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...

PRA Training Video 4: PRA Progression Criteria

Video
7/22/2021
Thumbnail image for PRA Training video 4, PRA progression criteria

In this lesson, we review the criteria for advancing through the stages of the Progressive Return to Activity (PRA) Clinical Recommendation. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

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

Caregiver Guide supports service members and veterans with TBI

Article
7/22/2021
Military family posing for a picture

Traumatic Brain Injury Center of Excellence’s 2021 Caregiver Guide provides specific tools to help caregivers manage TBI patient recovery.

Recommended Content:

Centers of Excellence | Traumatic Brain Injury Center of Excellence | Education & Training Events

2020 TBICoE Annual Report

Publication
7/9/2021

2020 Traumatic Brian Injury Center of Excellence (TBICoE) Annual Report.

Recommended Content:

Traumatic Brain Injury Center of Excellence

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

Publication
7/7/2021

The 2021 "Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans" is a recovery support tool to assist caregivers of service members and veterans who have sustained a traumatic brain injury at any severity level.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Psychological Health Center of Excellence

TBI Caregiver Support Forms

Form/Template
6/29/2021

This is a fillable and printer-friendly version of the forms available in the "Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans."

Recommended Content:

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

Aphasia, Caused by Stroke or TBI, is Frustrating and Little Known

Article
6/29/2021
A doctor looking at brain scans

Aphasia is an incurable disease usually caused by stroke that affects all forms of communication.

Recommended Content:

Total Force Fitness | Heart Health | Centers of Excellence | Traumatic Brain Injury Center of Excellence

NICoE Education Webinar Series: July Poster

Publication
6/25/2021

Service Members and TBI: The Not So Invisible Wound

Recommended Content:

Traumatic Brain Injury Center of Excellence | Education & Training Events | Centers of Excellence

NICoE Education Webinar Series: June Poster

Publication
6/23/2021

Combat-related Concussion: Understanding Trajectories of Long-term Clinical and Imaging Outcomes

Recommended Content:

Traumatic Brain Injury Center of Excellence | Education & Training Events

Progressive Return to Activity Following Concussion/mTBI Patient and Leadership Guide

Publication
6/22/2021

The Progressive Return to Activity Following Concussion/mTBI Patient and Leadership Guide alerts command and line leaders about the PRA process and provides service members with appropriate activities for each stage of their recovery.

Recommended Content:

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

TBICoE Virtual Quarterly Education Series: July 2021

Publication
6/22/2021

The Traumatic Brain Injury Center of Excellence is hosting a caregiver education series to learn about TBI caregiver resources, mind-body wellness exercises, and current research in the field.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Education & Training Events

TBI Topic Page Review Form

Publication
5/21/2021

The Traumatic Brain Injury Center of Excellence (TBICoE) manages the content on the Health.mil Traumatic Brain Injury Topic Page for the Defense Health Agency (DHA). To submit content for review and approval to this page, Military Health System agencies and other government partners can email this form, along with attached content in a Word document, to the TBICoE website manager at dha.TBICoEinfo@mail.mil.

Recommended Content:

Traumatic Brain Injury Center of Excellence

Signs and symptoms of a stroke, and what to do about them

Article
5/18/2021
Infographic about the sign of a stroke

For Stroke Awareness Month, we highlight some of the most important facts about strokes in men and women.

Recommended Content:

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

TRIP initiative bridges the gap between TBI research, clinical care

Article
5/13/2021
a statue of a broken circle

The Defense Intrepid Network launches the TRIP initiative to translate research findings into clinical practice.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Centers of Excellence | The National Intrepid Center of Excellence

Longitudinal Study on Traumatic Brain Injury Incurred by Members of the Armed Forces in OIF/OEF

Report
5/4/2021

HR 5122 NDAA Conference Report for FY 2007 Sec. 721

Recommended Content:

Traumatic Brain Injury Center of Excellence

NICoE at forefront of traumatic brain injury research and treatment

Article
5/3/2021
Picture of a mask with the American flag on one side and camo on the other side

The National Intrepid Center of Excellence is dedicated to treating and researching TBI injuries with the aim of getting patients back to maximum function.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Centers of Excellence
<< < ... 6 7 8 9 10  ... > >> 
Showing results 76 - 90 Page 6 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