The impact of concussion and migraine on my rugby career

Matthew tells us about his experience of vestibular migraine after sustaining head injuries, and the impact on his rugby career

17th June 2024

At the age of 22 I was playing rugby full time for the Saracens when I sustained two separate head injuries in quick succession. I had my first experience of vestibular migraine while trying to deal with concussion from the injuries.

I know that it’s likely my head injuries didn’t cause my migraine symptoms and instead triggered them, but trying to navigate everything all at once was incredibly difficult and my life changed overnight.

Concussion is something you can try to ‘fix’…migraine can’t be ‘fixed’ or cured, although it can be managed

I started a concussion rehabilitation programme that I completely threw myself into. I really focussed on improving my health, going as far as to stop eating sugar and gluten and giving up coffee. I even took on the London 2022 marathon! I have vastly improved my quality of life through implementing a healthier lifestyle, though I kept trying to get to a point where I was able to return to rugby, as it was such a big part of my life.

However, while concussion is something you can try and ‘fix’, and there are a lot of resources out there to support with concussion rehabilitation, that is not the case with migraine. It isn’t something that can be ‘fixed’ or cured, although it can be managed. Coming to terms with that and trying to understand the impact of migraine on my life has taken far longer to work out.

I think people generally still think I’m dealing with the ongoing effects of concussion, but it’s not, it is migraine. People in the sporting world are maybe more familiar with concussion. I occasionally have people say things like ‘just push through’, and I have to explain that there are some things that I can’t just push through.

A man looks toward the camera smiling, a brown dog is draped across his shoulders.
Matthew and Flora

My migraine affects my eyes in particular. Looking at screens is challenging, and movement on screens can be a trigger. I feel a dull ache constantly from my eye down to my neck, and my eyes get sore and tired. My neck is tight, and I do wonder whether there’s a defence mechanism that might have been triggered there from when I was injured. I notice a strong correlation between activities I do that affect the neck, and migraine attacks. I try to avoid the activities that do trigger them, but sometimes that’s just not possible. If I do get an attack, the after effect can last for months in my eyes.

It has taken a toll on my mental health.  I would set myself milestones and would continually gauge my progress and would throw everything at reaching those milestones. Of course, if I then didn’t achieve them because of a setback with migraine symptoms, it was a real blow. I struggled even to accept the diagnosis of vestibular migraine, as that’s something I would have less control over the management of. I’ve realised now that there are just certain aspects of vestibular migraine that are out of my control.

Over the years, I’ve tried several different types of migraine treatment and preventives, but I can’t even say with certainty that any have really worked. Certainly not enough to warrant the side effects of some of them. The medications left me so tired, it got to the point that I’d rather live with the pain of migraine than the side effects I was feeling, and so I came off them.

I’ve tried so many other things, including alternative therapies but there comes a point where I don’t feel I have the energy to keep trying new things, and have that build-up of expectation then failure. As well as that, there is the cost of trying different approaches. I was lucky in that, the first three years, I had private medical care and that allowed me to explore more options than I would have been able to otherwise. Now I don’t have that, and I find myself debating about trying treatments and thinking ‘what if I go down this route, and it doesn’t even work again’, and that’s really difficult.

Ultimately, I just want to get back to life

It’s been nearly nine years since my experience of vestibular migraine started, and I ultimately just want to get back to life. It impacts all areas of life, including relationships. I feel like I’m not who I was before. Exercise was such a big part of my life – it was my entire career, and therefore a big part of my identity, but it was also something that I really enjoyed, and it’s just not the same now. I still keep going to the gym, but now I have to manage my other activities around it. I had to stop weight training as that is still a big trigger for my vestibular migraine symptoms, even now. I will plan to go to the gym when I don’t have somewhere to be immediately after, to give myself time to recover.

My career path is purely guided now by what I can or can’t do as a result of my migraine symptoms. Physio is a huge part of my life now and I’m still really committed to building myself back up.

I’m a Quantity Surveyor in London now, and I also coach rugby which I really enjoy, although I would love to play again.

I found The Migraine Trust through researching online. I’m keen to speak out more about migraine because I think if I’d seen someone like me talking about it back when I first experienced it, that would have really helped me. There’s also a lot more awareness about migraine that’s needed – even in terms of knowledge about the different treatments. I still have hope that with advancements in migraine treatments there will be better options in the future to manage migraine, and I will continue to research and trial different approaches and treatments to find what works for me. I can’t help but wonder if I’d had more knowledge of treatments years ago, things might be different for me now, and that’s why I’m sharing my story.