In previous columns, I suggested that the increased size, speed and strength of today's
We have known for years of the devastation these collisions cause on every joint in the human body. It has become crystal clear that the effects of blows to the head affect emotions, memory, reasoning — what it means to be human — in frightening ways. The ticking time bomb and undiagnosed health epidemic that is developing consists of the cumulative effects of millions of sub-concussive blows that are rarely recognized or treated.
The potential reticence of parents to allow their children to play football at all, combined with the legal and insurance liability highlighted in current lawsuits, poses a long-term threat to the game of football.
David Epstein wrote recently on SI.com that new studies reveal the deleterious effect of low-level hits. Epstein highlighted studies from
the University of Rochester and
This occurred with players who were not knocked out. Last week I urged readers to contemplate the fact that an offensive or defensive lineman who plays in high school, college and pro football may suffer 10,000 of these subconcussive hits. It is time to take action to stem this damage. A damaged brain threatens the very essence of personality and consciousness.
The first area to explore is prevention. Can each collision sport have rules that minimize destructive hits and can we coach players from the day they enter sports to avoid dangerous practices? Collision is the essence of a sport like football; each play begins with massive bodies colliding. There is no way to have so many bodies in motion at such speed and not have collision.
We can do everything possible to coach and enforce rules that take the head and neck out of being the target or tool for blocking and tackling. Heading the ball in AYSO can result in lower test scores — it needs to be eliminated. Can playing surfaces be designed that have some give and flexibility on impact?
If we can send a rocket to Jupiter, can helmet designers find materials and energy absorbing designs that are safer? Do mouthguards offer protection. Football is a multi-billion dollar sport, shouldn't the NFL put aside research and development funds to find better protection? Are there any substances or nutrients taken internally that can provide the brain with protection? It seems clear that certain genotypes and alleles are predictors of
Better technology and monitoring are needed to chart all hits so that subconcussive hits are included. Technology exists today to measure the degree of force occurring with hits — it needs to be monitored and perhaps displayed on the television monitor as pitch speeds are. A neurologist needs to be on the sideline of every high impact sport to insure proper diagnosis and caution.
A standardized regimen for rating concussions, with a corresponding "sit out" period, needs to be maintained. Most of these suggestions were part of the "White Paper" we issued after I held concussion and player safety conferences in the 1990s. My conscience wouldn't permit me to represent athletes and facilitate sending them into harm's way without raising awareness and advocating safety change.
Baseline testing, developed by Dr. Mark Lovell, needs to occur prior to play to provide a way of measuring how degraded mental faculties are after a concussion occurs to insure that players are asymptomatic at rest, on an exercise bike, and at practice before they return to play. This can stop the dreaded "second-concussion syndrome," which can occur when players return too quickly and are at higher risk for a perfect neurological storm.
There are new diagnostic tests on the way which provide maximum accuracy. Remember that the adolescent brain is at higher levels of risk and longer periods for recovery. Should we mandate high school, college or NFL rules which disqualify a player for continuing in the sport once they reach a mandated level of repeated concussion damage?
The brain is the last frontier of medical research and more is learned about how it functions and how to potentially heal it every day. A physician I have worked with has developed a anti-oxidant, nutraceutical compound which seems to have a curative effect. We have plans to put it into a sports drink. A race is underway to find a solution to the brain damage dilemma.
Dr. Daniel Amen and his associate Dr. Kristin Willeumier have treated large numbers of impacted professional athletes using brain spect technology and healing supplements and had promising results. Research into alternatives for healing need to be funded. Neurologists such as Dr. Julian Bailes, Dr. Robert Hovda, Dr. Robert Cantu, Dr. Kevin Gusciwiecz, Dr. Mickey Collins and many more have done breakthrough studies on the impact of concussions. More research is critical.
Awareness and education are important. Athletes are in denial about their physical health and safety and will take any risk to play. Retired athletes suffering symptoms need to be aware of them and be open in sharing the risks with younger players. Leagues, owners, coaches, trainers, athletic directors, physicians, players associations, parents, families and the athletes themselves need be committed to better prevention, monitoring and treatment.
To his credit, NFL Commissioner
Either this epidemic becomes a recognized public health issue with an urgency to address it, or we risk the future of sports we love and the pain of too many shattered lives.