Olympic Rower Head Injury: James Cracknell's Story

James Cracknell’s story is the best-known Olympic rower head injury: in 2010 a petrol tanker hit the double Olympic champion while he was cycling in Arizona, and the damage to his brain changed his personality. His case brought wider attention to brain injury, and it holds lessons for rowers at every level. If you or a crew mate takes a blow to the head, stop rowing and get checked. In an emergency call 999, and otherwise call NHS 111 within 24 hours, because what follows here is general information and cannot assess your case.

Who is James Cracknell?

Cracknell won Olympic gold in the Great Britain coxless four at Sydney 2000 and Athens 2004, alongside Matthew Pinsent. He also won six World Championship golds, in the four, the coxless pair and the coxed pair. To see what it takes to reach that level, read what Olympic rowing medallists have in common. He retired from competitive rowing in February 2006 and took on endurance challenges, and has written and broadcast about them.

The accident

On 20 July 2010, near Winslow, Arizona, Cracknell was attempting to cycle, row, run and swim from Los Angeles to New York in 18 days. At about 5:30 am a petrol tanker hit him from behind on a quiet road. He credits his cycle helmet with saving his life, and he suffered a contrecoup injury to the frontal lobes.

Date	What happened
July 2010	Crash near Winslow, Arizona
About 6 months later	Finished second in the 430-mile Yukon Arctic Ultra
2012	Described the effects in Touching Distance, written with his then-wife
April 2019	Won the Boat Race with Cambridge, aged 46, the oldest competitor in its history

Those results make it easy to assume he recovered fully, but he has spoken openly about the effects. The injury left him with epilepsy, a lost sense of smell and taste, and a more volatile personality. For anyone with a similar injury, recovery and support vary from person to person and need specialist care.

What the frontal lobe does

The frontal lobe sits behind the forehead. It plays a major part in planning, decision-making, impulse control and emotional regulation. Damage here can change how a person behaves, even if they look physically recovered. That is one reason brain injuries can be hard on families as well as the person injured, and why rehabilitation often involves several kinds of professional, such as neuropsychologists and occupational therapists.

How head injuries happen in rowing

Rowing is not a contact sport, but head injuries still happen. Common causes include:

• Being struck by an oar handle or blade, for example when a crew member catches a crab.
• Collisions with another boat, a bridge, a pontoon or a bank, particularly in poor visibility.
• Falls on a slippery pontoon or while carrying a boat.
• A capsize in which the rower strikes the boat or an obstacle.
• Cycling to and from the club, as Cracknell’s own case shows.

What to do straight away

British Rowing’s RowSafe guidance adopts the UK line: if in doubt, sit them out. British Rowing also notes that loss of consciousness happens in less than 10 per cent of concussions, so a rower who stayed awake can still be concussed.

1. Stop at once. Do not row back at full pressure or carry on to see how you feel. Get to the bank, or into the launch, with help.
2. Call 999 if the person was knocked out and has not woken, cannot stay awake, has a seizure, or has new numbness or weakness, vision or hearing problems, or clear fluid from the ears or nose. Repeated vomiting, worsening confusion or a severe headache also need urgent assessment, as the NHS head injury page explains.
3. Otherwise call NHS 111 within 24 hours for assessment.
4. Do not leave them alone for the first 24 hours.
5. For 24 hours, no alcohol, driving, cycling or training.

Symptoms such as headache, dizziness, nausea, blurred vision, sleepiness or feeling “not right” can appear hours later.

Going back to rowing

The UK concussion guidelines for grassroots sport give a staged return. The day of the injury is Day 0, and work or study comes before sport.

Stage	What it means	Earliest
1. Relative rest	Rest, gentle walking, limited screens	First 24 to 48 hours
2. Daily activities	Build up everyday tasks	After stage 1
3. Build tolerance	Add light mental and exercise activity	No stage under 1 day
4. Non-contact training	Return to work or study, easy erg work	Once symptoms allow
5. Full training	Full work and training	Day 15, after 14 symptom-free days at rest
6. Competition	Racing	Day 21

Those are minimum dates, not targets. If symptoms worsen or have not improved by 14 days, call 111. If they last beyond 28 days, stay out of sport and see your GP. Our guide to returning to rowing after injury has more on rebuilding training, and a GP, physio or sports doctor should guide your return. Once a professional has cleared you to train, our page on how rowing can improve your mood and well-being suggests which session to pick for how you feel.

Reducing the risk

Good steering and lookout habits, following your club’s water rules, wearing a helmet when you cycle and keeping pontoons clear all lower the chances of a head injury. Coaches in launches should be ready to spot a rower who looks dazed after an incident. On the water, make sure someone knows where you are, and carry a phone in a waterproof pouch. Our page on the most common rowing injuries covers the wider risks, and the Olympic rowing hub has more on elite rowers.