
Contact Sports are probably one of the greatest risks for head injuries, considering that sports related injuries account for a large percentage of TBI among young athletes. Contact sports are just that – sports where it’s necessary for the players to make bodily contact with each other. We think of football, wrestling, boxing, hockey and martial art as contact sports, and rightly so. All of these sports carry the potential for its players to receive a jolt to the body or a blow to the head, so there is a risk of TBI. Each one has its own set of safety equipment that usually includes pads and more importantly, helmets to reduce the risk of traumatic brain injury. Generally, there are certain rules that apply to all contact sports that will go lengths to keep its players safe. These safety measures are not game specific, they are rules that apply to athletes and coaches, as well as the general public to prevent trauma during practice and game play.
- Wear the required gear. Most contact sports require helmets and pads or some form of head gear to prevent trauma to the brain during game play. It’s there for the player’s safety and should be used accordingly. Helmets should fit snugly and be strapped on completely. Pads that support the neck or shoulders should not slide around. The gear needs to be worn correctly or else instead of reducing the risk of traumatic brain injury, it increases chances for equipment failure and accidents.
- Play by the rules. Illegally checking, bodily contact, and tackling should not be tolerated and the rules should be enforced. Avoid helmet to helmet contact and illegal spearing. The spirit of fair play says that catching someone off guard on purpose or outside of the rules of the game isn’t very nice and it should be handled accordingly. Enforcing the consequences of illegal game play, horse play, and general upheaval can prevent many trauma situations if warning signs are paid attention to. Coaches should not dismiss verbal altercations between players and keep an eye on the field.
Be mindful of the play environment. Avoiding wet play fields or littered areas can prevent athletes from losing their footing and potentially making a dangerous play worse. Broken or rusted equipment can also be an issue and should be removed from game play or practice. Goalposts should also be in good repair and removed from the field if otherwise damaged.
- Warm up! Getting your body ready for physical activity is very important; it allows the prevention of injury and allows the brain to be more alert during practice because adrenaline is released. This can keep you safe by keeping you on your toes and able to expect what is coming at you.
- Don’t play or practice if you’re tired or feeling unwell. Overexertion and exhaustion can cause the brain to be a little slower – meaning that your reflexes and hand-eye coordination can be off. This increases the risk of accidents and lowers the reflex to react to the impact. Well rested athletes are better able to respond to surprises and have the alertness to react on time against possible head injuries and shocks or jolts to the body. Sitting out doesn’t make you a poor athlete – it makes you a safe one.
- DO NOT return to practice or games if you have suffered a previous head injury and you are not completely recovered. A concussion received during contact sports game play might be mild and the recovery time might be short, but an athlete that has suffered a head injury already that returns to the game before their reflexes and concentration have returned to normal run the risk of another head injury, possibly a much worse one.
- Know the signs and have an action plan in place – just in case. You can’t prevent every single injury on the field and a human body can only take so much punishment before it gives. This means that athletes and coaches should be well versed in the signs of a head injury and should know what steps to take to prevent the further injury of their teammates while the necessary care is given or before emergency services arrive.
These guidelines are here to help everyone and when used faithfully,
can prevent many head injuries and increase the general safety of any contact sport. More than being a team on the field, players and coaches that look out for each other can prevent a lot of traumatic brain injuries. Let’s move on to some of the specifics that can be applied to individual contact sports.
Football:

Football, especially American football is definitely one of the roughest contact sport that exists. Wearing the safety helmets and pads making sure they fit properly is the first step in preventing traumatic brain injuries. Players should be coached to avoid head injury and bodily contact should be limited during practice. Practice time of scrimmages and full-speed routines should be limited. During tackling drills, space should be limited between colliding players. This prevents too much build up in speed and therefore the extra shock against the body. Athletes should not make helmet to helmet contact with other players and or try and purposefully hit another player in the head. Practices should not be held unless there are competent skilled athletic trainers present. These ideas go a long way to preventing a traumatic brain injury during football practice and play – a sport where there is plenty of obvious risks.
Wrestling:

When we mention wrestling here, we are talking about Olympic style athletic wresting, not Monday Night Raw (Although, these rules are applicable there as well, there is definitely less risk of having your bell rang with a metal chair or having a takedown executed from six feet off the ground). Even in athletic wrestling, the takedown accounts for many head injuries, as it is a move that sweeps an athlete off his feet from a standing position to the mat. Wrestlers should be coached to properly execute a takedown and coached to be able to move to avoid head injury when taken down. Beyond that, making sure that the mats and headgear are in good condition can prevent many unnecessary traumatic brain injuries from occurring.
Boxing:

It seems like avoiding head trauma in boxing would be a little silly, considering that the point of the game is to literally give your opponent a traumatic brain injury as quickly as possible. However considering that repeated concussions, even mild ones, can create a deficit in brain function, the best advice here to prevent traumatic and acquired brain injuries is to literally be better than your opponent. Boxing is not a safe sport when speaking in regards to traumatic brain injuries. Professionals don’t wear any safety gear and only one of the fouls in boxing (no head-butting) have anything to do with avoiding blows to the head so dodging fists and keeping your hands up is the best way to avoid being injured. Float like a butterfly!
Martial Arts/MMA:

Martial arts can be gratifying and fun but there still runs a good risk of getting hurt and sustaining a head injury. While there are helmets, we find that there is not a lot of safety gear worn so defensive moves are your best bet to avoid injury. While in combat, keep your chin down and your jaw closed while making sure you have one hand up ready for defense at any time is the best way to avoid being hit.
Beyond that, there are a few warning signs that you might see while practicing. For example, making sure that your trainer is responsible is a key element in ensuring your own safety. You don’t want to work with someone who is punishing or placing beginners in full contact martial arts. Anyone that encourages you to continue to fight with an injury is probably not responsible. You know what you’re physically capable of and listening to your body can save you a lot of pain down the road.
Mixed martial arts are a little different from plain Eastern martial arts. It is a combination of wrestling moves and kickboxing, martial arts, and street fighting. Different styles of fighters are welcome to oppose each other and this makes for interesting matches. Again, the best way to avoid head injury in these cases is to beef up your defenses and pay attention to the opponent. Remember, chin down, mouth closed, hands up. Beware that you might be slammed on the mat quickly and be prepared to have to react quickly to keep your skull from hitting the mat at a high velocity.
Ice/field Hockey:

Most of the concussions that are sustained during these games here come from illegal checking or equipment to player contact. Players should avoid swinging their stick around or above the head and try to avoid bodily contact. Look out for the puck and avoid it if you think it’s going to hit you! Caution should be displayed during practice, and full speed drills and checking exercises should be carefully monitored for proper technique. In ice hockey, wingmen should stay away from helping their fellow players along the wall and defensive players in field hockey are at risk as well. Goalies should be trained to catch or guide the puck into the net versus blocking it with their body and taught to dive properly to avoid head injury. Make sure all of your equipment is in good working order and of course, wear your helmet properly.
Contact sports are obviously dangerous but they don’t have to be risky. Coaches should go great lengths to teach their athletes to be attentive and wear their safety gear properly. They should also be willing to penalize players for things like aggressive behavior, illegal contact, unsafe plays like spearing, and other risks that might be overlooked. Traumatic brain injuries can affect many people, not just the injured party, and surely a coach would want an athlete out for a few weeks versus dealing with a fatality or possibly being responsible for a player’s permanent injury. If they are really that willing to risk someone’s life then perhaps they should sit the game out instead. Contact sports should be made as safe as possible in order to prevent traumatic brain injury, and everyone needs to be willing to be on the same page.
Traumatic Brain Injury Prevention in Non-Contact Sports.
Don’t be fooled into thinking that just because there isn’t or shouldn’t be a lot of bodily contact that there is not a risk of traumatic brain injury. Any time your body gains speed or leaves the ground, there’s potential for accidents. Have you ever seen a cheerleader get dropped from the top of the pyramid and hit the ground? Or a basketball player fall and hit the court? Soccer even has its own move that you hit the ball with your head on purpose! There is plenty of risk involved in non-contact sports, but just like with contact sports you can reduce the risk by following the general rules of sportsmanship and applying the proper etiquette with each individual sport. We already covered sportsmanship and safety rules that apply to all sports and outlined how to avoid traumatic brain injuries in contact sports with seceond part. Now we’re going to talk about individual non-contact sports and how to be as safe as possible while playing.
Non Contact Sport Safety
Basketball:

Basketball seems like a surprising place to find traumatic brain injury, but it’s completely possible. Consider that personal fouls where one player illegally makes contact with another may cause a jolt against the body, over even an over-rotation of the head, which is indeed a risk of concussion. Most of the bodily contact that happens in basketball happens during intense moments over the net while players are grappling for control of the ball. Flagrant fouls, which is when a player makes excessive and/or unnecessary physical contact with another often end in players hitting the gym floor. To avoid traumatic brain injuries, the penalties for these kinds of fouls need to be strictly enforced until the penalized player understands that you can’t push other players on to the floor in aggression, and if you’re doing it by accident, you need more practice. Oh, and if you see the ball flying at your face, stop playing basketball and play dodgeball instead.
Baseball and Softball:

Baseball is another non-contact sport where you might not believe that someone could sustain a head injury, but one has to understand that you are swinging a wooden or metal stick around your head to hit a ball that’s flying toward your face at ninety miles an hour or more – and the goal of the game is to hit that thing! One of the easiest ways to avoid a traumatic brain injury in baseball is to wear a batting helmet that fits and is in good condition. While there aren’t a lot of chances to make bodily contact another baseball player, it’s still entirely possible. Avoiding collision with other players goes a long way to prevent traumatic brain injuries and concussions on the field. The same rules apply for softball, although because the pitching types are underhand but the helmet rules and avoiding a collision will keep you safe from TBI.
Cheerleading:

This is an incredibly dangerous sport because your whole body can come into contact with the ground rapidly. Attention is a great way to prevent accidents on the cheerleading field. Coaches should be present all general practices and make sure that practice areas are safe and landing areas are soft. Many traumatic brain injuries acquired during cheerleading come from trying to practice difficult stunts. Stunting during practice should be limited. Safe stunting techniques should be coached religiously and difficult or new cheers and stunts should not be attempted without proper supervision and instructions. Stunts should always use spotters and the cheerleaders themselves should practice techniques to remain flexible and conditioned physically. It’s been a long standing joke that cheerleading is not a sport but in reality, it is just as dangerous and physically demanding as some full body contact sports.
Volleyball:

Much like basketball, most of the bodily collision in volleyball occurs around the net and puts players at risk for concussions and other injuries. Balls that are spiked over the net are traveling very quickly and should be avoided if you are unable to tag the ball with your hands to get it back over the net. In volleyball, there is a defensive position/technique called digging that requires the player to get low to the ground and get the ball back in the air before it touches the court. There is potential for the body to contact the ground very fast and the head to snap back causing a head or neck injury. Diggers should be taught rolling techniques to avoid concussions and more severe traumatic brain injuries.
Soccer:

The most obvious risk for traumatic brain injury in soccer is called “heading” which is exactly what it sounds like – using your head to pass or shoot the ball. The heading is, of course, debated whether it causes traumatic brain injury, even though it seems like certainly, it would, the jury is out of exactly to what extent. Nonetheless, since TBI is a hot-button issue, this move has its own set of rules to help prevent accidents and injuries. For example, this is not a technique that is encouraged for children under 14 but is a focus for adult players. When heading, athletes should plant themselves in the soccer ball’s trajectory path with a wide stance, using their arms for balance. Keeping their eyes open and their mouths shut, they should keep their head still and use their forehead to execute the move. These tips will help reduce the risk of traumatic brain injury.
Lacrosse:
This is a field game that is played with a long stick that has a net on the end, and a ball. The same rules apply about horseplay in this game as with hockey – don’t swing the stick around unnecessarily and try to limit body contact with other players. Pay attention to other players that are trying to pass the ball – a majority of concussions sustained during lacrosse are because of equipment contact with the player.As always, make sure that helmets and guards are in good condition and fit properly and your risk of traumatic brain injury is lowered drastically.
Important Aspects of Preventing Concussions and TBI
As you can see, just because a sport is labeled as “non-contact” doesn’t mean that you can’t sustain a decent head injury. Lots of people get hurt on the field all the time and it’s imperative that an individual take the time to play safely and follow the rules of safe sportsmanship.
Youth, in particular, should be paid special attention to in terms of traumatic brain injuries as their brains are not quite done developing and an injury that might be mild for an adult might be severe for a younger person. Coaching and supervision are of the utmost importance, and teaching techniques to avoid head injuries should be a priority. Rules that apply consequences to illegal contact should be put in place and enforced. Situations that would escalate and continue onto the field to motivate the urge to injure a teammate should be recognized and diffused immediately. These ideas are peripheral ways to prevent traumatic brain injury but they are just as wearing the safety gear.
Believe it or not, education is probably one of the best preventions for traumatic brain injuries in sports. Coaches, athletes, parents of athletic youth, and even administrative staff of arenas and schools should know what a concussion looks like and use best practice to avoid them. Knowledge about traumatic brain injury is something that should be shared and discussed freely and frequently among players and coaches of all sports, not just contact sports. These discussions should include TBI prevention during practice and gameplay, concussion recognition, treatment options and proper recovery time, and especially encouragement to report concussions. Traumatic brain injuries that go unreported or untreated can lead to permanent damage or fatality and the best way to make sure they get reported is to make players and coaches comfortable with talking about them.
Reporting concussions should be taught as the norm. In many cases, athletes are embarrassed to report that they might have a traumatic brain injury or downplay the severity to avoid ridicule from their teammates. Head injuries are serious, so good sportsmanship should be encouraged among athletes. Teammates should be coached to support each other through their injuries and to be on the lookout for symptoms or strange behavior among their peers. It is important to support one another on and off the field. Traumatic brain injuries are no laughing matter and it’s everyone’s responsibility to make sure that they’re reported.
As a reminder, coaches are usually not medical doctors and should not be allowed to dismiss athletes’ injuries until they are treated. While it may be uncommon, there are coaches that will tell a player to “shake it off” or return them to play before they are fully healed. This is dangerous, unfair, and it does not display team play or sportsmanship. Any good trainer will tell you that your body needs to rest after it is injured and to wait until they are fully healed to return to game play. A decent coach will be able to look for behaviors that will tell whether or not something is wrong and look for ways to validate their concerns medically. A coach that ridicules or punishes the injured should probably not be coaching.
Another important aspect of preventing TBI that was mentioned in both chapters on sports is making sure that the sporting equipment and playing areas used are in good working order. This is also everyone’s responsibility. This is important because equipment failure can cause an accident that could be much worse than just not wearing any safety gear. Helmets, guards, and pads should be in good repair. Hockey and lacrosse sticks should not be cracked or broken gym mats should not have any cracks or breaks in them. Goal posts and nets should be well padded and rust free. It is good practice to check each piece before use and remove any broken items from the rotation.
On a final note, defensive players should be watched after carefully. Defensive players for any sport seem to suffer the most damage. Considering that they stand in the opposition’s way of getting to the ball or puck they become a likely target that it seems necessary to remove to get to the player in control of the ball. Coaches of contact sports should be ready to pull players that are being overly aggressive, or seem to be injured, especially those displaying signs of a traumatic brain injury. They should also not put players back in the game that are not ready to be there – the healing process must be complete and if the player is not able to return to normal activities then they certainly aren’t ready to get back in the game.
When the team comes together as a whole to agree on safety and best practice, many emergency situations can be avoided altogether. The idea that someone would put themselves at that much risk of a brain injury is enough to know that every single measure of precaution must be taken to keep these athletes safe. After all, who really wants to have a concussion? There is no question that while every accident might not be able to prevented, there are plenty of reduction measures to save many athletes pain, and possibly their lives. This reduction applies to our whole lives, even down to every day hobbies.