Dr Kevin Campbell, Chief Medical Correspondent, Bold Global Media
In the last several years, concussions among NFL players are making headlines. Suicides and other tragedies among retired players have brought forward some of the more severe long-term effects of repeated head injuries—Chronic Traumatic Encephalopathy or CTE. While the NFL has developed a policy designed to protect players, there appears to be more and more cases where these protocols are being ignored and putting players at risk
What is a concussion?
A concussion is a type of brain injury that occurs when there is a blow to the head. There are many causes of concussions but most commonly they are caused by falls, car crashes and sports injuries—particularly in football. The brain is surrounded by a fluid called cerebrospinal fluid or (CSF); when a violent blow to the head occurs, the brain is slammed against the inside of the skull as it moves back and forth in the CSF. This movement can produce bruising of the brain tissue, bleeding inside the skull as well as potentially permanent brain damage. Most concussions are short lived and self-limited. Symptoms include confusion, headache, extreme sensitivity to light, mood changes and sleep disturbances. It is vital to get rest when recovering from a concussion. Sports that are most likely to be associated with concussion include: Football, hockey, soccer and boxing. Concussions change brain chemistry and it may take up to a week or more for these chemicals to reset—it is important that athletes DO NOT return to competition until they have completely recovered.
What is the Current NFL Concussion Protocol?
Currently the NFL requires that there is an unaffiliated neurological consultant or UNC at every game. This is typically a neurologist or neurosurgeon who is not affiliated with the team or teams that are competing in order to remain impartial when evaluating players for potential concussions. The UNC is part of a team of more than 30 medical professionals on the sidelines of every single team. The UNC and his or her assistants (spotters) are looking for signs of concussion in every player during the course of the game. The signs that warrant evaluation and pulling a player from the game immediately include:
–Any loss of consciousness
–Slow to get up after a hit to the head
–Balance problems after a hit to the head
–Blank or vacant look
–Clutching of head after contact
If ANY of these high risk features are observed, the NFL mandates that the player must be taken off the field immediately and the UNC must administer a sideline neurological test in order to determine if a concussion has occurred. Each player has a baseline test performed prior to the season in order to serve as a comparison tool during competition.
What is CTE?
The deaths of Frank Gifford and Junior Seau have brought the condition chronic traumatic encephalopathy to the forefront in the last several years. While Mr. Gifford appeared to die of natural causes, his autopsy showed pathology consistent with CTE. NFL standout Junior Seau tragically committed suicide and suffered from long-standing depression. Autopsy results also showed that he had CTE. Actor Will Smith also portrayed Dr. Bennet Omalu in the 2015 movie Concussion. This movie tells the story of Dr Omalu who discovered and characterized CTE for the first time after performing an autopsy on former NFL player Mike Webster. CTE has been extensively studied since that time and a study from 2015 revealed that the brains of 87 of 91 former NFL players who underwent autopsy had evidence of CTE.
What is being done to improve safety for NFL players?
Following multiple lawsuits by former players, the NFL has finally begun to take CTE and concussions seriously. Last year, there were 271 documented concussions during the season but I suspect the actual number is far greater due to underreporting. As outlined above, there are now mandatory protocols in place. If teams do not follow these protocols, they can be fined and penalized the following season—resulting in lost draft picks and other penalties. However, this season, the application of these mandatory protocols has been quite variable. This week NFL star quarterback Cam Newton will not be in the game due to a recent concussion. He has sustained numerous hits to the head this season and only now has he been pulled from a game. In the opening game of the season, after taking multiple violent hits to the head, Newton was never even evaluated per protocol. Last year, the St Louis Rams were disciplined for not removing quarterback Case Keenum after it was clear that his head had slammed into the turf. He was never even evaluated with the concussion protocol. Teams must do more to protect players. More importantly, the NFL must set an example for player safety for younger athletes in college and in high school. We cannot allow players to continue to suffer concussions that can have long reaching negative health effects. Football is a violent game and professionals make a decision to participate—however, we cannot put winning games ahead of the neurologic safety of players. There must be more accountability for organizations and coaches who do NOT put player safety first.
Dr Kevin Campbell, MD, FACC is chief medical correspondent for Bold.global. Dr. Campbell is an internationally recognized Cardiologist who specializes in the diagnosis and treatment of heart rhythm disorders. Dr. Campbell is the Medical Expert for WNCN and appears weekly on the CBS morning news and also makes frequent appearances nationally on Fox News, CBS, and HLN.