Ryan Gosling plays a Hollywood stuntman in the new action comedy The Fall Guy, a loose adaptation of the popular 1980s TV series of the same name starring Lee Majors. Gosling even did a few of his own stunts, although professional stunt performers handled the most dangerous sequences. It's their job to assume the risk so the stars don't get injured but that can translate into a high rate of head injuries in particular. According to a study published in the Journal of Occupational Medicine and Toxicology, a significant fraction of stunt performers never report such injuries, largely because it's a competitive industry, and they are afraid of losing work. The impacts can lead to more serious cognitive issues later in life.

“Many stunt performers are afraid to report their injuries, especially head trauma, in fear they will be put on a do-not-hire list or looked at as a liability,” said co-author Jeffrey Russell of Ohio University. “The more injuries or trauma, the harder it may be to find work. But that should not be how it is; production companies and their unions should be ensuring stunt performers are taken care of and not reprimanded for any injuries sustained on the job.”

The work builds on Russell's prior research, published last year, looking at the prevalence of head trauma and concussion in stunt performers and how well such injuries are managed. The prevalence of such injuries means that stunt performers are at high risk for chronic traumatic encephalopathy (CTE)—a degenerative brain disease associated with a history of repetitive head impacts that is a cause of much concern in collision sports like football and ice hockey—over the course of their careers.

For the 2023 study, stunt performers responded anonymously to an online survey. In addition to collecting relevant demographic information, the survey asked how many head impacts or "head whips" (i.e., when the body's rapid acceleration causes a whipping motion of the head) they had experienced on the job, how many of those produced concussion-like symptoms, and whether a medical professional had diagnosed them with concussion.

Those results indicated that 80 percent of stunt performers had experienced at least one incident of head impact or head whip on the job. That is a much greater prevalence than similar injuries reported by dancers, theater workers, and even professional fighters. Of those, 86 percent exhibited concussion-like symptoms, and 65 percent of those continued to work despite those symptoms. Only 38 percent said they were officially diagnosed.

Forty-four percent failed to report it because of shame, fear of losing work, or just wanting to tough it out, but most simply didn't realize the severity of the injury at that moment. Educating stunt performers might help them better recognize such symptoms, although there is limited evidence that this would increase the likelihood of the workers to report the injury and seek medical care.