How might we moderate the rare but very real risk of headbanging?
The Dangerous Effects of Heavy Metal Music
4.6/5 - (86 votes)
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
If you search for heavy metal in the National Library of Medicine database, most of what you find is on heavy metal contamination in fish, for example, making it so hard to clearly establish the role of fish in a healthy diet, perhaps helping to explain the quintupling of odds of autoimmune diseases like juvenile arthritis for instance.
But searching the hazards of heavy metal also pops up entries like this, on the “risks from heavy metal music.” Here, they were talking about traumatic injuries from slamming around, but you’re more likely to get injured at an alternative rock concert. It’s the Goo Goo Dolls you’ve got to worry about, not Nine Inch Nails.
Okay sure, music-induced hearing loss is a serious problem, but that can be from any loud music. It’s interesting that clinical recommendations include the “80–90 rule”: no more than 80 percent of the maximum volume on personal listening devices for no more than 90 minutes a day. But that’s not what the science shows; “do not exceed 60 percent of the maximum volume” may be more evidence-based, but they figure teens would just ignore that, so they came up with more “acceptable” advice.
I assumed I’d see a lot of satanic panic nonsense from the 80s, where parents bereaved by suicide started suing heavy metal musicians. What kind of evidence did the parents present? There has been little scholarly research, until this study that proceeded to try to correlate the number of statewide heavy metal magazine subscriptions to youth suicide rates. Oh, you’ve got to be kidding.
It got really crazy, though, when researchers called psychiatric institutions, pretending to be parents worried because their son started listening to that heavy metal music–– even though they made it clear that their son didn’t exhibit any symptoms of mental illness, no drugs, no alcohol, and was doing fine at school. Ten of the twelve facilities believed the son required psychiatric hospitalization. Imagine what that would do to a kid! In turns out if you actually come back a few decades later, metalheads were significantly happier in their youth, and appear better psychologically adjusted than their peers.
Some studies were just strange. Do Parkinson’s patients walk better listening to “Yellow Submarine” or “Master of Puppets”?
Other studies were just like, duh. Heavy metal musicians exhibit a higher heart rate than those performing “contemporary Christian.” Not much of a shocker.
Some studies were kind of cute: Influence of music on promoting patient safety during surgery—veterinary patients. Kitties getting spayed with little earphones on their head. It turns out that “Adagio for Strings” may be more relaxing than AC/DC.
A review on music therapy for human patients warned that caution should be exercised when guiding patients in selecting their music, as “chaotic music,” such us hip-hop and metal, is not healing to human cells—with three citations no less, though two of them don’t say anything, and the third is a nursing newsletter merely quoting someone’s opinion.
But I did some digging, and it turns out stomach cancer cells like metal. If you play them “Cannibal Corpse” versus Beethoven, 12 hours of death metal increased their growth in a petri dish (that’s so metal). But who puts headphones on their stomach? Or their chests, for that matter?
While in one study, Mozart killed off one type of breast cancer cell line and not another, in another study, only Beethoven’s Fifth Symphony seemed to work, and Mozart flopped when the petri dishes were surrounded by speakers on a little platform. How do they even get this stuff published?
Anyway, the true danger from heavy metal is headbanging. “Headbanging is a contemporary dance form consisting of abrupt flexion–extension movements of the head, most commonly seen in the heavy metal genre.” The number of avid aficionados is unknown, but some fans might be endangered by indulging excessively. Although generally considered harmless, health complications attributed to this practice include ripping your carotid artery, rupturing your lung, whiplash injury, neck fracture, or, in this case, a subdural haematoma. This guy reported headbanging at a Motörhead concert, and all that brisk forward and backward acceleration might have ruptured his bridging veins, and caused him to bleed into his skull.
Bridging veins bridge the gap between the brain and the covering that lines the inside of your skull, and if the veins tear, blood can build up under your skull, and compress your brain. This bridging vein rupture has been demonstrated on headbanging cadavers (again, a very metal study). It’s been likened to a kind of shaken-baby syndrome in adults.
The researchers conclude that their case serves as evidence in support of Motörhead’s rock-and-roll reputation, but I think the real takeaway is that a potentially dangerous complication like that can result from a seemingly benign activity. And some of the brain bleeds can be massive. Hmm, why did he have a headache after headbanging at a party? Here’s the CT scan. This is all blood, squooshing his brain over. It’s amazing he survived, though this poor guy didn’t.
See, you can tear more than just veins. There are two sets of arteries that tunnel into the skull— the carotid arteries in the front and the vertebral arteries in the back—and you can tear both sets. A 15-year-old indulged in headbanging, ripping his carotid artery, which led to a massive stroke. He presented half-paralyzed, unable to speak, and died in a coma within a week.
What about the vertebral arteries in the back? They’re wedged into your skull, rendering them susceptible to shearing forces from extremes of neck motion, and that’s exactly what appeared to happen: a heavy metal drummer tearing the wall of the artery. Now obviously, all this is really rare, probably afflicting less than one in a thousand or so. What can metalheads do to reduce their risk? To prevent injury due to such head-banging, the range of head and neck motion should be reduced; slower-tempo music should replace metal (good luck with that); the frequency of head-banging could be only on every second beat (that’s actually not a bad idea); or personal protective equipment should be used (like a neck brace?).
Little formal injury research has been conducted on the worldwide phenomenon of head-banging; so, researchers constructed a theoretical head-banging model with enough physics terms to make any nerd happy: angular displacement, sinusoidal motion in the sagittal plane, amplitude of the displacement curve. Study participants: head bangers. But you do need a control group: easy listening music.
Head injury curves and neck injury curves, based on head-banging tempo and angular sweep. At an average head-banging tempo, we’re trying to keep the range of motion under 75 degrees, so something like this. So, to minimize the risk of head and neck injury, head bangers should decrease their range of head and neck motion. Oh, there’s that “personal protective equipment” again. “Unfortunately, it is difficult, if not impossible, to change the habits of heavy metal aficionados.” Maybe what we need are metal-studded neck braces.
Please consider volunteering to help out on the site.
- PubMed search on "heavy metal".
- Bosch AC, O'Neill B, Sigge GO, Kerwath SE, Hoffman LC. Heavy metals in marine fish meat and consumer health: A review. J Sci Food Agric. 2016;96(1):32-48.
- Castro-González MI, Méndez-Armenta M. Heavy metals: Implications associated to fish consumption. Environ Toxicol Pharmacol. 2008;26(3):263-71.
- Kindgren E, Guerrero-Bosagna C, Ludvigsson J. Heavy metals in fish and its association with autoimmunity in the development of juvenile idiopathic arthritis: A prospective birth cohort study. Pediatr Rheumatol Online J. 2019;17(1):33.
- Drew PJ. "Mosh pit" breast? BMJ. 2009;338:b42.
- Westrol MS, Koneru S, McIntyre N, Caruso AT, Arshad FH, Merlin MA. Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):289-96.
- De Bartolo D, Morone G, Giordani G, et al. Effect of different music genres on gait patterns in Parkinson’s disease. Neurol Sci. 2020;41:575-82.
- Portnuff CD. Reducing the risk of music-induced hearing loss from overuse of portable listening devices: understanding the problems and establishing strategies for improving awareness in adolescents. Adolesc Health Med Ther. 2016;7:27-35.
- Hughes MA, Knowles SF, Dhingra K, Nicholson HL, Taylor PJ. This corrosion: A systematic review of the association between alternative subcultures and the risk of self-harm and suicide. Br J Clin Psychol. 2018;57(4):491-513.
- Stack S, Gundlach J, Reeves JL. The heavy metal subculture and suicide. Suicide Life Threat Behav. 1994;24(1):15-23.
- Rosenbaum JL, Prinsky L. The presumption of influence: Recent responses to popular music subcultures. CAD. 1991;37(4):528-35.
- Howe TR, Aberson CL, Friedman HS, Murphy SE, Alcazar E, Vazquez EJ, Becker R. Three decades later: The life experiences and mid-life functioning of 1980s heavy metal groupies, musicians, and fans. Self Identity, 2015;14(5):602-26.
- Vellers HL, Irwin C, Lightfoot JT. Heart rate response of professional musicians when playing music. Med Probl Perform Ar. 2015;30(2):100-5(6).
- Mira F, Costa A, Mendes E, Azevedo P, Carreira LM. Influence of music and its genres on respiratory rate and pupil diameter variations in cats under general anaesthesia: Contribution to promoting patient safety. J Feline Med Surg. 2016;18(2):150-9.
- Mofredj A, Alaya S, Tassaioust K, Bahloul H, Mrabet A. Music therapy, a review of the potential therapeutic benefits for the critically ill. J Crit Care. 2016;35:195-9.
- Retzlaff K. Perioperative nurses take note of music: Music therapy may ease anxiety andimprove outcomes for surgical patients. AORN. 2009.
- Ramírez-Rivera S, Bernal G. Music is capable of inducing changes in gene expression in gastric cancer cells. J Gastrointest Cancer. 2019;50(1):175-80.
- Lestard NR, Capella MA. Exposure to music alters cell viability and cell motility of human nonauditory cells in culture. Evid Based Complement Alternat Med. 2016;2016:6849473.
- Lestard Ndos R, Valente RC, Lopes AG, Capella MA. Direct effects of music in non-auditory cells in culture. Noise Health. 2013;15(66):307-14.
- Pirayesh Islamian A, Polemikos M, Krauss JK. Chronic subdural haematoma secondary to headbanging. Lancet. 2014;384(9937):102.
- Zhu Y, Wang F, Deng X. Hemodynamics of cerebral bridging veins connecting the superior sagittal sinus based on numerical simulation. Biomed Eng Online. 2018;17(1):35.
- Wikimedia Commons. File:Types of Intracranial hematoma.jpg.
- Depreitere B, Van Lierde C, Sloten JV, et al. Mechanics of acute subdural hematomas resulting from bridging vein rupture. J Neurosurg. 2006;104(6):950-6.
- Matsuzaki S, Tsunoda K, Chong T, Hamaguchi R. Mediastinal emphysema after head-banging in a rock artist: pseudo shaken-baby syndrome in adulthood. Ann Thorac Surg. 2012;94(6):2113-4.
- Neyaz Z, Kandpal H, Sharma R, Kale S. 'Head banging' during rock show causing subdural hematoma. Neurol India. 2006;54(3):319-20.
- De Cauwer H, Van Giel R, Mortelmans L, van den Hauwe L. An uncommon cause of headache after headbanging at a party. Eur J Emerg Med. 2009;16(4):212-3.
- Mackenzie JM. "Headbanging" and fatal subdural haemorrhage. Lancet. 1991;338(8780):1457-8.
- Cunningham DJ, Robinson A. Cunningham's Text-book of anatomy. New York: William Wood; 1925.
- Cunningham DJ, Robinson A. Cunningham's Text-book of anatomy. New York: William Wood; 1925.
- Jackson MA, Hughes RC, Ward SP, McInnes EG. "Headbanging" and carotid dissection. Br Med J (Clin Res Ed). 1983;287(6401):1262.
- Egnor MR, Page LK, David C. Vertebral artery aneurysm--a unique hazard of head banging by heavy metal rockers. Case report. Pediatr Neurosurg. 1991;17(3):135-8.
- Incirlik Air Base. Photos: Driving requirements, documents unique to Turkey.
- Patton D, McIntosh A. Head and neck injury risks in heavy metal: Head bangers stuck between rock and a hard bass. BMJ. 2008;337:a2825.
- "Flickr. Blondinrikard Fröberg. 2014. "
- Coyote Vest. Studded collar for big dogs.
Video production by Glass Entertainment
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
If you search for heavy metal in the National Library of Medicine database, most of what you find is on heavy metal contamination in fish, for example, making it so hard to clearly establish the role of fish in a healthy diet, perhaps helping to explain the quintupling of odds of autoimmune diseases like juvenile arthritis for instance.
But searching the hazards of heavy metal also pops up entries like this, on the “risks from heavy metal music.” Here, they were talking about traumatic injuries from slamming around, but you’re more likely to get injured at an alternative rock concert. It’s the Goo Goo Dolls you’ve got to worry about, not Nine Inch Nails.
Okay sure, music-induced hearing loss is a serious problem, but that can be from any loud music. It’s interesting that clinical recommendations include the “80–90 rule”: no more than 80 percent of the maximum volume on personal listening devices for no more than 90 minutes a day. But that’s not what the science shows; “do not exceed 60 percent of the maximum volume” may be more evidence-based, but they figure teens would just ignore that, so they came up with more “acceptable” advice.
I assumed I’d see a lot of satanic panic nonsense from the 80s, where parents bereaved by suicide started suing heavy metal musicians. What kind of evidence did the parents present? There has been little scholarly research, until this study that proceeded to try to correlate the number of statewide heavy metal magazine subscriptions to youth suicide rates. Oh, you’ve got to be kidding.
It got really crazy, though, when researchers called psychiatric institutions, pretending to be parents worried because their son started listening to that heavy metal music–– even though they made it clear that their son didn’t exhibit any symptoms of mental illness, no drugs, no alcohol, and was doing fine at school. Ten of the twelve facilities believed the son required psychiatric hospitalization. Imagine what that would do to a kid! In turns out if you actually come back a few decades later, metalheads were significantly happier in their youth, and appear better psychologically adjusted than their peers.
Some studies were just strange. Do Parkinson’s patients walk better listening to “Yellow Submarine” or “Master of Puppets”?
Other studies were just like, duh. Heavy metal musicians exhibit a higher heart rate than those performing “contemporary Christian.” Not much of a shocker.
Some studies were kind of cute: Influence of music on promoting patient safety during surgery—veterinary patients. Kitties getting spayed with little earphones on their head. It turns out that “Adagio for Strings” may be more relaxing than AC/DC.
A review on music therapy for human patients warned that caution should be exercised when guiding patients in selecting their music, as “chaotic music,” such us hip-hop and metal, is not healing to human cells—with three citations no less, though two of them don’t say anything, and the third is a nursing newsletter merely quoting someone’s opinion.
But I did some digging, and it turns out stomach cancer cells like metal. If you play them “Cannibal Corpse” versus Beethoven, 12 hours of death metal increased their growth in a petri dish (that’s so metal). But who puts headphones on their stomach? Or their chests, for that matter?
While in one study, Mozart killed off one type of breast cancer cell line and not another, in another study, only Beethoven’s Fifth Symphony seemed to work, and Mozart flopped when the petri dishes were surrounded by speakers on a little platform. How do they even get this stuff published?
Anyway, the true danger from heavy metal is headbanging. “Headbanging is a contemporary dance form consisting of abrupt flexion–extension movements of the head, most commonly seen in the heavy metal genre.” The number of avid aficionados is unknown, but some fans might be endangered by indulging excessively. Although generally considered harmless, health complications attributed to this practice include ripping your carotid artery, rupturing your lung, whiplash injury, neck fracture, or, in this case, a subdural haematoma. This guy reported headbanging at a Motörhead concert, and all that brisk forward and backward acceleration might have ruptured his bridging veins, and caused him to bleed into his skull.
Bridging veins bridge the gap between the brain and the covering that lines the inside of your skull, and if the veins tear, blood can build up under your skull, and compress your brain. This bridging vein rupture has been demonstrated on headbanging cadavers (again, a very metal study). It’s been likened to a kind of shaken-baby syndrome in adults.
The researchers conclude that their case serves as evidence in support of Motörhead’s rock-and-roll reputation, but I think the real takeaway is that a potentially dangerous complication like that can result from a seemingly benign activity. And some of the brain bleeds can be massive. Hmm, why did he have a headache after headbanging at a party? Here’s the CT scan. This is all blood, squooshing his brain over. It’s amazing he survived, though this poor guy didn’t.
See, you can tear more than just veins. There are two sets of arteries that tunnel into the skull— the carotid arteries in the front and the vertebral arteries in the back—and you can tear both sets. A 15-year-old indulged in headbanging, ripping his carotid artery, which led to a massive stroke. He presented half-paralyzed, unable to speak, and died in a coma within a week.
What about the vertebral arteries in the back? They’re wedged into your skull, rendering them susceptible to shearing forces from extremes of neck motion, and that’s exactly what appeared to happen: a heavy metal drummer tearing the wall of the artery. Now obviously, all this is really rare, probably afflicting less than one in a thousand or so. What can metalheads do to reduce their risk? To prevent injury due to such head-banging, the range of head and neck motion should be reduced; slower-tempo music should replace metal (good luck with that); the frequency of head-banging could be only on every second beat (that’s actually not a bad idea); or personal protective equipment should be used (like a neck brace?).
Little formal injury research has been conducted on the worldwide phenomenon of head-banging; so, researchers constructed a theoretical head-banging model with enough physics terms to make any nerd happy: angular displacement, sinusoidal motion in the sagittal plane, amplitude of the displacement curve. Study participants: head bangers. But you do need a control group: easy listening music.
Head injury curves and neck injury curves, based on head-banging tempo and angular sweep. At an average head-banging tempo, we’re trying to keep the range of motion under 75 degrees, so something like this. So, to minimize the risk of head and neck injury, head bangers should decrease their range of head and neck motion. Oh, there’s that “personal protective equipment” again. “Unfortunately, it is difficult, if not impossible, to change the habits of heavy metal aficionados.” Maybe what we need are metal-studded neck braces.
Please consider volunteering to help out on the site.
- PubMed search on "heavy metal".
- Bosch AC, O'Neill B, Sigge GO, Kerwath SE, Hoffman LC. Heavy metals in marine fish meat and consumer health: A review. J Sci Food Agric. 2016;96(1):32-48.
- Castro-González MI, Méndez-Armenta M. Heavy metals: Implications associated to fish consumption. Environ Toxicol Pharmacol. 2008;26(3):263-71.
- Kindgren E, Guerrero-Bosagna C, Ludvigsson J. Heavy metals in fish and its association with autoimmunity in the development of juvenile idiopathic arthritis: A prospective birth cohort study. Pediatr Rheumatol Online J. 2019;17(1):33.
- Drew PJ. "Mosh pit" breast? BMJ. 2009;338:b42.
- Westrol MS, Koneru S, McIntyre N, Caruso AT, Arshad FH, Merlin MA. Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):289-96.
- De Bartolo D, Morone G, Giordani G, et al. Effect of different music genres on gait patterns in Parkinson’s disease. Neurol Sci. 2020;41:575-82.
- Portnuff CD. Reducing the risk of music-induced hearing loss from overuse of portable listening devices: understanding the problems and establishing strategies for improving awareness in adolescents. Adolesc Health Med Ther. 2016;7:27-35.
- Hughes MA, Knowles SF, Dhingra K, Nicholson HL, Taylor PJ. This corrosion: A systematic review of the association between alternative subcultures and the risk of self-harm and suicide. Br J Clin Psychol. 2018;57(4):491-513.
- Stack S, Gundlach J, Reeves JL. The heavy metal subculture and suicide. Suicide Life Threat Behav. 1994;24(1):15-23.
- Rosenbaum JL, Prinsky L. The presumption of influence: Recent responses to popular music subcultures. CAD. 1991;37(4):528-35.
- Howe TR, Aberson CL, Friedman HS, Murphy SE, Alcazar E, Vazquez EJ, Becker R. Three decades later: The life experiences and mid-life functioning of 1980s heavy metal groupies, musicians, and fans. Self Identity, 2015;14(5):602-26.
- Vellers HL, Irwin C, Lightfoot JT. Heart rate response of professional musicians when playing music. Med Probl Perform Ar. 2015;30(2):100-5(6).
- Mira F, Costa A, Mendes E, Azevedo P, Carreira LM. Influence of music and its genres on respiratory rate and pupil diameter variations in cats under general anaesthesia: Contribution to promoting patient safety. J Feline Med Surg. 2016;18(2):150-9.
- Mofredj A, Alaya S, Tassaioust K, Bahloul H, Mrabet A. Music therapy, a review of the potential therapeutic benefits for the critically ill. J Crit Care. 2016;35:195-9.
- Retzlaff K. Perioperative nurses take note of music: Music therapy may ease anxiety andimprove outcomes for surgical patients. AORN. 2009.
- Ramírez-Rivera S, Bernal G. Music is capable of inducing changes in gene expression in gastric cancer cells. J Gastrointest Cancer. 2019;50(1):175-80.
- Lestard NR, Capella MA. Exposure to music alters cell viability and cell motility of human nonauditory cells in culture. Evid Based Complement Alternat Med. 2016;2016:6849473.
- Lestard Ndos R, Valente RC, Lopes AG, Capella MA. Direct effects of music in non-auditory cells in culture. Noise Health. 2013;15(66):307-14.
- Pirayesh Islamian A, Polemikos M, Krauss JK. Chronic subdural haematoma secondary to headbanging. Lancet. 2014;384(9937):102.
- Zhu Y, Wang F, Deng X. Hemodynamics of cerebral bridging veins connecting the superior sagittal sinus based on numerical simulation. Biomed Eng Online. 2018;17(1):35.
- Wikimedia Commons. File:Types of Intracranial hematoma.jpg.
- Depreitere B, Van Lierde C, Sloten JV, et al. Mechanics of acute subdural hematomas resulting from bridging vein rupture. J Neurosurg. 2006;104(6):950-6.
- Matsuzaki S, Tsunoda K, Chong T, Hamaguchi R. Mediastinal emphysema after head-banging in a rock artist: pseudo shaken-baby syndrome in adulthood. Ann Thorac Surg. 2012;94(6):2113-4.
- Neyaz Z, Kandpal H, Sharma R, Kale S. 'Head banging' during rock show causing subdural hematoma. Neurol India. 2006;54(3):319-20.
- De Cauwer H, Van Giel R, Mortelmans L, van den Hauwe L. An uncommon cause of headache after headbanging at a party. Eur J Emerg Med. 2009;16(4):212-3.
- Mackenzie JM. "Headbanging" and fatal subdural haemorrhage. Lancet. 1991;338(8780):1457-8.
- Cunningham DJ, Robinson A. Cunningham's Text-book of anatomy. New York: William Wood; 1925.
- Cunningham DJ, Robinson A. Cunningham's Text-book of anatomy. New York: William Wood; 1925.
- Jackson MA, Hughes RC, Ward SP, McInnes EG. "Headbanging" and carotid dissection. Br Med J (Clin Res Ed). 1983;287(6401):1262.
- Egnor MR, Page LK, David C. Vertebral artery aneurysm--a unique hazard of head banging by heavy metal rockers. Case report. Pediatr Neurosurg. 1991;17(3):135-8.
- Incirlik Air Base. Photos: Driving requirements, documents unique to Turkey.
- Patton D, McIntosh A. Head and neck injury risks in heavy metal: Head bangers stuck between rock and a hard bass. BMJ. 2008;337:a2825.
- "Flickr. Blondinrikard Fröberg. 2014. "
- Coyote Vest. Studded collar for big dogs.
Video production by Glass Entertainment
Motion graphics by Avo Media
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The Dangerous Effects of Heavy Metal Music
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
What about the healing potential of music? Check out Music as Medicine and Music for Anxiety: Mozart vs. Metal.
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