NFL overlooks concussion risks
This past season, 271 football-related concussions were recorded by the National Football League (NFL), one of the highest numbers documented in the past several years. Helmet-to-helmet contact accounts for about one-third of these mild traumatic brain injuries. While more and more people become aware of the severity of concussions, medicine has no treatments and interventions that could reconstruct severely damaged brains.
Now, it is a fact that football players are heavy men composed largely of muscle mass. With so much weight being thrown around on the field, imagine the force that one player has when running directly at another — and the damage that it can do when all of that force is directed at the brain, our most vital organ! When we think of football players, the immediate image typically conjured is an iconic American one, a picture of toughness and colossal strength. But in this vision we often forget that these figures of power, too, are subject to natural human frailty, something that cannot be conquered by physical feats and happens to be our greatest vulnerability.
The brain is our powerhouse, which makes it slightly ironic that it is such a fragile and sensitive creation. The brain is cushioned by cerebrospinal fluid, and while this serves as a protective measure in the case of small impacts, when a much larger hit is sustained, it allows space for the brain to rock back and forth, causing repeated hits against the skull, effectively bruising the brain. At the same time, the brain also endures other types of motion – including twisting, pulling, and stretching forces, a result of the curious fact that, while the brain is being violently rocked, not every part of it moves at the same speed. These harmful forces can then cause tears in the nerve tissue, impairing its ability to communicate through synapses, or killing the nerve cells altogether. The extent of the injury continues in the days to come after the initial impact. The brain experiences various changes, including inflammation and decreased blood flow that can lead to a decreased supply of oxygen and necessary nutrients and ions (key elements to recovery), which can in turn continue to lead to further cell death. In some cases, brain function can be restored to normal if it is left to heal. Other times, the damage can become permanent.
Relatively little is still known about concussions and traumatic brain injuries of their type, a result of the incredibly complex nature of the brain. The damage done by a concussion is usually not visible in most brain scans. The effects of a concussion vary from person to person. There is no specific treatment that can be administered, other than time to rest to leave the brain to heal itself (though it is a fragile organ, it is at the same time remarkably resilient). This includes restricted physical exertion and restricted mental activity, or, in extreme cases, surgery. After sustaining a concussion, the most common symptoms include headaches, fatigue, decreased cognitive function, dizziness, and a sensitivity to sound and light. Typical pain relievers are ineffective in treating the pressing pain from headaches caused by concussions.
Two summers ago, I sustained a severe concussion while surfing after I was hit in the head twice, in the same place, by a surfboard. Two isolated, momentary events, ones that have impacted me in the following months, going on years – and yet this impact was nowhere near the impact that football players often take. I experienced a large decrease in cognitive function, trouble with focusing my eyes, dizziness, and horrible headaches. To this day I still experience painful, localized headaches as a result of something called Post-Concussion Syndrome (PCS), an umbrella term for the lasting symptoms even after the initial injury component of a concussion has healed. I feel overwhelming fatigue when I study a lot, and I find myself making stupid mistakes in areas I have never done so before. There is never any telling how long PCS can plague a person — and if I am still being affected over a year later, I can only wonder at the impact that an even more severe concussion from more force can have on a football player.
To add to the fact, football players in particular are incredibly susceptible to receiving not just one, but multiple concussions. Secondary concussions, especially if they occur before the brain has had the chance to reach a full recovery, can lead to life-long cognitive decline and dangerous brain swelling that can even be life-threatening. It can also lead to a degenerative condition called Chronic Traumatic Encephalopathy (CTE) in which the brain experiences atrophy, and massive amounts of cells die over time. Depending on the part of the brain, this can dramatically impact things such as balance, emotional control, judgment, and memory. It can even trigger a gradual onset of dementia. The even bigger issue? The symptoms of CTE bear resemblance to several other conditions, and CTE can only be diagnosed by examining brain tissue after death.
So here’s the upshot: if football players are particularly vulnerable to receiving concussions — to sustaining injuries to the most important part of the body — and if we are so aware of it, why are they still on the rise? The best treatment for a concussion is to prevent one in the first place, so why aren’t more preventative measures in place? While players may participate in the sport for 20 or so years, those 20 years shouldn’t dictate their health and mental condition for the rest of their lives; those 20 years shouldn’t diminish the quality of their life for the next many decades.