The damage caused by concussions among athletes has grown too large to ignore and sports all across America have been racing to find solutions. Surfing is right there among other sports, yet it is faced with a unique challenge. It’s hard to plan for the recovery of an athlete falling off a 50-foot wave and hitting water that’s suddenly turned into concrete. It’s even harder to prevent.
Despite all the testimonies from professional surfers, there aren't many statistics to put into perspective the issue that’s before the sport. In fact, the last research publication available on the internet is from 2015, when a study by the National Library of Medicine found head injuries to be the most commonly sustained injury amongst surfers.
After 11 years on the World Surf League’s Championship Tour, Olympic surfer Owen Wright announced his retirement, stating in a heartfelt Instagram post: “Competing at some of the heaviest waves on the planet is no longer in the best interest of my long-term health.” He suffered a head injury in 2015.
Wright is one of many. Koa Smith, Shawn Dollar, Albee Layer, Derek Dunfee and many more have spoken publicly about the challenges of suffering head traumas while surfing. The common thread in all their stories is the glaringly difficult unknown of the path to recovery.
In 2022, surfing's premiere professional organization, the WSL, implemented its new concussion and safety protocols. It includes a new concussion baseline evaluation for all surfers at the beginning of the season, a new return to competition protocol, and the provision of SIMBA helmets available for athletes who choose at Pipeline and Teahupo’o.
But what about resources after competition is over?
Albee Layer suffered a life-altering head injury from a wipeout at the 2019 Jaws challenge.
“I had to diagnose myself,” Layer said, “which is a really dumb thing to do because when you have a concussion, you’re not yourself. My friends said after that wipeout that I was looking through them. I wasn't even looking at them.”
After Layer fell from the sky into solid water off of a 50-foot wave, he was impacted right away. But he was encouraged to paddle back out.
“It's hard because you’re super high on adrenaline and just wanting to get back out there,” he said. “If no one’s telling you that maybe you shouldn't go for another wave and everyone’s trying to get you back out there, then, of course, you go back out.”
What about the SIMBA helmets?
“On my wipeout, a helmet would have made my neck break before it protected my brain,” Layer said. “The concussion I had was more from whiplash than direct impact, but helmets can definitely make a difference at Pipeline and Teahupoo.”
It wasn’t just a headache and sensitivity to light after Layer’s initial injury. His mood started changing. He still didn't quite grasp the severity of it.
“I went surfing two weeks after the Jaws challenge,” he said. “I fell on a really small wave, a fall I’ve done a thousand times, but because of my initial concussion, I was concussed again. I think that’s really what did me in.”
Layer started having panic attacks and severe anxiety.
“I was a nightmare to be around, I hated going to dinners and doing things that used to be normal,” he said. “I wasn’t fun to be around and I knew it, but my family and my relationships were the ones that suffered the most.”
He started to take his injury more seriously. After visiting a neurologist on Maui and being told to just stop surfing indefinitely in order to recover, he sought a more complete diagnosis.
“Thanks to Shawn Dollar, I started going to a clinic in California,” Layer said. “I began treatment with electromagnetic therapy. After a week of treatment, I noticed my timing coming back.”
But that was only the beginning of a long road to recovery. There wasn’t just one cure-all. For the last three years, he has tried a variety of different treatments, different clinics and different medications, with symptoms coming and going.
“The most important thing for me during all of this was having the mantra of, ‘This isn’t me, this is my injury,’ ” Layer said, crediting Dollar.
Layer encountered what many surfers suffering head traumas have said – they didn't know what to do or where to turn for resources.
“For me, I didn't learn about any of this other than by word of mouth from friends,” he said. “If it wasn’t for Shawn Dollar and Shane Dorian, I would’ve been so much more lost.”
Not knowing about resources is one thing, but simply having a lack of resources is another. In all of the Hawaiian islands, there are only two board-certified chiropractic neurologists, experts of the brain, spine and nervous system.
The practice is fairly new, founded only 30 years ago by Dr. Ted Carrick, the first to realize the concept of neuroplasticity and rewiring brain networks after strokes and concussions. Nowadays, it’s widely used by athletes in restoring brain function without medication or surgery.
Dr. Josuke Tanaka is one of the two. He is a former gold medalist judo competitor and a current chiropractic neurologist in Honolulu, where he has operated his neurological rehabilitation clinic, KOS Integrative Chiropractic, since 2019.
“Because of my background in sports, I can relate to other athletes easily,” Tanaka said. “I know how it feels to have an injury and a deadline for the next upcoming event to compete at. Those are things that I lived, having that sense of urgency and need to recover quickly.”
Tanaka was 16 years old when he suffered his first major concussion as a Swiss national team Judo competitor. He was told by his primary-care doctor to try antidepressants, and he didn't take them.
“At that time, there was no information,” he said. “If you had a concussion, you would just go sit in a dark room and stay there until you feel better. And now we know it's actually not
the way to go. There were no assessment tools, the diagnosis was made by a doctor asking
a few questions to see how coherent the athlete’s answers were.”
Tanaka went on to suffer six severe concussions with a brief loss of consciousness.
“I now know that every time that I had a concussion, my mental health was getting worse and worse,” he said. “But I didn't know the two were linked.”
After retiring from judo, Tanaka went to the chiropractor for back pain, and it was there that he found the help he needed for his brain. That’s when he decided to go to chiropractic school.
He graduated in 2004 and began interning in San Francisco at a Chiropractic Neurology Clinic where he treated football players and professional athletes.
“Many sports like football or European soccer have been addressing the concussion issues for a while but for other sports like surfing, it’s more recent,” Tanaka said. “I think that the WSL is doing a fantastic job to support the athletes. I think everything is moving in the right direction in terms of prevention and access to care. In that sense, I think we still have a lot to do to maintain the health of surfers, especially for children and teenagers whose brains are more vulnerable, but I think we are rapidly moving forward.”
Tanaka said the WSL adding more concussion protocols is a huge step in the right direction. The hardest part is getting athletes to understand symptoms related to a concussion and how they might appear different for every person, days or weeks after the initial incident.
“That’s why it’s hard to diagnose and treat,” Tanaka said. “Everybody is a little different; some people have headaches, nausea, appetite, irregular sleep patterns or changing of moods. For me, the big one was my mood. I started developing depression, and it took me years to realize it was coming from my concussion.”
Surfers are already doing more than ever before to be in tune with their health, but practicing surfing isn’t the same as going to football practice. Surfers go out for a session like the general population goes out for a bike ride; it’s easy and natural for them, except the risks are a lot higher, and concentration is a key requirement.
“The hard part with surfers is they're traveling a lot,” Tanaka said. “Surfing all day, taking a red eye flight, getting poor sleep, not eating properly and then going back to surfing for hours. That kind of routine will make your brain more vulnerable and less resilient to handle an impact."
"You can’t always predict a head impact, but you can minimize the chances of developing a concussion by bulletproofing your brain, making sure that you are physically and mentally ready, and being well rested.”
Another thing that Layers said could help is having priority at the Jaws event and to discontinue giving high scores to surfers who fall off waves.
“They’ve given the ride of the year to wipeouts time and time again,” Layer said. “We had a few meetings with the WSL to discuss it. That would help people with concussions more than having a doctor out in the water.”
No matter the resources or lack thereof and no matter the change in policy or the rapid changing of the sport, Layer won’t stop surfing – competing maybe, but never surfing.
“I think I’d have to be drooling in the corner and unable to talk for me to stop surfing,” he said. “I would never stop if I was capable, I would just be a lot smarter, which I’m already doing now because of that injury.”
Resources for surfers in Hawai’i suffering from concussion symptoms: