Hi everyone, this is my first post and i'd just like to say thank you for responses, regardless of whether or not they come.

I'll preface my question with saying that I've had two concussions, one as a result of an accident that occurred New Year's Day of this year, after which i was diagnosed with "concussion symptoms." The other concussion was prior to that, when i was in approximately 7th grade, and was skateboarding, hit my head on the pavement, retained consciousness and seemed to have been symptomatically fine afterwards.

I was wondering, if falling, at 1-2 mph, with no contact, could possibly induce a concussion, in addition to pondering as to whether or not getting hit in the head with a tennis ball, by my 14 year old sister, could cause one.

Thank you for your time,

aterzian

What you are talking about is likely a 'sub-concussive impact.' This is when the impact does not cause any immediate concussion symptoms but may lead to later symptoms or be part of an accumulation of sub-concussive impacts that causes full blown Post Concussion Syndrome.

There are many on this forum who have difficulty with sub-concussive impacts. I can not tolerate something as simple as shaking my head "No."

The medical industry is just starting to understand that there is very little direct correlation between impact forces and concussion symptoms. The symptoms from shaking or G forces to the brain is a very individual issue. Some brains are more sensitive than others, especially after a previous concussion that caused serious symptoms.

Remember, with concussion, it is the symptoms that matter, not the level of force during the impact or non-impact. If concussion symptoms result form the event, then you treat those symptoms as resulting from a concussion.

Hope this is understandable.

My best to you.

Thank you very much for your response, I am still wondering as to whether or not these "subconcussive blows" can cause impact similar in permanence to these of compounded concussions? Do they merely aggravate/provoke symptoms synonymous to those of a concussion, as some sort of physiological response with regards to the necessity of "taking it easy?"

Sub-concussive impacts can cause as much damage as a full concussion. They also accumulate to cause long term symptoms and more importantly, they are a leading cause of chronic traumatic encephalopathy (CTE). This is a atrophying of the brain that results in early onset dementia.

Sub-concussive impacts can combine to cause PCS symptoms or follow a more severe concussion and act as full concussions. I am extremely susceptible to sub-concussive impacts after a severe concussion in 1965. A sub-concussive impact while playing soccer in 1970 caused my grade points average to drop an entire grade point.

Think of this as an example. Take a hard boiled egg. You can juggle with it without breaking the shell. Once you crack the shell, you will continue to crack the shell even more by handling it with any level of intensity.

You brain is similar in structure. Once it is injured by a concussion, it become much more sensitive to lesser impacts.

The sports industry is still struggling with this concept. They are allowing full contact play after the primary concussion symptoms are gone. The only protection this affords the athlete is limited to Second Impact Syndrome where the brain has lost its ability to regulate blood pressure and can quickly become over-pressurized with possibly deadly results.

Waiting for primary concussion symptoms to resolve before returning to play does nothing to limit the chances of Multiple Impact Syndrome which is an accumulation of injury and damage from even mild sub-concussive impacts. Dr Julian Bailes is the most vocal proponent of this information.

So, sub-concussive impacts do both,. They aggravate previous symptoms than may have resolved and they cause new manifestations of symptoms. Either way, you have the cumulative effect.

I hope this explains it.

My best to you.

This may be a stupid question, but when you talk about these sub-concussive impacts having a cumulative effect, is this how it will be for the rest of your life? Or is it only for a certain amount of time after your initial concussion?

I believe I had this happen to me, because after my initial concussion my symptoms had improved for the most part, but then a few months later I bumped my head at work one day, and shortly after that is when my symptoms began to get worse again, and now haven't gone away since.

I told my Neuro about this and she said that bumping your head like that wouldn't make any difference at all, and that it would have to be an extremely hard bump to have any effect. This is pretty stupid if you ask me, especially since my initial concussion wasn't even caused by a bump on the head, it was from whiplash.

It's frustrating when you feel like you know more about what's wrong with you than your doctor does. I seriously wonder why these people get paid so much when they are so often of no help at all.

jd,

As you said, it is frustrating when you know more than your doctor.

The subconcussive impact issue is soundly based or as some put it, evidence based. The old idea that only serious impact can have a concussive effect is based on medical ignorance. Most of the medical establishment is ignorant of concussion issues, especially the recent research. One of the problems is that there is not much a doctor can do about concussions or even less with sub-concussive impacts. Sort of a "If I can not image it or heal it, it does not exist.

I would suggest looking for a new neuro who understands concussion and subconcussive impacts. maybe you need to find some info about subconcussive impacts to show this woman and see if she will learn. Google subconcussive impact.

Here3 is an article from NIMH: http://www.google.com/url?sa=t&sourc...NmMBQHIpXrUXRQ


Subconcussive impacts have two results. Those that are many over a short period of time can cumulatively cause serious long term damage, sometimes, the damage that does not become evident until years later.

If the subconcussive impacts follow a more serious insult to the brain, they can build on the prior injury with symptoms that manifest within a short period of time. If this is shortly after the more serious concussion, the symptoms will likely be attributed to the concussion.

If it is longer after recovery from the concussion, it is unlikely the symptoms will be even connected to the subconcussive impact since subconcussive impacts are usually disregarded and forgotten.

Those that understand the seriousness of subconcussive impacts suggest the need to keep track of them for future reference. They suggest that sport trainers and sport doctors include this in the medical history of the athlete. Failing to note or consider subconcussive impacts can cause a later diagnosis of hypochondria or malingering or somatoform disorder.

Many doctors who even know of such impacts will still disregard them like your doctor does and thus diagnose something other than concussion symptoms.

Dr Julian Bailes is the first to coin the term subconcussive impacts. He was formerly the team physician of the Pittsburgh Steelers football team. Dr. Bailes' research includes a study sponsored by the National Football League Players Association on head injuries among professional football players; team physicians frequently consult him for his expertise in this area.

The term subconcussive impacts is quickly becoming understood by those working with football head injuries. The research shows that the average football athlete suffers between 700 and 900 subconcussive impacts during a single season with lineman suffering the most.

Since most of my impacts have been subconcussive impacts, this is an area of great interest for me. My life changing injury was more of a whiplash injury than an impact. All I did was take a bad step off a curb and land with a jarring vertical foot plant.

Neuro's need to understand that it is the symptoms that determine the injury, not the amount of force estimated.

So basically.. if i tap my head, with my finger, as if I were playing some sort of intangible instrument, that could qualify as a "subconcussive blow" as it is under the threshold which would be considered necessary to inflict a concussion upon myself...?