High school, collegiate and professional football players will soon be putting on their pads and buckling their chinstraps in anticipation of another season on the gridiron.
Long considered by many to be the king of contact sports, football frequently draws enthusiastic applause for a bone-jarring tackle as often as for an electrifying touchdown run.
It is the former that many coaches and trainers are now taking much more seriously, especially when those tackles or hits cause concussions. Recent studies show a spike in head trauma, and a report in the medical journal Pediatrics released Monday, Aug. 30 shows that visits to hospital emergency rooms have doubled since 2005. The majority of the injuries occurred to youngsters between the ages of 8 to 13, according to the report.
Three years ago, a study by the Centers for Disease Control and Prevention suggested children and adults sustain as many as 3.8 million sports- and recreation-related concussions a year in the United States.
Coaches and trainers, as well as neurologists and neurosurgeons are learning more and more about how concussions can have long term effects on a player, sometimes weeks or months after the injury has been sustained.
“It is a rapidly evolving field,” Dr. Vernon Williams, a neurologist and pain management specialist at Kerlan-Jobe Orthopaedic Clinic in Westchester, told The Argonaut. “We are learning so much more about the long and short term effects of a concussion on athletes and we have better information about concussions than we’ve had over the last 10 years.”
Medical professionals say testing for head trauma that can lead to a concussion has greatly improved over the last decade. Dr. Robert Watkins Sr., an orthopedic surgeon and co-director of the Marina Spine Center at Marina Del Rey Hospital, says developing a game plan to properly diagnose concussions is essential for a football program.
“When the brain is injured, it makes it very vulnerable for a period of time,” Watkins explained. “That’s why it’s important that trainers should be alerted when a player has a head injury.”
These experts and others agree that teams that have established these protocols identifying the symptoms of a possible concussion and have a plan to diagnose and treat injured players for head injury, which in some cases can be fatal, are protecting their athletes’ lives and careers.
Between 10 to 15 percent of all football players suffer some form of concussion during their careers, according to Williams.
Santa Monica College head football Coach Gifford Lindheim says his staff does not make the final call when a player returns to the field after an injury.
“When there is any injury, and especially a head injury, we let the professional handle it,” said Lindheim, who is in his first year as the Corsairs’ head coach. “As coaches, we never try to assess the degree of injury to a player; first our training staff assess the injury, and then our team doctor makes the final call.”
State legislatures are beginning to weigh in on how athletes must be diagnosed and how their care is managed after suffering a concussion.
Washington state has legislation named after a young football player, Zachery Lystedt, who fell into a coma three years ago after sustaining a concussion while playing football and returning to the game too soon. The Zachery Lystedt law is the most stringent in the nation, and requires a youth athlete who experiences a concussion or head injury during a contest to be removed from play, no questions asked. Only after the athlete is cleared by a licensed health care professional can he or she return to full-time athletic competition.
Subsequent to the adoption of the Lystedt law, California and other states have added similar legislation as well.
Williams said the science of concussions is evolving due to more in-depth studies on brain trauma as well as better-educated medical staffs in football and other sports.
“One thing that we now know is unconsciousness is not required to have a concussion,” Williams, a former football player, said. “Young players’ brains are still maturing, so they are very vulnerable if they are not diagnosed properly.”
Watkins, who has treated and operated on several collegiate and professional athletes, says a player’s biggest risk is not knowing what is happening to him.
“It’s vitally important for a team to establish a program to recognize the signs of a concussion,” the doctor, a member of the National Football League’s Task Force on Concussions, said. “Players have to be cautioned about the symptoms of a concussion, and coaching methods have to be responsible as well.
“A player has to know that if he tries to return to the field with a concussion, his life could be in danger,” Watkins added.
Both doctors say that it is essential that a player who has symptoms of any kind of head injury be removed from the field and not be allowed to participate even in practices until they are cleared by the medical staff.
Williams and others attribute the number and the severity of head injuries to the kind of conditioning and training that football and hockey players endure, as well as the emergence over the last 15 years or so of bigger and faster athletes, especially on the defensive side.
“There are much bigger and stronger players now who are also very fast, and the impacts (of tackling) are much greater,” the doctor said. “The equipment has improved, but it has had a marginal effect on reducing brain injuries.”
Williams cited a study among youth hockey players where checking — using the body to knock an opponent against the boards or to the ice — was not allowed and where the tactic was permitted. According to the study, there were fewer injuries, including to the head, in the leagues where checking was not permitted.
While Division I football schools and larger high schools in more affluent areas often have the most modern medical equipment or parents who can afford the services of a neurosurgeon, all schools do not have the means to diagnose signs of possible concussions.
“Unfortunately, we don’t have the medical technology that a lot of schools have,” Lindheim acknowledged. “But we always hold our players out who have sustained a head injury and make sure that they are evaluated by our medical team.”
Williams added, “There are significant disparities for support systems from school district to school district, but it’s important to have a game plan on how to diagnose the symptoms of a concussion.”
Williams suggests schools that do not have the most updated medical technology explore private-public partnerships between various business groups and hospitals and schools. The Kerlan-Jobe neurologist said despite the report in Pediatrics, players engaged in contact sports can continue to have long careers as long as the proper protocols are followed.
“There are going to be collisions in contact sports,” he concluded. “But with the proper care and the right treatment, a player can successfully return to the playing field.”