Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber. Before I tell you the year and provide the link I want so share some quotes from it;
“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.
“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”
That sounds very similar to what we are discussing now in 2012.
•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.
•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, […] that special teams players were at the highest risk per minute spent on the field.
•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”
•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.
•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. […] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.
Hmmm, we all thought this was information new to us – new being 2008.
That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”
He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.
Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.
Do you have a guess on the year…
Farber and Sports Illustrated may have unknowingly created a timeline for which we all can look back on and decide if enough was being done 18 years ago. And why did it take so long? The quotes don’t end there, just see below for some very peculiar information. Early on the discussion was about the NOW DEFUNCT grading of concussions; the overall theme was that consensus of this brain injury was difficult at best, yet we are still plagued with it today. As for the injury, it is an inherent risk of the profession/sport as this now criticized – former NFL – doctor said;
“Concussions are part of the profession, an occupational risk,” says Elliot J. Pellman, the Jets’ team doctor. A football player, he says, is “like a steelworker who goes up 100 stories, or a soldier.”
I think we all, including those that choose to play, understand and accept that; however the question is/was what were you doing to inform the players of this risk and how it could shape their lives? Was the league and the sport doing enough to make sure further damage was not happening? In respect to the litigation; was there any information being provided about the dangers of this injury?
The next bit of information may be very telling to me and our concussion tracking of the NFL. Finding information about the past and this injury is so buried and inaccurate its it nearly like climbing Mount Everest to find and analyze it. Farber did get enough information from the league in this article for us to make an observation;
League spokesman Greg Aiello says preliminary numbers for 1994 are in line with statistics on concussions for the past five years. According to data supplied by the 28 teams, 445 concussions were suffered by 341 players between 1989 and 1993. That is about four concussions per weekend, or 2.5 concussions for every 1,000 plays. On Dec. 9, Pellman, Dr. Andy Tucker of the Cleveland Browns and Dr. Ira Casson, a New York neurologist, met with league officials, including commissioner Paul Tagliabue, to discuss concussions and suggest ways to cut down on their frequency. No concrete proposals were adopted.
Based on our data collection concussions have risen from 4/weekend to 10/weekend in a 20 year span. That would be a 150% increase in concussions; surely some of that is due to awareness, however there is NO DOUBTING that concussions have been on the rise. Even Farber credited that to athletes getting bigger, faster and stronger; thus eliciting more forces during action that is getting to the brain (as we have argued here). Look at this list of prominent players in 1994:
- Troy Aikman (QB)
- Dave Brown (QB)
- Chris Chandler (QB)
- Jeff Hostetler (QB)
- David Klingler (QB)
- Chris Miller (QB)
- Vinny Testaverde (QB)
- Jack Trudeau (QB)
- Steve Wallace (OT)
- Jeff Lageman (DE)
- Ronnie Lott (DB)
- Mark Collins (DB)
- Don Beebe (WR)
- Tom Waddle (WR)
- Raghib Ismail (WR)
- Rob Moore (WR)
- Merril Hoge, a fullback for the Chicago Bears, quit on Oct. 17 after suffering two concussions in six weeks.
Troy Aikman was quoted about his recent (in 1994) concussions after a quote from Joseph Maroon that is certainly not the case today;
“Think of a concussion as the lights going out,” says Dr. Joseph C. Maroon, chairman of the department of neurological surgery at Allegheny General Hospital in Pittsburgh and a consultant to the Steelers. “Sometimes it’s insignificant, just like a bulb dimming for an instant. Does a very mild concussion need to be reported? Probably not.”
A concussion occurs when axons and their synaptic connections—the fibers that transmit impulses away from the brain’s neurons—are stretched or distorted by a blow to or a sudden movement of the head. When these fibers have been mildly affected, mental awareness can return in seconds or minutes. If axons are severely stretched or even sheared, the lights go out and no one will be home for a while.
“To this day I don’t recall playing in the [1993 NFC] championship game at all, and I don’t think I ever will,” says Aikman, who got a concussion in that game and has suffered two more concussions this season. “Last season’s Super Bowl isn’t real clear. I remember playing and being there, but what happened during the game isn’t clear to me.”
I think we are all in agreement that EVERY concussion is brain injury and should be treated as such. Look at the example above, is it really a good thing that the “lights were out” for Aikman? The man has no memory of a game and limited memory of very huge game in his career. As Farber tells us these are things that Al Toon deals with after football.
Another set of quotes really caught my eye on how times have changed, or at least I am hoping no one shares the belief of the last quote any more;
Take this question: Do concussions have a cumulative effect?
The answers: “Definitely” (Kelly), “Possibly” (Maroon) and “I know of no football player who has had residual neurological impairment from repeated insults to the head” (Joe Torg, the Eagles’ team doctor). Torg says that boxing’s punch-drunk syndrome doesn’t apply to football, because rarely is a football player knocked unconscious.
As if 1994 was a prelude to our current times, Farber gets Toon to discuss some demons; possibly the same demons that are haunting some of the former players now (bolded for emphasis);
“You can see on the tapes the difference in force of the blows [that caused my concussions],” says Toon. “Each new concussion came from less of a blow, and recovery time increased. The last one, against Denver [Nov. 8, 1992], was hardly direct contact.” After that concussion, Toon retreated to a dark room for six weeks, turned into a recluse and even contemplated suicide. He never played again.
The final part of the article sums all of this up, even today;
The virtual absence of brain testing is one of “the things that lead to the current problems,” Kelly says. “I don’t think most athletes want to know the effect an injury has had or the amount they’ve recovered, and I don’t think most pro or college teams want their athletes scrutinized that way. They’re not in the business of identifying worrisome neurological problems.
“I hope another player doesn’t have to die before all this is taken seriously.”
It was there, were we listening?
Reblogged this on Broken Brain – Brilliant Mind and commented:
People have been asking questions about this for decades. Why did we not listen?
Lots of good researchers who should have been recruited to drive this science forward were bypassed for let’s say promoters and spinners who had a degree of scientific flexibility or pure incompetence to muddy the issue with pure nonsense. The usual suspects who were well represented and compensated to blather equivocations rather than search for the truth. The NFL and the NFLPA committees are dominated by the same people who caused the problem.
Kutner (clinician), Barr, Randolph (who I think is a Luddite but has good reputation as a clinician) and others were booted for screening and treating NFL players for their opinions and their unwillingness to rely on Impact to baseline players. These clinicians wanted to do their best, report their findings, and treat their patients. For this, these fellows and others, were fired and replaced by handpicked lackeys.
Don’t think this will get any better, the NFL and NFLPA claim to be supporting $100MM novel research but one can only suspect it the league and union lawyers will guide (under the false belief any findings will be bad for the lawsuits being pressed against although the last science class they passed was high school biology) the money to preferred researchers to ensure the experiments are designed to generate equivocal results sometime around 2020 or later. Their will be no independent oversight or independent thinking. One needs to look no further the concussion mess the CDC is promoting (I know Congress has directed their behavior but this is a national health issue and it is embarrassing) or these watered down concussion laws supported by NFL money to seriously question their ethics.
If the NFL is serious, own up to the issue. Lots of pro-football players were injured due to football. Put the research under direction and oversight of former professional players. People who played in the league and own nothing to the union. Since it is their health that has been damaged and they love the game, they are likely to appoint the right people and get on with the job down. Further, all researchers and doctors who have been on the payroll over the last two decades should be excluded to the man. They failed and compromised themselves so they should be on their own. Finally, anyone with a law degree should banished from the process as they have agendas that have nothing to do with the health and well-being of football or athletes in general.
Hopefully, the NFL reads this and realizes that not everyone is so gullible to buy into the spin that ultimately threatens contact sports through its mindless spin.
This might be the best comment ever!
I’ve been doing this for 17 years now and for the first 9 or 10 years I would direct parents to the local hospital or their physician and tell them that their child did indeed have a concussion, but in all likelihood the doctor you see will tell you that they did not have one. So, I think that the bigger question is why were the average physicians so slow to acknowledge the severity of concussions?
To be redundant (-:
Please see the below excerpt of my 2004 Dissertation re Active & Retired NFL Players’ Knowledge of Concussions.
I strongly suggest that readers of this blog obtain a copy of my PhD research. You will find much historical information re concussions, sport-related concussions, interpretations and recommendations that are pertinent today. Is it quite apparent that significant conflicts of interest (COIs) exist that are grossly and adversely influencing the mismanagement and ‘misassessment’ of ALL concussions.
Mike Farber’s ‘The Worse Case” (1994) is also cited within the significant amount of references utilized to create this 2004 research document that appears to be on a “blacklist” of certain persons and organizations. No surprise here!
Excerpt from 2004 Dissertation re education lacking in Medical School…
“Not only is there a need for better and more accurate concussion education, it also seems appropriate that professional, collegiate and amateur organizations, along with secondary educational institutions, be held accountable for providing essential knowledge to the athletes, coaches, trainers, health care professionals, and students enrolled in their medical and health care educational programs.
In addition, since much concussion information filters down from health care institutions, curriculum changes seem to be needed to significantly better educate medical students and physicians-in-training pertaining to concussions (Alexander, 1995; Kelly, 1999; Sweeney, Davidson, Melgar, Patel, & Cucos, 2002).
Alexander (1995) pointed out that the lack of available research funding for TBI had also adversely impacted this topic being adequately discussed with students enrolled in medical school. Sweeney et al. (2002) not only specifically cited studies reflecting “suboptimal sports medicine educational experience for residents” (p. 219), but also concluded that sports medicine received minimal focus in the US when curricula were formulated. The authors also found that a survey of recently graduated chief residents revealed that approximately 68% of 233 survey participants reported being less than comfortable managing a concussion sustained by an athlete.” (p. 91)
Joe Bloggs comments above serve to highlight and expand upon some apparent COIs exisiting within the present sport-related concussion arena…
Sadly these COIs muddy the waters for the “man & woman in the street” who are trying to grasp and comprehend accurate concussion info.
Reblogged this on Athletic Training and Fitness and commented:
This could get interesting for the NFL… Check it out for yourself!
“I think we all, including those that choose to play, understand and accept that; however the question is/was what were you doing to inform the players of this risk and how it could shape their lives? ”
You make a great point. Injury is a risk that every athlete agrees to take. But their coach/team/organization is supposed to step in when needed to help an injured athlete. You would never expect someone with a broken leg to be running around on the football field, and no one would call them out for not being able to play. That same attitude needs to be taken when it comes to concussions.