Join us for this LIVE Q&A where our expert panel β Dr. Mari Swingle, Dr. Andrew Hill, Anthony Ramos, John Mekrut, Joy Lunt, Santiago Brand and Jay Gunkelman β dive into the neurological effects of concussions, using Tua Tagovailoa's recent head injury and fencing response as key examples. π§ Our experts explain the posturing reflexes seen in traumatic brain injuries and discuss how neurofeedback can aid in recovery. We'll also explore the impact of concussions in sports like soccer β½ and hockey π and what parents and athletes should know about brain health. Key Moments: 0:00 - Guardian helmets and concussion reduction: Discussion starts on how Guardian helmets are designed to reduce concussions by 10% on both the hitter and the one hit. 1:04 - Tuaβs posturing (fencing posture) explained: Conversation about Tua Tagovailoaβs contribution to mental health awareness, specifically when people search for "fencing posture" after his injury. 2:00 - Brainstem trauma and primitive reflexes: Detailed explanation of how the fencing posture is a result of brainstem trauma and primitive reflexes like the Babinski reflex. 5:04 - Posturing response indicates major brain injury: A distinction is made between mild concussions and more severe injuries like posturing or fencing responses, indicating significant brain injury. 6:49 - Decorticate phenomena and cortex injury: More technical discussion about the neurological response to brain injuries and the difference between posturing from trauma and posturing from swelling events. 8:00 - Debate on children in sports: Discussion turns to whether it's ethical to let children participate in sports with high injury risks, like football, without being able to make rational decisions. 10:02 - Gender differences in neck injuries in sports: A discussion on how females are more prone to neck injuries due to less muscular protection compared to males, especially in car accidents and sports. 12:01 - Footballβs inherent design risks: Football is singled out as a sport where injury is inherent due to its design, with heavy players crashing into each other. 15:45 - Heading in soccer and brain injury: A study is cited showing that even one heading drill in soccer can create brain inflammation and short-term memory loss equivalent to a mild concussion. 17:45 - Chronic TBI and depression: A study is discussed that found traumatic brain injury (TBI) could be the main culprit for depression and sleep problems in adults, potentially stemming from high school sports injuries. 21:02 - Baseline EEG mapping for children in sports: The panel discusses the importance of baseline EEG mapping for children before they start playing contact sports to monitor brain health. 24:00 - Autism and QEEG mapping: The panel discusses how QEEG (Quantitative Electroencephalography) mapping is used to identify patterns in individuals with autism and how neurofeedback can assist. 31:00 - Artifact removal debate in EEG software: Discussion about the pros and cons of using automated artifact removal software in EEG data and the importance of manual review. 39:05 - Psychedelics and mental health: Psychedelics like MDMA and psilocybin are discussed in the context of trauma therapy, with both benefits and potential risks mentioned. 43:30 - ADHD and neurofeedback interventions: Neurofeedback's ability to address core symptoms of ADHD, including impulsivity and attention, is debated, with a focus on lasting effects and personality preservation. 52:00 - Meditation and neurofeedback interactions: The potential for neurofeedback to enhance meditative states is explored, as well as cases where meditation might not be suitable for everyone. 55:40 - Photobiomodulation and neurofeedback: A discussion on using photobiomodulation (red light therapy) before or after neurofeedback sessions to enhance results. Got questions? We answer them LIVE every Wednesday at 6 PM CST! Don't miss your chance to engage directly with experts in brain health and neurofeedback. π Join us LIVE for Q&A every Wednesday at 6 PM CST: https://www.youtube.com/@NeuroNoodle π½οΈ Catch more episodes on mental health and neurofeedback here: [Channel Link] #TuaConcussion #NFL π #FencingPosture #BrainHealth π§ #LiveQandA #Neurofeedback #ConcussionRecovery π€ #ADHD #BrainInjury #CTE #SportsInjuries #MentalHealth #Neurofeedback #MentalHealth #BrainHealth #LiveQandA #YouAskWeAnswer #ADHD #Anxiety #Trauma #BrainOptimization #NeurofeedbackClinician #PeakPerformance
Episode Summary
This conversation originally aired on NeuroNoodle, where I joined a panel to talk through concussion, brain injury in youth sports, and a stack of audience questions on QEEG, psychedelics, ADHD, and meditation. You can watch the original conversation. What follows is drawn from my own contributions to that discussion.
What is the fencing posture, and why does a head hit trigger it?
When a football player takes a hard hit and his arm shoots up into that rigid on-guard position, you are watching a primitive reflex reassert itself. The asymmetric tonic neck reflex is a normal infant reflex. Babies show it so they can turn their head, extend one arm, and start the rotation that leads to crawling. It fades as the nervous system hits its developmental milestones, usually somewhere between nine months and a year.
It looks a lot like the Babinski reflex, the toe-fanning foot response you also see in healthy infants and that disappears with maturation. When either of these reflexes shows up in an adult, something has gone badly wrong in the central nervous system. A positive Babinski sign in a grown person signals a significant problem.
The reflexes never leave. They get masked. As more tissue develops, secondary inhibitory systems either fold these primitive patterns into voluntary movement or hold them down with inhibitory tone. The fencing response is a failure of that inhibition. When the brainstem takes significant trauma, the inhibition drops out and the old reflex surfaces in a 300-pound athlete who just got his bell rung in the air. The fencing response as a reliable marker of moderate brain trauma was characterized in video analysis of injuries (Hosseini & Lifshitz, 2009).
This matters for one practical reason. A posturing or fencing response is not a mild concussion. It signals a major brain injury, with likely bleeding and secondary inflammation. If a child shows that response on the field, they are done for the day. The good news from the past two years is that parents now recognize this. People search "fencing posture" after seeing it on television, and that awareness is changing sideline decisions.
What actually happens to the brain in a concussion?
The mental image most people carry is wrong because of where they have seen a brain. On television, someone in the morgue holds up a firm object. In a teaching lab, the specimens are firm because they are fixed in formalin. A living brain is nothing like that. It is soft, closer to jelly, and it moves.
The brain pulses with every heartbeat. At night, slow delta-band activity drives fluid through it in waves, part of the glymphatic clearance we are still mapping out (Xie et al., 2013). Now take that soft, moving organ, encase it in a hard skull, and slam the whole assembly to a sudden stop. The brain keeps moving and strikes the inside of the skull, then rebounds and strikes the opposite side. That is the contrecoup, the "opposite blow." Picture an egg in a jar, thrown around. That is roughly what a hard tackle does.
Swelling injuries produce a different picture than mechanical posturing. The fencing response is instant, locked to the moment of impact. With a swelling event, the cortex becomes disengaged from deeper tissue over a longer timescale, and you can see related phenomena like torticollis develop.
Should children play contact sports?
We make calculated risk decisions as adults. A Formula One driver, a professional athlete signing for millions, accepts the danger and that is their choice. Children cannot make that choice. They do not have the development to weigh it. We send them onto the field before they can consent to the cost.
Football carries a risk that is inherent to its design. You have two very large, very fast people deliberately crashing into each other. The body wears armor. The brain does not. There is also a real argument that helmets may have made things worse by letting players hit harder, which incentivizes more violent contact.
Soccer is a useful contrast because the injury source is more specific. A large cohort study found professional outfield soccer players had several times the rate of neurodegenerative disease compared with the general population, with goalkeepers showing no such elevation, and the difference points squarely at heading (Mackay et al., 2019). The clean intervention is to remove heading. There is research showing that a single session of routine heading can produce immediate, measurable changes in brain function and short-term memory that resolve within about 24 to 48 hours (Di Virgilio et al., 2016). One drill, measurable GABA-related changes and short-term memory decline. It looked like a subacute concussion.
Sex differences in injury risk are real and physical, not political. Females generally have less muscular protection around the neck. With less neck girth to absorb force, the same impact transmits more acceleration to the head, which matters in soccer, in other sports, and in car-accident whiplash. If you coach young female athletes, building neck strength is a reasonable protective target.
The deeper public-health problem is that we are operating in the dark. Most traumatic brain injury goes undetected, and undetected does not mean harmless. Research on this point traces a real signal: in middle-aged adults, a history of traumatic brain injury is associated with later mood and sleep problems, often tracing back to injuries sustained decades earlier in sports. Most of these people were never college athletes. The effect can show up twenty years later.
I have watched American football participation drop steadily over the years I have spent working with teenagers and adults. Programs are closing below the high school level for lack of players, and a lot of youth football has shifted to touch. We could do far more with screening. Fieldside QEEG exists. Professor Mike Loosemore in the UK developed a mouthguard sensor that models the accelerative force of an impact in real time and shows where in the brain damage is likely, so a sideline judgment can be made on the spot.
When should a child get a baseline brain map?
You get a physical before you play a sport. The same logic argues for a baseline brain map, so you have a road map back to your own healthy function if a car accident or a sports injury ever happens.
Developmentally, the picture stabilizes around six and a half years old. That is when the first big developmental phase slows down, when normative databases start showing stable norms, and when a child is generally functional enough to participate in assessment. Before about five, you have to build in heavy age corrections. For solid traction on who a child is, around nine is when the brain is fine-tuning and you can better separate a mislearning phase from a true learning deficit.
For a longitudinal map, I like to capture the first slowdown at six and a half, then map again after the left-right hemisphere and language divides consolidate, around nine or ten. I run a QEEG and a continuous performance test side by side, never one without the other. There are exceptions. I will map an 18-month-old right after an autism diagnosis if the family is frightened and wants something they can act on. You can read more about the procedure in my QEEG brain mapping guide, and the role of SMR neurofeedback in training focus and self-control.
This is just data. Knowing how someone's attention, retention, sleep, and stress systems are built lets you scaffold behavior and strategy around their actual hardware.
What does the brain look like in autism, and where do meltdowns come from?
There is no single meltdown location. My working theory is that you are looking at hyperarousal nearly everywhere, which is also why you can enter the system from many points and still help. FZ is one of the few near-universal sites I see implicated, tied to rigidity. Past that, it is highly individual.
One clear pattern shows up around emotional valence and laterality. In a socially intact brain, pleasant, exciting, rewarding stimuli tend to engage the left side, and aversive, scary, unpleasant stimuli engage the right. In a classic autistic presentation with social deficit, any intense emotion, good or bad, drives the right side. You get a lateralized avoidance response, a stress reaction to intense social input.
You also see parietal areas for sensory and social processing, frontal areas for conflict resolution, and central pre-central regions for inhibitory tone. Because there is so much visible and so many entry points, neurofeedback is one of the more workable interventions to study for change in this population. The sensory and social processing piece covers how integration works in more detail.
How do you set good neurofeedback thresholds?
Measure the parameter you intend to train, let it stabilize, and watch where it settles. A given band amplitude or a given speed will hang out in a range once it settles. Then set your reward and inhibit thresholds as a percentage of that range. It is a standard approach and it works.
One upgrade: do it manually, not automatically. Some individuals respond far more strongly at a different percentage than the auto-threshold would pick, and you only find that by watching and adjusting by hand.
On artifact handling, I am cautious about mathematical cleanup. I will run an amplitude or blink threshold through software to tag suspect data, then visually scan it to confirm the software did not do something wrong. The non-negotiable rule is that you match the EEG cleaning method to the analysis you are running. There is real information hiding in what looks like an outlier, and aggressive automated removal throws it away.
Can neurofeedback get rid of ADHD?
Both answers are true depending on what you mean. The research shows you can reliably move the core resources. Across most people, studies and brain-map data point to meaningful improvement in impulsivity and in attention, on the order of a couple of standard deviations. The gains usually change and usually stay changed, with durability holding at follow-up in controlled work (Van Doren et al., 2019), though it can take a few months to get there.
Those gains are in the core executive resources, not in the diagnosis itself. The psychosocial features are subtler. Procrastination, rejection sensitivity, and some related patterns do not move as cleanly as gross executive function. We are not trying to flatten personality. The curiosity and the drive to innovate are worth keeping. The target is the ability to follow through on that curiosity.
My honest framing is around 50% change, and for most people that is more than enough to do what they need to do scholastically and at work. There is also a real cost to keeping a child in therapy for years. They start to believe something is wrong with them. My favorite outcome is a brief intervention where, ten years later, the now-grown child has no memory of ever having had a problem. Even better is the person who came in distracted, never got a diagnosis, and simply learned how their own brain works and walked away feeling more in control. For more on the evidence, see my guide to neurofeedback for ADHD and the parenting piece on why your ADHD kid makes you yell.
What about psychedelics for mental health?
I sit on the cautious end. I have seen people report life-changing improvement, and I have seen people slip into episodic psychosis and never fully recover. These are our brains, and the field is in its infancy.
A useful frame is a scrambling effect. You give the brain a hard scramble and, for some people with severe depression or anxiety, it resettles somewhere better. For others, it resettles somewhere worse. We hear far more about the favorable resets than the bad ones, and I cannot tell you the true ratio.
There is also a plasticity story, and more plasticity is not automatically good. There is a whole community reporting damage from Lion's Mane, where plasticity gets pushed too high and indiscriminate, producing something that looks like depersonalization and anhedonia. You do not need indiscriminate plasticity. Targeted, controllable approaches like neurofeedback, meditation, and cold exposure are safer ways to drive change. The biohacking plasticity article walks through this.
I do think psychedelic-assisted psychotherapy for trauma is a genuinely interesting place. I have mapped brains before and after these experiences for years. When someone escapes acute damage, you often see no lasting EEG effect at all, even from heavy historical drug use, though sometimes a history of opioids leaves diffuse alpha sitting around. Occasionally I see someone go through a dramatic healing trajectory in a single weekend, looking like years of rebuilding compressed into days. That is rare. Most of the time, the transformative subjective experience does not show up clearly in the EEG.
On effectiveness, the trial data are sobering. Response rates cluster around 50%, similar to antidepressants, TMS, and ketamine, and even biomarker-matched approaches land near the same place. Durability is contested, with reports ranging from a few months to a year or two. Our goal in this field is decade-long sticking power, and psychedelics are not clearly there yet.
Can neurofeedback amplify meditation?
Yes. One of the original purposes of this technology was to help ordinary people reach states that took yogis decades. With a real-time feedback loop showing where your brain is going, you can potentiate a meditative state substantially.
Meditation is not for everyone, though. Some people calm best through quiet, and some people need arousal to reach quiet. For a busy-brained person, being told to sit silently in a room can itself raise arousal rather than lower it. Know which type you are. If silent stillness is feeding your arousal instead of calming your autonomic nervous system, that is worth knowing before you commit to a practice. I cover this in biohacking meditation and the broader mindfulness piece.
Does red light therapy combine well with neurofeedback?
Photobiomodulation streams red and near-infrared light into the brain, typically in the 1100 to 1800 nanometer range, with many devices around 1170 to 1180. The mechanism, and I think the science here is reasonably solid, is that light in this range interacts with cytochrome c oxidase in the mitochondria and speeds the electron transport chain, increasing ATP production in the tissue (Hamblin, 2016). Some devices go further with entrainment-driven or quadrant-driven stimulation.
I am seeing strong potentiated effects when clients combine photobiomodulation with neurofeedback, similar to combining neurofeedback with hyperbaric oxygen. I have most clients buy their own device and use it four or five days a week, some twice a day, because, like neurofeedback, a couple of sessions a week is probably not enough to do much on its own.
Overtraining is a real risk, with red light and with everything else. Some clients get exhausted when light is mixed with feedback, so I ease them in, starting with a couple of minutes of basic non-pulsed light and checking how they feel that session and the next day. More is not better. I worked with a client who had a sulfur metabolism issue, loved N-acetylcysteine after seeing her anterior cingulate on her map, kept increasing the dose, and within two weeks was nauseated and overactivated by one of the most innocuous cognitive supplements out there. The dose and the individual matter. The photobiomodulation article goes deeper on the mechanism.
How do you actually get good at this?
The single most useful skill is reading raw EEG. Learn to read the brain map and you can use any tool, any flavor of neurofeedback, under almost any circumstances. Skip that step and you stay locked into recipe books and software defaults forever.
Get a mentor. Look at a lot of raw signal. The BCIA credential gives you a base level of tested knowledge, and the same master-practitioner names tend to circulate in the field. Worth saying plainly: that credential is a baseline-training signal, not a guarantee of skill or outcomes, and no research links a specific neurofeedback credential to better results. Some of the best practitioners built their skill through years of practice rather than a certification pathway. One red flag worth naming: anyone who tells you that you do not need to understand the brain to do the training. You do.
For people researching whether to start, the practical questions about access and price are covered in is neurofeedback legitimate, neurofeedback cost in 2026, and remote neurofeedback.
The through-line across all of these questions is the same. Measure first, understand the individual brain in front of you, then choose the tool. A baseline map for a young athlete, a threshold set by hand, a supplement eased in slowly, a meditation practice matched to a person's arousal type. The data tells you what the body can take and what it needs, and that is where good decisions start.
References
- Hosseini (2009). Brain injury forces of moderate magnitude elicit the fencing response. doi:10.1249/MSS.0b013e31819fcd1b
- Xie (2013). Sleep Drives Metabolite Clearance from the Adult Brain. doi:10.1126/science.1241224
- Virgilio (2016). Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading. doi:10.1016/j.ebiom.2016.10.029
- Van (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. doi:10.1007/s00787-018-1121-4