Why is driving hard after a concussion?
Driving asks the brain to combine fast visual motion, signals from the inner ear about acceleration, and control of the hands and feet, all at once. After a concussion that processing is slower, so driving can bring on nausea, anxiety or exhaustion. In a simulator study, reaction time was still about 0.3 seconds slower after symptoms had cleared. When to drive again is a decision for your physician.
Is It Safe to Drive After a Concussion?
Feeling normal doesn't settle it. Researchers put 14 people in a driving simulator within 48 hours of their concussion symptoms clearing and compared them with 14 matched drivers who hadn't been injured. Across 3 scenarios, a light turning yellow, a car to avoid and a pedestrian running out, the concussed group reacted 293 milliseconds slower. The authors wrote that the slowing, in people with no symptoms, raises driving safety concerns (Lempke, 2021).
Most people get back behind the wheel anyway, and many of them don't feel right. In a survey of 140 people with a concussion, 74% had resumed driving. Of those, 27% said they felt unsafe while driving, 44% had symptoms while driving, most often headache and trouble concentrating, and 75% had changed their habits by driving less often, going shorter distances and avoiding night driving and heavy traffic (D'Silva, 2021).
Whether you're fit to drive is a decision for the physician managing your concussion, and the rules differ by state and country. If driving brings on symptoms, that's a reason to stop and get it looked at, and it's the kind of symptom our team can work with.
Why Does Driving Bring On Symptoms?
Driving is complicated, and all of it happens at the same time. You hold your speed with your feet and keep the car on the road with your hands. Your eyes take in the road, the cars around you and the scenery sliding past. Your body is sitting still in the seat while the car moves, and the part of the inner ear that senses acceleration reports every speed-up and stop. The brain has to put all of that together into 1 picture, quickly.
When processing is already slow after a brain injury, that's a lot to ask. Our team treats trouble driving as useful information for that reason. It shows whether someone can take in information from all of their senses fast enough, and where those senses aren't working together.
Why Do You Get Anxious or Nauseous Behind the Wheel?
Many people notice their anxiety climbing when they drive after a concussion. Part of it is worry about an accident, and a larger part is physiology. Sorting out all that information runs at a rate above what the system can handle, and the body responds: the chest tightens and breathing can feel short. Those are signs of overload.
Nausea usually points at the visual and balance side. Our team worked with a woman who had given up driving because it made her so nauseous she'd have to pull over and lay the seat back. The exam found a specific problem with how she took in visual motion. She couldn't process the movement coming at her well enough, almost as if it were too fast. After that was recalibrated she could tolerate more and more of it, and she got back to driving her kids around.
That's 1 case, and it shows the questions our team asks about anyone who struggles with driving. Is it the visual motion going by? Is it how the eyes work together? Is it how they pick up information? Is the inner ear working the way it should? Being a passenger can be hard for related reasons, which car sickness covers.
Why Is Night Driving and Heavy Traffic Worse?
They're the conditions people with a concussion most often avoid (D'Silva, 2021). Our team's explanation is load. Heavy traffic adds more moving objects to track and more decisions per minute. At night, headlights add glare for anyone with light sensitivity, and the eyes have less to anchor on. What light sensitivity is and what helps is on light sensitivity, and eye teaming is on blurry vision after a concussion.
Do You Have to Give Up Driving?
So many people have to quit driving because they can't tolerate all the motion going by while controlling the car, and it takes away a great deal of freedom, especially for young people, people who work and parents. For many of them there's a way back.
It doesn't always mean avoiding the car. Sometimes working through it gradually is enough and it improves by itself. When it doesn't, our team works on the piece that's failing: visual processing, how the balance system feeds in, or how the body's position sense feeds in. In that woman's case, whole-body rotation was used to recalibrate how her head and body interpreted motion. Driving then becomes its own target, because the aim is to get people back on the road.
What our team measures to find the failing piece is on concussion testing: what to expect.
See how we test it in 3D
Tour the testing our team uses to find which systems are struggling.
Take the 3D TourIs driving still hard months after a concussion? See how our team finds what's behind it and treats post-concussion syndrome.
Post-concussion treatment at the clinicDriving After a Concussion: FAQ
How long after a concussion can you drive?
There isn't a single rule, and the decision belongs with the physician managing your concussion. Drivers tested within 48 hours of their symptoms clearing still reacted 293 milliseconds slower than uninjured drivers (Lempke, 2021), so feeling normal doesn't prove the reactions are back.
Can you drive with post-concussion syndrome?
Many people do: 74% of 140 people surveyed had resumed driving, 27% of them felt unsafe, and 75% had changed their habits (D'Silva, 2021). Symptoms while driving are a reason to talk with your physician about restrictions.
Why do I get anxious driving after a concussion?
Our team's view is that driving asks the brain to combine vision, inner ear signals and body control faster than an injured system can manage, and the overload shows up as a tight chest, short breathing and anxiety.
Why does driving make me dizzy or nauseous after a head injury?
In our team's experience nausea while driving points to how the eyes and the balance system handle visual motion. In 1 case the problem was processing movement coming toward her, and recalibrating it got her driving again.
Why is driving at night harder after a concussion?
Night driving and heavy traffic are the conditions people with a concussion most often avoid (D'Silva, 2021). Our team's explanation is glare for anyone with light sensitivity and fewer steady visual references.
Sources
- Lempke LB, Lynall RC, Hoffman NL, et al. Slowed driving-reaction time following concussion-symptom resolution. Journal of Sport and Health Science. 2021;10(2):145-153. doi:10.1016/j.jshs.2020.09.005
- D’Silva L, Devos H, Hunt SL, et al. Concussion symptoms experienced during driving may influence driving habits. Brain Injury. 2021;35(1):59-64. doi:10.1080/02699052.2020.1857839