Concussed! Immediate Action Required

By Emily Harris

“Whoa, Whoa, WHOA!” was all that I heard before I was slammed into the ground with my back and head taking the brunt of the force. I was schooling cross country and the horse I was riding ran out on a little log jump. He then turned sharply to the left which sent me flying in the opposite direction. I felt completely jarred and confused. “How did I get backwards?” I thought. A few seconds passed which seemed like minutes to me. A quick mental check of my extremities told me I hadn’t broken anything and I got up and dusted myself off. The horse I was riding was waiting patiently for me a short distance away as if nothing happened. Great! At least he didn’t run off like last time! This wasn’t my first fall on this horse, it was my second. I had fallen and hit my head two weeks before.

As my trainer was talking to me, I noticed that my left side felt strange. As I shifted my weight to the left, my leg started shaking. I thought that was odd, but I continued to listen to what my trainer was telling me. I then decided to take the weight on my left leg hoping that it would get better. Before I put my foot in the stirrup, I checked my left leg again. As soon as I put weight on that leg my eyes rolled up and I fell like a tree. I had fainted.

I quickly regained consciousness and I was totally confused and scared to tears. I RARELY cry when I am hurt and I NEVER cry when I am scared. I tried to laugh it off but the tears kept coming. It felt like a computer crashing suddenly and then starting back up slowly. That was my first time fainting. My trainer, who was standing right by me, didn’t see me when I fainted and when she turned around, I was lying on the ground. She asked me what I was doing, and I said I didn’t know. My sister, who was also riding with me, had been watching the whole time. She was shocked by it and informed our trainer that I had fainted. Then came the round of the usual questions you ask a person when they are not acting normal. I was asked multiple questions, by three different people all at once! I was slow to answer but I did answer them correctly. They pointed out a jump for me to sit on but in my confusion I turned and went the opposite direction of the jump. They then redirected me to the jump. I sat for a while to catch my bearings, while also discussing what had happened.

I got back on and rode for about 30 minutes more. I helped with evening chores and I drove me and my sister back home. The next morning I did not feel the greatest but it wasn’t enough for me to stay home, so I thought. My parents were very concerned about me, but I kept saying I was okay. So I drove us back to the barn. If I am honest, it was all I could do to get us home the night before and it was all I could do to get us back to the barn that morning. We did morning chores and after I was finished with the main barn, that was it. I couldn’t do anything else. I had a headsplitting headache, felt nauseous, dizzy and was sore like crazy. I went and laid down and slept for several hours. During that time my parents came and picked me up to take me to an immediate care doctor. Because of COVID restrictions I had to go in by myself and explain what happened. Thankfully, my fall and faint was recorded and I was able to show the doctor what had happened. She said that it was serious and she was glad that I had the recording. She then had me transferred to the emergency room.

At the emergency room, they called a level 2 trauma alert and rushed me into a trauma room on a stretcher with a neck brace around my neck. I was surrounded by a whole room full of nurses working busily with the doctor. It was like stuff I had only seen in the movies. I was in the emergency room for hours! I had x-rays done, a CT scan and was hooked up to an IV. Thankfully, the tests showed that I didn’t have any broken bones, fractures or hemorrhaging. I was diagnosed with a concussion and was discharged with a referral to see a concussion specialist doctor, which I was to see within a week.

Now I am sure that you can tell that I had quite a few red flags when I fell off. The biggest and most obvious one was that I fainted. Next, would be that my left side was shaking. These two things are considered some of the dangerous signs of concussion.

There were so many mistakes that it is embarrassing. It’s so embarrassing to me because I felt like I should have known better; I am a Pony Club member, I should have known. But as frustrating as it all is, I also have to remember that when you have a head injury like that, everything is “out of order.”

I saw the concussion specialist a week after I had been to the emergency room. I had to take an Impact Test that tested my motor skills, memory, and speed. My balance was checked as well. The results I got were sobering. Based on the Impact Test, my ability to remember words was at 62 %, shapes and patterns were at 23%, speed was at 4%, and reaction time was at 1%. I also learned that when I fainted, that was considered another fall. So there was my first fall on that horse two weeks earlier where I hit my head, my second fall schooling cross country where I hit my head again, and then when I fainted before remounting that was another fall and blow to my head. I hadn’t thought about it like that before then. I was given eight weeks of recovery and six weeks of physical therapy. I was not allowed to ride until I had completed therapy. I couldn’t work with my horses, muck out stalls, or be near excitable horses out of caution for the risk of having a repeat fall and head injury. I was allowed to use a smartphone and computer since that is necessary for the work I do, but I had to drastically limit my time on devices.

Emily doing physical therapy

Being aware of the risk of concussion is the first step in being safe. Knowing what to do in a situation where a concussion may have occurred is next in line. A concussion is a type of traumatic brain injury (TBI) that changes the way the brain normally works. It is caused by a bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth. Researching and learning about concussion signs and symptoms will help you know what to look for in case you or someone else has hit their head while riding.

There are two sets of symptoms, the typical symptoms and the dangerous symptoms. Knowing both sets is crucial because it will give you an idea of what is going on and will help you in relaying information to your doctor. Also it is important to note that concussion symptoms can play tricks on you. They might not show up right away and can even take hours, maybe even days to show up. That is why it is necessary to stop riding after a blow to your head. It’s okay to not get back on, even if you were bucked off, thrown, or fell while jumping. I know that as equestrians, we are trained to think that we have to get back on so that your horse doesn’t think it has gotten away with unacceptable behavior. But making sure that you are all right is more important than toughing it up and getting back into the saddle. Your horse can wait another day and you can always fix what went wrong later, but your brain cannot wait. Ignoring and pushing through your symptoms is not good and will only make things worse. Healing takes time and the longer you wait to get things checked out the longer your recovery time may be. You are also much more likely to have another concussion while the brain is still healing, and repeat concussions can increase the time it takes to recover. So the more you do to prevent a repeat concussion the better your chances are during recovery.

My concussion affected me differently than it would have affected a non-athletic person. Once you have recovered and are released to ride, do not jump back into your routine abruptly. Make sure that you ease yourself back into work. You don’t want your body to have a negative reaction to the sudden change. Another thing that you will need to be aware of is Post Concussion Syndrome (PCS). This is where you experience concussion-like symptoms weeks or even months after your initial concussion. If you suspect that you are dealing with PCS, contact your doctor and let them know.

As horrible as it sounds, if you have or suspect that you have a concussion, you are the one who will experience the consequences if you mount up, not the person who tells you to get back on. You need to do what is necessary for your well-being. If you are younger, let your parents know and don’t spare any details. Be honest with yourself and with others. It is far better to miss one ride than to go weeks, months, or even an entire season without riding due to recovery.

Recovery after a concussion will be different for everyone. Some will recover quickly and others will recover slowly. Recovery time is based on the severity of the concussion—the more severe it is, the longer it will take to heal. My doctor told me that I had a pretty bad concussion, but I made sure that I did all that I could to recover and I was able to be released two weeks earlier than my original prognosis. Also my concussion specialist told me that the way I had hit my head, if I was an “ordinary” person, it would have been much worse for me. But because I was an active person, an athlete, and an equestrian, my balance starting off was better than the average person (Go “Team Equestrian!”). That in turn meant that my concussion affected me differently than it would have affected a non-athletic person.

Once you have recovered and are released to ride, do not jump back into your routine abruptly. Make sure that you ease yourself back into work. You don’t want your body to have a negative reaction to the sudden change. Another thing that you will need to be aware of is Post Concussion Syndrome (PCS). This is where you experience concussion-like symptoms weeks or even months after your initial concussion. If you suspect that you are dealing with PCS, contact your doctor and let them know.

Pony Club is strict when it comes to falls and concussions. There are also a lot of resources and information available on the Pony Club website for you to learn about concussions. You can also visit the Centers for Disease Control and Prevention (CDC) website to learn more. If you have ever hit your head during a fall, however minor it is, your DC will have to file a Pony Club Incident Report. It might seem like a hassle to have to fill out a report when you fall off a horse during a Pony Club function, but it actually is a good thing because the more we know about how falls occur, the more we can prevent them from happening, and the safer our rides will be.

Personally, I have had quite a large number of falls in my riding career. I have had to replace several helmets. But I never remember hitting the ground as hard as I did that day. Then to have another concussion on the heels of an already concussed brain was pretty bad. Life post concussion has gotten better with time but it’s not the same as before. I can’t even begin to express how happy I have been to ride my horse again! I am extremely thankful that I can go outside to see her and take care of her, and our bond has grown stronger and I wouldn’t want to miss that for the world. But as much as I don’t want to admit it, I still feel the effects of my concussions even now. I still deal with memory loss, difficulty concentrating, light and noise sensitivity, headaches, and fatigue. Concussions are serious business, and are an injury you should not take lightly. If you have had one, just know that you will get through this. Take it one day at a time. And if you have never had one, be mindful and careful. An ounce of prevention is worth a pound of cure.