Thoughts on the ethics of medical hardships
I was like many Mgobloggers yesterday in being unhappy to learn of the acrimonious end of Ondre Pipkins’ career at Michigan but also uncertain of whether the coaching staff did anything wrong. Regardless of the specifics of Pipkins’ situation, it raises this difficult question: When is it appropriate to for a player to take a medical hardship? Edit: I presented the question I addressed below poorly. The question is: When - if ever - is it appropriate for a program to try to impose a medical hardship on a player? The analysis below is from the point of view of the school. I thought that was obvious, but it was not.
I think we can all agree that a medical hardship is appropriate when a player, his doctor(s), and the coaching staff all determine that the player cannot or should not play football again. This is the Platonic ideal of medical hardships. It doesn’t require discussion, because of what I assume to be a consensus on its propriety.
Reality rarely fits, though, so neatly into such a category. It is uncommon, as far as I know, that a player becomes incapable of playing football in the most literal sense. Antonio Bass stands out to me as the only player I know to have left Michigan while being truly unable to carry out the basic functions of a football player. We are accordingly left to sort out what a program ought to do regarding a medical hardship when faced with various shades of grey.
To help think about medical hardship situations, I refer below to an imaginary player, Player X, who plays wide receiver for State University (“SU”), a major-conference Division 1 team. When uninjured, he has the speed to be a deep threat, runs good routes, has good hands, and is a willing and capable blocker. It is realistic to believe that he can catch 75 passes for 1,200 yards. To make this all easier, assume that he is neither a positive nor a negative presence in the locker room.
To further help think about medical hardships, I list below a series of situations in which Player X suffers an increasing accumulation of injuries but – crucially – does not want to leave the team. I’ve done this because I think considering plausible scenarios – but not real players who played for schools we may like or dislike – keeps us grounded in reality but not so grounded that we make choices based on our fandom. Many injured players will not fit exactly into the situations I describe, but I believe I’ve broadly covered the possibilities.
A final thought before we start: When thinking about what SU should do when Player X has suffered an injury or injuries, we have to consider SU’s ethical duty to Player X, to its competitors, and to its own program. The need for SU to consider its duty to Player X is obvious. It may be less obvious (to an Alabama fan) that SU has to consider the rightness of its actions in relations to its competitors, but it does. A team that removes injured players from its 85 man roster more liberally than its competitors will likely have an advantage over them in terms of talent (thus the long-time complaints about Nick Saban). Finally, I think SU has at least some ethical duty to its program – its coaches, players, etc. – when considering whether to give a player a medical hardship. We can at least imagine a player or players who insist they can still play despite the fact that they have no realistic chance of contributing and who become, at the risk of being crude, dead weight that takes up reps, time in the weight room, scholarships, and fall camp slots* that could go to players who can help the team win.
*Poster Reader 71 pointed out yesterday that the NCAA limits you to having 105 total players – scholarship or walk-on – in fall camp.
All of that having been said, on to the hypothetical situations:
Situation No. 1: Player X suffers an ACL tear, and he can now realistically be expected post-recovery to catch 50 balls for 500 yards in a season.
I think the vast majority of us will agree that SU owes a duty to Player X to keep him on the team here. 50 catches for 500 yards are the numbers of a very valuable player even if they are not as good as those Player X could have produced pre-injury. And we have to assume that he still takes satisfaction of some sort in playing football. We can hardly say that he has broken any obligation to the program by “only” gaining 500 yards or that he is not still benefitting from being on the team.
I think the vast majority of us will also agree that SU would be violating an ethical duty to its competitors by pushing Player X out the door in this case if it did so to replace him with a better player. I’m not sure anyother program would cut Player X here (maybe Tom Crean if this were basketball), but we can certainly say that most would not and that pushing him out here would violate the intent of the medical hardship rule. SU, then, would at least potentially gain an unfair competitive advantage by cutting Player X to make room for, say, an all-everything high school wide receiver or an All-American wide receiver transferring from another school.
As for SU’s duty to its program in this case, Player X could possibly be replaced by a better player, but he is hardly a non-contributor. Cutting him and replacing him with a better player would improve the talent on SU’s team but also likely hurt team chemistry and player morale.
Considering all of SU’s ethical duties in this case, it’s easy to say that they should keep Player X. Using a medical hardship in this instance would be wrong.
Situation No. 2: Player X suffers yet another knee injury and can now realistically only be expected to catch 25 passes for 250 yards.
I think the vast majority of us will still agree that SU owes a duty to Player X to keep him here just as they did in Situation No. 1. The same reasoning applies despite the fact that Player X is less valuable than he was before. 25 catches for 250 yards is a nice contribution even if it likely won’t get you on an honorable mention all-conference list. It’s also still the sort of contribution a player presumably takes pride in making. Player X has not broken any duty to SU that would allow them to impose the end of his playing days, and football is likely still rewarding to him.
I think the vast majority of us will also still agree that SU owes a duty to its competitors not to cut Player X to make room for a better player in this instance. The same reasoning that applied in Situation No. 1 makes sense here. Rule-abiding teams do not get rid of guys who can catch 25 passes.
As for SU’s duty to its program here, the same reasoning applies as applied in Situation No. 1, though I think we have to concede that – all things being equal – team morale will take less of a hit when a player who catches 25 balls is pushed off the team than when a player who catches 50 balls is pushed off the team. The player with 25 catches is less obviously succeeding, and so it is easier to find logic in getting rid of him (even if that logic seems more misguided than not). And I think we have to concede that a potential replacement of the 25-catch player has a better chance of improving the production of SU’s wide receiver position than would a replacement of a 50-catch player (the replacement of the 25-catch player only has to catch 26 passes for there to be an improvement). So the team is more likely to lose out on increased production by keeping the 25-catch player than it is by keeping the 50-catch player.
Considering all of SU’s ethical duties in this second situation, it is still fairly easy to say that SU should keep Player X on its roster here. A replacement of Player X who is better than him could be found somewhat easily, but that consideration is trumped by all the others by a wide margin.
Situation No. 3: Now things get a little harder. Player X tears an Achilles. He can only be expected post-injury to catch 10 passes for 75 yards, serve as a decent blocker, and play a bit on special teams.
My guess is that Mgobloggers are somewhat divided over a case like this. I believe, though, that the reasoning of Situations 1 & 2 still applies here as far as SU’s duty to Player X. 10 catches for 75 yards is not a lot, but it’s still a contribution. And Player X made no promise when he accepted a scholarship that he would play football with any particular degree of success. He also likely feels some satisfaction in what he provides to the team.
As to SU’s duty to its competitors here, I believe it would still be an unfair competitive advantage to dump Player X in this situation. We might say that a player who is only going to grab 10 passes for 75 yards didn’t pan out, but not all players pan out. And the medical hardship rule was not designed – nor is it generally used – to allow teams to cut a player simply because he might be considered a bust.
As for SU’s duty to its program in this situation, I think we have to conclude that dropping 10-catch Player X will hurt team morale but – all things again being equal – not hurt it as much as dropping 25-catch Player X would. It is relatively easy to see 10-catch Player X as having failed and therefore to rationalize his departure. It is also the case that replacing him with a wide receiver who can out-perform him will be that much easier than it was for 25-catch Player X.
Balancing all of SU’s ethical duties here, I believe SU must keep Player X on the roster. He is not giving SU a great deal, and he could likely be replaced by someone who would help the team more. But SU would be violating the agreement it made with Player X when it offered him a scholarship to play football, robbing him of a still-rewarding experience, and gaining an unfair advantage over other schools.
Situation No. 4: Now we will certainly be divided. Player X tears a hamstring and suffers an MCL tear and ACL tear to his other knee. He is capable of running routes in only the most literal sense, and he is a poor blocker. He gives 100% effort at all times, but he produces no more than a good intramural player off the street could.
SU’s duty to Player X in this instance is difficult to pin down. They offered him a scholarship to play D1 football. He can now do so in a literal sense, but he will never contribute to a win. We could thus arguably say that Player X now has – through no fault of his own – reached a point at which he is failing to live up to his end of the scholarship-for-play bargain. And it also becomes fair to question how rewarding football could still be for Player X, though it is ultimately only Player X who can make that determination.
SU’s duty to its competitors here is also hard to determine. Is the medical hardship rule generally taken to mean that a player like Player X can be pushed into leaving the roster? My sense is that it is, and this is partly informed by posts by Reader 71, who played at Michigan.
SU’s duty to its program, when considered in isolation, points toward pushing Player X to take a medical hardship. Every practice rep that he takes could go to a player who might help the team win. And his scholarship could be used for a player who could help the team win. There would presumably be some morale loss by pressuring him into a medical hardship, but it would be relatively easy for players to rationalize this action.
When balancing the above considerations, I still lean toward believing SU would be wrong to force Player X to take a medicalhardship. As I noted regarding Situation No. 3, Player X never promised to play football with any particular success. And we have to assume that being on the team is still rewarding for him even if an outside observer might question that, because the cost to him of staying on the team in terms of time and energy spent is very high. He is being rewarded – at least in a subjective sense – by remaining on the roster, or he is self-destructive, and we have no right to assume the latter.
SU seemingly wouldn’t gain a competitive advantage by cutting Player X, and the program as a whole would benefit from removing him from the roster. But my instinct – and I admit this is a conclusory statement – is that SU’s ethical duty to Player X is more important than its ethical duty to the rest of its program within the context of considering his scholarship. I do not feel particularly strongly about this, though, and readily admit that I may be discounting the wellbeing of the program as whole.
Another thought: The question of whether Player X has a duty to his teammates to take the medical hardship here is an interesting one, though one I don’t have time to take up.
Situation No. 5: Player X suffers multiple concussions, a neck injury, or something similarly serious. He can play post-recovery, but his doctors tell him he is at risk of experiencing a lifetime of unpleasant and debilitating symptoms if he endures another injury of the same type.
I believe SU is free to take a paternalistic approach here and tell Player X that, while he is free to transfer and risk his health with another program, they are not going to watch him leave the field on a cart in an SU uniform. If the coach of SU wants no part of Player X having to spend years sitting in a dark room because, like former New York Jet Al Toon, he becomes dizzy and experiences terrible pain if he stands or sees light, then the coach is free to tell Player X that he has to play elsewhere if he is to play at all.
If SU is willing to keep Player X on the roster, then I think they at least owe him a duty to explain to him the potential risks and the potential rewards of continuing to play football. Perhaps a potential top-10 pick could rationally choose to continue to play even if he faced, say, a 25% chance of paralysis. But he should make that decision with as must information as possible.
There is no problem here as far as SU’s duty to its competitors. A great many programs would, I think, push Player X into a medical hardship here.
As far as the program as a whole, the question hinges in part on how well Player X can play. Can he still gain 1,200 yards? Then the program obviously benefits from keeping him around. Can he only gain 75 yards? Then the program might gain by being rid of him. But regardless of his remaining ability, it is worth considering the potential damage to the program in terms of morale and image that would result from having a player seriously hurt (consider the Shane Morris incident last year).
The issue of how well Player X can play, though, is very small in relation the potential that he suffers a debilitating injury. The consideration that dwarfs all others is whether he ought to risk his health in order to gain from remaining on the team and potentially playing professional football.
Summary: This isn’t an easy issue. Some cases will be black and white, but the right answer is often unclear – and arriving at it requires a good deal of detailed information about the given situation. I lean toward believing programs should keep players on their rosters in almost all instances, but there is room for reasonable argument as to when exactly they are not required to do so. And there may even be cases in which a program should force a player to take a medical hardship.
Not quite.
Putting your body through intense exersize like playing football will definitely increase your chances of reinjuring yourself and worse, leave you with lingering effect for rest of your life.
HOWEVER...
I am very uncomfortable with deciding medical hardship based on projected "usefulness" of the player. The only question that should be relevant is whether or not further playing will leave the player with disabilities that may affect him for the rest of his life. If not, no matter how ineffective he will be, he should be allowed to play or at least keep his scholarship (not medical).
If you decide that his value as the member of team is a legit factor in deciding whether or not to medical a player, you are in the exact same boat with Saban and other questionable SEC actors. I see no difference in cutting a player because he cannot crack the two deep and medicalling a player because of projected lack of output.
I am very disappointed that most on this site is fine with SEC tactics as long as it is our team that is doing it. We should never be making any fuss about Saban tactics in the future.
lt may be a "different situation" than that of a boxer, but a player who can't run as fast is he is accustomed to is not as able to defend himself on the field when bodies are hurtling at literal "breakneck" speed.
If a player's mobility is compomised enough, that player is at more risk for concussions. If that player has already had concussions, it becomes the responsibility of the coach and medical staff to do exactly what Harbaugh did.
The Pipkins situation is the classic case of "player thinks he can play, medical staff thinks he's headed for further debilitating injury and a lifetime of problems if he doesn't retire."
This is not a case of a guy getting cut. It's a 5-star with a history of injury at one of the thinnest spots on the team.
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MICHIGAN IS THE GREATEST TEAM TO LIVE IN THE SHITWHOLE TOWN OF DETROIT!!!! BURN THE TOWN DOWN!!!!! LET IT BURN LIKE USHER!!!! GOOO BLUE!!!!!!!! LETS MAKE THE BLUE GO ALL THE WAY!!!!!
That's a perfectly valid viewpoint. But you may well not be in the majority here, so saying "this is morally bankrupt" and walking away doesn't accomplish much of anything.
As for Michigan not being Alabama's competitor, they are competing with them for recruits right now. And they played them a couple of years ago. There's a pretty good case to be made that they are competitors.
Given that a medical hardship scholarship gives all the major benefits of a football scholarship, except without the football, isn't it equivalent to workers' comp? We're not throwing Peewee on the street, he's still being offerred a free education.
Aren't you confusing a medical redshirt with a medical hardship? In the first case a player recovers for a year and gets 4 years of eligibility over 5 years. A medical hardship ends the players career and frees up a scholarship(like Austin Hatch). You seem to miss the role of the medical staff, which must be separate from coaching staff. They need to certify that medically the guy can play. In Pipkins situation, if the doctor told him to rest a year, he could have redshirted for 2015. Then he could have come back in 2016 as a redshirt senior. That may be were the conflict with Harbaugh is since we are getting more verbals than currently available spaces. I guess Harbaugh good have opted to give Pipkins the handshake after 2015 and not offer him a return for 2016. Looks to like Harbaugh wanted to move forward sooner than Pipkins.
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I'm guessing he said tl;dr about every book they assigned him to read at So Cal. What the hell brings ya to Mgoblog?
Blowhard? Petros is awesome.
I was going to say something similar. Even after the fact, we almost never would have enough details to objectively determine what the right call should have been.
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Yes reading yesterday's comments a lot of the same comment repeated: "We only have 1 side of the story so who are we too judge."
Yet so many judge other schools when they only have 1 side of the stoy there as well. You only get 1/2 of the story from Bama and OSU just the same as UM.
Also by the thinking expressed in "we only have 1 side of the story" in theory you can never come down against the coaches/administration in any scenario including a player ever because you can always fall back to "well the coaches/admin never got to tell their side".
All I know is I expect more gray areas in the future and the same groups - those who think Habaugh walks on water so anything he does is of course for the betterment of mankind and each player, those who think the player is 100% always in the right, and then the last group which is probably the smallest and just scratching their head.
As to the OP I will say I disagree that level of production (except in extreme cases like Hatch) should determine whether a guy gets a medical. That is very Nick Saban type of thinking. I'd think it should be if the player is healthy enough to contribute ...or not. Your OP seems to say any injury will potentially rob a player of ability. I truly think that happens in only a small amount of cases. A 25 catch contributor pre injury is probably going to remain the same when he comes back in 90% of the cases.
So the real question many dont want to ask is how more aggressive should medicals be for guy who like Pipkins was not a real contributor. And does it differ from 1st line starter? I saw a whole lot of "2 concussions! Thats why! This is the right thing to do!" yesterday but I thought would they say that if it was Denard Robinson with the 2 concussions? I doubt it.
I got the feeling in the OP you are saying that people should or should not be offered medicals based on what they can contribute to the team. Your different categories of production for example.
My thinking is you recruited a guy based on X set of circumstances out of HS and unless the injury tangibly robbed him of major skills he should not be medicaled just because he is not the contributor you thought he would be out of HS. That is an easy way out of getting out of your bad evaluation or bad development. It is SEC thinking to me.... i.e. an easy way to dump a player.
Put another way if player A (front line starter) and player B (3rd string) both had the exact same injury and exact same recovery in some theoretical world what I got out the OP is player B should be guided to a medical while player A should not. Player A being the 50 catch guy and player B being the 10 catch guy. My theory is both should be evaluated solely on the injury and recovery. Production should not be what medicals are about - medicals should not be a way to "cut" guys based on production or lack of. Medicals should be for guys who physically can't come back to play football at the level they once did (even if that pre injury level sucked because of poor evaluation or development) or at minimum their injuries robbed them of a great amount of ability.
...I was among those who said that after two serious concussions one should retire.
I would say the same if the player in question is the starting QB, a third string player, a special teams player, or a whatever.
The decisions should not turn on how valuable the player is to the team. It should turn only onthe risk of long term health consequences, IMHO. And the standard should be the same no matter how important or good the player may be.
However, I feel that this is simply an idealistic view that is not feasible in today's world of competitive college football.
If UM wants to compete with the Alabamas and Ohio States of the world, then they need to traverse these muddy waters delicately and with the program's best interest in mind. Is it right? No. Is it the way the CFB world works now? Unfortunately yes.
Until these loopholes are eliminated, UM, OSU and Alabama are going to have to play this game to keep up with each other and maximize the talent on their roster.
Don't hate the players, hate the game.
While I am sure you feel that way, and you stated that when everyone is in agreement (coaches, player and medical staff) a medical is appropriate, reading your post I don't really get that because all of the emphasis on your different scenarios all focuses on what the team gets from each player with no discussion of the various risks and little to no discussion on what what potential reward (and the likelihood of it being obtained) the player gets for the risk he is taking.
Every player that puts on a helmet, whether in a game or practice, risks a debilitating injury. Regardless of any injury history. Add in a given injury history, the risk assessment is a total judgement call, and really at best a SWAG (Scientific Wild Ass Guess).
Should it be only the medical staff's call? If so, then why the qualification you made when you stated that when everyone is in agreement (coaches, player and medical staff) its an easy call. If not, then whose call(s) is it? Is the player really qualified to make that call? He is the one taking the risk. Should the coach should make that call or have an imput? His interests often run counter to that of the player, as we see often in the SEC.
But what seemed to be a focus of your OP was what the player could do for the team, how many receptions and yards the team can expect from the player (and these are probably WAGs), and that what the team could expect from the player would affect their decision to medical hardship him. That is your ethical problem - that particular factor should not effect the decision to medical hardship the player.
Either the player is fit to play or not and should not and what he could deliver for the team should not influence that decision. Kind of like the movie "Hoosiers" when coach Dale realizes that he just can't "patch up" his bleeding player in need of new stiches and benches him dispite his need to have in on the floor.
Of course it is a judgement call and there will be "gray area." This is where it gets interesting - at what point does the player's potential NFL prospects be taken into consideration? How much weight is given to that player's enjoyment of just being part of the team and participating in games? Is one neccissarily more important than the other, or are they both equally unimportant?
And there are other considerations as well. At what point does the University become negligent and liable due to exposing the player to excess risk of injury? Who steps in and makes that call? The coach's interest nor the player's are really aligned with the University. The medical staff would be more so, but I don't know. Prospective receptions and receiving yards suddenly don't seem so important.
Finally, of course if the player is judged unfit to play (either by the medical staff or the player himself; I am a quite dubious the coach making that call himself contrary to the other 2) he should get a medical hardship for the remainder of this 4 years. That has never been an issue, at least on this blog and its readership.
...about cutting players to make room for other players? Why else would we be talking about this? No one is arguing that Michigan's doctors (or Pipkins' outside doctors) are wrong in a medical sense (because we have no idea).
As for this:
But what seemed to be a focus of your OP was what the player could do for the team, how many receptions and yards the team can expect from the player (and these are probably WAGs), and that what the team could expect from the player would affect their decision to medical hardship him. That is your ethical problem - that particular factor should not effect the decision to medical hardship the player.
I argued after each example that the player should not be forced to take a medical hardship except in the case of the player facing a debilitating injury. Yes, I considered other factors, but then I said they were trumped by SU's duty to the player. Your self-righteous lecture is based on nothing but me thinking things through out loud.
While I take your point that every player faces a debilitating injury to some extent, some players (like Steve Young at the end of his NFL career) are much more prone to suffering such injuries b/c of preexisting conditions. Here, I addressed possible risks to players and how increased risks should change a school's approach to a medical hardship, and you are brushing this off as if the risk to a guy who's had five concussions is the same as the risk to a guy who's had none because, hey, everyone can get hurt.
Either the player can be cleared medically or not; what he can deliver on the field is ethically (for the coaching staff's decision) completely irrelevant.
This dodges the issue. Jamel Dean was not cleared by OSU's doctors, but he was medically cleared by Dr. James Andrews. The same thing seems to have happened with Pipkins. What do you do in those situations?
I apparently don't know where to respond to you either either (though I try a bit below), and it would be nice to know where to start.
As for your desire to talk about real-world examles rather than hypotheticals, you my want to Google "Jamel Deam Ohio State." The fact that you haven't heard of him doesn't make his situation any less illustrative of one of the quandaries this issue presents.
I will say this: I should have framed the question as "When, if ever, should a program pressure a player into a medical redshirt?" The above is written from the point of view of the school.
As for the notion that it's unethical to even consider ramifications of a medical hardship other than those directly relating to the player, that seems almost willfully myopic (it's also nothing but a conclusory statement and a value judgment, which is fine but not convincing). A great many people benefit quite a lot when Michigan has a winning football team. A program would be derelict to not at least consider the effect a medical hardship might have on a program. So, yes, I did consider that. And then, in four out of five situations, I said I at least lean toward believing the school should not press a medical hardship on a kid.
I appreciate your thoughts here - you helped me clarify what I was saying. And apologies for my jerkishness earlier. I have a bad habit of sometimes letting work stress affect my posts on the blog, which isn't an excuse. It's just a (bad) reason.
I'm just guessing. Maybe the simple reason Coach Harbaugh told Ondre Pipkins that he's too banged up to play football is because Ondre Pipkins is too banged up to play football.
I feel bad for the young man. My football career was derailed by a knee injury. Hard to deal with. Life goes on.
What I do think is more questionable, and what Saban has been criticized for, are situations where an underperforming player is given a medical hardship even though injury is only tenuously (or demonstrably not) related to the poor performance--yet is used as an excuse to clear the roster spot
Agree 100%. The "moral" part of it for me comes when it is used as a way to clear space for underperformers.
If player comes to Michigan and turns out to be a dud and plays at level 65/100 and then has an injury....recovers...and comes back to play at 65/100 the SEC way is to medical (cut) that guy since he is only a 65 and was recruited to be a 85. The injury didnt rob him of ability - he just wasnt that good to begin with.
Someone like Fox is a lot easier than Pipkins to make a view on. His knees have simply not allowed him to play football. Chris Bryant was the same. Those to me are obvious medicals.
Pipkins - without all the info - is more difficult to figure. I am sure there are plenty of guys on the team who have had concussions.
What position on the coaching or medical staff do you occupy? You post sounds a lot more authoritative than I am willing to bet your actual knowledge would support.
Health issues are a totality. The risk of further knee injury may not itself justify a medical, nor the two concussions in limited playing and practice (because let's face it; lots of players probably have had two concussions, but Pipkins has had two concussions while playing and practicing a lot less than others), but together they may add up to too much risk.
So, I suggest you take your red herring accusations out and try to sell them elswhere, because you have no reason to claim that here. The second concussion came at about the time Pipkins claims the staff started to push him towards a medical. We don't know that it was a factor, but also don't know that it wasn't.
nothing to do with the concussions (based on the limited info that is public) is a fair one. Maybe you are right that they are mostly basing this on his knee.
But on the other hand, would you want your own kid to keep playing after having suffered two concussions?
I'm no medical expert, but based on what I have read, I would not want my son to continue and risk a third concussion.
Why not apply that same standard to Pipkins, and really to all college players?
But on the other hand, would you want your own kid to keep playing after having suffered two concussions?
I highly doubt there is a single player on the team that hasn't suffered two concussions.
Are you exagerating? I mean real concusions, the one's that produce dizziness and balance problems,blurred visions, nausea or vomiting, and other symptoms.
I doubt that most football players have had two of those.
Not evey nasty/scary looking helmet to helmet contact produces a concussion. Most do not.
When I read the Pipkins has suffered two concussion, I am assuming that they were the types where he had blurry vision, nausea, etc, The serious stuff.
Also, the issue of hundrends of repetitive sub-concussion impacts comes into it too. If a guy has had two of the concussion with nausea, dizziness, blurred vision, etc,, I would imagine that the risk of the normal lower level impacts from practice and games become a much bigger risk.
...I wonder what gets counted in the statistics you cite.
Is there a distinction between serious concusiions--concussions that generate nausea, vomiting, blurred vision, memory loss, etc.--versus more mild concussions--just head impact followed by headache for 24 hours?
I wonder if the numbers you cite are mostly the later mild type. I guess I have a hard time believing that 53% of HS athletes suffer the sort concussion that causes vomiting, memory loss, etc. But I have only my own experince to go by, so I could be wrong.
I also don't really know if two of the more mild type of concussions are cause for ending a playing career. Though I really do not now, my guess would be that they are not.
So I guess I am saying that if my kid had two serious concusions--vomiting, blurred vision, memory loss, etc.--I would not want to risk a third. But if it were two head impacts that produced 24 hour headaches, I would guess that it would be o.k. to continue playing. But I would probbaly defer to the judgment of a neurologist.
Were Pipkins' concussions of the former or the later type? I have no idea.
...I wonder what gets counted in the statistics you cite.
Any concussion. Most concussions are relatively mild... in fact concussions themselves (of all severities) are considered mild traumatic brain injuries.
95% of all concussions don't result in loss of consciousness.
Current evidence seems to show that not enough time/recovery between concussions is more of an issue than the absolute number of concussions, and that severity of the concussion has little relation to long term prognosis.
I've personally had about 10 concussions in my life - the first being a severe one requiring hospitalization (bicycle accident at 5 years old), 2-3 in my 6 years playing football, and a good half dozen from snowboarding before I started wearing a helmet.
I've got a 13 year old who will be playing his 5th year of youth football this year. He's had one concussion (mild) in that time. Of the ~30 kids he's played with over the years at least 6-8 have had at least one mild concussion.
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