Monthly Archives: February 2013

Concussion and Sports

By now most of you have heard, seen, read, or experienced personally or in the family the head injury we clinically refer to as concussion. A concussion is generally defined as an injury to the brain that can result in temporary loss of normal brain function. Such functions can include orientation, alertness, judgment, information processing, processing speed, attention and memory. Concussions can, but do not need to involve a loss of consciousness.

Some estimates are that more than 300,000 sports-related concussions occur annually in the United States, and that there is a 19% per year of play likelihood of sustaining a concussion. High school sports yield about 60,000 concussions each year and among college players 34% have had one concussion and 20% multiple concussions. Suffering one concussion increases the risk for that person to incur a second concussion and this is particularly true for football.

Estimates are that between four and twenty percent of college and high school football players will sustain a brain injury over the course of the season. Nearly 60% of college soccer players reported symptoms of a concussion at least once during the season. Concussion rates are comparable for soccer and football. Concussions also occur in non-sport activities such as automobile, biking, sledding, and falls around the home.

Implications for Health

There is no good reason to strike your head and brain. That is a simple, yet important statement for any person at any age. A concussion not only leads to a higher risk for another concussion, it also correlates with depression, impulsivity, and even dementia later in life. We are bombarded now with reports of football players suffering dementia from sustained head injuries clinically referred to as chronic traumatic encephalopathy (CTE).

On a practical level, if your brain is damaged your ability to conduct basic daily activities such as driving, school work, sports, employment, and relationships may be limited. Our life as we had known it will likely be changed and the more severe the brain injury or concussion, the more limited we will be. This is devastating at any age, but it is particularly unfortunate for young persons who may not have even entered the work force yet.

Practical Ideas to Consider:

I am the father of three boys and I was raised and live in Pittsburgh Pennsylvania where football is second only to God! I want to provide you this context because the following ideas are not only difficult for me to express, they will be difficult for many to process. However, I work as a neuropsychologist and after 20 or more years of witnessing the consequences of brain injury I cannot be quiet:

  1. Communities should agree (not be legislated) to remove all tackle football for any child below the 11th grade. It is one thing to have ongoing discussions about the NFL and concussion, it is something completely different for our support of 6 and 7 year-olds dressing up with helmets and being instructed to “hit hard.” I refer to this as “organized stupidity.”
  2. All elementary schools should agree to provide curriculum on the basics of the human brain, how to keep it healthy, and what is not good for the brain.
  3. For those children who wish to play football prior to the 11th grade, flag football should be used.
  4. For those in the 11th grade who wish to play HS football, all schools should seek training and consultation of proper methods of play from college and professional coaches.
  5. All players in all sports, beginning at early ages, should undergo baseline assessments for brain integrity (Impact Test). This will provide important data on that child if a head injury occurs. All players should also be informed of proper lifestyle to help boost the health of their brain (see www.paulnussbaum.com).
  6. For those players who do play tackle football in the 11th grade and later, advanced equipment should be used and severe penalties should be extended to those who strike the head.
  7. For all sports, proper headgear should be used. I encourage all soccer, baseball, hockey, biking, basketball, etc. athletes to use some form of protective headgear or headband prior to setting foot on the field. The same is probably true of gymnastics, cheerleaders, and dancers.

It is my opinion that we are a great nation that should be more enlightened than our behavior suggests at times. I am not a proponent of legislating behavior change. We still have our rights and anyone has the right to be stupid! However, I think communities across the world and within school districts can have reasonable discussions that foster policies intended to protect our brains, particularly our young brains!