“I knew I’d hit my head. I knew that I’d landed on my face. I remember as I was crashing, and I had this almost weird sensation of like my helmet, like compressing against my head. I was a little bit stressed. I took my helmet off, and I checked the inside of everything, and my helmet was actually totally fine, covered in mud, but like nothing noticeable.”
What seemed to be a fairly innocuous fall in a practice run for a National Series Downhill event would be where Emily would suffer her concussion. The multi-disciplined rider suspected that nothing was wrong and would continue to race later that day. Much to the relief of Carrick-Anderson in hindsight, further racing would be cancelled for unrelated reasons.
“It ended up being a good thing, and because at the time I didn’t know, I was concussed.”
The first signs of Emily’s concussion would appear in the days’ following the incident:
“I had headaches. Pretty much every day for, I want to say like four or five days in a row, and starting the day after I crashed.”
Putting the headaches down to the nerves of moving into a new team, and the packed calendar of racing she was looking forward to, Emily kept the headaches to herself, and had no idea that she was suffering the effects of concussion:
“I however, big mistake, did not tell anyone. I think it was just the thought in my head that I was meant to be going away to Germany a week later and it was a big trip. So you know, it’s that whole thought in your head. You don’t really want to miss out and everything. And then once the headache stopped, I was like, OK, I’m fine.
The following weekend, Emily would race a National MTB Cross Country series event, and the first psychological effects were made evident:
“I think my parents knew something was up. I should have known something was up. I didn’t want to be there. I didn’t really want to race. I had absolutely no motivation. Not really any energy. I was just like, that’s really weird for me, like, you know, especially doing a national cross country race.. I wasn’t really sure what was going on it was a big change from the weekend before at the downhill race, I was having an amazing time.”
Looking back months later, with the benefit of hindsight, Emily suggests that was the moment she should have spotted the concussion, before traveling abroad for her first big block of racing with her new team, something that should have been an exciting prospect for the 19-year-old rider:
“Suddenly it was this one big change, looking back on it we’re all like, wow, OK, we really should have seen the signs. I was then away for just over three weeks. So I wasn’t with my family, who obviously know what I’m like. They would have been able to spot the signs as they live with me every day.”
Emily’s symptoms would significantly worsen when she headed abroad:
“I was racing and training abroad and I was just basically getting worse and worse. It was more emotional effects that I had. I didn’t really have any issues with balance or anything but I was very tired – that was one of the big things. I was very tired but no headaches or anything, but extremely emotional, extremely low motivation, low energy.
For a rider that races Cross Country, Downhill, Enduro and Cyclocross, all to a very high-level, Emily had never suffered any motivational issues, and so it came as a real shock, especially at a time when there should have been a lot to celebrate:
“At the time I honestly just thought I was falling out of love with the sport. I just didn’t want to be there, and I was having a pretty rough time abroad. It was my first few races with my new team, so I was like, wow, why am I not having a great time why am I crying a lot? Like just crying for no reason.”
Unsure of what was causing these issues, Emily, with the advice of her parents and coaches would decide to pause her training and racing and come back to Scotland to see what was going on:
“I was still at home, just kind of crying all the time. I got really, really anxious. That was one of my big, big symptoms. I was finding it really difficult, speaking to people. I had some friends over at the house, we’d be doing totally normal things, and I’d have to take breaks every few hours just to go and cry on my sofa for no reason.
“I came home and that’s when we kind of started figuring it out – we were like, OK, thinking back and it all this started after the downhill race where I crashed and I hit my head and we were like, OK, it could be concussion, but we still weren’t sure.
After suspecting it may be concussion, Emily immediately started speaking to doctors at the sportscotland Institute for Sport.
“We started the whole process of going to the doctor with the Institute doctors, and I had 16 out of 22 of the symptoms; and we were like, OK, it’s most likely concussion and obviously it’s so hard to like, diagnose. You can never really 100% say it’s this, but it kind of made a lot of sense considering what happened, the time frame and all that.”
In accordance with sportscotland guidelines on concussion, Emily followed a graduated return to sport after a period of time away from the bike, supported by the expert medical team.
“What really confirmed it was concussion for me was once I took three to four weeks, completely just off the bike, and the difference I felt was like insane. Like the improvement I had, it was almost just quite sudden.”
Even then once she started her return to the bike, at the most gradual of paces, the effects of the concussion would still have an impact:
“One weekend I had done my, I think it was like half an hour on the rollers and then me and my mum went on a walk. Our walk ended up being longer than we thought and it was very sunny. So obviously it’s quite hard on the eyes and everything, and on the head. I had a bit of a set back from that – I just had another day the next day where I was just like kind of crying randomly, again, feeling very anxious again.
“We had to take a bit of a step back and then progress up again. But then after that, it almost quite suddenly got quite a lot better.”
Progress was slow, and when it seemed that Emily could return to racing the after effects of the concussion were still showing:
“I had planned to get back to racing and go out to a World Cup for Enduro. However, when I got there, I had an anxiety attack. The best way to describe it was when I was on one of the gondolas up to one of the stages, I just had a major panic and that’s one of the biggest things for me, even once I’d fully recovered from this concussion. I didn’t really know that could happen after concussion and I wouldn’t ever say I’ve really been an anxious person beforehand or anything.”
Fortunately, the support of the doctors and sport psychologists at the sportscotland Institute for Sport were able to provide key support to help Emily fully recover.
“I’ve had to work with psychologists and stuff just to kind of manage it. And like, obviously, it’s great. I’m pretty much completely better now. But yeah, the after effects have been crazy. Not just the full-on concussion symptoms, but what can happen afterwards.
After her concussion in the middle of April, it was the end of July where Emily would make her return to racing:
“We decided to take a little bit more time just riding my bike. And then I started back in my first race back at a national. I did national champs, which was a little bit easier to gradually ease myself into. Then I raced a World Cup and yeah, thankfully it’s been smooth sailing since then.
Dr Carrie McCrea is a Sports and Exercise Doctor with sportscotland and worked closely with Emily on her recovery from concussion. Her advice to athletes, as well as parents and coaches after a head injury, is always to air on the side of caution and familiarise with the symptoms:
“If you sustain a head injury, it is important to recognise the symptoms of a potential concussion, remove yourself from training or competition, and seek medical advice as soon as you can. Early recognition and appropriate management will support a safe and full return to sport. The sportscotland Scottish Sports Concussion Guidance provides both quick reference and detailed guidance to support athletes, parents and sports staff.
Emily, fortunately, is back racing, and competed at the Enduro World Championships last weekend, but her advice is to ensure you get checked out immediately after a head injury:
“I think 100%, you’re better safe than sorry. And if you know you’ve hit your head, just like for the next like few days or even the week, just like everyday sort of check in with yourself and be like, am I feeling completely normal? Do I have any headaches? Have I had any sort of symptoms? If you do have any symptoms, you should definitely be safe and contact a doctor. I think it’s just it’s not worth the risk. You only get one head!”
A massive thank you to Emily Carrick-Anderson for being so open and candid about her experience with concussion and to the team at sportscotland Institute for Sport for their time.
Resources from sportscotland Scottish Sports Concussion Guidance can be found here.