"If I'm going to be forced to live this shitty existence, at least I'm going to warn people."
In 2010, Jason Fraga drove to a supermarket near his home in Belchertown, Massachusetts, to pick up some groceries. A veteran BMX racer, he was accustomed to the claustrophobia of the pack, the thrown elbows, and the barely controlled choreography of speed on the dirt track. But when another shopper wheeled his cart into Fraga's path, something snapped. It was a completely unremarkable cut-off, the type of thing that happens a hundred times a day in a grocery store, and yet he found himself overcome with rage. He wanted to kill the man who'd pulled in front of him. What's worse, he didn't understand why.
Later, it would seem obvious: The day before, Fraga—founder of the Knockout Project, a forum dedicated to spreading awareness of concussions in sport—had suffered a concussion. It was his ninth. Or maybe his 19th. It's hard to say, because for years, stretching back to when he first started racing as a kid in the early 1980s, concussions were rarely talked about.
Today, the discussion around concussions and traumatic brain injuries (TBIs) revolves largely around professional football. In 2015, a federal judge approved a class-action lawsuit brought by some 5,000 former NFL players who accused the league of downplaying the dangers of the game.
Those dangers include chronic traumatic encephalopathy, or CTE, a degenerative disease caused by an individual blow or series of smaller blows to the head. According to the Boston University CTE Center, symptoms include deteriorating cognitive function, memory loss, dizziness, headaches, erratic behavior, impaired speech, vertigo, and suicidal ideation. In 2012, Kansas City Chiefs linebacker Jovan Belcher killed his girlfriend, and then himself, in front of his coach at the stadium where he played. The same year, former linebacker Junior Seau killed himself. Autopsies later revealed evidence of CTE in both of their brains. Since then, a number of high-profile football players, like San Francisco 49ers linebacker Chris Borland, have retired early, citing concerns about CTE.
It isn't limited to football: In February, Dave Mirra, the most-decorated BMX rider in X Games history, was found dead of an apparent suicide at his home in North Carolina. Toward the end of his life, friends reported Mirra was behaving strangely, and many have speculated that he was suffering from some form of CTE, although results of an autopsy that might prove this have not yet been released.
"The rub some dirt on it mentality you see in football is the same [in the bike world]. I'd break ribs, and it sucked, but I'd shrug it off." — Jason Fraga
The typical BMX course is 1,100 to 1,500 feet of dirt road, spiked with jumps and hard, paved turns. A race consists of one lap around the course, and takes a little under a minute, more than enough time for regular crashes. Broken ribs, fingers, wrists, and arms are typical—as are a lot of blows to the head.
Even wearing a helmet doesn't guarantee protection, although, as in football, the bicycling world has tried to offset the dangers with better helmet technology. Recently, USA BMX instituted a national head injury policy, but it has yet to make its way down to local competitions.
Fraga got his first concussion in his first race in 1982, when he was 10 years old. "I went over the handlebars and landed right on my head," he recalled in an interview. "I didn't get knocked out, but I saw a big flash. I remember being out of it and running with my bike to the finish line. Nobody noticed anything was wrong."
As a teen, Fraga competed on a fairly high level, but was forced to take a break after a terrible car accident at age 19. He eventually found his way back into the sport in his late 20s. He started coaching a team, Aggro Bikes, which at its height had about 60 people riding, and in his first year back racing in 2004, won a state title in Massachusetts.
"The rub-some-dirt-on-it mentality you see in football is the same," Fraga said of the bike world. "I used to take pride in the fact I could get up from crashes that people thought were absolutely brutal, and I felt like a badass for doing it. I'd break ribs, and it sucked, but I'd shrug it off. And I still see it. The people attracted to football and BMX are tough people, and I think it's an uphill battle to get them take head injuries seriously."
Then, on May 14, 2010, Fraga suffered his final head injury. It happened during the first qualifying round of a race, and the guy next to him had a several-foot lead. Fraga decided to go for it, but leaned back too far; the next thing he knew, he had slid off the back of the bike, his head bouncing off one of the hills. The back of his left eye burned like it was on fire. His helmet was destroyed.
That night, at the hospital, a CT scan showed swelling around the occipital area in the back of his head—the eye pain was from his brain bouncing off the optic nerve. "I just knew in my head, This is it," Fraga said. "I cannot ever take one of those again because I'm sure it will kill me."
In all of his ER trips for concussions over the years, no doctor had ever suggested that he give up racing. He doesn't blame them—when you've got a guy with a stab wound or his knee twisted sideways, the one who whacked his head isn't high on the ER's list of priorities. But after the incident in the grocery store, Fraga finally saw a specialist at the Bay State Sports Concussion Clinic in Springfield. His new doctor suggested very strongly that he give up his BMX career.
After a hit like the one he had taken, the brain suffers rapid cell death and tissue damage, which can impair someone's memory and cloud their judgment. People who have suffered similar brain injuries report all manner of crazy feelings, Fraga's doctors told him. Jails are full of men who've reported at least one TBI in their lives—and that very well could have been him.
In the days following his fall, he suffered constant headaches, vomiting, dizziness, and suicidal thoughts. "The difference is you don't really want to do it," he said. "You just want some relief."
At first, it felt like the worst hangover imaginable, but one that wouldn't go away. He remembers being at a lunch counter, trying and failing to remember what he wanted to order, until the server eventually suggested, "Mac and cheese?" Later, his spatial awareness began to diminish, and he would get lost driving on roads he'd known for 30 years.
The experience isn't uncommon in Fraga's sport. BMX star Mat Hoffman, who estimates he's had 100 concussions over his career, once forgot his wife was pregnant after getting knocked out by fall.
"What I learned a long time ago is whenever I get knocked out, and I lose my memory, the deepest memories, the most emotional memories, come back first," Hoffman told the Los Angeles Times in 2012. "When those come back, and you don't have all those other memories to balance [them]... you start getting really depressed, like, How do I even deal with life?"
Fraga started the Knockout Project in 2012, after meeting a group of kids in the waiting room at his specialist's office, all of whom were suffering the same type of brain injury symptoms. The Centers for Disease Control estimates that almost 250,000 children were treated for concussions in 2009, the most recent year for which data is available, up 57 percent from a decade earlier.
"It was a really difficult thing to see, so I figured at that point I had to do something," Fraga said. He added, "If I'm going to be forced to live this shitty existence, at least I'm going to warn people."
The organization connects with athletes at every level of play, from high school sports to professional football. Many are simply looking for others who can commiserate.
"There is nothing more painful than having an injury that other people can't physically see," a former high school basketball player wrote in a personal essay on the Knockout Project website earlier this year. "There's no cast, there's no brace, and there are no crutches. Nobody can see that you're physically, mentally, and emotionally dying inside."
While some have advocated for banning sports that cause high numbers of head injuries, Fraga is not an abolitionist. The primary message he wants to impart, particularly to young athletes and their parents, is to get checked out after a hit; if it turns out to be a concussion, he said, cognitive rest is critical, and athletes should make sure they are free of symptoms and cleared by a doctor before returning to the field.
It sounds obvious, he said, but it's something he'd never considered before. "We just went back out and blasted ourselves."
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