As a nationally ranked snowboard competitor, “Shredder Dave” of St. Louis is no stranger to hard falls. So, he wasn’t too alarmed when he took a spill on the evening of March 7, 2019.

“I was riding down the front side at Hidden Valley with some friends, doing 360 spins at about 35 to 40 miles per hour, having the best time. I’d done similar runs down the same hill probably 200 times before,” said Dave, who prefers not to share his last name.

From there, his memory gets a foggy. He remembers the view of the ski lift from his back, and then riding about 100 yards down to the base. He also recalls refusing medical attention, opting to do a few more runs instead.

He even returned to Hidden Valley the next afternoon and enjoyed about three hours on the slopes, before suddenly waking up in the hospital. It took him some time to piece together the events of that day, but he eventually learned that he’d collapsed on the mountain and gone into cardiac arrest. The cause: a brain bleed from a severe concussion, which disrupted his heart rhythm.

Dave is recovering well after having surgery to relieve the swelling in his brain. And while his injury is certainly an extraordinary case, concussions are a fairly common occurrence in adventure sports.

Defining a Concussion
Concussions are mild traumatic brain injuries (TBIs) that occur when a hard impact to the head or body causes the brain to bounce around inside the skull. This, in turn, causes cellular and chemical changes within the brain.

When most people think of sport-related concussions, they think of football and other contact sports. However, bicycling had the most TBI-related emergency room visits between 2001 and 2009, according to a 2011 report by the Centers for Disease Control and Prevention (CDC).

The reality is, there are inherent risks in any sport that has the potential for falls and collisions. Per the same CDC report, concussions accounted for greater than 10 percent of all injuries sustained while horseback riding, ATV riding, ice skating, and sledding. Other studies suggest an elevated risk of TBI in skiing, snowboarding, and skateboarding.

Fortunately, there are a few steps that adventure athletes can take to lower the likelihood of concussions, as well as the risk of complications if they suffer a concussion. The most important is to take quick action when symptoms are present.

Treatment in the Wild
The most obvious symptom of a concussion is a loss of consciousness. It’s important to act quickly when this happens.

“Sit up, keeping the head and shoulders elevated to minimize swelling. Don’t move more than necessary,” said Perry Whitaker, a wilderness first-aid instructor at Alpine Shop in Kirkwood, Missouri. “Keep in mind that where there’s a head injury, there’s often a neck injury as well. It’s best to leave on the helmet to avoid worsening any trauma to the neck.”

Preferring to err on the side of caution, Whitaker advises calling 911 any time there’s a loss of consciousness. Same goes for vomiting or a severe headache after impact.

However, most concussions aren’t so obvious. By some estimates, only 10 percent of concussions result in a loss of consciousness. They more commonly present with milder symptoms — including confusion, loss of coordination, dizziness, ringing in the ears, and sensitivity to light — that sometimes don’t even show up right away.

Case in point: Shredder Dave recalls feeling completely normal in the hours that followed his TBI. He only started showing minor symptoms (vision changes and an intermittent stabbing head pain) a day after his fall.

It’s easy to brush off a bump to the head, especially when you’re having fun or competing. In a 2019 report by Enduro World Series, nearly one-third of mountain bike racers with suspected concussions went on to complete their races after they were injured. The same report found that more than a third took no time off from training after sustaining concussions.

However, exercising with a TBI can delay recovery and increase the likelihood of long-term complications. What’s more, athletes who’ve had a concussion are nearly four times more likely to suffer another one, according to a 2019 analysis.

For these reasons, Whitaker advises, “It’s better to make a mistake on the side of caution.” Take it easy if you’ve sustained a blow to the head or body, at least until you’ve been cleared by a doctor. It’s better to be sidelined for a few days than to sustain another, worse TBI.

Prevention in Adventure Sports
The best way to prevent a concussion in adventure sports?

“Wear your damn helmet,” said Whitaker.

Jake White, assistant manager and head of the bike and snow departments at Alpine Shop, echoes that sentiment. White, who’s skied and snowboarded for more than 30 years, only started wearing a helmet after a serious concussion in 2012.

“It’s not just you. It’s the people around you,” said White. This includes beginners on the slopes, cars on the road — even animals in your path.

A 2018 report by the National Ski Areas Association indicates that helmets reduce the risk of head injuries in mountain sports by up to 50 percent. Other studies on cyclists suggest that a high-quality helmet can slash the odds of concussion by more than half when used properly.

The emphasis here is on “high-quality” and “used properly”. White recommends a sport-specific helmet with Multi-Directional Impact Protection System (MIPS) that’s well fitted to your head. MIPS technology was designed by a neurosurgeon and a brain researcher to reduce shock to the brain with a hard blow to the head or body.

But that’s not enough. You have to wear your helmet all the time, without letting it impact the intensity of your activity. In other words, don’t use your helmet as an excuse for recklessness.

Doing these things won’t eliminate your concussion risk entirely, but they will lower the odds of injury — and we can all agree that’s a good thing.

Author: Kimberly Yawitz is a regular contributor to Terrain Magazine.