Hannah is the Associate Head Athletic Trainer at Marymount University in Arlington, Virginia. She received her undergraduate degree in Athletic Training from the University of New Hampshire (UNH), and her Masters in Applied Physiology and Kinesiology with a Concentration in Athletic Training from the University of Florida. She has taken on the role of Concussion Specialist in her clinic and has a very personal passion for concussion awareness and advocacy.
In Hannah’s sophomore year playing Division I lacrosse for UNH, her world flipped upside down. It was the last drill of practice and a defender cross checked her, causing major whiplash. She left the field brushing off the impact and went inside to lift with her teammates. Feeling a little off, she pushed through the extraneous powerlifts and returned to her dorm room as usual. Her roommate at the time, having their own history with brain injury, recommended Hannah check back in with her athletic trainer (AT) after seeing how out of it Hannah was. She was diagnosed with a concussion and had an X-ray taken of her neck in the ER. She then followed the proper return-to-play protocol and was back out on the field in just over a week. In theory, this should have been fine. But in her first game back, she was hit directly in the goggles by an opponent’s stick and fell straight to the ground. Again, trying to brush off the intensity of the impact, she convinced her coach and medical staff she was fine and went back in to play during the second half. Then she began to feel the classic concussive delayed onset of symptoms, and ended the day completely distraught in the AT room. Hannah said she had never experienced feeling so overly emotional before; she was laughing one second and sobbing the next, feeling entirely out of control and overwhelmingly confused.
The weeks that followed consisted of quiet, dark rooms, mental fogginess, heightened emotions, debilitating headaches, missed practices and games, and lots of isolated rest. She experienced “Tip of the Tongue” phenomenon, struggling with word retrieval in her daily conversations leading to embarrassment around peers. At first, her teammates were really supportive of her recovery, but as time went on and her concussion symptoms lasted, it was hard for her and her friends to manage social pressures. She was constantly told to go home when trying to join lacrosse events, and was excluded from her normal routine in efforts to promote her physical healing. This began taking a really big toll on her mental health. In our conversation, Hannah shared, “It is really hard to explain the true fogginess and emotional intensity that comes with a concussion. It’s only something that you can understand by experiencing it.” I couldn’t agree more.
Still not allowed to practice, she began to use the elliptical and stationary bike, monitoring symptoms as she increased her tolerance to activity. She had a lingering deeply uncomfortable pressure in the front of her forehead, and was later diagnosed with occipital neuralgia (a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head). These rams-horn patterned headaches were treated with anti-inflammatory nerve medications, three rounds of injections in her neck, and eventually surgery. After finally finding relief and recovering from her operation, Hannah began her true return to UNH lacrosse. She had spent the majority of her sophomore and junior year doing concussion rehab, and in the summer before her senior year, she was finally cleared to get back on the field.
Hannah had kept the focused mentality of overcoming her injury and worked hard to earn her place back on the field playing the sport she loved so much. Lacrosse was a massive part of her identity and missing it for all those months was soul crushing for her. But in one of her first scrimmages back, she was bodied by a larger teammate and although not harmed from the contact, had a moment of realization that she didn’t want to risk getting hurt again. So, Hannah made the incredibly difficult decision to step away from the sport she loved before injury could take it away from her. She had done what she set out to do- to be able to play again- and that was enough. She was empowered by her decision knowing that it was just that – her decision. It wasn’t a forced removal or medical ban, but a personal choice to put her mind and body first, regardless of the social or emotional consequences.
Stepping away from the sport she’d spent her entire life playing was truly heartbreaking for Hannah. “My entirely identity was being an athlete. My identity was being really strong and I prided myself on that,” she shared as we talked about her experiences. Her physical body completely changed through injury, going from the strongest lifter on her whole team to someone so thin, they were put on an eating disorder watchlist. She lost all her muscle from lack of use, which was only heightened by all of the steroid-based medication she was prescribed for occipital neuralgia. The changes in her physical body were obvious, and people around her made comments which deeply impacted her self-esteem. “To look in the mirror and not recognize the person I saw, that was really hard,” Hannah told me. We began to talk more about the mental and emotional hardships that accompanied her brain injury, and how critical it is to acknowledge those in concussion awareness. She experienced Post Traumatic Stress Disorder (PTSD), and would wake up in a panic from nightmares about hitting her head. After a particularly troubling dream, she remembers waking up and completely falling apart on the phone with her mother. She felt at a loss, riddled with anxiety and not sure how to cope. Her mom connected her to a sports psychologist who she now says changed her life. She had no idea how much she needed therapy until she started going. At her first session she was simply asked, “What’s going on?” and began uncontrollably crying in response. As noted by her clinician, she was a super bubbly and light person, giving no outward indications to what she was deeply struggling with inside. She described the introduction of mental health care into her life as pivotal, and something that she thinks everyone could benefit from, but especially those in the brain injury community. Having a safe space to talk about everything you’re going through with someone dedicated to listening to you in a nonjudgmental and unbiased way is something Hannah says she would not be where she is without. She was able to learn so much from her unfortunate experiences, and take that knowledge with her into her profession as an athletic trainer.
Hannah spent most of her time in graduate school studying concussion and brain injury in depth, writing case studies on herself, and presenting to boards of athletic trainers and other soon-to-be clinicians with hopes that something she said would stick with the audience. Her goal was to spread the word about invisible injury and make others aware, and her hard work paid off, as she has had multiple colleagues reach out in years following, asking questions and seeking guidance for their patients with experiences resembling her own. She wrote a systemic review addressing the “Effect of Exercise Following a Concussion to Reduce Risk of Developing Post-Concussion Syndrome,”and is using what she learned in her clinic today. Because of her own experience, her students are getting better care. She is able to guide them through proper rehabilitation and uses the newest technologies to aid with healing. She has had multiple students feel the unexplainable confusion, fogginess, and heightened emotions from concussion that she knows so well, and is able to meet them with true empathy and understanding. She knows what it is like to feel completely alone and not understood, and does everything in her power to make her students feel seen and heard; something that is crucial for someone experiencing an invisible injury.
