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Concussions: What is the risk and how can they be prevented?

With the release of the Will Smith film ‘Concussion’ being scheduled on Christmas day, the spotlight of the general public will be focus


With the release of the Will Smith film ‘Concussion’ being scheduled on Christmas day, the spotlight of the general public will be focused on the long term impacts of American football on the human brain. There will be nowhere for the NFL to hide on this, and they will have to bear the full brunt of an uninformed public reacting emotively to a film representation of the industry, which will almost definitely portray them as the bad guys. For those of you who have not already followed this topic closely, the film portrays the researcher Bennett Omalu, and his struggle with the NFL to get his research publicised.   The NFL have just agreed to pay a total of $765,000,000 to be shared between 18,000 retired players. They are expected to pay up to $5m for each player, depending on severity of their current condition. This is all down to Chronic Traumatic Encephalopathy, a condition which has been linked to repeated concussive injuries by a study on the brains of deceased football players. In the study, 79% of those players examined showed signs of CTE, and of those 79%, professional football players accounted for 96%. CTE can lead to dementia, paranoia, depression, Parkinson’s-like symptoms and speech problems. The long term impacts of repeated concussions are undeniable, and incredibly diverse, and as a result, the NFL have taken decisive action to try and restrict the level of concussions in their players. Using the Virginia Tech rating system, players are advised to select helmets with high ratings on the scale to try and reduce the risk of concussion. The rules were changed to try and reduce the amount of high impact helmet to helmet collisions in the game, and hard tackles on stationary players.   So how much more dangerous is the NFL than other comparable sports? Should concussion related issues be solely dealt with by the NFL, or have other sports got to answer? I took a look at some figures from other sports, which were few and far between, and measured in a multitude of different ways.   Rugby Union studies indicated that a player can expect roughly 4.73 concussions per 1000 player match hours. That equates to around a 4% risk of concussion per player, per game. In Rugby League the figure is shown as 5-7 concussions per team, per season. That translates to a risk of 15% per game for each player. The NHL is the only other contact sport that runs using the Virginia Tech rating system, and so far, not a single helmet has been rated as 4 or 5 stars. Their statistics show 53 concussions over the whole league, over the whole season. That translates as a 4% risk of concussion per player, per game. Comparatively, the NBA registers 9 concussions over the course of a year. Less than 1% risk for the player. The NFL stands at a 43% risk level per player, per game. That means that a team is almost guaranteed to pick up at least 7 concussions over a season.   Looking at the stats, it’s pretty clear that the NFL has a higher risk level – that has to be accepted. The question is: Why? Over the course of every single down, there can be as many as 20 registered hits on the field. The linemen will receive the first set of hits, followed by the tight ends, running backs, quarterbacks and wide receivers. Players blocking in the field can take as many as 112 low level hits in a game. This is almost twice as many as players in the NHL can expect, and four times that of rugby players. Quarterbacks and wide receivers can take the biggest hits in the game, and an unprotected quarterback, even with the changes to the rules, is almost guaranteed to be prone to picking up a concussion over the course of a game.   The very way the game is played, the nature of the game itself, is what increases the risk. There is no way of talking past it. This is a major factor in the game, and needs to be addressed. How?   There are three trains of thought. The first is that we change the rules of the game. By removing three point stances, and changing the way players tackle, we can reduce the amount of incidences where a player receives a high velocity impact to the head. This is undebatable, but the trade-off for that is that you merely change the way players tackle. Instead of head injuries, you deal with knee injuries, or rib injuries instead. Shorter term solution, long term complications. Then there’s the idea that technology can solve the problem. More advanced protection from the helmet industry, better sensors in the players gear to detect hits that could result in concussions, and better side-line assessments could enable a reduction in the long term affects. However, bosses in the helmet industry (most notably, the head of Schutt) have questioned the value of the Virginia Tech ratings. Could it be possible that relying on technology could result in an increase of concussion, due to increased confidence in players as they commit to harder tackles, due to their super-duper new gear? Then there’s the third way. Forcing players to retire after they have received a set amount of concussions. This would definitely reduce the long term impacts on a player. Most likely outcome? Players will fail to report a concussion, or hide the symptoms to avoid the risk of early retirement from the game, and loss of possible earnings. Colleges and teams could well become involved in the process of fudging figures to try and keep players on the field, or keep them available for the draft. None of these have completely clean solutions, but it is undoubtable that something is going to need to happen to stop this happening.   Ideally, this will need to be resolved by a combination of the suggested routes. Better protection, better game mechanics, and better medical support. If we’re going to put concussions under a magnifying glass, we’re going to need to look at how we treat all sports. Boxing and the UFC both have accepted risk levels when it comes to cognitive damage and brain trauma in their athletes – Dementia Pugilistica (another form of CTE) is a recognised and accepted condition that ex-competitors suffer from. Rugby is starting to take action to address long term concussion, with studies on the long term effects, and trials of changes to rules to see if it can reduce risks. Suppliers of helmets to the NHL are starting to adhere to the Virginia Tech rating system, to help increase helmet protection. Even the NBA and MLB track and record concussions, looking for escalating trends.   The NFL is leading the field in trying to deal with the legacy of concussions in the sport, and it seems that this is making other sports take note, and take affirmative action. This can only be good. We all love playing sports, and we love the physicality of our sport in particular, but one must wonder how much longer players will willingly sign up for the game when confronted with the direct effects that a hit could have on them as an individual. Hopefully, the compensation that the retired players get will go some way to alleviate the symptoms they now suffer, and the coverage of the issue will lead to a reduction in individuals suffering later in life.   Concussions are a real and dangerous element of all contact sports, and the more focus we can bring to that fact, the better we can understand – and avoid – the complications they can lead to.   Want to read more? Check our some of our latest posts

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Concussions: What is the risk and how can they be prevented?

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