According to an article in the Los Angeles Times (September 17, 2010), both quarterback Kevin Kolb and middle linebacker Steward Bradley from the Philadelphia Eagles sustained concussions during their game against the Green Bay Packers last Sunday (September 12, 2010). Bradley staggered so badly coming off of the field that he fell down before the athletic training staff could assist him.
Why should anyone care that these athletes were allowed to reenter the football game against the new concussion guidelines that were supposed to have been adopted and in use by the NFL this year?
Concussion Guidelines Protect Athletes from Second Impact Syndrome
First, the concussion management guidelines were developed to protect athletes from returning to play with brain injuries that have not healed. Returning an athlete to the field with a concussion can place the athlete at risk for second impact syndrome. Second impact syndrome has a high fatality rate. Even if an athlete survives, the athlete is at risk for permanent brain damage.
Concussion Guidelines Protect Athletes from Chronic Traumatic Encephalopathy
Second, recent research out of the Boston University School of Medicine’s research on Chronic Traumatic Encephalopathy (CTE) has shown evidence that retired NFL players with multiple concussions have permanent brain damage resulting in symptoms that mimic dementia.
In fact, the new concussion management guidelines were developed in light of this research and the growing evidence that athletes who have suffered multiple concussions may be at risk for CTE. The guidelines were established to protect the athletes from the possibility of permanent brain injury.
Third, the NFL serves as a role model for football organizations at all levels. If the NFL will not follow their own established guidelines for correctly managing concussions, other organizations may follow their lead including college, high school, and youth football programs.
Last, the message that is being sent to athletes is that the outcome of the game (otherwise known as winning) is more important than the safety and health of the athletes. Sacrificing athletes for profit and prestige is a dangerous precedent to continue to set.
The Role of the Physician and Certified Athletic Trainer in Enforcing Concussion Guidelines
The concussion guidelines were developed by sports medicine professionals to protect the athletes. Unfortunately, during the heat of a competition, head coaches have a tendency to place the outcome of the game above the safety and health of the athletes. Even athletes have a tendency to not use good judgment because of their focus on the “immediate” rather than on their own long term health.
The sports medicine staff is the group that is supposed to protect the athletes from themselves and from their coaches. Physicians and certified athletic trainers need to follow the concussion guidelines and not be pressured by head coaches or athletes to bend the rules. Unfortunately, this happens all too often.
Physicians have the ultimate authority to remove an injured athlete from the field of competition. If a coach has the authority to overrule the physician or certified athletic trainer, the athletes will be the ones who will be sacrificed for their sport and the organization will be setting themselves up for future lawsuits.
While many are watching this year to see how NFL teams respond to their own concussion protocols, the hope is that wisdom will overcome the powerful pull of winning and that better choices will be made for the protection of the athletes.
References:
Center for the Study of Traumatic Encephalopathy, Boston University, “20 More NFL Stars to Donate Brains to Research”, (accessed on June 29, 2010).
Farmer, S. (September 17, 2010). A head slap on issue of injuries. Los Angeles Times.
McKee, A.C., Cantu, R.C., Nowinski, C.J., Hedley-Whyte, E.T., Gavett, B.E., Budson, A.E. Santini, V.E., Lee, H., Kubilus, C.A., & Stern;, R.A. (2009). Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. Journal of Neuropathology and Experimental Neurology 68:7, 709-735.
Los Angeles Times Staff and Wire Reports (June 28, 2010). Bengals’ Henry had chronic brain injury. Los Angeles Times.
Sportslegacy.com, “Chronic Traumatic Encephalopathy”, (accessed on June 29, 2010).
Telander, R. (June 25, 2010). What football did for us and … what football did to us: the story of the 1968-1970 Northwestern Wildcats. Sun Times. (accessed on June 29, 2010).
Terry Zeigler - Educating through writing with over twenty-five years of experience as a Kinesiology Professor and Certified Athletic Trainer.
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