The Untold Wreckage of Concussion The role concussion plays in traditional contact sports such as Rugby, American Football and to some extent Football has been getting more and more attention in the media and more appropriate concussion protocols have been put into place, but concussion protocols in sports that fall out of the mainstream like surfing are rarely discussed. In Surfing, Mercedes Maidana recently spoke to the Guardian about how concussion in surfing is flying under the radar and how the symptoms of concussion can be truly devastating, especially for elite athletes. Mercedes Maidana was one of the world's best big-wave surfers until the head injury she suffered swept away the life she knew. After wiping out and, on face-value, getting away with some pretty minor injuries with just a small cut above her eye visible. Maidana started vomiting that night. She was diagnosed with a mild concussion after a scan at an emergency room and told to rest. A few days later her mind and her body began to fail. Within weeks of her board smashing into her forehead she could barely get off the couch or hold a conversation. She was too weary to walk her dog and even sending text messages was exhausting. She was dizzy confused, anxious and depressed and paranoid. Three months after the accident she got divorced. “My world just crumbled. I lost my husband, my dog, my house, my sponsorship, I had a coaching business, I couldn’t do it anymore. I lost everything... The cut, the cut in your eyebrow. We were all concerned about the blood, instead of what’s happening underneath.” The lack of understanding in concussion in sports like surfing is encouraged by the culture of the sport. The sport encourages people to take risks and they playdown any injuries. There is a massive reluctance in wearing protective headgear and there is limited to no medical help and any real established head injury protocols. Maidana returned to the water but eventually realised she was causing “concussions over concussions, like a boxers brain”. In dire need of money, with her medical care not covered by insurance, she tried delivering pizzas and cleaning houses but was too unwell. To force herself away from the ocean, she moved to Austin and took a job in a café. “A doctor told me when I got to Austin, ‘you are an inch away from a stroke’ if I kept on surfing. At one point, when she did not maintain a strict and health diet, she had suicidal thoughts. “It was like – just end it, just end it, just end it. A lot of it was the nostalgia of what I lost. Life without big-wave surfing is nothing, look what your life was before, living at the beach, you were in Hawaii, now you’re in Austin, you’re a waitress, life sucks basically. And it was so scary”. Daniel Amend, a doctor in California who has treated numerous surfers, including Maidana, often finds they have frontal lobe injuries which affect judgement and impulse control. Maidana is now doing better and spending time with her family in Argentina. She hopes that her experience will raise awareness of the perils of big-wave surfing but says there still needs to be a cultural change. “When I talk to the younger guys they’re aware of what I went through and they’re asking questions like how can they prevent it themselves, how can they take care of themselves, what have they got to do. At the end of the day they’re still all charging really hard and getting hurt constantly. There’s an awareness out there but there isn’t really a change. The symptoms of concussion are complex and vary from person-to-person. Concussion can be life-limiting and terrifying. Your cognitive capacity is reduced and there is no real direction on when things will get better. In sport, more can certainly be done to protect athletes or even educate athletes on the dangers of concussion so they can make informed decisions on whether to take the risk.