Take a Hard Hit? You Really Need to Get Off Your Damn Bike and Get Your Brain Checked – Bicycling

It’s time for a pop quiz.

You’re out there in full enduro mode, ripping down the gnarliest run of the day, feeling the flow, when suddenly your front wheel washes out, sending you over the bars and into the dirt like a human javelin. You get up, a little woozy and unsure of what just happened. What do you do next?

• A: Make like Taylor Swift, Shake It Off, and jump back on your bike and finish the run.
• B: Take a moment to let the fog clear; check your bike, and then saddle up and let it rip.
• C: Give yourself a few minutes to assess yourself and your bike. Then walk/cruise it out, getting off for any steep, technical stuff so you can get out safely and get checked out as soon as possible.
• D: Count back from 20 and make sure you know what day it is. If successful, hop back on and shred away.

You picked C, right? Seems like a no brainer (pun fully intended), but way too many people are actually picking those other choices instead. According to the largest ever medical review on the sport of mountain biking, which included more than 2,000 Enduro World Series (EWS) racers, nearly one third said they went ahead and finished their race immediately after being concussed, and 43 percent of the racers said they took zero time off the bike after a concussion.

Okay, maybe during a big elite race when you’re all hopped up on adrenaline, you can be forgiven for taking leave of your senses—though that’s not giving you a pass—even after you’ve been knocked a bit senseless. But the survey, which also polled more than 3,000 amateur level enduro riders, found that lots of mountain bikers of every level blow off their brain injuries even when they’re just out there riding for fun.

Specifically, the report, which was funded by EWS and conducted by Edinburgh Napier University, found 25 percent of recreational mountain bikers out of 3,000 surveyed (1,941 who completed the entire survey) kept riding right after sustaining a concussion. Sixty-three percent didn’t follow any safety protocol before getting back on their bike in the days and weeks that followed a brain injury.

As one would expect, the study revealed injuries of all sorts, including many of the usual broken collarbones and bashed shins. But the concussion statistics, in particular, are what caught the attention of the researchers.

Though the rate of concussion was fairly low, it was still the third most common injury in the amateur mountain bikers, affecting 4 percent of all riders. Though women only accounted for 10 percent of the surveyed population, they sustained three times as many concussions as their male counterparts. (Women appear to be at higher risk in all sports; researchers are investigating the why.) Almost half of riders who reported a concussion also said they have had significant recurrences of concussion injury.

Concussions by the Numbers

Among EWS Racers:
9% of the 188 rider injuries were concussions
5.4: Average number of days missed from injury
57%: Took time off from riding following injury
43%: Took no time off
71%: Abandoned race immediately post concussion
29%: Continued racing
Among Amateur Enduro Riders:
7.1% of 1,234 rider injuries were concussions
50%: Stopped riding immediately post injury
25%: Stopped riding a little while later
25%: Continued riding immediately post injury
63%: Did not follow a medical safety protocol to return to riding
3x: Female riders had three times as many concussions as male riders
Source: Enduro mountain bike medical study by Enduro World Series and Edinburgh Napier University

That all prompted the researchers to call for better concussion education and more rigorous concussion safety protocols at events. Despite news reports, magazine features, and even movies being made about the dangers of traumatic brain injuries, it’s clear too many people still don’t take concussion seriously.

“It’s a problem across all sports and recreational activities,” said athletic trainer Tamara C. Valovich McLeod, Ph.D., a writer on the National Athletic Trainers’ Association (NATA) Position Statement on the Management of Sport-Related Concussion. “People don’t recognize and understand all the symptoms of concussion, and if they do, there are other factors—like riders not wanting to lose fitness—that lead them to avoid getting checked out.”

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While every concussion is different, there are some telltale signs to watch out for. These include: headache; loss of consciousness; amnesia; foggy headedness; nausea; rapid and/or severe mood swings; unsteadiness; slowed reaction times; irritability; and drowsiness.

But here’s the thing McLeod wants everyone to know: Head injuries no longer mean riding the La-Z-Boy for weeks on end while your brain mends. The 2017 Concussion in Sport Group consensus statement overturned the long-standing notion that you needed complete rest to recover from a concussion. Instead, the report, recommends 24 to 48 hours of rest and then gradually becoming more active as symptoms subside.

“That means under the direction of a health care provider, you could be doing 20 minutes of riding and then some other exercises on the first day, and ultimately get back to safe, unrestricted riding sooner than someone who doesn’t seek medical help right away and just pushes through,” McLeod said.

One study published in JAMA Pediatrics found that adolescents who followed this type of active protocol postconcussion recovered in 13 days compared to 17 days for teens who did no aerobic exercise during their recovery.

“There’s recent evidence that if you delay seeking treatment for concussion, you take up to 10 days longer to recover,” McLeod said. “It’s like taking one little step forward and five steps back.”