Surfing and Brain Injuries and HBOT

Every now and again, an article like this gives me hope. My brother has surfed for 60+ years at a high level and sent this along. Two interesting sites:  and

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Dashel Pierson
Apr 28th, 2021.
At a remote surf spot in northern California, Shawn Dollar was in trouble. It was 2015 and Dollar was surfing alone. When a large set steamrolled his way, he stood on his board for a few feet of extra leverage, and dove beneath the whitewash. But, as he broke the surface, he went head-first into a shallow rock.

His neck was broken; his brain, scrambled.

“The real problem was, which I found out later, that all the concussions I had before added up, and this one was the straw that broke the camel’s back,” said Dollar, a two-time world record holder for biggest wave ever surfed (one at Maverick’s, another at Cortes Bank). “When I went up to the Amen Clinic, the results from the scans looked like I had played high school, college, and pro football. I had the brain of a pro football player, even though I never played. I just surfed. They were shocked. They scan thousands of NFL players, and they were very surprised to see that in a surfer.”

What followed for Dollar was a long road to recovery. And through his experience, along with those of numerous other surfers, the question arose: How common are brain injuries in surfing? Turns out, they’re more frequent than one might expect.

Shawn Dollar’s 2010 world record paddle wave at Maverick’s. Photo: Fred Pompermayer

“Any big swell at Maverick’s,” said Audrey Lambidakis, a big-wave photographer and founder of Healing Brainwaves, “you’re going to see anywhere from two to 10 brain injuries. It’s not necessarily the big crazy ones when the guy or girl is super out of it; it can be those minor ones, too. You might have a little headache, or you might feel a little cloudy. Those can be the more dangerous ones. Those are the ones that cause CTE [chronic traumatic encephalopathy], which is what football players deal with.”

RELATED: Why Has Nobody Died in Big Waves Lately?

Lambidakis, a traumatic brain injury (TBI) survivor herself, started Healing Brainwaves as a tool for people (and especially surfers) to get the information they need. It’s a platform for discussing experiences, treatments, and, ultimately, helping those affected heal. The organization works in tandem with another non-profit, OneHitAway, which, in addition to education, focusses on raising money for treatment. Again, OneHitAway specializes in patients suffering from sports-related brain injuries, ranging from bull-riders to surfers.

Maya Gabeira, over the handlebars at Teahupoo. Photo: Fred Pompermayer
Maya Gabeira, over the handlebars at Teahupoo. Photo: Fred Pompermayer

“When a brain is injured, when you take a hit on a surfboard or in a boxing ring or on a football field, these are traumatic events,” explained Jill Cde Baca, who co-founded OneHitAway with her husband after their son had a TBI playing football. “They’ll take hit after hit, especially surfers. It happens every time you fall. Your brain is the consistency of butter, and the skull is sharp and hard. So, the brain shakes in there. Over time, areas of the brain overwork or underwork. For instance, the frontal lobe or the forehead, that’s your executive function. That keeps you at your job every day, that keeps you making the right choices, that keeps you being able to reason appropriately. And when you shake the brain forward and backwards, a lot of the time the frontal lobe is impaired.”

For Albee Layer, Maui big-wave surfer and aerial wizard, he experienced that impairment of judgement firsthand after a wipeout during the 2019 Peahi Challenge. After the fall, a clearly concussed Layer did the one thing he shouldn’t have: paddle back out.

“I was so out of my mind,” said Layer. “I had broken my vest, and I got buck naked in the channel to switch vests with one of my friends. I would’ve never f*cking done that if I was in my right mind. Just stripped down in the middle of the Jaws event. I paddled back out and I just started puking and my vision was all out of whack. Luckily, a little voice inside my head told me I was concussed. If I had caught another wave that day, I would’ve had a pretty good chance of ruining my normal life. If I would’ve fallen again, there was a good chance I would’ve died.”

So, what exactly does it look like when someone sustains a brain injury?

“Depending on where the brain is impaired, it effects people in different ways,” said Cde Baca. “Some people will be volatile, some people will be emotional, some people will walk like they’re drunk, some people who used to be A students, will be C students.”

Grant “Twiggy” Baker going headfirst after a fall at Mav’s in January, 2021. Photo: Audrey Lambidakis
Grant “Twiggy” Baker going headfirst after a fall at Mav’s in January, 2021. Photo: Audrey Lambidakis

“It’s kind of like when you’re a little kid and you’re around people who are drunk,” added Layer. “You don’t realize why they were acting weird. But then, once you get drunk yourself, you realize why they were acting that way. It’s the same way with concussions. Once you know, you can totally recognize it.”

And these effects can develop and worsen over time, especially if the injury goes untreated. Additionally, the more hits to the head one takes, the more fragile and likely the brain is to be damaged in the future.

READ MORE: How Safety Transformed Big-Wave Surfing

“We had this one surfer from Ocean Beach, who kept getting concussed,” said Lambidakis. “And eventually, he was getting concussed in really small waves. He didn’t know why. But it makes sense. The more brain injuries that you sustain, the easier it is to get concussed.”

“The more I was getting my bell rung, the longer the recovery was,” added Dollar. That’s the elasticity of the brain. The more you drop something, the more fragile it’s gonna be. I’ll fall surfing Pleasure Point now, and I’ll have my bell rung, and I just know that I’ve added another mild concussion to my ticket.”

Jamie Mitchell pre-rescue in Mexico. Photo: Billy Watts
Jamie Mitchell pre-rescue in Mexico. Photo: Billy Watts

And in some instances, a cumulation of concussions have led surfers to abandon big waves for good. That was the case for San Diego native and former Biggest Paddle Award winner, Derek Dunfee, who suffered multiple brain injuries throughout his career in heavy water which he talks about at length in his new book, Waking Up in the Sea.

“My concussions have impacted my everyday life,” said Dunfee. “I had to stop surfing big waves because of my concussions. And that’s what I love – surfing big waves – especially at places like Maverick’s. It was a really difficult decision, but it was affecting my emotions, my anxiety, my isolation from the world. It’s serious stuff and it can lead to things like suicidal thoughts. I shifted my focus to shooting photos and that’s when I realized: the more I document, the longer I live.”

But the good news is that there’s a variety of treatment available for brain injuries. And one that’s been gaining steam and popularity is the hyperbaric chamber – essentially a cocoon pumped full of pressurized air, allowing the body to take in increased oxygen levels and sending that to areas that need healing, i.e., the brain. (Note: although it’s not FDA-approved as treatment for TBIs, studies have shown that hyperbaric chambers can help.)

“I had the brain of a pro football player,

even though I never played. I just surfed.” — Shawn Dollar

“I feel that it’s one of the gamechangers for brain injuries, because it heals injured brain tissue,” Cde Baca explained. “When you infuse pressurized oxygen, the cells and your brain start to work better. When you have a brain injury, you lack blood flow. This increases oxygen and blood flow to the affected areas.”

Of course, there’s also the question about helmets. Recently, legions of groms have been wearing them while surfing places like Pipe, places breaking over a shallow reef. But they’re not as common is big waves at places like Mav’s, Nazaré, or Jaws. Why?

“Had I been wearing a helmet, when I went head-first into a rock, it would’ve helped,” said Dollar. “After my accident, I wore a helmet for years and it was really difficult to surf with. It doesn’t feel natural, it’s obstructive. In my opinion, nobody has made a really good surfing helmet yet.”

Cde Baca continued: “Helmets are good for preventing skull fractures. But the brain can still shake around.”

An unidentified helmet-wearer at Pipe. Photo: Jeremiah Klein
An unidentified helmet-wearer at Pipe. Photo: Jeremiah Klein

So, when it comes to big waves, the concern isn’t so much smacking one’s head into a reef or a rock; but rather, it’s the force of the fall, combined with the speed of the surfer and the power of the wave, which can lead to unwanted internal brain injuries.

Dollar elaborated with a comparison: “If you look at the military, these guys and girls are wearing ballistic helmets. Those are to prevent a bullet going through their head. But say their humvee runs over a bomb. The helmet isn’t preventing a concussion that comes from the rip through the air from the blast. We’ve all felt the impact of a wave – it’s like a blast. So, that helmet is not going to prevent your brain from jostling. Don’t get me wrong, helmets are good and there’s a need for them; but when it comes to concussions, they’re not going to help you when you get tossed from the lip at Mav’s.”

Another concern with the current helmets in big waves is the stress they can impose on the surfer’s neck. They can catch on the water, thus causing even more whiplash — and potentially worse.

RELATED: Five Takeaways from the Big Wave Risk Assessment Group Summit

“How do you protect your head without compromising your neck?” mused Layer. “There’s a way to do it, I’m sure. But the current helmets would compromise your neck before they would protect your head. And this is just in big waves. In small waves they’re fine. If I was wearing the helmet I wear in small waves during my Jaws wipeout, I would’ve broken my neck 100 percent.”

The truth is, it’s early days in the conversation about brain injuries and big waves. And although things are changing with regards to talking publicly about concussions and TBIs – with athletes like Dollar, Layer, and others vocalizing their experiences and rehabilitation – the subject is still somewhat taboo thanks, in part, to potential career ramifications.

“We’re seeing lots of surfers coming in and seeking help,” said Cde Baca. “For them, especially the big-wave men and women, it’s very similar to rodeo cowboys in that, if they don’t perform, they don’t get a dime. There is no injury reserve. They either perform or they don’t. It’s hush-hush to talk about it, because the fear of what it’ll do to their career.”

Chase LaRue off the lip, Pete Mel below; Mav’s. Photo: Audrey Lambidakis
Chase LaRue off the lip, Pete Mel below; Mav’s. Photo: Audrey Lambidakis

“I was pretty embarrassed about my head injuries for a long time,” said Dunfee. “I’d be out in the lineup shooting photos, and people would ask, ‘why aren’t you surfing?’ I’d be embarrassed to tell them. There were fears about sponsorships, about losing my job. But at this point in my life, after going through all this, I know that it’s better to talk about. There is help out there. Because of that, I still surf every day, and I live a happy life.”

Oftentimes, the verboten nature of brain injuries leads surfers to paddle back out after they’ve been rattled and potentially concussed – because, particularly in big waves, if they don’t surf, they don’t get paid. And that can result in further damage and even death. But what OneHitAway and Healing Brainwaves are trying to do is spread information, normalize talking about TBIs and concussions, and encourage treatment.

READ MORE: What It’s Like Falling at Giant Maverick’s, with Ian Walsh

“Bottom line: they’ll last longer if they do [seek treatment],” said Lambidakis. “How amazing would it be to have a doctor onsite at these big events with a hyperbaric chamber? A lot of these athletes are scared to admit they have a concussion because they’re worried about repercussions from their sponsors. Why not be open about it and get them the help they need?”