Dr. Clif Cleaveland and his wife live on Signal Mountain. He practiced internal medicine in Chattanooga until retiring in 2004.
His interest in concussions began during his 1968-70 Army service at Fort Knox, where he saw a number of concussions in the emergency room, including several in high school football players. One of his former Chattanooga patients was a former ranked boxer who deteriorated steadily into incapacitating dementia.
Dr. Cleaveland, who regularly writes a column for Thursday's Life section of the Times Free Press, offered his insight into concussions in a Q&A with Sports Editor Jay Greeson:
Q: Why do you think concussions are on the rise in frequency and publicity?
A: "Concussions are on the rise because of heavier players who move faster. Force equals mass times acceleration. Equipment improvements have not kept up with the this. At UNC, studies are ongoing that measure significant blows to helmet-protected heads of players. I've read that the average lineman sustains up to 1000 significant blows to the head annually. Increasing publicity is due to the high-profile, former NFL players such as John Mackey who are now incapacitated by concussion-related dementia. I suspect that most concussions go undiagnosed because of the reluctance of players to report symptoms and risk the loss of playing time."
Q: What are some of the warning signs players and parents can look for to know if a concussion occurred?
A: "Warning signs of a concussion in a player who has not been knocked unconscious (and unconsciousness always means concussion) include persistent headache, difficulty concentrating, problems with sleep and amnesia of varying duration. These symptoms can persist for weeks."
Q: What is the best treatment for concussions (from slight to serious)?
A: "A necessary treatment for all concussions is avoidance of further trauma until all symptoms have cleared and the player has been evaluated by a medical professional. I personally think that any player suspected of even a mild concussion -- say someone dazed after a block or tackle -- should not re-enter that game. I firmly believe that medical clearance can only be given by a health professional who is not connected to the team in any way."
Q: Are there any ways medically to prevent or safeguard against concussions?
A: "Prevention -- this comes down to taking the emphasis away from inflicting hard hits. Any televised football game has its highlight moments of 'great hits' with no thought of the potential concussive injury that may be inflicted. I think a change in the culture of coaches, players and their families is the only way that this can be brought about. Better headgear can prevent skull fractures but cannot blunt the shock wave generated by a violent collision with another player or with the playing surface."
Q: If there was a "dangerous scale" of football-related injuries, where would you rank concussions and why?
A: "I regard brain injury as the most dangerous on an 'injury scale.' The problem of concussions in particular is that most are not associated with changes on brain scans. We have no way to measure cumulative effects of multiple concussions until it is almost too late."
Jay was named the Sports Editor of the Times Free Press in 2003 and started with the newspaper in May 2002 as the Deputy Sports Editor. He was born and raised in Smyrna, Ga., and graduated from Auburn University before starting his newspaper career in 1997 with the Newnan (Ga.) Times Herald. Stops in Clayton and Henry counties in Georgia and two years as the Sports Editor of the Marietta (Ga.) Daily Journal preceded Jay’s ...
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