Head Injury w/ Clean CT

[NoStepOnSnek]

Slipped on ice last night and bashed the back of my head against the door jamb. I saw stars and was disoriented for a few minutes and, after realizing I had a good sized laceration on the back of my noggin, went to the ER.

Got stapled up and asked for the CT scan, which came up clean. I have no nausea and no headache (except for pain at the laceration) and otherwise feel completely fine. In fact, I credit my training for not having any back, neck, or limb injury as a result of the fall.

Also, I’ve read Mark’s admonition in an old thread of “Have you had a cranial CT? If not, get one now. And do not ask some shithead on the internet about your closed-head injury ever again.” But, I’ve had the CT. The guy in that thread did not and had other symptoms.

The ER doctor said to take a week off because I have a “head” injury. But, if everything came up clean and I have no other symptoms, I’m wondering if I really have a “head injury” or just a laceration that happens to be on my head.

Knowing that doctors will tend to be overly cautious, I just don’t know if a clean CT is enough to take me out of the realm of legitimate medical advice, to which I should adhere, and back into the realm of listening to shitheads on the internet.

A week off sounds excessive, considering I haven’t missed a training day in two years. I want to just shift my schedule back one day to see how I feel today before getting under the bar again tomorrow. But, if I’m really in a “don’t be an asshole and listen to the doctor” situation, I’ll just suck it up. Dying under the bar with a brain bleed sounds less than productive for my training goals.

Thoughts?

[Mark Rippetoe]

I don't think you have a "head injury" per se, but rather a cut on your head. Warm up carefully and see if anything unpleasant occurs.

[NoStepOnSnek]

Thanks.

Feeling ok today, not great. But that might have something to do with lack of sleep after a night in the ER.

My wife says I was disoriented for more like an hour, not just a few minutes, so I guess that’s more reason to take it slow. I’ll feel it out with the warmups tomorrow and try not to be a hero.

[Matt James]

I had what I thought was a mild concussion in 2016. Was a fair bit disoriented for most of the evening. Didn't think too much of it and went off on a week's vacation that involved hiking/running all over the Black Hills and generous quantities of good bourbon. By the time I got back I was in bad shape, and dealt with the after effects for months (headaches, memory loss). I got a CT when I got back from the trip and it was clear, for what it's worth.

A week off may be excessive assuming it's mild. But be careful. You may feel fine during your workout and feel like shit the next day. Obviously if that happens you need to rest until your symptoms are gone. If you're feeling off today, it may not be a bad idea to give yourself another day or two of rest before you train again.

Just my two cents. Don’t be a dumbass like me. A couple days off from training is a lot better than weeks or months of bullshit.

[Mark Rippetoe]

I had what I thought was a mild concussion in 2016. Was a fair bit disoriented for most of the evening. Didn't think too much of it and went off on a week's vacation that involved hiking/running all over the Black Hills and generous quantities of good bourbon. By the time I got back I was in bad shape, and dealt with the after effects for months (headaches, memory loss). I got a CT when I got back from the trip and it was clear, for what it's worth.

Yes, you can concuss without a bleed. Remember: warm up carefully and pay attention to what is going on.

[jfsully]

Thanks.

Feeling ok today, not great. But that might have something to do with lack of sleep after a night in the ER.

My wife says I was disoriented for more like an hour, not just a few minutes, so I guess that’s more reason to take it slow. I’ll feel it out with the warmups tomorrow and try not to be a hero.

Sorry, I had written a longer response before, but I guess it timed out or my phone browser just lunched it.

For a pseudo-medical opinion (I am a doctor, but I am not your doctor): It does sound like you had a concussion. A head CT would show bleeding or skull fracture, both of which would be worse than a simple concussion, but a CT does not show concussions. That diagnosis is based on symptoms.

For a simple concussion, training is probably safe. If it makes you miserable, however, you won't get extra credit for torturing yourself, and may delay the resolution of symptoms. Better to take a few days off or a few light days if needed. But if you can train without discomfort, I wouldn't worry about doing so.

[NoStepOnSnek]

Thank you for all the feedback.

In case anybody is interested, i was able to finish a squat day yesterday and bench day today without dying, but it sucked bad. Barely squeezed out squats and missed the last rep on bench. Listening to Dr. Sullivan about not torturing myself, I cut back volume deadlift to one set and dropped weight on volume presses by 10% and still felt way too heavy. Attempted no accessories.

I’ve never been more aware of head pressure during Valsalva. Not that there was more of it - but it sure felt like it and I was just more aware of it. Pain around the stapled laceration certainly didn’t help.

This is the most negative impact I’ve experienced from non-training stress. At least training kept me from breaking anything else when I took the digger.

[Jonathon Sullivan]

The most important thing here is to avoid another head injury. I don't have a problem with resuming training after a few days off. But don't fall down again.