Hi Everyone, I'm new here and appreciate the ability to join this space.

I crashed on my bike last week - went over the bars and landed hard. I was able to get my arms up in front of my face while mid-air. They caught most of the crash but my helmet visor was pushed up a bit and I caught a small scrape on my chin. Still, I didn't feel much of a head impact (if any) but immediately felt my neck tighten up.

Since then, I have had severe neck tightness, intermittent headaches that are obviously craniosacral, but also headaches across my temples. It's these temple headaches that make me worried I had a concussion despite avoiding a hard blow to the head.

I had two concussions in 2015/2016 from hockey and avoided them for years after before a direct head-to-ground impact mountain biking last summer. I recovered with vision therapy and have felt amazing recently. Each of those concussions came with wooziness and disorientation that I do not feel right now. My balance seems totally fine and my vision feels healthy, though a bit fatigued at times. But the temple/forehead headaches that come and go are really stressing me out...

I am diagnosed OCD/anxiety and have years of therapy under my belt to combat it. I really struggle with concussions as my therapist and doctors are usually in direct odds - one says to ignore it so as not to obsess and the other says to take it very seriously.

I'm reaching out to this community for advice on how to take it from here. Based on your experiences and my description of the crash, do I need to treat this like a concussion? Or do I have whiplash and a bad case of anxiety that is manifesting symptoms?

Thank you for hearing me out.

Sounds like more of a neck strain or whiplash thing..
Treat the neck muscles and see if things improve.

There is nothing to Treat as a concussion. There is no general concussion treatment.

You treat the symptoms, not the diagnosis.

80% of concussion symptoms are neck related.

Take care of your neck.

The doctor or whoever says to be concerned is wrong.

What does that doctor suggest doing about it? What is that doctor's training level regarding concussions?

Yes, take the risk of concussions seriously. Wear a good helmet. Many bicycle helmets are marginally better than useless. They don't protect because they don't stay in place.

Hi Mark, thank you for the thoughtful response.

The last "concussion doctor" I went to was a sports medicine doc I saw last summer. All ego, no real treatment advice besides ambiguous advice around brain rest. The PT he referred me to and VT I found were far more impactful than anything he could have told me.

You and Jomar have prompted me to make another appt with my PT to get my neck looked at again, I really appreciate the advice.

Where I am still stuck is this whole concept of "brain rest" that every Dr seems to prescribe to various capacities. I know no one can really tell me certain if I had a concussion, but I would love to know if I can push through headaches from a tight neck or if I need to listen to the headaches and stop doing things because they are impacting my brain. This is where the ambiguity between Dr/Therapist advice is frustrating, as I just want to make sure I am doing the right thing to get better as fast as possible. If brain rest is truly needed, wouldn't the advice from my therapist potentially elongate symptoms?

This is a really unique problem I deal with and a lot of folks on this forum seem to face, so I really appreciate the intelligent discussion.

A tight neck and possible trigger points in the muscles can cause referred pain and symptoms like headaches.
Here is one info site
The Trigger Point & Referred Pain Guide

Search our site or Internet for trigger point information and see if it fits. Some TRPs are self treatable. Some are harder to reach yourself lor near side of the neck where artery and nerves are.
Quality PT is a good starting base treatment if you find trigger points or for a chronic sore neck.

Don't push through the pain. It's best to listen to your body and rest accordingly.

Trying to determine whether or not there was a "concussion" is futile and besides, your course of action will be the same either way. The headache could be from inflammation which can occur with or without a concussion, or from the neck injury.

The amount of rest you give your brain depends on the severity of the symptoms. And the type of rest you want to give your brain is to avoid high-level intense cognition like computer work or driving. So lower your activity level to a level that you can tolerate comfortably. Once your condition stabilizes and begins to improve, gradually increase your activity level.

Anxiety is linked to brain inflammation and concussions are an inflammatory condition so seek treatment to reduce related inflammation.

Welcome traxtion.

Brain rest is too vague. If an activity increases your symptoms, reduce the level of that activity or stop the activity. BRAIN REST, as many present it, it counter to recovery. You need to keep the brain mildly stimulated without increasing symptoms so you get good blood flow through your brain. Blood flow is key. Good sleep at normal sleep times is also key.