6 simple precautions to avoid life-threatening concussions

With the NFL’s Super Bowl LIII coming up, you will probably again hear concerns about safety on the playing fields — including concerns about traumatic brain injuries (TBIs). In my experience as a Medical Examiner, I saw many TBIs. Indeed, rates are on the rise, despite recent increases in public awareness.

Plus, even mild TBIs, known as concussions, can lead to a cascade of mental and physical problems. Including an increase in suicide risk.

Fortunately, taking some simple protective measures can make all the difference. And I’ll tell you about six of these important precautions in just a moment.  

But first, let’s back up to look at the scope of the TBI epidemic…

TBIs can cause a cascade of problems

TBI is a major cause of death and disability in the United States.

And the severity can range from “mild” (i.e., a brief change in mental status or consciousness) to “severe” (i.e., an extended period of unconsciousness, memory loss — and even death — after the injury).

Concussions are the most common form of TBI that occur each year. But even these milder head injuries can cause serious, chronic issues….

Granted, in about 75 percent of concussion cases, all neurological symptoms are gone within a week. But in about 25 percent of cases, victims continue to struggle with chronic brain and mental health issues. Especially mood disorders such as anxiety and depression.

Plus, a recent study found a strong link between concussion and an increased risk of suicide. 

For this new meta-analysis, researchers at the University of Toronto in Canada analyzed data for 700,000 patients with a history of concussion or mild TBI and 6.2 million people who hadn’t experienced a TBI.

It turns out, after four to 12 years, the absolute risk for suicide among all patients was 0.3 percent to 0.6 percent — which translates to three to six people in every 1,000. But the participants who experienced at least one concussion or mild TBI had double the risk of suicide. Concussion was also associated with a higher risk of suicide attempt and suicide ideation.

Unfortunately, the study ended there. But I’m curious to know if participants who experienced multiple concussions — which is common among football players, for example — had increased risk of suicide? In fact, the risk could very well compound with multiple concussions — especially considering how sensitive and susceptible to further harm the brain is immediately after a head injury.

But, apparently, there were too few study participants with multiple concussions to determine that risk.

Medical reasons for suicide after TBI

You’ve probably heard the tragic stories of football players and veterans with TBIs who take their own lives. In my work with the NFL on hydration I heard many such stories.

Thankfully, we’re finally beginning to understand reasons for that tragic outcome…

For one, abnormal brain activity can occur after a TBI. For instance, brain imaging studies have confirmed that communications between the brain regions that control your emotions and thinking can function abnormally.

Another explanation is that injury to the brain may simply lead to damage and degeneration of brain cells. 

Plus, clinical observations show that even if TBI patients don’t commit suicide, the brain injury can result in a lifetime of emotional instability and suffering. So, if you or someone you know ever experiences even a mild head injury or concussion, it’s important to get a medical examination and to follow medical recommendations

In addition, when evaluating patients with anxiety, depression, or suicidal ideation, physicians, psychiatrists, and psychologists should always carefully consider any history of concussion or TBI.

It seems to me that far too many health professionals skip this important screening. And instead, they jump right into exploring how the patients felt about their parents and doling out dangerous pills that can further alter brain chemistry.

What these doctors should really be doing is taking a moment to learn more about their patients’ actual history of physical head injuries, and also if they’re putting themselves at risk for additional brain injuries. And more importantly, IF these patients have a history of head injury, they should immediately be advised on the proper steps to take to prevent further damage.

What you can do to prevent concussion and TBI

Of course, a large number of children suffer TBIs each year. In fact, between 2001 and 2012, the rate of concussions and TBI diagnosed in the emergency department following visits for sports- and recreation-related injuries more than doubled among children ages 19 and younger.

For that reason alone, I recommend against allowing young children to play high-contact sports, such as football, hockey, and rugby. And when young people do play sports, they should always wear a helmet and mouth guard.

Of course, the sport that may pose the greatest hidden risk to the head is soccer. It’s inexplicable to me personally, but in recent years the sport has experienced a tremendous uptick in popularity. (Perhaps because fewer are now playing football, rugby, and ice hockey?)

But it turns out, the risk for concussion in soccer is almost as high as football. For one, soccer players routinely hit the large, hard ball with their heads — on purpose!

On a positive note, many youth soccer programs now require coaches to undergo concussion training sessions each season. Plus in 2015, U.S. Soccer — which oversees many of the youth programs in the country— eliminated “heading the ball” (hitting the ball with your head) at any time during practice or games for children under 10. Children between the ages of 11 and 13 can head the ball during games, but the organization recommends limiting it during practice.

We’re also starting to see some professional soccer players who’ve suffered previous concussions wear soft, protective helmets. Of course, as the new studies show, these are the players who need protection the most.

Horseback riding is another recreational activity that can result in concussion or TBI. Of course, when practiced safely, horseback riding benefits the body and mind. In fact, Winston Churchill once said, “there is something about the outside of a horse that is good for the inside of a man” (or woman). And my daughter is an avid horseback rider.

But there are lots of accidents that can cause injuries to the head. Particularly if the rider, the horse, the terrain, and the training aren’t carefully matched. So, never push your horse or yourself beyond your abilities. I also recommend always wearing a protective helmet.

All in all, there are six basic, precautionary steps you should take to avoid brain injury in your daily life:

1. Always wear a seatbelt when riding in a vehicle.

2. Don’t exceed safe speed limits when driving.

3. Always wear a helmet when playing a contact sport like football, rugby, or ice hockey — even when playing soccer or baseball or riding a horse or bike.  

4. Stay a safe distance away from the road when walking or riding a bike. Instead, opt for bike lanes and sidewalks. Or better yet — blaze an unbeaten path in Nature.

5. Avoid “polypharmacy” (taking multiple drugs at once), which can often affect balance or cause fainting.

6. Safeguard your home against falls. Some of the deadliest TBIs among older people occur at home due to falls.

Lastly, if you or someone you love has suffered a brain injury, many mind-body techniques — including brain wave biofeedback — can work wonders in retraining your brain.

You can learn more about which mind-body approach will work best for you by taking this short quiz. In addition, you may also find some help for dealing with lingering migraines and headaches by reading my book, Overcoming Acute and Chronic Pain.


“Association of Concussion With the Risk of Suicide: A Systematic Review and Meta-Analysis,” JAMA Neurology (jamanetwork.com) 11/12/2018

“To Avoid Soccer Head Injuries, Soft Protective Headgear Is Only Effective Solution, Study Shows,” Science Daily (sciencedaily.com) 7/14/2007

“TBI: Get the Facts,” Centers for Disease Control (cdc.gov) 4/27/2017