Concussion: When The Smooth Pursuit Is Not So Smooth
Mary had a fall on her bathroom tiles. Tania was coming back home at night when she had a car accident. Becca was playing with her kids in their newly built swimming pool when her son hit his head against hers.
None of these women was engaged in high-impact sports. None lost consciousness. None of them suspected concussion … for a while.
That’s true that most often concussions happen in sports. That’s also true that most of them resolve spontaneously, without medical help, within 7-10 days. So it can be tricky to pay attention and suspect a concussion when it was not sport-related.
The thing is, the most important thing you can do when you have a concussion is REST in the first few days, giving your brain a chance to fuel the repair. When this doesn’t happen and we carry on with our daily lives as usual – work, driving, computers and social media – the brain’s energy doesn’t go to early repair and timely healing.
For two of my friends that I described in the beginning, the diagnosis of concussion came several weeks later, and healing takes more time now. Rest is not optional any more: off work, driving and reading, with migraines, nerve pain and medication.
I suggested help. I knew that working with the eyes would make a lot of sense, and indeed when we gave it a go – in class or individual sessions – it proved to be beneficial. “It’s a big relief”. “I feel calmer and more connected to my body”. “Tension and pain have subsided”.
However, it was only last week that I learned that the clearest tell-tale sign of a concussion was in eye movements. Dr Jeffrey Goldberg, an ophthalmology professor at Stanford, tells in one of the latest Huberman Lab podcasts:
“One of the really telling ways to diagnose concussion - and this can be concussion from sports or a fall, any source of concussion – is [observing] your smooth pursuit … which is the ability to very smoothly follow [a movement] with your eyes. After a concussion, the systems in our brain, their reflexive ability to properly follow the visual input to tell your eye muscles exactly where to move, gets disrupted. And all of a sudden, your smooth pursuit starts to look choppy and it's not so smooth anymore”.
For example, you could notice this when you watch a child playing on the swings, or following a hockey puck on the ice: observing any moving object.
But apart from being used in diagnostics, eye movements are used for neuro-rehabilitation post-concussion: focusing near and far (accommodation), the ability of both eyes to work together (convergence) and smooth pursuit exercises would be often a part of recovery protocols. Having a check with a neuro-optometrist is a very good idea following a concussion diagnosis.
In the Feldenkrais Method®, we have a lot of lessons that invite you to pay attention to your eyes’ movement. Your eyes are literally a part of your nervous system: during development, your retina is formed as a cup-like outgrowth of one of the parts of your brain. Plus, more than half of the brain’s pathways are dedicated to vision and eye movement control. Because of this connection, eye lessons often have more pronounced neurological benefits. Like lesser migraines or a calmer, less alerted and more healing-promoting state of your nervous system. Especially when bigger movements can cause dizziness, small and gentle sequences involving your eyes can help your brain heal.
We rarely realise how strong our vision habits can be, and how much effort we use to see. Most of the time, we could easily fare with less effort, and this makes a considerable difference while healing from a concussion.
Besides focusing on eye movements, I believe the general Feldenkrais Method® principles apply to healing concussion as well – as eloquently described by another practitioner, Julie Francis, here:
Do less, go slow, pay attention and rest often
Play and explore rather than doing “exercises”
Imagine when moving is too much.
Please note: signs and symptoms of concussion may be complex and highly variable. Always check with your doctor – I’ll repeat that a timely diagnosis is essential. If you’d love to raise the issue of visual difficulties with your GP, here is the article that could help: Persistent visual disturbances after concussion
And here is a good flyer for children explaining why their brain needs rest: How Brain Rest Works For Concussion Recovery
If you recently had a concussion and would love to try a Feldenkrais® session – group or individual, please get in touch and we’ll arrange a brief chat to see how I could help.