Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 08-27-2020, 02:56 PM #1
Tbaughcome Tbaughcome is offline
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Default Sharp pain in head with Heavy footstep

Hello all,
This is my first post on this forum despite visiting it on a multitude of occasions for reassurance, the physics of a concussion, etc.

I suffered my first concussion (mild) in November of 2018 after being headbutted in the back of the head while going up for a header, and my symptoms were characterized mainly by a dull headache throughout the head and a foggy brain. I thought I recovered in a matter of days, returning to sport (soccer) in a week's time. A dull headache persevered throughout this timeline, but I felt enough cognitively stable to continue sport and my schooling (in retrospect quite foolish).

I suffered my second concussion in April of 2019, this one far more severe. Sprinting to a certain position in the box, I ran full-speed, head-first into the back of opposing player's head as he backed into position. I was facing slightly away from him, so my nose made first contact. The next thing I remembered was awaking on the ground on the opposite side of the field. Though uncertain if my nose fractured, it was bent out of shape and the trainer on sight neither diagnosed me with a concussion nor suggested anything about my nose. At the time, I only felt really a headache around my nose and forehead. The trainer said it was ok to continue play provided that was my only symptom (buffoonery). I continued playing (more buffoonery), and the worst that happened was slide-tackled and spun in mid-air and upon landing, it felt like my eyes lulled.

The next day, I went to a physician, he x-rayed my nose(not broken), and I informed them of my headache. I was informed it was unlikely I was concussed. The next day I played in another game. I spent the entire day unable to focus at school, with a severe headache, brain fog, and I did not feel like myself. I, however, was in extreme denial. In the game later, the ball was punted in my face twice, in both instances feeling quite dizzy after the hit but continued play (I am quite ashamed of my disregard for my health).

Since then, I have been suffering from PCS. At around 16 and half months now, I have given up my sport and live with the same timidity and reticence that the quite of anxious of us do. I have, however, taken upon a more academic life and am quite happy with myself and my life. I do, however, get anxious from time to time about a head bump or jerking motion, but I recover and attribute it to anxiety mostly, as that usually has distinct symptoms.
I come here today because I'm somewhat perplexed at the sensation I've started to experience when I walk. Going down a hill, my footstep tends to be heavier and in doing so, a sharp pain will course through my head if I walk on my heels. It is brief and then subsides into the subtle forms of the more general symptoms of my concussion as listed previously.

I was wondering how much experience people have with this and what it signifies. For the record, this is not an "am I concussed" post, but it does hurt like hell even if ephemerally. It feels like a sub-concussive hit my head (for instance a strong header in soccer with a headache that lingers). I have noted in the past that when I maintain good posture, I can still feel the "bouncing of my brain" but it does not hurt. I have a sharp pain when pressed slightly above the last protruding bone in the neck and my neck and shoulders are incredibly stiff, for the record. Thank you and recovery to you all.

Tyler
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Old 08-27-2020, 08:18 PM #2
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Hi Tyler,

Sorry to hear about your symptoms. There are others on here who experience similar things. The feeling you can "feel your brain move" in your head when you move thing is described somewhat often on here, and there seems to be a few variations of it.

The good news is that you can't actually feel your brain--this is all just proprioceptive sensations that likely come from either your vestibular system or the nerves in your neck. Basically, the way I understand it, your brain thinks your head is moving a lot more than it actually is because stuff is out of whack., So these sensations are really extreme with small movements. Don't have to worry about brain damage This is literally your brain playing tricks on you.

I've experienced a variation of this (I call it motion sensitivity) that is a vestibular thing...where my brain is amplifying the signals sent from my inner ear to my brain. I used to get "headaches" with every step I took. My issue was diagnosed as migraine-related, so I'm being treated for that.

You mentioned you have problems with your neck, so I wonder if that might be the cause, as a lot of other folks have issues with that on here (maybe some of them can weigh in). Worth getting it looked at. If you search old threads you'll find a couple where people describe having this issue and then having it resolved when they got an underlying neck injury treated.

Also, this symptoms is not well-understood in the medical community. It took me a while to find one who knew what was going on.

Best of luck!
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Old 08-27-2020, 10:14 PM #3
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Tyler,

Welcome to NeuroTalk.

First things. You have been fed a load of lies about concussions. If you were knocked out, you were seriously concussed. If you have headaches after an impact, even just a strong header, that is a concussion, not a subconcussive impact. Subconcussive impacts do not cause headaches. They have no symptoms except maybe an awareness of 'woah,' I hit my head.

The doctor who said you were not likely concussed is an ignorant doctor. I would go as far as to call him an idiot. Your trainer who returned you to the playing field IS an idiot, a grossly negligent one at that. Trainers have access to excellent concussion information. He must have avoided it or is one of the concussion deniers.

btw, What country/state do you live in? Many states have regulations for management of concussions in sports.

Nobody should ever return to play after losing consciousness. Often, a 2 week wait is the minimum if there are no symptoms at 2 weeks. A concussion trained doctor's release is important.

As you realize, your soccer is over. Your head butt to the back of your head likely caused a concussion that included an upper neck injury. The 1st 2 cervical vertebra are easily injured and can take many months to heal, even years if they are not allowed to heal. The joint between C-1 and the skull (occiput) and between C-1 and C-2 are not very stable and need gentle rehabilitation.

Walking with a heel first foot plant gait can be rough. Put ear plugs in and listen to your heel hit. Try to walk to reduce that pounding. Learn to walk down hill with a bent knee or landing on your toes. This will reduce the pounding.

Feel free to post any questions. I have 50 years' experience with concussions. My soccer playing was ended by a header in 1970.

It appears you may be in SC.

Here is the SC law regarding Concussion Management in High School Sports:

2013-2014 Bill 3061: Student athletes - South Carolina Legislature Online
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Old 08-27-2020, 11:22 PM #4
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[I have a sharp pain when pressed slightly above the last protruding bone in the neck and my neck and shoulders are incredibly stiff,]

I suggest looking at upper cervical treatment information and also physical therapy for the neck/shoulder soft tissue.
Treat the symptoms that you can and the rest may improve.

Up C Spine has very good info and the National Upper Cervical Chiropractic Association - NUCCA.
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Old 08-28-2020, 10:27 AM #5
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Thanks for your response Burrito Warrier,
I have been looking into vestibular therapy and neck exercises to alleviate some of the motion sensitivity if possible. How long do your migraines typically last? The anxiety from the event compounds my symptoms somewhat, so our timelines would certainly be different.
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Old 08-28-2020, 11:01 AM #6
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Thank you for input Mark,
I certainly concur with the fact that i was misinformed and ignorant concerning the nature and precautions of concussions and concussion protocol. I curse myself everyday for my mistakes but it is what I have to live with. I have definitely come to terms with never playing soccer again competitively, and in retrospect, have come to realize that I have probably suffered more concussions than those documented, from headers and the like. I am 6'5" and have always been tall, so I was always called upon to win the ball off goal-kicks and set-pieces. As you said, the onset of symptoms following a header is indicative of a concussion provided no other extenuating conditions. My concern is that if that were true, I would probably have 15-20 concussions at this stage. Cognitively, I do not feel like I am at such a stage of disrepair, though I am young so I suppose healing could be expedited. I generally noted such a sensation after my first diagnosed concussion so I wonder now if you believe that the header could compress the cervical spinal cord briefly, leading to a sharp pain should their be a lack of stability or lingering subtle injury. Otherwise, they were merely concussions, which is concerning.

As you concluded, I do live in SC though I recently moved to Troy, NY for school. It appears the trainers have immunity and though I did report symptoms after coming off, though I did not admit to a lack of consciousness, on both accounts of my diagnosed concussion I was given a cognitive test (recite words, number, dates) and succeeded without fail on each. I did so at a physician following my first concussion and again at a neurologist after my second, more severe concussion. I put my hands in the trainer's hands on both accounts (different trainers), and it is clear the process should be refined.

As the Burrito Warrier made clear and as I have come to understand through experience, these sharp pains with footsteps are not concussive. I have experienced similar sensations in the car bumps in the road and whatnot as many others do. The difference for me is that I am concerned that they mimic my experience with headers in the past after my first concussion. Perhaps I am generalizing the pain, but what I experienced then with headers, and what I experience now with heavy footsteps and the occasional bump in the road, is the sharp pain that courses through the head and then a lingering headache behind the eyes. Given my experiences and readings, there are three things that can contribute to this: a neck issue, migraines, or brain damage (brain damage the only other option but illogical and an anxiety-induced conclusion). As you suggested, I have modified the way I walk since my most recent concussion, many saying I walk strange. I suppose what I am asking is if, from the further information I am providing, if you think it is a neck issue or a migraine related issue and where I should direct my efforts in terms of treatment. Obviously I can try both, but in terms of professional advice, financially that is more trying.

On a lighter note, how unwise is it for me to kick a ball about with others? It would not be a game, but it is difficult to meet people without doing activities like frisbee, soccer, etc. in college at first. As someone with so much experience, what are the limits of your physical activity, if you don't mind my asking? I know that is relative to the individual, but one grows incredibly tired of merely a stationary bike.
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Old 08-28-2020, 03:33 PM #7
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During injury recovery a general suggestion is to limit any possible impact or rough, jarring, aggravating activities while you are having bothersome symptoms..
If walking is still an issue then maybe kicking a ball might be aggravating for now..
Might look at Feldenkrais and Alexander movement - this may help others that have issues with body movement & hard step sensations..
Feldenkrais - Google Search
Alexander movement - Google Search

Caution and care for now will pay off in time..

Return to activities as your body allows, with no increase of any symptoms....listen to your body....
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Old 08-29-2020, 01:02 AM #8
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Tyler,

As Jo*Mar said, limit your risk of head impacts. If you can kick a ball without a need to head it or a risk of others kicking it at your head, you should be fine.

The neck injury is not usually a spinal cord injury. It is a spinal joint/ligament injury that can radiate when aggravated. The inflammation in the neck can impact nerve signaling that can cause a myriad of symptoms. It can change blood flow to the brain stem and such.

Icing the neck if you have a headache or any other symptoms is good. Headaches can be triggered by neck trauma, especially when you have tenderness at the bony spot behind your ears. That indicates ligament strain and muscle spasm from the neck.

An important issue for you is sleep posture. At 6'5", a bed that allows straight head and neck position can be a challenge. Your neck can be stressed when you sleep since no muscles are holding the neck in alignment.

I doubt you've had 15 or 20 concussions. More like 5 or 10 concussions and hundreds of subconcussive impacts if you did a lot of heading.

I would like to see contested headers outlawed, especially from corner kicks or in the goal box/area, maybe even the penalty area. Too many lives are changed by concussions in the goal box/area.

It sounds like you got an abbreviated sideline SCAT test. To make matters worse, nobody ever scared you and impressed in you the importance of being forthcoming when you have symptoms. They don't like to risk losing a key player. But, you can be gambling your future.
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Old 08-29-2020, 11:38 AM #9
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Quote:
Originally Posted by Tbaughcome View Post
Thanks for your response Burrito Warrier,
I have been looking into vestibular therapy and neck exercises to alleviate some of the motion sensitivity if possible. How long do your migraines typically last? The anxiety from the event compounds my symptoms somewhat, so our timelines would certainly be different.
For me (and again, it sounds like our symptoms are somewhat different since your neck seems messed up), it's like I feel a pressure sensation in my head opposite to the direction of movement. When I used to walk "heavy on my heels", as you describe, the pressure sensation would be on top of my head, and if it was great enough, I would feel it as more of a pain than a pressure. If it was greater still, the pain would linger after the motion had stopped (as a headache). Same with bumps in the car. But stopping quickly in the car, I'd get it in my forehead, if that makes sense. Took me a while to pick up on the pattern of it, but the pain/pressure was always in the same "plane" that I was moving in. Once I learned that I was just feeling sensations that I was supposed to feel but WAY amplified, it all made a lot more sense.

These "headaches" never came with any other symptoms and never lasted any longer than a day or two at the worst (though the symptom itself was disturbing and did cause me anxiety until I figured out what it was and adapted to having it).

For me, there were five or so instances where I moved significantly more suddenly compared to what was "comfortable" at the time (tripping and falling, for example), and each time it cause me two days worth of really awful additional symptoms (fogginess, dizziness, head pressure, ear popping, etc.) and then about a 6-month regression in the motion sensitivity symptom. These were what was diagnosed as "migraine attacks" (with primarily vestibular symptoms).

I don't know if any of this was helpful..,everyone is going to be slightly different, and I never had the neck issues. You will find so many stories of it on here, though! Hopefully you can find a good doctor. I honestly went through about 6 or 7 before I found one who really knew his stuff, and it made a world of difference in my progress, so don't give up on that. Don't be afraid to advocate for yourself and ditch one if they aren't working.
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Old 08-29-2020, 12:14 PM #10
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I agree, don't settle for poor MDs or poor PTs, DCs or from any treatment providers.. seek out better care providers..
Really good ones are out there..
Read online reviews and look for informative website information..
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