What I’d Do If I Were an Athlete With Brain Damage

                                       Written By: Andrew Fox 

 

If you suspect brain damage, you should seek professional, medical help. But we’ll get to that. First, let’s give you some much-needed background information on concussions and how they occur.

The recent film Concussion, starring Will Smith, did a pretty good job of detailing the controversial story behind the discovery of chronic traumatic encephalopathy (CTE) in deceased NFL players. It brought a spotlight on an extremely important and often neglected discussion of the risk of brain trauma in the world of contact sports. In the film, Will Smith plays the character of Dr. Bennet Omalu, a Nigerian-American physician and neuropathologist who is credited with the discovery of CTE in American football players.

A Brief Primer on CTE

On studying the brains of deceased NFL players, Omalu found evidence of a condition earlier found in professional boxers, namely dementia pugilistica. Repeated blows to the head over the span of their careers had resulted in long-term neurodegenerative changes in the brain which manifested as intellectual impairment, mood disorders, drug abuse, depression and other life-changing symptoms.

However, until Omalu came along, little was known about CTE and its devastating effects on the brain. In fact, most athletes who showed symptoms consistent with brain damage were often diagnosed with Alzheimer’s because of the overlap in the symptoms they experienced. However, only after CTE was discovered did it become apparent that athletes with a history of repetitive mild brain trauma develop a distinctive condition other than Alzheimer’s or dementia that requires a different approach to treatment.

What is a Concussion?

To understand concussion, let’s first take a quick look at the anatomy of the skull and the brain. The brain is encased inside the skull and floats around in cerebrospinal fluid. Because of this, it isn’t attached to the head. The skull protects the brain from external damage or puncture, and the liquid, which is mostly water, acts like a cushion or suspension to dampen any impact the brain may take.

That isn’t much protection at all when it comes to sustaining large impacts as in boxing, American football, ice hockey, or even an accidental fall to the ground. In layman’s terms, a concussion happens when the brain makes contact with the skull due to a large or small impact, depending on the angle of the blow. Watch this animation to get a clearer picture of what happens inside the skull of a concussion victim.

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Most people think that you have to “pass out” or get “knocked out” or be “out cold” (as in boxing lingo) to suffer a concussion. This couldn’t be farther from the truth. Even smaller impacts that cause the brain to make contact with the skull can lead to a concussion. Most times, a person that gets concussed feels like their “bell has been rung” while otherwise being wide awake and aware!

In most cases, if you suffer a concussion, you may experience any or all of the following symptoms:

  • Double/blurred vision, seeing stars
  • Sensitivity to light
  • Headaches
  • Dizziness and loss of balance
  • Nausea
  • Vomiting
  • Fatigue
  • Depression
  • Trouble sleeping
  • Confusion, difficulty in concentration
  • Loss of consciousness

These symptoms may either resolve within a few days or can even persist for several weeks and months after the incident. In rare cases, when they persist for longer than a couple of weeks or months, the individual usually has PCS (post concussion syndrome).

Let’s take a look at the myriad ways that athletes suffer concussions across various contact sports.

Concussions in Sports

Boxing

Boxing is notorious for its heavy blows to the head and chin and highlight reel knockout finishes. It’s one of the toughest and most violent contact sports on the planet. In fact, the most cases of CTE and PCS result from long and punishing boxing careers, by far.

In boxing, fighters target one of two ‘sweet spots’ on the body to finish the fight: the chin and the solar plexus. The chin is the more sought-out of the two targets, simply because a clean blow on it can cause the brain to dislodge the most in the skull, hitting both the front as well as the back of the head, thus causing a concussion. The most knockouts result from accurate shots to the chin (whether from a jab, hook, or other power punch) and not from heavy shots to the face or head. On the other hand, a clean blow to the solar plexus, which is located in the abdomen, can “wind” the opponent and leave him/her gasping for air before the fighter lands the finishing blow.

Wrestling

While not as violent as boxing, wrestling too has seen some athletes fall prey to the debilitating and life-altering effects of CTE. In a recent and tragic event, a famous wrestler turned WWE superstar, Chris Benoit, killed his wife and son before committing suicide himself. It was found on an examination of his brain (post-mortem) that Chris, too, suffered from CTE as a result of several injuries to the head, much like in the cases of famous NFL players and boxers.

American Football And Rugby

Both American football and rugby are high levels, full-contact sports. However, the major difference between the two lies in the format of the game and the protective gear the athletes wear. In the NFL (National Football League), athletes wear helmets, shoulder pads, and other guards to protect themselves. However, despite the protective gear, athletes clash head-on at forces upwards of 40 G’s, and as you can imagine nothing good happens at impact.

While the NFL denied and even dismissed the evidence of CTE in their players, in light of the testimonies of several top level NFL athletes, they had to reconsider and take seriously the disease that has plagued many of their athletes.

Ice Hockey, Snowboarding, and other Extreme Sports

Ice hockey, or hockey on skates, is as extreme as extreme sports go. Players traverse the ice at shocking speeds to collide into each other, score, and save goals. Needless to say, it has its fair share of injuries.

Snowboarding, mountain biking, skiing, skate boarding and other extreme sports have also seen athletes suffer the consequences of brain trauma. Take, for example, the inspiring story of snowboarder Kevin Pearce, who took a hard fall on his head and created awareness for so many other survivors.

Prevention and Protection

It goes without saying that the best possible approach is prevention. Although protective gear such as helmets and head gear help to protect the skull, they don’t do much to keep the brain from moving around inside the skull on impact.

Athletes need to be educated, not only on the science behind concussions, but also on the leading factors that could cause concussions in their respective sports, so that they can prepare themselves to minimize incidents of concussion.

Players should be encouraged to:

  • Play by the rules of their game
  • Wear the necessary protective gear in the proper way (e.g. mouth guards, helmets or head gear)
  • Practice good sportsmanship, which involves listening to the referee/coach and curbing excessive aggression
  • Spend more time practicing techniques and less time hitting targets or sparring, in the case of boxing.
  • Stay hydrated, since the cerebrospinal fluid in which the brain floats is mostly made up of water. With dehydration, it’s easier for the brain to impact the skull.
  • Avoid using their head as the main area of contact. They should be informed of the repercussions of using their head and helmet as a weapon. Especially in football and boxing, athletes should be encouraged to target the head less.
  • Strengthen neck muscles, since a stronger neck can absorb some of the force from a hit to the head and decrease the amount force that transfers to the head and brain.

Research and development into protective sports gear have made several breakthroughs in creating improved designs for helmets as well as other gear to help minimize injury and brain trauma. For example, check out this cool new Q-collar for American football players.

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If You’re an Athlete with Brain Damage

If you’re an athlete, and you have suffered a concussion and experience all or any of the above-mentioned symptoms associated with a hit to the head, you should first and foremost visit a qualified physician. It is important that you seek good care, preferably under the hands of a sports doctor who specializes in brain trauma.

Your physician will assess your condition. He or she may suggest MRI, CT scans, or other screens to determine if there is any structural abnormality in the brain post-impact. If the above tests are clear, but you still experience some symptoms, your physician may advise certain other types of cognitive and postural stability tests.

Neuropsychological testing may be the desired course of action if your symptoms persists for several months. These tests measure cognitive abilities such as concentration, motor and impulse control, reaction time, and other such functions that can help your physician gather concrete data to treat you.

As we said earlier, symptoms can either be resolved in a week (as in most cases), or they may last for several weeks or months. At any rate, whether or not you have PCS (Post-Concussion Syndrome) your priority after seeking care should be to rest.

Resting involves:

  • No activity for the prescribed period, depending on the severity of the blow
  • Minimal exposure to unnatural lights and noises (e.g. computers, television, your phone or iPad)
  • Prescribed medication for headaches and sleep. Getting good sleep is crucial to the proper healing of the brain

Research suggests that for every concussion, a person is 1-2 times more likely for a second, 2-4 times more likely for a third, and 3-9 times more likely for a fourth(1).Hence, it is absolutely paramount that as an athlete you give yourself the proper rest and recuperation required before stepping back out onto the field.

If you have a history of concussions and think that you might have CTE, here are some valuable resources with the latest information on diagnoses and treatment:

Concussions are serious threats to the proper functioning of the brain. However, that does not mean that you should stop playing the sport you love to play. You simply need to educate yourself on prevention and protection, so that you can compete in the way that won’t compromise the quality of your life and those around you after your career is over. Play hard by all means, but respect the game and your fellow athletes.

 

References:

(1) http://www.concussiontreatment.com/concussionfacts.html

(2)https://www.psychologytoday.com/blog/calm-brain/201307/the-anatomy-concussion

(3)http://www.usmedicine.com/agencies/department-of-defense-dod/often-misdiagnosed-as-alzheimers-disease-chronic-traumatic-encephalopathy-could-play-a-role-in-veterans-dementia/

(4) https://en.wikipedia.org/wiki/Concussion_(2015_film)

 

Author Bio: Andrew is the founder and CEO at Aim Workout and Wise3 (http://wise3.com/), which helps large MNC’s and small businesses choose the best marketing automation software. He is both a passionate fitness professional and a die-hard geek. From mountain biking, rock climbing and cycling to hackathons and writing code, Andrew has a penchant for the outdoors as well as the online world.

 

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