No Fun In Concussion

If you were watching football or sports highlights last Sunday, chances are you saw the vicious hit that Philadelphis Eagles’ wide receiver DeSean Jackson suffered.  While running full speed in one direction, he was hit on the chin by an opposing player (helmet to helmet) who was running at full speed in the opposite direction.  Jackson’s head snapped back and he crumpled to the turf lying nearly motionless in what looked like a “decorticate” posture.  A decorticate posture is the result of a severe brain injury causing flexion of the arms, wrists and hands.  Jackson ultimately was able to stand up and leave the field under his own power, but he will miss at least one game and likely more.  It seems the numbers of these types of hits and resulting injuries are increasing in the NFL.  In an effort to curb the frequency of helmet-to-helmet hits that result in concussion, the National Football League (NFL) has instituted a stricter enforcement for helmet-to-helmet hits to include suspensions.

Some players are actually complaining about this.  There may be some legitimacy in the sense that some helmet-to-helmet hits are unavoidable.  From interviews I’ve heard, however, some players feel that these hits are a natural part of the game and that stiff penalties for them will result in diminishing the “purity” of the game.  I even heard one player say, “We might as well wear skirts.”  He continued that the NFL is a “hitting” league, not a “ladies” league.   Besides being completely offensive, what a bunch of macho -pardon the expression- BS!  I understand that football players are brought up from Pee Wee league on to show no fear or pain, and they are supposed to hit as hard as possible, but who is teaching these players that concussions can result in permanent brain damage?  This is especially true for players who suffer multiple concussions.  And who in the NFL does not have a concussion?  I got a nice laugh out of the title of a recent article from “The Onion” which is a paper that prints satirical fictitious articles; “Report: 3 Players In NFL Currently Do Not Have Concussions”.

In all seriousness, concussions are not a joke.   Basically, a concussion is a bruise to the brain.  Most concussions result in what is known as a “shearing” injury in which axons (nerve cells in the brain) are damaged.  This damage interrupts connections between cells and sometimes results in cell death.  The areas of the brain that are often affected by concussion include the hippocampus (memory), frontal lobes (attention, planning, and judgment) and temporal lobes (emotion).  Concussions are generally graded from “mild to severe”, depending on the time of unconsciousness and/or memory loss.  Common symptoms following a concussion include sleep disruption, irritability, difficulty with short-term memory, attention problems, headaches, and mood changes.   Most people will recover fully after a concussion, but up to 15% may suffer long-term and permanent problems.  Often changes are subtle and may even be difficult to attribute to the brain injury.  This may result in frustration for the victim and his or her loved ones.  

In order to maximize healing, a person who suffers a concussion should get plenty of rest and should avoid any drugs or alcohol.  Stress should be eliminated when possible and activity re-introduced slowly.  Often light exercise can enhance healing.  A person who has suffered a concussion should not play any kind of contact sport until it is clear that there is no evidence of symptoms from the concussion.   In other words, if you are a football player, do NOT rush back to the field as fast as possible to prove how tough you are.  We know you’re tough.  Thank goodness football programs at all levels are realizing the magnitude of this problem and are holding athletes out (much to the athlete’s chagrin of course).

Concussions are not just a problem of football players.  They affect millions of people in the United States each year with estimates of 250,000 suffering ongoing complications.  This is a brain injury we are talking about here, not a hang-nail.  You only have one brain and it does not like to get hurt.  The brain is one of the, if not THE most complicated structures on the planet.  It therefore takes a very long time to heal and, despite advances, there is still a long way to go in terms of understanding the brain and how to optimize the healing of an injured brain.  My feeling is that the best way to deal with a concussion is to prevent a concussion.  Wear helmets and mouth-guards (when applicable), wear seat-belts, avoid using your head to hit other people’s heads, and avoid situations that could lend themselves to a brain injury (examples of these are plentiful in the “Jack-Ass” movie series).

I love football.  I love the athleticism, the speed, the power, the competitiveness.  It is no surprise that it is the most popular sport in this country.  However, I have to take the side of the NFL brass in their decisions regarding helmet-to-helmet hits.  With this, I ask the players the rhetorical question: Can’t you preserve the integrity of the game without putting so much risk to your elegant, not well understood, one-of-a kind, very sensitive and, definitely useful, brain?

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