Let's solve the concussion issue in here... (1 Viewer)

[zftcg]

Here's why I think the title of this thread is misguided: There's still so much we don't know about concussions. For a long time, the NFL used that as an excuse for inaction, which was reprehensible. But in terms of actually solving the issue, you need to know specifics. From what I've read, the biggest unanswered questions right now are a) the relative effects of concussions vs. sub-concussive hits, b) what makes certain concussions worse than others, and c) what actually causes CTE.

The last decade has been very good in driving a general awareness of the dangers of concussions. But my guess is that, 10 years from now, we'll look back on the discussions we're having right now and regard our past selves as silly and misinformed.

 

[Quasimoto]

Quickest way to drastically reduce the number of concussions in the NFL is to revert back to the definition of "concussion" that served medical science fine for a great while prior to the "discovery" of CTE. It seems that most of the concussions currently being diagnosed in the NFL are injuries that were once referred to as 'getting your bell rung.' A player would spend enough time on the sideline to shake off the 'cobwebs', then go back in the game and play just fine. If we take everything the concussion alarmists say at face value I think we would probably be forced to accept that everyone who ever played in the NFL is doomed to a future of strained peas and blank stares, because as near as I can tell every former NFL player who has ever undergone a post-mortem brain autopsy is confirmed to have 'suffered' from CTE. I can't help wondering what we would find if autopsies were performed on a large cross-section of the non-football playing public who lived active, sport oriented lives. Could it be that CTE is simply a common byproduct of active living? Anyone got a link to any such research, or is CTE a condition exclusive to professional athletes?

 

[comfortably numb]

Here's why I think the title of this thread is misguided: There's still so much we don't know about concussions. For a long time, the NFL used that as an excuse for inaction, which was reprehensible. But in terms of actually solving the issue, you need to know specifics. From what I've read, the biggest unanswered questions right now are a) the relative effects of concussions vs. sub-concussive hits, b) what makes certain concussions worse than others, and c) what actually causes CTE.

The last decade has been very good in driving a general awareness of the dangers of concussions. But my guess is that, 10 years from now, we'll look back on the discussions we're having right now and regard our past selves as silly and misinformed.

Perhaps...but in the meantime during these next 10 years....just wait and do....nothing?

 

[zftcg]

Here's why I think the title of this thread is misguided: There's still so much we don't know about concussions. For a long time, the NFL used that as an excuse for inaction, which was reprehensible. But in terms of actually solving the issue, you need to know specifics. From what I've read, the biggest unanswered questions right now are a) the relative effects of concussions vs. sub-concussive hits, b) what makes certain concussions worse than others, and c) what actually causes CTE.

The last decade has been very good in driving a general awareness of the dangers of concussions. But my guess is that, 10 years from now, we'll look back on the discussions we're having right now and regard our past selves as silly and misinformed.

Perhaps...but in the meantime during these next 10 years....just wait and do....nothing?

Absolutely not. We know concussions are dangerous at some level, so it would be unethical not to try to reduce them. Improve helmets, teach better tackling techniques, all of the above. It just seemed like a lot of people in this thread feel pretty certain about their solutions, and I think a dose of humility is in order. The good news is, compared to a decade ago, we at least seem to know what we don't know. But we still don't know those things.

 

[zftcg]

Quickest way to drastically reduce the number of concussions in the NFL is to revert back to the definition of "concussion" that served medical science fine for a great while prior to the "discovery" of CTE. It seems that most of the concussions currently being diagnosed in the NFL are injuries that were once referred to as 'getting your bell rung.' A player would spend enough time on the sideline to shake off the 'cobwebs', then go back in the game and play just fine. If we take everything the concussion alarmists say at face value I think we would probably be forced to accept that everyone who ever played in the NFL is doomed to a future of strained peas and blank stares, because as near as I can tell every former NFL player who has ever undergone a post-mortem brain autopsy is confirmed to have 'suffered' from CTE. I can't help wondering what we would find if autopsies were performed on a large cross-section of the non-football playing public who lived active, sport oriented lives. Could it be that CTE is simply a common byproduct of active living? Anyone got a link to any such research, or is CTE a condition exclusive to professional athletes?

I think you may be onto something here. If we just all stick our heads in the ground and pretend there's no problem, there's no way they can be concussed!

 

[cobalt_27]

Remove helmets.

Yep. Lots of data suggests that helmets are definitely part of the problem.

As a neuropsychologist who is reasonably up to date with the literature (I'm a brain nerd and a sports nerd, so this topic is of particular interest to me), attended numerous conferences, consulted with brain trauma experts who are a lot smarter than I am, there simply are no reliable studies (nor is there solid rationale) at this point to suggest that helmets are the problem. More likely, they are continuing to save lives, as intended. Moreover, my concern is the danger of even entertaining the idea of removing them, as this invariably would result in more skull fractures, bleeds, and death.

Just my .02.

 

[cobalt_27]

Quickest way to drastically reduce the number of concussions in the NFL is to revert back to the definition of "concussion" that served medical science fine for a great while prior to the "discovery" of CTE. It seems that most of the concussions currently being diagnosed in the NFL are injuries that were once referred to as 'getting your bell rung.' A player would spend enough time on the sideline to shake off the 'cobwebs', then go back in the game and play just fine. If we take everything the concussion alarmists say at face value I think we would probably be forced to accept that everyone who ever played in the NFL is doomed to a future of strained peas and blank stares, because as near as I can tell every former NFL player who has ever undergone a post-mortem brain autopsy is confirmed to have 'suffered' from CTE. I can't help wondering what we would find if autopsies were performed on a large cross-section of the non-football playing public who lived active, sport oriented lives. Could it be that CTE is simply a common byproduct of active living? Anyone got a link to any such research, or is CTE a condition exclusive to professional athletes?

Your questions here characterize the skepticism shared by the broader neuroscience community on the CTE issue. First, there really is just the simple issue of whether or not concussions even increase the risk of developing a tauopathy like CTE, as Omalu and the Boston group have articulated in their case series design. Scientists in general don't like case reports as a means of promoting a generalized narrative about X causing Y. It lacks the rigor of good hypothesis testing, but, that's exactly what's going on here. And, so far, the concussion-->CTE pathology link has not been established (Zurich concussion conference made this abundantly clear just a year ago, and nothing has appreciably changed from a science standpoint).

The second issue is, even if concussions, repetitive concussions, subconcussive blows increase the risk of abnormal tau deposits, so what? To date, there's nothing in the literature that establishes that tau accumulation at the levels being detected in circumscribed brain areas result in clinical/behavioral changes. Which shouldn't be surprising, to be honest. Abnormalities are found all the time in the brain with no associated clinical symptoms. Yet, Omalu and the Boston group have taken great liberties to connect the dots with concussions, autopsy exams, and behavioral symptoms without first having established some parameters around what's going on in the general population, in those with a history of psychiatric disease or substance abuse/dependence history, etc.

Again, it's not that the vast majority of brain scientists don't think the link is plausible. It's just that there's a feeling the cart has gone way ahead of the horse here, there is a lot to be skeptical about, and those groups are taking exceptional liberties to inflame the hysteria around this issue without rigorous science to back up their claims.

 

[cobalt_27]

Welp. It was a good try, at least.

http://profootballtalk.nbcsports.com/2016/01/14/no-oscar-nominations-for-concussion/

 

[jonessed]

The helmet technology needs to get better and the suspensions need to get longer. I think the NFL is squeezing the tackling guidelines about as far as they can go.

No helmet is insane. You would have broken noses, eye sockets, and teeth every game.

 

[cobalt_27]

The helmet technology needs to get better and the suspensions need to get longer. I think the NFL is squeezing the tackling guidelines about as far as they can go.

No helmet is insane. You would have broken noses, eye sockets, and teeth every game.

Biomechanics of concussions make me immensely skeptical anything can be done on the helmet technology front to reduce their incidence rate. They are an inevitable part of the game. Goals for future should revolve around improving techniques, treatment, and management. If nothing else, the misplaced hysteria around this issue has helped on those fronts, and I suspect there's still room for lots of improvement.

 

[32 Counter Pass]

Speaking of helmet technology: http://www.wired.com/2016/01/the-zero1-flexible-football-helmet-may-save-players-brains/

Again slow the players down by going to long bladed grass fields and use technology to reduce the impact of collisions.

 

[Bri]

FYI https://nflconcussionsettlement.com/