Current rules and protocols provide inadequate protection for the health of football players. New rules aimed at reducing head injuries – particularly concussions among professional, collegiate and high school players – are unevenly enforced.
The media continue to highlight the “big hits” that can lead to concussions. Even hard tackles in games involving young boys are highlighted at halftime of televised games.
An adult, human brain weighs about 3 pounds. Within this soft structure and its spinal and nerve connections is a delicate array of countless electrical and chemical connections. Though encased in a rigid skull, the brain can be damaged by shock waves that thrust it against its bony perimeter. The resulting impact can tear connections and lead to the release of chemical transmitters. In addition to the acute injury, which can cause a spectrum of disorders from dizziness to unconsciousness, physical and psychological symptoms may persist for days or even months.
For combat-related injuries, we use the term, “post-traumatic stress disorder.” The same term should be considered for sufferers of sports-related concussion.
Persistent, post-concussive symptoms may include dizziness, fatigue, problems with memory and concentration, a sense of mental fogginess, irritability and sadness. Several symptoms may co-exist in players, especially in players who have a history of three or more concussions. Herein lies a problem: While attention is paid to a single, acute concussion, little attention is paid to the cumulative effect in a player of multiple concussions, some of which may seem minor. Since players are encouraged to play through an injury, they are often reluctant to report symptoms that might lead to being benched.
Earlier this season, concern over the rising number of concussions lead the National Football League to urge officials to penalize blows to the head by the arm, shoulder or helmet of a tackling or blocking opponent. Even if a personal foul is not called at the time it occurs, league officials reserve the right to review plays and assess stiff fines for players judged to have launched dangerous tackles or blocks.
The National Collegiate Athletic Association describes concussion as “a minor traumatic brain injury.” Its website minimizes the frequency of concussion. The NCAA makes available to all teams posters describing the symptoms and risks of concussion. A model program at the University of Georgia for the evaluation of concussion is highlighted on the NCAA website.
Personal fouls for hits to the head are infrequently called in NFL or NCAA games. Even rarer is expulsion from a game or suspension for repeated infractions.
In October the American Academy of Neurology released a position paper reflecting increasing concern with concussions among athletes. The AAN statement advises removal from further participation of any athlete with symptoms of concussion. The athlete should not return to play or practice until cleared by a physician with experience in assessing brain injury. The AAN further advised that a certified athletic trainer should be present at all practices and games at all levels of competition in which there is a risk of head injury.
An October report in the New York Times addressed concerns over the safety of football helmets. Design of helmets has not been updated since the 1970s when players were not as heavy as today. Design updates in the 1970s focused upon preventing skull fractures. Helmet standards are overseen by a voluntary organization largely financed by helmet makers. Many teams, especially in budget-strapped high schools, depend upon reconditioned helmets which are often inadequately repaired and inspected.
Six measures could substantially reduce head injuries among football players:
* Address helmet design to minimize risks of concussion.
* Enforce rigorous inspection before reconditioned helmets are used.
* Require seminars for players, their families, and coaches on recognition and prevention of head injury prior to each season below the collegiate level of competition.
* Mandate uniform policy by the NCAA for education of players, trainers, and coaches of all member teams regarding concussions, especially their prevention, evaluation, treatment, and possible long-term effects.
* Follow the AAN recommendations at all levels of play.
* Enforce existing rules regarding blows to the head uniformly.
E-mail Clif Cleaveland at cleaveland1000@comcast.net.