X-games and brain injury

Extreme sports have captivated audiences with their adrenaline-inducing athletic performances. The X Games, drawing millions of viewers, showcase a multitude of genres, including BMX, skateboarding, Moto X, snowboarding, Skier X, mountain biking, rally & off-road truck, skiing, ice climbing, and many others. These events are known for introducing new tricks, and the competition is consistently intense, keeping viewers on the edge of their seats.

In difference from sports such as football or hockey, beginner extreme sport athletes tend to train under less medical supervision. Concussions are not attended to while injuries that acutely incapacitates the athlete (e.g., bone fractures, neck injuries, etc), get treatment. Mr. Dave Mirra was asked about the bigger and greater tricks needed to make the podium and the psychological state of an X Games athlete:

“I could see it in their eyes, man, they’ll do whatever it takes to win, Mirra said in an interview last year, “they’ll die…just like I would when I was younger. I would have died to win.” (Jesse Hyde, The Rolling Stones, Sept. 13, 2016 *).

Between 2000-2011, Vinay K. Sharma and other researchers collected injury data in seven different X Games sports using the National Electronic Injury Surveillance System of the Consumer Product Safety Commission (Sharma, et al, 2015). They analyzed injuries from patients presenting to United States hospitals (n.b., that means that the results only reflect X Games athletes who sought medical care for their injury. The actual number of injuries are likely higher).

Snowboarding had the greatest calculated incidence of concussions (535.7 per 1,000,000 person-years), followed by skateboarding (414.9 per 1,000,000 person-years). Furthermore, a snowboarder was 3.5 times more likely to suffer a concussion compared with a snow skier (152.5 per 1,000,000 person-years). There was a 54 times greater calculated risk of a skull fracture for skateboarding (54.7 per 1,000,000 person-years) compared with snowboarding (0.98 per 1,000,000 person-years).

There are multiple reasons for concern regarding the development of a concussion protocol and policies in extreme sports. Firstly, a significant number of extreme sports athletes are young. In 2012, for instance, two of the top six finishers on the Mega-Ramp (62 feet tall and 293 feet long) were under 16 years old. Secondly, the X Games currently lack a concussion protocol, leading to many concussions going unrecognized or ignored. Thirdly, the majority of training sites for extreme sports are situated in remote areas where accessing medical care may pose challenges.

Motocross sports have gained significant notoriety, particularly through events like the X Games, and are increasingly popular among youth. Research indicates that even with appropriate protective equipment, motocross poses an elevated risk for major trauma to the brain, spine, and limbs. Unfortunately, the long-term consequences of these injuries have been inadequately studied. It is essential for riders and parents to receive counseling regarding the risks associated with these injuries before participating, aligning with state laws and safety guidelines.

In 2012, BMX athlete Jay Fraga initiated The Knockout Project to raise awareness about the issue of concussions in extreme sports and encourage fellow athletes to actively address it. The goal is to foster a safer environment through education and exposure, particularly for athletes striving for success and recognition on the podium at events like the X Games.

References

Hyde, J. (2016). Dave Mirra’s Tragic Legacy: CTE and Extreme Athletes. Rolling Stone, September 13.<https://www.google.com/search?q=%3A+http%3A%2F%2Fwww.rollingstone.com%2Fsports%2Fdave-mirras-suicide-cte-and-extreme-athletes-w438361&rlz=1C1ONGR_enUS1056US1056&oq=%3A+http%3A%2F%2Fwww.rollingstone.com%2Fsports%2Fdave-mirras-suicide-cte-and-extreme-athletes-w438361&gs_lcrp=EgZjaHJvbWUqBggAEEUYOzIGCAAQRRg70gEINDY0MWowajSoAgCwAgA&sourceid=chrome&ie=UTF-8>

Nesvick, C.L., Kapurch, J.R., Daniels, D.J.. Pediatric and adolescent injury in motocross. Res Sports Med. 2018;26(sup1):57-70. doi: 10.1080/15438627.2018.1438283. PMID: 30431361.

Sharma, V.K., Rango, J., Connaughton, A.J., Lombardo, D.J., & Sabesan, V.J. (2015). The current state of head and neck injuries in extreme sports. Orthopedic Journal of Sorts Medicine, 3 (1): 2325967114564358 doi:  10.1177/2325967114564358.