This is Your Brain on Sports, Any Questions?

April 22, 2010
by Justin

Having suffered my fair share of concussions in my life, I can tell you first hand when suffered concussions should never be dismissed and should be given priority when treating them. Obviously there are variants degrees of concussions, which can range from a bump on the head to full blow amnesia and hemorrhaging. Defining a concussion is not what is important, but rather knowing what causes it is. The Mayo Clinic states, “Your brain has the consistency of gelatin. It’s cushioned from everyday jolts and bumps by the cerebrospinal fluid that it floats in, inside your skull. A violent blow to your head can cause your brain to slide forcefully against the inner wall of your skull. Even the sudden stop of a car crash can bounce your brain off the inside of your skull. This can result in bleeding in or around your brain and the tearing of nerve fibers.” When you put it like that, geez! The reality is, athletes today are bigger, stronger, and faster and the growing number of facial and head injuries has risen considerably. Research is still relatively new and understanding the complications that result from concussions is still being explored.

One of the most poorly understood complications is what the Mayo Clinic calls, post concussion syndrome. When such an instance occurs, symptoms can persist for weeks or even months. While some have theorized that another syndrome exists called Second Impact syndrome. Of course this doesn’t go without controversy as to whether or not it exists. It is thought though, that such a condition could have “potentially catastrophic consequences” assuming a second injury would occur prior to a full recovery, which ultimately could lead to death. Athletes who have had concussions also run the risk of other more severe injuries including seizures, cervical spine injuries, skull fractures and/or intracranial bleeding.  Additionally, those athletes who have had multiple concussions could potentially develop epilepsy within the first five years after injury. And it gets worse, for those who have suffered multiple head injuries over the course of their athletic careers or even lives, run the risk of serious cumulative neurological damage. It has been suggested by some doctors that there is a link between multiple concussions and dementia, or better known as Alzheimer’s disease.

So what can you do when you think you have suffered a concussion? Personal experience has taught me to rest, and I was always told to have somebody to monitor your first night of sleeping. I have also been told, and confirmed by the mayo clinic, to not take aspirin and/or ibuprofen (i.e. Advil) but rather take acetaminophen (i.e. Tylenol). If you truly have a concussion then anti-flammatories could cause an increase in bleeding which will only increase the severity of the injury.

“According to the Centers for Disease Control and Prevention, 20 percent of the brain injuries that occur yearly in the U.S. can be attributed to athletics. That is more than 300,000 concussions! High school, college and amateur athletes receive most of these injuries, because there are so many more of these players than there are pros.”  There are an estimated 62,800 concussions annually among high school students nationwide, according to an article published by the Capital Sports Injury Center.

In a report published by the NCAA Injury Surveillance System (ISS), from 1988 to 2004 concussion injury rates increased an average of 7 percent annually in all sports, including football. In fall 2004, 3.4 out of every 1,000 student-athletes who stepped onto a football field suffered a concussion. However, the concussion rate dropped significantly in 2005 to 2.4 per 1,000 football players as it was the first year since the NCAA implemented a new rule preventing spearing and head-down contact.

On the contrary, a study by the National Athletic Trainers Association showed head and facial injuries in basketball increased by an annual average of 6.2 percent from 1988-2004. Concussions represented 3.6 percent of all injuries reported. Women basketball players were three times more likely to get a concussion than men, as reported by the Associated Press. There game has seen the demand for bigger, faster and stronger players. The number of Division I players 6-foot-9 or taller increased from 649 in the 2000-01 season to 681 in 2008-09, according to STATS Inc., and they tend to be a bit more filled out than before. Some believe the sport is changing into a more physical game.

While football has seen a steady decrease in the number of incidences since 2004, inversely basketball has seen a steady rise in concussions. But overall this is an issue that is facing a lot of sports whether it’s considered a “contact” sport or not. As published in the NCAA Handbook, and reported by the ISS, during 2000 to 2002 in which sports had a rate of concussion fall between 6.4 and 18.3 percent of the total injuries were as follows:

  • Football was 3.1
  • Men’s Ice Hockey 2.4
  • Men’s Wrestling 1.6
  • Men’s Lacrosse 1.4
  • Women’s Ice Hockey 2.4
  • Women’s Soccer 2.1
  • Men’s Soccer 1.7
  • Field Hockey 0.8
  • Women’s Lacrosse 0.8
  • Women’s Basketball 0.7
  • Men’s Basketball 0.5

In addition, according to a study done by the Journal of Athletic Training, “collegiate athletes whom are highest at risk for suffering a concussion were; male and female lacrosse, male and female soccer, and female basketball players. A possible explanation may be attributed to the nature of each sport. For example, soccer does not involve intentional collisions between players; however, incidental collisions occur frequently. In addition, soccer players are often required to “head” the ball, but occasionally they miss the ball and strike their opponent’s head. Although male lacrosse players are required to wear helmets, the higher incidence of concussions may be the result of their style of play. For example, male lacrosse players are permitted to make body contact with their opponents, which may result in a concussion. Female collegiate lacrosse players are not required to wear a helmet because the sport is classified as noncontact. However, unintentional collisions with opponents’ heads or sticks may contribute to the high incidence of concussions. Concussion is the second-most frequent injury in fall football and women’s soccer, and the fourth-most frequent injury in field hockey, men’s soccer and women’s volleyball.”

Lastly, some additional points illustrated in the ISS fall report were as follows:

  • Concussions are the second-most frequent injury in fall football and women’s soccer, and the fourth-most frequent injury in field hockey, men’s soccer and women’s volleyball.
  • Concussions account for 7.2 percent of game injuries across the five fall sports and 4.7 percent of injuries suffered during practice.
  • Of every 1,000 student-athletes who take the field in any given competition, 2.7 suffer a concussion in football, compared to 2.1 in women’s soccer and 1.1 in men’s soccer.
  • Concussions during competition accounted for about 11 percent of injuries in women’s soccer, 9 percent of injuries in field hockey, 6 percent of injuries in football and men’s soccer, and 4 percent of injuries in women’s volleyball.

So what is being done to reduce the amount concussions across all sports? To start, the NCAA Football Rules Committee passed and implemented new rules to eliminate hits on defenseless players and blows to the head, including a ban on hitting an opponent with the crown of the helmet back in September 2009. The NCAA has also gone on to change the guidelines on players returning from a concussion in which it emphasizes “it is essential that no athlete be allowed to return to participation when any symptoms persist, either at rest or exertion,” and details circumstances in which a student-athlete should be withheld from competition pending clearance by a physician. And more specific they added points of emphasis to the basketball rule book for the 2009-10 season to curb excessive elbow swinging and to allow officials to stop the clock when someone gets hurt. More over they have concussion guidelines that apply to every sport and has asked each playing rules committee to look at ways to further decrease the number of head injuries.

But is this enough?

Today there is such an increased amount of importance and pressure put onto these college programs to perform and we need to make sure that the student athletes’ well being is not compromised. Depending on the severity of the concussion a student-athlete can miss much of the regular season. Data collected by certified athletic trainers at NCAA institutions, count injuries causing a student-athlete to miss at least one day of competition or practice. They indicate that football and women’s soccer student-athletes who suffer a concussion are missing an average of six days of competition and practice, while men’s soccer and women’s volleyball student-athletes miss an average of five days and field hockey student-athletes miss four days. And we are just assuming these student athletes have reached the status of full recovery. Treatment and research is still relatively new in the sports world but efforts are being made to reduce the amount of occurrences and long term repercussions for those student athletes whom are involved with them. I am guessing like many, one of the biggest concerns is how can we protect the student athletes but also protect the integrity of each sport?

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