A concussion is a mild form of traumatic brain injury (TBI) that occurs when a bump, blow or jolt to the head or body causes the head and brain to rapidly move back and forth. This jarring movement not only stretches and damages brain cells, but also triggers chemical changes in the brain. In the U.S., around 3.8 million concussions occur annually mainly due to sports and other recreational activities.1
But even if a concussion appears to get better, it can still lead to certain symptoms like brain fog, fatigue, dizziness, concentration difficulties, depression, and amnesia, which last for weeks. In some people, the effects can be even more long-lasting and could predispose them to more risks in the future, such as being involved in a car crash.
New Evidence Shows How One Concussion Reshapes Future Driving Risk
Recent research published in BMJ Open investigated how a single diagnosed concussion influences a person’s chances of experiencing a later motor-vehicle crash. The analysis reviewed records from more than 3 million patients in Ontario and sought to determine whether concussion symptoms leave lasting functional changes that affect driving skills and increase crash risk.2,3
• Study design and population — The retrospective cohort analysis was conducted using 20 years of administrative health data, covering 3,037,028 adults who presented to one of 178 emergency departments between 2002 and 2022.
• Two cohorts were compared — The first was the concussion group, which was composed of 425,158 adults. The second was the control group, composed of 2,611,870 adults diagnosed with ankle sprain. Patients younger than 18, have conditions incompatible with driving (e.g., dementia or blindness), individuals hospitalized for severe injuries, and those who died within 30 days were excluded. They tracked both groups for a median of 10 years.
• Among the participants, 200,603 ended up in a car crash — Out of those, 33,508 were from the concussion group, while about 167,000 were from the ankle sprain group. When the researchers compared the two groups, they found that people who had a concussion were at noticeably higher risk, even after adjusting for factors such as age, health conditions, income level, and past health care use.
Those who had suffered a concussion were 49% more likely to be in a serious crash than those who only had an ankle sprain.
Concussed? Take Caution Before Taking the Wheel
Your safety depends on how seriously you take the aftermath of a concussion. Many people rush back to daily routines, including driving, because their symptoms feel manageable. But, as the featured study showed, this rush can lead to another injury or a serious crash.
• The first month after a concussion is the most dangerous time for driving — During this period, people with a recent concussion were about six times more likely to get into a serious car crash. This sharp increase in risk likely happens because concussion symptoms can make it much harder to drive safely while the brain is still healing.
• Several other factors also made the risk of a traffic crash higher after a concussion — These included being younger, male, or living in a rural area, as well as having a lower income, driving late at night, or having a history of alcohol misuse.
• The more incidents of concussion, the higher the risks — Another important finding from the featured study is that there’s a dose-dependent relationship between concussions and car crashes. People with one concussion had about a 73% higher crash risk; those with two concussions had more than double the risk, and people with three or more concussions had an even higher increase — about 124%.
• The higher crash risk has a significant impact on the health care system — It resulted in an estimated 1,633 additional ambulance trips, 59,978 extra days spent in the hospital, and about $835 million in medical and societal costs. These numbers highlight how even a seemingly mild brain injury can create significant real-world consequences, not only for the individual but also for the health care system and the community.4
Given the findings of this study, people who’ve suffered from a concussion are advised to take it easy and allot sufficient time for recovery. This will help manage symptoms like insomnia, headaches, depression, or substance use problems, as these can affect driving safety.
“I worry that sometimes a concussion requires more recovery time than most people realize. Rushing things might lead to another injury including a life-threatening traffic crash,” study author Donald Redelmeier, a scientist at ICES and Sunnybrook Research Institute, said.5
The researchers also recommend avoiding high-speed driving, especially late at night or in bad weather, during the first month after the injury. In addition, clinicians are advised to warn patients about the increased risk of car crashes after a concussion.
“These results highlight the importance of traffic safety following a concussion as well as preventing concussions in the first place,” Robert Tibshirani, a professor of statistics at Stanford University and one of the study authors, said.6
There’s No Such Thing as a ‘Minor Concussion’
A concussion usually occurs when a person slips or falls, accidentally hitting their head. Those who play contact sports like football, rugby, or ice hockey are also prone to getting these injuries.
However, because they often seem minor, many people do not see a doctor following a concussion. This can be harmful, as the symptoms vary widely; they can occur even if you do not lose consciousness and can last for days, weeks, or months. Below are some possible symptoms of a concussion:7
• Headache or feeling a “pressure” on the head
• Nausea or vomiting
• Balance problems or dizziness, or double or blurry vision
• Feeling sluggish, hazy, foggy, or groggy
• Unable to recall events prior to or after the incident
• Appears dazed or stunned
• Clumsy movements
• Answers questions slowly
• Loss of consciousness (even briefly)
• Mood, behavior, or personality changes
• Bothered by light or noise
• Confusion
• Concentration or memory problems
• Sleep problems
It can also be difficult to distinguish a concussion and a more life-threatening brain injury. Hence, the best thing to do is to seek medical attention following a bump, blow, or jolt to the head. Regardless of how severe it appears to be, it’s also important to pay careful attention to any mental or psychological changes that might occur over the coming week or two.
TBI Expert Shares Helpful Ways to Treat a Concussion
For those who are prone to concussions or other head injuries, such as professional athletes or military personnel, “The Concussion Repair Manual: A Practical Guide to Recovering from Traumatic Brain Injuries”8 is one of the best resources out there to help in recovering from a TBI. This work comes from 20 years of research by Dr. Dan Engle, board-certified in adult psychology and neurology, and who completed psychiatric fellowships in child, adolescent and forensic psychiatry.
If you have TBI or you know someone who does, I encourage you to pick up a copy of this book. I’ve summarized a few Engle’s strategies below to give you an idea of what you can expect from this valuable resource.
• Floatation therapy — Engle is a strong proponent of floatation therapy, noting its ability to reset so many different systems. He recommends doing a series of eight to 10 floating sessions within a three- to four-week period. Afterward, there would be a significant improvement in your symptoms. For maintenance, do one or two sessions per month.
• Hyperbaric oxygen — This therapy works by saturating your tissues with oxygen, allowing it to get into all of the neuroreparative mechanisms in your entire neurologic system, from head to toe. Hyperbaric oxygen therapy accelerates all wound repair processes, be it in peripheral vasculature or in central vasculature, around the nervous system, brain, and spinal cord.
An alternative for home use would be Exercising with Oxygen Therapy (EWOT). It’s not as effective as hyperbaric oxygen treatment for neurological recovery because you’re not saturating the tissues with oxygen, just your blood, but you can still benefit if you have a low partial pressure of oxygen (low oxygen in your blood).
• Low-light laser therapy (LLLT) or photobiomodulation — This can be done using either lasers or light-emitting diodes (LEDs). “There are a lot of different studies that show light is beneficial,” Engle says. “When we’re talking about neurologic recovery or building adenosine triphosphate (ATP) production, driving mitochondrial function, there are certain wavelengths that seem to be optimal for that.”
• Transcranial direct current stimulation (TDCS) — TDCS provides a more global stimulation, so while some patients experience good results, others do not, due to lack of specificity. According to Engle, if it’s going to work, you’ll notice results quickly. If no benefit is noticed in the first few sessions, move on to some other therapy.
• Cannabidiol (CBD) oil — Cannabis has two primary therapeutic components; one is tetrahydrocannabinol (THC) and one is CBD. THC has a psychoactive component. CBD has a neuro-reparative component. The CBD receptors are globally affiliated with neurologic function throughout the entire brain. When we’re engaging and stimulating those receptors, we see the neurochemical cascade toward repair, regardless of the input, but particularly with concussion.
For a more comprehensive explanation of these strategies, I recommend reading “Concussion Repair Manual: A Guide to Traumatic Brain Injury.” Engle has also put together a free Concussion Repair Checklist,9 which covers exactly what you need to know for recovery, along with the Top 10 foods for supporting your brain health.
Safety First — Tips to Prevent Head Injuries
If you had a concussion and notice a change in yourself within the days or weeks, it’s vital to seek a more comprehensive medical evaluation and workup to avoid long-term repercussions. In the interim, be sure to avoid any activities that could further injure your brain until the concussion is fully healed.
Still, preventing a concussion from occurring in the first place is still the best option. If you’re doing activities that could lead to bumps and thumps on your head, follow these commonsense tips to protect yourself and lessen the impact:
• Always wear your seat belt when driving or riding in a car.
• Never drive while under the influence of alcohol or drugs (some medications can also make you drowsy).
• Wear a helmet or appropriate headgear when riding a bike or motorcycle, playing contact sports, horseback riding, or snowboarding.
• If you have seniors at home, install grab bars next to your toilet, tub and shower, and handrails along both sides of stairways.
• Safeguard children in your home by installing window guards and safety gates.
• Never leave your child unattended in the playground. The playground equipment also needs to have shock-absorbing materials, such as hardwood mulch or sand, in key areas where falls are likely to occur.
Frequently Asked Questions (FAQs) About Concussions and Car Crash Risk
Q: How much does a concussion increase the risk of a future car crash?
A: A single concussion raises your long-term car crash risk by about 49%, even after symptoms seem to fade. This increased risk holds true for years and reflects how lingering brain changes affect reaction time, concentration, and judgment.
Q: When is driving most dangerous after a concussion?
A: The first month is the highest-risk period. During this window, your chance of a serious crash rises more than sixfold, especially if you drive late at night, during bad weather, or at high speeds.
Q: Do multiple concussions increase driving risk even more?
A: Yes. The risk climbs with each additional concussion. Two concussions more than double your crash risk, and three or more raise it by about 124%, making long-term brain protection essential.
Q: Which factors make post-concussion driving even riskier?
A: Young age, alcohol misuse, rural roads, low income, and nighttime driving all magnify the danger. These factors interact with concussion symptoms like insomnia, headaches, and slowed thinking, making driving more hazardous.
Q: What steps help reduce driving risk after a concussion?
A: Giving your brain more time to heal, avoiding late-night or high-speed driving, treating symptoms like sleep problems and depression, and following medical guidance all lower your risk. Paying attention to symptoms and adjusting your habits protects both your safety and recovery.
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