Protecting the brain is no longer optional. Expert Dr Patrick Neary explains how sport is adapting – and what more can be done to prevent concussion.

“You only have one brain, and you need that for the next 70 years of your life.”

Dr. Patrick Neary, 68, a professor in the Faculty of Kinesiology and Health Studies at the University of Regina in Saskatchewan, Canada, shares his perspective not for shock value but simply because it’s the truth.

A former ice hockey player in his youth with five concussions to his name, Dr Neary now leads research on the effects of concussions on the brain, and has been doing for over 20 years.

He knows, first-hand and scientifically, that the effects don’t always go away.

“A concussion is the movement of the brain inside the skull,” he says. “You don’t even need to hit your head.”

It’s something most athletes still don’t realise. A jolt. A rotation. A violent stop. It can all lead to a concussion, and this isn’t preventable externally.

“Sideways movement is often worse, that’s where you get the shearing forces,” Dr Neary explains.

He brings up the case of Sidney Crosby. A glancing shoulder hit in 2011 took the NHL (National Hockey League) star out of action for a year. No direct head blow. Just a twist. And months of recovery.

In Dr Neary’s lab, elite rugby players who’ve suffered multiple concussions show changes in brain function. Compared to tennis players or cyclists, the difference is clear.

“There are long-term consequences,” he says. “Even if we can’t draw a straight line to conditions like Alzheimer’s, the association is there.”

For athletes in the modern game, that is the frightening truth, a truth that was not discussed until recently.

“In the ’70s and ’80s, you just sucked it up,” he says. “Now we’re learning. But it’s still hard.”

Denial remains one of the most dangerous parts of the injury.

“They don’t want to let the team down,” Dr Neary says. “But the next hit? That could be the one that breaks you.” 

Athletes lie. They stay on. They tell coaches they’re fine. This is one of the most damaging things top sportspeople can do, resulting in issues after their sporting careers. 

But what is being done?

The introduction of concussion spotters in the NFL, NHL, and top-level rugby is just one of the innovative changes to sport to help prevent damage from worsening. These are individuals in the stands who are trained to remove players from the field when they notice something is wrong.

In football, leagues like the Premier League now permit temporary concussion substitutes to prioritise player care. 

Still, too many think helmets are the answer and concussions are preventable from the exterior. Dr Neary is quick to disprove this theory.

“Helmets don’t stop concussions,” he says. “They stop cuts and fractures. But the brain still moves inside the skull.”

He once told a gridiron, a term used for American and Canadian football, coach to train players without helmets. The coach wanted to teach safer tackling. “You take the helmet off, and no one leads with their head anymore,” Dr Neary says. “It’s instinct. You protect yourself better.”

Life after sport

Athletes still walk into Dr Neary’s lab years after retirement. 

“I’ve had NHL guys. Rugby guys. You can see it on their faces,” he says. “I really feel for them.”

But he’s not without hope.

“Exercise helps. Staying hydrated and staying mentally active. It all matters. The brain can adapt if we give it the chance,” Dr Neary says.

Even heart rate variability (a measure of the variation in time between each heartbeat) something most people don’t think about, is affected by concussion. The brain and heart are in constant communication.

“We’ve seen it, that variability drops after a concussion. The brain is trying to protect itself by limiting stress,” he says.

The message is simple: early recognition saves lives.

Dizziness. Nausea. Blurred vision. That foggy feeling you can’t shake. “Most athletes know, deep down [they have a concussion],” Neary says. “The question is whether they’ll admit it.”

For too long, saying something was seen as a weakness. Now, he hopes that this is something which is finally changing.

“You’re not soft for speaking up. You’re smart,” he says. “Every jolt matters,” he says. “Even if it’s not a concussion, it can still do damage.”

That’s why education and research are key, and that’s why, every time he talks to a young athlete, he reminds them of one thing.

“You only get one brain.”

Read more about Dr Patrick Neary’s work here.