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...

Progressive Return to Activity After Concussion Video

Video
2/25/2021
Progressive Return to Activity After Concussion Video

The PRA is an evidence-based, easy-to-use approach to help providers return service members with mild TBIs back to duty safely. TBICoE researchers have found that, if medical providers completed a two-hour, in-person training on the use of the PRA, their patients saw an overall reduction in symptoms after one week, one month, and three months, when compared to patients treated by providers who had not received the training.

Recommended Content:

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

TBICoE 2020 Publications

Publication
2/25/2021

Master list of 2020 TBICoE Research Publications.

Recommended Content:

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

Returning to Duty After Concussion

Infographic
2/24/2021
Returning to Duty After Concussion

This TBICoE infographic gives an overview of the risks of returning to duty too soon after a concussion and explains how a progressive increase in activity can help get you back to duty safely. Returning to duty too soon after concussion can lead to prolonged symptoms, poor marksmanship, decreased readiness, accidents and falls, and increased risk of more concussions.

Recommended Content:

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

Progressive Return to Activity Following Acute Concussion/Mild TBI Provider Training

Publication
2/23/2021

The TBICoE revised the Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury Clinical Recommendation (PRA) and this updated provider training slide deck. The trainings objectives will help providers to identify the key changes to the updated 2021 PRA; explain the rationale for using a PRA protocol for service members post-concussion; understand the criteria for progression following a concussion or mild traumatic brain injury; identify appropriate activities at each stage of progression; understand how to apply primary care management strategies and specialty referral considerations to treat concussed service members who are not progressing as expected; utilize the Tri-Service Workflow mild TBI Alternate Input Method Form to document the PRA in the Armed Forces Health Longitudinal Application.

Recommended Content:

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

March 2021 Toolkit

Publication
2/22/2021

March is nationally recognized as Brain Injury Awareness Month, with the goal of increasing traumatic brain injury (TBI) awareness and improve health care providers’ ability to identify, care for, and treat all those who are affected by TBI. A TBI is a blow or jolt to the head that disrupts the normal function of the brain. According to the Defense Health Agency Traumatic Brain Injury Center of Excellence, 430,720 service members have been diagnosed with a first-time TBI since 2000. The toolkit also contains information on patient Safety Awareness Week, National Nutrition Month and many other graphics and messages you can use for holidays and observances during March.

Recommended Content:

Brain Injury Awareness | Total Force Fitness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

DHA’s TBI-focused Caregiver & Family Member Study continues at TBICoE

Article
2/19/2021
A husband, wife, and two children sitting at the Warrior and Family Support Center

TBICoE and NICoE continue with the Caregiver and Family Member Study.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DOD TBI Worldwide Numbers | Patient and Family Resources | TBICoE Research | TBICoE Podcasts | A Head for the Future

Sleep After Concussion

Infographic
2/18/2021
Sleep After Concussion

"Sleep After Concussion" is intended for patients and caregivers of those who have sustained a TBI. The infographic reviews general information of sleep-related concerns and points towards additional educational resources.

Recommended Content:

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

Sleep and TBI

Video
2/8/2021
Sleep and TBI

Sleep disturbances are common for service members and veterans following a mild TBI, also known as concussion.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | TBI Provider Resources | Traumatic Brain Injury Center of Excellence | Brain Injury Awareness | Brain Injury Awareness | Total Force Fitness

2020 DOD Worldwide Numbers for TBI

Publication
1/28/2021

TBICoE is the Defense Department's office of responsibility for tracking traumatic brain injury data in the U.S. military. Here you'll find data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis in calendar year 2020. The data is also broken down by each branch of the armed services.

Recommended Content:

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

2000-2020 DoD Worldwide Numbers for TBI

Publication
1/28/2021

TBICoE is the Defense Department’s office of responsibility for tracking traumatic brain injury data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis since 2000.

Recommended Content:

DOD TBI Worldwide Numbers | Traumatic Brain Injury Center of Excellence

Sleep After mTBI

Infographic
11/19/2020
Sleep After mTBI

"Sleep After mTBI" is intended for providers to show the importance of screening and treating service members affected by sleep issues following mTBI.

Recommended Content:

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

DVBIC blood plasma study assists in TBI and PTSD diagnosis

Article
10/8/2020

Since 2000, more than 400,000 active-duty service members have been diagnosed with TBI

Recommended Content:

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

2019 DoD Worldwide Numbers for TBI

Publication
9/30/2020

TBICoE is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DOD TBI Worldwide Numbers | Traumatic Brain Injury Center of Excellence

2000-2019 DoD Worldwide Numbers for TBI

Publication
9/30/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis from 2000-2019.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Armed Forces Health Surveillance Division | Traumatic Brain Injury Center of Excellence | TBI Educators | TBI Provider Resources

MACE 2 Provider Training Video

Video
9/29/2020
MACE 2 Provider Training Video

This video illustrates how to conduct a Military Acute Concussion Evaluation 2 (MACE 2) training event. This video supports the MACE 2 and its training materials created by the Traumatic Brain Injury Center of Excellence (TBICoE).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | TBI Provider Resources | TBI Educators | Provider Education
<< < ... 6 7 8 9 10  ... > >> 
Showing results 106 - 120 Page 8 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