Jan 29, 2015
Early Warning Wakeup Call

By Patrick Bohn

Awareness of the dangers of concussions and their long-term health impact is at an all-time high. And the death of 26-year old NFL wide receiver Chris Henry, who was later found to have the brain disease chronic traumatic encephalopathy (C.T.E), has served as a high-profile warning sign that damage can occur early in a career.


Because C.T.E. cannot be diagnosed until after death, it’s difficult to know when the damage occurred. Henry was ten years younger than the previous youngest player diagnosed with C.T.E., which is caused exclusively by brain trauma and causes depression, impaired decision-making and ultimately dementia.

Problems Begin Early
And there’s been further proof that concussions and injuries aren’t exclusive to those who play at a high level for an extended period of time. According to a study published last month in The Journal of the American Medical Association, physical play among youths can lead to a significant increase in concussions.

The study compared Pee-Wee (ages 11-12) hockey teams in a league in Alberta–where body-checking was allowed–and a league in Quebec–where it was not–and found a significantly higher occurrence of concussions in the Alberta league. The data, compiled during the 2007-08 season, reported 78 concussions in the Alberta league and only 23 in the Quebec league. Additionally, the players in the Alberta league had a higher number of severe concussions–defined as a concussion resulting in more than ten days of lost time–14 to four.

Perhaps more troubling, a study published in the June 2009 issue of the Canadian Journal of Neurological Sciences showed that many young hockey players and their coaches are not familiar with what constitutes a concussion. Nearly two-thirds of the 267 players–who ranged in age from 10-14–mistakenly thought you needed to lose consciousness to have a concussion. Only a quarter of the 142 adults surveyed were able to correctly identify at least one symptom of a concussion.

Preventative Measures Increasing
The NHL has taken steps to reduce the occurrence of concussions, recently approving a stiff penalty on blindside hits to the head. They now result in major penalties and ejections. The NFL has also strengthened rules regarding concussion management.

However, as the studies show, it may be too late for players by the time they get to the pros. That’s why the National Federation of State High School Associations (NFHS) recently updated language on the concussion rules that are a part of all high school sports. According to the new language:

“Any player who exhibits signs, symptoms or behaviors consistent with a concussion, including but not limited to loss of consciousness, headache, dizziness, confusion or balance problems, must be removed from the contest immediately and shall not return to play before being cleared by an appropriate health-care professional.”

In May, Jim Schmutz, executive director of the American Sport Education Program (ASEP) division of Human Kinetics spoke to the House Committee on Education and Labor about concussions among high school athletes. In a written testimony to the committee, Schmutz stressed the problem is often that coaches simply lack the information they need to take the correct measures.

“No evidence would suggest that the coaches, in general, are derelict in their duty to provide for the safety of their athletes. What is clear is that in the case of what are often less apparent and cumulative injuries like concussions, the uninformed and untrained coach is over-matched by the role he or she is expected to play.”

Cause and Effect a Cause for Concern?
In Henry’s case, some have wondered if the trauma he suffered could be responsible for his erratic off-the-field behavior. Henry was arrested and suspended several times, and his death was the result of an injury sustained in a domestic dispute. But Dr. Richard G. Ellenbogen, the new co-chairman of the N.F.L.’s head, neck, and spine medical committee, told the New York Times that was a difficult conclusion to draw.

“I’m really worried that we’re going to get to where if you have a challenging personality, it must be C.T.E.,” he said. “That’s really a dangerous way of going.”

Patrick Bohn is an Assistant Editor at
Training & Conditioning.

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