{"id":98,"date":"2010-11-09T15:45:59","date_gmt":"2010-11-09T20:45:59","guid":{"rendered":"http:\/\/blogstemp2.wpengine.com\/?p=98"},"modified":"2015-05-18T10:30:19","modified_gmt":"2015-05-18T14:30:19","slug":"concussion-in-sports-a-new-ballgame","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2010\/11\/concussion-in-sports-a-new-ballgame\/","title":{"rendered":"Concussion in Sports: A New Ballgame"},"content":{"rendered":"

\"football <\/a>The September issue of Journal Watch General Medicine <\/em>included an article from the American Academy of Pediatrics about new criteria for diagnosis and management of concussions in children and adolescents<\/a>. Shortly after this issue was published, a segment aired on ESPN regarding a confrontation between the head football coach at Texas Christian University and its team physician <\/a>over holding a player out of the game due to a concussion.
\nAs a sports medicine enthusiast and team physician to a local high school, both news reports hit close to home for me. I have long believed that concussions have never received the special consideration that they deserved. In my own athletic career, I have been a part of several incidents where I or a teammate had symptoms that would qualify a as a concussion and was either too afraid to tell the coach or was instructed to \u201cplay hurt.\u201d Even now, standing on the sidelines on Friday night, I all too often hear coaches tell players to \u201cshake it off\u201d and to \u201cget back in the game.\u201d And, unfortunately, despite the literature and mounting evidence that concussions are serious business <\/a>, coaches are not jumping on the \u201cbetter safe than sorry\u201d bandwagon. So, when the TCU team physician was seen being berated by the head coach, I was empathetic. The progressing culture change in dealing with concussions in sport needs to start being embraced. In medicine, we tell patients that chest pain is a warning sign of heart attacks and that TIAs are warning signs for stroke. But no one tells athletes and coaches that concussions are warning signs for brain damage.
\n\"CTE<\/a>
\nIn April of 2010, Owen Thomas<\/a>, captain of the University of Pennsylvania football team committed suicide by hanging himself. Owen had no documented concussions, but, when his brain was studied by Boston University, he had evidence of early chronic traumatic encephalopathy (CTE). CTE, also called dementia pugilistica, is a result of repeated blows to the head. Its effects are primarily neurobehavioral and can involve \u201cpoor decision-making, impaired memory, erratic behavior, use of drugs and alcohol, depression and suicide.\u201d It is brain damage, and it raises a question: If you can develop this condition without an obvious concussion, what is going on in the brains of those with repetitive concussions? Boston University and the Center for the Study of Traumatic Encephalopathy<\/a> are trying to answer that question by enlisting NFL players to donate their brains postmortem, but, as of now, we can only speculate.<\/p>\n

<\/embed><\/object><\/div>\n

Clearly, when coaches allow kids to participate in contact sports after a blow to the head, they are effectively risking their futures. We need to eradicate the mentality that a player is weak when they are injured and begin supporting making the right decision for that player\u2019s health. Comments like TCU head coach Gary Patterson\u2019s, \u201cAs far as I’m concerned [he] was fine 10 minutes after he was hurt,\u201d need to be a thing of the past.<\/p>\n

Some states \u2014 Texas<\/a>, Washington, and Oregon \u2014 have proactively passed laws about managing concussions, and a national push is on for others to follow suit <\/a>. In fact, Congress currently is trying to pass legislation that will further protect U.S. student athletes<\/a>. The Protecting Student Athletes from Concussions Act<\/a> would make acute management of concussions easier by mandating school districts have concussion management plans in place; students, parents and school personnel would be educated about concussions; and the tug-of-war between a coach\u2019s competitive drive and a player\u2019s best interest would be nullified.<\/p>\n

If Congress\u2019s actions and the recent article in Pediatrics<\/em> aren\u2019t proof enough, the governing body on \u201call things neurological,\u201d the American Academy of Neurology, has issued its own position statement on concussion and its management<\/a>. The tide is beginning to turn. And eventually, it will be an exception that an athlete returns to the field of play after a significant blow to the head. We all just need to start listening to the evidence \u2014 and following it. One day, our college athlete-students will once again be called student-athletes. Mind will once triumph over matter (and money). I, for one, will welcome this day. A sports concussion assessment <\/a>is available to help with medical evaluation of a player who has received a blow to the head.<\/p>\n","protected":false},"excerpt":{"rendered":"

The September issue of Journal Watch General Medicine included an article from the American Academy of Pediatrics about new criteria for diagnosis and management of concussions in children and adolescents. Shortly after this issue was published, a segment aired on ESPN regarding a confrontation between the head football coach at Texas Christian University and its […]<\/p>\n","protected":false},"author":18,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[20,26,32,39],"class_list":["post-98","post","type-post","status-publish","format-standard","hentry","category-clinical-implications-of-research","tag-concussions","tag-evidence-based-medicine","tag-pediatrics","tag-sports-medicine"],"yoast_head":"\nConcussion in Sports: A New Ballgame - Insights on Residency Training<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2010\/11\/concussion-in-sports-a-new-ballgame\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Concussion in Sports: A New Ballgame\" \/>\n<meta property=\"og:description\" content=\"The September issue of Journal Watch General Medicine included an article from the American Academy of Pediatrics about new criteria for diagnosis and management of concussions in children and adolescents. 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