The Dangers of Concussion in Football In a country that thrives on competition it is no wonder Americans have embraced football as their favorite sport. Every weekend during football season, millions line up, tune in, or change the channel to watch their favorite teams do battle for 60 minutes. It is a rough physical game and at the collegiate and professional levels, played by some of the worlds best athletes. There are many dangers involved when participating in such a sport.
Rarely will a player go through a game without being hurt in some capacity. This is part of the game and everyone involved knows it. Because of this, players often have to be the judge of whether they are “Injured”, or “hurt. ” The difference being that someone who is just hurt can still perform physically and should be able to return to the game. However if a player is injured, this means that they have been hurt to the point where they are not physically able to play, or to the point that further play could escalate the injury into something much more serious.
For most injuries this distinction is easy to make, for instance a sprained ankle can either be ran on or it cant, depending on the extent of the sprain. If a player suffers a concussion though, it can be much more difficult for that player to consider himself injured. The reason concussions are such a problem is because physically a player can still perform, even though they may be impaired mentally. Dedicated football players will often do anything they can to avoid coming out of a game, especially if the player is not well educated on the effects of concussions.
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They may notice concussion like symptoms, but may chose not to tell the coach or medical staff in order to stay in the game. In fact many teams (required by NCAA/NFL) give their players a baseline test before the season to see how fast their mind works when completely healthy. A player can then be retested during the season if showing symptoms and in theory their thinking process should work slower. The problem with this test however is that many players actually cheat on the baseline exam so that when concussed their answers appear the same, according to Dr. Daniel Amen. Marvez) In some cases coaches even look the other way when a player appears to be showing symptoms. This issue was brought to light in July, 2012 when over 2,000 former NFL players joined together to file a lawsuit against the league. Claiming that the NFL “exacerbated the health risk by promoting the game’s violence and deliberately and fraudulently misled players about the link between concussions and long-term brain injuries. ”(Avila) The NFL is currently taking preventative measures, and even started attempting to improve concussion safety before the suit was filed.
Enforcing stricter rules on illegal hits, and concussion protocol. This is not eliminating the problem however. On november 11th 2012, three NFL quarterbacks suffered concussions during their respective games. Michael Vick, Alex Smith, and Jay Cutler. In Smith’s case he remained in the game for the rest of the offensive series, throwing a touchdown pass with “blurry vision” before being diagnosed on the sidelines. (Sando, ESPN) Of the three players, none of them have been cleared to return as of 11/22/12.
Although strides are being made to improve treatment and prevention of concussions, they remain footballs greatest health concern and further steps still need to be taken. In order to truly recognize the dangers of concussions, it is important to know what exactly a concussion is. According to the textbook Modern Principles of Athletic Training, the definition is as follows: Most traumas suffered by the head are the result of direct or indirect blows and may be classified as concussion injuries.
Literally, “concussion” means an agitation or a shaking from being hit, and “cerebral concussion” refers to the agitation of the brain by either a direct or indirect blow. Surgeons define concussion as a clinical syndrome characterized by immediate and transient impairment of neural function, such as alteration of consciousness, disturbance of vision, equilibrium, and so on, caused by mechanical forces. The indirect concussion most often comes either from a violent fall, in which sitting down transmits a jarring effect through the ertebral column to the brain, or from a blow to the chin. In many cases of cerebral concussion there is a short period of unconsciousness, having mild to severe results. (Klafs 463) The text then explains that concussions are classified into three degrees. A first degree concussion “is considered as being of mild intensity. There is no loss of consciousness but there may be a slight and temporary memory loss, minor mental confusion, unsteadiness, ringing in the ears, and perhaps minor dizziness. A dull headache may also follow. (Klafs) Second degree concussions “are considered as being of moderate intensity, the second degree concussion can pose a serious medical problem. There is a loss of consciousness (up to 4 minutes); moderate tinnitus; retrograde amnesia, which constitutes a condition where athletes are unable to remember recent events; mental confusion; balance disturbance; and headache. ”(Klafs) The third and final degree of concussion is “obviously the most severe of the so called knocked-out states. It implies many serious consequences.
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A prolonged period of unconsciousness (over 5 minutes); mental confusion for an extended period with retrograde amnesia (lasting over 5 minutes); and other symptoms such as dizziness, balance difficulties, and convulsions may occur. ” (Klafs) In football the first and second degree concussions are the most common do to the protective helmets worn by players, however third degree concussions still occur. Where the problem really lies though is when a player suffers repeated concussions without giving the brain sufficient time to heal.
Jeffery Bartholet’s article pulbished in Scientific American magazine in February 2012 discusses the issue of how serious repeated concussion actually is. His example is former NFL fullback Kevin Turner. Turner played in the league from 1992-1999 and was given the nickname “The collision expert” due to the “gouges he collected on his helmet” from hard hits. “In 2010 Turner was diagnosed with amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease. ”(Bartholet) Turner’s fingers and other joints for the most part can not function correctly. He cannot pick up a glass of water, shave, or button his own shirt.
... further damage to the brain and its function. Since a concussion cannot be physically seen, many players and coaches do not ... to the head, face, mouth, or eyes. Prior to the institution of rules by the National Alliance Football Rules Committee ... general public, parents and athletes themselves. Unfortunately, some youth sports organizers are refusing to participate in educational programs because ...
Bartholet goes on to explain that “a group of scientists” in Boston believe that Turner does not actually have ALS. “Around the same time he was diagnosed, these researchers discovered what they say could be a separate disorder with exactly the same clinical syndrome as ALS. It is also incurable. The only real difference is that this disease seems to have a clear cause: repeated blows to the head, like those that often occur on the football field. ”(Bartholet) The group is led by “Dr. Ann McKee, a neuropathologist at Boston University and the Bedford VA Medical Center in Massachusetts. (Bartholet) These finding are highly controversial, however many doctors and scientists that doubt the theory still believe McKee’s findings are significant. Bartholet then transitions into what happens inside the brain when a concussion occurs. Defined by Dr. Christopher Giza, a neurology professor at UCLA: What is clear is that when the head, moving at significant speed, comes to an abrupt stop, the brain cells inside get stretched, squeezed and twisted. In their normal state, these cells function by transmitting electric current. A part of the cell called the axon acts somewhat like a wire, conducting current between the cells.
Ions shift back and forth along the axons in a controlled fashion, transmitting messages from one part of the brain to the other and to the rest of the body. When a concussion occurs, however, the membranes of brain cells get damaged and the cells become leaky, Giza says. Ions rush in and out indiscriminately. As sodium and calcium rush in, potassium rushes out. The brain needs to restore balance. (9) This depresses the brains ability to “metabolize energy. ” Which is why a players nueral function will slow down, causing them do fail a concussion test. assuming the baseline was accurate) Bartholet acknowledges that it has “long been clear multiple blows to the head can cause mental impairment. ” But only in the past ten years has it been identified as a problem in football. “They (McKee) have also been able to identify, on autopsy, pathological markers for the disease, now called chronic traumatic encephalopathy (CTE).
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” Concussions occur in all levels of organized football, starting at the youth level. In the case of most muscle or joint injuries children generally tend to recover much faster and have fewer lingering effects.
This is not the case with concussions, according to Dr. William Perry (Former president National Academy of Neuropsychology, NFl dementia consultant) school age children actually take longer to recover due to their developing brain, and suggests that even one concussion may affect their ability to retain information in school. He explains that as children mature, the brain recovers faster, and even high school age athletes require a shorter recovery time. (Marshal) The growing concern surrounding concussions long term effects has become a fright to parents across the nation.
A survey conducted by ESPN shows that parents are now 57% less likely to allow their children to participate in football. Due to this raised awareness and declining participation numbers, the nations largest youth football organization, Pop Warner Little Scholars inc. has changed its rules for safety. “Pop Warner now limits the amount of contact drills allowed to one-third of total practice time and has banned full-speed, head-on drills. ”(Attwood) State lawmakers are even taking action and in 2009 Washington became the first state to pass concussion legislation. Attwood) This new law requires that any youth athlete suspected of having a concussion must receive clearance to return to play. “It stipulates that only licensed health care providers can make return-to-play decisions and that they be trained in the evaluation and management of concussions… and stipulates that student-athletes and their parents sign an information sheet about concussions and head injuries prior to each season. Youth sports associations that use publicly owned fields (just about all of them) also must comply with the law. (Attwood) Since passed in Washington, 37 other states have now followed with 6 others pending legislation. Although the new laws and policies do help, there were still over 173,000 sports related concussion/ traumatic brain injury hospital visits in 2011 of youth between ages 5-18. This was the highest number of all time, and is 57% higher than in 2001, most likely due to increased awareness. (Momsteam) Of the 173,000 youth concussions, the following chart shows almost 40% are a result of playing football. Displaying its significantly higher risk as opposed to other sports. (Lopez-Doran)
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While the new laws will continue to do their part, concussion safety in youth football starts with its coaches. In youth football concussions are generally suffered due to improper technique. It is a coaches responsibility to coach their players in proper tackling and blocking form. Concussions are frequently suffered three different ways playing football. The first being a hit or tackle that forces a player off his feet resulting in the back of the head coming down hard on the ground. This is often not a result of dirty play, just a consequence of a hard hit in a contact sport.
The second being a result of an illegal hit. This could be a helmet to helmet hit, a forearm or elbow to the head, or block in the back. Poor technique along with helmet to helmet hits are the most common in youth football. As a tackler you are taught to come in with you head up, never down. you are taught to put your shoulder into the opposing players stomach, put your facemask where the player is holding the ball, and wrap up with your arms. If a player comes in with their head down, it can result in extremely serious injury. Not just the risk of concussion, but also putting the neck and spine at risk.
Sometimes resulting in paralysis, or even death. One specific example of poor coaching that has seen national attention took place in massachusetts on October 23rd 2012. In a Pop Warner game, 5 players ages 10-12 suffered concussions. The game was between Southbridge and Tantasqua, Southbridge won the game 52-0 and all 5 concussions were suffered by Tantasqua players. Both coaches have been suspended, and the games referees have been banned from Pop Warner football for life. The game should have been stopped but was not, when the game finally ended Tantasqua only had 10 players on the field due to injury. Pop Warner has a mercy rule after one team goes ahead by 28 points or more. By rule there will be no kickoffs, with the team that’s behind getting the ball at the 30 to start each possession. Also there’s a running clock, and the team that’s ahead must take out as many starters as possible. ”(Chandler) These rules were not enforced in the game. Many may argue youth football is the most dangerous level, due to developing bodies and loose understanding of how to properly play. However one must consider how the game changes at the high school varsity level. This is truly the level where boys become men.
... . The impact of concussions is of great importance dealing with football injury and the well being of the players but the injury is a consequence ... any association between football head injuries and issues. Currently, today a NFL player who sustains a concussion may not return to the game that day. As ...
A significant amount of physical growth takes place in the high school years, and by the junior or senior year almost all athletes are fully grown. High school is also the point where building strength, speed, and overall physical ability becomes a factor. Most high schools introduce a training program starting the summer before potential players become freshman. This adds a whole new physicality to the game. Harder hits, and more aggressive blocks often result in more significant injury. In terms of growth I myself as a football player grew significantly during high school.
Starting out as a 5 foot 10 and a half inch, 210 pound freshman. I could bench press about 115 pounds and squat 250. By my senior year of high school, I was 6 feet, 2 inches, weighed 275 pounds and could bench 280, and squat 410. This type of physical change in high school is not uncommon, which is why it becomes such a different game. In order to go further in depth on the high school game, and its relation to concussion, I will briefly summarize my experience playing high school football. When signing up for football before my freshman year I had no idea what to expect.
I had played two years at the youth level but knew high school would be much different. From day one of summer workouts the emphasis, was get stronger, get faster. The motivation was all around us. A huge painted banner hung in the weight room reading “fatigue makes cowards of us all”, seeing the dedication of the older players we looked up to, the thrill of playing in front of the entire school. For football players it is a culture, a bond, a brotherhood. Which is why players become so much better, because they get to the point where they are playing for a greater purpose than themselves, adding extra motivation.
Youth football is played for fun, varsity football is played to win. It is a faster paced, more brutal level of football. With this increased level of injury risk, should come an increased level of injury awareness. This was not necessarily the case. We were always told about muscle injuries, how to stretch, and help them heal. Never once though do I remember being told anything about concussions. So this either means that nothing was ever mentioned, or that I thought so little of it as an injury that I didn’t even remember it. Point being, I had absolutely no knowledge of concussions adverse effects.
The first concussion I knowingly suffered was during my sophomore year. It was practice and we were doing kickoff drills at full speed. I was on the scout team against the varsity return team that was made almost entirely of senior starters. As I sprinted downfield towards the ball carrier, the rear wedge formed. This is where 5 guys group together and proceed to run forward like a wall to block for the return man. Thinking I would be able to get through the wedge, I lowered my shoulders in an attempt to overpower the blocker. It was like running into a brick wall. ur helmets made contact and I fell straight on my back, hitting my head again against the ground. I then stumbled off of the field and was told by a coach to see the trainer. I was diagnosed with a mild concussion and our head coach was notified. By the next day my symptoms were far less significant. Before practice I went into the coaches office and said something along the lines of “I feel alot better, i’m ready to go today. ” Coach said alright and I returned to practice that day, full contact. Under state concussion legislation, I should have needed a doctor’s clearance to return to play.
At the time I didn’t know that, and knowing what I do now about concussions I never would have returned to practice that day. When I reached the varsity level, I really became exposed to how non significant everyone saw concussions as. During my senior year not one player was ever sidelined with the injury. It was not often talked about but it became something that everyone played through. During one game against our divisions top team I was hit hard in the head. Soon after the headache started, then my vision became blurry. I proceeded to finish the game and was never diagnosed because I never told anyone.
In that same game, I could easily tell our starting center was going through the same thing. He was extremely dedicated and never once came out of a game for anything. This particular game though, there was an instance where he started walking towards the wrong huddle until a teammate grabbed him. I have never forgot the look on his face, i’m not sure he even knew where he was exactly. He is now playing in college. This is an example of how part of the reason so many concussions are suffered are because of the limited awareness. Although it has improved in the last year or two, that season we had no idea what we were doing to ourselves.
Concussion safety is still a major controversy at the collegiate level as well. In August 2012 a group of current and former student athletes (mostly football players) filed a lawsuit against the NCAA ( National Collegiate Athletic Association) similar to the one filed against the NFL. “The suit alleges that the NCAA “has engaged in a long-established pattern of negligence and inaction with respect to concussions and concussion-related maladies sustained by its student-athletes, all while profiting immensely from those same student-athletes. Hackney Publications) The difference between this suit and the NFLs’ is the NCAA players are claiming that simply nothing was done, and the issue was ignore. While NFL players suit claims that the NFL tried to hide concussions negative health effects. The suit against the NCAA goes on to mention that “the association failed to implement ‘return to play’ guidelines for athletes with concussions, and screening and detection guidelines for head injuries. (Hackney) So what players are bringing to light here is that the NCAA really does not have a concussion policy. According to a statement made by David Klossner who is the NCAA’s director of health and safety “The NCAA has no protocol with respect to concussion management; it allows each college that is a member to devise its own procedures.
”(Schwartz) The only thing the NCAA has done as an attempt to improve concussion management is provide loose guidelines. The first guideline states that a player should be removed from play rather than told to “shake it off. The second guideline says the player should then be evaluated by a healthcare professional, and the third says to only allow a player to return to the game with approval from a medical professional. An example of how loose these guidelines are occurred on october 16th 2012 in a game played by Arizona against USC. Arizona quarterback Matt Scott was unintentionally kicked in the head while sliding in the 4th quarter. A timeout was called and Scott looked as if he were having balance trouble when walking towards the sideline. Scott immediately began vomiting as the game went to commercial.
Scott was not initially seen by trainers and simply told head coach Rich Rodriguez that he was ok. Arizona followed none of the concussion guidelines and Scott returned to the game. He stayed in for another offensive series resulting in a touchdown. When he came off the field he began to vomit again, prompting trainers to finally issue a concussion test. After the test was issued Scott did not return to the game. Arizona clearly failed to protect their player until they were basically forced to. The problem here though is that the NCAA will not take action or penalize Arizona for their actions in any way. Diamond) In a separate event several weeks earlier USC wide receiver Robert Woods “took a shot to the head in a game vs. Utah, stumbled around the field, and was administered a simple three- question concussion test before being allowed back on the field within minutes. ”(Diamond) Even with the wealth of recently discovered knowledge regarding concussions, the NCAA has failed to implement appropriate policies. In 2003 a study was conducted by a group of doctors let by Kevin M. Guskiewicz, PhD, ATC and Michael McCrea, PhD among others.
The purpose of the study was “to estimate the incidence of concussion and time to recovery after concussion in collegiate football players. ”(Guskiewicz, McCrea) What the study found regarding recovery time is that players need at least 7-10 days to heal in order to return to play, and not until ninety days later had the brain fully recovered. The following the findings given in the study results. (Guskiewicz) The most significant result of the study’s findings however was that once a player suffers a concussion his risks will then increase for future concussion.
The statement released as a result of the study is as follows. Our results suggest that college football players with a history of concussion are likely to have future concussive injuries. We observed an increase in the likelihood of recurrent injury with each successive previous injury. Given our finding of a 3-fold greater risk of future concussions following 3 concussions vs no concussions, athletes with a high cumulative history should be more informed about the increased risk of repeat concussions when continuing to play contact sports such as football.
The multivariate-adjusted rate ratio in our study nearly doubled between the group with 1 previous concussion (rate ratio, 1. 4) and the group with 2 previous concussions (rate ratio, 2. 5), suggesting that as few as 1 previous concussion may present a cumulative effect. Additionally, we found that 1 in 15 players with concussion may have additional concussions in the same playing season and that these injuries typically take place in a short window of time (7-10 days) following the first concussion. (Guskiewicz)
So what this means is that for every concussion a player suffers he becomes more susceptible to further concussions. These statistics were previously unknown, coinciding with Dr. Ann Mckee’s finding on the severity of repeated concussions, and their potential for neurological damage. Although concussions continued to be an issue the NCAA needs to address, the NFL is already taking major strides to improve safety and awareness for its players. These strides were in part prompted by a lawsuit filed in june of 2012.
The suit involves more than 2,000 former players who claim the league knew about the dangers of concussions but covered them up from players and misled them about long term effects of brain injury. To date it is the biggest lawsuit in the history of sports. The plaintiffs in the suit claim that the “mild traumatic brain injury committee” formed by the NFL in 1994, “generated false findings rather than actually studying the issue of concussions. ”(Avila) According to abc news the committee stated in the 90’s that “returning to play after a concussion does not involve significant risk of a second injury.
This is what players claim to be a false finding, and the committee “didn’t even have brain experts on it. ”(Avila) The NFL is by far the hardest hitting level of football and according to ESPN sports science, a head on full speed hit can generate upwards of 1,800 pounds of force, and are the equivalent to a “sledgehammer blow to the head. ”(Avila) Abc goes on to say that a study done by the Sports Concussion Institute concluded that the average NFL player takes “900 to 1500 head shots per season. According to former bears quarterback Jim McMahon, the league knew of these danger the whole time. McMahon is 53 years old now and is suffering from dementia. He believes the cause is the hits he sustained during his football career. In an interview with ESPN McMahon discusses his dementia. He explains how when he listens to a message on the phone we will delete with the intention to call right back and then completely forget who called him. His girlfriend Laurie talks about how she bought him a kindle for his birthday because he love to read.
Saying that “there are many times he downloads the same book but not until hes half way through does he realize that hes already read it. ”(AP, ESPN) Laurie continues to explain how he will wander around a room for 20 minutes because he does not remember what he was going to do, and that she has their home address programed into the GPS in his car in case he ever gets lost. During the interview McMahon was asked how many concussions he sustained during his NFL career. “I know for sure I had three” said McMahon “but I don’t know how they defined concussions back then.
I know there was three times I was too whacked out to do anything. ” Mcmahon says that the tests for concussions back then were brief and that if you could follow the trainers finger with your eyes and tell them your name and where you were that they would say “you’re good to go. ” The interview showed a release from bears trainers in the late 80’s saying that “McMahon had a concussion, but it cleared by halftime. ” knowing what we do now this is obviously not possible, and McMahon says if he knew that then he would have played baseball instead. AP, ESPN) Towards the end of the interview McMahon acknowledges his sorrow for former teammate Dave Duerson who ended his own life in february 2011. Dave Duerson former Chicago bears safety killed himself with a bullet to the chest. He was 50 years old and McMahon acknowledges Duerson had battled dementia as well. Before Duerson’s suicide he had “spoke openly about donating his brain to scientific research upon his death. ”(AP, ESPN) Duerson left a suicide note saying he was experiencing “fading vision, and pain in the left side of my brain. (AP) He then left another note reading “PLEASE SEE THAT MY BRAIN IS GIVEN TO THE NFL’S BRAIN BANK. ”(AP) One would could only assume the shot to the chest was to preserve the brain. This was one of the first in a troubling string of former and current NFL player suicides. Next came former falcons player Ray Easterling who shot himself in the chest at the age of 62. An autopsy on his brain revealed he was suffering from CTE. (Manfred) Then came 43 year old former Chargers linebacker Junior Seau who also shot himself in the chest.
Seau’s suicide came in May. Followed by Titans wide receiver OJ Murdock, he was 25. (Manfred) There are countless other former NFL players who have suffered from dementia, depression and other mental illness. All of the 2,000 plus players suing the NFL have had their own trouble with brain damage. The league has responded by implementing new, strict rules on concussion management and safety. Players can be fined up to 75,000 dollars for dirty hits such as helmet to helmet, or an arm to the face.
A player now must be cleared by a doctor to return to game game and the NFL will soon require each team to have a neurologist at all games. Although new NFL regulations should help reduced concussion it will not end them by any means. What we’ve learned is that every concussion has a negative impact, and that in football there will likely never be a way to completely prevent them. However it is clear that thing need to change even more. Starting at the youth level. Such young people can not be exposed to the brutality of football, and something needs to be done to put a limit on the age kids can begin play.
Throughout all of football though action needs to be taken. There needs to be stricter sanctions in high school, and college need to enforce concussion safety period. The NFL continues to make strides and I have no doubt that even more major steps will be taken. As I am no expert in brain injury, I am not qualified to make suggestions for what needs to be done. But its clear that something does, or else we’ll see even more players end up like Jim Mcmahon or Dave Duerson.