Concussion Discussion: Getting Back In the Saddle With the Help of Hyperbaric Therapy


With roots in dressage and a current career on the track, Jennifer Miller paid a visit to her former Grand Prix dressage mount days before her recent accident.

May 25, 2021 – Wellington, FL – In December of 2020, career equestrian Jenn Miller was involved in a freak accident on a Florida farm and suffered her second major traumatic brain injury. The Equestrian Aid Foundation partnered with the Help Our Wounded Foundation (HOW), a South Florida-based nonprofit that funds medical grade hyperbaric oxygen chamber treatments for people with brain injuries, to help Jenn through her recovery and back into the saddle. 

Having taken the necessary time off and completed a course of medical grade hyperbaric oxygen therapy (HBOT) treatments, Jenn has regained self-sufficiency and has made a full return to work. We caught up with her and Hilary Loftus, HOW’s healthcare education director, to learn more about HBOT and its possibilities for equestrians with brain injuries.


What, exactly, is HBOT? 

HL: Medical grade hyperbaric oxygen therapy involves an injured individual receiving a treatment of 100 percent oxygen under pressure. This is five times the amount of oxygen in the air we breathe, and because the treatment chamber is pressurized, the oxygen molecules penetrate the cells more easily. When the head is hit, brain cells are torn and twisted and some cells just die, but around the area, others are just stunned and cannot do their jobs. HBOT can awaken these stunned cells while also combatting the chemicals produced during the injury that cause inflammation. HBOT also enhances stem cell production and promotes the growth of new vessels and capillaries. 


How long does HBOT take? 

JM: I went every day, so I completed 17 sessions in just under four weeks. 

HL: A session itself lasts 80 minutes on average. For those with acute brain injuries, if we can get them in when the inflammation is fresh (usually within a week of their injury), three to five sessions are frequently sufficient because the chemicals that cause inflammation haven’t had time to run amok and create havoc in the brain circuitry. For those with chronic concussion symptoms, it takes longer—on average, 20 or more sessions—to undo the damage so the brain can repair its circuitry. 


Is every equestrian with a concussion a good candidate for HBOT? 

JM: I’ve seen the wonders a hyperbaric chamber can do on horses’ legs, so I was open to trying it. Even though I’ve been able to move past my previous concussions, there’s a lot of research out there on the negative effects of repetitive TBIs as a person gets older. If there’s a chance HBOT can help my brain function for the long term, why not try it? 

HL: In general, yes, but with some exceptions. For example, HBOT is not recommended for those who have a seizure disorder. It’s important to realize that medical grade oxygen administered at this level of atmospheric pressure is essentially a drug. You need a prescription, and you need to treat it carefully. That’s why it’s so critical to be under the care of a doctor and the trained clinicians at a medically run hyperbaric facility. 


Does HBOT speed up healing time? 

JM: Every brain injury is just so unique, and my experiences have shown me there’s no time frame for TBIs. But I can say that when I sustained my first major TBI in 2017, I was out for nine months. This time, I recovered more quickly. 

HL: While there’s no textbook timeline, medical grade HBOT—especially when administered within a week of a brain injury—shows incredible efficacy. It’s also worth noting that HBOT has been shown to accelerate other treatment modalities athletes are using to recover, such as physical therapy. 


Jenn Miller (foreground) has made a full return to work, riding seven horses every morning and performing laser therapy in the afternoons.

What changes did you see as your HBOT treatments progressed? 

JM: I definitely noticed a change in my ability to focus. After my fall, loud noises—any noises—could completely undo me. Also, compared to the pre-HBOT cognitive testing I did at HOW, my post-treatment testing showed improvement in almost all areas. 

HL: Everyone and every brain is so different. When our brains are functioning well, they require 20 percent of our oxygen. When there’s a problem, they require a lot more, which is why concussed people frequently feel so tired. As HBOT progresses and the brain heals itself, many people regain their pre-injury level of energy. One student athlete who suffered from chronic TBI symptoms told me that after he completed 15 sessions, his memory came back. Among other things, he could remember people’s names, which started after his third session. 


How do I find a HBOT center in my area? 

HL: I can’t stress how important it is to go to a medically run center. If you need help finding one, email or call the HOW Foundation (561-450-6213) or my cell (860-227-0352).


What’s the takeaway? 

JM: The brain has amazing plasticity and it can heal, given the opportunity. When it comes to concussions and TBIs, we need to treat our brains like we would treat any other injured body part: take the necessary time off and do the required therapy so your body can heal itself. Treat yourself with the same amount of care and respect you show your horses. You can’t give your horses all they deserve if you’re injured and not thinking straight. 

HL: You only have one brain to last yourself your whole life, which is hopefully going to be a long one. So pay attention when you fall or when your head gets hit. When in doubt, if you can get to a medical grade HBOT center with a prescription from your physician or the HBOT physician, do it. When your brain is messed up—and maybe subsequently your balance, emotions, and vision—you can cause more injury than you’re already dealing with, both to yourself and your horse. Medical grade HBOT can help people fulfill their real potential rather than having to live with a diminished new normal. 



About HOW Foundation of South Florida 
The HOW Foundation of South Florida is a 501c3 nonprofit organization dedicated to improving the quality of life for individuals, families, and communities by advocating for and providing access to medical grade hyperbaric oxygen therapy for people with brain injuries. Located in Delray Beach, their comprehensive team of distinguished medical professionals and staff have created partnerships and fostered connections to advance safe and effective access to hyperbaric therapy not only in South Florida but across the United States.