Back of head injury how to get back into it

[LengLeng]

Two days ago after training I was doing some body work (my gym in Yangon opened up with some measures in place). My body and head were pretty sore after some tough sparring. I played around with tractor tires and I tried to lift and flip one overhead. But I lost balance, fell backwards smacked my head into the asphalt and then the tire smacked me in the face. I didn't lose consciousness and no amnesia. I have a lot of scrape wounds in my face and my nose was bleeding a lot but no back head wound, just a big bump. No nausea no sickness just dizziness and aches.

The day after -just to be sure- I went to the hospital (had to go to three in total jeez) and a doc did a neurological examination checking reflexes and all that stuff. Nothing seemed to be wrong and they didn't feel the need for a scan as I had no symptoms of inner swelling. 

It was a nasty hard blow but I doubt I even had a concussion. 

Anyhow, I rested one day and thought I would do some light swimming today. Unfortunately I have to work although thinking feels overwhelming a bit. 

Since fighters are the best to ask about these stuff, any advice on how to get back into training? What to think about? 

I feel so stupid getting injured like that first day back...

[Oliver]

God that sounds horrible... and especially on a rock hard floor like that. 

Can you not get more time off work from your boss? You got hospital receipts for evidence.

Never had anything like that from muay thai, only slipped in the shower once and then head crashed on the side wall tiles. Stitches and pain, so rested at home after.

Feel better soon

[LengLeng]

1 hour ago, Oliver said:

God that sounds horrible... and especially on a rock hard floor like that. 

Can you not get more time off work from your boss? You got hospital receipts for evidence.

Never had anything like that from muay thai, only slipped in the shower once and then head crashed on the side wall tiles. Stitches and pain, so rested at home after.

Feel better soon

Hey thanks so much. Yeah it hurt so much but ok..stitches from slipping in the shower sounds more painful.

I could get time off work, but I'm involved in the country's covid response activities so it's more my own choice. 

[Oliver]

That's a great thing to be doing, being part of the effort to help  

And no way...a shower slip doesn't compare - you landed on concrete with a tire on your face. You win this one

You might have even earned the right to be selfish and take another day or 2 days rest. But your call if course

[Kevin von Duuglas-Ittu]

6 hours ago, LengLeng said:

It was a nasty hard blow but I doubt I even had a concussion. 

Sylvie and I have really thought about these things, and in fact recently have been measuring an injury. This the problem, it's very difficult to tell if there is a mild concussion. I mean, if you have nearly zero of the symptoms (fogginess, poor or too much sleep, in ability to concentrate, and the other physical ones you've surely searched), that is a super good sign, but it doesn't mean that there is no brain injury. Because of what you do is prone to mild brain trauma our thought has been: just be super careful and conservative that it is healed. From our Google about 7-10 days, with zero symptoms towards the end, is the broad safe advisement for a mild concussion. The problem with brain injury, even mild injury, is that it makes you more prone to more brain injury. And what you do is full of lots and lots of mild impacts. Even if you aren't sparring or directly getting hit in the head, really vigorous bagwork can be somewhat rocking. You don't want to get on a track where you can't do what you love because a brain injury groove has been worn.

We've also paid attention to some research that suggests that a ketogenic diet can be beneficial to brain repair, so being even more super strict against carbs is something we've moved to, and adding Omega 3 fats (fish oil) which also has reported benefits. Who knows with these studies and suggestions, but in a career and circumstance which may produce mild, undetectable but repeated injury, it might be best to be on the safe side.

So sorry you got hurt!

[Sylvie von Duuglas-Ittu]

Yeah, I'm not sure what to add to what Kevin said, since he's speaking from our shared experience with this. I'd say pay very close attention to any symptoms that might develop after the fact and, even if you don't have dizziness, fogginess, headaches, or anything like that to still be very cautious in resuming anything that rattles your brain. So, no sparring with head punches and see whether or not hitting a heavy-bag causes any kind of discomfort to that area of your head (from the impact, obviously not from contact). 

Maybe increase Omega 3 fats in your diet to help your brain heal as well, knowing that it took a shock even if you don't have any concussion symptoms.

[Oliver]

When the doc did the neuro exam on you, what kind of things he look for/ask you? 

Got told the same after the shower thing on the back of my head, even though really wanted the MRI or whatever it's called, doc said no need and all fine and sent me away. This was a Thai hospital so couldn't really communicate much

But felt scary anyway. Fine eventually but...it's the fact that the impact was in the back of the head that caused the worry. Never happened before, and feels different to getting hit on the forehead.

[LengLeng]

1 hour ago, Sylvie von Duuglas-Ittu said:

Yeah, I'm not sure what to add to what Kevin said, since he's speaking from our shared experience with this. I'd say pay very close attention to any symptoms that might develop after the fact and, even if you don't have dizziness, fogginess, headaches, or anything like that to still be very cautious in resuming anything that rattles your brain. So, no sparring with head punches and see whether or not hitting a heavy-bag causes any kind of discomfort to that area of your head (from the impact, obviously not from contact). 

Maybe increase Omega 3 fats in your diet to help your brain heal as well, knowing that it took a shock even if you don't have any concussion symptoms.

Hey @kevin and @Sylvie many thanks for these this very helpful replies. Although I have very little experience/knowledge I also instinctively feel my head needs to be still somehow. 

 Omega 3 of course, excellent advice. And it might be a good idea to start keto again. It makes sense it would be beneficial for the brain considering the nice sharp focus ketosis gives you and also the science on Alzheimer's and ketones. 

[LengLeng]

37 minutes ago, Oliver said:

When the doc did the neuro exam on you, what kind of things he look for/ask you? 

Got told the same after the shower thing on the back of my head, even though really wanted the MRI or whatever it's called, doc said no need and all fine and sent me away. This was a Thai hospital so couldn't really communicate much

But felt scary anyway. Fine eventually but...it's the fact that the impact was in the back of the head that caused the worry. Never happened before, and feels different to getting hit on the forehead.

Oh if it was a Thai hospital and they said MRI not necessary they were probably pretty sure as my experience is they are happy to do any tests. 

My injury happened during the evening and although I almost lost balance in the shower afterwards,because of night curfew and that I felt ok, it felt better waiting until the morning. I tend to hold my breath when I get nervous and with the face mask I think some of the dizziness came from lack of oxygen. 

My trainer went with me for translation and the first doc at a Thai affiliated hospital (SML) told me I definitely needed a scan and neurosurgeon. She referred me to SSC. At that place they wouldn't let me in, got concerned I'm a foreigner even though I have 0 travel history since January. Eventually they sent us off saying I should find a different hospital, because they didn't have the specialist I needed available right now.

So my trainer called one of his students who is a doctor who told me I don't need a specialist right away but a general practitioner can do the first check. So I went to a private hospital (Parami which has good reputation). Triage area was outside under a little tent. And then the doc (not a specialist) asked a lot of questions also questions like where I am and so on. He did the touch nose touch finger things, I had to close my eyes and tell him where I felt a tickle, he checked my neck for stiffness or looseness, checked my smell, pupils, I had to do a lot of gesture things with my hands and he also explained very well what and why he checked this and that. All in all it was very similar to neurological checks I've done in Europe. 

Right now I feel a bit like I wear a helmet forehead pain and neck pain. But ok and thinking doesn't exhausts me like the day after. 

[Oliver]

....God... The first doc that said to get the MRI scan but then the referred place denied you... That's fucked up. 

Hate to be the hypochondriac kind of person who overreacts, but did you say you went down on an asfalt floor? Does that mean like, concrete or something softer

 

[LengLeng]

1 hour ago, Oliver said:

....God... The first doc that said to get the MRI scan but then the referred place denied you... That's fucked up. 

Hate to be the hypochondriac kind of person who overreacts, but did you say you went down on an asfalt floor? Does that mean like, concrete or something softer

 

Yeah it's how it is with health care here...

Yeah it was outside, so basically like concrete. I'm still a bit shocked it went as well as it did. 

[Kevin von Duuglas-Ittu]

4 hours ago, LengLeng said:

 Omega 3 of course, excellent advice. And it might be a good idea to start keto again. It makes sense it would be beneficial for the brain considering the nice sharp focus ketosis gives you and also the science on Alzheimer's and ketones. 

From Googling about several sources suggest that the benefits may come from the idea that ketone energy requires less chemical steps, than the burning of glucose, some of that making it a favored choice during strain. But yes Alzheimer's too. I imagine also that autophagy, clearing out damaged cells, may also help.

[LengLeng]

45 minutes ago, Kevin von Duuglas-Ittu said:

From Googling about several sources suggest that the benefits may come from the idea that ketone energy requires less chemical steps, than the burning of glucose, some of that making it a favored choice during strain. But yes Alzheimer's too. I imagine also that autophagy, clearing out damaged cells, may also help.

Yes! I really do believe this from my own experience and (uneducated) research. 

[Kevin von Duuglas-Ittu]

I'm sure you googled around, but I'm doing so as well for my own interest. Ran into this timeline:

Quote

After a concussion, the majority of people recover from the initial symptoms within 2 weeks to 1 month.

Longer term effects are unusual, though an estimated 20% of people will experience persistent symptoms of post-concussion syndrome, where their symptoms last for more than 6 weeks...

...Concussion recovery can be more complicated for athletes. Some doctors may recommend as little as 7–10 days of healing before returning to play, although research from 2018 found that full recovery from concussion averaged 29.4 days. - source

I'm sure this extended averages are tilted by the higher grade concussions, but it is worth thinking about what standard one wants to use for return. How many symptom-free days before returning to the gym? And being ready for symptoms to possibly persist longer than expected.

[LengLeng]

On 5/9/2020 at 5:07 PM, Kevin von Duuglas-Ittu said:

I'm sure you googled around, but I'm doing so as well for my own interest. Ran into this timeline:

I'm sure this extended averages are tilted by the higher grade concussions, but it is worth thinking about what standard one wants to use for return. How many symptom-free days before returning to the gym? And being ready for symptoms to possibly persist longer than expected.

Thanks for sharing. It is funny, only during the last couple of weeks I started thinking about head injuries and whether I ought to be more careful. My current trainer goes pretty hard and many times, well I am not blacking out, but I just feel that my head is taking hits and it gets affected. And then because I started thinking of it I started noticing that sometimes I forgot small things. Like the name of the condo where I lived two years.  Could be because of stress or cognitive bias of course. My best friend used to be one of the best female boxers in Sweden (amateur) and she took part in a study where they investigated whether there is a certain gene that will make some boxers more prone to brain damage than others. I should ask her for the outcome of the study. I remember she was suffering as they did bone marrow tests or something. 

Except from headache in the back of the head I feel ok. Staying away from boxing and things that make my head shake or bounce (running, jumping) and instead swimming, bicycle and yoga. I stocked up on Omega 3 and will get into ketosis this week. I will start with a high fat breakfast followed by 24 hour fast and a long bicylce ride to deplete glycogen. It seems to be the fastest way for me to get into ketosis. 

I wonder whether sensory deprivation tanks like float tanks would be good for healing? I have tried it once and it was pretty amazing. I should probably care more about trianing my neck as well, lethwei fighters are quite crazy with their neck training and I saw kids doing head stands against a wall after a training for what seemed to last forever. Haven't seen that in Thailand, but it might be common as well. 

 

[Barbara_K]

Dear LengLeng, I'm aware it is more than a year later, but how are you feeling today and when could you restart your training again and at what pace?

I'm asking because I had an incident this year middle of April when sparring in training. I received a head kick, got KO, hit the ground with the back of the head and went unconscious for some 20-30s. We went to hospital right away, the doctor's checks according to Glasgow Coma Score were all fine and he said it looks like a mild concussion and I can either go back to running in around 2 weeks - or shall go and see a trauma doctor if symptoms get worse.

For 2 weeks I was pretty slow, not feeling well, thinking, noises were exhausting, but I could go for a walk and even fly back home (from Finland where I live to Germany where I wanted to go to holidays for some days anyway).
After these 2 weeks unfortunately I collapsed on a morning walk, after 3km I could not walk anymore, my head was exploding. Different checks and an MRI later I knew I didn't only have a mild concussion, but a severe head trauma (which even killed my olfactory nerve).
I was on sick leave for 8 weeks of which I stayed 3-4 weeks only on the couch, being able to talk to someone only for 2x 1 hour per day and resting, doing just nothing for the rest of the day.
A side walk of some 300m per day was already a success - I was getting crazy when I thought about how fit I was before and then I can hardly go for a 1km walk. After a while 2km took me 1,5hrs, it was scary.

Later doctor explained me such bruise in the brain takes around 10-12 days to develop completely until healing process starts that explained why I felt more or less ok for the first 2 weeks.

Just last week, 11 weeks after the incident, I felt able to do some sit-ups, push-ups and shadow boxing again. I might even give it a try to go for a slow run in some days. But the doc insisted on no heavy bag training, padwork or even sparring for at least 6-8 months...

Now my goal is to be on the level where I was before in spring 2022...

But what I was wondering in general, how fighters handle(d) KOs. I never heard of one taking such long break until everything is healed completely.

Anyway I wish you all the best and hope you don't suffer from long-term effects. For my case I'm just thankful I still can walk and speak properly. It could have been much worse...

[Joseph Arthur De Gonzo]

On 5/7/2020 at 11:07 PM, Oliver said:

Never had anything like that from muay thai, only slipped in the shower once and then head crashed on the side wall tiles. Stitches and pain, so rested at home after.

I had the same thing as a kid. Slipped in public showers and hit my head and needed a few stiches.