With the warm weather upon us, those of us who didn’t ride much over the winter are now ready to hit the ring and the trails. As we all know, riding comes with risks, not the least of which are head injuries from falls. A few new studies on the impact of concussions on long-term health have revealed that current assessment methods might be flawed.

The first, a study at Tel-Aviv University, found that one in four children who are released from the hospital following a mild head injury are misdiagnosed and continue to suffer with post-concussion syndrome for years afterwards. This unnamed syndrome includes such “chronic symptoms as forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems and, instead of receiving treatment for the syndrome, they are mistakenly diagnosed as suffering from ADHD, sleep disorders, depression, etc. The misdiagnosis leads to treatment that is not suited to the problem, thus causing the children prolonged suffering.”

Concussions are traumatic brain injuries, primarily caused by a trauma to the head. While not often life-threatening, the side effects can be impactful and chronic. According to the second recent study, this one from Rutgers University, about 3.8 million sports-related concussions are reported each year in the United States.

The same study suggests that current method to assess head injuries might be flawed. The Sport Concussion Assessment Tool (SCAT) is the gold standard in diagnosing concussions resulting from sports and is a questionnaire that attempts to find so-called “red flag” symptoms including neck pain, headache, muscle weakness and vision problems, as well as tests that assess memory loss.

The Rutgers study used rugby players – some of whom had head injuries, and others who did not – and compared them post-game with the SCAT. Many players without a head injury had symptoms similar to those reported by head-injured players, including fatigue and neck pain.

“Our data shows that exertion during a match increased the number and severity of self-reported symptoms in control players even though they had not experienced a head impact,” one of the study’s authors wrote. “This could lead to difficulty differentiating these players from those that had experienced a head impact when using on-field assessments.”

However, certain symptoms like headache and ‘not feeling right’ were more closely aligned with having a head injury. This might mean that these symptoms are a stronger indicator of concussion than others on SCAT. In addition to headache, other symptoms that those with a head injury felt most often were “cognitive-sensory effects, emotional-affective symptoms, and hypersensitivity.”

And finally, a third study from Sweden’s Lund University found that vestibular nerve damage could be a cause of chronic concussion symptoms in certain patients. Symptoms such as depression, dizziness, difficulty focusing the gaze and balance problems can linger in those affected by concussion and be very debilitating. The vestibular nerve is in the inner ear and is chiefly responsible for our balance.

The Swedish study  investigated the vestibular system of athletes with continued symptoms for over six months after a sports-related concussion. According to the paper, athletes with such an injury “had a high burden of self-perceived symptoms and a negative impact on health because of dizziness, depression, and anxiety.”

The study found that these athletes had a peripheral vestibular deficit, specifically dysfunction of the inferior vestibular nerve.

“These injuries lead to the inward nerve impulses not working properly, and the brain, therefore, does not receive important information about body movements and sensory impressions required to maintain a good balance,” says Anna Gard, the first author on the paper and a doctoral student at Lund University, resident in neurosurgery at Skåne University Hospital.

So we strongly suggest that when you lead your horse to the mounting block next time, you make sure you are wearing the latest MIPS helmet to help protect yourself and your future health. Happy (and safe) riding!