Concussion-ology

Time to Re-Define An Emerging Field

Athletes, young and old, are struggling with concussions and effects of mild traumatic brain injury, often whether they realize it or not. The modern sports culture is colliding with neurological intelligence, forcing athletes to decide between getting more ‘game-time’ or preserving a healthy brain.

Today’s athletes must become aware of blank stares, confusion, memory loss and other symptoms, which we will explain in this book, because these symptoms may lead to significant problems in the future. Yet the sports culture that breeds “toughness,” hopes for scholarships and professional big-time income may be pulling the wrong end of the tug-of-war. Because in the end, the wealth that lures many young athletes is not worth the cognitive and emotional consequences that could impede a happy, healthy life.

But the athletes aren’t alone. Parents, coaches, athletic trainers, league officials and virtually everybody else involved with supporting athletic development are grasping for answers to what can be done to assure athletes avoid the dangerous risk of short- and long-term cognitive and emotional impairment resulting from concussions.

Concussion incidence rates are much higher than most realize, with many athletes in contact sports experiencing a concussion more often than they actually report. The Center for Disease Control (CDC) estimate more than 3 million concussions occur every year in the United States. If we calculate all the hits in practice, hits off the field, jarring falls, whiplash affects from driving accidents, even falls as a child, the incidence rates far exceed what we can estimate.

The growing number of lawsuits by former players in the National Football League (NFL) and National Hockey League (NHL) have brought concussions and brain trauma to the spotlight in recent years. The trickle down has affected the NCAA, and inevitably will reach the high school and youth league levels. Like dominos, a trail of repercussions have followed, including daily news reports about concussions, states establishing concussion education laws, documentaries have been filmed, and the scientific community has a new frontier to discover. This has caused a rapid convergence of consensus statements and guidelines regarding the management of sport related concussions to be written, forcing the sports world to reexamine their knowledge about the brain and how to protect it.

Still, questions remain about how the sports world will effectively manage concussions moving into the future, and equally important began to change it’s culture.

I would love to be able to say that gone are the days that we call a concussion a "ding" or "getting your bell rung.” Although respected organizations such as the National Athletic Trainers Association (NATA) have put forth guidelines calling for an end to references like these which minimize the serious nature of concussion injury, these references still permeate throughout our society. Dizzy athletes are told to "walk it off" by their coaches. The crowds in the stands and stadiums cheer as the clearly injured athlete returns to the field. Athletes fail to report their symptoms for fear that they will not be allowed to play. Team doctors push pills to mask the symptoms in professional athletes. In the end, it is the athlete's brain that suffers from mismanagement of the concussion injury due to this minimization. Risks of prolonged symptoms, long-term impairments of memory and thinking, emotional consequences and early dementia seem to be blocked out of the picture as the injury is minimized. There must be a cultural shift in the sports world to prioritized brain health over gameplay in order to correct this phenomenon.

Unfortunately, parents and coaches aren’t typically well-versed in brain matters. And, the sports therapy and athletic trainer industries have been strapped with outdated learning and inconvenient tools and techniques.

The phrase “concussion management” is emerging on the sports front at all levels, yet it is still a relatively new concept leaving most sports teams with the task of piecing together various materials, tests and tools to create protocols that helps prevent, detect and protect athletes from significant brain damage. The heightened awareness has created a void for a single reliable and practical source of information that provides expert guidance.

That’s why it’s time for “Concussionology” and to redefine best practices for an emerging new field in sports and science.

As a cognitive neurologist, I’ve specialized in concussions, and particularly the behavioral alterations associated with brain trauma. After nearly 25 years studying the brain and treating hundreds, perhaps thousands, of concussions, I’ve seen a gap between what happens on and off the field, and what doctors and scientists know about these mysterious, elusive concussions I call “brain sprains.”