Why Are We Here? Confusion and muddy water

With all the work that has been done up to this point with concussions I truly believe that we should have a better grasp on this injury.  Recently, we have seen some very confusing information come forward, I feel the message has been mixed and may lead to further issues when handling concussions.  Patrick Hruby, in his article on Sports on Earth, takes a very critical look at the Collins research as well as other studies that have pointed to the players being the problem in this concussion issue.

It is not the players fault, it’s not the referees fault, it’s not the coaches fault, it’s not the sports fault.

I do think that football and collision sports do require some sort of “full” practices in a controlled environment.  Although the actual speed of a game is difficult to replicate in a practice, full-go is needed for players to understand the closing speeds, angles and decision-making of the sport.  Without a full grasp on this the player may be at further risk for overall injury in sport.  It would be insane to have a football, hockey, or lacrosse player to participate in only drills and walk throughs then throw them into a game, someone would get hurt.

This is where I think we are having the confusion and why the water is being muddied.

It is simple logic – the more we expose athletes to collisions the more chance we have at a concussive injury, the less we prepare for collision the more chance we have at a concussive injury.  Is that clear as mud?

Less exposure but more preparation; a difficult task in a sport entrenched on repetitions and misguided machismo.

Coaches have learned over the years to be more efficient, and I have personally seen coaches starting to trend to “quality” over “quantity” for practices.  The shorter time everyone (including the coaches) are out there the more intense and focused personnel seem to be.  This is one reason I believe football is ready for limits on hitting.  As an athletic trainer in a high school I have seen fewer and fewer concussions in practice, yet seen better performances on the game field.  How is that possible?  Exposure limitations – for concussions and all injuries.

Over this same period of time I have seen a steady number of concussions in games.  No matter how horrible the tackling technique is (far from “Heads Up”) and how big the collisions are the number of concussions remains constant.  When they appear is also very obvious, the vast number of concussions show up in week 6 and beyond.  Sure there are injuries in any given week (average of one concussion per week in my observations), those mechanisms are also obvious; blind sided type collision where the injured didn’t have time to prepare for the hit.

The point I am trying to make is that we may be digging way too deep on this issue.  Trying to find the proper “mechanical” techniques to protect our heads, certain percentages of time one can hit on a given day, all these concussion finding devices, and on-and-on-and-on.  I think we need to keep it simple.

Remember that it is not the actual occurrence of the injury that is the problem, it is the mismanagement of the injury that is the issue.  Had every concussion been handled correctly or as correct as possible we would not be in this situation.

This should be clear and remain clear and yes it can be this simple;

  • Respect and accept that with sport comes concussion risk
  • The more exposure we have the greater risk of concussion
  • The accumulation of hits can and will lead to problems later in the season
  • Once a concussion is discovered or suspected remove the player from harm and take your time getting them back

5 thoughts on “Why Are We Here? Confusion and muddy water

  1. Glenn Beckmann June 17, 2013 / 22:28

    Very good Dustin. Simple does not mean simplistic. It’s a complex biological problem but steps in the right direction don’t have to be complex.

  2. Bruce June 19, 2013 / 16:12

    I look at the new equipment like airbags for a car. They won’t prevent you from getting injured in a collsion but they can help prevent severve damage when a collsion happens. The fear of getting a concussion shouldn’t prevent you from playing football no more than a fear of getting into an accident should prevent you from driving a car. I always tell my kids Fundamentals 1# and then lets take a closer look at your equipment. I bought all my kids the newest equipment available to reduce injuries from impact online from a company called safeguardsports.com. Cool stuff. Great article

  3. brokenbrilliant June 29, 2013 / 16:15

    Great points. It seems to me that the push to find equipment and protocols that will prevent concussion may be grounded in a fundamental fear of the injury, which short-circuits complex reasoning and keeps us from thinking clearly. The idea of brain injury, quite simply, terrifies people. They certainly want to keep their loved ones safe, impossible as that may be 100% of the time. But the campaign to find a piece of equipment or set of rules to keep concussion from happening seems to be (at least in part) about not wanting to deal with the complexities of management. It’s human nature to seek absolutes and absolute safety, but it’s not the most realistic expectation.

    Personally, I think concussion management initiatives are hindered by commercial interests and those jockeying for position as foremost experts in the field. I think it would serve us all better, if there were an independent group which were acknowledged as foremost experts all across the board, who came up with a specific protocol for different scenarios. I don’t think it would be terribly difficult — it would require a complex algorithm, no doubt, but we’ve done more daunting things as a species.

    Folks just need to agree to agree, regardless of commercial interests — even if for the time being we are still learning a lot, and more remains to be discovered.

  4. brokenbrilliant June 29, 2013 / 16:17

    Reblogged this on Broken Brain – Brilliant Mind and commented:
    Concussion issues are uppermost in many folks’ minds (I think that qualifies as a pun?), but there’s still a lot of work to be done in coming to some agreement about how best to handle things. Some want to eradicate it entirely — or at least prevent it as much as possible. Both are noble ideas, but hardly realistic. We still have a long ways to go…

  5. sports medicine doctor June 25, 2014 / 22:19

    Excellent article. There are many traumatic brain injuries that occur annually as a result of joining a collision sports. So I think the best answer to reduce concussion incidents is to reduce the amount of head trauma an athlete receives by reevaluating how the game is practiced, checking the protective equipment used, and reconsidering the culture of the game.

    sports medicine doctor

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