Concussion 101: The basics

By Dylan Dahlquist- Sport Scientist

With Monster Energy’s Supercross series kicking off last weekend, we figured it is a good time to start talking about the many nuances of racing, the plausible injuries you may suffer from during the season, ways to mitigate the damage of a injury and accelerate your return-to-sport. What are we kicking things off with? Concussions. We’ll take a quick trip on (1) “what exactly is a concussion” in article one and (2) how you can “fortify your brain” to minimize the damage if you succumb to one and various “strategies one can implement to return-to-sport faster” following one in article two.

106 out of every 100,000 people globally will suffer from a traumatic brain injury (TBI) each year. Athletes that compete in contact or extreme sports such as NFL, NHL, Snowboarding, Mountain Biking and Rugby are at a heightened risk then others due to their susceptibility to direct and indirect insults and 3.8 million sport-related concussions are reported each year in the United States alone. Even, light, repetitive blows, known formally as sub-concussions, are linked to a host of pathological and psychological diseases, and have shown to elevate markers of axonal injury in both boxers and American football players. 

These sub-concussive blows are underrepresented in the totality of data because of the lack of observable damage, improper diagnosis tools, and underreporting of the injury by the asymptomatic athlete. With 89% of all forms of patients suffering from a concussion not acquiring proper medical care, the long-term health risk of these repetitive head impacts is a concern for athletes, as retired rugby players show increased headaches, cognitive decline, depression and even higher risks of neurodegenerative disease compared to other retired athletes from non-contact sports. 

With that said, what about the world of Supercross? A nine-year retrospective study found motorsports having the highest rate of concussions at 181 per 100,000 participants. That analysis further elucidated that 14% of the 4745 hospitalizations for concussions were from motor sports incidents. Most of the literature in the world of Supercross or Motocross hinge on concussion research – with 48% of riders self-reporting symptoms of concussions within a typical Motocross season. A review highlighted that collectively, concussions are one of the most prominent injuries sustained in motor sports, with a 9.5-19% likelihood in competitive events.

A multitude of studies have demonstrated that sub-concussive impacts, in the absence of a concussion diagnosis, result in quantifiable pathophysiological changes as demonstrated via advanced imaging and fluid biomarker quantification. The American Medical Society for Sports Medicine suggested the need for different approaches to prevent brain damage, and nutritional interventions are at the forefront as a safe and relatively risk-free option for both the protection and recovery from concussions.

What is the difference between a traumatic brain injury (TBI), sub-concussion and concussion?

First and foremost, concussions =/= traumatic brain injury. Although they are commonly used interchangeably – and quite similar – a more precise label to a concussion is a mild TBI. We’ll define a concussion as a highly complex pathophysiological insult to the brain that is induced either by direct or indirect biomechanical forces. The forces are measured in G-forces (a measurement of acceleration). For example, gravity is about 1G. These G-forces are typically a combination of rotational impulses, linear impulses, and impact decelerations. The magnitude of G-forces will ultimately dictate the severity of the head trauma:

• Sub-concussion: ~20g

• Concussion: ~70g

For example, a study showed that heading a soccer ball is on average about ~20g’s with a range of 8-37g depending on the speed of the person and ball. Punches in boxing are typically ~28’s with a range of 8-54g. This is also where we get the term, Punch Drunk or more commonly known as, Chronic Traumatic Encephalopathy or CTE for short. CTE is a progressive degenerative disorder of the brain that is caused by repeated head traumas over an extended period. The risk of CTE increases with the number (frequency) and severity (magnitude) of said head trauma – which is why some boxers experience this later in life after repeated blows to the head.

Typically, sub-concussions are not harsh enough to elicit symptoms (read: you are asymptomatic), where concussions – which involve very high accelerations and quick decelerations to the head – cause a host of symptoms to be expressed. Such as neurochemical imbalances, metabolic and glucose dysregulation, unregulated temperature control (fever), apoptosis (cell death), oxidative stress, blood-brain barrier dysfunction, demyelination, etc.

Now that we have the basics under control, make sure you tune in next week for various evidence-based practices in order to minimize the damage and accelerate your ability to recover from a concussion through various nutritional means.

Thanks for reading!!

The end of this video portrays just how concussed Alex was… CBD for brain inflammation!