Screaming down the hill on Hawaii Kai Drive from Kalama Valley, the back wheel of the bicycle I was riding suddenly came loose. My right hip and leg crashed to the ground and slid along the wet asphalt for what seemed like an eternity.

My son and I were competing in the Honolulu Tin Man Triathlon. With the swim done and just past the halfway point on the bikes, we were heading toward Kapiolani Park for the run around Diamond Head. Adrenaline pumping and feeling no pain, I jumped up, popped the wheel back on and resumed the race within a minute or two to steal a decent finish.

Now, one month later, the road rash is still healing, but I remain relieved that I didn’t hit my head even though it was protected by a good helmet. I thought again of the fall when we heard the sad news this week of a traumatic brain injury (TBI) suffered by Alan Mohika, star quarterback for Damien High School. It is gripping when a moment of glory for a young athlete is followed by a tragic injury.

At an estimated annual cost of $60 billion, each year 1.7 million children and adults sustain a TBI, and 3.1 million people in the United States live with a lifelong disability due to TBI. Injury Prevention and Control at the Hawaii Department of Health estimates that there are 1500 new serious brain injuries each year on the islands. Military cases are not included.

The State Neurotrauma and Traumatic Brain Injury Advisory Boards supported a bill that now requires fees assessed for moving violations to be placed in Hawaii’s Neurotrauma Special Fund. The balance had been as high as $2 million until some of it was tapped for the State General Fund because of the flagging economy. Available monies are dedicated to needs assessments, education and prevention of TBI. The Concussion Management Program supported by the Neurotrauma Fund in association with the Departments of Health and Education is now studying the incidence and treatment of the problem while focusing on improving the awareness of coaches and trainers of school-age athletes.

Health is only one of many motivations for participation in sports and fitness. Some aspire to become a professional athlete with all those lucrative endorsements. Others seek athletic scholarships and view sports as a ticket to the best education. There are those who prize, above all, the fame that comes with winning or that feeling that comes with being the best. I also have patients who, despite being aware of the risks, scour GNC for supplements that give them the best buzz during their workouts. Some just want to look good no matter the cost.

The older we get, the more we tend to go for quality and longevity. We tap into sports and fitness as a way to get a breather from technology and an opportunity to reconnect with ourselves, our loved ones, our community and the environment. We often naturally make a transition from high-impact contact sports to activities that are easier on the body and support a healthy lifestyle. Paddling offers these benefits. We pull together, synchronizing ourselves with the ocean, with other paddlers in the canoe and with a rich cultural heritage.

We all seek freedom in our lives. That includes freedom of movement and freedom from pain. Approach physical activity in a manner that will keep you well for the long run. Consider it asset protection. It’s a strategy that can’t be beat.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.