Concussions in the NFL (1 Viewer)

[BGP]

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Concussions a dirty little secret for many in the NFL

By TIM DAHLBERG, AP Sports Columnist

October 26, 2006

AP - Oct 25, 1:03 pm EDT

Questionable is a word used a lot around the NFL. It's there every week in the injury reports that bookies and bettors like to study so much, usually stuck somewhere in between probable and doubtful.

Ben Roethlisberger, who was last seen sprawled unconscious on the field in Atlanta, is questionable this week. The Pittsburgh Steelers said so, meaning their star quarterback may or may not play Sunday against the Oakland Raiders.

Questionable. It's a word that can be used to describe many things.

Let's begin with the judgment of anyone involved with the Steelers who actually believes it is a good idea to rush back Roethlisberger after two concussions in four months.

Head injury one Sunday, starting nod the next. You don't need a degree in neurology to figure out something is wrong with this equation.

Concussions forced two other quarterbacks out of the game in recent years. Troy Aikman and Steve Young retired early because of the cumulative effect of concussions, and they're hardly alone among NFL alumni.

Current players aren't faring much better.

Quarterbacks Charlie Frye and Steve McNair recently left games with concussions and so did Minnesota receiver Troy Williamson.

Carolina linebacker Dan Morgan's season is over, and the horrifying image of Chiefs quarterback Trent Green having his head slammed to the ground in the first game of the season is an indelible one.

Concussions, it seems, are the NFL's dirty little secret. It's not just that they happen so often, but that the league doesn't seem to be doing much about it.

Sure, the NFL says it has had a committee of doctors studying them since 1994. But experts in the field say the league's studies are flawed, use suspect data, and don't stand up to peer review.

So when the NFL says no evidence has been found that brain function declines as a result of a concussion, the news is greeted with skepticism in the medical community.

"What the NFL allegedly finds is totally at odds with scores of publications that are out there," said Dr. Robert Cantu, a neurologist and leading expert in brain injuries at Brigham and Women's Hospital in Boston. "The stuff the NFL is putting out is just not the way the thinking is in the community of sports medicine and specialists with expertise in this area."

Among those is a recent study by the University of North Carolina, which reported 10 percent of retired NFL players say concussions have had a permanent effect on their ability to think and remember things as they've gotten older.

Hall of Fame linebacker Harry Carson of the New York Giants is one of them. He estimates he had a dozen or more "bell-ringers" in his career, though he wasn't aware they were concussions. Carson said he has long had memory problems because of postconcussion syndrome.

For others, it's even worse.

Former Steelers lineman Terry Long died last year at the age of 45 from a brain inflammation that resulted, in part, from repeated head injuries. Fellow Steelers center Mike Webster was diagnosed with football-induced dementia before he died at the age of 50.

Coaches, though, seem to regard them as minor irritants.

Vikings coach Brad Childress offered his own diagnosis the other day after Williamson was injured.

"He does know what time zone we're in right now, and he can read a clock. So he's going to be OK," Childress said.

Football, of course, isn't alone in having to deal with brain injuries. Keith Primeau had two years and $6 million left on his contract with the Philadelphia Flyers but retired earlier this year when even the most mundane skating drills caused him problems due to past concussions.

And David Eckstein and Jim Edmonds of the St. Louis Cardinals struggled for much of the season after concussions.

Still, the NFL, filled with violent helmet-to-helmet tackles and players with bad intentions, stands out.

In boxing, a fighter knocked out is automatically suspended for 60 days. In the NFL, a player knocked unconscious has returned to play in the same game.

Roethlisberger didn't go back into the game last Sunday, though he wanted to. He also wants to play this Sunday.

"If I get cleared I'm going to beg and plead to be out there," he said.

Hopefully, no one will be listening. Hopefully, the Super Bowl champions, 2-4 so far this season, will resist the temptation to put him in.

Roethlisberger has no business playing Sunday. There's a good argument to be made he shouldn't play again this year.

Big Ben has only one career -- and only one life.

It's up to those around him to make sure neither is cut short.

Tim Dahlberg is a national sports columnist for The Associated Press. Write to him at tdahlberg@ap.org

 

[Kyoto Burger]

One of the reasons I wouldn't play in the NFL if I could. These guys deserve every penny.

 

[Gandalf]

Interesting article. I just finished the neuroscience block in med school. The question arose about how long the minimum waiting period should be after a concussion (defined as a period of unresponsiveness). The neurologist speaking noted that the minimum should be two weeks because if a player suffers another concussion within that time it greatly increases the damage and chance of long term issues.

Obviously, NFL players play sometimes in the same game after a concussion, so there's definitely some inconsistency between what the medical community is teaching students and the reality of the NFL. My guess is over the next decade rules surrounding concussions will become more cautious.

 

[BGP]

Interesting article. I just finished the neuroscience block in med school. The question arose about how long the minimum waiting period should be after a concussion (defined as a period of unresponsiveness). The neurologist speaking noted that the minimum should be two weeks because if a player suffers another concussion within that time it greatly increases the damage and chance of long term issues. Obviously, NFL players play sometimes in the same game after a concussion, so there's definitely some inconsistency between what the medical community is teaching students and the reality of the NFL. My guess is over the next decade rules surrounding concussions will become more cautious.

How easy is it to diagnose a concussion properly? The article talked about how some players didn't even know. Would they need a specialist present at every game to handle diagnosis?

 

[Gandalf]

How easy is it to diagnose a concussion properly? The article talked about how some players didn't even know. Would they need a specialist present at every game to handle diagnosis?

A concussion is a syndrome of altered consciousness after head injury. I would think that is a relatively easily thing to diagnose on a football field, especially since you usually know how and when the injury occurred. It might be difficult to diagnose minor concussions that the player wasn't even aware of, but at least the obvious and serious ones could be dealt with first.

 

[fatness]

Concussions a dirty little secret for many in the NFL

By TIM DAHLBERG, AP Sports Columnist

October 26, 2006

AP - Oct 25, 1:03 pm EDT

..........Sure, the NFL says it has had a committee of doctors studying them since 1994. But experts in the field say the league's studies are flawed, use suspect data, and don't stand up to peer review.

So when the NFL says no evidence has been found that brain function declines as a result of a concussion, the news is greeted with skepticism in the medical community.

"What the NFL allegedly finds is totally at odds with scores of publications that are out there," said Dr. Robert Cantu, a neurologist and leading expert in brain injuries at Brigham and Women's Hospital in Boston. "The stuff the NFL is putting out is just not the way the thinking is in the community of sports medicine and specialists with expertise in this area."

Among those is a recent study by the University of North Carolina, which reported 10 percent of retired NFL players say concussions have had a permanent effect on their ability to think and remember things as they've gotten older..........

That is quite disturbing.

 

[Jene Bramel]

How easy is it to diagnose a concussion properly? The article talked about how some players didn't even know. Would they need a specialist present at every game to handle diagnosis?

A concussion is a syndrome of altered consciousness after head injury. I would think that is a relatively easily thing to diagnose on a football field, especially since you usually know how and when the injury occurred. It might be difficult to diagnose minor concussions that the player wasn't even aware of, but at least the obvious and serious ones could be dealt with first.

Grade 1 concussions (no loss of consciousness, quickly resolving neurologic symptoms) can be very difficult to diagnose on the field. Players get their bell rung all the time and quickly recover -- that's by definition a mild concussion. Predicting which mild concussion is the one that leads to what you hinted at earlier (second impact syndrome) is another issue entirely. Very often, you'll learn from a player who has just sustained a serious (Grade 2 or higher) concussion that they had their "bell rung" earlier that game. The culture is such that players just don't mention getting their bell rung -- like they'll shrug off mild ankle sprains, bad bruises, dislocated fingers, etc.Right now, standard of care is to allow a participant to return to play after a Grade 1 concussion if all neurologic symptoms have cleared within 15 minutes of the injury. Most of those concussion get missed by virtue of the tough guy culture of football. Even mild Grade 2 concussions (brief loss of consciousness) can be missed if the period of time a player is knocked out is only a second or two -- a player gets up from the hit dazed with a mild headache. Those are the tough ones.You'll hear sometimes that a trainer/team physician has had to hide the helmet of a football player who thinks he's safe to return to play. The guidelines regarding concussions and return to play have been finetuned a lot over the past decade. Still, they can be some of the toughest things to diagnose and properly treat within a culture like professional football.

 

[ATC1]

How easy is it to diagnose a concussion properly? The article talked about how some players didn't even know. Would they need a specialist present at every game to handle diagnosis?

A concussion is a syndrome of altered consciousness after head injury. I would think that is a relatively easily thing to diagnose on a football field, especially since you usually know how and when the injury occurred. It might be difficult to diagnose minor concussions that the player wasn't even aware of, but at least the obvious and serious ones could be dealt with first.

You can easily tell the guys that should sit out. Concussions are usually graded by how long they are unconscious after the hit. Memory loss and awareness also play a big role. There are computer base tests that are done to tell when an athlete should be able to go back in after a concussion over grade 1. With the grade 1 concussions, players may think they get their bell rung and continue playing. It may not be an issue at all, but there will be a huge risk if he were to get hit again. When a concussion occurs the brain swells and that puts the athlete at risk to have much more severe brain damage if he were to get hit again. That's why it is safer to just sit the athlete eventhough he maybe fully aware and conscious.

 

[ATC1]

How easy is it to diagnose a concussion properly? The article talked about how some players didn't even know. Would they need a specialist present at every game to handle diagnosis?

A concussion is a syndrome of altered consciousness after head injury. I would think that is a relatively easily thing to diagnose on a football field, especially since you usually know how and when the injury occurred. It might be difficult to diagnose minor concussions that the player wasn't even aware of, but at least the obvious and serious ones could be dealt with first.

Grade 1 concussions (no loss of consciousness, quickly resolving neurologic symptoms) can be very difficult to diagnose on the field. Players get their bell rung all the time and quickly recover -- that's by definition a mild concussion. Predicting which mild concussion is the one that leads to what you hinted at earlier (second impact syndrome) is another issue entirely. Very often, you'll learn from a player who has just sustained a serious (Grade 2 or higher) concussion that they had their "bell rung" earlier that game. The culture is such that players just don't mention getting their bell rung -- like they'll shrug off mild ankle sprains, bad bruises, dislocated fingers, etc.Right now, standard of care is to allow a participant to return to play after a Grade 1 concussion if all neurologic symptoms have cleared within 15 minutes of the injury. Most of those concussion get missed by virtue of the tough guy culture of football. Even mild Grade 2 concussions (brief loss of consciousness) can be missed if the period of time a player is knocked out is only a second or two -- a player gets up from the hit dazed with a mild headache. Those are the tough ones.You'll hear sometimes that a trainer/team physician has had to hide the helmet of a football player who thinks he's safe to return to play. The guidelines regarding concussions and return to play have been finetuned a lot over the past decade. Still, they can be some of the toughest things to diagnose and properly treat within a culture like professional football.

excelent