Sports Injuries – Concussions

What is a Concussion?

The Latin word concutere — the source for the English word concussion — means, literally, “to shake violently,” according to Dr. Robert Cantu, Chief Clinical Professor of Neurosurgery and co-director of Boston University’s Center for the Study of Traumatic Encephalopathy. In his book, Concussions and Our Kids: America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe, Cantu reports that nearly four million sports and recreation-related concussions are sustained each year, and “…many times that number” go unrecognized (Cantu, 2012, p. 2).

Concussions in sports happen when an athlete is “…slammed and makes sudden and forceful contact” with the ground, a court, a pool deck, a batted or thrown ball, a kicked ball, and “…of course with another player,” Cantu explains (p. 3). A concussion can occur without any contact with the head, Cantu asserts. The “whiplash effect” is when a player’s body makes sudden and violent change in direction and speed; the “…brain shifts in the cerebrospinal fluid” and slams against the inside of the player’s skull (Cantu, p. 4).

There are two types of accelerations that cause concussions, Cantu explains. The first is “linear,” like the force when a car crashes into a tree. The driver’s head snaps “violently” at the moment of impact. The second type is “rotational”; for example, a football player runs from sideline to sideline and a “hard-hitting defensive player…makes a crunching tackle from the side” (Cantu, p. 4). The collision causes a violent whip of the ball-carrier’s head to one side. In this jolt, the brain contacts the skull and it is likely an injury can occur is the collision is violent enough (Cantu, p. 5).

Concussions trigger a “complicated chain of chemical and metabolic reactions,” which causes the brain to temporarily lose its ability to “…regulate, to transmit signals, and to send messages that control how we think and what we remember,” Cantu continues (p. 6). Hence, the brain goes into an “overactive state” of “hyper-alertness” which means it releases chemicals that communicate to cells in a “disorderly way” (Cantu, p. 6). Symptoms include: headaches, nausea, vomiting, problems with balance and vision, dizziness and sensitivity to light and noise; sadness and depression may also occur; sound sleep may be interrupted; and there may be difficulty in concentrating and in short-term memory (Cantu, p. 8).

Statistics on Traumatic Brain Injuries (TBI) / Concussions

The Centers for Disease Control and Prevention reports that between the years 2001 and 2005, an estimated 207,830 individuals visited emergency departments in the United States due to concussions and other TBIs that were linked to sports and recreational activities (CDC, 2011). Of those 207,830 patients, 65% of them were children between 5 and 18 years of age, the CDC reports. In fact younger people are more at risk for TBIs than adults are, and according to the National Electronic Injury Surveillance System (NEISS), between the years 2001 and 2009, an estimated 173,285 individuals under 19 years of age were treated for “nonfatal TBIs” that were connected to sports activities (CDC). The highest rates of TBIs occurred to male sports participants between the ages of 10 to 19 years, CDC reports.

As to what kinds of sports activities injuries occurred in, recreational injuries were most often “…bicycling, skating, or playground activities” (swing sets, in-line skating, bikes); and of the 453,655 emergency department visits for young people, 36,230 were head trauma injuries (CDC). Overall, the greatest number of visits to the emergency room that were TBI-related were from bicycling, football, playground activities, basketball, and soccer. Ten percent of those trauma injuries resulted from horseback riding, golfing, tobogganing and sledding, and all-terrain vehicle riding (CDC).

Professional Football and Concussions

Authors Mark Fainaru-Wada and Steve Fainaru published a book called League of Denial, in which the authors assert that former NFL Commissioner Paul Tagliabue had instituted a research body called the “NFL’s Mild Traumatic Brain Injury Committee,” that claimed NFL players were “impervious to brain damage” (Fainaru-Wada, 2013). An excerpt in ESPN the Magazine pointed out that apparently the physicians that the NFL used to research concussion problems in the NFL were not objective, and in fact the NFL has covered up the facts. Interestingly, an investigation (Frontline and ESPN) found that the NFL Retirement Board awarded disability payments to at least three former players “…after determining football caused their brain injuries.” Why is this relevant? Because the top medical experts in the League have denied links “between professional football and long-term brain damage” (Fainaru-Wada).

What are the facts as to concussions in the NFL? According to the Public Broadcast Service (PBS), 160 NFL players suffered head injuries in 2012. By collaborating with ESPN’s “Outside the Lines,” PBS has revealed that the NFL averaged 8.4 concussions per week in 2011; in 2010 the NFL reported 7.6 concussions per week; and in 2009, there were a reported 5.4 concussions per week. The head injuries reported in the 2012 season was on pace to “increase more than 9% from last year, to nearly 9 per week” (Fainaru, et al., 2012). In all, 160 NFL players were diagnosed with concussions (head injuries) in 2012 (Breslow, 2013).

The sad part of these injuries is that not all teams pay close enough attention to players with head injuries. For example, Breslow reports in a PBS article, Detroit Lions’ receiver Calvin Johnson took a helmet-to-helmet hit in a game against the Minnesota Vikings. The attack was by linebacker Chad Greenway, and Johnson was tested during the game for a concussion but was sent back into action. The Lions had a week off after that game with the Vikings, but “…Johnson was not listed on the injury report. Johnson later told the media that he had three concussions, but he kept on playing; “You get concussed, you gotta keep on playing,” he said. The Lions stated that “Calvin did not suffer a concussion at any time this season” (Breslow).

Prevention and Testing for Concussions

Athletic departments in universities have sought objective, science-based research on concussions, and are trying to find the “…right balance between prevention and properly diagnosing head injuries” (Van Valkenburg, 2012). For example, at Virginia Tech, the school has created the Department of Biomedical Engineering, which has outfitted football players with sensors in the helmets in order to “…measure the number of collisions they are involved in,” as well as the severity of those blows (Van Valkenburg). This is seen as a trend in major college football, and could well help players avoid serious head trauma. “We know every single head impact that has happened to all of our football players in the last ten years,” said Stefan Duma, the engineering professor who is head of the Biomedical Engineering Department.

Meanwhile, Pop Warner football has changed its rules so that contact will not be permitted “…for two-thirds of each practice,” so that young players will not be slamming into one another nearly as much during practice (O’Connor, 2012). Pop Warner officials believe this rule change will “…eliminate 60-plus percent of brain impacts or concussions” (O’Connor).

In conclusion, the NFL and youth sports leagues are struggling with how to reduce the number of concussions, but there are still a dangerous number of hits that players receive. What can be done? The Virginia Tech program is very positive and forward-looking, and should be followed by other universities and even high school sports programs.

Works Cited

Breslow, Jason M. “NFL Concussions: The 2012-13 Season in Review.” PBS / Frontline.

Retrieved November 13, 2012, from http://www.pbs.org. 2013.

Cantu, Robert, and Hyman, Mark. Concussions and Our Kids: America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe. Boston, MA: Houghton Mifflin

Harcourt, 2012.

Center for Disease Control and Prevention (CDC). “Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged <19 Years — United States, 2001-

2009.” Retrieved November 13, 2013, from http://www.cdc.gov. 2013.

Fainaru-Wada, Mark, and Fainaru, Steve. “Head-on Collision.” ESPN.com. Retrieved November

13, 2013, from http://espn.go.com. 2013.

O’Connor, Anahad. “Trying to Reduce Head Injuries, Youth Football Limits Practices.”

The New York Times. Retrieved November 13, 2013, from http://www.nytimes.com. 2012.

Van Valkenburg, Kevin. “Game-changers off the playing field.” ESPN.com. Retrieved November 13, 2013, from http://espn.go.com. 2012.