Though it doesn’t factor directly into COLOSSAL, head injuries and concussions are a large part of the conversation about American Football. Many football governing bodies, from Pop Warner all the way up to the NFL, are facing lawsuits around injuries to players. This recent New York Times piece describes a suit against the Illinois High School Athletic Association.
With all this in mind, I approached Allyssa Memmini, a research intern at the BU School of Medicine Chronic Traumatic Encephalopathy (CTE) Center, with some questions about how concussions affect football players.
RO: How are concussions usually sustained in football players?
AM: Someone can sustain a concussion in a couple of different ways – whiplash, subconcussive blows/trauma such as seen amongst linemen, and hard hitting blows. It’s interesting because a concussion occurs when there is a rapid acceleration AND rotation of the brain that occurs within the skull – thus causing a “bruise” on the brain, for a lack of better words. This rotation can occur without even getting hit in the head – thus seen in whiplash.
With football, the bulk of concussions seem to come from players who engage in the most impact during practices and competitions such as linemen (offense & defense), running backs, linebackers, and wide receivers. As you can probably tell, some of these guys will obtain concussions through the hard hitting plays, or it may be through subconcussive blows – such as how linemen continually go head to head in every play.
What techniques/equipment have been developed for the sport to try to prevent concussion and head/neck injuries? How effective are these?
There is some literature that seems to believe mouthguards are an effective way to reduce concussions, but the fact of the matter is that the research is inconclusive. Helmets have evolved tremendously over time to better the overall fit, as well as create more protection for the athlete. Some researchers are attempting to put in sensors in the helmets as a way to count the number of hits someone sustains, but again, the data is inconclusive. At what point is a certain number of hits TOO many? It can be quite confusing. When it comes to the musculature of the neck, this too can play an impact on if someone sustains a concussion. Researchers believe that if you have stronger sternocleidomastoid, trapezius, levator scapulae, rhomboid musculature, that you will be able to prevent some of the acceleration/rotation of the brain if they are fired upon impact. Other than increasing neck musculature, there hasn’t been any type of equipment to prevent neck injuries.
Over time, have we seen concussion statistics get better or worse?
Over time, we have seen concussion statistics increase because people are now more aware as to what the signs/symptoms consist of and how to report them. Others have witnessed their teammates take a hard blow to the head and have been more responsive to contact either their coach, athletic trainer, or team physician if possible. In my opinion, we have certainly seen more willingness from professional sports organizations to finance and enact solutions greatly increase, especially with all of this concussion talk all over ESPN. It’s crazy to think that the concussion debate is so young because people have been knocked around millions of times for hundreds of years – but were always told to shake it off and get back in the game. Now that we have evidence-based research to prove that concussions are real and do impact people for the rest of their lives, the general public has been very outspoken about their support for better concussive care, in addition to bigger sports organizations.
What is the common period of recuperation for a concussion, and what does that look like for a player? For professional athletes, what support structure currently exists for recuperation and does taking time to heal pose a serious career threat?
Recuperation is also pretty wishy-washy because it depends on the individual as well as the severity of the concussion. When someone first comes to an athletic trainer or physician with concussion-like symptoms, we have them fill out a Symptom Score Sheet which is a list of symptoms with a scale next to each one. Common symptoms of a concussion include: headache, nausea, difficulty concentrating, sensitivity to light, sensitivity to noise, insomnia, hypersomina, mood swings, difficulty with balance, dizziness, ringing in the ears, seeing stars, amnesia, slurred speech, depression, difficulty with taste and/or smell, etc. There are many resources to help athletes in terms of a support structure. There are sports psychologist, counselors, and even athletic trainers to help get this patient through their rehabilitation as smoothly as possible to return them to play quickly. Although taking time to heal may pose a threat to an athlete’s career, concussions have been very closely monitored by huge organizations such as the NFL, NBA, NCAA, etc. so they typically will not threaten a player to continue playing should they present concussive symptoms.