When we hear “sports injury,” we tend to envision sprained ankles, ligament tears, or broken bones. But what’s going on in the brain after a helmet-to-helmet hit or a head-on crash isn’t always so clear-cut. 

Whether a concussion from football, a tumble in gymnastics, or the repeated blows of boxing, such injuries can take a lasting toll on brain function. Most athletes recover physically, but the brain doesn’t always have the same timeframe, sometimes causing memory issues, mood swings, and even permanent cognitive impairment. 

Knowing what sports injuries do to the brain is important not only for athletes, but also for coaches, parents, and anyone on the sports sideline. So what’s actually going on under the hood? Let’s get in.

How do Sports Injuries Affect the Brain?

Sports injuries, particularly those resulting from head trauma, may have a profound effect on brain health, causing short-term and also possible long-term neurological problems. It is important to grasp these effects for athletes, parents, coaches, and medical personnel so that prevention, diagnosis, and treatment of such injuries can be ensured.

Types of Brain Injuries in Sports

Traumatic brain injury (TBI) is an acquired brain injury caused by a blow or jolt to the head, which interrupts the normal functioning of the brain. Concussions in sports, a form of TBI, are diffuse brain injuries that cause changes in mental status. Concussions can be caused by the brain shaking inside the skull, which can lead to shearing injuries to nerve fibers and neurons. Here are some of the following types of brain injuries in sports:

• Concussion: A mild traumatic brain injury (TBI) due to a blow to the head that is sudden and results in temporary loss of brain function.
• Second Impact Syndrome (SIS): Results when a second concussion occurs before the first concussion has had a chance to heal, resulting in fast brain swelling and grave damage.
• Chronic Traumatic Encephalopathy (CTE): A degenerative brain disease that results from chronic head trauma, common among athletes who participate in contact sports.
• Contusion: A brain bruise resulting from direct trauma, which may cause bleeding and swelling.
• Diffuse Axonal Injury (DAI): Resulting from severe rotational forces or shaking, which tears the nerve fibers and causes widespread damage.
• Intracranial Hemorrhage: Bleeding within the brain or in the surrounding tissues, which may be fatal if not immediately treated.
• Skull Fracture with Brain Damage: A fracture of the skull that potentially injures underlying brain tissue, resulting in severe consequences.

Prevalence of Sports-Related Brain Injuries

Sports and recreation are a major cause of traumatic brain injuries, particularly in children and adolescents. It is estimated that 10% of the 1.7 to 3.8 million annual TBIs in the United States are caused by sports and recreation. A CDC report showed a 60% per year increase in emergency department visits for sports- and recreation-related mild TBIs (mTBIs) in children and adolescents over a 10-year period. Cycling and football are the sports most often linked with emergency department visits for TBI. In 2018, an estimated 454,407 head injuries from sports were treated in U.S. hospital emergency departments.

Short-Term Effects of Sports Injuries on the Brain

The immediate impact of sports-related head injuries may be in the form of a wide range of effects on physical, cognitive, and emotional functioning. Headaches, dizziness, nausea, and vomiting are some of the most common symptoms. Cognitive deficits like confusion, concentration difficulties, and memory deficits are also commonly experienced. Concussions are also known to impair sleep and mood, manifesting as drowsiness, irritability, anxiety, and emotional lability

Long-Term Effects of Sports-Related Brain Injuries

Recurrent head injuries in athletics have been known to cause long-term neurological and psychiatric effects. Among the most serious long-term effects is chronic traumatic encephalopathy (CTE), a progressive dementing illness linked with recurrent head injuries. CTE can cause cognitive impairment, including learning disability and memory disturbances, and psychiatric illnesses, including depression, anxiety, and suicidal thoughts. In advanced stages, CTE can cause progressive dementia and motor features, such as instability of balance.

Specific Sports and Risk Factors

Some sports have a greater prevalence of head injuries because of the nature of the sport. Football, for instance, is linked to a high rate of head injuries, such as concussions and more serious traumatic brain injuries. Cycling also accounts for a high rate of head injuries, with a high percentage being avoidable with the use of helmets. Baseball, basketball, soccer, and sports involving powered recreational vehicles are other sports with high rates of head injuries.

Prevention Strategies

• Preventing sports concussions is a multi-faceted effort. 
• Wearing helmets and protective equipment is essential in most sports, including bicycling, football, and horse riding. 
• Proper equipment fitting and regular use are necessary for full protection. 
• Rule modifications and enforcement in sports such as football seek to limit head-down contact and penalize helmet-to-helmet contact. 
• Education of coaches, players, and parents is crucial to encourage concussion symptom awareness and the need to report them.

Management and Return-to-Play

Proper sports-related brain injury management is imperative to avoid lasting symptoms and long-term effects. Any player with a suspected concussion must be immediately taken out of competition and examined by a healthcare provider knowledgeable in concussion treatment. Initial therapy includes physical and mental rest to decrease stressors on the brain. The process of returning to play must be gradual and in accordance with the direction of a healthcare provider, with each phase needing symptom absence before moving on.

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Key Takeaways

Sports injuries, especially those that involve head injuries, may have a dramatic impact on the brain, ranging from immediate symptoms to extended neurological effects. Concussions and TBIs are prevalent in sports, with some differing levels of severity and likelihood of causing long-term damage. Prevention measures, such as wearing protective equipment, rule modifications, and education, are vital for diminishing the risk of brain injury. Accurate management of concussions, through immediate removal from competition and progressive return-to-play protocol, is essential to prevent chronic symptoms and long-term complications. Ongoing research and policy shifts are required to further safeguard athletes and optimize brain health in sports.

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