Skip to main content

Military Health System

Ask the Doc: Hit Head Hiking

Image of U.S. Marines with The Basic School, Headquarter and Service Battalion, hike Old Rag Mountain at the Shenandoah National Park, Madison County, Va., Nov. 7, 2018. The motivational hike was held in honor of the Marine Corps Birthday as well as Veterans’ Day. (U.S. Marine Corps photo by Lance Cpl. Quinn Hurt). U.S. Marines with The Basic School, Headquarter and Service Battalion, hike Old Rag Mountain at the Shenandoah National Park, Madison County, Va., Nov. 7, 2018. The motivational hike was held in honor of the Marine Corps Birthday as well as Veterans’ Day. (U.S. Marine Corps photo by Lance Cpl. Quinn Hurt)

Recommended Content:

Traumatic Brain Injury Center of Excellence | Ask The Doc

Dear Doc: I decided to take advantage of the beautiful weather last weekend and went out hiking with a few friends. As we were headed up a pretty steep incline, I fell and hit my head on a rock. It hurt pretty badly at the time, but being the “warrior” that I am, I brushed it off and we finished the hike. I haven’t been to a doctor yet, but now I'm having pretty painful headaches, and I’ve also been getting dizzy and nauseous. Did I have a concussion and, if so, what should I do next?

Hit Head Hiking 

Illustration of a female face with the words "Ask the Doc"

Dear HHH: While it’s not necessarily my area of expertise, it sounds like you may have suffered a concussion, and my initial advice would be to go see a doctor as soon as possible.

That being said, I do know someone whose area of expertise is exactly that. I reached out to Navy Cmdr. (Dr.) Adam Susmarski, medical director of the United States Naval Academy Concussion Center of Excellence and USNA sports medicine team physician for the Midshipmen in Annapolis, Maryland, about some of the specifics of identification and treatment for concussions.


When we think of concussions, we think of an athlete who looks dazed and disoriented immediately after suffering head trauma from a violent hit on the field or a service member following a blast injury on the battlefield. However, there is also the potential for the symptoms of concussions to present themselves in the days after the trauma. 

We would recommend that you contact your primary care physician and set up an appointment to be evaluated after your fall. Your primary care physician will take a detailed history including a battery of questions specific to concussion evaluation which may include a Military Acute Concussion Evaluation 2nd edition (MACE2) or Sports Concussion Assessment Tool 5th edition (SCAT-5). These questions, along with a thorough physical examination that may include neurological, musculoskeletal, vestibular, and ocular testing will help your physician determine the underlying cause of your symptoms.

Keep in mind that there are a variety of other diagnoses and conditions that can occur after a fall that may mimic or exacerbate the symptoms of a concussion including, but not limited to, potential injuries to you neck and vestibular system.

If your primary care physician diagnoses you with a concussion, they will help guide you through a step-by-step return to duty protocol that will include guidelines for progressive return to physical and mental responsibilities at work and home.

Throughout your recovery, you will have serial follow-ups with your physician, and they may incorporate additional treatment modalities (vestibular therapy, medications, supplements, physical therapy, and ocular therapy). Your physician may also have you consult a concussion specialist (typically a physical medicine and rehabilitation or sports medicine physician) to help aid in your recovery.

A key item to remember is to not return to activities in which you may be susceptible to head trauma before being cleared to return to duty by your treating physician. A subsequent head trauma before the brain is healed/ready may lead to severe consequences and neurological injury. As you progress through the stages of recovery your physician will perform a variety of tests to include the aforementioned questionnaires, daily symptom scores, balance and eye testing, and neurocognitive computer testing prior to allowing you to return to duty. 


HHH, the bottom line is that, without seeing a physician, there is no way of knowing if you have a concussion. Only after that has been determined can you be put on the correct road (or perhaps trail…if you’d prefer) to recovery.

Just know that within the Military Health System we have an array of tools, facilities, and personnel just like Dr. Susmarski to help people like you.

I hope you feel better soon. Feel free to let us know what your diagnosis is and how you’re progressing through your treatment. 

Until then…take care (of your head) out there!

–Doc

You also may be interested in...

SCORE Chapter 1

Publication
8/4/2020

Study of Cognitive Rehabilitation Effectiveness Clinical Trial Overview Chapter one provides a concise overview of the SCORE clinical trial and measures, plus the Congressional mandate for the study, and implications for the military and veterans.

Recommended Content:

TBI Provider Resources | Traumatic Brain Injury Center of Excellence

TBICoE Research Review: Mild TBI and PTSD

Publication
8/4/2020

This research review provides an overview of the topic of co-morbid mild TBI and posttraumatic stress disorder. This review focuses on symptoms, diagnosis, and treatment of PTSD and mild TBI symptoms in patients with mild TBI history. While it can be difficult to differentiate symptoms of mild TBI from PTSD symptoms, especially months or years after the injury event, this review aims to present information relevant to understanding these often complex cases.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | TBICoE Research | TBI Provider Resources

TBICoE Research Review: Chronic Traumatic Encephalopathy

Publication
8/4/2020

The purpose of this research review is to summarize the available peer-reviewed scientific literature regarding the definition, epidemiology, risk factors, pathology and clinical manifestations for CTE.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBICoE Research | TBI Provider Resources | Traumatic Brain Injury Center of Excellence

DVBIC Publications 1992-2018

Publication
8/4/2020

DVBIC research publications from 1992-2018.

Recommended Content:

Research and Engineering | Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | TBICoE Research

TBI Hot Topics Bulletin September 2020

Publication
8/4/2020

Are you a busy health care provider? Not enough time to keep up with research? Stay informed with the TBI Hot Topics Bulletin. We track the latest TBI scientific studies, advances, and discoveries most relevant to health care providers. This issue covers the second quarter of calendar year 2020.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | TBI Provider Resources | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

DVBIC Publications 2019

Publication
8/4/2020

Citation information for 2019 publications of DVBIC research.

Recommended Content:

Research and Engineering | Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Traumatic Brain Injury Center of Excellence | TBICoE Research | TBICoE Research Studies

Back to School Guide for Academic Success After TBI

Publication
8/3/2020

This booklet provides guidance to service members and veterans who have ongoing symptoms from a TBI and are going to college, university or vocational school. It gives answers to common questions about accommodation plans, financial aid, and assistive technology.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | Traumatic Brain Injury Center of Excellence

2019 DVBIC Annual Report

Publication
8/3/2020

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

Return to Activity Educational Guidance for Service Members with Symptoms Following a Concussion

Publication
8/3/2020

This guide is intended to help service members and veterans who have experienced a concussion recover as quickly and safely as possible. It outlines each stage of the recovery process, explains what affected individuals should expect throughout the recovery process, provides guidance on how to track progress and includes a table to track developments.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

MACE 2 Provider Training

Publication
7/31/2020

Full-length medical provider training material for the Military Acute Concussion Evaluation 2 (MACE 2).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | TBI Educators | Traumatic Brain Injury Center of Excellence

Management of Headache Following Concussion/mTBI Clinical Recommendation

Publication
7/31/2020

This clinical recommendation outlines the assessment and management of headache following mild TBI. It includes specific recommendations regarding how health care providers can help patients manage pharmacologic and non-pharmacologic treatment of post-traumatic headache (PTH).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | TBI Educators | Traumatic Brain Injury Center of Excellence

Management of Headache Following Concussion/mTBI Clinical Support Tool

Publication
7/31/2020

This clinical support tool uses an algorithmic approach for health care providers to help assess and manage headache in service members and veterans who sustain a mild TBI and experience post-traumatic headache (PTH). The tool offers providers a step-by-step process to determine the type of headache following mild TBI and indications for emergency or specialty referral.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | TBI Educators | Traumatic Brain Injury Center of Excellence

Indications and Conditions for Neuroendocrine Dysfunction Screening Post TBI Clinical Support Tool

Publication
7/31/2020

This clinical support tool serves as a quick reference offering medical guidance following indications from post-injury neuroendocrine screening.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Traumatic Brain Injury Center of Excellence

Indications and Conditions for Neuroendocrine Dysfunction Screening Post Mild TBI Clinical Recommendation

Publication
7/31/2020

This clinical recommendation serves as a reference tool offering medical guidance following indications from post-injury neuroendocrine screening.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Traumatic Brain Injury Center of Excellence

Indications and Conditions for In-Theater Post-Injury Neurocognitive Assessment Tool (NCAT) Testing

Publication
7/31/2020

This clinical recommendation provides background of pre-deployment neurocognitive testing and the use of automated neuropsychological assessment metrics (ANAM).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence
<< < ... 11 12 13 14 15  ... > >> 
Showing results 151 - 165 Page 11 of 17
Refine your search
Last Updated: September 01, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery