A year and counting: My long road back to riding after concussion

by Simone Giuliani


I’ve just hit a cycling landmark that I never aspired to. It is now a year since my last proper ride. A year since I was enjoying the thrill of a descent, the satisfaction of summiting a climb, that mind-settling solo ride, that lung-busting race, the camaraderie of the bunch.

My bikes are sitting in the shed gathering dust, my cycling kit is untouched in the wardrobe, and any semblance of fitness is becoming an ever distant memory. I miss riding my bike. I miss it every day. And I don’t know when I will be able to do it again.

“Hopefully soon”, is what I’ve been saying and working toward for nearly 12 months now.

And as I’ve kept repeating that phrase it’s actually been somewhat of a relief that I still miss it so much. It makes me still feel like a cyclist at heart if not one in reality. Not for the moment anyway.

The headache that lasted a year

So why haven’t I been riding? Clearly it hasn’t been by choice.

A short while into a relaxed solo Sunday afternoon mountain bike ride on my local trails I crashed. When I made it to hospital – and walked in rather off-balance – they looked at my helmet, put me in a neck brace and told me not to move. A few hours later I was walking out completely relieved.

There were no signs that anything was broken. I was even wondering: “Could I perhaps get back on the bike by next weekend?” I had no concept that, a year later, I’d still be wondering when I’d be able to ride again. Surely it would just be a matter of letting my bruised and battered body heal a bit and taking life quietly for a couple days to allow for concussion recovery?

However, I quickly learnt that concussion is not something to take lightly, nor is it something that is always dealt with quickly and easily. Every concussion is different and unfortunately my mild traumatic brain injury decided to take the long road to recovery.

A few weeks after my crash, I wrote an article on the experience of concussion recovery – thinking I’d already been dealing with a long, slow process. I looked with sympathy at people like Carmen Small, who at that stage had been dealing with the debilitating consequences of a career-ending concussion for months. Then there was promising cyclocross racer Ben Frederick who had been dealing with the effects of concussion for even longer.

Their recovery processes seemed so long and hard. Unrelenting headaches, sensory overload, nausea, balance problems, vision problems … for month after month after month, with no end in sight!

I felt fortunate that the consequences of my crash weren’t as life-changing — Small and Frederick were top-level racers whose careers were completely dependent on their cycling ability. I just ride for fun. But what made me feel most fortunate was the conviction that I wasn’t going to have to face up to my symptoms for so long.

Sometimes ignorance is bliss.

Just HTFU! (The worst response ever)

The thought that recovery was just going to take a matter of weeks probably helped me keep a positive attitude in those early stages. That and an unshakeable gratitude that I was still here. When you break a big fall with your head it’s hard not to think about how much worse the consequences could have been.

But thinking I would have a swift recovery worked against me too. It meant I didn’t have the drive to urgently seek out the very best of specialist care. It took me a little while to work out that this wasn’t an issue that would be quickly resolved and that I’d need more help than my general medical practitioners could give.

The expectation and planning for rides in the not-too-distant future continued. And so did the disappointment when I couldn’t do them.

Meanwhile, the HTFU attitude that’s so prevalent in us cyclists didn’t do me any favours either. Push too hard, ignore the warning signs, and I’d go backwards rather than forwards. Push even harder to try and overcome the backward steps, and I’d go even further back and take longer to recover back to the start point.

Sometimes the sheer mental boost of doing something enjoyable – like venturing out for dinner or coffee with friends – makes it worth a small backward step. A small patch where the headache is more intense, the nausea more pronounced, and the capacity to take on tasks that challenge — like staring at a computer screen for hours — is reduced.

But getting carried away with the excitement of feeling almost normal and trying to slot back into what would have been a full but manageable week before the crash? Maybe not so clever. The hours of recovery can stretch into days and the days into weeks or even more. The capacity to focus, manage in a noisy bright room full of people, or even concentrate on enlisting the mental agility required for a bit of friendly banter, seems impossible. On a bad day a dark quiet room is all the head can manage.

And unfortunately every time I’ve attempted to ride my bike, even just for five or ten minutes, that dark quiet room is where I’ve ended up. Sometimes for hours, sometimes for days.

Acceptance, not defeat

So many of my symptoms have improved to a point where, in the rest of my life, I feel I’m able to manage much of what I could before. But my balance and ability to process the visual aspect of movement seems to be inching along.

Every journey to recover from the mild traumatic brain injury of concussion seems to be different. For me the part of my brain that seems to be most heavily affected is the one that has the most impact on my ability to ride, or jog, or do anything else that requires balance and dealing with a moving landscape at the same time.

Initially even short walks were a problem, but just by adding a minute at a time I’m now comfortable with relatively long ones. That said, I still struggle to walk with someone else and throw a complicated conversation into the mix. The way my specialists have described it is that my head is working so hard to relearn those simple tasks of balance and visually processing movement that there is just no capacity to manage other things as well.

I suspect that could be an issue when I get back on the bike again too.

That’s why last night, on the eve of my one-year crash anniversary, I packed all my cycling kit away and stashed it in the back of the cupboard. That wasn’t easy, but it felt important. Important that it wasn’t sitting there looking ready to use at a moment’s notice, ready for a hilly loop tomorrow morning, ready to pin a race number onto, or throw in the case for a mountain biking holiday.

That’s not the type of riding I need to look forward to right now.

A different type of cyclist

Riding at all will be a bonus, even if, for a while, it can only be a short leisurely ride on a bike path. I don’t want to jeopardise things by getting carried away. The distances will be short, with no distracting conversation from riding buddies, no traffic to process, no noisy race crowds, and no technical trails.

It’s not that I’m any less determined to get back on the bike and back into those long challenging rides with good company. Doing the rehab to help me get there is a priority every single day. But the times I’ve pushed to go too far too fast have probably slowed me down, and have come with too big a cost to the rest of my life.

If I get back on the bike tomorrow it’ll be a while before I’m doing the type of riding that warrants wearing bibs and a race cut jersey. And if I can accept that, it’ll probably take less time. Even if it doesn’t, at least it’s less likely to be filled with disappointments about what’s missed. I can embrace the pleasure of what I can do instead.

It’ll be a matter of seeing riding with fresh eyes and just enjoying the feeling of turning the pedals. There will be no worrying about whether or not I’ve done enough to avoid falling off the back of that bunch ride, or post a respectable result at that race.

Maybe the forced break from the bike will even make me appreciate it more; make me fall in love with cycling all over again.

 

The experience has certainly given me more respect for the complex tasks our brain tackles to get us around on a bike, without us even noticing. I had taken that for granted.

For now the rising headache, pins-and-needles-like tingling in the back of my head, and blurred vision reminds me. The heightened sensitivity to, well, everything, for days after feels like my head’s way of constantly telling me “Don’t you dare do that to me again – I’m not ready yet.”

But when will it be ready to tackle riding again? That’s sometimes the hardest thing. I don’t know. For a long time now I have only had one answer for that question.

“Hopefully soon.”

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