April is National Pickleball Month

By Thomas Lehrich, President, Plus One Foundation of Seattle  

April is recognized across the country as National Pickleball Month, a celebration of one of America’s fastest-growing and most inclusive sports. 

For those of us in the Pacific Northwest, pickleball has special meaning. The game of pickleball was born a short ferry boat ride away on Bainbridge Island, making this month not only a national celebration but a local point of pride.

As the story is told, in the summer of 1965, three friends on Bainbridge set out to entertain their families using a worn badminton court and whatever equipment they could find. With ping-pong paddles, a perforated plastic ball, and a lowered net, they created a new game that was easy to learn and engaging. What began as a backyard solution to summertime boredom quickly evolved into a global sport. 

Increasingly, research and clinical experience are showing that racquet sports like pickleball can play a meaningful role in supporting individuals with neurological conditions, including traumatic brain injury (TBI), stroke recovery, and neurodegenerative diseases.

The benefits are multifaceted. Physically, pickleball promotes balance, coordination, and cardiovascular health, all of which are critical in neurological rehabilitation. Cognitively, the game requires players to track movement, anticipate shots, and make quick decisions—engaging neural pathways that support brain plasticity and recovery. Socially, it fosters connection and reduces isolation, an often-overlooked factor in long-term neurological health. Studies suggest that pickleball and similar activities can improve psychological well-being and overall quality of life.  

At the Plus One Foundation, we see these benefits firsthand. Our mission is grounded in helping individuals with brain injuries reclaim independence and purpose. That mission comes to life through our Think About It education program—a community-centered initiative designed to raise awareness about brain health, injury prevention, and the power of active recovery.

Think aBout It emphasizes three key pillars: education, engagement, and empowerment.

As we celebrate National Pickleball Month this April, we honor more than just a sport. We recognize a movement that began on Bainbridge Island and has grown into a powerful tool for connection, recovery, and resilience. At Plus One, we encourage everyone—whether you’re an experienced athlete or picking up a paddle for the first time—to step onto the court, stay active, and most importantly, think about it

Recognizing National Brain Injury Awareness Month

By Thomas Lehrich, President, Plus One Foundation

March is recognized across the United States as National Brain Injury Awareness Month, a time dedicated to increasing understanding of brain injuries, supporting survivors, and promoting brain safety in our communities.

Traumatic brain injuries (TBIs) can affect all individuals, from athletes and workers to children and older adults, and their impact can last a lifetime.

Brain safety is an essential part of public health. A traumatic brain injury occurs when a blow or jolt to the head disrupts normal brain function. These injuries range from mild concussions to severe trauma. TBIs can result from falls, motor vehicle accidents, sports injuries, assaults, or other impacts to the head and body.

The numbers underscore the importance of awareness and prevention. In the United States, approximately 3 million people sustain a traumatic brain injury each year. Of those injuries, hundreds of thousands require hospitalization, and tens of thousands lead to death. We know an estimated 5.5 million Americans are currently living with a disability related to brain injury.

Survivors may face challenges with memory, mobility, speech, emotional regulation, and daily living activities.

The Plus One Foundation provides life-changing programming and services to those with TBIs. We also promote awareness and learning about safety practices—such as wearing helmets, preventing falls, using seat belts, and protecting young athletes—which is a critical component to brain injury awareness.

At the Plus One Foundation of Seattle, we believe recovery and quality of life extend beyond medical treatment alone. Our mission is to assist children and adults living with neurological injuries, disorders, or diseases by providing opportunities that support rehabilitation, personal growth, and joy in everyday life. We fund classes, training, and therapeutic experiences—such as art and music therapy, therapeutic horseback riding, aquatic therapy, meditation, and movement programs—that are proven to help individuals recover and rebuild their lives but are often not covered by insurance.

During National Brain Injury Awareness Month, we invite our community to join us in recognizing the importance of brain health, supporting those affected by brain injury, and working together to promote safer environments for everyone. Through awareness, compassion, and innovative programs, we can help make the journey of recovery possible.

The Healing Waters: How Aquatics and Swimming Benefit the Brain Injury Community

Our mission is not only to support survivors and their families but to promote evidence-based programs and interventions that improve quality of life after brain injury. 

The Plus One Foundation and its Think aBout It education initiative is a program dedicated to empowering communities with knowledge about brain health, injury prevention, and rehabilitation. TBI26 has elevated public understanding and continues to spark meaningful conversations across the Pacific Northwest and beyond.

One of the most powerful yet underutilized rehabilitative tools for many of the individuals we serve is aquatics and therapeutic swimming.

Our founder, Kacey, pioneered the aquatics concept of enhancing access to pools and aquatics for those with neurological conditions. Plus One knows water. Whether it’s regaining strength, rebuilding confidence, or supporting cognitive recovery, the aquatic environment offers a range of benefits uniquely suited to the needs of people recovering from brain injury.

Why Water? The Science and the Sensation

The properties of water and buoyancy, resistance, hydrostatic pressure, and thermal effects create an ideal environment for gentle yet effective rehabilitation. For many brain injury survivors, traditional land-based therapy can be painful, fatiguing, or demotivating. Water, however, can reduce the impact of gravity, support weak muscles, and enhance movement with less effort.

Here’s how aquatics help:

1. Enhances Physical Function Without Overload
Buoyancy reduces stress on joints and the nervous system, allowing individuals to perform movements that may be difficult or impossible on land. This promotes improved range of motion, balance, and motor control, all of which are common challenges after a brain injury.

2. Reduces Muscle Spasticity and Pain
Warm water has a calming effect on muscles, often decreasing involuntary spasticity that can limit functional movement. Many survivors report reduced pain during and after aquatic sessions, which supports longer-term engagement in therapy.

3. Boosts Cardiovascular and Aerobic Fitness
Swimming increases heart rate and circulation without the jarring impact of running or walking. Improved cardiovascular fitness is linked not only to physical health but to neuroplasticity, the brain’s ability to reorganize and heal.

4. Improves Balance and Coordination
Water provides dynamic feedback that challenges the sensory and motor systems. This helps retrain balance and coordination in ways that often transfer into improved performance on land.

5. Supports Cognitive and Emotional Well-Being
Aquatics isn’t just about physical gains. The focus required for swimming patterns, breath control, and rhythmic movement engages cognitive processes such as attention, sequencing, and memory. Many survivors also describe feeling more relaxed, less anxious, and more confident after spending time in the water – a reminder that emotional well-being is inseparable from rehabilitation success.

Integrating Aquatics Into Comprehensive Care

While aquatics is exceptionally beneficial, it works best as part of a comprehensive, interdisciplinary rehabilitation plan, one that includes physical therapy, occupational therapy, cognitive rehabilitation, and psychosocial support. Each survivor’s journey is unique, and aquatics offers a flexible, adaptable pathway that therapists and caregivers can tailor to individual goals.

Think aBout It

Programs like The Plus One Foundation’s Think aBout It initiative remind us that education and awareness are critical pieces of recovery. When communities understand the benefits of interventions like aquatics, we can advocate more effectively for access, funding, and innovative practices that put survivors first.

Aquatics is one such beacon of possibility, and when combined with education initiatives like Think aBout It, we move closer to a future where every person with a brain injury has the tools, support, and opportunities they deserve

CTE and Dementia: Brain Health Awareness

By Thomas Lehrich, President, Traumatic Brain Injury Foundation, Plus One Foundation of Seattle

A groundbreaking study from researchers at Boston University’s Chronic Traumatic Encephalopathy (CTE) Center has provided the evidence that many of us in the brain-injury advocacy community have long suspected: severe CTE isn’t just associated with dementia, it can be a cause of it.

For numerous decades, families of individuals exposed to repetitive head trauma, from contact sports, military service, domestic violence, and other causes, have watched loved ones struggle with memory loss, confusion, and cognitive decline.

The scientific community has debated whether CTE causes these clinical symptoms or if it’s merely an incidental finding at autopsy.

The Boston University work, published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, is the largest and most definitive of its kind.

Researchers studied 614 donated brains from individuals exposed to repetitive impacts and found those with advanced CTE had four to four-and-a-half times greater odds of having dementia compared with those without CTE pathology.

Importantly, the study isolated CTE from other neurodegenerative conditions, showing that this connection is not merely a correlation but a strong, independent association with cognitive decline and dementia.

Why This Matters

For too long, patients had unclear messages about CTE’s relevance to symptoms. This study of over 600 brains shifts how we think about repetitive brain trauma and its long-term consequences.

CTE should be formally recognized as one of the causes of dementia. Just as Alzheimer’s disease and other neurodegenerative conditions are classified within the realm of “Alzheimer’s disease-related dementias,” so too should severe CTE. This recognition matters, not only for research and clinical diagnosis but for families struggling to understand why their loved one’s cognition deteriorated.

Think About It

At Plus One, we have long championed education as one of the most powerful tools for helping our stakeholders 

Our signature initiative, Think About It, is designed to reach the neurological communities with evidence-based education about concussion, repetitive head impacts, and long-term brain health.

Studies have shown that repeated subconcussive and concussive impacts — even those that don’t cause immediate blackout symptoms — contribute over time to cumulative brain injury. CTE pathology is characterized by abnormal tau protein accumulation in specific brain regions, likely driven by repetitive trauma.

Now, with a clearer link to dementia, the message of Think About It is more urgent than ever: brain health matters across the lifespan. Early education, timely recognition, and a culture that prioritizes neurological safety can change outcomes for countless individuals.