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The invisible danger- Written by Heather Fisher

My first concussion was in the spring of 2017. The injury that I sustained was different than any of my other crash injuries in the past. I didn’t have the road rash signs or bruising to indicate to me that actually had an injury had occurred. Therefore in my mind, I didn’t understand that it was a serious injury that required a medical evaluation. I just took a few days off before getting back to training and I was racing a week later . Two weeks later, I crashed again on a training ride, hit my head and even experienced memory loss. Again, I didn't see a doctor, just treating it like another crash and taking the allotted amount of time I would normally for any crash. I carried on my training and racing, still able to perform due to my fitness and experience, but I was not ok. I was suffering from constant headaches which would become migraines after really hot or intense days on the bike. I had a lot of trouble sleeping. I was more emotional than usual with drastic mood swings. I experienced depression and panic attacks, one memorable one immediately after the Redlands Bicycle Classic criterium.

Looking back on it now it is important to share my story so I can let people know that a concussion is serious business, but also that if you proper concussion protocol and help, it does’t have to mean that your cycling career is over. That fear I think is what drove my to ignore so many of my symptoms. I was scared of seeking medical attention because I did not want to be told to take a break from racing. I also was scared of making a "big deal" of it with my team and coach because I felt the pressure of my contract, the pressure to succeed and the fear of losing the momentum that I had worked so hard for in all of the years leading up to that moment. If the people on my team, my coach or my friends knew more they would have told me to stop and seek medical treatment. If I had immediately sought treatment from a concussion specialist and gained access to physical therapy and taken a more measured and monitored return to training and competition I would have saved myself a lot of pain. It was very easy for me to hide my head injury. It is normal for people in competitive environments to hide any sign of weakness. I was strong enough to push through it and I had the skill and experience to continue to do my job and help my team get results. My worsening symptoms ultimately took me out of the sport at the end of 2017. I let people think what they wanted. I continued to hide my problems. It's taken me three years of medical treatment and refocusing my life and athletic goals to get back to a better place physically and mentally. I hear stories like mine from a lot of other athletes. I've decided to stop hiding. I've learned these last few years that it's better to be vulnerable even though everything inside of me resists it. It's ok to not be ok.

if you, a friend or teammate sustains a concussion, it’s ok and recommend that you stop. Stop your race, stop your training an seek proper medical treatment. This will result in you getting back to racing sooner. Not stopping could mean a whole lot of potential problems and a longer time away from the sport. It can be difficult to stop because we are athletes and programmed to push through, be resilient, and embrace pain. Let’s ask ourselves, would we stop if our leg or collarbone was broken? Even the most resilient athlete would consider stopping the race with any of these types of injuries. Why? Because we can see them and because they are all socially recognized and acceptable reasons to stop play and seek treatment. Because concussions are invisible injuries they are often under diagnosed, overlooked and considered less of an injury by athletes, coaches and spectators. We need to start recognizing concussions as being as significant as visible injuries. I believe this requires an increase in education and a change in culture which can be a lot more complicated than education. For example, most of us learn about some level of proper nutrition in school but does that mean we suddenly change our habits and beliefs in the kitchen with this newfound knowledge. No. Let’s be real. These kinds of behavioral changes take time, they take planning and they take social acceptance and cultural reinforcement. I believe the same is true of concussion culture in the cycling community. We have to educate ourselves, our family and friends and teammates. Our coaches and team directors need to be more knowledgeable on these types of injuries and the symptoms and timelines associated with them. We need to be more cautious about our heads. We need to get comfortable with stopping the race or removing an athlete from the event. We need to speak up when something doesn’t seem right. There needs to be a plan, a team protocol in place so that people know what the next step is when things are fast and hectic on race day. It is vital that we do not leave it up to the concussed athlete to decide if they are good to continue. We should not allow our feelings about the importance of an event to take precedence over an individual's health. All it takes to change a racing career or potentially someone’s long term health is a more knowledgeable rider, a more knowledgeable observer speaking up and social change to the effect that everyone believes that head injuries are serious injuries and need to be dealt with immediately. There is a big difference between saying we care about concussions and then actually preparing for and enforcing a medically advised protocol so that people in leadership positions are not only knowledgeable but held responsible for the management of injured riders. It's too easy for invisible injuries to slip through the cracks. If we care about the health and future of our sport then we need to address the issue of concussions.This is the first article in a series on concussions. 

Please check out the CDC Heads Up to Youth Sports: Online Training regarding concussions

https://www.cdc.gov/headsup/youthsports/training/index.html

Here’s a link to an awesome educational video with Mountain bike World Champ Kate Courtney

https://usacycling.org/article/crashcourse-brain-fly-through-with-kate-courtney

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