Concussion Hard Limits?

If you have read Fifty Shades of Grey you know what a hard limit is (yes I will freely admit I have read the series after my wife brought it home) and there is at lease one respected doc Down Under that has proposed such a limit to footballers.  Quick reminder we are talking Australian Football, however this could be extrapolated across all sports.  However there is danger is such hard limits, as we will discuss later.

From ABC news in Australia, Jeffery Rosenfeld the director of neurosurgery at Alfred Hospital in Melbourne feels that three concussions over a life-time in football should disqualify you from competitive and full contact forms of the game;

“I personally would say three significant concussions, three strikes and you’re out. I would be a bit wary of that player going back,” he said.

“They can still play sport but perhaps not the rough and tumble and risk associated with the tackling in a contact sport like football.”

Concussion in sport – and particularly in rugby league, rugby union and Australian rules – is now a hotly debated issue, with parents, players, coaches and administrators increasingly focused on the potential long-term brain injuries which may result from repeated head knocks.

And Professor Rosenfeld has found an unlikely ally in Australian rules great David Parkin.

“Jeffrey’s one of the more astute, I think, and well-balanced in terms of what needs to be done,” Parkin said.

“As a parent and as a grandparent that will stick in my gizzard from now on as I watch my grandchildren go through the same processes – because I think coming from him who has probably got as much knowledge as anybody else in this country about those issues – that seems to be pretty strong advice and something that we should maybe adhere to.”

The concussion issue is picking up speed in Australia, once a country I felt was in the know but for some reason was behind in implementation of their information on sports.  If you recall we were contacted by a group in Australia for some insight from across the Pacific and the hopes it would bring clarity.

The only problem with such a hard limit is that the reporting of the injury can take a nose dive if the athlete is facing an early retirement due to brain trauma.  Also of concern is that one concussion can be enough for some people, so playing to the threshold of three can cause further damage.  Concussions are a case-by-case injury but caution should be adhered to and thought MUST be given to ending the high-risk playing if brain injury is becoming and issue for a player.

One thing that is becoming undeniable is a quote in the Australian article from Carolyn Mountford, director of the Centre for Magnetic Resonance in Health in Australia;

We’re at the stage now where we can say, ‘Yes, repetitive hits to the head does cause a difference to brain chemistry’. Whether we can do anything about it remains to be determined.

3 thoughts on “Concussion Hard Limits?

  1. joe bloggs May 14, 2012 / 12:06

    One can be enough in some players, some can take many more concussion, if treated. Certainly, children require protection and a lot more research needs to be done.

    The three and out UNC study was based partially on self-report and therefore does not necessarily have any validity.

    Safer than sorry is suitable but most players do not report concussion and doctors and ATCs are still having issues picking them up.

  2. Don Brady, PhD, PsyD, NCSP, Licensed Psychologist May 14, 2012 / 23:32

    Augustus Thorndike, MD— viewed by some as the Father of Sport Medicine

    1— Below is a quote from a 1952 journal article that he wrote…note his specific beliefs re sport-related concussions…3 and done, or 1 and done…

    Obviously definitions of concussions varied but the essence of retiring form the sport remains the same.

    “Body contact sports should not be permitted for any student athlete who has suffered removal of a spleen or a kidney, or who has suffered 3 cerebral concussions of moderate degree, or one concussion resulting in the laceration of the brain, or loss of an eye.” (Page 556)

    Above excerpt from: Serious recurrent injuries of Athletes – Contraindications to Further Competitive Participation, The New England Journal of Medicine (Oct 9. 1952)


    2– Dr. Thorndike’s Obituary notice as it appeared in the NY Times:

    (note some of the policies he is credited with advocating for…)

    Dr. Augustus Thorndike, 89, Sports Medicine Specialist
    AP Published: February 1, 1986

    NEWTON, Mass., Jan. 31— Dr. Augustus Thorndike, chief of surgery at Harvard University Health Services from 1931 to 1962 and a specialist in sports medicine, died Wednesday. He was 89 years old.

    Besides writing two books that became standards in the field of sports medicine – ”Athletic Injuries” and ”Manual of Bandaging, Strapping and Splinting” – Dr. Thorndike began many policies governing athletes during his tenure at Harvard.

    For example, he decided that a doctor must be present at every contact-sport game and initiated the rule that doctors must decide if an injured athlete should play.

    He also was the first doctor to design improved protective gear for football players and the first to insist on helmets for hockey players.

    He is survived by 3 sons, a daughter, 13 grandchildren and 10 great-grandchildren.

  3. A Concerned Mom May 15, 2012 / 07:29

    “”It was shocking in this day and age to see that kids are playing with overt symptoms after multiple concussions and recent blows to the head,” said Philip Schatz, a professor at St. Joseph’s University and an expert in head injuries who learned of the cluster of cases in Downingtown after it was reported last week on NBC’s Rock CenterWith Brian Williams.”

    “”If you were talking about adults and mild heart attacks, only one would require a complete change in lifestyle,” Schatz said. “Here we are subjecting our children to multiple traumatic brain injuries and not changing their behavior.””

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