Dr. Charles Park | Mercy Medical Center
In an analysis of how physical activity, whether it is football, boxing, or other sport, may lead to injury such as concussion, it is important to first define terms. What are the physics of concussion? What is actually occurring to the brain when we say, “concussion”?
The brain is a soft organ surrounded by a thin layer of spinal fluid. It is encased in a hard shell of skull for protection, but within the skull itself there are sharp edges. When there is a sudden acceleration, deceleration or rotation of the head, the brain can be injured as it impacts the sides of the skull.
We have seen this many times. A wide receiver catches the ball and running at full speed, only to be met by a cornerback with a brutal hit that stops him cold, and falls to the ground, unconscious.
Concussion happens in all type of sports, though football in particular has brought the issue of concussions in athletics to the forefront. Professional football is typically a violent sport with fully grown men hitting other fully grown men with full speed and power.
Does this mean we should ban football? I recently attended the American Association of Neurological Surgeon s (AANS) national meeting in Chicago. The meeting opened with a panel discussion on concussion in various areas, such as sports, and also in military. American neurosurgeon and CNN correspondent Sanjay Gupta moderated the discussion with several prominent figures from sports and military.
One of the participants was football coach and former pro football player, Mike Singletary. He was asked a question from the audience about whether he would let his sons play football (Mike has seven children, including two boys). He went on to tell about his concussion experience when he was hit by his own teammate, William “The Refrigerator” Perry.
Singletary was neutral about the boys playing the game. They could play, if they really wanted to play, like any other activities. But he emphasized the use of correct techniques of hitting as well as getting hit, both on and off the field. Off field training includes the strengthening the neck muscles which would help to stabilize the head during the hit. On the field preparation included various techniques of hitting and getting hit. He also emphasized that the game has a lot to offer, in terms of discipline, teamwork, value of hard work, etc, that has to be considered and balanced with the danger of concussion. As the old saying goes, “You don’t throw away the baby with the bath water.”
It is a myth that a helmet and protective gears shield the players from injuries. In fact, I would argue that the protective gears, such as helmet, have made the sport more violent and more likely to lead to concussions. With a helmet, a football player can run at full speed and hit his opponent with his helmet. Helmet actually becomes a weapon, not a defensive protective gear.
In rugby, another highly physical contact sport, participants do not wear helmets so there is no incentive to weaponize one’s head in tackling. Unlike football, rugby players don’t “spear tackle” their opponents, that is, slamming the player head and shoulders first to the turf. Instead, players must wrap with the arms in tackling and will protect the head by leading with it on the outside of the opponent’s hip when tackling, reducing the intensity of collision.
Boxing, though not as popular in the United States as it was in years past, remains a brutal sport that can cause severe concussions and eventually Chronic traumatic encephalopathy (CTE), a progressive degenerative disease. In fact, CTE was previously referred to as “dementia pugilistica (DP)” as boxers were described as being “punch-drunk” after too many blows to the head.
And in other sports, not typically considered to be intense “contact” sports, like girls’ lacrosse, are now debating whether helmets should be mandatory.
Concussions, how they occur in sport, and what can be done to address them, continues. In the interim, we need to be aware of dangers; players should do their best on and off the field to protect themselves. Both coaches and parents need to understand the threat of concussion is real, recognize this threat and treat appropriately with adequate rest and recovery. Then we can enjoy the benefits of sports while minimizing the risk. It’s a life lesson that we need to learn in all aspects of our lives.