Bicyclists and Head Injuries – What You Need to Know


By Russ Hymas and Ken Christensen — As bicycle accident attorneys, some of the most common injuries we see are orthopedic in nature – shoulders, knees, or wrists. But one of the most serious injuries in cycling, and the one that gets overlooked the most, is an injury to the brain.

According to the American Association of Neurological Surgeons, cycling accidents played a role in about 86,000 of the sports-related head injuries treated in emergency rooms in 2009, making it the top sport for head injuries that year! Football, a sport notorious for concussions, only accounted for 47,000 of those head injuries.

It’s a shocking statistic that leaves one wondering … If head injuries and cycling are so intertwined, how and why might they be overlooked?

We believe that sheer grit provides part of the explanation to that question. Anyone who has watched the Tour de France or other professional cycling races has seen wrecks where cyclists pick themselves up with broken collar bones and road rash and finish the race. This kind of mental resilience is borne out of intense training designed to help cyclists ignore physical pain and symptoms (think of Jens Voigt’s quote, “Shut up legs! Do what I tell you to do!”).

While this fortitude is admirable, it can often cause a cyclist to discount or disregard symptoms following an injury. This is particularly true with head injuries, where symptoms are often subtle enough to be missed by the cyclist, his/her family or friends, and even doctors.

It’s also common for cyclists to overlook a head injury because their concern about the damage to their bike overshadows their concerns for their own health. Cyclists spend countless hours on their bikes, and have invested precious time, money, sweat, and tears into their two-wheeled friend.

One of our past clients fractured his thumb and tore several ligaments in his shoulder when a car turned in front of him. Yet he was so concerned about the damage to his bike that he would only agree to take an ambulance to the hospital if his bike could come in the ambulance with him!

What’s more, even when a cyclist is diligent about seeking medical care after a wreck, brain injuries are still frequently missed. In the case of a mild traumatic brain injury, commonly referred to as a concussion, a brain MRI or CT scan will often show everything is “normal.” Such a result requires that the doctor look to other symptoms such as headache, difficulty thinking, memory problems, mood swings, and frustration in determining whether a concussion is a proper diagnosis. Often, though, these types of symptoms do not surface (or are not recognized) for days or even weeks, when the injured person attempts to return to work or their normal activities and notices that something isn’t right.

So what should a cyclist with a suspected brain injury do? First, take head injuries seriously. Even though this type of TBI is called “mild,” the effect on the family and the injured person can be devastating. Seek medical care as soon as possible, and don’t hesitate to return to the doctor if your symptoms are persisting – even if you have already been “checked out.”

In addition, cyclists – as well as their family members and close friends – should be aware of the common symptoms of concussions. These include:

  • Fatigue
  • Headaches
  • Visual disturbances
  • Memory loss
  • Poor attention/concentration
  • Sleep disturbances
  • Dizziness/loss of balance
  • Irritability/emotional disturbances
  • Feelings of depression

Because the symptoms above are subtle and can be associated with other stresses in life, an injured person may simply feel frustrated at work or when performing household tasks or other activities. Take time to review the list of symptoms and consider the possibility of concussion. And remember that family and friends will often notice changes in behavior before the injured person realizes there is a problem.

Ken Christensen and Russ Hymas are avid cyclists and Utah attorneys at Their legal practice is devoted to helping cyclists injured in collisions with motor vehicles. They are authors of the Utah Bicycle Accident Handbook and are nationally recognized legal experts on cycling laws and safety.

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  1. I live in the square state to the right of you all, and we’ve come across an interesting problem that involves bicyclists, head injuries, and the law that may also involve you all in Utah. A local bicyclist was hit by a driver with their car, the bicyclist fell to the ground, hit her head, and suffered a concussion. As required by law, the driver stopped and asked the bicyclist if she was okay. In her fuzzy and compromised mental state she didn’t realize the extent of her injuries and told the driver that she was okay, so the driver left the scene of the injury collision.

    When a Colorado based lawyer with Bike Law gave a talk to our group, Mesa County Bicycling Alliance, we asked if what the driver did was legal. To my surprise, the answer from both the lawyer and a Colorado State Patrol office in attendance was ‘yes’. If you, as a bicyclist hit by a driver tell that driver that you are okay, the driver is apparently released from all responsibility to stay at the scene. Wow.

    As anyone who has ever dealt with someone who has just been on the receiving end of a head injury knows, the last person who is qualified to judge the state of the person who has hit their head is the person who has just hit their head. Any statement the concussed or potentially concussed person makes should not be considered to be well reasoned, let alone have the legal power to absolve responsibility. I’ve personally suffered a bad head injury due to a bicycle accident, believe me when I say that the person who is hit on the head is not capable of clear thought.

    I have mentioned this situation to our friends at Bicycle Colorado and hopefully we’ll be able to make some changes to the law post pandemic. Perhaps you folks in Utah might want to investigate whether or not your laws contain this same idiosyncrasy.

  2. I had an accident a few years ago, low speed even, where the back of my head with helmet slammed into the asphalt. After a short self-assessment I stood up, shook off the dust and since I could still see clearly and had no pain in my head I finished my ride. I never visited a doctor to be checked out and over the next few weeks the other bruises healed and and I thought no more about it. A few months later I went in for my annual hearing test as I wear hearing aids. The results from that test showed that since the last test I had lost a significant amount of hearing ability. Was this caused by my accident. Even the ENT Physician I subsequently visited could not answer that question. But as stated in the article above balance can result from head injury and much of our balance is centered in the ears. So what’s the best advice here (hear)? Obviously wear a helmet (and a mask? LOL) and that will give you some significant protection but you do hit your head, even with a helmet, perhaps a doctor’s visit is called for.


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