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Braining the Players: Brain Injury in Sports
Englewood Cliffs, NJ
Thursday, January 28, 2010
Dr. Patricia A. Farrell
ENGLEWOOD CLIFFS, NJ: Head injuries, even the mildest ones, have long-lasting consequences and repeated hammering of the brain leads to dementia. How many kids who are playing soccer, football or any other type of contact sport today are getting injuries that won't show up until their early 20s or 30s? According to neurosurgeons, 21% of all traumatic head injuries among American children and adolescents are sports related.
Football was second only to cycling in terms of sport-related head injuries in ERs in 2008, but who does the 20-year follow-ups on these patients? Children who played sports through their elementary, high school and college years may not be followed at all. Behavioral symptoms such as irritability, inability to concentrate and sudden mood changes may all be seen as a psychiatric disorder or related to emotional difficulties, not brain trauma. Medicating them without a careful history to reveal any pre-existing brain injury would be inappropriate. Parents and professionals have to become aware of this invisible disability because it can, mistakenly, be seen as Attention Deficit Hyperactivity Disorder or Attention Deficit Disorder. How many kids are actually screened appropriately must be the central question here. Escalating rates of ADHD and medication of children would seem to mandate such a screening.
Brain trauma doesn't always show up immediately and prolonged sports activities where there is hard, physical impact leaves the brain with more injury. Better helmets have been proposed as a means to protect players, but this fails to address the basic question; what is the injury caused by brain-against-skull? Helmets have been shown, in statistical analyses, to decrease rates of concussion. No matter what type of padding is used, however, the brain is still swimming in liquid and, like a boat on a lake, it hits the "dock" when there is an impact. You don't have to have a hit directly to the head because the impact follows the bones and, ultimately, hits the head.
New interest has now been given to these types of injuries. Studies recently conducted by Boston University indicate there is a concern regarding what is termed Chronic Traumatic Encephalopathy (CTE) as it relates to sports injuries. This syndrome has, in the past, been referred to as dementia pugilistica or "punch drunk" and was seen in prize fighters. The characteristics include tremors, confusion, slurred speech, movement problems and memory impairment. It was the conclusion of researchers at BU that "there is grave concern that CTE affects far more athletes than previously believed."
Amateur athletes may experience multiple concussions during their nonprofessional engagement. These injuries may often be overlooked and seen as little more than the usual minor scrapes of the sport. Estimates are that, in the US, 52,000 deaths a year are related to traumatic head injury and 2% of the US population lives with disabilities related to TBI (traumatic brain injury). Brain injuries, according to the Brain Trauma Foundation, are the "leading cause of death and disability in children and adults from ages 1 to 44."
Who is coaching your kids and who is evaluating them for sport-related head injury? If you don't receive satisfactory answers, you should become more involved. Remember, it's not just football because we have now seen that hockey players are also at risk.
Boston University School of Medicine: http://bit.ly/9nCYf7
Brain Trauma Foundation: http://bit.ly/aWST37
Brain trauma (Wellsphere): http://www.wellsphere.com/wellpage/brain-trauma
Concussions and Repercussions: http://bit.ly/H1OAl
National Center for Catastrophic Sport Injury Research: http://www.unc.edu/depts/nccsi/
Neurosurgery: http://www.neurosurgerytoday.org/what/patient_e/sports.asp
Sports Legacy Institute: http://sportslegacy.org/
Football was second only to cycling in terms of sport-related head injuries in ERs in 2008, but who does the 20-year follow-ups on these patients? Children who played sports through their elementary, high school and college years may not be followed at all. Behavioral symptoms such as irritability, inability to concentrate and sudden mood changes may all be seen as a psychiatric disorder or related to emotional difficulties, not brain trauma. Medicating them without a careful history to reveal any pre-existing brain injury would be inappropriate. Parents and professionals have to become aware of this invisible disability because it can, mistakenly, be seen as Attention Deficit Hyperactivity Disorder or Attention Deficit Disorder. How many kids are actually screened appropriately must be the central question here. Escalating rates of ADHD and medication of children would seem to mandate such a screening.
Brain trauma doesn't always show up immediately and prolonged sports activities where there is hard, physical impact leaves the brain with more injury. Better helmets have been proposed as a means to protect players, but this fails to address the basic question; what is the injury caused by brain-against-skull? Helmets have been shown, in statistical analyses, to decrease rates of concussion. No matter what type of padding is used, however, the brain is still swimming in liquid and, like a boat on a lake, it hits the "dock" when there is an impact. You don't have to have a hit directly to the head because the impact follows the bones and, ultimately, hits the head.
New interest has now been given to these types of injuries. Studies recently conducted by Boston University indicate there is a concern regarding what is termed Chronic Traumatic Encephalopathy (CTE) as it relates to sports injuries. This syndrome has, in the past, been referred to as dementia pugilistica or "punch drunk" and was seen in prize fighters. The characteristics include tremors, confusion, slurred speech, movement problems and memory impairment. It was the conclusion of researchers at BU that "there is grave concern that CTE affects far more athletes than previously believed."
Amateur athletes may experience multiple concussions during their nonprofessional engagement. These injuries may often be overlooked and seen as little more than the usual minor scrapes of the sport. Estimates are that, in the US, 52,000 deaths a year are related to traumatic head injury and 2% of the US population lives with disabilities related to TBI (traumatic brain injury). Brain injuries, according to the Brain Trauma Foundation, are the "leading cause of death and disability in children and adults from ages 1 to 44."
Who is coaching your kids and who is evaluating them for sport-related head injury? If you don't receive satisfactory answers, you should become more involved. Remember, it's not just football because we have now seen that hockey players are also at risk.
Boston University School of Medicine: http://bit.ly/9nCYf7
Brain Trauma Foundation: http://bit.ly/aWST37
Brain trauma (Wellsphere): http://www.wellsphere.com/wellpage/brain-trauma
Concussions and Repercussions: http://bit.ly/H1OAl
National Center for Catastrophic Sport Injury Research: http://www.unc.edu/depts/nccsi/
Neurosurgery: http://www.neurosurgerytoday.org/what/patient_e/sports.asp
Sports Legacy Institute: http://sportslegacy.org/
Patricia A. Farrell, Ph.D.
Licensed Psychologist
Patricia A. Farrell, Ph.D., LLC
Englewood Cliffs, NJ
