Written by: Dr. Jeffrey Sankoff
Several years ago I was racing in the Ironman 70.3 California when, during the bike, I came upon a rider who had a bad crash. He was lying on the ground, completely unconscious. With the help of a Marine who was assigned to that very spot on the course, we carefully stabilized the fallen rider’s head and neck and ensured that his airway was open and he had a pulse. His helmet was shattered and he had a cut over his temple. That helmet had likely saved his life and, although he had sustained a significant traumatic brain injury (TBI), he would survive to race again.
Lately there has been a heightened awareness of the frequency and effects of head injury in sport. While this is more of a problem in contact sports such as football or hockey, triathlon is not immune. Get to know the signs and symptoms of minor head injuries as well as the risks of ignoring them.
The classic term for a minor head injury is “concussion.” They can result from even mild force to the head, and in triathlon are most likely to occur from accidental contact during the swim or on a fall during the bike.
While the understanding of a concussion at the cellular level remains unclear, much is known about the short- and long-term effects of even mild TBI:
The likelihood of a second concussion is much higher after a first episode.
Post-concussion syndrome can consist of dizziness, difficulty concentrating, headaches, nausea and vomiting, and may last from days to months.
Repeated concussions may result in memory loss and progressive brain deterioration.
If you get a concussion, you should avoid activity until all symptoms have resolved. A gradual progression with light exercise escalating to full exertion over several days is OK so long as there are no symptoms during or after any session.
Physicians are notorious for ignoring their own advice, so it may come as no surprise that I once completed a half-Ironman after being struck in the face during the swim. Although I knew I had sustained a very mild concussion, I did what any triathlete would do: I took it as a challenge and pushed through the pain. Had I been volunteering in the medical tent I would have insisted that any athlete in my circumstance be retired, as continuing after a concussion is simply not worth the risk.