BLOCK, TACKLE, CHECK: Concussions can leave permanent brain damage
Evidence of permanent brain damage resulting from concussion in sports is driving nationwide changes in policy. While over 4000 former National Football League players have filed lawsuits against the NFL for failing to take appropriate steps to protect them from permanent brain damage caused by multiple concussions, it’s not just a professional affair. An estimated 300,000 amateur sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States.
Sports are second only to motor vehicle crashes as the leading cause of traumatic brain injury among people aged 15 to 24 years. At least one player sustains a mild concussion in nearly every American football game!
Traumatic Brain Injury in High School Sports
A 2012 study of 20 high school sports, reported in the American Journal of Sports Medicine (Am J Sports Med), found that 13.2 percent of all injuries in the sports studied were concussions, two thirds (66.6%) in competition and one-third (33.4%) during practice.
(Source: Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of Concussions Among United States High School Athletes in 20 Sports. Am J Sports Med 2012;40(4):747-755.)
The Am J Sports Med also reported that slightly more than a third of high school players in one recent survey reported two or more concussions within the same school year.
While football has the greatest proportion and rate of concussions, ice hockey, girls’ and boys’ soccer, lacrosse, wresting, softball, baseball, and basketball, even gymnastics, volleyball, and yes, cheerleading report concussive injuries.
The NFL Lawsuit
On April 9, 2013 a U.S. District court heard preliminary procedural motions, which will determine if the NFL claims can go forward. Behind the NFL story is growing research concerning the long term impact of traumatic brain injury in sports, primarily concussions, including frightening new findings that even a single concussive episode can lead to atrophy of the brain, detectable through objective volumetric measurements, as well as ongoing neurological and psychological symptoms.
As reported on PBS’s Frontline website, Kevin Turner, a former fullback for the New England Patriots and the Philadelphia Eagles said he was glad to see the case “at last moving forward.” After spending eight seasons in the league, Turner, 43, is now battling amyotrophic lateral sclerosis, or ALS.
The Good News
The good news is that this research, prompted by the lawsuit as well as increasing media coverage of sport-related traumatic brain injuries, has recently led the American Academy of Neurology to publish a new “evidence-based guideline on sports concussion” based on a comprehensive analysis of all published evidence-based research since 1955. The research is based on clinical risk factors, diagnostic tools, and interventions that may reduce further concussion risk and enhance recovery. In addition, the Academy issued a position paper urging states to pass laws requiring that best practices be followed to reduce the severity of harm caused by sports concussions. (Link to a PDF of the position paper from the American Academy of Neurology on Sports Concussion)
Many states, including Vermont, have passed legislation governing the response to concussions in public school sports programs, including a requirement that athletes not be returned to training or competition after a suspected concussion until cleared by a qualified medical professional – hopefully reducing the risk of catastrophic “second-impact syndrome.”
The VT state legislature is currently considering amendments to strengthen those legislations, which would require an athletic trainer or other health care provider to be present at athletic events, to develop statewide guidelines, to require schools to have concussion management plans, and to monitor data concerning concussions sustained by student athletes. The Vermont Senate passed the bill, S4, and it is currently pending in the House.