Recovery Files with Dr. Bridget: Crashes, Concussions & Comebacks

Crashes, Concussions & Comebacks: A Female Mountain Biker’s Guide to Spotting and Recovering from Head Injuries

We all hate to be injured but when you are riding hard it can happen. Scrapes and broken bones can be visually seen and treated but what about the hidden injuries. Concussions happen after hitting your head with or without a helmet. Let’s discuss the signs and symptoms, what to do and how to recover quickly to get back on the trails. 

“Your brain doesn’t come with a spare. Handle it with care.” 

Common Concussion Symptoms:

• Physical Signs:
  • Headache or pressure in the head
  • Dizziness or balance issues
  • Nausea or vomiting
  • Blurred vision or sensitivity to light/noise
  • Fatigue or drowsiness
• Cognitive Symptoms:
  • Confusion or difficulty concentrating
  • Slowed thinking or trouble finding words
  • Memory problems (forgetting the crash or recent events)
• Emotional & Behavioral Changes:
  • Mood swings, anxiety, or irritability
  • Feeling more emotional than usual
  • Depression or sadness
• Delayed Symptoms (Hours to Days After):
  • Difficulty sleeping (too much or too little)
  • Persistent headaches or brain fog
  • Trouble focusing on screens or reading

What to Do if You Suspect a Concussion

1. Stop Riding Immediately – Continuing to ride increases the risk that you may experience a more severe injury.
2. Assess Symptoms – If you are feeling any of the above symptoms, assume a concussion.
3. Seek Medical Attention – Even mild symptoms require evaluation, especially if they worsen over time. Schedule an appointment with your doctor.

“Informed athletes make safer athletes, and safer athletes make healthier sports.” — Dr. Cindy LaBella

Get Back to Riding: Post-Concussion Protocol

Phase 1: Acute Recovery (0-72 Hours Post-Concussion)

• Rest & Brain Downtime: Give your brain a break. Avoid screen time, reading and bright lights for at least 24-48 hours.
• Hydration: Let’s fuel that brain by drinking 2-3 liters of water daily and add electrolytes if the injury was after a hot or long ride.
• Contrast Hot/Cold Therapy: We think of ice only after an injury but I encourage my patients to use contrasting hot and cold therapy. Ice is beneficial immediately to reduce swelling. However after 24 hours, try to rotate hot and cold packs to encourage blood flow which speeds healing to the injury. Apply hot packs to the neck/shoulders for 5 minutes followed immediately by cold packs (10-15 min, 3x/day).
• Magnesium:
  • Magnesium, especially the L-threonate form, crosses the blood-brain barrier, relaxes muscles and can support calming neurotransmitters. Find it as a supplement or enjoy magnesium rich foods like nuts, seeds, legumes, dark leafy greens and dark chocolate. 
• Arnica:
  • Arnica cream can be applied topically to areas of pain and tension or oral homeopathic arnica 30 C (3 pellets, 3 times a day) reduces swelling and bruising while aiding in faster recovery. Homeopathy is a great way to gently nudge the body to heal but should always be discussed with your doctor before trying anything new. 

Phase 2: Brain regeneration (3 Days – 4 Weeks Post-Concussion)

• Omega-3 Fatty Acids (EPA/DHA) – 
  • Omega-3 fatty acids improve overall brain health and reduce inflammation which is essential post injury. These omega-3 fatty acids have also been shown to increase your brains ability to grow new nerve cells by increasing Brain Derived Neurotrophic Factor (BDNF). Post brain injury, these characteristics of Omega-3 fatty acids put it on the list. 

Omega-3 fatty acids can be found in fatty fish like salmon. Not into fish? Try supplementing with chia seeds or seek out an omega-3 supplement. Always talk to your doctor as omega-3 fatty acids may act as a blood thinner therefore should be discussed before starting any new supplements. 

• • Phosphatidylserine 
    • A fatty phospholipid that can improve memory, focus and cognitive function. Find it in foods like soy, organ meats, beef, chicken and white beans or ask your doctor about supplementing.
  • Acetyl-L-Carnitine
    • An amino acid that shows anti-inflammatory and neuroprotective effects for our brain. Our body can make it naturally but it is boosted by eating beef, chicken, whole milk and cheese. Supplement if needed.
  • Coenzyme Q10
    • Secondary trauma can happen after a concussion from inflammation and free radicals. Focusing on antioxidants can help reduce this ongoing inflammation and help aid in the healing process. CoQ10 can be found in meats, soy, pistachios and broccoli or look for supplements with Ubiquinol, the bioavailable form of CoQ10.

• Curcumin

• • The active ingredient in turmeric is known for its vibrant yellow color. Curcumin has been shown to boost BDNF, increase blood flow to the brain, reduce free radical damage, and improve cognitive function. This antioxidant supports brain recovery. Enjoy it in a curry, drink a juice with turmeric, black pepper and ginger or discuss with your doctor the best supplement for you.
    

Phase 3: Long-Term Brain Boosting (4+ Weeks Post-Concussion)

By now, you may be feeling more like yourself, back on your bike, navigating trails, and testing your limits again. But just because the acute symptoms of your concussion have faded doesn’t mean the healing is over. Your brain continues to recover long after the impact, and how you support it now can shape your long-term cognitive health, emotional well-being, and athletic performance.

This phase is about going from “better” to optimized. Here’s how we make that leap:

B Vitamins: Foundational Fuel for Your Brain

Think of B-vitamins as the spark plugs of the brain, they’re essential for neurotransmitter synthesis, energy production, and the detox pathways that clear inflammation and waste from your nervous system.

After a concussion, your brain burns through nutrients rapidly, and B-vitamins are among the first to deplete. Replenishing these helps stabilize mood, improve mental clarity, and enhance sleep, three areas often impacted after a head injury.

How to get your B’s?
Brewer’s yeast, meat, poultry, fish, dairy, and eggs are rich in bioavailable B vitamins.
Vegan or vegetarian? Work with your naturopathic or functional medicine provider to ensure you’re getting the active forms, particularly methylcobalamin (B12) and methylfolate, as many over-the-counter supplements use forms that are poorly absorbed.

Probiotics & Gut-Brain Axis Support

Did you know your gut is often called your “second brain”? The microbiome directly influences brain inflammation and neurochemical balance through what’s known as the gut-brain axis. After a concussion, systemic inflammation can impair gut health, and vice versa.

Support strategies:

• Probiotic-rich foods (like kimchi, kefir, or yogurts)
• Targeted probiotic supplements (strains like Lactobacillus rhamnosus and Bifidobacterium longum are particularly helpful)
• High-fiber, plant-forward diet to nourish beneficial bacteria

A healthy gut leads to clearer thinking, better mood regulation, and faster neurological recovery.

See also

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Reclaiming Restorative Sleep

Sleep is where the magic happens, literally. During deep sleep, your brain undergoes a process called glymphatic clearance, flushing out metabolic waste and promoting cellular repair.

If your sleep is still disrupted weeks after your concussion, it’s time to take action:

• Create a wind-down routine: Limit screens at night, dim the lights, and use blue light blockers after sunset.
• Nutritional support: Magnesium glycinate, L-theanine, or melatonin (when appropriate) can help reset sleep cycles.
• Therapeutic sleep hygiene: Keep a consistent sleep schedule and prioritize 7–9 hours nightly.

Poor sleep impairs every aspect of healing. Invest in it like you would any other piece of your recovery.

Want to Take Your Recovery to the Next Level? Consider These Advanced Therapies:

Hyperbaric Oxygen Therapy (HBOT)

This therapy saturates your tissues, including brain tissue, with oxygen at a cellular level. It can dramatically accelerate repair in areas affected by reduced blood flow post-concussion.

Red Light Therapy 

Near-infrared wavelengths stimulate mitochondrial activity in neurons, boosting energy production and reducing oxidative stress. It’s non-invasive, gentle, and deeply restorative.

Brain Rehabilitation & Mindfulness Practices

This is where structure meets subtlety.

• • Begin reintroducing cognitive tasks: puzzles, light reading, strategic games.
  • Mindfulness practices, like meditation or breathwork, can retrain the nervous system and reduce residual anxiety or cognitive fog.
• Ease back into riding with awareness: start with smooth, low-stimulus trails and increase complexity gradually.

Final Thoughts

Healing your brain isn’t just about bouncing back, it’s about building resilience for the long haul. By nourishing your body, calming your nervous system, and staying consistent with these tools, you’re not only recovering, you’re upgrading.

Ride smart. Heal strong. And remember: your brain is worth the long game.

P.S. Crashed? Ditch the helmet.

After a crash, and the helmet has worked its magic protecting your head, it’s time to throw it away and get a new helmet. The consumer product safety commission recommends replacing your helmet every 5-10 years even without an impact crash. After an impact, even if the helmet looks fine from the outside, the internal foam may have compressed or cracked which is hard or impossible to see. Let’s be safe and replace! Check out my article in Recovery Files Fridays on how to choose the correct sized helmet for your gorgeous head. 

Current Concepts in Concussion: Initial Evaluation and Management | AAFP

Zemdegs J, Rainer Q, Grossmann CP, Rousseau-Ralliard D, Grynberg A, Ribeiro E, Guiard BP. Anxiolytic- and Antidepressant-Like Effects of Fish Oil-Enriched Diet in Brain-Derived Neurotrophic Factor Deficient Mice. Front Neurosci. 2018 Dec 21;12:974. doi: 10.3389/fnins.2018.00974. PMID: 30622454; PMCID: PMC6308198.

Sarraf, P., Parohan, M., Javanbakht, M. H., Ranji-Burachaloo, S., & Djalali, M. (2019). Short-term curcumin supplementation enhances serum brain-derived neurotrophic factor in adult men and women: A systematic review and dose-response meta-analysis of randomized controlled trials. Nutrition Research, 69, 1–8.