Broken Brains with Bruce Parkman

Repetitive Brain Trauma, Sleep, and the Hidden Risks Facing Young Athletes

Bruce Parkman Season 1 Episode 77

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What happens when brain trauma starts earlier than we realize—and recovery never truly begins?
 In this episode of The Broken Brains Podcast, host Bruce Parkman sits down with neurobiologist Dr. Allison Breger to examine the growing crisis of repetitive brain trauma in youth sports and military environments. They explore how repeated head impacts, poor sleep, and cumulative exposure affect mental health, neurobiology, and long-term brain function.

This conversation highlights the risks facing young athletes—especially in gymnastics and non-contact sports—the overlooked role of sleep in brain recovery, and why year-round training without off-seasons may be setting children up for lifelong neurological challenges. Dr. Breger also shares insights from research in extreme environments, emphasizing how environmental stressors compound brain trauma and recovery demands.

This episode is a call for prevention, smarter training, and better mental health protections—especially for developing brains.

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Chapters

 00:00 Introduction to Repetitive Brain Trauma

02:51 The Journey into Neurobiology

05:30 The Impact of Sports on Mental Health

08:20 Understanding Concussions in Non-Contact Sports

11:25 Military Operations and Brain Trauma

13:57 Protecting Developing Brains in Sports

16:48 Environmental Impacts on Human Performance

19:45 The Importance of Sleep in Recovery

22:25 Long-Term Effects of Concussions

28:21 Conclusion and Future Directions

29:32 Understanding Brain Trauma and Methylation

30:56 The Impact of Youth Sports on Mental Health

34:10 Gender Differences in Sports Injuries

36:49 NCAA Mental Health Initiatives

39:54 The Correlation Between Sports and Suicide Rates

40:44 Fascinating Studies and Personal Accomplishments

 

Connect with Dr. Brager today.

LinkedIn: https://www.linkedin.com/in/allison-brager-80a58210/

Instagram: https://www.instagram.com/docjockzzz/


Produced by Security Halt Media

SPEAKER_01:

Hey folks, welcome back to another episode of Broken Brains with your host, Bruce Parkman, sponsored by the MA Parkman Foundation, where we look at the issue of repetitive brain trauma in two forms: repetitive head impacts from contact sports and repetitive blast exposure for military veterans in their service. And how both these conditions are contributing to the mental welfare of our kids, adults, and veterans, and why this is so important because the connection between repetitive brain trauma and mental illness, i.e., brain damage, is not taught in our nursing medical and suicide prevention training courses. And that makes us the front line of knowledge for you, the parents, the stakeholders, the caretakers, to become informed about these situations so that you can take care of the ones you love. And on this podcast, we bring on authors, researchers, patients, professional football players, amateurs, parents of those that have lost, and researchers and scientists to discuss this. So you have that 360-degree perspective of this issue because you are literally the first line of defense when it comes to protecting those that you love, as we said. On the show today, another amazing guest. We have with us today, Dr. Allison Brager. Brager? I said that right, ma'am.

SPEAKER_00:

But it's all right.

SPEAKER_01:

All right, Brager, sergeant major in English, man. Bad combination. Tell you not right. Dr. Allison Brager is a neurobiologist and one of the nation's leading experts on sleep, circadian rhythms, and human performance. She serves as an assistant professor at the United States Military Academy at West Point, Hua, and as a Ghost Fellow with U.S. Special Operations Command. Her work spans clinical trials and field studies with special forces and elite performers operating in some of the world's most extreme environments, from Antarctica to the Central American Rainforest, Seventh Special Forces Group, been there multiple times. Dr. Brager advises organizations such as NATO, U.S. SOCOM, NASA, and the Army Surgeon General on fatigue, resilience, and neuroenhancement. And she helped write the U.S. Army's holistic health doctrine as well as the NCAA's first mental health handbook. She's published more than 50 scientific papers and contributes regularly to national science outlets and is the author of Meathead, Unraveling the Athletic Brain. Ma'am, Dr. Allison Bragger, welcome to the show. How are you doing today, ma'am?

SPEAKER_00:

I'm doing great. We're uh getting a snowstorm soon. So uh, you know, I'll be tuckered in for the next few days.

SPEAKER_01:

Wow, man. You guys do get some bad weather up there at West Point.

SPEAKER_00:

Yeah, we're supposed to get like seven inches over the next hour.

SPEAKER_01:

I haven't been up there a while, and from what I hear, I don't plan to be up there. I had a lot of friends that served one as the commander of the 10th Mountain Division. It was not a lot of fun.

SPEAKER_00:

No, I agree. I'm not a cold weather person myself. Having spent you know a lot of my last assignment down in Florida, um, I I'm really craving that Florida weather now.

SPEAKER_01:

Well, that's where I'm right now, and it's not as nice as as it was yesterday, 80 degrees and sunny, but I'll take it anyways. I really don't care. So all good. So, ma'am, what led you on this journey? How did you get into neurobiology, neuro, neuroscience? What led you?

SPEAKER_00:

So it's really from being an athlete. So I was a uh a gymnast, uh more or less like a high-risk athlete growing up. Uh so I did gymnastics from the age of two all the way through high school. And then in high school, I actually picked up pole vaulting too. I grew up in Ohio and actually girls weren't allowed to pole vault in Ohio until I was about a junior because it was considered too dangerous. But uh as soon as girls were allowed to pole vault, my track coach basically recruited all the gymnasts and forced us to pole vault. But it was, you know, it was a great event to pick up because I ended up going on to college competing in pole vault. Um, and then I did after college try to make the Olympic team, uh the 2008 team. I wasn't successful. But it was around that time that I had fallen in love with taking neuroscience courses where I went to college, which was Brown University. And I think why I was so fascinated by it is because of being a gymnast and putting my body in very dangerous situations and doing these complex, advanced skills and not really thinking about it. But that whole process of how does one go from throwing their body in every which direction upside down and risk injury and do it time after time, day after day, and go back to it, even when you have right, um, a near miss or a fall or something like that. So that's what fascinated me with neuroscience. So throughout my career, I've always tried to center my research and relate it back to athletes and give back to athletes, not just through research, but also coaching. I've coached high school, track and field ever since graduate school. And I'm also involved with a lot of nonprofits now, for example, to help soldiers who are about to retire refine their purpose through coaching and stuff as well. So more or less, I feel like my entire career, even with TBI, for example, that we'll talk about today, has been centered around athletes. Because I have done a lot of work with the NCAA, the NFL, and then also some of the research we've done in the early days at Walter Reed.

SPEAKER_01:

We can stay on the athletic track this whole time. I mean, of course, that's how we got all got going was, you know, my son's overexposure to subconcussive trauma from contact sports. And um it's interesting that a lot of people don't associate with gymnastics with what we call repetitive head impacts. And it's while it's not just RH, so let's talk about that because you know, Simone Biles came out a couple of years ago struggling with mental illness, and I people would come to me and say, Well, what do you what do you think? And I was like, Well, do you can you think of how many times that young lady has hit her head on a beam, on the bar, you know, in practice with all those crazy flips? And they're like, wow, we never thought about that. Yeah, is that it? Is that that's it that that should be an issue of of concern for parents when they look at these sports?

SPEAKER_00:

Absolutely. I mean, I'm probably I forget how old Simone Biles is. I'm 41. So I am of that generation where the word concussion really didn't even exist in high school. And I can at least recollect three times, essentially, like on floor exercise and then also beam too, where I was trying to add a new twist or say an additional flip to my already existing skill repertoire. And yeah, I've landed on my neck. Fortunately, I've never damaged or to the best of my knowledge, injured my neck. Uh, but I do remember like all those subconcussive and even concussive symptoms that we now know of and we asked athletes about as soon as they get hit. Like I definitely experienced it's just at the time we didn't know what they were. I did have two concussions from pole vault too. Again, during the time period where I we didn't know much about it, right? I remember like clearly having a moment of like blacking out, but then I like you know, still competed throughout the meet, and then I had a massive headache the next day. But again, we didn't know what we didn't know back then. And the same was true in the military too. In pole vault, where it happened was the first time was if you think about the pole, right? It has to be oriented a certain way because it bends a certain way. And if you don't turn the pole over that certain way when you're planning in the box, it will shoot you in whatever direction. So that's basically what happened is it catapulted me right into the standards, the metal standards that hold up the crossbar. Gosh. And I hit smacked my temple pretty hard. And then the second time I was, you've probably seen that like social media video of a male vaulter when he releases the pole and the pole hits uh a not so friendly area that's very common in males. But I had that same thing happen, except where my eye socket is, is I was releasing the pole. I was coming down with gravity, and my pole came and hit me right in the eye. Um, and I I definitely felt a little concussed after that too. But again, we didn't know what we didn't know at the time. I remember Brown had just started doing concussion protocol stuff. Like they were one of the first people in the game, them and Virginia Tech, because the football players at Brown back then were wearing the sensors integrated into the helmets to look at the cumulative total load and intensity of subconcussive hits. But I would say outside of football, the other sports, like yeah, gymnastics, track and field, even, you know, other non-contact sports like swimming, like concussions really weren't thought of. But think of how many people have probably hit their head on like the side of the pool.

SPEAKER_01:

Right. And the only difference is though, is as we know, is that those sports, they they concussions and concussive events are they're not part of the sport. They're they're not not accidentally, they could be, you know, like you said, you know, poor form, poor style, but they're not part of sports like they are in soccer or you know, hockey. And, you know, so but it is interesting that parents are like, wow, but gymnastics is a whole nother it that's like wrestling to me, right? It's like it is a contact sport. The head moves violently, the the risk for the head trauma is is pretty high. And then what's your opinion of uh there were some studies at one of the brain conferences I was that was looking at the G forces that are that are um that are driven by these, I mean, really, you know, those those triple moves and all that, and all of a sudden you stop, but the brain don't stop, right? Because it's in fluid. What's your what's your perspective on that?

SPEAKER_00:

Yeah, and I think that's the thing where the biggest risk for issues arises because of the repetitive nature of it. And the perfect example I can give you um related to military operations, because we had done we have done a lot of work in this space too, is like the opening shock of the parachute during military free fall. Or actually, what's even worse in free fall, uh sometimes is static line jumping.

SPEAKER_01:

No way. Yeah, just because I've done both, so I'd I'm all curious now. So what you got?

SPEAKER_00:

Well, you know, and the landing too, right? At least in free fall, you have like a more gentle landing most times. So you're the static line, you know. Yeah, it's up to you and the god and God and the winds as to like how you're gonna land, right?

SPEAKER_01:

Okay, so explain to the audience, because we have a lot of civilians to read this. All right, so the difference between halo and and store free fall and static line. And then what what there is so there's a significant difference in the opening shocks between they all st they all stunk for me. I wasn't a big fan, I jumped a lot, but I wasn't a big fan.

SPEAKER_00:

Yeah, so the the basic difference is static line, it's exactly what it is. It's uh you jump out of that plane and that parachute releases. Uh, the difference is it's the altitude, right? It's only about 1800,000 feet. But the chute, in terms of how it's designed, it is creating a very disruptive and very violent opening. And because of that opening in your body uh being subjected to terminal or to velocity, it's going to jolt your body around. Now, if you add on altitude, so high altitude, low opening, essentially you're jumping out of a plane at about 13,000, we'll even say like 23,000 feet, depending on the circumstance. Um but you are free falling and you're reaching terminal velocity, and then around 5,000 feet, that's when you pull the chute to open the canopy. The chutes are designed differently, so it's it they're designed to have uh to absorb more of the shock, but because you have been falling at terminal velocity for the last 12,000 feet, there is it's still going to be a pretty disruptive and and violent opening. And so if you're doing that not just once a day, but several times a day, compounded by weeks on end, um, it's going to have a significant impact. Right. To equate it to gymnastics to your point or wrestling, it's fine if you're doing that move once, but in any gymnastics practice, you're not just doing that move or that skill on a single instance, you're doing it like every 90 seconds, essentially, for at least 45 minutes. So that's where the cumulative trauma becomes a concern. And sure, your body, like from the research I know, your body does adapt and adjust to those physical forces, just like right, there's this idea that if a high school football player was tackled at full intensity and effort by an NFL player, it would probably kill him. So your body does adapt, but at what point does the adaptation stop and the harm take over? And that's more or less what we're interested in, especially with some of the research we do now, is what is the cost-benefit of ratio where we can still achieve the training effect, but at minimal cost?

SPEAKER_01:

Yeah, and that brings up some good points that I want to dial into later because you know, I I was on General Fenton's um uh brain health team. Uh, you know, I was uh fortunate enough to be invited into SOCOM a couple times and sit there. And and you know, when you're wrestling with lethality and mission, you know, the you know, the the desire to go, and then you got all these, you know, angry men and women that want to train, train, train, right? Getting them to understand that they're we have to you have a life after the military, right? And we uh we have to protect that brain. But let's get back to gymnastics and wrestling, all this in children's brains. Okay, a child's brain that you know doesn't develop until 25, and of course, women develop a lot faster than men, and we all know that because we act like idiots. And and and and then, of course, you know, you're an adult at 18, you can do whatever you want with your undeveloped brain. What can we do right now to you know just kind of do we know now, we we cannot deny this anymore that these impacts are are they they're in no way beneficial to the to brain health. There's they're not. And sports should be fun, sports should be productive. And yes, we have so much to gain from sports. I played all army rugby, semi-pro rugby, uh, you know, I was greenbred, done all team stuff, right? Love being on a team. Everybody wants to be on a team, right? But there is uh a growing recognition right now that these forces are unnecessary when a kid's brain is developing. Yet we've got gymnasts competing on Olympic teams in their what? How old are these kids? 18, 15?

SPEAKER_00:

Like they're barely old enough to drive.

SPEAKER_01:

Barely old enough to drive. And how long have they been beating their brains around?

SPEAKER_00:

Since they were long as I since they were two or three.

SPEAKER_01:

Right. So we've got we've got a uh, you know, it's just like and and and when you start looking at the religion of these, like it does you can pick a sport, gymnasts, hockey players, you know, you got NFL guy, you know, let's start them at five. Let's let's always start younger, younger, younger, younger. And now we understand, like back in the 70s, this stuff, well, I mean, gymnasts, yes. I mean, the gymnasts were always cultivated at a very young age for decades, right? But we didn't have a lot of pop warner. We didn't have all this club soccer, we didn't have all this sports stuff that's kind of been pulled down through whatever you want to call it. You want to call it greed, you want to call it, you know, whatever, passion, whatever. We're exposing our children to a lot of head trauma. Do you have any recommendation, you know, any ideas on what we can do to because it looks like it's going to be a significant societal shift to say, look, we're you're, you know, our gymnasts are going to compete as adults, which is going to limit the amount of crazy moves that they can do because they don't have the suppleness in what they can do as a child, a child athlete. But we are hurting these kids.

SPEAKER_00:

I think the biggest thing outside of like preventative measures and perhaps reducing the reps and sets, which again, the reps and sets are necessary, but you have to do a scientific evaluation of at what cost, right? Just like at with military free fall, like, okay, how many times a day can we jump or how many rounds should we have in a shoot house before it's time to stop, where we've achieved the objective and we're not reaching this point of diminishing returns and harms. So outside of that, I think the one thing that is different now compared to when I was an athlete in high school and college, is kids don't have an off season. So at least right during preseason and competition season, that's where you're gonna have the most cumulative trauma. And that's true for gymnastics too. So we actually would have an off-season. And what I mean by that is during the summer, like that was for strength and conditioning and skill development. So we would have three hour, four-hour practices four times a week in the summer, but we would spend two of those hours doing aerobic conditioning andor right uh more like CrossFit stuff before CrossFit was a thing. And then in terms of skill development, we would either refine, like if we were doing rotations or say release moves, we would focus on those, but we want to like do skills to completion. We only really focus on stringing all those rotations and release moves together during the preseason and the actual season. And I think that's where that's the most preventative thing people can do is to have an actual off season. Uh, because you're not gonna right, you're not gonna forget those skills, right? Those skills have been executed thousands of times. So they're they're encoded into lots of memory. And sometimes you do need that break, right? Simone talk Biles talked about that when she developed the twisties and she had to take like months off from being in the gym to more or less like reset and rewire her brain in order to do that. But I think that's the biggest thing that needs to be implemented here more than anything.

SPEAKER_01:

I and I and I do not disagree. I mean, I think that right now we just think that pea is for plenty, right? And we've got and and and and I I was just talking to a chiropractor who's actually a concussion uh he wrote the concussion protocols for one of those states here in the U.S. And he was telling me that, you know, that these these kids are specializing in the same sport, and it's causing huge problems because they don't you work other muscle groups, they don't, you know, and and and so this whole age of being a two or three sport athlete is, you know, or in the case of my son, where it was two concussive sports that hurt him, right? It wasn't if he would have played baseball and football or football and anything, or had there been a break to your point between football and we're trying to get this state, this one state right now, to separate these two sports so the kids can have an off season in between. And this is the kind of you know the logic that I think needs to be applied to some of these. And then of course, these kids just got to be kids, if you ask me.

SPEAKER_00:

Exactly. They're not uh, you know, it breaks my heart when I see just the amount of focus that these kids have. Not I mean it's respectable, but right? Burnout is real, it doesn't matter who you are.

SPEAKER_01:

It is. Let's talk about some of the environmental impacts on our. I mean, you obviously you've been working with people in Antarctica and While this is a little bit off topic, it is kind of interesting. Um, you know, having sweated in the jungle for 11 years down in Central South America, I mean, I'm pretty big. I used to cramp up all the time. Um, and we, you know, we have a lot of athletes that listen to this. What are you learning from these studies on whether it's the you know the coldest of colds or uh you know operating in jungle and or desert environments? We just got done with 20 years of conflict over there.

SPEAKER_00:

I mean, so we were doing sleep studies in all these environments uh to include the in the Middle East. So during the war, um we were part of a mental health advisory team that was sent out by the Pentagon to basically capture sleep objectively using sleep watches and active combat zones, and then correlate that with performance, but also mental health. I think in all these environments, whether it's Arctic, jungle, or desert warfare, it all comes down to adaptation. And that's just how incredible the human body is at adapting on its own. So when we were doing this study in Antarctica, for example, and this is all published research, um, it was actually with the Argentinian Navy. They have a very small Navy base in the southernmost part of the world called Belgrano II. And they share that base with like NASA researchers andor researchers who study environmental issues. So we studied their sleep objectively using a sleepwatch uh for an entire year. 24 hours of light, 24 hours of dark, and then the twilight period in the spring and fall. Uh, we also looked at blood pressure, we looked at core body temperature every single day, twice a day. And then we also had them do a test of reaction time for two to three minutes. And what was really interesting is the body would adapt with every season. So during the 24 hours of darkness, the people who were stationed down there essentially they had longer sleeping belts and fewer belts in a 24-hour period. So instead of taking a 20-minute nap, they would take a 75-minute nap and do that three times versus taking a 20-minute nap six times. During the summer, it was the opposite where they would have they would have a very short sleeping bout, but sleep more frequently. So if you looked at a 24-hour average, it all amounted to about seven hours of sleep in a 24-hour. And sure, some of that was structured because of their schedule, right? Just like astronauts stationed on the International Space Station. They have a list of tasks and duties that they have to complete during the day in order to achieve their mission and objectives down there. But really, this is just like ad libidum on your own sleep amounts. It all amounted to seven hours. What that meant for physiology is blood pressure essentially stayed the same, core body temperature rhythms stayed the same. And then tests of reaction time, at least when we tested them, were about the same because the body was able to adapt in those environments. And it's the same thing when you look at heat acclimation. That's why there's such a huge, huge focus. And there's an entire research institute at Natick Labs in Boston dedicated to the study of altitude and heat acclimation, because there is a way to do it, and there's a way to do it, right? Uh, but the body can adapt to these environments if it's given the opportunity. I mean, I'll I'll like as a silly anecdote, when um we were part of this mental health advisory team and we were going out to, we were mostly in Kuwait, which was in February, high 90s. Um you know, wearing kit all day for 16 hours a day. It was only 20 degrees back then in DC. It was like a really, really cold winter in DC. So I actually would go to the local hot yoga place right near Capitol Hill, like every day after work for five weeks. And I would do hot yoga for 90 minutes to two hours in my BDUs just to like acclimate. And so when we finally were boots on ground in Kuwait, I was completely fine because I had spent five to six weeks prior in the 30 and 20 degree weather acclimating my body to those conditions.

SPEAKER_01:

Good for you. Well, we also know that sleep is an also an indicator that the brain is struggling at times. And we see this with um, you know, soldiers that have suffered from repetitive blast exposure. Also, a lot of the athletes that are suffering from repetitive ed impacts and the impacts in their brains are suffering. My son suffered from sleep deprivation, we finally understood, you know, after we, you know, we kind of put it all together after he left. So from the the correlation just for the education of our audience with sleep, if somebody has had extensive blast exposure and or repetitive ed impacts, which is, you know, uh, you know, from from contact sports, what would you know, how does how is sleep impacted and what can these, you know, what can be done to improve sleep? Because it's so you know, obviously. I think one of the reasons our son left us is that he was just so tired. And he was just at a point where impulsivity took over.

SPEAKER_00:

And he couldn't we could Yeah, it's um, you know, this has been more or less my life's work, and we've even I've even done this type of work in animal models too, like 15 years ago. Sleep is the integral mediator of recovery and also not just short-term recovery, but long-term recovery from any sort of traumatic brain injury, whether it's open head wound, closed head wound, even things such as ischemic strokes. So 15 years ago, when I was doing my fellowship after my PhD at a medical school, we did this neat thing where we gave mice essentially ischemic strokes. And right after they had their ischemic stroke, which damaged essentially half their brain, we gave them an opportunity to sleep or to be sleep deprived, like what used to be right, the old recommendation when you had a concussion was you should never sleep after you have a concussion. You have to stay awake. And we found that the extent of recovery post-chemic stroke in the mice that were sleep deprived and weren't provided with an opportunity to sleep after the stroke, their brains never recovered, right? They had lost all movement on that side of where the stroke was. And those who were allowed to sleep showed significant recovery. And so that was right, small animal evidence showing, okay, this medical recommendation that has been ubiquitous and universal for so long. This is one reason why it's not true. But now we have evidence from this just from human work as well, in terms of the importance of sleep. Actually, this paper is coming out any day now. So this is a study we did when I was at the Center for Military Psychiatry at Walter Reed. We did a study where we recruited football players in the Maryland area, so collegiate football players. And so we worked with the athletic trainers of Division I football teams, well, division one through division three football teams around Maryland to basically, as soon as a football player had a concussion, um, we would enroll them in our study. And then after they had returned to play from their concussion, they would come to the sleep lab at Walter Reed and essentially do what most college students do, and or someone in the military would do is they would stay up for 24 hours, right? Whether it's a field training exercise or pulling an all-nighter to study for an exam. And what was interesting is although this was months after they had recovered from the concussion and had effectively returned to play, all those symptoms that they experienced post-concussion would return during the sleep deprivation. And they could not focus, they could not attend to any of the cognitive tasks we gave them. And then one of the most interesting things we found, and again, this should be coming out any day in the Journal of Biological Rhythms research, is that their restorative sleep amounts, so the type of sleep important for growth hormone release, testosterone release, as well as other anabolic factors for the brain and the body, had been reduced after their concussion. So at baseline, they already had less restorative sleep. And even during the recovery period from the sleep deprivation, they still had reduced restorative sleep. So it did do something to the ability to achieve restorative sleep, not just in the short term, but in the long term, well after they were quote unquote deemed medically cleared to play. So it does, you know, that study doing it was a little difficult because I started thinking back to right, the supposed concussions, although never diagnosed and pole vault and gymnastics and, you know, it was it was it's certainly good information to know moving forward, but one of those things that it can show you just how pervasive um and impactful um concussion can have on your long-term health and and performance.

SPEAKER_01:

And this is just a concussion. This is not like participating in a contact sport, which is that's amazing. I as a matter of fact, I need to get some of the information for the revision of our book because now we're talking about, you know, impacting and and so I guess it could be postulated that if this is happening to a college athlete, these same symptoms will be happening to a child that also not only has a concussion, but also a subconcussive lifestyle.

SPEAKER_00:

Yeah, I'll send you one of our already published um components of this study too. So I guess we also looked at molecular factors. So throughout the day, right, every day our DNA, RNA is red so that we can continue to live life and to thrive and perform function. So something happens to the DNA sometimes under trauma, particularly brain trauma, called methylation, where you will have these methyl groups attached to the DNA that interferes with their ability to read the amino acids correctly. And so that's actually something else we found in this study too. And it's already published in bioarchives, and I can send it to you, is we did find evidence for DNA methylation in some of these encoding regions of genes related to sleep and circadian function in these college football players who had been deemed medically cleared from um having a concussion.

SPEAKER_01:

Medically cleared, yeah. I mean, it's uh it's yeah, it's it's gonna be right now our our you know our our focus, and we keep talking to people about this, is that unless we can reduce the total aggregate amount of trauma that these brains are taking, we are not gonna fix this problem. I mean, it's and as long as we allow children to start playing at younger and younger ages, this, I mean, we have no idea the contribution to this epidemic of mental illness in our youngsters that sports is just is contributing to. Just, you know, I I mean, it it's uh I mean it and it's all unintentional, right? Nobody's out to harm their children, but it's because we're uneducated. And I have talked to, and and I'll ask you, you know, as a neuroscientist, are you gonna allow your children to play contact sport?

SPEAKER_00:

That that is an interesting question because it's like I know. Well, here's the thing I also grew up in, I struggle with this. I've had this conversation with myself a lot because I grew up in Ohio. I have family who played in the NFL. My great uncle was a linebacker for the New York Giants, Luke Slayby, and then my distant cousin was played for the New England Patriots, who's a backup quarterback to Tom Brady, O'Brien Hoyer. Like I growing up in like football America, youngstown, Ohio, that's where I grew up. It's pretty well known for football. That's what you do growing up is you play football if you have a boy. But yeah, I'm not so sure I would now, knowing what I know.

SPEAKER_01:

And it's and it's you know, the thing is, what we're what we're aggregating, what we're asking for is like, look, if we could just delay contact until high school, when the prefrontal cortex, the most important part of our brain, starts to develop. And then if we could just say, okay, can we contact, have contact two, two hours a week, right? Save it for game day, because like all these boys aren't going to the NFL. Sorry, they're not Youngstown, Ohio guys, right? But, you know, we could reduce the trauma, right? We could reduce it, make the sport safer, and then these children can grow up to be like you. They can be neuroscientists, neurobiologists. And one of my buddies came out of, I think it was Youngstown. Is that a it's a it was a very poor, he played at Pitt, and there's this massive rivalry between Pitt and this other. He brought me in, he's a Pitt team captain, uh Mike McGlynn.

SPEAKER_00:

That's where my great uncle played, uh Lubey. He was at Pitt before he got drafted by the Giants and uh the Lions.

SPEAKER_01:

Okay. Uh Mike McGlynn played in the NFL for five years or eight years. Good friend of mine. And his son plays, and we've had very, and he says, bro, he said in my town, if you didn't play football, you couldn't get out. And he is, and he's adamant about it. And he's but he's, you know, we we've talked about, and and but that's that's the way it is in these towns. Like I'm in football, I'm in Florida right now, football city. And it's like, all right, do you really want to harm your children? So that we're coming to a compromise because there is a compromise, like everything. Just like going back to the military, um, you know, looking at how how much time you're gonna spend in that shoot house. I mean, how many times do you have to shoot that AT4 before you can know how to shoot an AT4? Right? I mean, it's like you said, it's all about program. Yeah, well, well, uh, thank you for taking that that question. I appreciate it.

SPEAKER_00:

No, it's uh it's something I've thought about, but I think to your point, it's like I would I would let my child play contact sports with with the understanding that they would have an offseason and they would do other things. Like there is a whole legitimacy to the strength and conditioning, and like the more you strengthen your neck muscles, the more it's going to reduce the impact and the velocity and the forces of the concussion.

SPEAKER_01:

Let's talk let's talk about that real quick if we could, because I've heard this over and over again. It was validated by a doctor. I'd like you to talk about this. The impact of a soccer ball on a on a female's anatomy vice-a male. There is significant science out there that given the way God built window women with a longer neck-to-body ratio and a weaker neck muscle structure, that these soccer balls are hitting our girls with significantly more impact. Like I've seen estimates of up to 70% more impact than a boy. So what's your what's your perspective on that?

SPEAKER_00:

No, I I mean, physiologically, you're absolutely right, right? We don't testosterone is one hell of a drug. Like when you have testosterone, you build bulk muscle, you build muscle quickly. You know, women, yes, we're capable of building muscle, but it's not going to be the breadth and depth that a male can. And so even if you are doing like neck focused exercises, the male is still going to make significant gains more quickly than any female can.

SPEAKER_01:

Yeah, it's um it it's it's unfortunate because well, the other, and that's the other unfortunate side of it, is women are are highly underrepresentative in a lot of the studies that are being done. And I I think that's uh part of the focus that even on the military side, like there's hardly been any studies done on, you know, we've had, you know, a lot of female EOD personnel. There's a lot of female paratroopers out there. And you're talking about an opening shock on a neck with the same helmet that a man has, and those helmets, you know, I've jumped at everything. And that's there, that there's a lot of traumas going on. And I don't even think I'm working with the military. Well, we do you know what a GBEV is? The generalized blast exposure variable. Okay.

SPEAKER_00:

My friend, um, my friend Claire, she's uh neuroscientist with the Navy. She helped create the GBEV when she's like, yeah. Yeah.

SPEAKER_01:

The GBEV doesn't even take into account other forms of subconcussive trauma like combatives and parachute jumping. It's all blast, right? But yet it all comes together when we start talking. Now, I noticed that, you know, when you wrote you wrote the uh mental health playbook for or the handbook for the NCAA. Tell us about that. How'd you get involved with that?

SPEAKER_00:

Yeah, so I got involved with that through um the professional sleep research society. Essentially, the NCAA, they wanted to bring together all professional societies across holistic health. So mental health, nutrition, sleep, psychology, psychiatry, um, to help write this handbook. Sadly, the handbook came out of increased suicides across the NCAA. In 2013, the amount of suicides that year was the highest the NCAA had ever seen. And they realized they couldn't ignore this problem anymore of not having sufficient and adequate mental health resources in universities. I can tell you when I was an athlete at Brown, we had very few resources. And, you know, unfortunately, I was from a generation of female athletes where I had teammates who had eating disorders and or, you know, the mental health uh struggles that come with that. So the NCAA, this was their initiative to increase the amount of mental health resources as well as money allocated to mental health at all their institutions, division three through division one and NAIA. Um, so it's really a collaborative effort to break down mental health holistically. So to look at sociocultural factors, for example, the fact that there are differences in terms of how much an athlete is willing to trust a coach to handle their mental health issues appropriately, how much they're willing to disclose based on whether they're male or female or whatever their race, ethnicity is, or even what sport they play, or are they varsity or JV? Um, and then we focus mostly on the sleep component, just again, everything I talked about with this research, how sleep really is a protector and a mediator of recovery from not just TBI, but also to help reduce risk for any mental health issue, whether it's clinical or subclinical. And so that's what I worked a lot with the NCAA. Essentially, we would meet quarterly and come up with a series of guidelines. So they get all of us in the room, the sports psychologists, the psychiatrists, the clinical psychologists, the dietitians, the sleep clinicians, um, and just write uh and athletic administrators too, right? Because you had to make it feasible, scalable, and realistic for whatever institution it was. Um, and it was like a two, three-year effort, but the handbook is now available online. I know they have started working on future editions, and there was a lot of nonprofits involved with this too. And some of the nonprofits were focused on youth sports. So it wasn't just, it was preceding college sports as well.

SPEAKER_01:

Did they did they look at the correlation between suicides and the types of sports that were being played? Was there any focus on the issue of subconcussive trauma, repetitive, repetitive impacts, and maybe any uh contributions to the suicides that were taking place? Unfortunately.

SPEAKER_00:

Yeah. So that was one of the trends that was appearing. I don't know if it's specifically in the handbook, but the trend that, right, in contact sports, there's a trend towards increased suicide for all the reasons that we now know.

SPEAKER_01:

Yeah. And that and that's what we're it was so important to get out there. And that's why, you know, it's uh it's just it is time. It's time that, you know, we we just can't sit here and ignore this any longer in the face of, I don't care, fame, money, fortune, whatever, dude. We we have to effect some changes. So doctor, you've done a lot in a 41-year-old 40 for a 41-year-old woman, uh you have done a lot in your career. What what's like what's the most interesting study that you've been a part of or so far that maybe we have to do that?

SPEAKER_00:

I thought you were gonna ask, what is what is the most interesting fact about me? I was we'll get to that next.

SPEAKER_01:

We haven't asked that question yet, but go ahead.

SPEAKER_00:

Really, I think that it's this the study in Antarctica, that was the most fascinating because I was not expecting for physiology to balance out in an environment like that. That totally blew my mind. But it makes sense, right? If you look at how long people are able to um survive and thrive in in space and these other austere environments.

SPEAKER_01:

Yeah, I mean, and I am in fact absolutely impressed by the fact that you went and did hot yoga for five to six weeks to prepare yourself for a deployment.

SPEAKER_00:

That's uh like a weirdo, I will say. I mean, sure. Do you see it's a military town, but you you know, you're not supposed to wear your uniform on the metro and be a target, but here I was showing up in a yoga studio outside.

SPEAKER_01:

Not only that, in the back of the yoga studio.

SPEAKER_00:

Oh, I was I was in the hottest part of the studio every time, which is usually the sun.

SPEAKER_01:

Yeah, those those environments are no fun, especially if you go there, you haven't done both invasions. So, what is the most interesting fact about Dr. Allison Brager?

SPEAKER_00:

Well, I guess I'd say more or less my like proudest accomplishment is being so Bernie Kozar and I are inducted into the same Hall of Fame, which is my high school hall of fame, um, because Bernie Kozar went to my high school. So, and I actually have a picture from when I got inducted for track and field with Bernie.

SPEAKER_01:

Really? So you just you still hold you still hold some state records?

SPEAKER_00:

Actually, I don't hold any records anymore. So that was the thing about being the first, is like every meet I set a new record. I had the indoor state record for a while, but actually the reigning Olympic champion, Katie Moon, uh she is from Cleveland, Ohio. Um, and I was actually coaching high school track at a nearby high school when she was competing in high school, but she she had broken most of the like regional and district records that I had and probably like still has the the state records in the street.

SPEAKER_01:

In pole vaulting?

SPEAKER_00:

In pole vault, yeah. Yeah, so this is this is uh if you can see Bernie and I.

SPEAKER_01:

Congratulations. How tall are you?

SPEAKER_00:

Uh I'm only five. I'm five five, which is tall for a gymnast. Bernie's really tall. I was not expecting him to be so tall.

SPEAKER_01:

I was thinking pole vaulters, when you see him at the Olympics, all the all the guys are like, well, they look like they're six.

SPEAKER_00:

The guys are tall.

SPEAKER_01:

Yeah, they're very lanky.

SPEAKER_00:

When I was stationed at Bragg, um, I used to coach at a club up in uh Raleigh, and we actually had uh Duplantis, the uh Swedish guy who finally broke Sergei Bupka's like 40-year-old record come. He's really tall. The women are short because most of us were gymnasts in a previous life.

SPEAKER_01:

Really? So that's like the follow-on career for a gymnast is moving into pole vaulting.

SPEAKER_00:

Yeah, I mean, I could have done gymnastics in college, not division one, like a division three school, but I think my body, you know, after 17, 18, it was it was it was done with gymnastics, especially and start taking care of that body because I'm in my 60s right now.

SPEAKER_01:

I'm I've got rotator cuff surgery coming up, I've got lower back surgery. And I played rugby all the way up into my early 60s. So I you know, it's uh yeah, yeah, I just uh kind of love it, you know. Just uh I understand.

SPEAKER_00:

I still so I still pole vault. Uh so I do coach at a club, but I also pole vault with my athletes too. So I compete in like masters, track and field. Uh I do CrossFit too, competed in the CrossFit games a few times on a team, not not as an individual on a team years ago. But that's really how I just try to stay fit and injury free.

SPEAKER_01:

Staying fit is one thing, but the hurting yourself carrying them lay them sandbags around is another issue. Yeah. Uh doc, this has been an amazing conversation, man. So before before we close out every show, I'd love I love to give my guests time to talk about themselves. Where can people find you? Some of the studies that you're coming out, and what's next for you? Where do you where do you go from West Point and and and there? So go ahead and uh and and talk away.

SPEAKER_00:

Sure. Um, so I guess, yeah, you can find me on on social media. Um I'm not on uh Twitter or um yeah, I have a profile on LinkedIn. I quite honestly only check it like once a month. Uh, but I am active on Instagram. It's docjockz.

SPEAKER_01:

Okay.

SPEAKER_00:

And I do have a, and I'll send you a copy. I got to get more books. I have a popular science book I wrote over a decade ago called uh Meathead, Unraveling the Athletic Brain. More or less is uh a neuroscience textbook for athletes. So it it talks about how the brain goes from developing into a youth sport athlete into a professional athlete and what happens in the brain from decision making to risk taking to emotional regulation. Also has a significant focus on exercise and the importance of exercise for reducing risk for Alzheimer's and neurodegeneration, also reducing and improving mental health. Um, and there's also a chapter on sleep as well as like using legal performance enhancers like caffeine, how that is like I think an underutilized or underappreciated thing for cognitive function during the sports. So, yeah, you can find it on Amazon. Beyond that, yeah, if you want to look up any of my studies, all my studies are publicly available outside of the ones I've done with um organizations that you've worked for. Um and you can find those um on Google Scholar. And after this, um yeah, I'm just hoping to go back to the community that uh you were a part of for um a long period of time. You know, it really is a special community. I do miss it. I do get to do some things here, like tomorrow I get to participate in a role-playing exercise, which I'm like super excited about to have some interface with, you know, people from Fort Bragg and stuff. But um, yeah, that's my plan is to, you know, keep serving my country and and helping, you know, your teammates be the all, you know, be the best they can be, but make sure that they're doing it safely um and that they're protecting themselves short term and long term.

SPEAKER_01:

Well, Doctor, uh, this has been amazing. And just so you know, uh let us know. I'll be talking about this in the closing as it's but uh we'd love to continue working with you. If you have you know anything you need from the foundation, please reach out. Uh, we've just uh won several grants down here to provide free uh ketamine treatments and uh brain supplementation programs. We'd like to turn these into studies. So we're very focused on this is for veterans, and then on youth sports. I mean, you're this is one of the few the dual youth sports and military conversations I've had on this podcast. It was it was a wonderful surprise. And I thank you so much for uh for coming on the show. And we look forward to I look forward to seeing you at the tailgate. I'll talk about that, the Army Navy game, and uh because we'll be down there if you're gonna be around.

SPEAKER_00:

House literally overlooks um the rugby field. Like we hear practice every single day. When I when it's uh 4 30, I get home from work and I'm taking out our dog, like I can hear the both men's and women's team yelling. So God.

SPEAKER_01:

Women's yeah, I I I got into a a very, well, not a loud argument, but one of the women doctors at a TBI conference got up and you know, she was backed by world rugby and the NFL, and she got up there in front of this whole new group of brain people, right? And she's like, Well, you know, you know, and I've been told by the rugby players that if you're not tackling, it's not rugby. And she was up there actively condoning that girl start tackling at the age of eight in rugby. And of course, with that young athlete that ran over everybody in the Olympics, rugby's the fastest growing women's sport in this country right now.

SPEAKER_00:

It is. Yep. My former boss at my last job, his um daughter, she was the all army athlete, Sammy Sullivan.

SPEAKER_01:

Oh, okay.

SPEAKER_00:

Yeah, yeah. Yeah, I worked in my last job. He's a retired Green Beret, I think. I don't know if you knew that.

SPEAKER_01:

Who's that?

SPEAKER_00:

Mike Sullivan, her dad.

SPEAKER_01:

Oh, Mike Sullivan, yeah, dude. Mike was my coach on All Army years and years ago, man. It was the same Mike Sullivan. Yeah. Uh yeah, it's just uh it's just another because when I was down in Australia, the problem that we have between U.S. football and rugby is that most kids are done playing football at high school. Very few make it to double one. There's no football teams out here. You know, I mean, it's very few. It costs a lot of money for all that patch. With rugby, all you need is a pair of cleats. They're a pair of boots, man, you get on the field. And I'm I'm actually part of that with my own mental health issues after playing for so long. And uh, but it's something that we do have to watch for. But Dr. Brager, thank you so much for your time today. I want to thank you so much for your service to our country, to our veterans, and congratulations on all the success that you have. I've got it down to order your book, and I'll go ahead and do a review on that, and uh look forward to helping you in any way you can uh we can with your mission.

SPEAKER_00:

Well, I really appreciate uh time with you too. It's uh the best part of my day for sure.

SPEAKER_01:

All right. Well, may the Lord bless you and you take care of yourself.

SPEAKER_00:

Thank you so much.

SPEAKER_01:

No problem, ma'am. Folks, another wonderful show. And this is these are the amazing conversations that we have that could just make you more informed to make better decisions or to understand that people, and we get calls all the time from men and women in their 30s, 40s, and 50s that are starting to understand why they're suffering now and how we can help them because there's all kinds of treatments out there out there. So as you as we keep going, I want to say thank you to everybody, Dr. Brager and the team for producing this uh wonderful podcast. Don't forget the book, the only book for parents that I had to write, okay, it's for available for free on our website, Youth Contact Sports or Broken Brains. Please take a look at it. Please read it. 88 pages, get smart on the issues so that you're not listening to influencers, because if it's on the internet, it's not exactly true sometimes. You can think for yourself, all right? And then like the podcast, spread the Poscat around, share it, please. Let everybody know that we're out there just trying to make a difference, and we appreciate all your support. Remember, for those of you with the with children, and for yourself, if you're an athlete, you only got one melon. Please take care of it. May the Lord bless you all. Take care from me, your host, Bruce Parkman, and the Mac Parkman Foundation. We'll talk to you later. God bless.