions are the key to fast and effective recovery. The ideal timeframe for an evaluation happens within 72 hours of injury.
If you think you have a concussion or someone you know and care about has a concussion, contact me ASAP and we can get you on the road to recovery.
NOTE: If you have severe symptoms (loss of consciousness, vomiting, sustained double vision, passing out) then you need to go to the emergency room as soon as possible.
Summary
Here is the bullet:
Concussions are very common and, while they should be taken seriously, most people completely recover within a short time.
Most common symptoms include headache, neck pain, and dizziness, but anyone who has an injury involving the head and neck should get evaluated
Concussions are diagnosed by a history and a physical exam, in which the primary goal is ruling out a more serious injury
A timely exam and treatment can enhance healing and recovery. Guidance can help decrease the chance of re-injury or persistent symptoms.
Have a question about concussions? Shoot me an email: drmurdoch@basecampclinic.com or give me a call: 250-307-7819
For a great video on concussions, check this video from TED: https://www.youtube.com/watch?v=xvjK-4NXRsM
Author: Dr. Mark Murdoch, Chiropractor and Co-Founder at Base Camp Chiropractic and Sports Rehab in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc
References:
Jackson, W. T., & Starling, A. J (2018) Concussion Evaluation and Management. The Medical Clinics of North America.
Vagnozzi et al., 2010.
SCAT 5
The Two Options You Have When You Are Injured…
The options are simple, but the process is complex. You can either decrease your activity or increase your capacity.
Person: “Doctor, my back started to hurt this earlier this week, and hasn’t gotten better. It hurts every time I bend forward.”
Doctor: “Ok, stop bending forward then. I want you to take the next few days off and just relax at home.”
Hmm… that IS one way to go about it. But what if there is a better way? What do you think the downside is of stopping your activities?
When you are injured, the activities you were doing before can be painful, whether it is deadlifting or washing the dishes doesn’t really matter.
To manage your injury, you essentially have two options….
Option 1: Decrease your activity level
The idea here is that you decrease your activities to a level that doesn’t cause pain.
This is a viable option for some injuries, but it is never a permanent solution. If you decrease your activity too much for too long, you will end up deconditioned, and then you live in a feedback loop where you keep getting worse… Just like this picture:
I recommend that MOST of my patients decrease their stressors for a period of time (but this is only for a few days). Then we get into Option 2…
Option 2: increase your capacity
With this strategy, you work to increase your strength, endurance, and recovery to improve your overall capacity to a level that can handle the stresses of your activity.
Personally, Option 2 sounds like a better solution to me.
The more we can increase your capacity, the larger buffer you have between your demands and your threshold.
In order to use Option 2 though, you need to have a plan. We need a structured, progressive and intentional exercise plan in order to build up this buffer. It can’t be done in a day, and it doesn’t work to just use random exercises with no intention.
Option 2 is a 3 step process.
Step 1: Calm Stuff Down
This often still consists of a period of decreased activity, but it is NOT a permanent strategy. It is only long enough to give us a window to build upon. We also use things like stretching, foam rolling, mobilization, and hands-on therapy during this phase to decrease your pain.
Step 2: Build Back Up
During this phase, the focus is on building strength and endurance around the body parts and systems involved in your activity. This means strength and mobility exercises, with less emphasis on mobility or hands-on treatment.
Step 3: Bridge the Gap
This is the fun part. After your symptoms are under control, we start to work on speed, strength and re-integrating your favourite activities. You like to run? Your rehab plan involved running. You like to ski? Yup, that’s part of the plan. Mountain Biking? You bet we include that.
Here are a couple of the components of Bridging the Gap:
Movement Quality and Capacity: how well do you move in relation to your sport/activity, and do you have enough range of motion for your task
Sport/Activity Specific Cardiovascular and Muscular Endurance: even though you are out of pain doing a simple single-leg squat in the clinic, doesn’t mean you maintain that same quality when you are out of breath
Rate of Force Development: can you generate force quickly enough, as you need it, during your activity?
Recovery: making sure you have the strategies and skills in place you need to recover from the demands of your activity.
This is also one of the most IMPORTANT parts. If all you do is get out of pain, but you don’t continue to improve your movement quality, recovery strategies, and overall capacity, it is extremely common to start sliding backwards, right back to where you started.
The reason I use this framework is that it is not only the most effective method that I have found, it also helps YOU develop the tools you need to keep your pain from coming back.
If you are ready to take control of your pain and get back to doing the things you love, I can help you.
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Chiropractic and Sports Rehab in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc
Upper Body Training: Exercises Every Runner Should Be Doing - Part 5
EVERY runner should be performing Upper Body Strength Training. Here are the exact exercises I give to many of my running clients and patients.
This is Part 5 of a 6 parts series covering the exercises that Every Runner Should Be Doing.
Missed the First 4 Parts? Find them here
All runners should have 1-2 strength sessions per week if they want to run faster and further while remaining injury-free.
Here are the exercise categories I start all my runners with:
Lower Legs
Hips and Thighs
Core
Compound Movements (integrating the trunk and lower body)
Upper Body Exercises
Foot Strength
This is an area that I tend to get a lot of push back… or at least a lot of blank looks and confused head scratches.
Huh? Upper Body Training for Runners? That seems silly.
Hear me out…
Our body parts do not function in isolation.
Have you ever tried running without using your arms? Go ahead. Try it and then come back to this article.
…
Feels weight right?
That is because our bodies are BUILT to run, and the upper body is no exception. It is part of the reason we have so much less muscle mass in the upper body. Every time you swing your arms, you are preserving energy from your stride. So… if the upper body is involved in running, it is worth training.
You don’t need to aim for Arnold size arms… but you should have adequate pressing and pulling strength to make you more efficient overall.
Some basic upper body strength work
While runners don’t need extensive upper body strength work, adding in some balanced pressing and pulling can be beneficial to your overall athleticism.
Arm to perform each of these exercises at a moderate weight for 8-12 reps one week, and a heavy weight for 3-8 reps on the alternative weeks.
In sum…
In reality, you do not need to be doing THESE exercises. There are literally thousands of exercises you can choose from, these are just the ones that I like to see my patients and clients doing. But you should be doing SOME form of strength training. Both for injury prevention AND to improve your performance.
In general, I recommend some form of:
Lower Leg Specific Training
Hip Specific Training
Core Training (primarily “anti-rotation” or '“anti-movement“ exercises)
Compound Movements emphasizing the Posterior Chain Strength Exercises (glutes and hamstrings)
Basic Upper Body Strength exercises (1-2 pressing and pulling exercises)
Foot Strength
Cover all these bases and you are bound to feel better and run with more confidence
NEXT UP: Part 6 - Foot Strengthening Exercises
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Sport and Spine in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc
Compound Exercises: Exercises Every Runner Should Be Doing - Part 4
Compound Exercises you should be doing to make you a better runner
This is Part 3 of a 6 parts series covering the exercises that Every Runner Should Be Doing.
Missed the First 3 Parts? Find them here
Part 2: Hip Exercises for Runners
Part 3: Core Training
All runners should have 1-2 strength sessions per week if they want to run faster and further while remaining injury-free.
Here are the exercise categories I start all my runners with:
Lower Legs
Hips and Thighs
Core
Compound Movements (integrating the trunk and lower body)
Upper Body Exercises
Foot Strength
The reason we use Compound Exercises (exercises that require more than one joint to move) is because they help our body learn to coordinate muscles and joints through a larger range of motion. This can help our strength and balance, and enhance the transfer of our training to our running.
compound movements
Running is essentially a series of repetitive single-leg jumps, from one foot to the other, THOUSANDS of times per run. It pays dividends to train what we refer to as the ‘posterior chain’ (which is essentially from the soles of your feet to your back).
If you are paying attention, you may have noticed that some of the exercises in the Hip/Glute post are also compound movements. The exercises below take it a bit further, and challenge you through additional Range of Motion.
Here are some of the compound movements I use for my training and I have my runners use:
Some final points…
In reality, you do not need to be doing THESE exercises. There are literally thousands of exercises you can choose from, these are just the ones that I like to see my patients and clients doing. But you should be doing SOME form of strength training. Both for injury prevention AND to improve your performance.
In general, I recommend some form of:
Lower Leg Specific Training
Hip Specific Training
Core Training (primarily “anti-rotation” or '“anti-movement“ exercises)
Compound Movements emphasizing the Posterior Chain Strength Exercises (glutes and hamstrings)
Basic Upper Body Strength exercises (1-2 pressing and pulling exercises)
Foot Strength
Cover all these bases and you are bound to feel better and run with more confidence
NEXT UP: Part 5 - Upper Body Training
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Sport and Spine in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc
Core: Exercises Every Runner Should Be Doing - Part 3
Do these core exercises if you want to run faster and stay injury-free
This is Part 3 of a 6 parts series covering the exercises that Every Runner Should Be Doing.
Missed the First 2 Parts? Find them here
Part 2: Hip Exercises for Runners
All runners should have 1-2 strength sessions per week if they want to run faster and further while remaining injury-free.
Here are the exercise categories I start all my runners with:
Lower Legs
Hips and Thighs
Core
Compound Movements (integrating the trunk and lower body)
Upper Body Exercises
Foot Strength
Having a strong core when you are running has one primary function: making you more efficient.
If you have a strong and stable core you both CONSERVE more energy on each step AND your legs general more force be being anchored to a stiff trunk. This means you can run faster and further, and can even help prevent some injuries.
The core exercises I use are a circuit that targets each side of the trunk, and an anti-rotation exercise called the Pallof Press. All of these exercises are targeted at building ‘anti-movement’ strength.
Here are some videos and how I use them with my runners:
Core Training
The primary function of your core while running is to keep your trunk stable and stiff as an anchor for your limbs while preserving as much energy as possible as you bounce along the route.
The McGill Big 3 routine is a great intro for core training for running.
The Pallof press is another great one that focuses primarily on resisting rotation (a job that the core muscles have to do on every step).
Here is how I would use them if you are training for performance:
CORE CIRCUIT
Perform 1-3 reps of the full circuit for 3-5 sets, 3-5 days per week. Hold each position for 10-seconds and rest 2-seconds when switching positions.
Pallof Press
Choose the hardest progression you can perform with proper technique. Perform 5-10 reps per side for 3-5 sets.
To clarify…
In reality, you do not need to be doing THESE exercises. There are literally thousands of exercises you can choose from, these are just the ones that I like to see my patients and clients doing. But you should be doing SOME form of strength training. Both for injury prevention AND to improve your performance.
In general, I recommend some form of:
Lower Leg Specific Training
Hip Specific Training
Core Training (primarily “anti-rotation” or '“anti-movement“ exercises)
Compound Movements emphasizing the Posterior Chain Strength Exercises (glutes and hamstrings)
Basic Upper Body Strength exercises (1-2 pressing and pulling exercises)
Foot Strengthening
Cover all these bases and you are bound to feel better and run with more confidence
NEXT UP: Part 4 - Compound Exercises
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Sport and Spine in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc
How running injuries happen