Leading neurologist gives insight on Dale Earnhardt Jr. recovery

Photo by Rusty Jarrett/Harold Hinson Photography

By Jerry Jordan, Editor

LONG POND, Pa. – After being out of the racecar for the past three events, one of the biggest questions in the Sprint Cup garage this weekend has been whether Dale Earnhardt Jr., who is suffering from “concussion-like symptoms,” will return next week at Watkins Glen International Raceway.

This past week, Earnhardt Jr. said the recovery process was taking longer than anticipated and that was after he Tweeted a few days before that he was getting better. No one is willing to confirm whether he will return to the car for the Cheez-It 355, which is a week before the series gets a rare off-weekend, but many are speculating he will take another week off.

“I’m going for another evaluation here soon to see what kind of gains we’ve made, get in front of my doctors, let them look at me and let them tell me where they think I am at and that will help us make the decision on what we are going to do for Watkins Glen,” Earnhardt Jr. said, in a very somber Dale Jr. Download podcast last week. “There are certain things that you can race through but one of the things you cannot race through is concussion-like symptoms. And, you know the balance deal is a critical of being able to drive a racecar and this process is going to take a little bit longer. I think that is what I was trying to convey when I was telling you guys how I was going to take this slow and listen to the advice of my doctors. I am not going to go against that advice no matter what.

“I can’t play around at this age and with my history, I definitely don’t need to get cute.”

Kickin’ the Tires reached out to one of the top neurologists in the country, Dr. Christopher Giza with the UCLA Brain Injury Research Center, to get an idea what Earnhardt Jr. is going through and what an expert in the field would advise in this situation. Dr. Giza was clear that he could not speak specifically about Earnhardt Jr.’s case, only that he could address the scenario as it would apply to athletes in-general who may suffer from post-concussion syndrome. Dr. Giza is the director of the UCLA Steve Tisch BrainSPORT program, has specialized in both adult and pediatric traumatic brain injuries (TBI) and currently serves on advisory committees for TBI/concussion with the Centers for Disease Control, NCAA, Major League Soccer and U.S. Soccer Federation and has been a clinical consultant for the NFL, NHL and MLS.

Dr Christopher Giza

Dr. Christopher Giza, Director UCLA Steve Tisch BrainSPORT program

Dr. Giza explained that someone suffering from the symptoms Earnhardt Jr. has described would likely not do well in a high-speed driving situation, especially with the twists and turns of Watkins Glen.

“Post-concussion syndrome is a situation with persistent symptoms – usually longer than 1-3 months. These symptoms are typically headache, dizziness, fatigue, cognitive problems, sleep problems, mood problems, etc,” Dr. Giza said. “Even though the twists and turns of driving are probably not severe enough to induce a concussion on their own, in a person suffering from post-concussion syndrome the act of driving at high speed is physiologically stressful and could certainly worsen symptoms like dizziness, neck strain, headache and fatigue.”

Dale Earnhardt Jr. is routinely on the treadmill and he said his treatment regimen is fairly intense.

“I’ve been working on the exercises, physical and mental exercises that they gave me from my doctors,” Earnhardt Jr. said, in his podcast. “That stuff takes about two hours, two and a half hours every day and I’ve got to do it every day.”

Dr. Giza explained the treatment and rehab for concussion-like symptoms can take time and there is no one size fits all scenario. In fact, doctors look at each patient and concussion differently based on the situation.

“Concussion rehab is very individualized.  It depends on the persons symptoms, risk factors and resiliency,” Dr. Giza said. “Someone with headaches may need medication, relaxation, physical therapy, etc. Someone with dizziness may need vestibular therapy and exercise. Most concussion patients have disturbed sleep and benefit from things that improve sleep. And so forth.

“Most concussion symptoms resolve over 3-4 weeks but there is wide variation depending on many factors.  Patients with a history of prior concussions, migraines, current migraine-like symptoms, learning disabilities, anxiety and depression can take longer.  Those whose concussion involved symptoms of confusion/amnesia, migraine headache – light sensitivity/noise sensitivity, dizziness or fogginess have been reported to take longer to get better also.  Experts say ‘if you’ve seen one concussion, you’ve seen one concussion’ because they are so individualized.  I like to say that ‘for concussions, there’s no one size fits all.’”

 Dr. Giza was provided with audio recordings of comments made during Earnhardt Jr.’s podcast and provided with other publicly documented information about Earnhardt Jr.’s concussion history and the symptoms he is currently experiencing. Again, Dr. Giza was clear that he could not give a diagnosis or predict what Earnhardt Jr.’s own doctors might recommend regarding when the sport’s most popular driver could return to the racecar but he did say that he advises his own patients to take a conservative approach.

“It’s not possible to predict when any single person gets better.  It is a process that requires evaluation, treatment, re-evaluation and monitoring of progress,” Dr. Giza said. “We do say ‘when in doubt, sit it out’ because premature return to activity, and particularly premature return to a risky activity, has a higher risk of getting another concussion or another bodily injury.  This is because the injured brain is metabolically more vulnerable during this time and also because the injured brain may cause slow reaction times, slow thinking, in-coordination and poor attention – all things that increase risk of further injury.  This is an important message to youth athletes, and particularly athletes in high speed sports like racing, motocross, alpine skiing, etc. because of the importance of quick reactions and the potential for very significant impacts if they make a mistake.”

On Friday, Jeff Gordon, who is subbing for the injured Earnhardt Jr. said he is willing to stay in the No. 88 Nationwide/Axalta Chevrolet for as long as he is needed. He said, after just one race last weekend at Indianapolis, he realized how much pressure there is in filling-in for Earnhardt Jr.

22 July 2016 - Jeff Gordon during NASCAR Spring Cup Series practice at Indianapolis Motor Speedway. (HHP/Gregg Ellman)

Jeff Gordon during NASCAR Spring Cup Series practice at Indianapolis Motor Speedway. (Gregg Ellman/Harold Hinson Photography)

“We’ll, we have to cross that bridge when we get there. It seems like … it was great last Friday to see him say ‘hey I feel good today and made some progress,’” Gordon said. “We want to just keep going with how he is feeling. The doctors are evaluating. I’m not speculating anything at this time. I wouldn’t be here in Pocono if I wasn’t committed to be there for Hendrick Motorsports and this team in any way that they need me. I think there is a balance between trying to make this transition. First of all you want Dale to have the comfort of knowing that somebody is there for him. He doesn’t have to worry about that aspect of it through this process. Just get well at the pace that is the right pace to do it. So, nobody is putting any pressure or time frame on that. He may be putting that on himself more than anybody else.

“That was one of the toughest things I ever did, not just getting into the racecar after 8-months, but trying to fill-in for Dale Earnhardt Jr. knowing the kind of attention it gets. My heart was beating out of my chest because of the pressure and the eyes that were on you, as much as just not being in the car. You know, I will be here as long as they need me.”

An announcement on when Earnhardt Jr. could return to the car has not been set but he did say he would update fans on this week’s podcast, which is usually released on Monday mornings.

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