Concussions in Sledding Sports and the Unrecognized “Sled Head”: A Systematic Review

Abstract

Background: Sport-related concussion is a significant public health concern. Little research has been conducted on sport-related concussion and injury prevention strategies in competitive sledding sports like bobsleigh, luge, and skeleton. Athletes have identified “sled head” as a key concern due to its symptom burden.Purpose: To summarize our knowledge of the prevalence of concussion and related symptoms in sledding sports; to utilize Haddon's Matrix to inform and define strategies for injury prevention.Methods: An independent information specialist conducted a search for the known literature on injuries in non-recreational sledding sports, and specifically for concussion via OVID Medline, CINAHL, the Cochrane Database, EMBASE, PsycInfo, PubMed, Scopus, and the Web of Sciences from 1946 to December 2017. After iterative searches of reference sections, a total of 844 articles were assessed for inclusion.Results: Nine articles were included for review. Concussions are a common occurrence in elite sledding sport athletes, affecting 13-18% of all sledding athletes. Significant variance exists between events, indicating a potential effect of the ice track in injury risk. The condition known as “sled head” is discussed and identified as a key point of further investigation. A number of potential injury prevention strategies are discussed.Interpretation: Head injuries and concussions are an important injury for elite sledding sports and a number of avenues exist for prevention. More work is required to delineate the mechanisms, characteristics, natural history and management of “sled head.”

Heads-Up: Risk-Specific Neurodegenerative Mortality and Years-Saved Analysis on the US Olympian Cohort

“…Each sport was classified into one of the three categories, namely, Collision, Contact, and No-Contact ( Table 1 ). The Collision category includes sports, such as boxing, ice hockey, judo, rugby, and wrestling, where players purposely and frequently hit or collide with each other and with inanimate objects ( Zwiers et al, 2012 ; Reynolds et al, 2017 ; Mccradden and Cusimano, 2018 ; Čierna et al, 2019 ). In the Contact category, sports with less frequent and often not purposeful shock on the head (e.g., basketball, soccer, and gymnastics) were included ( Table 1 ; Reynolds et al, 2017 ).…”

Short narrative review on main winter sports-related accidents: epidemiology, injury patterns, arguments for prophylactic behavior to avoid orthopedic and catastrophic neurological injuries

“…Prevention strategies are limited, with no possibility of attenuating a catastrophic collision to the head, by interposing the hands. Concussions are a common occurrence in elite sledding sport athletes, affecting 13-18% of all, and this risk factor was entitled "sled head" (26). Recreational sledging (tobogganing), very popular in Alpine regions, consists in ascending and sledging down on the same track.…”

High-Frequency Head Impact Disrupts Hippocampal Neural Ensemble Dynamics

“…Repetitive mild TBI (rmTBI), such as those injuries seen in contact sports athletes and members of the armed forces, increases the severity and duration of symptoms ( Guskiewicz et al, 2007 ; Greco et al, 2019 ). Evidence is also emerging to suggest that sub-concussive impacts such as heading a soccer ball or sustained high frequency low amplitude cranial movement seen in professional sled athletes can lead to lasting cognitive symptoms ( Colvin et al, 2009 ; Talavage et al, 2014 ; McCradden and Cusimano, 2018 ). The mechanism by which high frequency sub-concussive impacts can lead to lasting cognitive impairments is poorly understood.…”