The Concussion Discussion: Understanding the risks facing today’s athletes

We have entered an age of enlightenment on the topic of concussions. Advancements in technology and research have changed the game for everyone, from the high-stakes world of professional athletes to youth sports staged on the grass-roots level.

Concussions are no longer marginalized.  The dangers and long-term consequences of brain trauma can no longer be rationalized as “getting your bell rung.” Gone are the days of athletes enduring massive hits, sniffing smelling salts and told to get back in the game by hard-nosed coaches.

We are no longer overlooking the effects and treatments for concussions.  In the process, we are ultimately creating a better, healthier and more successful environment for athletes in every contact sport.

Concussion Education is the foundation for safety

Dr. Javier Cardenas is the director of the Barrow Concussion and Brain Injury Center  at Barrow Neurological Institute.  Also known as “The Concussion Doctor,” Cardenas has been instrumental in crafting policy and education around concussions in Arizona and affecting change in policy across the country.

If you are a student athlete in Arizona playing a contact sport, you likely have participated in the Barrow Brain Book training—a course that all athletes take prior to practice or competition to understand how to prevent, assess, and manage concussions. Launched in 2011 in Arizona, now over 400,000 high school athletes have been educated in this practice as a part of their athletic participation.

Impact policy with innovative design

A pivotal point in concussion prevention has been an implementation of play policy. This has particularly applied to the helmet dislodgement rule. If a helmet comes off after a hit in play, it is mandated that the players need to go to the sidelines for assessment. Young players may have taken on habits of loosening or leaving chinstraps unbuckled as they are running down field, putting themselves at risk for serious injury. By implementing the helmet dislodgement policy in Arizona and seeing its success, this policy was later implemented in teams nationally.

Helmet design is another way that the game is changing. Advances in technology have been gearing up to protect players in ways like never before. Helmet design has come a long way from leather helmets. And it continues to evolve, as prototype helmets are now in development for player-specific positions. Linebacker’s helmets are being crafted with extra protection up front, as they run into the line of defense. Whereas a quarterback’s helmet may be crafted with more support in the back of the head, and a wide receiver’s helmet might be lighter, with more support on the sides. Changing the way we think about protective and preventative gear is just another way that we are protecting our players from the beginning.

Making the choice as a family

Year over year, more parents have taken a stance against their children participating in contact sports. In 2016, 67% of parents said they would allow their children to play contact sports. This number has decreased in 2018 to only 59% of parents who will allow their children to play sports. (source: Barrow Concussion Survey)

But the weight is not solely on parental shoulders. Children themselves are agreeing that they are choosing not to play sports out of fear of concussions. As more former athletes speak to the media to share their stories about the impact of concussions, the more accessible the conversation becomes. From former NHLer Eric Lindros to former Pro Football Hall of Famers like Tony Dorsett and Joe DeLamielleure, all have openly spoken out about the dangers and long term effects that athletes suffer as a result of un-addressed concussions. The media attention and continued education can leave young athletes and parents alike hesitant to put their “head in the game.”

All that said, even with the decline, there are still over 1 million student athletes playing football every season. So how do we protect and prevent dangerous conditions?

Get in a performance mindset

Prevention is a mindset. Where a lot of concussion education initially formed around the dangers and effects of taking big hits, one of the most effective ways to educate players on concussion awareness is by talking about performance and brain health. Going back into a game after a possible concussion can impair judgement and making the wrong call can cost your team the game. By making this the leading education point, it sets up players to protect their team’s performance as well as themselves.

The performance mindset also starts in practice. While coaches have argued that not participating in tackle during practice sets players to be unprepared on the field, research has stated otherwise. Players who do not participate in tackle during practices have shown a lower rate of concussions during game-time. Every member in a leadership position on the team should be in an awareness mindset. Coaches, team trainers and game referees should all be able to identify concussion signs and make the right call for the safety of the player and the success of the team as a whole.

Ultimately, the health you have prior to a concussion is the key to successful recovery. Prioritizing healthy eating, being well rested and managing stress are keys to a faster recovery from head injuries. Players should work with a team trainer, coaches and parents to identify a baseline to help assess return-to-play plans post-concussion.

Know the signs

The team coach has upwards of 30 players to look after on the field. It is essential for every member of the team—whether that is the coach, assistant coaches, trainers, parents of student athletes and players themselves—to be trained to identify the signs of a concussions. If the players are feeling symptoms such as headaches or head pressure, blurry vision, nausea, concentration problems or extreme emotional swings, these can all be results of concussions and should be addressed with a medical professional.

If the players are feeling symptoms such as headaches or head pressure, blurry vision, nausea, concentration problems or extreme emotional swings, these can all be results of concussions and should be addressed with a medical professional. Progress and advances in medical research have dispelled a lot of misconceptions about how we should be treating athletes who have suffered a concussion. Rest and recovery should be prioritized as much as possible in the first 24-48 hours. But it’s also important to return to light activity after that time, as too much rest has been shown to lead to heightened anxiety and depression. You may have heard that a person with a concussion should stay awake for 24 hours, but rest is important for recovery and allows the brain to heal.

Getting safer year after year

Ultimately as a parent and an athlete, you have to make the call as to whether the risk of playing contact sports is worth the reward. Science, research and technology are making advances year after year that prioritize the health and safety of the players on the field. Dr. Cardenas, whose own son played contact football, knows the challenges firsthand as both a former athlete and a parent. He and his team at the the Barrow Concussion and Brain Injury Center have led the initiatives to make education and safety a priority for teams and Arizona and across the country. When it comes to the protection of student athletes, Cardenas states, “When it comes to the safety of any sport…we will do our best to make it safer.”

For more information on ways the the Barrow Concussion and Brain Injury Center is working to protect and prevent athletic concussions, visit https://concussion.barrowneuro.org/