Chris Berryman

Sport in Modern Society

Concussions in Sport: An Analytical Discussion

“I had no idea what a nickel was (Kevin Kolb, The Concussion Blog).” NFL quarterback Kevin Kolb has suffered three major concussions since 2010 (Galliford, Buffalorumblings). His most recent one just this past August effectively ended his football career. This is just one example of the many in which multiple or severe concussions have cut short careers in sports.

The issue of player safety in sport has become a topic of controversy and debate in recent years. Many professional leagues such as the NFL and the NHL have adopted strict concussion test protocols and procedures for its players. Player safety has no doubt become a major concern in contact sports. The problem is, many of these regulations have yet to address what happens after playing careers are over. What happens to former players’ mental and physical health after they retire? How do players whom have suffered multiple concussions playing contact sports live their lives as opposed to players whom have played non-contact sports such as golf or baseball?

What will be questioned in this analysis is do known players that have suffered multiple and/or severe concussions throughout their playing careers due to playing a contact sport develop abnormally high levels of mental and physical health problems at an early age? Previous history on the attempts to lower the frequency of severe injury and concussions have shown advances in equipment and medicine.

In the middle of the twentieth century, players participating in contact sports such as football and hockey rarely wore any protective equipment. Due to the increased violence of these sports over time, advances in equipment were made to increase player safety. Although many critics argue that these advances in equipment have shown a statistical drop-off of major injuries, other studies have found that many players have been given a false sense of security wearing safer equipment (Stankovich, The Sports Doc). Players’ have been prompted to play at an even more dangerous level causing more violent collisions. A particular study on the long-term effects of concussions occurred in 1994 when sports agent Leigh Steinberg led multiple conferences for current NFL players about the dangers of concussions. Two main goals of these conferences was to one, inform players about the “causation, long-term impact and the potential ways to alleviate the whole specter of concussions (Steinberg, Frontline Interviews).” Secondly, to see if a standardized regimen of diagnosis and treatment could be made (Steinberg, Frontline Interviews). These conferences did spawn new areas of research but nothing was really changed during that time. In 2006, another conference was called invited members of the media and included many distinguished researchers and doctors that had done numerous studies. The studies did conclude that multiple concussions appeared to indicate a higher rate of dementia, premature senility, ALS, Parkinson’s, Alzheimer’s, and elevated rates of depression (Steinberg, Frontline Interviews). A new pattern called chronic traumatic encephalopathy or CTE was also discovered that showed a behavioral curve that led to depression, loss of job, loss of family, and in some cases suicide (Steinberg, Frontline Interviews). Studies done in high schools also showed a greater risk for potential damage in high school football athletes and showed lower test scores for kids who headed the ball in youth soccer (Steinberg, Frontline Interviews). A study done by the American Association for the Advancement of Science in 2012 concluded that damage to the brain caused by concussions can last for decades (Norqvist, Medical News Today). “There is abnormal brain wave activity for years after a concussion as well as a partial decay of the motor pathways which can lead to significant attention problems (Norqvist, Medical News Today).” Among older athletes, the lingering effects are even more of an issue. A 2012 study compared healthy athletes of the same age who suffered a concussion 30 years ago. The results showed that those that experienced at least one concussion had symptoms similar to those of early Parkinson’s disease as well as memory and attention deficits (Norqvist, Medical News Today). Recently, these studies have helped to increase awareness of the possible complications of concussions. A college football player study was conducted by ESPN the Magazine in 2012 surveying 320 senior players asking them about concussion-related issues. The first question was, “Is a good chance of playing in the NFL worth a decent chance of permanent brain damage as a result of concussions (ESPN the Magazine)?” 54% said yes they would take a chance (ESPN the Magazine). The second question was, “Your star player is concussed in the state title game. Would you rather lose as he sits out or win because he keeps playing (ESPN the Magazine)?” 51% said they would want their teammate to keep playing (ESPN the Magazine). A 2013 study by Steven Flanagan showed that upwards of 15% of all individuals whom suffer at least one concussion will develop chronic long-term health problems. These same individuals suffer an, “actual shrinkage of the brain compared to people whom have not suffered past concussions (Flanagan and Flatow).” Flanagan goes on to say that helmets and protective equipment only protects the skull and not the brain because the brain is floating in cerebrospinal fluid. The brain can still get jerked back and forth (Flanagan and Flatow). Another study performed by the New York University Langone School of Medicine found that out of 28 MTBI patients with post-traumatic symptoms, 22 of them showed measurable global differences in brain volume (Grush, FoxNews). It also found structural damages to regional areas of the brain. To further enhance the reasoning behind the hypothesis that concussions can cause serious health issues at an abnormally high rate in former athletes, statistical research has been conducted. Concussion statistics for high school sports concluded that athletes between the ages of 16 to 19 sustain 29% of all sports-related concussions (Barton, Moms Stream). Nearly 15% of all sports-related high school injuries are concussions (Barton, Moms Stream). Since 1997, concussion rates in high school athletics have increased by 16% annually (Barton, Moms Stream). High school football is consistently shown in studies to be the sport with the greatest number of concussions with an average rate of 52% (Barton, Moms Stream). 11% of all high school athletes have suffered multiple concussions (Barton, Moms Stream). A study of college and professional athletes have found that concussion numbers in these sports are generally lower than in high school sports. 37% of all college athletes whom have suffered a concussion play football (NCAA Sport Science Institute). 2.5 concussions are reported for every 1,000 game-related exposures (NCAA Sport Science Institute). According to the NCAA, concussion rates in college sports has remained steady over the past eight years (ESPN, 2012). In professional sports, concussion rates have actually shown minor decreases over the past few years. In the NFL, there were 190 reported concussions during the 2010 season which was down 12.5% from the previous year (USA Today). In the NHL, 128 concussions were reported during the 2011-2012 season which was down 9% from the previous season (USA Today). In the NBA, there were 12 reported concussions during the 2011-2012 season which was down 5% from the previous season (USA Today). In the MLB, there were 13 players put on the concussion DL which was an increase from 11 the previous season (USA Today). Based upon these findings, I decided to conduct my own survey of former contact sport athletes. I surveyed 10 former athletes ranging between the ages of 19-55 whom have played no less than 2 years and a maximum of 15 years of any major contact sport (football, soccer and hockey). Some individuals have played strictly park district sports while others have played as many as 5 years of college sports. I asked four survey questions which included the following: 1.Would you play your sport again even if you knew of the risks associated with concussions today? 2. Would you allow your children to play the same sport knowing the risks associated with concussions today? 3. How many known concussions have you had playing your sport? Each individual could answer by saying none, 1-2, 3-4, 4 or more. 4. Do you feel like concussions have affected your life today? This was only asked to those individuals whom have suffered a concussion. The results of these surveys produced these results: 1. Would you play your sport again even if you knew of the inherent risks associated with concussions today? 9 said yes and 1 said no. 2. Would you allow your children to play the same sport knowing the risks associated with concussions today? 6 said yes and 4 said no. 3. How many concussions have you had playing your sport? 4 said 1-2. 3 said none. 2 said 4 or more and one said 3-4. 4. Do you feel like concussions have affected your life today? 5 said no, 1 said yes, and 1 said they didn’t know for sure. Looking at the percentages, 90% of those surveyed still would play their respected sport even knowing the risks of concussions. 60% said that they would allow their children to play the same sport knowing the risks of concussions. 70% of those surveyed have suffered a concussion while playing their sport. Of those 70%, 71% said that their lives have not been affected by concussions. Only 1 out of 7 or 14% said that their lives have been affected. In the ESPN the Magazine survey, almost half of the students surveyed apparently believed that concussions are a serious issue and that a persons’ health is more important than a game or career. In the survey that was conducted in regards to this paper, 60% of those surveyed wouldn’t allow their children to take part in major contact sports but 90% would still play the game they played even knowing the risks of concussions. Of the seven former athletes surveyed that said they suffered at least one concussion during their careers, only one knew for sure that his life was currently affected as a result of concussions. This differs from the results of New York University’s findings that found a higher percentage of individuals with signs of long-term health problems due to concussions. Steven Flanagan’s study, however, found similar results with about 15% of all concussion patients being affected with chronic health issues. The results are pretty accurate with each other in regards to the increased awareness of current and former athletes of concussion-related outcomes. The ESPN survey showed an increased in the percentage of college athletes that thought that any game became trivial to one’s own health. This ideology becomes clear when a rather elevated amount of former athletes that were surveyed for this topic, 60%, said they wouldn’t allow their children to play the sport that they played. In closure, the results of the survey mostly do compare with the findings of previous studies. There are some explanations as to why these studies compare very well with each other. One being that athletes are so passionately involved in their respected sports that the risk of concussions are pretty much obsolete to them. They may feel as though the inherent risk of major head injuries are just an uncontrollable part of the game. Another explanation would be that the results are finding that more current and former athletes are becoming increasingly aware of the dangers of concussions. The increased number of high school athlete concussions may exemplify this awareness as team trainers, doctors, and coaches have been more inclined to diagnose and treat concussions due to an elevated level of preparedness. This may have not been the case in previous generations. A third explanation would be that a large percentage of former athletes (40%) whom have children or want to have children don’t want their children exposed to the risks of concussions because they want to be over-protected towards them. They don’t want to see their own children succumbed to the increasing threats of concussions and major injury. Most believe, however, that the benefits of these sports outweigh the risks. Can anything be done to decrease the amount of concussions suffered as a result of violent collisions in sport? “Fear is not the problem, physics and biology are the problem (Hruby, sportsonearth.com).” The inherent risks of playing contact sports are part of the game. A helmet can protect the skull but not the brain. What needs to be done is a continued emphasis on the education of brain injuries and how they relate to future health problems. It should be mandatory for any athlete whom chooses to play any contact sport to sign a contract or wavier specifically addressing the risks involved playing the sport. Another option would be to adopt state laws requiring players who show signs of a concussion be removed from games or practices and not be allowed to return until he or she is seen by a health professional and cleared of all symptoms. “Of course, there’s a problem with set laws. How do you spot concussions in the first place? Self-reporting is unreliable (Hruby, sportsonearth.com).” Most coaches, trainers, and players themselves are mostly unaware of any mild concussion symptoms simply because some players may not realize they have one. Another problem is that in most middle schools and high schools, athletic trainers are few and far between. Every school team needs to have an athletic trainer. If a school can’t afford one then obviously they can’t afford to have a team anyway. “In light of what we now know about concussions and the brains of children, though, many sports should be fine-tuned (Cantu, New York Times).” While the risks at higher levels are pretty much unavoidable, mandated changes in the way games are played at the youth level can decrease the risks of head injuries. Rule changes in major youth sports can take into account protecting the head and the brain from head trauma. One major change should be the elimination of heading in soccer until the high school level. Requiring the use of chinstraps on all youth baseball and softball helmets should be mandatory as well as the elimination of head first slides. Not much can be included to induce head trauma in football but continued education of proper tackling and running techniques can help to reduce head injuries. At higher levels of sport, awareness and education are two keen points in helping to reduce concussion rates. Rule changes can also be taken into account. The problem with rule changes in college and pro sports is that these rules can take away from the overall persona of these sports. The NFL, for example, has set new rules to help alleviate violent collisions in the sport. The kickoff was moved up 5 yards so players on the kickoff units wouldn’t be inclined to hit as hard. Any hit to the head of any player is considered a penalty and severe blows to the head of any player often includes a hefty fine and/or a suspension to the culprit. Yes these rules do indeed create a safer environment for the players but head hits are still very prevalent. Many players and fans have complained recently that the game is being watered-down because of these rule changes. That’s where more of a balance should lie. Players should be educated enough to make their own decisions about the perceived dangers of playing such a violent sport. Athletes will continue to become bigger, faster, and stronger due to advances in equipment and medicine. In turn, violence in contact sports will become even more rampant leading to an unfortunate increase in head trauma. The comparison of previous studies to the survey taken for this study have concluded that while many more current and former players are becoming increasingly aware of both the short-term and long-term effects of concussions, most would not stop playing solely because of this risk. Concussions are still being studied. A lot is still unknown about how they are officially diagnosed, what the exact means of treatment should be, and how long a player should really be sidelined when diagnosed. These risk factors are an important factor in the future of society’s sport specific culture. Will more and more people succumb to the dangers of concussions and play other sports? Will rule changes eventually cause major contact sports to become a hybrid of the original? Maybe even cease to exist? The answers may become clearer as studies about concussions continue to come out.

Bibliography

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