The big air Olympic vice-champion had to stay away from the snowparks for three weeks last fall, before making a gradual return there so as not to risk seeing her symptoms persist.
“In freestyle disciplines, concussion is one of the main injuries. There are as many as cruciate ligaments in a year, for example.” Cyril Barthomeuf, the doctor in charge of the French freestyle ski and snowboard teams, is categorical: few high-level skiers have not already experienced this far from trivial injury. In the running for a second world title in big air, Sunday March 5, in Bakuriani (Georgia), the Olympic vice-champion of the specialty, Tess Ledeux, lived this painful experience at the end of October.
While training in Germany, she hits the snow violently when landing a jump. As she gets up, her nose bleeding and her mind clouded, the 21-year-old freestyle skier quickly recognizes the signs of a concussion. “When I fell, I was first stunned. Then, I felt like vomiting and had strong headaches. I had already had two head injuries when I was younger, but never so important”she remembers.
With the video of the fall and the list of symptoms, Cyril Barthomeuf is quick to give his verdict. “I didn’t have to look any further, there was at least one concussion, ie mild head trauma”, explains the sports doctor. Concussion, which many skiers suffer each year, is not an injury like any other. Its diagnosis is difficult to establish – the lesions being undetectable on MRI – and the symptoms are multiple (loss of consciousness, vomiting, fatigue, balance and memory disorders, confusion).
“There are 30 concussions a year among top athletes. It’s a lot, because it only concerns our alpine and freestyle teams, ie 90 athletes.
Stéphane Bulle, doctor for the French teams at the FFSat franceinfo: sport
For Tess Ledeux, after the diagnosis comes the long post-concussion protocol: “My headaches persisted for a long time and I was very tired. I also had insomnia. To resume competition, all the symptoms had to disappear. It took three weeks.”
Rest, the only remedy
The only treatment to make them go away is rest. “It was frustrating, but I took my pain in patience. I resumed gradually, with walking, then light jogging, then skiing by increasing the volume and the intensity, testifies the skier of La Plagne. Ten years ago, we would have taken it lightly. From now on, we are directly taken care of and it is reassuring, because we know the seriousness of concussions.
“The French Ski Federation recommends a minimum stop of one week for adults, and three weeks for young people, up to 18-20 years old. Their brains being less mature, they are more at risk of presenting symptoms that endure.”
Cyril Barthomeuf, doctor for the French freestyle teamsat franceinfo: sport
According to the doctor of the French freestyle team, rest allows above all to avoid short-term complications and to avoid second impact syndromes. “If a person has a concussion and it lands on their head before their brain has recovered, it can trigger major problems like strokes. In a discipline like big air, the concussion also leads to a real risk of getting lost in the air because it affects bearings, balance, memory and rapid decision-making. So the idea is to wait for the brain to recover before subjecting it to further stress.”
Concussions are also the subject of special surveillance since a causal link has been established with theChronic traumatic encephalopathy (ECT), a neurodegenerative disease. “It is an anatomical lesion recently discovered by autopsying the brains of American footballers. Today, we do not really know what triggers it because there is no threshold. You can develop ECT after three concussions as after twenty. But we know the effects for which it is responsible: aggressiveness, memory loss, attention disorders…”, points out Cyril Barthomeuf.
“ECT inevitably worries me. We immediately think of the worst. I discussed it a lot with my doctor. But we now have rigorous protocols in skiing, and there is no reason why it’s going badly”, assures Tess Ledeux for her part.
>> READ ALSO: Head injuries in sport: chronic traumatic encephalopathy “is a judicial time bomb”, warns a neurosurgeon <<
Raising awareness of amateur skiing
If the two doctors of the France team underline a change of mentality for ten years, both agree to say that the margin of progress remains immense. Because if Tess Ledeux was able to benefit from excellent follow-up and a rapid diagnosis, a large number of concussions go under the radar due to a lack of knowledge and means, especially in the amateur world. “In skiing, there is no concussion protocol as we know it in rugby. We are inspired by it, but in reality, if the athlete wants to finish his run and he assures that everything is fine, the race doctor will not carry out a complete evaluation.specifies Cyril Barthomeuf.
To prevent post-concussion disorders, the French Ski Federation (FFS) relies on prevention. She sent all her coaches a document listing the symptoms of a concussion as well as the right actions to adopt. “We are trying to raise awareness among skiers, volunteers, coaches, physiotherapists, city doctors. concussion”, supports Stéphane Bulle, FFS doctor.
Tess Ledeux claims for her part to have recovered all her faculties but she learned new reflexes from this episode. “I have incorporated neck exercises into my routine and I listen to myself a lot more. I also worked with my mental trainer and my coach because I was afraid of falling on my head. When you hurt your shoulder or your knee, it’s annoying, but the brain is never an injury like any other.” she explains. Again victim of a fall, Tuesday, during the final of the slopestyle, Tess Ledeux wants to be reassuring. “Everything’s good”, assured the Habs, Friday, on the channel l’Equipe, after qualifying for the big air final: “I still have a few small after-effects but nothing serious, I’m well surrounded. The two days of rest really did me good so yes I think I’m re-boosted.”