In Football, Stigma of Concussion Creates Incentives to Hide It - March 2nd Article in Chronicle of Higher Ed
In Football, Stigma of Concussion Creates Incentives to Hide It ($)
March 2, 2015 - The Chronicle of Higher Education
By Brad Wolverton
This is an interesting read on concussions featuring a lead interview of Jeff Kutcher - photo below, Associate Professor of Neurology and Director of Michigan Neurosport.
Courtesy of Jeffrey Kutcher
Jeffrey Kutcher, a neurologist at the U. of Michigan, says people in college athletics are avoiding the word “concussion” because of its implications.
For those of you who don't have a subscription you can access this article at the academic library of your choice - link.
Kutcher serves as a nice counterpoint to the notorious handling of Shane Morris' concussion in last year's Minnesota game. Michigan Neurosport and the Kinesiology program is a leader in what has become a very public issue in sport in recent years. The article itself focuses on many of the issues players, trainers and team doctors face due to the heightened focus on concussions in football.
Here are a couple quotes from the article which is well worth the read.
"There is no question that if you have on the books a law that says a student-athlete suspected of concussion must be removed until they’re cleared by a licensed health-care provider, that kind of law is going to drive some concussions underground," says Jeffrey S. Kutcher
And this...
After football players at Virginia Tech take big hits during games, the university’s medical staff performs a series of concussion tests on the sidelines, says P. Gunnar Brolinson, the team’s head physician.But before evaluating for concussion, he says, his staff members often look as well at a player’s shoulder, knee, or back, even if the player did not appear to suffer an injury there.Those exams, Dr. Brolinson says, are intended to distract television commentators and fans, who have become more vocal in their criticism of medical treatment. The approach allows more time to perform a full medical evaluation.
College athletes are intuitively at a greater risk for concussion than in HS due to the higher magnitude of impacts but this is not reflected in the historical incident data. That is changing if only incrementally. This article gets at some of the root cause for what might be an under reporting phenomenon due to the "toughness" culture, damaged goods concerns from players and hysteria from the media and fans.
This came up on my feed... thought I'd share.
Go Blue!
This is another stigma, like all the others in society, which needs to go away. Concussions are a big deal and need to be treated that way. Players need to swallow their pride and not try to play through concussions. Concussion testing must continue to get better to prevent players from playing with concussions. The toughness culture bullshit needs to stop. Concussions don't make players weak.
I can only speak from experience. I played whole games after experiencing a concussion early in the game. I wanted to be on the field! I was there to play! It was not a matter of toughness to me -- it was my own desire to be on the field!
You see it on the sidelines all the time. The conversation goes something like this: "You okay?" "Yeah! I'm fine" "Let's Go! I want to get back out there." The doctors and people who know better have to over ride this! Dude is hurt and he hurts the team. There is no way you are going to play to your best after suffering a severe concussion. If it is determined that an athlete has "blacked out" for any period of time -- They should not be back on the field!
You can tell from replays when someone has hit or been hit so hard that a black out has occured! Don't let the athlete determine if they are FIT to go back out!
You can tell from replays when someone has hit or been hit so hard that a black out has occured! Don't let the athlete determine if they are FIT to go back out!
Not always. One of the ongoing hurdles to properly handling concussions is that proper diagnosis often relies on self-report from players to an extent that other injuries do not. That's why culture and stigma are brought up so often, players need to feel comfortable reporting head injuries to trainers and not try to fake their way through assessment protocols.
But you are also right that the people in charge (both doctors and coaches) need to be aggressive and pro-active in protecting players from their own desire to go back out on the field.
My only point was this: I was allowed to go back out and play when I never should have been. It was quite clear from the video evidence (and thus the outcry) that Shane Morris had suffered a concussion and yet was "cleared" by a staff that allowed him to make the decision.
...then of course, you need to address the degree of the concussed state. Mild all the way to severe.
I have to believe that on nearly every football play, one or more players suffer some degree of brain injury, if even very mild and seemingly benign. Helmet to helmet (or helmet to ground) contact virtually guarantees it. It's the nature of the collision sport. When a brain in motion comes to an abrupt stop, it's going to bang around in the cranium, yes?
Then there's the cumulative effect of many mild concussions. At what point can we determine this to be a problem and which objective scale should be utilized to determine whether a particular player is fit to play? I don't think anyone really has that answer and it's ultimately a subjective decision.
One thing is certain. There will continue to be controversy over this issue as long contact sports such as football are played.
...to the 1970s when I played in high school. I'm sure I suffered concussions of varying degrees in both football and basketball. Interestingly, the only time I blacked out was after getting elbowed in the face playing basketball.
We NEVER came out of the games back then. I think you would have had to have been unconscious for the coach to take you out. "Get back in there... you just had your bell rung..."
I wonder if those earlier hits are why today I often find myself functioning in an alternate universe? ; )
is one of the bigger issues when it comes to concussions in my opinion. Athletes are lauded for playing with other injuries all the time (See: Gardner, Devin @ OSU in 2013), so it is natural for this mentality to extend to concussions as well.
Hopefully new technologies and playing techniques can reduce the number and severity of concussions going forward.
a professor of Kinesiology at Michigan. I will reference for you later tonight. The numbers are old but the incidence has not changed dramatically since.
Numbers here are sketchy which is the gist of this article in the first place.
I'm sure added weight and speed exacerbates the likelihood of brain injury.
The NCAA solution, therefore, is easy. No player shall weigh more than 200 lbs and no player shall be allowed to run faster than 5.0 seconds over any 40-yard span. (Mandatory ankle weights for the skill position players.) ; )
It is in the Jan 2014 book Concussions in Athletics : From Brain to Behavior - Steve Broglio and Kevin Guskiewicz wrote the chapter on the Management of Collegiate Sport-Related Concussions. Here is the excerpt I was thinking about...
...concussion appears to be about the same across both levels of play with 3.6-5.6% of HS and 4.8-6.3% of collegiate football athletes sustaining concussions on a annual basis. As the literature indicates that larger magnitude impacts are occurring at the collegiate level with comparable concussion rates as high school athletes, it is possible that college players may be more likely to hide concussive symptoms form medical professionals or they have an injury threshold that differs from the adolescent athlete.
This goes along with what you are saying about injury tolerance but the numbers are comparable HSFB to CFB. I've emailed Steve but he's pretty busy and my interest is not professional. In fact I've talked to several concussion and CTE experts with a wide variety of responses. Steve Broglio is very well respected. I'd be curious to know if I'm misinterpreting his discussion in this paper. If you see him, mention this to him. I created an email account tss.mgoblog(at)gmail.com. Send me a note if you think about it.
That said there is a huge discrepancy in CFB on reporting. Florida State reported double digit concussions while Oregon, Ohio State and Alabama all reported zero to one. OSUs one being Kosta Karageorge - which didn't become widely known until after his disappearance and death. Accounting for numbers is difficult.
Let me think about this and check on these numbers. They look like they are taken from the early 2000s. If I come up with something that adds value I'll diarize it.
isn't the obvious knocked out episode or disoriented/loss of balance episode but the marginal loss of consciousness for a short duration of time with persistent subjective symptoms. If the player doesn't relate headache, dizziness, light sensitivity etc and plays he will risk the 2nd impact with higher risk of long term injury. But we know players want to play so there is no way to completely eliminate risk for TBI in a collision sport like football. The Shane Morris episode was not a marginal injury it was obvious and that oversight cost the previous coach and AD their jobs.