Rider Health

Truth and Consequences of Concussions

Brianna Kerr shares the story of how she became "grounded," unable to ride because of her struggles with post-concussion syndrome.

Courtesy Boston Center for the Study of Traumatic Encephalopathy

By: Brianna Kerr | June 27, 2012

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you're listening to an article from horse canada.com. truth and consequences of concussions by: brianna kerr. there are as many different ways to fall off a horse as there are horses and riders, and the results can vary from amusing tales that stick with you for life, to injuries that threaten, change or end your life. according to statistics, head injuries are the most common reason riders end up in the hospital or dead. while wearing a helmet can protect you from catastrophic brain injury, like a skull fracture, they can’t protect you from mild traumatic brain injury, like a concussion. you don’t even have to actually hit your head to sustain a concussion – a severe jolt to the body is all it takes. the consequences can be long-lasting or permanent, and affect you physically, cognitively and emotionally. advertisement scroll to continue with content so, it turns out concussions aren’t actually as “mild” as you would think. in fact, repeated concussions can have devastating results. brianna kerr, who suffers from post-concussion syndrome, can attest to that. here, she shares her story and explains why getting right back on the horse is not always the best medicine for fall. living with post-concussion syndrome. i have been riding horses for almost as long as i can remember. as a member of high county pony club for more than 15 years, i am no stranger to safety precautions, especially the importance of wearing a helmet while riding. nonetheless, two years ago, i started a very difficult journey through post-concussion syndrome following a series of traumatic head injuries due to riding accidents. in june 2001, i had my first major concussion at 11 years old, while riding at a pony club event. one of the games ponies got loose and ran up behind my mount, spooking her. she immediately started bucking and ran towards the trailers. i still can’t remember what happened after she spooked, but my mother later told me she stopped suddenly and i went over her neck, head-first into a trailer and onto the ground. i didn’t regain consciousness for more than five minutes. after a visit to the hospital, everything checked out, and the usual precautions of rest and monitoring were taken. i continued riding once the back injury i also sustained healed. i never thought anything of it again until many years later. in july 2010, on a trail ride with my pony cowboy and my friend nevin on his mount phoenix, we decided to let our ponies go for a run. we were soon laughing and galloping down a narrow path. my unruly, troublesome pony had a sudden and unexpected burst of energy and we found ourselves in the lead, excited by the fact that we were always the slower pair. i turned in my saddle to grin back at nevin, not paying much attention to cowboy. in that moment, we crossed over a shadowy area on the path. cowboy has always been quick to spook at his own shadow, and frequent invisible birds. he stopped and turned on his haunches, throwing me headlong into a tree. nevin dismounted, checked to make sure i was okay, and kept me still on the ground. immediately, i felt a thundering headache come on. i was dizzy, nauseated and very disoriented. i tried to gather myself as much as i could because i had no choice but to get back on and ride home. we were a two-hour ride from our farm, with no cell phone service and, worst of all, the sun was going down and a thunderstorm was rolling in. i remounted and we slowly picked our way home in the dark, cold rain. i have always known the importance of wearing a helmet and have never gotten on a horse without one. my family doctor as well as my neurologists and several other specialists i have seen, have stressed the gravity of the situation. they explained that if i had not been wearing a helmet with such a severe hit, at such a speed, the chances of me surviving were very low, particularly because i had suffered from a severe head injury previously. even though it was almost 10 years before, the neurologists explained that my brain had probably not fully healed from the trauma. after my encounter with the tree, i did the worst possible thing anyone suffering from a concussion can do, i didn’t rest. all my life, chiefly when i was young, every time i fell off, i was told to promptly get back on the horse – a phrase i am sure all riders are familiar with. it is a way of thinking that is instilled in us from our first fall – a way of thinking i have instilled in my students. growing up, every time i took a tumble, my coaches told me, “ninety-nine more and you will be a great rider.” not knowing i needed time to heal and rest, i didn’t explain to my family how bad the fall had been. i never dreamt it would affect me so much in the future. i continued to go to school, extremely focused on graduating in two more months. worst of all, i kept riding. i continued to feel dizzy and nauseated, and i suffered from constant migraines, fatigue and blurred eyesight, as well as extreme confusion, memory loss, insomnia and lack of concentration. sometimes, when the symptoms got really bad i could not even remember my own thoughts half way through a sentence. all of this continued to worsen as i pushed myself. from august to october, i received three more blows to the head. two were from riding, as i was having difficulty with my performance due to my lost sense of balance. with every new injury, my symptoms got worse. at first, i blamed it on school, stress and lack of sleep from my final exams. i decided once i was done school i would start to feel better. i knew i had gotten several concussions by then, but i had never been told about how one concussion on top of another could be extremely damaging. after the brain is injured once, it is extremely sensitive to any and all jarring or trauma. at the time, i hadn’t known this. but my symptoms didn’t get better and those around me began to notice a big difference in my behaviour. trying to decide what the problem was, i explained my injuries to my family and they immediately took me to the doctor. i was told even if i rode and didn’t fall, the jarring motion of riding could be dangerous. i have been through a series of scans and tests, and have seen several different doctors and specialists. they all say rest is the best thing. there is no way of telling how long it will take me to fully recover. there is also no guarantee that i will ever fully recover. almost two years later, the way i live my life is still dictated by the injuries i have sustained. i haven’t ridden since september 2010, and because riding was a very large part of my life, it is an extremely difficult challenge. the head neurologist from the acquired brain injury physical medicine and rehabilitation program, in hamilton, on, recently stated in her last letter: “unfortunately, given the length of time from her last injuries and the persistence of her symptoms as well as repeated concussions, her prognoses is not particularly good at this time. of course, she is told that there should be no more horse riding and this is a permanent restriction. she is also encouraged not to be involved in high risk activities at all.”. not only has the riding portion of my life been altered, but so has my ability to function day-to-day. i graduated from college as a cabinetmaking technician, but not knowing how long this will continue, i have no choice but to re-train in a different field. the large saws and power tools that i operate in cabinetmaking are not safe for me to use for long periods of time or when i am getting dizzy spells without warning. i currently cannot drive, or be active in any sports, or do anything mentally stressing for too long, like read, for example. a lot of the activities i used to do i can’t do or have difficulty doing now. there are countless things i took for granted that are only slowly coming back to me. every day, i deal with migraines, dizzy spells, nausea, mental confusion, fatigue, insomnia, memory loss and lack of concentration. the symptoms of post-concussion syndrome are heightened when i am mentally or physically over-stimulated. sometimes, it takes as little as a 10-minute walk to send my head spinning. i have large amounts of bruising, which takes a long time to heal in brain tissue. there is also excess fluid and pressure in my brain, which causes the dizziness and pain. from the trauma, the muscles and the bones in my head, neck and back are locked in a tight pulling position. not allowing for natural movement, this causes pressure build up and, in turn, pain and discomfort all over. over time, the symptoms have lessened very slowly, with the help of multiple supplements, medications and ongoing physiotherapy. no one can tell me for sure what the end result will be. it continues to be a long and trying journey. if i had taken the time to rest and heal after i hit my head on the tree, i might not have been as bad as i am today. there is a great possibility i would have been back to normal in no time. the most important thing to do after sustaining any kind of head injury is to rest. do not get back on a horse until all symptoms have gone away, and you have seen a doctor. you will end up waiting a lot less time to return to your regular routine that way. your brain runs your entire body, and if it’s hurting and injured, nothing can function properly. learn from my experience and always wear a helmet and always rest after a fall. you will never regret it. you might even be grateful to it for truly saving your life, and your way of life, one day. concussion facts. concussions (or mild traumatic brain injuries) are caused by excessive, rapid movement of the brain inside the skull. this movement causes damage that changes how brain cells function, leading to symptoms that can be physical, cognitive or emotional. depending on the severity of the concussion, loss of consciousness may occur. initial symptoms of a concussion include: headache, dizziness, drowsiness, weakness, numbness, disorientation, confusion, decreased coordination or balance, nausea, slurred speech, vomiting and seizures. post-concussion syndrome (pcs) is diagnosed when the temporary symptoms of a mild traumatic brain injury become more permanent – lasting from several weeks, up to a year in some cases. beyond that, it is likely the condition will not resolve, and that the injured person will continue to suffer the effects such as short-term memory loss, difficulty concentrating, irritability, depression and insomnia, as well as headaches, dizziness, light and noise sensitivity and visual disturbances. people who have experienced a concussion are 40 per cent more likely to suffer subsequent head injuries and are at increased risk for ‘second impact’ syndrome. although rare, this condition occurs when the person receives a secondary blow – even minor – resulting in severe brain swelling, brain damage and death. research indicates that repetitive blows to the head are likely precursors to debilitating, progressive degenerative brain diseases similar to alzheimer’s and other dementias, parkinson’s or lou gehrig’s. chronic traumatic encephalopathy (cte), a slowly progressive, eventually debilitating, neurologic condition, is believed to be caused by repeated concussions. the direct relationship between concussions and cte is not yet known, however. ~ with files from nicole kitchener. &&>

There are as many different ways to fall off a horse as there are horses and riders, and the results can vary from amusing tales that stick with you for life, to injuries that threaten, change or end your life.

According to statistics, head injuries are the most common reason riders end up in the hospital or dead. While wearing a helmet can protect you from catastrophic brain injury, like a skull fracture, they can’t protect you from mild traumatic brain injury, like a concussion.

You don’t even have to actually hit your head to sustain a concussion – a severe jolt to the body is all it takes. The consequences can be long-lasting or permanent, and affect you physically, cognitively and emotionally.

Scroll to continue with content

So, it turns out concussions aren’t actually as “mild” as you would think. In fact, repeated concussions can have devastating results. Brianna Kerr, who suffers from post-concussion syndrome, can attest to that. Here, she shares her story and explains why getting right back on the horse is not always the best medicine for fall.

Living with Post-Concussion Syndrome

I have been riding horses for almost as long as I can remember. As a member of High County Pony Club for more than 15 years, I am no stranger to safety precautions, especially the importance of wearing a helmet while riding. Nonetheless, two years ago, I started a very difficult journey through post-concussion syndrome following a series of traumatic head injuries due to riding accidents.

In June 2001, I had my first major concussion at 11 years old, while riding at a Pony Club event. One of the games ponies got loose and ran up behind my mount, spooking her. She immediately started bucking and ran towards the trailers. I still can’t remember what happened after she spooked, but my mother later told me she stopped suddenly and I went over her neck, head-first into a trailer and onto the ground. I didn’t regain consciousness for more than five minutes. After a visit to the hospital, everything checked out, and the usual precautions of rest and monitoring were taken. I continued riding once the back injury I also sustained healed. I never thought anything of it again until many years later.

In July 2010, on a trail ride with my pony Cowboy and my friend Nevin on his mount Phoenix, we decided to let our ponies go for a run. We were soon laughing and galloping down a narrow path. My unruly, troublesome pony had a sudden and unexpected burst of energy and we found ourselves in the lead, excited by the fact that we were always the slower pair. I turned in my saddle to grin back at Nevin, not paying much attention to Cowboy. In that moment, we crossed over a shadowy area on the path. Cowboy has always been quick to spook at his own shadow, and frequent invisible birds. He stopped and turned on his haunches, throwing me headlong into a tree. Nevin dismounted, checked to make sure I was okay, and kept me still on the ground.

Immediately, I felt a thundering headache come on. I was dizzy, nauseated and very disoriented. I tried to gather myself as much as I could because I had no choice but to get back on and ride home. We were a two-hour ride from our farm, with no cell phone service and, worst of all, the sun was going down and a thunderstorm was rolling in. I remounted and we slowly picked our way home in the dark, cold rain.

I have always known the importance of wearing a helmet and have never gotten on a horse without one. My family doctor as well as my neurologists and several other specialists I have seen, have stressed the gravity of the situation. They explained that if I had not been wearing a helmet with such a severe hit, at such a speed, the chances of me surviving were very low, particularly because I had suffered from a severe head injury previously. Even though it was almost 10 years before, the neurologists explained that my brain had probably not fully healed from the trauma.

After my encounter with the tree, I did the worst possible thing anyone suffering from a concussion can do, I didn’t rest. All my life, chiefly when I was young, every time I fell off, I was told to promptly get back on the horse – a phrase I am sure all riders are familiar with. It is a way of thinking that is instilled in us from our first fall – a way of thinking I have instilled in my students. Growing up, every time I took a tumble, my coaches told me, “Ninety-nine more and you will be a great rider.” Not knowing I needed time to heal and rest, I didn’t explain to my family how bad the fall had been. I never dreamt it would affect me so much in the future.

I continued to go to school, extremely focused on graduating in two more months. Worst of all, I kept riding. I continued to feel dizzy and nauseated, and I suffered from constant migraines, fatigue and blurred eyesight, as well as extreme confusion, memory loss, insomnia and lack of concentration. Sometimes, when the symptoms got really bad I could not even remember my own thoughts half way through a sentence. All of this continued to worsen as I pushed myself.

From August to October, I received three more blows to the head. Two were from riding, as I was having difficulty with my performance due to my lost sense of balance. With every new injury, my symptoms got worse. At first, I blamed it on school, stress and lack of sleep from my final exams. I decided once I was done school I would start to feel better. I knew I had gotten several concussions by then, but I had never been told about how one concussion on top of another could be extremely damaging. After the brain is injured once, it is extremely sensitive to any and all jarring or trauma. At the time, I hadn’t known this. But my symptoms didn’t get better and those around me began to notice a big difference in my behaviour.

Trying to decide what the problem was, I explained my injuries to my family and they immediately took me to the doctor. I was told even if I rode and didn’t fall, the jarring motion of riding could be dangerous. I have been through a series of scans and tests, and have seen several different doctors and specialists. They all say rest is the best thing. There is no way of telling how long it will take me to fully recover. There is also no guarantee that I will ever fully recover.

Almost two years later, the way I live my life is still dictated by the injuries I have sustained. I haven’t ridden since September 2010, and because riding was a very large part of my life, it is an extremely difficult challenge. The head neurologist from The Acquired Brain Injury Physical Medicine and Rehabilitation Program, in Hamilton, ON, recently stated in her last letter: “Unfortunately, given the length of time from her last injuries and the persistence of her symptoms as well as repeated concussions, her prognoses is not particularly good at this time. Of course, she is told that there should be no more horse riding and this is a permanent restriction. She is also encouraged not to be involved in high risk activities at all.”

Not only has the riding portion of my life been altered, but so has my ability to function day-to-day. I graduated from college as a cabinetmaking technician, but not knowing how long this will continue, I have no choice but to re-train in a different field. The large saws and power tools that I operate in cabinetmaking are not safe for me to use for long periods of time or when I am getting dizzy spells without warning. I currently cannot drive, or be active in any sports, or do anything mentally stressing for too long, like read, for example. A lot of the activities I used to do I can’t do or have difficulty doing now. There are countless things I took for granted that are only slowly coming back to me.

Every day, I deal with migraines, dizzy spells, nausea, mental confusion, fatigue, insomnia, memory loss and lack of concentration. The symptoms of post-concussion syndrome are heightened when I am mentally or physically over-stimulated. Sometimes, it takes as little as a 10-minute walk to send my head spinning. I have large amounts of bruising, which takes a long time to heal in brain tissue. There is also excess fluid and pressure in my brain, which causes the dizziness and pain. From the trauma, the muscles and the bones in my head, neck and back are locked in a tight pulling position. Not allowing for natural movement, this causes pressure build up and, in turn, pain and discomfort all over. Over time, the symptoms have lessened very slowly, with the help of multiple supplements, medications and ongoing physiotherapy. No one can tell me for sure what the end result will be. It continues to be a long and trying journey.

If I had taken the time to rest and heal after I hit my head on the tree, I might not have been as bad as I am today. There is a great possibility I would have been back to normal in no time. The most important thing to do after sustaining any kind of head injury is to rest. Do not get back on a horse until all symptoms have gone away, and you have seen a doctor. You will end up waiting a lot less time to return to your regular routine that way. Your brain runs your entire body, and if it’s hurting and injured, nothing can function properly. Learn from my experience and always wear a helmet and always rest after a fall. You will never regret it. You might even be grateful to it for truly saving your life, and your way of life, one day.

CONCUSSION FACTS

Concussions (or mild traumatic brain injuries) are caused by excessive, rapid movement of the brain inside the skull. This movement causes damage that changes how brain cells function, leading to symptoms that can be physical, cognitive or emotional.
Depending on the severity of the concussion, loss of consciousness may occur.
Initial symptoms of a concussion include: headache, dizziness, drowsiness, weakness, numbness, disorientation, confusion, decreased coordination or balance, nausea, slurred speech, vomiting and seizures.
Post-concussion syndrome (PCS) is diagnosed when the temporary symptoms of a mild traumatic brain injury become more permanent – lasting from several weeks, up to a year in some cases. Beyond that, it is likely the condition will not resolve, and that the injured person will continue to suffer the effects such as short-term memory loss, difficulty concentrating, irritability, depression and insomnia, as well as headaches, dizziness, light and noise sensitivity and visual disturbances.
People who have experienced a concussion are 40 per cent more likely to suffer subsequent head injuries and are at increased risk for ‘second impact’ syndrome. Although rare, this condition occurs when the person receives a secondary blow – even minor – resulting in severe brain swelling, brain damage and death.
Research indicates that repetitive blows to the head are likely precursors to debilitating, progressive degenerative brain diseases similar to Alzheimer’s and other dementias, Parkinson’s or Lou Gehrig’s.
Chronic traumatic encephalopathy (CTE), a slowly progressive, eventually debilitating, neurologic condition, is believed to be caused by repeated concussions. The direct relationship between concussions and CTE is not yet known, however.

~ with files from Nicole Kitchener