Strava for the Brain

Crashes stink. I recently had a little crash at the 9-5 Mountain bike race. I mainly landed on my shoulder and hip but I hit my head with enough force to hurt my neck too. It got me thinking about concussions and brain health. How would I know if I really hurt myself? There was a time years ago when people would joke about their concussions. They would say “Oh, I got hit so hard I didn’t know if I was mountain biking or kayaking.” Or stories of football players who played an entire half of a game and didn’t remember any of it. There is really nothing to be proud of when it comes to concussions, except for treating them correctly. In high school sports, there is a mandate for baseline concussion training. In adult sports, there is no such mandate. People go back to playing as soon as they feel OK. I don’t think that this is the healthiest way to go about things. This thought process led me to Derek Kunz M.D. of St. Alphonsus Sports Medicine. Dr. Kunz is a physician with an ER background who specializes in sports medicine. He handles a wide variety of cases including sport related concussion. He and his staff performed baseline tests on me and found that I am pretty much… average. But the purpose of the test was not to determine how I stand when compared to other people. The purpose of this testing is to see how I compare to myself. Specifically, how I present after an injury compared to how I was before the injury. He performed a battery of test including computer based and clinical examinations. These tests looked at many types of cognitive and motor functions. The tests used were ImPACT for cognitive function, BESS Assessment for balance, and baseline vision screening. Much like using the Strava cycling app to gauge performance on the bike and progress through a season, this testing gives a baseline of brain performance. We went over the information after the test and found that while my accuracy was fairly high, my reaction time was low. This finding indicates that I spent time processing information in order to make a response. He said that the same person may flip-flop on alternate tests because they may try to speed up and in doing so be far less accurate. There is now information in the physician’s and my hands. If I am injured in the future we can use it as a comparison. It will be useful to know what my deficits are compared to my uninjured self. We will be able to specifically put together guidelines for treatment or return to sport. This data gives me great confidence in judging return to activity if I have an incident. I see great benefit in baseline testing for adult athletes who are at risk for concussion. I highly recommend it. Ron Miller PT MS OCS Here are some resources: Derek Kunz MD Concussions in Cycling Consensus Statement 2012 Facts about Concussion and Brain Injury

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