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...

Neuroimaging following TBI in non deployed setting

Form/Template
7/8/2013

The guidance contained in this CR represents a review of currently published literature and expert contributions obtained by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) in collaboration with clinical subject matter experts representing the Services, Department of Veterans Affairs (VA), academic, research and civilian sectors.

Recommended Content:

Health Readiness & Combat Support | Public Health | Disability Evaluation | Traumatic Brain Injury Center of Excellence

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Update

Presentation
6/27/2013

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Update presented to the Defense Health Board

Recommended Content:

Traumatic Brain Injury Center of Excellence

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Update

Presentation
11/27/2012

Defense Health Board briefing on Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Update

Recommended Content:

Traumatic Brain Injury Center of Excellence

DCoE Concussion Management Algorithm Cards

Form/Template
10/8/2012

Combat Medic/Corpsman Algorithm Card to diagnose a concussion in a deployed setting

Recommended Content:

Public Health | Disability Evaluation | Traumatic Brain Injury Center of Excellence | Health Readiness & Combat Support

DoD Instruction Number 6490.11: DoD Policy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting

Policy

This instruction establishes policy, assigns responsibilities, and provides procedures on the management of mild traumatic brain injury (mTBI), also known as concussion, in the deployed setting.

Management of Traumatic Brain Injury in Tactical Combat Casualty Care

Report
7/26/2012

Defense Health Board: Management of Traumatic Brain Injury in Tactical Combat Casualty Care

Recommended Content:

Health Readiness Support | | Traumatic Brain Injury Center of Excellence

Proposed Addition to the Tactical Combat Casualty Care Guidelines on Traumatic Brain Injury

Presentation
6/25/2012

Defense Health Board briefing on Proposed Addition to the Tactical Combat Casualty Care Guidelines on Traumatic Brain Injury

Recommended Content:

Traumatic Brain Injury Center of Excellence

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury

Presentation
11/14/2011

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury briefing presented to the Defense Health Board Nov. 14, 2011

Recommended Content:

Traumatic Brain Injury Center of Excellence

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

Report
5/31/2011

In accordance with Section 1673 of the NDAA HR 4986, signed into law in January of 2008, the Secretary of Defense was instructed to establish a protocol for the pre-deployment assessment and documentation of the cognitive functioning of Service Members deployed outside the United States.

Recommended Content:

Public Health | Health Readiness & Combat Support | Traumatic Brain Injury Center of Excellence | Disability Evaluation

Devastating Dismounted Improvised Explosive Device Injuries in Operation Enduring Freedom

Presentation
3/8/2011

Devastating Dismounted Improvised Explosive Device Injuries in Operation Enduring Freedom briefing presented to the Defense Health Board March 8, 2011

Recommended Content:

Health Readiness Support | Extremity Trauma and Amputation Center of Excellence | Traumatic Brain Injury Center of Excellence

National Intrepid Center of Excellence

Presentation
11/1/2010

National Intrepid Center of Excellence briefing presented to the Defense Health Board Nov. 1, 2010

Recommended Content:

Research & Innovation | Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury A Guide for Caregivers of Service Members and Veterans Module 3

Report
4/1/2010

Defense Health Board: Traumatic Brain Injury A Guide for Caregivers of Service Members and Veterans Module 3

Recommended Content:

Health Readiness Support | Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury A Guide for Caregivers of Service Members and Veterans Module 1

Report
4/1/2010

Defense Health Board: Traumatic Brain Injury A Guide for Caregivers of Service Members and Veterans Module 1

Recommended Content:

Health Readiness Support | Traumatic Brain Injury Center of Excellence

A Guide for Caregivers of Service Members and Veterans Caregivers Companion

Report
4/1/2010

Defense Health Board: A Guide for Caregivers of Service Members and Veterans Caregivers Companion

Recommended Content:

Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury A Guide for Caregivers of Service Members and Veterans Welome

Report
4/1/2010

Defense Health Board: Traumatic Brain Injury A Guide for Caregivers of Service Members and Veterans Welcome

Recommended Content:

Health Readiness Support | Traumatic Brain Injury Center of Excellence
<< < ... 11 12 13 14 15  ... > >> 
Showing results 211 - 225 Page 15 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