Denim Millward

Sports Editor

In the realm of sports, there is no buzzword that will instantaneously create more controversy than the word “concussion.”

The very utterance of the word conjures images of muscle-bound behemoths annihilating unsuspecting foes with malicious helmet-to-helmet hits, or basketball players crashing to the ground and slamming their heads on the ground resulting in a nauseatingly audible “thud.”

Despite the myriad of measures either newly-instituted or re-emphasized in an effort to reduce concussions, these serious brain injuries still permeate nearly every collegiate sport that involves even a small modicum of contact or collision.

Even with the herculean efforts of entities such as the Sports Legacy Institute, the mission of which is to “advance the study, treatment and prevention of the effects of brain trauma in athletes and other at-risk groups,” according to it’s website, the exact short-term and long-term ramifications of concussions are still difficult to pin down.

In the bygone era of football, masculinity and nearly inhuman toughness were the names of the game.  Not only was playing through serious injury allowed, it was regularly expected.

Players still got concussed, almost certainly more frequently than current players, but the word “concussion” was rarely used.  More innocuous terms such as “getting your bell rung” were used, trivializing the potentially serious brain injury.  In that machismo-oozing era, the anatomy of a concussion was still widely unknown.

“A concussion is a violent trauma to the head where the brain moves within the skull and causes physical damage to the point of impact,” explained “Dr. A,” a Physical Medicine & Rehabilitation specialist who works closely with numerous NCAA Division I programs as an outpatient consultant.  (Dr. A requested to remain anonymous for this interview.)

In addition to his medical qualifications, which include a fellowship in traumatic brain injury as well as the aforementioned credentials, Dr. A has a first-hand knowledge of what it’s like to experience a concussion.

“I received my first concussion playing high school rugby, “ Dr. A explained.

Despite losing consciousness, he was cleared to return to the game after being given a rudimentary examination consisting of three simple questions.

Dr. A’s ability to answer three questions led to the erroneous assumption that he had suffered no serious injury and was fit to return.

Nothing was farther from the truth.

“I could not see out of my right eye, and my field of vision was very reduced, “ Dr. A recalled.  “My head hurt like it never had before. My vision improved slowly over the next few days, [but] the migraines persisted for two years.”

The physical symptoms of a concussion can widely vary, a key factor in complicating the prompt diagnosis and treatment of concussions.

Some of the most common physical symptoms include headaches, dizziness, vomiting and lack of motor control.  Cognitive symptoms such as confusion are the most widely associated with concussions, but any given athlete who suffers a concussion may experience any number of these symptoms to widely varying degrees.

According to Dr. A, losing consciousness after head trauma does not always necessarily lead to more severely diminished cognitive brain function, as some concussions sustained when the athlete remained conscious can be as bad or worse in that regard.

While sustaining a concussion is serious enough in and of itself, failing to properly and promptly treat a concussion elevates the potential damage rendered by the concussion from serious to catastrophic.

“Individuals who are concussed are at greater risk to experience future concussions,” said Dr. A.

“If you have a concussion, you need to be examined.  Failing to do so can seriously ruin your life.  There’s no simpler way to put it.”

When delving into the realm of potential effects of repeated concussions, the waters get even cloudier.

According to Dr. A, there are strong arguments to be made that there is a relationship between repeated mild traumatic brain injuries, or MTBI, and chronic traumatic encephalopathy, or CTE.

CTE, which Dr. A refers to as “the smoking gun of diseased anatomy which produces physical and mental diseases,” is a progressive brain disease that can lead to memory loss, dementia, depression and thoughts of suicide.  Though concussions in and of themselves can be debilitating injuries, the possible link to CTE is arguably the most disconcerting fact regarding concussions and the chief reason concussion prevention is so important.

A relatively recent rash of suicides by former football players and other professional athletes forcefully thrusts the potential effects of CTE into the public eye.

One of the most prominent and jarring cases was the murder/suicide case involving professional wrestler Chris Benoit.  Over a three-day period ending June 25, 2007, Benoit murdered his wife and son before taking his own life.  Post-mortem examination of Benoit’s brain revealed severe CTE and damage to all four lobes of the brain and the brain stem.

Other notable suicides where evidence of CTE was found post-mortem include the cases of former San Diego Chargers linebacker Junior Seau, former Chicago Bears safety Dave Duerson, who specified in a text message to his family that he wanted his brain to be used for concussion research and shot himself in the chest to ensure his brain remained intact and Owen Thomas, a 21-year-old lineman at the University of Pennsylvania who is the second-youngest player to be diagnosed with CTE post-mortem.

The laissez-faire manner in which concussions used to be treated is as much of a relic of the past as the Wishbone offense and leather helmets.

Jodi Wotowey has been the head athletic trainer at Idaho State University for the past five years, and explained the careful and gradual steps in clearing a player who has suffered a concussion to play.

“I think we continue to see more conservativeness towards concussions [today than in years past],” said Wotowey.

According to Wotowey, a player has to wait until 24 hours after a passed concussion test or be completely asymptomatic before resuming any activity.

At this point, the athlete will only be cleared to do very minor, low-impact activities such as a brief workout on a stationary bike.  The work an athlete will be allowed to do will be gradually increased until the player is finally cleared to fully participate in practice and play in games.

The entire process usually lasts approximately six days, and the entire process will be reset if the athlete in question exhibits any concussion symptoms at any point in the process, according to Wotowey.

Though the lion’s share of controversy and newsworthy concussion incidents occur within the realm of high school, college or professional sports, Wotowey made a point to implore athletes of all levels of skill and competitiveness to seek immediate treatment for any suspected concussions.

“It’s important to stress to the recreational athlete that concussions are serious deals,” Wotowey said.  “It’s not in anyone’s best interest to hide concussions.

Once chalked up to being “just part of the game” and routinely ignored, the real and long-lasting ramifications are now coming into increasingly clearer focus.

On Aug. 29, 2013 the NFL settled a class-action lawsuit brought on by thousands of former players for an astounding $765 million.  Even with that astronomical price tag, many observers consider the deal to be an excellent one for the NFL.

New tackling methods and re-emphasizing rules to prevent helmet-to-helmet hits have been instituted across all levels of football.

While the new rules are clearly a step in the right direction, they come too late to help potentially thousands of former players unlucky enough to play in an era that, whether out of ignorance or apathy, concussions were minimized or ignored.