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


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Old 04-19-2021, 04:09 PM #1
Alaska89 Alaska89 is offline
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Default How much should you rest after a setback?

My initial concussion which triggered my PCS was in August of 2018. Until two days ago, I had not had any "setbacks" or major events that triggered symptoms since October of 2019. So I had been mostly symptom free and improving every day for a year and a half.

Then, two days ago, it was a beautiful day so I decided to go on a bike ride on a trail that I rode many times last summer. Unfortunately, there had been some recent construction on the trail, and it was torn up by construction vehicle tire tracks which had hardened in the mud. I did not realize this until I made it some way into the trail. I decided to tough it out, as I have a full-suspension mountain bike and I rode several fairly bumpy trails last summer with no issues.

I ended up spending 30+ minutes grinding across the hardened tire tracks, sustaining nearly continuous vibrations that my bike's shocks failed to fully absorb. Eventually I got off my bike and walked with it most of the way back to my car.

The rest of the day I felt a little off but mostly okay. Yesterday I felt a little off, but went on my usual jog and had no headache afterwards. Today I have felt worse. Symptoms are slightly blurry vision, slight light sensitivity, fatigue, brain fog, depression, and a general malaise feeling that seems to intensify the more I wonder about whether that bike ride did any physical damage to my brain.

My question is, under these circumstances, how much should I rest? My symptoms are vague and I cannot nail down whether they are concussion symptoms or the result of general anxiety/stress. When in doubt, what should I do? I have tried doing nothing today, aside from some video games and a short walk, but I seem to feel worse because I'm sitting around worrying about how much I should rest!

I am a student and luckily I have a light week ahead of me, but starting next week I am moving into a final exam period which will last several weeks and will be very intense. Sticking to my routine is crucial to my managing of stress and general depression/anxiety that I have apart from PCS.

So, does it sound like I had another concussion and should I fully rest as much as possible or should I push through and stick to my routine (which includes coffee, ice cold showers every morning, jogging every other day, other light exercise whenever I can fit it in, and studying/reading/writing 8-10 hours a day 6 days a week)?
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Old 04-19-2021, 08:14 PM #2
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Stress is more likely to cause a relapse than a rough ride. Worrying about a rough ride that obviously stressed your body and especially your neck is the king of stress. Rest is not video games......They are stressors.

I bet your body was surging in lactic acid from your beat up muscles.

You do not need to be resting at all. Let symptoms be your guide. If symptoms increase, stop the activity. Jogging is rough on the neck and can put vertical loads on C-1 and C-2 causing inflammation, just like your bike ride. Avoid all stressors until after exams.

Caffeine should be avoided.

Studies show that people 80% of people who suffer long term PCS have a pre-existing struggle with depression and anxiety. Resolving that will be a great improvement.

The vitamins regimen in the sticky above helps many tolerate stress. Adding 5-HTP and L-Theanine also improves anxiety and depression symptoms without drugs.
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Old 04-20-2021, 01:16 AM #3
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Hey Alaska 89,

I would say that your symptoms have nothing to do with concussion and everything to do with pushing yourself hard on a lot of fronts.

Your student work load is enormous. You should congratulate yourself on extraordinary discipline. However are you studying effectively? It's important to take frequent rest breaks between study sessions to actually speed learning. There's a lot of information out there on study techniques/ simple memory training that make studying more effective and fun.

I think your body/mind is crying out for rest and you attributing natural fatigue to an old concussion. Naturally it is making you anxious. and stressed. If your body/mind is telling you to cut back then listen to it.

Best wishes,

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Old 04-20-2021, 05:09 PM #4
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Leaning forward on a bike & adding in very bumpy ride is a big factor in neck /arm tension/stressors..
Consider how much your head weighs, then add in the factor of how it hangs out in front of the body on our neck..
There are calculations on the added weight & stress to our neck muscles, shoulders , even upper back adds in to it..
A web search can find that info..
Plus you naturally would tense up from the bumpy ride, so that stifles the free flow of good blood/oxygen to the areas involved..

Cyclist's Neck - Physiopedia
more...
how much head weight is added to spine when riding a bike - Google Search
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Old 04-20-2021, 07:26 PM #5
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I appreciate everyone's responses. As Mark and Jomar suggest, I have long suspected that I have a subtle neck injury, which I apologize for not mentioning in my original post. Stress is also a factor that I try my best to reduce.

The "concussion clinic" I went to in 2019 referred me to a physical therapist who prescribed various neck stretches, which I used to do daily until recently. I'm not sure if they help, but I figure they can't hurt. Also, I'm not sure what else can be done if it is a neck injury.

Today I studied most of the day, and seemed pretty good until later afternoon when I stopped for the Chauvin verdict (I live near the twin cities). At that point I realized I had an inordinate amount of brain fog that continued to accumulate when I tried to keep working.

Is it normal for brain fog to increase during cognitive work and staring at a computer screen with a neck injury? Also this may be a stupid question, but is it possible to make a neck injury worse by "pushing through" symptoms?

I do notice a very subtle tender/sore spot at the base of my skull on my right side, kind of where the C1/C2 vertebrae that Mark mentioned are located. What other indicators might there be to know for sure that I have a neck injury?

Thanks everyone.
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Old 04-21-2021, 12:36 AM #6
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Subtle neck injuries may manifest as a tender spot at the bone behind the ear.

Neck stretches are not therapeutic. Neck strengthening with minimal movements can improve the muscles but the ligaments take a long time of no stress to improve.

Good sleep posture and good head and neck posture while looking at a computer is important. Texting neck posture is the worst. Do not look down at your phone and text with your head tipped forward.

Staring at a computer screen is not helpful to recovering from brain fog.
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Old 04-21-2021, 01:06 PM #7
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You might also look up trigger points - there are websites with interactive body maps , symptoms and can help to find out if you have them.
If you have trigger points- stretching will not get rid of them, you have to apply pressure right on the tender spot until it fades away..then gentle stretch to bring good flow into the area..
The wrong stretches or too aggressive stretching can make things worse..

This is a good one for neck & upper back..
Pain Reference Chart
you don't need any special tool, a thumb or pencil or such works fine..

trigger points chart - Google Search
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Old 04-22-2021, 12:41 AM #8
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Hey Alaska 89,

Brain fog is perfectly normal with excessive computer and means you need a break. Regular breaks are essential for exam preparation and learning.
A lot of young people these days will study, then look at their phone and then play video games. All of them employ the same bent over posture and use the same brain circuits resulting in fatigue and the symptoms you have described. It would also explain the symptoms you experienced off road cycling that employs a forward head posture.
Running requires an upright posture as does walking and these are great ways of relieving stress caused by excess near vision tasks and resting brain circuits associated with convergence. On top of a previous neck injury this is the most likely explanation given your extraordinary revision schedule.

You may have something called upper crossed syndrome ...

Upper Crossed Syndrome: Exercises, Treatments, and Symptoms

I urge you not to automatically blame a previous concussion for your symptoms. Anxiety and concussion are separate entities.

What are you studying?

What do you hope to do post examination?

Best wishes,

Atty
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Old 04-22-2021, 03:31 AM #9
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Jogging causes a vertical impact component in the upper neck. If it is traumatized, those vertical impacts can cause inflammation.
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Old 04-25-2021, 10:34 AM #10
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Atticus, you are absolutely right about the poor posture/brain fog from too much screen time. I usually spend most of my time in front of a computer or reading/studying, and then I watch tv and play video games in the evening. I am trying to alter this pattern but with covid/quarantine it's hard to do activities out of the house. Walking and especially jogging were my biggest stress relievers and they break up that pattern.

I am in law school and am about to graduate at the end of the summer. Law is an inherently stressful profession, but I am planning to specialize in tax and estate planning, which should be less stressful because it is not a litigation-driven area.

As a quick update, I went for my usual jog a couple days ago after abstaining all week, and I wound up with a terrible headache afterward, which is what always used to happen after any trauma events to my head/neck.

Yesterday it was sunny and it killed my eyes to the point I couldn't go outside. I also have fatigue, brain fog, and nausea throughout the day. It's worth mentioning that my two daughters were sick with a virus (not Covid) all week which I may have picked up, but I am not having any of the symptoms they had. It has been one week since the bike ride.

My plan is to listen to my symptoms and stop when activities make things worse. However, I have two final questions:

1) Cold showers - does anyone have any experience/knowledge/theories about whether they could delay healing or otherwise be bad for a head/neck injury?

2) In the morning, while laying in bed for 5 minutes or so before getting up, I get this grinding/popping/crackling sensation (the closest comparison I can think of is the "pop rocks" candy) in the back of my head, right where my spine connects with the base of my skull. I remember looking into it in the past and learning that it may have something to do with the cerebrospinal fluid. This is a reoccurring sensation that has always followed any physical trauma (no matter how minor) to my head/neck since my pcs began. Does anyone know anything about this?

Thank you all and God bless.
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