Head Injuries in Sports (JanR)

Head Injuries in sports, What they Lead to, and What significant moments in sports happened due to Head Injuries.

Head Injuries:
Head injuries are injuries to the scalp, skull, or brain caused by trauma. The most common known head injury is sports is a concussion which "is a type of traumatic brain injury (TBI) that happens when the brain is jarred or shaken hard enough to bounce against the skull" (Head Injuries webmd). A concussion can happen when two athletes collide heads, when an athlete hits there head on the ground, or can even happen with an object making contact to the head. Concussions alter a humans mind and cause disruption to the normal functions or the brain. An athlete that has multiple concussions can lead to long term effects that can negativity affect there life. Other injuries to the head can be even as severe as becoming paralyzed and head injuries can lead to diseases such as ALS (Lou Gehrig s Disease) and even Parkinson's.

Key Moments and Athletes in Sports Involving Head Injuries.

-On October 19, 2010 the world of college football had changed with one significant injury that know one could ever forget. Sometimes in college football we watch a big hit and we hear a roar come from the player who made the tackle but "sometimes, there is not a roar at the end of the play, but silence" (Lopresti 3). On this day while attempting to make a tackle during a kickoff Rutgers defensive tackle Eric Legrand was in a helmet to helmet collision but this hit was none out of the ordinary. After Legrand received the severe blow to his head he was unable to reach to his feet so the trainers brought the cart to get him off the field. To let the fans know you are alright a player typically will put a thumbs up to the crowd on there way off the field but while Eric attempted to do this it was known that it was impossible. This was because the hit was so severe that it had paralyzed Eric for the neck down. Eric had fractured his C3 and C4 cervical vertebrae and was transferred to Kessler Medical Center the nations top spine and head rehabilitation center. Eric was at first unable to breathe on his own and doctors said his chances to walk were very slim. Eric now is able to eat and breathe on his own and is a motivational speaker. He goes to local high schools all over the east coast and speaks on his story and his Believe fund that he started to benefit athletes with head injuries. Although being paralzyed Eric was drafted in the NFL by his college coach and was selected by the Tampa Bay Buccaneers and his Jersey number 52 was retired by Rutgers University. Eric was named the Jimmy V award winner presented by ESPN during the Espy's in 2012. He is an inspiration to us all as he begins to work his way to walk again. He has progressed more and more then anyone has though he would be able to and was a pleasure to talk to at my time at Rutgers.

Eric Legrand enters High Point Solutions Stadium to get his jersey retired
Eric Legrand enters High Point Solutions Stadium to get his jersey retired

-In 1939 New York Yankee Lou Gehrig was diagnosed with a deadly disease known as Amyotrophic lateral sclerosis (ALS) which is a currently a incurable illness. "Motor neurons (brain cells that control muscle movement) degenerated die, leading to a progressive paralysis that eventually robs people of the ability to breathe on their own" (Miller 8). Lou Gehrig was forced to retire from major league baseball in 1939 when he was diagnosed with ALS and two years later he passed away. On the day he retired from the Yankees is the day his famous "luckiest man" speech was captured by the media and is still known as one of the most famous speeches in sports history. In the 1930's doctors and scientist did not know much about ALS and how it was caused but in 2010 Dr. Ann Mckee began to look at three athletes brains who had a lot of head injuries. While studying the brains of each of the athletes the question arose could all these head injuries really be a direct link to an illness like ALS. Gehrig was brought up in this study not because his name was one of the first linked to ALS but "He was known—paradoxically—for his durability. He played in 2,130 consecutive games (a record that stood for more than 50 years). It is also known that he played several times after being knocked unconscious" (Miller 8). Mckee also concluded in her studies that Gehrig had three or four concussions that landed him in the hospital. When finishing the studies it had been shown that head injuries could have a direct link to ALS. This was ultimatly shown when McKee studied the three athletes an saw "these three individuals, they had this hideous abnormal protein called TDP-43" (Smtih/Mckee CNN). TDP-43 is a protein that is associated with many motor neuron diseases including ALS, this protein is found in the nucleus of the nervous system cells. When studying brains Dr. Mckee saw that TDP-43 was leaking out of the nucleus of the spinal cord and brain; all these athletes levels of TDP-43 were in extremely high amounts way more then the normal and were found in many sections throughout the central nervous system. The one thing that hurts this study is not being able to compare the three athletes brains to Lou Gehrigs because then we could see the direct comparison between all of the athletes with head injuries and ALS. Although the study is still young scientists are still studying athletes to determine if there is a positive link to head injuries and ALS. It has been shown more and more that athletes with large amounts of head trauma are more prone to ALS. Scientists are taking head injuries way more serious now and it is amazing that looking at the Iron Horse scientists are able to see if there is a link to head injuries and sports. Gehrig had a great career as a Yankee and looking at him may eventually help scientists determine how to cure ALS or how to prevent. Lou Gehrig may of had a terrible disease but he was positive and his final words that day at Yankee stadium: "So I close in saying that I might have been given a bad break, but I have an awful lot to live for."























Sports That are having Brain Injuries Involved.

-Sports like MMA (Mixed Martial Arts) and Boxing are two sports where many fighters are experiencing head trauma from there fights. In each of these sports fighters are receiving full blown punches, knees, and even leg attacks to the head which can cause head trauma, a fighter being knocked unconscious, and concussions in some athletes. In MMA rules are have been changed partial to protect the fighters lives but the current rules allow knees and head kicks which can cause head trauma. MMA is a full contact sport which makes the athletes fighting more vulnerable to head injuries. Since the career of MMA has been so short over the years there are no key athletes that have been studied to determine if these athletes are having long term effects from the sport of MMA. Although there are no key athletes "MMA athletes reported concussive symptoms, training routines, and medical histories through an online survey. Nearly 15% of the MMA athletes reported history of a knockout, and nearly one-third reported a technical knockout" (Heath/Callahan 198). Many athletes in MMA have been knockout and have had concussions but these athletes report back to training anyways or some do not get the concussion checked by a doctor. Boxer on the other hand has many notable athletes that have head injuries linked to problems later in life. Two notable boxers would be Joe Frazier and Muhammad Ali who had been boxing for many years and later in life developed Parkinson's disease which was linked to there many head injuries. Ali after his fighting career was over went to Dr. Fahn and he concluded that Ali had Parkinson's disease. They believed if Ali took his medication he would be okay the Parkinson's was developed in a way the doctors had not seen and although it was unknown why Ali developed Parkinson's "doctors and the former champ himself agree with the thousands of observers that there might be a connection between his condition and professional boxing career" (Leavy 139). Ali himself talks about the thousands of punches he took throughout his career and said that the "punches would affect anyone" (Leavy 139). The disease took a toll on Ali because as it progressed he began to become self-conscious about his speech and refused to be interviewed on his condition. After many careers Olympic boxing lead a study and drew blood from althetes 1-6 days after there fights and then again another 14 days later. When the study was finished it was concluded "olympic boxing is associated with elevation of tau in plasma. The repetitive minimal head injury in boxing may lead to axonal injuries that can be diagnosed with a bood test" (Neselius 427). It was also shown just like other sports that repetition in brain damage and injuries can lead to serious injuries later in life.

-Football and Hockey are two sports that have helmet to helmet contact which can lead to things such as small head trauma and concussions. In both these sports "an attitude that stresses ‘‘toughness’’ and ‘‘ruggedness’’ of players who can ‘‘heroically brush off’’ injuries often pressures players to neglect their own safety and health for the game " (Cusimano 1). Players want to play more and more and almost forget about there health in order to play in a game. Players play the sports so competitively that they forget about what helmet to helmet contact can do a player. In Football it was been very apparent in times as defensive back attempts to make a tackle they lead in with there helmet sometimes hit a player who is defenseless. Some of these hits are extremely hard and lead to a player getting a concussion. The same goes for hockey and a player attempts to check another player this can lead to a helmet to helmet collision which can also cause some head trauma or a concussion. Both these sports are full contact and with full contact we can head trauma and other injuries. There are many notable moments in football where a wide receiver goes up for a ball and gets crushed by a defensive player resulting in a helmet to helmet collision causing a concussion. In hockey although checking can cause trauma the fans favorite part the fights can cause many head injuries. As each player take their helmet off during a fight it can leave a player vulnerable to getting hit in the head. There have been plenty of hockey fights that lead to concussions because player get hit in the head or hit their head on the ice.





What Can We Do Prevent Head Injuries?


The Impact Test: "ImPACT provides trained clinicians with neurocognitive assessment tools and services that have been medically accepted as state-of-the-art best practices -- as part of determining safe return to play decisions" (ImPACT). Athletes will take a baseline test which will test:

  • Attention span
  • Working memory
  • Sustained and selective attention time
  • Response variability
  • Non-verbal problem solving
  • Reaction time

The baseline test will record a score that is sent to the trained clinicians who will keep the results of the test. If an athlete has or is suspected to have a head injury the baseline report will serve as a comparison to a repeat ImPACT test, which professionals can use to assess potential changes or damage caused by a concussion. An athlete will not be able to report back to competition until the score of the baseline test is back to normal to assure that an athlete is safe to compete. The test is in four parts and takes about 20 minutes and is very useful in highschool and college sports. Having this test has actually helped get athletes back on the field safely. It is now required by the NCAA for all school to administer an ImPACT test to all athletes before they can participate in sports.

Below is the ImPACT Programs plan to help get athletes back on the field
ImPact Test Plan
ImPact Test Plan



College Football
-College football in the 2013 season made a rule change that can be benefitcal to help make the sport more safe. In 2010 there was a rule that was adapted to college football that "targeting and initiating contact with the crown of the helmet, or striking another player in the crown or neck area of a defenseless opponent with the helmet, forearm, elbow or shoulder" (Rolling (Bleacher Report)) would result in an automatic penalty. This rule was doing its job but it did not change the number of helmet to helmet collisions due to the collision only resulting in penalty. The rule was changed in 2013 now that any targeting contact on the neck area of a defenseless opponent would result in ejection from the player making the contact and a 15 yard penalty. The ejection is up for review by the coaches but the referee has the last decision weather or not to eject the player. This is excellent for the sport because players now are more aware of tackling correctly rather then attacking a player by a helmet to helmet collision. Although there will still be some helmet to helmet collisions the number of concussions this year in college football is significantly lower. Another thing that has been helpful in college football is that if a player losses there helmet during a player then must sit out on the next play to ensure that the helmet is placed on safely. This helps reduce the number of head injuries because it requires a player to safely put their helmet back on. Now many coaches were not happy with the rules changes because they felt that the players were going to be the ones to suffer in an accidental hit but its was to help ensure safety in the sport. Some coaches were very happy about the new rules.

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Gary Patterson on adjusting to the new targeting rule: "It was easy. We tackle legs. We've been tackling legs for 10 years here."
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    • Coach Ubben of TCU showed support for the new rule because he saw that the safety of his players was more important than anything else in football.
Hockey:
Hockey changed its rules in 2013-2014 as well the new rules stands as

"Players are now subjected to an extra two-minute minor penalty for unsportsmanlike conduct if they remove their helmet prior to engaging in a fight. The rule was made strictly with player safety in mind to reduce the risk of a player hitting his head on the ice while not wearing a helmet." (Rosen)

This rule is excellent for the sport because it now will help players be much safer during the game and limit the head injuries in the sport. There is a rumor now that fights will be banned in the NHL starting in 2014 but it has not been announced to be true or not yet.

Overall: Sports are attempting to change and help prevent the many head injuries in sports. People are starting to realize that head injuries are nothing to take lightly and can lead to some terrible things. If you think you may have a concussion check these signs below.


external image symptoms-chart_001.png


Questions you will probably be asked if you have a concussion or have been knockout.1) Do you know what your name is?
2) Do you know where you are at?
3) Do you have any remembrance of what happened?
4) Can you give me your birthday?
5) An important holiday or date
6) Remember some numbers or spelling or word?

If you can answer these questions it does not mean you do not have a head injury but it is a good sign that is not too severe. The less you can answer the worse your head injury could be.

Conclusion:
If you think you have a concussion consult a doctor or athletic trainer. If you are a college athlete do not go back into the game until you are fully healed. Take the impact test serious and enter back into sports when you are healed and ready for competition. Concussion and other head injuries are being taken very seriously now in sports. Hopefully one day we can limit the head injuries to a minimal amount and use the athletes in the past to help find cures for ALS and Parkinson's and other head induced injuries. In the future we will see less and less head injuries. People may think this takes away from the sports but its important to ensure all athletes are safe that is the number one priority.


ResourcesCusimano, M. D., Sharma, B., Lawrence, D. W., Ilie, G., Silverberg, S., & Jones, R. (2013). Trends in North American Newspaper Reporting of Brain Injury in Ice Hockey. Plos ONE, 8(4), 1-6. doi:10.1371/journal.pone.0061865

Head Injuries: Causes and Treatments. Retrieved on December 3, 2013 from. http://www.webmd.com/fitness-exercise/guide/head-injuries-causes-and-treatments

Heath, C. J., & Callahan, J. L. (2013). Self-Reported Concussion Symptoms and Training Routines in Mixed Martial Arts Athletes. Research In Sports Medicine, 21(3), 195-203. doi:10.1080/15438627.2013.792082
Impact. Retrieved December 1, 2013 from http://www.impacttest.com/ ImPACT Applications, Inc. © 2013
LEAVY, W. (1985). Muhammad Ali: 'DON'T COUNT ME OUT.'. Ebony, 40(5), 138-144.

Miller, M. C. (2011). Did Lou Gehrig have Lou Gehrig's disease?. Harvard Mental Health Letter, 27(8), 8.
Neselius, S., Zetterberg, H., Blennow, K., Randall, J., Wilson, D., Marcusson, J., & Brisby, H. (2013). Olympic boxing is associated with elevated levels of the neuronal protein tau in plasma. Brain Injury, 27(4), 425-433. doi:10.3109/02699052.2012.750752

Rolling, Chris. College Football Rule Changes 2013: Breaking Down Most Important New Rules. The Bleacher Report. Retrieved December 3, 2013 from. http://bleacherreport.com/articles/1754276-college-football-rule-changes-2013-breaking-down-most-important-new-rules

Rosen, Dan. Hybrid icing tops list of rule changes for 2013-14. Retrieved December 1, 2013 from http://www.nhl.com/ice/news.htm?id=684940
Mike, L. (n.d). Football's frightening human toll. USA Today

Smith, Stephaine. Did concussions play role in Lou Gehrig's disease? Retrieved on November 27, 2013 from. http://www.cnn.com/2010/HEALTH/08/17/als.lou.gehrigs.concussions/




Media Citing


Greatest Sports Legends- Lou Gehrig's Farewell Speech. Youtube. Retrieved on December 3, 2013 from http://www.youtube.com/watch?v=626Dt9JdjQs

Huge Concussion Hits in Football. Youtube. Retrieved on December 1, 2013 from. http://www.youtube.com/watch?v=9NNT8lhqbPw

Impact. Retrieved December 1, 2013 from http://www.impacttest.com/ ImPACT Applications, Inc. © 2013
Rolling, Chris. College Football Rule Changes 2013: Breaking Down Most Important New Rules. The Bleacher Report. Retrieved December 3, 2013 from. http://bleacherreport.com/articles/1754276-college-football-rule-changes-2013-breaking-down-most-important-new-rules