Over the last two weeks, Chris Nowinski said he’s had conversations with four athletes in their early 20s who are all dealing with trauma and post-concussion syndrome.
He said each of their stories include either a mismanaged concussion or an unreported concussion.
“That shouldn’t be happening,” Nowinski said. “But it’s not easy to convince athletes to report their concussions when they feel pressure to play.”
As CEO and co-founder of the Boston-based Concussion Legacy Foundation (CLF), he understands the way a brain injury can affect who a person becomes. But he’s also speaking from firsthand experience.
“My eyes were opened in 2003 when I had a series of concussions at WWE that I wasn’t forthcoming about, and wasn’t properly educated to recognize the damage I was doing by continuing to perform with concussions,” Nowinski said.
As a Harvard graduate, and a former All-Ivy defensive tackle for the university’s football team, Nowinski debuted as a professional wrestler on WWE’s Monday Night RAW in 2002 as “Chris Harvard.”
Nowinski said wrestling was like theater.
“It’s sort of endlessly fascinating. I mean, you think you have an idea of what it is by watching it on television,” he said. “Then you get into it and it’s just this fascinating culture of entertainment performance and athleticism.”
With WWE, he put on shows for thousands of people, playing characters that were constantly evolving and performing some of the most physically demanding things he’d ever had to do.
Nowinski said showing up to the arena and being told who you’re wrestling against, sparring in the ring with icons like The Undertaker, was like no other career.
“Leaving it was difficult,” Nowinski said. “I left it slowly. I was injured in 2003, [and] after a year of symptoms I decided I couldn’t go back. I couldn’t deal with another year of that suffering … it was a slow death.”
Faced with an invisible injury, he reflected on his sports career and the times when he would black out, forget where he was, or experience headaches after head impacts. He said he hadn’t considered those incidents to be concussions, either.
“All this banging of my head for 18 years was detrimental,” Nowinski said. “When I started hitting my head at 5 years old, it was normal and no one ever told me not to. It was totally accepted by the culture. I would have adults hit soccer balls at my head and ask me to use my head to hit them back.”
He said it seemed odd to him now, as an adult, that he was facing problems he hadn’t really consented to.
“I decided I would take a shot at trying to change the culture,” Nowinski said.
He started by writing a book titled “Head Games: Football’s Concussion Crisis.”
— Chris Nowinski, Ph.D. (@ChrisNowinski1) May 20, 2018
“The book was sort of my penance for taking my Harvard degree and … injuring my brain,” Nowinski said.
After he finished writing, he expected someone else to spark the conversation.
“I thought somebody else would pick up the ball and run with it. It’d be some doctor who had a passion for medicine, who could sort of lead this movement better than I could,” Nowinski said. “But that person didn’t appear.”
He stuck with it after realizing that if he walked away, the work would never be done.
“My life today is just … overwhelmed with sad stories about what people’s lives become and the impact that their post-concussion or CTE issues have on their families,” Nowinski said. “I never want to minimize the severity of the risks we’re taking.”
Every year, there are an estimated 3.8 million concussions, and only one in six concussions are diagnosed, according to the Centers for Disease Control and Prevention.
An estimated 3.8 million concussions occur in sports each year, but only 1 in 6 are diagnosed.
— Concussion Legacy Foundation (@ConcussionLF) February 21, 2020
After beginning CLF alongside Dr. Robert Cantu in June, 2007, Nowinski went back to school and earned his PhD in behavioral neuroscience from Boston University, hoping to understand the science behind the numbers.
Thirteen years later, the non-profit has teamed up with 22 other organizations like USA Rugby, USA Hockey, and WWE to spread education efforts.
Besides creating a global brain bank focusing research on how to diagnose and treat chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repetitive brain trauma, the foundation has initiated multiple advocacy programs like Team Up Speak Up, Safer Soccer, and Flag Football Under 14.
Nowinski said the way society currently handles concussions in sports is costing people their lives.
“We’ve got generations of damaged people and sadly we’re still doing it to kids today,” he said.
Nowinski co-founded CLF to reframe the culture around concussions.
“Small changes to our understanding and behavior can directly save lives,” he said. Since concussions aren’t noticeable in people’s everyday lives, they’re often overlooked.
“Part of the reason concussions were under the radar is because they were an invisible injury and you couldn’t see the damage,” Nowinski said.
Oftentimes, people would just eventually drop out of social life because their heads hurt so much.
“They’re sort of ghosts,” he said.
With CLF, his goal is to change the culture within five years.
“The simple solution that we have to accept is that we have to stop hitting each other in the head,” Nowinski said. “If you think of the billions of impacts to the head that happen to children every year in sports, most of them are happening just because we haven’t been inspired enough to change the rules of youth sports relative to adult sports.”
He said asking children to tackle each other to the ground or use their forehead to bash projectiles is dangerous to their mental health and development.
How is youth tackle football like smoking? The longer you play, the greater the risk. Over time, a child’s risk of developing CTE from tackle may add up faster than a smoker’s risk of developing lung cancer.
— Concussion Legacy Foundation (@ConcussionLF) October 10, 2019
“If you think about a child’s brain, talking about 86 billion neurons, trillions of connections between them — you injure their brain, you’re literally rearranging their brain,” Nowinski said. “And it’s never better after the injury. It’s going to function differently, it’s going to physically be different.”
The worst-case scenario after a concussion is an enduring increased risk of suicide, he said.
“A brain injury can open the door to new problems, new mental health injuries, or it can exacerbate pre-existing mental health problems,” Nowinski said.
But he said the biggest issue is that kids are facing traumatic brain injuries during some of the most difficult times in their lives, while they’re under academic pressures and in the peak of their social development.
“I don’t think evolution anticipated that we were going to invent plastic helmets and go play football, or create cheap rubber soccer balls that could be used to bang our heads with,” Nowinski said.
And when it comes to his own brain trauma, he’s developed a permanent post-concussion syndrome, along with an REM behavior disorder.
“You never forget how much your head hurt, you never forget how terrible you felt about yourself, the struggle of getting through every day,” Nowinski said. “I’ll never forget the fear I developed of going to sleep.”
With REM behavior disorder, Nowinski said he’ll wake up a few times a month thinking he’s choking to death as if something is lodged in his throat.
“Your body is supposed to become quiet when you dream … and that part of my brain broke,” he said. “It’s like a recurring nightmare. Sometimes I’ll get up and chase shadows like there’s someone in the house.”
Despite everything, Nowinski said he’s found value in his experiences and where they led him.
“But would I go back and do it again, you know, recognizing how important your brain health is for your success and happiness in life?” he asked. “I’m not sure if I’d go back and take the same risks.”
Still, he said his concussions pushed him face to face with the severity of brain injuries, and gave him a path to change that.
“As I stand today, still functional, I’m glad I had those experiences,” he said. “It required me to get brain injured to really appreciate what was happening.”