What’s as American as Apple Pie? Concussions in Sports

football playersAre you ready for some footba…er, brain trauma?  This story in the HT, Concussions no laughing matter in football, is timely.

I was biking through our local park last night, beautiful weather; a little breeze, and though warm and sunny if you kept moving (walking or riding a bike), it was very pleasant.  A great evening to take the kids to the park so they can, well be kids, frolic, be free, laugh, play tag, swing and so on.

Or you could take your kid to the park and put him (her?) under the charge of a few men with whistles who appear to be interested in lining the little fellas up to run football plays, which is what I saw in the field where most kids I see are playing frisbee or kickball.

I could hear the coach trying to go over a running play and blocking scheme for a “24 dive”–and if my playing days aren’t too far behind me I can tell you that’s a tailback “dive” or run into the gap between the guard and tackle.  These kids were maybe 8 years old.

I could probably go on for too long on this one as it touches on our culture, our fans, our consumerism, our “team spirit”, our worship of jocks in general to no good purpose, and when the “labor” is the actual commodity in this profession you have a business that can readily compared to a kind of cattle auction for prize bulls.

But, the most important issue at hand here is traumatic brain injury (TBI).  Lynn Houser in the HT story writes:

The culprit is the concussion. With the season only one week old, no less than four starters have been diagnosed with concussions, as many as the Mustangs had all of last year. And that’s not counting the preseason, when a couple other players got their bells rung.

You can argue all you want with me…but donning armor before you grow hair on your testicles seems like begging for trouble.  Football requires head-to-head collisions.  It requires collisions be made at top speed.  It requires bodily sacrifice in the service of winning.  Certain positions, though valuable, are “expendable”, ie, “workman-like” and more easily “trainable”.  It requires top-down regimentation and acceptance of orders. Hmmm…sounds like a microcosm of a corporation or the military.  But, I digress.

The Centers for Disease Control (CDC) offers this:

  • Each year, U.S. emergency departments treat an estimated 135,000 sports- and recreation-related TBIs, including concussions, among children ages 5 to 18. (MMWR July 2007)–that’s Morbidity and Mortality Weekly Report
  • Athletes who have ever had a concussion are at increased risk for another concussion.
  • Children and teens are more likely to get a concussion and take longer to recover than adults.

And on WebMD in an article titled “Football Leads Youth Sports Injuries”, (which cites the CDC report) also offers this:

The new study on football injuries appears in The American Journal of Sports Medicine.

Football is the top scorer when it comes to racking up sport-related injuries, according to the study. But high school and college players may face very different injury risks.

Researchers found high school football players suffered more than half a million injuries nationwide during the 2005-2006 season. And they were more likely to suffer season-ending injuries, such as fractures and concussions, than those who play collegiate football.

Maybe you’ll recall this from back in 2009 as reported in the Boston Globe:

In a discovery that is bound to reverberate through the nation’s youth football community, clinical researchers reported yesterday that the brain of a recently deceased 18-year-old high school football player showed the earliest signs of an incurable debilitating disease caused by the kind of repetitive head trauma he experienced on the field.

What results from having your “bell rung” is further elucidated in this recent in-depth piece by Ben McGrath in The New Yorker on the “concussion crisis”:

What was missing from this picture was the effect of all that impact on the brain. You got your “bell rung,” they used to say. You’re “just a little dinged up.” This was not merely macho sideline-speak; it was, as recently as a decade and a half ago, the language of the N.F.L.’s leading doctors. Elliot Pellman, who served until 2007 as the Jets team physician, once told a reporter that veteran players are able to “unscramble their brains a little faster” than rookies are, “maybe because they’re not afraid after being dinged.”

Chronic traumatic encephalopathy, or C.T.E., is the name for a condition that is believed to result from major collisions—or from the accumulation of subconcussions that are nowhere near as noticeable, including those incurred in practice. It was first diagnosed, in 2002, in the brain of the Pittsburgh Steelers Hall of Fame center Mike Webster, who died of a heart attack after living out of his truck for a time. It was next diagnosed in one of Webster’s old teammates on the Steelers’ offensive line, Terry Long, who killed himself by drinking antifreeze. Long overlapped, at the end of his career, with Justin Strzelczyk, who was also found to have C.T.E. after he crashed, fatally, into a tanker truck, while driving the wrong way down the New York Thruway.

Recall, children and teens are more likely to get a concussion when they receive head trauma, and that once you have one concussion, your more likely to suffer another.

It is true, however, that TBIs are not limited to football and that all sports or athletic activities DO put kids (and adults) at risk.  Heck, I know a little boy that just fell off the playground equipment in the park and broke both his radius and ulna, and of course bicycling is dangerous too.  I’m not entirely sure what to make of this.  Looking at the tables in the report above (MMWR) one seeks “culprits”–damn you, football! Oh, wait, bicycling is rough…and there’s baseball, and basketball, and, doh, soccer too!

Okay, maybe football, though clearly very dangerous, is not the only debilitating sport; maybe they all are as we currently conceive them and participate in them.

If you allow me to extend or broaden the discussion, maybe it’s cultural; maybe it’s that we don’t MOVE unless it’s, well, a determined form of exercise and something more than simple animal/human play.  Games are not games for us unless there are winners and losers it seems, a “record” of success or failure.  This seems to me to spring from a cultural impulse to encourage and indoctrinate (you knew I’d say that eventually, right?) competition as almost the only reason to play games.  Ask most parents and they’ll talk about school sports in particular as a way to inculcate the “right lessons” of competition. But considering the physical trauma of the sports we’re asking our children to be indoctrinated by, this makes them seem all the more ill-focused.

What seems especially worrisome to me is that kids might easily be considered combatants, and activities that are “sectioned off” from daily life, regimented and scheduled, may in fact only present the very natural impulse to play (gambol, frolic) as a particularly “American” understanding of play as directed outward at a material pursuit; as a field where one learns the social rules.

Play is rule-bound–especially in groups.  How we play together is a key to understanding our culture.  What is it we teach our little gladiators in football garb? Is it worth the concussion risk?

Johan Huizinga has written the classic work on “Man the player”, Homo Ludens, in it he offers five characteristics of play:

  1. Play is free, is in fact freedom.
  2. Play is not “ordinary” or “real” life.
  3. Play is distinct from “ordinary” life both as to locality and duration.
  4. Play creates order, is order. Play demands order absolute and supreme.
  5. Play is connected with no material interest, and no profit can be gained from it.

If we examine what our “sports” are, or what they entail, and try to apply the above list to them, I think we might not designate our conception of sport as one equivalent to “play”. Athletic pursuits are one thing (increasing your body’s strength, endurance, speed), but the physical destructiveness of what I outlined above does not fit this bill either.

To the victor goes the spoils in America.  And a lifetime of debilitating effects.  Maybe it’s intentionally called “spoils”.

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10 Comments

  1. focus August 26, 2011 at 5:50 pm

    you have hit on an issue that is near and dear to me. Concussion is only one part of this problem, although one of the most dangerous as far as long term effects. Football is the most visible of these concussion heavy sports but soccer, rugby and cheerleading have exceptionally high statistics also. I know cheerleading may sound like it doesn’t fit with this theme but read this quote below:

    “For high school girls and college women, cheerleading is far more dangerous than any other sport, according to a new report that adds several previously unreported cases of serious injuries to a growing list.

    High school cheerleading accounted for 65.1 percent of all catastrophic sports injuries among high school females over the past 25 years, according to an annual report released Monday by the National Center for Catastrophic Sports Injury Research.

    The new estimate is up from 55 percent in last year’s study. The researches say the true number of cheerleading injuries appears to be higher than they had previously thought. And these are not ankle sprains. The report counts fatal, disabling and serious injuries. ” http://www.livescience.com/2775-girls-dangerous-sport-cheerleading.html

    Concussions lead to the most debilitating and long term injuries however we currently also have an epidemic of overuse injuries. Children play sports year round now. They specialize, as you say above, at younger ages than ever before. They play school, club and camp sports. They may play their particular sport year round and do school and club versions at the same time. Growing bones, ligaments and tendons are unable to cope with this kind of repetitive use. We may be dooming our children to be unable to play the sports they love by the time they are in college–the elusive carrot of college sports scholarships are not for all. The single minded pursuit of sport excellence, with sport enhancement clinics for kids or accelerated sports programs focused on youngsters only feed into this problem. Recently the Pediatric Community, Sports Medicine community, Physical Therapy and Athletic Training societies came out with a position statement against this kind of overuse activity schedule. Is anyone paying attention or listening? Doubtful.

    http://sportsmedicine.about.com/od/children/a/overusekids.htm
    http://www.healthnewsdigest.com/news/Children_s_Health_200/New_Guidelines_to_Prevent_Pediatric_Overuse_Injuries_in_Sports_printer.shtml

    Reply
  2. focus August 26, 2011 at 5:55 pm

    One good thing to have come out of research is the IMPACT program. http://impacttest.com/

    This allows baseline testing to be done on all athletes. After any kind of head injury/concussion type injury the athlete must be able to show that they have returned to their baseline exam result before they are allowed to return to sport. This is fact and data based information, not the old “48 hours he’ll be fine” kind of thing. Coaches, parents, primary care physicians–no one can override this. It is used by collegiate programs throughout the country and moving more into high school athletics and club sports.

    Reply
  3. Ian August 26, 2011 at 9:08 pm

    Gregg Easterbrook has been writing about the concussion issue in his TMQ column at ESPN.com for years. He rightfully points out the hypocrisy of the NFL in saying they want to crack down on head to head collisions, but still highlighting such plays in promotional video.

    He has a lot of interesting stuff about new helmet technology and how high schools should be made to conform to the new helmets.

    Reply
    1. Douglas Storm August 26, 2011 at 10:15 pm

      honestly my response is that it should not be a sport. There, I said it. Especially not as part of a public school cost. We waste too much energy and money on it.

      Reply
      1. Douglas Storm August 26, 2011 at 10:27 pm

        In fact, I would go so far as to say if any part of public school systems, including university programs, should be removed and privatized, it’s sports. Then there can be all sorts of lawsuits over injuries to minors.

        Reply
  4. focus August 26, 2011 at 11:21 pm

    athletics are costly. There is much more outcry when schools try to drop athletics however than when they drop art or music or any other activities. Sports boosters usually are able to provide a lot more financial support than say, music boosters. Priorities.

    Reply
    1. Douglas Storm August 27, 2011 at 7:31 am

      There is an argument to be made for a kind of community identity that one might align or “foster” via high school sports. But I won’t make it because I don’t buy it. I’d be open to hearing it though.

      But mostly, like anything, membership has its privileges. The more things cost, the more we value them.

      Also, we seem to believe that “sports” (like business) is the reigning “way of life” in America and so we privilege it. And we believe it’s for the “whole” school or community. While things like music and the arts, even where a decent theater program exists, is for the “individual” student. And when things benefit a few kids out of the “whole” and outside of the basic focus of the community’s (nation’s) “ideal” activities…then let’s have that “self-reliance” factor kick in for funding shall we?

      Reply
      1. Douglas Storm August 27, 2011 at 7:44 am

        Here’s a claim in a report from the “Aftershool Alliance” (who pays this tab?):

        Most of this remarkable benefit is derived from diverting a relatively small portion of at risk youngsters from a future path of crime. An at-risk child who becomes a career
        criminal costs society anywhere from $1.4 million to $1.7 million over his or her lifetime. Therefore diverting even less than one percent of participating at-risk youth from a life of crime saves several times the cost of the program.

        Color me skeptical.

        Reply
  5. Eric M. Sargent October 21, 2011 at 12:19 pm

    Just as an interesting note to this story: of our 600 or so students, 8 of them are currently out with athletic-related concussions. Largest number I have seen in my eleven years in teaching.

    Reply

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