I have been asked to write about concussions from time to time. I attempted a chapter on concussions for a book at some point, this is the conclusion of my writing as well as the sources, as I wrote it, no matter how horrible it is. After all I am not an author, but at least you can take a look. This particular chapter deals with concussions in the sport of football. We all should know this injury can be sustained in any sport. Because football is the biggest draw of sporting eyes I felt it was best to present it in this way. (Part I, Part II & III, Part IV, Part V & VI, Part VII & VIII, Part IX-XI)
Going Forward and Conclusion
There has been a lot of banter about what can be done to eliminate the epidemic of concussions, particularly in football. Let it be known that the injury of concussion is something that can and will continue in sport, no matter the changes. However there are things that can be addressed in order to bring this issue under control.
The key to all of this is the understanding of the injury, not only from inception but all the way through recovery, simply put, education and informed consent. Everyone that plays the sport or supports those that play should know what risks they are taking, from the broken toe to a concussion. This will allow all to make correct and prudent decisions regarding the safety of players. Along with the knowledge of this injury every person should what it takes to get back to the field safely and ACCEPT that. Erasing the stigma of the concussion epidemic is difficult due to the deeply ingrained traditions and money involved. It will not be easy but the number one thing that should be done is to get everyone on the same page.
Rule changes are another angle some are asking for; with the education this process will become much clearer. Reducing the exposure of contact will lessen the cases of this injury, but the game cannot and should not turn into a game of “backyard touch”. Decreasing the number of days in practice contact is allowed would significantly reduce the exposure and is a simple step, in terms of saying and implementing. Everyone should be on board with this as coaches would welcome “fresher” players and players would welcome “less pain” during the week. If everyone was held to those standards then pushing the envelope, hitting more to gain an edge would be eliminated, easing the coaches concern. As for game play itself, enforcing the rules already in place with a heavy hand will detour those from participating in the infractions. Helmet-to-helmet contact, butt-blocking, and spearing are already enforceable rules but really only called on heinous actions. There are many times I stand on the sideline and see kids lead with the top of the helmet while initiating contact, this should be penalized, often. We ask officials to make judgment calls all game long, adding an emphasis on the rules already ingrained in their heads would be a simple solution.
The age at which we allow full contact should be re-examined, going along the lines of increased exposure, the longer one can wait to be hit in the head the better off their brains will be prepared for the traumatic experiences in the game of football. This also has an impact on habits being learned at an early age, such as improper tackling and nuances of the game. If a player can wait until their body is near full development before attaining the skill set needed to perform their tasks on the gridiron the better chance he/she will have at being technically sound. Added to this topic is the real fact that the child and adolescent brain is much more susceptible to concussion and reoccurrence of injury.
Finally going forward full contact American football MUST have trained medical professionals on the sideline and at full contact practices to observe, find, asses, and remove those that exhibit conditions of concussion. The health care profession of Athletic Training is one that is both educated in this area and is “bread” for such action. This would of course require resources (see money), but would one consider getting on an airplane without a licensed pilot, or go into a heart surgery with a general doctor? I think not, having access to proper prevention and assessment of injuries including concussions is of the utmost importance.
In conclusion concussions will continue to plague the sport of football and all activities where contact is possible. It is not so much the injury that is the issue, rather it is how we handle the injury through recovery. Making sure athletes do not return prematurely is key to continual brain health, and is vital for child and adolescent brain function. Contact and collision sports do not have to disappear like the “do-do bird”, but we must be cognizant of the ramifications of all the brain trauma that can be incurred. It is better to miss one game then miss the rest of your life. When in doubt, sit out.
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