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November 2015 Issue
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Use your head

As gear and technique improve, adventure sports athletes are going bigger and falling harder than ever. Photo: Mark Banham

There’s nothing like getting into the great outdoors to make you feel glad to be alive, vertical and conscious. But some of the things we do out there can mess with all of those states if we’re not careful

Wilderness sports usually aren’t meant to be contact sports, but when you get them wrong they’re as brutal as boxing – and they’re getting worse.

As sports like skiing, climbing and downhill mountain biking develop we’re going bigger and faster and falling harder. Speeds and terrain that were once the exclusive realm of the elite are now within the grasp of us weekend warriors.

To compensate, we’re padding ourselves with a phalanx of ever-improving guards, helmets and braces. But the thing that hasn’t really improved in this arms race is the fragile body behind it all – notably the gelatinous lump of meat between our ears.

Yep, your brain is the same one your grandad used to go riding with.

When we crash, that brain tends to slosh around inside our skull doing all sorts of damage that’s awfully hard to protect against – even with the best helmets. Most commonly that damage is a concussion.

Globally, they’re quite trendy at the moment. In April, America’s National Football League settled out of court for more than a billion dollars in a class action brought by brain-damaged former professional players (Will Smith and Alec Baldwin are starring in a movie about it called Concussion) and in New Zealand they’re pretty popular too; ACC sees about 7350 sports-related head injuries each year. But our understanding of them is still patchy.

“There’s a lot of mythology out there,” says Dr Hamish Osborne, a senior lecturer in sport and exercise medicine at the University of Otago and part of the South Island Brain Injury Research Group. “Our best understanding of what is going on is that it’s a disturbance of energy flow, the way your brain metabolises and delivers that energy around within its systems. It’s a functional disturbance of the electricity. It gets disturbed so the brain then fails to function properly.”

In layman’s terms, failing to function properly can mean a lot of things. According to the Concussion in Sport Group’s guidelines, the tell-tale signs of a concussion can be everything from dizziness, blurred vision and balance problems to confusion, forgetfulness and difficulty concentrating, to increased emotionality, irritability, nervousness or anxiousness and a dozen other things.

Those symptoms aren’t necessarily life-threatening, according to Dr Osborne, 80-90 per cent of adults will recover within six days.

“A very small percentage of people will still have symptoms after three weeks – and then it mysteriously changes its name to ‘post-concussion syndrome’,” Osborne says. “But nothing particular has happened except they’re slow to recover.”

But in the long term, things are a bit different. “If you make a full recovery, we don’t believe there’s any significant long term consequences. Except there’s evidence from football literature that if you’ve had more than three or four concussions, your chances of getting depression later in life are greatly increased.

“There’s also a concern that if you sustain a significant blow to the head while you still have that energy disturbance, then you’re at a much greater risk of developing a much more severe injury as a result of that.”

In the context of a rugby game, the management plan is pretty simple: if a player gets a knock to the head and looks a bit wobbly you tell them to go hit the shower. Remove the brain from the field of play and the problem more or less goes away… at least in the short term. But what if getting off the ‘field of play’ isn’t so easy?

If you’re reading this magazine, then chances are your playing field is far from level and removing someone from it is easier said than done. Can you imagine trying to rappel down a mountain or cross a river with someone who’s irritable, wobbly, and can’t remember which way is east?

Dr Osborne says a backcountry head injury is cause for concern but not for panic. It’s a matter of establishing if it’s ‘just’ a concussion, or something more sinister.

“Are they just a bit off, a bit slow and a bit vague, but otherwise alright and they’re continuing to carry half of their pack load? [If that’s the case and] you’re walking them out of the bush and you know you’re going to see the doctor when you get out, that’s fine.

“If they start throwing up and getting unsteady on their feet – that’s when you set off your EPIRB..”

Osborne says a smart idea is to print out the Concussion Recognition Tool (bit.ly/bjsmconcussion): “There’s no reason why it can’t be in your wallet in the bush.”

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