Lessons to Learn: Fighting for Football

“Like there haven’t been concussions in the last 100 years of sports.  Toughen up.  Quit looking for an excuse to sit on the sidelines.” [Comment on USA Today’s “Concussions now a hot issue as leagues toughen policies”]

In football, “pain” is considered “weakness leaving the body.”  It is a sensation that comes with pride and is the noted product of an individual own sacrifice of self to perform for the well being of the team he plays for.  The game itself revolves around the violence that defines football—a collection of organized aggression that is considered to be only accepting of the hard-nosed play of men.  If you can’t take a hit, then you might as well get off the field.  With violence comes expendability, where both characteristics of football blend to give it its beautiful but unforgiving persona.

So tell me what pain is.  Across the country, football players throughout all levels of play are taught the clear difference between being hurt and injured.  The aches, bruises, and cuts; this is when you’re hurt.  You can play through them, and one way or another, you or your coach will make damn sure that you play through them.  The muscle tears and broken bones, however, are clear to be defined as injuries, where slings, crutches, and casts are provided in relations of series of x-ray scans that prove that something is wrong with your body.  Here you are forgiven.  We’ll see you in a few weeks when you’re ready to go.  And as long as you stay true to your promise that you have dedicated yourself to this football program, then you will have your position on the depth chart back when you’ve shown the medical professionals that your body is in sufficient condition to play.

Now the real question is, what is a headache?  Sure, we’ve all played through headaches at one point or another throughout the course of our football careers, but did we ever stop to think about what it may be, or take the time to give ourselves a self-evaluation of our ability to continue playing at an efficient level?  Did we maybe forget being the huddle immediately as we placed our fingers on the line of scrimmage before the play began?  Did we fumble our words when calling an offensive or defensive play because we simply did not consolidate the routine signals or calls that our coaches have engrained in our minds since day one?  Did we ever come to forget the score of the game, or wonder how or why you were in on a certain play but not have the ability to recall making the tackle?

Headaches are not as if we are out of breath because we just ran forty-yards down field to bring a wide receiver to the ground before he reached the endzone.  No, that’s a normal bodily response to something that can be easily fixed with hydration and rest until you’re called upon for duty again.  A headache means that something is not right, and that maybe these headaches aren’t just because it’s hot, or that you’re frustrated.  Maybe these headaches are trying to tell you that the hits you’ve received to your head during the game are doing damage to your brain?  Maybe I shouldn’t have led with my head on that previous play, because I blacked out for a few seconds and can’t ignore the pulsating effect projected upon my skull.  I’m fine though; headaches have never stopped me from playing before.

And such a mentality of “shaking it off” when one is dealing with headaches during practice or in a game is found to be so prevalent throughout the spectrum of football.  Why is this so?  It’s clear that our friend from the comment posted on USA Today’s article entitled “Concussions now a hot issue as leagues toughen policies” has shown to us that headaches have always been a part of the game.  He’s made it clear that concussions have always been a part of the game.  And yes, sir, they have been.  It’s an inherent risk of contact sports, but is it right to label concussions—still today—as an excuse to sit on the sidelines?  I’m not sure if all of the research and publicity on concussions in sports that has led to the scrutiny of such activities is an accident, or make-believe.  The implications are real, but many have chosen to ignore it.  Many have chosen to ignore fact, and have submitted themselves to being fine with seeing headlines of children dying from second-impact syndrome because their coach chose to ignore their complaints of headaches, or because an athletic trainer was not present at the time, or because the deceased player—rather, the deceased child—chose to continue playing through his headaches because he didn’t want to miss the rest of the game.  And yes, many have chosen to dismiss the findings of chronic traumatic encephalopathy, a neurodegenerative disease of the brain that is linked to repetitive trauma to the head—a disease predominantly found in the professional athlete demographic.  Their downward spiral of depression, memory loss, poor risk assessment, and progressive dementia, which all ultimately led to suicidal attempts in some, had nothing to do with the years and years of neurological damage brought on to their brains for the sake of a game.

At a time when neuroscience is at its highest, we choose to suppress its findings.  We find more pleasure through damage than health.  Malignantly altered lives, for a quite real percentage of athletes, over protected and preserved athletic careers full of memories that one will not have to worry about forgetting of.

An important question to be raised in relation to this particular matter is: how did we come to be where we are today with regards to how we view concussions in football?  How is it that we lived in the “middle ages” of neuroscientific technology for so long, and how is it that some still choose to live in it today?  The most real, and most important thing to note, is that progress in neuroscience has been undeniable, and that medical fact and advancement should, and always will, outweigh popular stigma associated with concussions in football.  The injury’s implications are nothing to joke about.

The last five years have largely been considered the golden age for neuroscience.  Our understanding of the brain has leaped tremendously during this time frame and reached a point where our medical community has learned more about the most precious organ of the human body than ever before.  There has been advances of exponential significance in deciphering the microscopic activities of neurotransmitters’ roles in affecting regions of the brain, how collections or interconnected paths of neurons in certain regions of the brain correspond to our behavior, why such regions of the brain associate their functioning with capabilities for language, cognition, memory consolidation, muscular movement, and homeostatic maintenance, how we interpret our world through sensory-specific cells, how neurological deficiencies come to be, and why our brains come to develop known diseases and disorders such as Parkinson’s disease, Alzheimer’s disease, schizophrenia, and depression.

A desire to understand, and to adapt to the recent findings in neuroscience, has been quite limited in the sports community.  Why is this?  Today we have seen uproar at levels of football in response to recently publicized findings on short-term and long-term repercussions of repetitive concussions.  We’ve seen policies come down on the game that change the courses of play through further enforcement of penalties, new recovery guidelines, and even the appearance of lawsuits and coaching obligations.  All of this has contributed to what many perceive to be an undermining of the game’s integrity, where this century old game’s characteristics of violence and physicality have been threatened by “softening” means that aim to cripple the sport itself.  The very values of the game are threatened if you remove the violence, for all aspects of football are intertwined one way or another—that being the appreciation of the game in providing life lessons, character building, pride, determination, and unity.  Taking away the physicality is thought to be practically taking away the existential of the game.

But is that the case?  No, not at all.  Through the findings of neuroscience, we have found that mild traumatic brain injury to be a hidden issue in football—essentially labeled to be a crisis.  Sure, there have been concussions since the dawning of the game, but how much about the brain did we really know in the 1900s, the 1950s, and even the 1990s?  Not all that much, to be honest.  It took a generation or two of the game’s past for us to see the commonalities shared between NFL retirees in showing the neurodegenerative effects of repetitive head trauma across a lifetime.  And what did we find?  It has been found that chronic traumatic encephalopathy, characterized by the toxic build-up of tau protein in the brain that causes Alzheimer’s-like symptoms in one’s forties and fifties, has been limited to this population of NFL (amongst other professional sports) retirees.  Want to know the most frustrating statement in response to such a thing?

“They signed up for this.”

“This is a manageable injury.  I hear the perception out there that this is the boogeyman and there will be problems long-term for everyone that has a concussion.  I completely disagree with that.” [Dr. Micky Collins, UPMC Sports Medicine]

Today’s worry is with our parents.  Rather than encouraging the continuation of play in football, many seem to have taken the “rather be safe than sorry” route in completely removing their children from such programs.  Of course, concussions will always be the risk in playing such games, but not everyone will be destined for long-term damage if their injury is managed properly.  This is key.

Let’s say that Mike sustained a concussion during football practice, and that he immediately chose to tell his coach about this headaches he developed and received attention from the on-site athletic trainer right away.  Mike is then told to wait one week to be reevaluated for symptom presence and severity until he can return to any physical activity.  It turns out that Mike’s symptoms went away in about 8 days, and that he was able to return to play the following week.  He missed two games of his ten-game schedule, but was able to continue his football career all throughout high school to eventually make it on a college roster after he graduated.

Now Dave, on the other hand, received a concussion and blacked out for several seconds on the field during a game.  His teammates noticed something was wrong, but didn’t care to tell anyone, and despite having short-term memory difficulties on the field during the game, Dave continued to play the rest of the game.  The following Monday, which marked the beginning of the preparation for next week’s game, Dave received yet another blow to the head.  This time he fell to a knee, and eventually collapsed to become unconscious.  His coaches immediately called 911, only to find several hours later that Dave, at fifteen-years old, developed a subdural hematoma—bleeding on the surface of his brain.  Ever since that day, Dave has been unable to speak as properly as he once did, he has developed a sleeping disorder because of the alterations in his brain, and he did not graduate high school in time because of his severe cognitive struggles.

In high school football, and youth football, such a risk that results in the condition that Dave wound up in is real and is not to be dismissed.  Had Dave opted to see the athletic trainer after his concussion from the prior week, he may have gone on to fulfill a proud and illustrious career as a football player.  He would have gone on to live a life that was full of memories playing football, but now he can hardly remember the names of individuals he sees on a daily basis.

Again, the risk is real.  We have seen such traumatic instances occur in individuals such as Greg DiTullio, Max Conradt, Zach Lystedt, and many others.  We have seen the lingering effects of post-concussion syndrome, which ultimately marked the final days of athletic careers, for individuals such as Tracy Yatsko, Drew Fernandez, and John Gonoude, amongst a list of hundreds and hundreds of other student athletes.

So is it worth the risk to go back onto the field, knowing the implications of repetitive head trauma in a setting such a football-game environment?  Is it really an excuse to just sit on the sidelines, or is it rather a decision that will ultimately preserve one’s football career, as opposed to risking the potential life-threatening, or long-term cognitive disabilities, of one’s livelihood?

According to the slogan often used by the Centers for Disease Control and Prevention: “It is better to miss one game than the whole season.”

Let alone an entire career at such a young age.

“We need to take a step back and start taking care of ourselves.” [Chris Nowinski, Sports Legacy Institute]

We really do need to rethink our perception of the concussion injury.  Of course, it will always remain the “invisible injury,” but it is up to our generation—meaning the youth, high school, and collegiate demographic—to give rise to the understanding of mild traumatic brain injury.  What more will have to happen for us to finally think, “hey, maybe I do need to learn more stuff about concussion?”

Let’s make sure we don’t have another case of Mike Leach, the former head coach at Texas Tech University who allegedly mistreated a player for having a concussion.  Let’s revise our outlook on injured players, and be sure to remember that these individuals are human beings.

Let’s make sure that we don’t have such a rate of second-impact syndrome that can be traced back to poor coaching decisions, where figures of authority choose to either ignore the issue in real time or disregard the need to learn about concussions in general.  Let’s be sure to protect and preserve the careers that our young athletes deserve.

Let’s make sure that our helmets are not out-dated, and that they are properly fitted for stability on our athletes’ heads.  In the case of Max Conradt, who fell victim to second-impact syndrome several years ago, his helmet was found to not have been reviewed properly in over twenty years.  Max is now in his 20s, living in an assisted living facility because of his cognitive deficiencies that developed after his second concussion.  Let’s make sure our children are properly equipped before taking the field.

Let’s be sure to realize that these helmets we provide our athletes are not used as weapons.  Football has seen tackling techniques crumbles in the last couple of decades, where the head has now become a point of contact rather the use of the body.  Tackling has lost its standing as an art in the game, and is something that needs to be restored to preserve the physicality of the sport while enhancing protection.  Let’s reduce the number of head injuries that occur because of poor tackling.

Let’s make sure we understand that our professional athletes in the NFL are not individuals who have signed up to follow a path of neurodegenerative decline because of poor decision-making and injury management.  Let’s make sure we recognize that these individuals have families to go to each day and night, and that they have lives after the game of football.  Let’s be real, football is a sport.  Let’s embrace the game, but respect those who play it.  Let’s protect their futures just as much as our children’s.

Let’s solve the sports concussion crisis.  There are so many ways to contribute to such a cause, as avenues of opportunity have presented themselves in ways that can get everyone involved in unique ways.  Whether we volunteer for an organization, or we stop to sit down with our children, teammates, or friends to discuss all that a concussion entails, so that we are all in this together to protect our brains.  Concussions are an inherent risk of football, but we need to be sure to speak up when we feel that we are concussed.  We need to allow ourselves time to heal to make sure that we avoid missing extensive playing time—whether it be several games or the rest of a career.  Taking care of ourselves is the most important thing in this.

Let’s erase the stigma associated with sport-related concussions and make ourselves heard.  A concussed athlete should not be assigned to a period of verbal abuse and ridicule.  If someone tears their ACL, they are not questioned.  Let’s be sure that we find the right balance of treatment for concussed athletes.  They shouldn’t have to be interrogated and embarrassed for having a brain injury.

A concussion is a brain injury.  Let’s fight for football.

JOHN GONOUDE

Tags: Chris Nowinski, Concussion, CTE, Dr. Micky Collins, football, Mike Leach, Neuroscience, NFL, Post Concussion Syndrome, Second Impact Syndrome