Sports Danger to the Nervous System, A Doctor’s Tier List

Why this tier list matters for your nervous system

A lot of people choose a sport for the obvious reasons, fitness, stress relief, friends, identity.

Then a concussion happens.

Or a neck injury.

Or a fall that changes how you walk, think, sleep, or work.

This is why the video’s perspective is so useful. It is not a generic “sports injuries” overview. It is a clinician who sees sports trauma up close, and also trains like an athlete, trying to rank danger the way real life feels in an emergency department and in training blocks.

The focus keeps drifting back to the nervous system for a reason. A sprained ankle is miserable, but it usually heals. Brain and spinal cord injuries can be different, they can linger, and they can reshape a person’s life.

Important: If you have symptoms after a hit or fall, like headache, dizziness, confusion, vomiting, worsening neck pain, weakness, numbness, or trouble walking, it is reasonable to get medical help promptly. Head and neck injuries deserve a lower threshold for evaluation.

The video’s core idea, danger is unpredictability plus brain risk

This tier list is intentionally not “most scientific.”

But it is not random either.

The central logic is a mix of two ingredients.

First is unpredictability. The discussion keeps elevating sports where you cannot fully control the environment, like roads with cars, mountains, waves, animals, ice, or high speeds. It is a practical point: even excellent technique cannot cancel out a driver, a patch of ice, a surprise gust, or an animal that panics.

Second is nervous system vulnerability. The framing is clear: injuries are part of sport, but brain injury sits in a more sensitive category than many other injuries. That is why collision sports, combat sports, and anything that produces repeated head impacts get pushed upward.

A useful way to translate this into everyday decision-making is to ask two questions before you commit to a sport, league, or training plan:

Did you know? The CDC notes that biking and sports are common causes of traumatic brain injury related emergency visits, and that helmets reduce the risk of serious head injury in many crash scenarios (CDC, traumatic brain injuryTrusted Source).

Extreme tier, when a sport can change your life in one moment

Some sports do not just “injure you.”

They can rewrite your baseline.

In the video, slap fighting lands in the extreme category, and it is not because it looks rough. The argument is that it strips away many protective elements of combat sports and leaves the worst part, repeated, defenseless head impacts whose whole purpose is to cause knockouts. That framing is unique: it is not an anti-combat-sports rant, it is a critique of a rule set that centers neurologic damage as the entertainment.

This is also where the video’s nervous system emphasis is the loudest. The fear is not a black eye. It is the brain.

Slap fighting and the problem of defenseless head impacts

A punch in boxing is dangerous.

A slap you cannot defend, and must absorb repeatedly, is a different kind of dangerous.

The brain floats in cerebrospinal fluid. Rapid acceleration and deceleration can strain brain tissue and disrupt normal function, which is part of why concussions can happen even without a skull fracture. The CDC describes concussion as a type of mild traumatic brain injury caused by a bump, blow, or jolt to the head or body that makes the brain move quickly inside the skull (CDC, concussionTrusted Source).

The video’s moral line is also worth noticing. It supports informed adults making choices, but questions whether a sport should be designed around repeated neurologic harm.

Cycling is also pushed into extreme, and this is the twist that surprises people. The danger is not the bike itself. It is the reality that many people must train and commute in uncontrolled traffic environments. The video cites roughly 900 to 1,000 cycling deaths per year and hundreds of thousands of emergency department visits in the US, then connects that to a lived experience of riding in New York City.

That is the point: the sport can be “no contact,” and still be extreme because the environment is.

Skiing and snowboarding are placed in extreme as well, with a specific psychological observation: they can feel safe, and that feeling can be misleading. High speeds, trees, ice, terrain changes, and crowded slopes create a fall profile where head and spinal injuries are not theoretical. Spinal cord injury and paralysis are explicitly mentioned.

Bull riding is framed as instant extreme because the bull is an unpredictable, forceful animal that can slam, toss, and gore. The list of possible injuries in the video is blunt: spinal cord injury, facial trauma, lacerations, bleeding risk.

And racing is treated as extreme when it includes road-like conditions or close-quarters racing. The video acknowledges modern safety improvements, like structural design and Formula 1’s halo, yet still treats speed plus proximity as a fatality risk amplifier.

Pro Tip: If your sport involves speed plus hard surfaces (ice, pavement, packed snow), treat a well-fitted helmet as basic equipment, not optional. Replace it after a significant impact, even if it “looks fine,” because internal damage can be invisible.

Very high tier, repeated collisions, speed, and hard landings

This tier is where the injuries are frequent, and the head and neck are regularly in play.

It is also where the video’s “doctor plus athlete” lens shows up, because the rankings are not just about raw injury counts. They are about the kinds of injuries that are hard to come back from.

NFL football is placed in very high largely because of concussion risk and the concern about returning too early. The discussion highlights a practical fear: you can break fingers and heal, but brain injury is different.

Hockey lands in very high too. The reasoning is layered: high-speed puck impacts, body checking, fights, dental trauma, and concussion risk. The mention of earlier eras without goalie face masks underscores how violent the mechanics can be.

MMA and boxing are also very high. The video makes an important distinction: boxing classes and training can be relatively low injury, but sparring and professional competition are a different world. It also notes that boxing has protocols like medical suspensions after knockdowns or knockouts, but still concludes it is very dangerous and not recommended as a professional path.

Horseback riding is placed in very high because animals add a variable you cannot fully control. A calm horse can still spook. A fall from height can produce head injury, spinal injury, and fractures.

Mountain biking is very high for the same “mother earth” reason, speed on uneven terrain, unpredictable surfaces, and falls.

Rugby is very high as a collision sport.

And WWE is very high even though it is scripted, because the stunts, falls, and chair impacts can still cause serious injury. The scripted nature is treated as a slight risk reducer compared with pure chaos, but not enough to make it safe.

What the research shows: In contact and collision sports, concussion risk is shaped by rules, enforcement, technique, and culture, not just the sport itself. Consensus statements emphasize immediate removal from play when concussion is suspected and a stepwise return to sport under medical supervision (6th International Consensus Statement on Concussion in SportTrusted Source).

High and moderate tiers, the “sleeper” risks people miss

This is where the video gets fun, and oddly practical.

Because this is where many people get blindsided.

The sleeper pick, cheerleading

Cheerleading is called out as a “sleeper dangerous sport.”

It is not just dancing on the sideline. The video points to real clinical experience treating cheer injuries, and the mechanism is clear: athletes are thrown into the air, and people land on each other. That is a recipe for falls, head impacts, and neck injuries.

Cheer also has a unique risk profile because the athlete who gets hurt might not be the one who made the mistake. A base can slip. A catch can be late. A surface can be uneven.

Skateboarding is placed in high, tied to concussion risk and aerial tricks. The logic is simple: anytime you are flying, gravity is waiting.

Surfing is high because nature is involved, waves, boards, rocks, and the unpredictability of the ocean. Sharks are mentioned too, but even without them, drowning risk and head impacts with the board or seabed are real concerns.

Wrestling is high, and the video’s angle is not only the combat. It is the weight cutting culture, with risks like electrolyte abnormalities, wooziness, and arrhythmias, plus broken bones and ligament tears.

Pole vault is placed in high after reconsideration. The initial instinct is moderate, then the video lists the real issues: height, the pole itself, landing mechanics, and even pad movement.

Skeleton is also high due to speed on ice and sharp blades, described memorably as the body becoming a cruise missile.

Now for the moderate tier, where the video makes several “hot takes.”

Marathon running is moved up to moderate, not because distance running is inherently extreme, but because training often happens on roads with cars. It mirrors the cycling logic: environment can elevate risk.

Soccer is placed in moderate, with concussions and ligament tears noted, plus the reality of cleats and kicks.

Volleyball is placed in moderate, and the reason is specific: a surprisingly high concussion rate from ball impacts, plus ACL and MCL injuries. This is another sleeper risk, especially in recreational leagues where reaction time and positioning vary.

Baseball is moderate, with several mechanisms listed: getting hit by pitches, start-stop sprinting without warming up (hamstrings), line drives, and the rare but dramatic event of commotio cordis (a chest impact at a vulnerable moment in the heart rhythm).

Expert Q&A

Q: Why does this tier list keep prioritizing brain injuries over “regular” injuries?

A: The nervous system has less margin for error. Many musculoskeletal injuries heal with time and rehab, but concussion symptoms can linger, and repeated head impacts can raise the stakes if someone returns before fully recovering.

The practical takeaway is not “avoid everything,” it is to treat head impacts differently than soreness or a mild sprain. If a sport makes head contact common, your safety plan has to be stronger.

Health educator summary based on current concussion guidance

Low and minimal tiers, safer does not mean zero risk

“Minimal” is not “nothing.”

That nuance shows up in the video when discussing even silly-seeming sports.

Golf is placed at minimal, with a cited injury rate per thousand hours that is very low, and the likely culprits are overuse and form.

Archery and darts are treated as minimal because of predictability. The object can be dangerous, but the setting is controlled.

Billiards/pool is framed as low risk, with jokes about bar fights and drinking, but the underlying point is that the sport itself rarely creates traumatic injury.

Bowling is low, not minimal, because slippery floors and a heavy ball can cause falls and strains.

Tennis is low with an overuse emphasis, shoulders, knees, and exertion, plus the humorous but real point that a fast serve to the body can hurt.

Weightlifting is low because you generally control the load and environment. The key phrase is “less outside variability.” That does not erase risk, technique, fatigue, and ego lifting still matter, but it changes the risk shape.

Pickleball is placed in low, but with an important cultural observation: injuries are rising because popularity is rising, and many participants are returning from sedentary lifestyles. That is not a reason to avoid it. It is a reason to ramp up intelligently.

Esports is treated as not dangerous in the acute trauma sense, but it is not dismissed. Overuse injuries are listed: carpal tunnel symptoms, tendinitis, and posture-related neck strain, plus long hours “locked in.” Those are quality-of-life issues, even if they are not life-threatening.

Chess and poker are minimal in physical danger, with a nod to calorie burn from brain glucose use, but the tier list is about injury danger, not metabolic training.

Resource Callout: »MORE: If you play a “low trauma, high repetition” sport (tennis, pickleball, esports, weightlifting), consider keeping a simple training log: minutes played, soreness level, and any numbness or tingling. Patterns are easier to catch early than after months of pushing through.

How to lower nervous system risk without quitting your sport

The most motivating part of the video is that it does not end with fear.

It ends with agency.

You cannot control everything, but you can control a lot.

Here are practical ways to reduce nervous system risk while still enjoying the sport you love.

1) Make the environment more controlled (especially for cycling and running)

A bike on an empty path is a different sport than a bike in traffic.

Same for marathon training.

2) Build a concussion plan before you need it

Most people improvise after the hit.

That is the worst time to improvise.

Pro Tip: Put your concussion plan in your phone notes, including who to call, where you would go for urgent care, and your “stop playing” rule. In the moment, decision-making gets fuzzy.

3) Respect the sports where gravity wins (cheer, skateboarding, skiing, pole vault)

Falls are not just orthopedic events.

They are neurologic events.

4) For combat sports, differentiate training from competition

This is one of the video’s most practical distinctions.

Bag work and footwork drills are not the same as hard sparring.

5) Treat “overuse” as real injury risk (tennis, pickleball, golf, esports)

Overuse injuries are not dramatic.

They are persistent.

A simple approach that often helps is to scale volume gradually, vary movement patterns, and address technique early. If pain changes your mechanics, it can set up a chain reaction that increases fall risk, collision risk, or compensatory strain.

Expert Q&A

Q: Is a “safe” sport always the best choice for brain health?

A: Not automatically. A lower-impact sport may reduce concussion risk, but overall health also depends on consistency, enjoyment, and whether the activity fits your body and lifestyle.

A practical goal is to pick a sport you will actually do, then reduce the biggest risks inside that sport, like controlling the environment, using protective gear, and taking head symptoms seriously.

Health educator summary aligned with public health guidance

Key Takeaways