Update: revised head injuries

Head injuries in athletes that cause concussions occur more often than previously thought. We are learning more about the problem and the important consequences. Each year, more than 300,000 athletes in the US suffer some type of traumatic brain injury (TBI). High school athletes included 60,000 of these injuries. The consequences vary widely, but can be both emotional and intellectual. TBI can cause short-term symptoms, as well as problems that are more serious and may not appear for several years. The type of problems that develop will depend on the part of the brain affected, the severity of the blow, the number of repeated blows to the head, the individual’s pre-existing conditions, and the personality traits of the injured person.

The more blows to the head, even the smallest, increase the risk of mental deficiencies. A significant head injury in a soccer player occurs hundreds of times a week during practice and experience of the game. Exploring options for protective equipment in contact sports and teaching fundamental sports techniques that can reduce head injury are critical to reducing the number of injuries and serious consequences.

A 2000 study surveyed 1,090 former NFL players and found that more than 60 percent had suffered at least one concussion in their careers and 26 percent had three or more. Those who had concussions reported more problems with memory, concentration, speech impediments, headaches and other neurological problems than those who did not, the survey found. Given that these professional players spent many years rising through the ranks as amateurs, the frequency of head injuries is likely underreported. Head injuries are also a problem for many of the non-contact sports.

Other common issues are being discovered as we take a closer look at this challenge. Depression, insomnia, attention deficit, and personality changes also occur with similar frequency among high school athletes. Long-term problems can take eight years or more to develop or get worse.

Immediate symptoms that require elimination from sports activities include amnesia, poor balance, headaches, dizziness, or other neurological deficits on examination, regardless of how quickly they disappear on the sidelines. It is widely accepted that the symptoms of a concussion can reappear hours or days after the injury, indicating that the player had not healed from the initial blow. This requires strict guidelines that conservatively allow adequate time for healing to occur. The question remains, how long is enough? A healthcare provider should be involved in the examination and investigation of these head injuries to ensure the best outcome. Even an episode of head trauma makes the athlete more vulnerable to the serious consequences of the next episode, which in many contact sports is unavoidable.

Both professional and university sports authorities are changing their recommendations regarding contact sports. Reduce the numerous blows to the head by imposing practices where there is no contact. Research has shown that the number of blows to the head during a college football season runs into the thousands to an individual player. Many of these have forces comparable to driving a car against a concrete wall at 40 miles per hour. Teaching better technique to reduce main head contact and providing better equipment can reduce negative effects. The manufacture and testing of football helmets is not strictly regulated. New helmet technology and better monitoring of equipment after a repeated impact can reduce the consequences of a head impact.

Repeated head injury that results in severe consequences of a traumatic brain injury should come as no surprise. We can do more to preserve and protect athletes of all ages. A concussion is a complicated problem that needs a thorough initial evaluation. Seek medical attention for head injuries, even if they seem minor and without loss of consciousness. The severity of symptoms and initial imaging studies can detect serious problems early and provide the reassuring basis for continued treatment.