Concussion Post 20 – Outside Magazine Article: CTE in Extreme Sports
A recent article in Outside magazine highlighted the problem of CTE (Chronic Traumatic Encephalopathy) outside of the NFL, namely in extreme sports. The article spoke of many X Games athletes who committed suicide because of CTE related issues. Some of these athletes include Dave Mirra, Mike Sherlock, Brian Bell, and others. While only Mirra has had an official diagnosis of CTE, the others are believed to have suffered from CTE as well, but it will never be known since the brains were not autopsied.

I work with several athletes who are in the extreme sports business. One thing I help them with is to make sure they take care of their heads. Making sure they are active in head injury prevention through nutrition, mental exercises, circadian rhythm optimization, vitamins, and more (just read my many blog posts).

With the advancing mentality that the general audience watches for huge jumps, huge impacts, and more risk, this motivates the athletes to go bigger, higher, and faster than ever before. Head injuries and their outcomes range widely—from concussions that fully heal, to a condition called post-concussion syndrome that can take months or years to resolve, to more serious traumatic brain injuries and CTE. Research shows that it doesn’t take much for a concussion to cause problems. A study in the Orthopaedic Journal of Sports Medicine analyzed more than 4 million emergency-room visits over ten years. They reported a steadily rising number of concussion injuries in seven sports: surfing, mountain biking, motocross, skateboarding, snowboarding, snowmobiling, and skiing. Snowboarding was the most concussive activity, with 42,811 concussions reported over that ten-year period.

The physiology of head trauma is pretty straightforward. You fall off your motorcycle, bicycle, skis, etc. and when your head hits the ground, the brain is literally floating inside the skull. The shaking that occurs with the hit causes a concussion. Sometimes it is just an instantaneous daze, other times it can be lights out. The important thing is to be proactive and know that it is happening. This is why it is so important to have a good team around you. Having a bunch of people who are your “cheerleaders”, so to speak, and applaud every move you make are not the ones who are going to point out the symptoms of concussion or CTE. It is a hard thing to tell someone that they are acting different, losing memory, or that they are just off. Typical symptoms of brain dysfunction consistent with CTE include memory loss, disequilibrium, headaches, depression, irritability, nausea – for days to weeks or even months.

The damage sustained, if not allowed to heal properly, can lead to problems with brain function. The proteins that allow for neuroprocessing are among the most severely damaged. While it may seem ironic, athletes with chronic head trauma can often perform their respective sports without difficulty. It is in their everyday lives that difficulties begin to present themselves. These insults to brain tissue result in problems of neuro-transmission; the way your brain sends and gathers information.

The other issue is there is little support for the plethora of athletes performing these high risk stunts. Like the NFL, the persons at the top of the X Games clearly state that every athlete needs to have their own insurance and tend to their own health outside of competition. Of course, if they fall during competition, the X Games organization will ensure the athlete gets to the hospital and receives proper acute medical care. But they don’t lift one finger to help those suffering from chronic head traumas. Organizations like the NFL and X Games are struggling with this very issue because it can become a Pandora’s Box. Where do you start and where does it end? We are seeing statements like the following from the Outside article,

Danny Chi (director of communications for the X Games) “Athletes who are determined by the X-Games medical staff to have sustained a concussion will not be allowed to continue to participate in practice or competition for the duration of those Games.”

This statement likely means that if the athlete has an obvious concussion, they will be taken out of competition, sent to a hospital, and if found to have a concussion by the standard medical system, not be allowed to return to competition. And if they are not found to have sustained a concussion, they will be allowed to continue to compete if possible.

Another statement read: “We have made a commitment to provide top quality medical care for athletes at X Games events. We constantly examine and evaluate our processes and policies, always with one goal in mind: athlete safety. This is a topic we take very seriously.”

Red Bull recognizes that it is not a straight forward process to hire appropriately-trained medical support capable of diagnosing a head trauma. But again, the organizers hands are somewhat tied. If someone has a minor head trauma, they will be allowed to compete. The long-term consequences are ignored. The reality is the athlete is likely not going to complain unless the injury is very severe. Most of these athletes have a “continue at all costs” mentality. This is how they were raised competing in their respective sports. I know this because I was an aspiring motocross athlete. Unless you were incapacitated by a broken bone or knocked out, you continued to compete. This mentality is slowly changing as we are seeing professional athletes being pulled from competition due to concussions.

The fact that Red Bull doesn’t list an athlete concussion policy and states things like, “The safety of spectators and participants is always our primary concern,” in reality means that they know they have a problem and are letting time pass in deciding what to do about it.

Many riders do not like to discuss the subject because they know they are taking a risk and want to leave it at that. These athletes love the sport so much that they would likely do it for free. And when things are going great, no one is thinking about the long-term effects on brain health. It is only when the constant headaches and pains arrive and athletes can’t practice their respective sport that the real questions raised. Basically, the riders waive their rights and ride wide open for the television.

One part of the article I found interesting was the Missy Giove story. I remember her from the Mammoth Kamakazee days and she was fast. I once rode behind her and found myself descending at 68 mph! I am glad she is doing better nowadays and seems to have settled down. She reports her symptoms of seizures, migraines, vomiting, tunnel vision – all symptoms of a chronic brain injury. She seems to have found a protocol that works for her, but I want to highlight the fact she says that she is on a vegan diet for her brain injury. The science is clear that a vegan diet is not the greatest for a brain injury. In fact, too strict of a vegan diet can decrease your IQ. You just need to remember that over a quarter of your brain is made up of cholesterol and another 25% of LDL type particles. The brain heals better on ketogenic diet that suppplies omega fatty acids, creatine, B vitamins, choline, Vitamins A, D, K2, etc. This has been shown in numerous studies and anecdotal reports. Living a vegetarian or vegan lifestyle will improve anyone’s health who is transitioning from a Standard American Diet by removing processed foods. Take out the processed, artificial and fast foods, a lot of things suddenly get better. All I am trying to say here, if you want to give your brain the best chance to heal, practicing a diet high in good fats, proteins and carbohydrates that is producing ketones is the best thing for a healing brain. Even more, eating highly nutrient dense foods such as liver and multi-colored organic vegetables is huge. Another part of this is the production of Brain Derived Neurotrophic Factor or BDNF. I wrote about this in this previous post. This is important if the brain is ever going to have a chance to heal. And for all I know, Missy’s vegan diet lifestyle is what gives her the balance to meditate and produce BDNF and heal her brain. No one can argue with success.

Outside magazine article (