According to estimates by the Center for Disease Control, sports and recreation-related concussions occuring every year in the United States number 300,000. With such a high rate of incidence, it is no surprise that concussions are now so highly scrutinized that sports leagues devote resources to researching prevention and treatment.
But concussion management has its complications.
The term concussion is highly ambiguous and can be caused by a variety of different blows to the body - not just the head. Dr. Joseph Rempson, co-medical director and co-founder of the Atlantic Health Care Sports Concussion Center at Overlook Hospital in Summit, New Jersey, breaks down the forces that cause concussions into two categories: linear, which cause the brain to bounce off the skull, and rotational, causing the brain to turn within the skull. But even this distinction is easily blurred, as concussions usually result from a combination of both forces.
On top of that, athletes often have their own misconceptions when it comes to acknowledging and reporting concussions. Whereas most athletes only consider some of the extremes - dizziness, nausea, loss of memory - as concussions, Dr. Gerald Maher, New England Patriots' dentist and Tufts Dental School alumnus, defines a concussion as any "change in cognitive ability," such as confusion or forgetfulness.
Not only are concussions hard to define, but they are also difficult to diagnose, especially when the sports culture encourages playing through pain. Because concussions are generally an invisible injury, producing cognitive deficiencies rather than physical impairment, doctors and trainers rely heavily on an athlete's honesty when assessing concussion symptoms. But athletes, especially pros, often hide their symptoms for fear of seeming weak.
"One of the challenges with professional athletes is the competing interests in terms of coming back in to play," Rempson said. "Players don't want to miss games because they don't want to miss paychecks, and there's a certain stigma associated with concussions."
But as concussions become increasingly prevalent and the cases of former NFL players Ted Johnson and Andre Waters highlight the dangers of traumatic brain injuries, doctors hope athletes are becoming more vigilant in managing their concussions before it is too late.
"Ted Johnson is a case in point of someone who kept playing with repetitive head injuries," Rempson said. "He sustained concussion after concussion and continued to play. He was not familiar with the long-term effects multiple concussions mean over time. Obviously, now he is.
"The most important thing is we will never prevent this - it's a natural part of sports," he continued "But our research will continue to evolve. At the grassroots level, we need education of parents and kids participating at all levels."
-by Rachel Dolin
