Question of the Week

September 15, 2008


The football season is currently underway. Whether as a spectator or an athlete, most people who are in any way involved with the sport know that there is always some chance of injury for those on the field.

No one wants to see a young athlete (in any sport) receive a career-ending injury -- or one that negatively affects their quality of life off the field. At the same time, some injuries are easier to detect than others, and there are times when neither the athlete nor the coach realizes at the time how serious something as potentially dangerous as a head injury actually is.

"Concussions range in severity from mild to severe, but they all share one common factor -- they temporarily interfere with the way your brain works. They can affect memory, judgment, reflexes, speech, balance and coordination. Usually caused by a blow to the head, concussions don't always involve a loss of consciousness. In fact, most people who have concussions never black out. Many people have had concussions and not realized it. Concussions are common, particularly if you play a contact sport like football. But every concussion, no matter how mild, injures your brain. This injury needs time and rest to heal properly."

With every concussion injuring the brain, and many people having concussions without even realizing it, it can be difficult to know when to give a football player that extra time to rest and heal that he may need.

Enter the next generation of helmets.

"[E]ach helmet is equipped with six sensors around the crown of the helmet. Those sensors feel the G-forces of hits that the player sustains to the head on any given play. If the hit is hard enough to cause a concussion, an alert is sent to a transmitter on the back of the helmet, which then sends a message to the sideline computer. ... Beyond monitoring individual hits during the game, the computer program used to run the system will also keep track of the number of hard head hits players receive over the course of the season. It’s more data that coaches and trainers can use to prevent over-exposure of players to hard hits. Medical people are quick to point out that the new technology won’t prevent concussions. But it will make sideline personnel more aware of potential problems to check out with players."

It's not just one bad hit that is of concern. Frequent hits with less force can also be problematic. Sensors can tell coaches, trainers, athletes (and their parents) about hits that have already been received. While this can't prevent those injuries already sustained, it can give those making decisions about future playing time objective information that may help them make choices that are better for the health of the athlete.

Without this objective information, it can be easier to downplay an injury. Players and coaches may underestimate the severity or number of head injuries -- information that is essential when determining whether or not the brain needs time, or more time, to heal.

"The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can slosh around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion -- a temporary loss of normal brain function."

While it may seem that any sort of damage to the brain, even minor damage, would be noticeable. That is not always true.

"The signs and symptoms of a concussion can be subtle and may not appear immediately. Symptoms can last for days, weeks or longer. The two most common concussion symptoms are confusion and amnesia. The amnesia, which may or may not be preceded by a loss of consciousness, almost always involves the loss of memory of the impact that caused the concussion. Other immediate signs and symptoms of a concussion may include: * Headache, * Dizziness, * Ringing in the ears, * Nausea or vomiting, * Slurred speech. Some symptoms of concussions don't appear until hours or days later. They include: * Mood and cognitive disturbances, * Sensitivity to light and noise, * Sleep disturbances."

Many athletes who have what appear to be minor symptoms at the time may think that they are fine -- that they'll be "as good as new" in no time. Unfortunately, the long-term and cumulative effects of repeated head injuries can make the healing process more complicated, and getting a more objective understanding of a vague injury can be helpful when trying to reduce the risk of future complications.

"Postconcussion syndrome, a poorly understood complication, causes concussion symptoms to last for weeks or months. People who have had a concussion also double their risk of developing epilepsy within the first five years after the injury. There also is evidence that people who have had multiple concussions over the course of their lives suffer cumulative neurological damage. A link between concussions and the eventual development of Alzheimer's disease also has been suggested."

Questions of the Week:
How can helmets with sensors that detect the severity and frequency of impact help athletes, parents, coaches, and trainers make more objective decisions about how long a player should rest after a collision that involves their head (or helmet)? What limitations do they have? What do players, coaches, trainers, and parents need to know about concussions and the potential short-term and long-term effects of concussions both on and off the field? In a sport where no one wants to look weak, and a lot can be riding on who wins the game, what can be done to discourage the downplaying of injuries?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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