Dear Alice,

I am the front man for a heavy metal band that is steadily growing in popularity. During shows, the whole band head bangs, but I seem to go a little bit harder than everyone else. Every morning after a show, I wake up with stiffness, soreness, and slight swelling of my neck and upper shoulders. Lately, I have been thinking that maybe thrashing my head around as if it isn't connected to my body is a bad idea.

My question is this: Does head banging cause any permanent injury that I should be concerned with? If so, how could I head bang differently to lessen the injury?

Thank you very much,

Pain in the Neck

Dear Pain in the Neck,

Oi — or rather, ow! If you think that head banging is giving you neck pain, chances are you have people to commiserate with, some of whom have been head banging since the late 60s (it's been reported that head banging got its start in 1968 when Led Zeppelin fans started banging their heads on the stage in time with the music). Others have reported similar symptoms as you have — including neck soreness and headaches, which could be possible symptoms of mild traumatic brain injury associated with head banging.

Here's the deal: While there haven't been many control trials researching the long-term health effects of head banging, a number of case reports indicate that there are risks associated with this activity — most notably blood vessel, neck, and head injuries. It is possible that head banging could lead to ripped blood vessels in the neck or head, leading to a subdural hematoma (a bleed in the brain), which in turn can cause seizures, memory loss, or brain herniation. Also possible, though not likely, is a carotid artery dissection: a tear in the major artery that leads from the chest up the neck to the head, which could cause a stroke.

Before you start feeling a new kind of stage fright (your band needs you!), it’s worth emphasizing that these serious complications have only been linked to head banging in case reports, not in any major studies. Also, because there’s no formal research on this topic, it’s not possible to say with certainty that head banging causes permanent injury. Finally, no two heavy metal bodies are alike, and there are a number of reasons why head banging could bother you more than a band mate — long-term or serious consequences aside. For example, a history of previous back, neck, or spinal cord injuries could be aggravated by head banging. The type of head banging you do (e.g., up-down, full body, etc.), the tempo at which you do it, and the angle can all have an impact on the severity of injuries you may or may not experience.

Ready for some tips for head banging without the headache? Here are a few suggestions:

  • Try to limit the range of motion of your neck while head banging, or bang every other beat instead of every single beat.
  • Consider head banging during the slower or mellower songs, (which deserve just as much performative emphasis as the up beat songs, right?!).
  • Try taking classes that uses Pilates or the Alexander Technique. These have made a difference for many performance artists and musicians.
  • Warm up with some heating pads! Some research has shown that applying a heating pad around the shoulder and neck area for 15 to 20 minutes a week can provide some much needed relief.
  • Consider using protective gear such as a neck brace to limit the range of motion, and therefore any added strain that may be causing your neck pain.

By making your performances work for you, you may actually enjoy performing more, and increase your influence on your audience. As the front man, eyes are on you, so this could be the perfect opportunity to come up with the next big move, and one that doesn’t leave you, or others, reaching for a neck brace the next morning.

Alice!

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