The National Football League (NFL) has a pretty, new poster that boasts a tagline that reads: Let’s Take Brain Injuries Out of Play. Turns out it was all a lot of hot air.

In Sunday’s game, Philadelphia Eagles player Stewart Bradley attempted a tackle that left him stumbling before he collapsed on the field. To an average fan, he appeared obviously hurt and impaired. But the team’s medical staff took him out of play for less than 3 minutes before allowing him back in the game.

It wasn’t until halftime, when he was officially diagnosed with a concussion, that Bradley’s brain and body were given a chance to rest.

According to an article in The New York Times, Eagles Coach Andy Reid and the Eagles’ medical staff all stated that they had not seen Bradley stagger and fall. (Makes you wonder exactly who is watching the players, other than the fans, of course.)

Interestingly, one of the excuses the medical staff gave was that:

…they were apparently tending to quarterback Kevin Kolb — who also was suspected of having a concussion, returned during the quarter, and then was found during halftime to have sustained a concussion.

So they didn’t catch Bradley’s concussion because they were treating Kolb…but Kolb was also returned to play because his concussion wasn’t diagnosed until halftime.

To an outside observer, it seems that the doctor who is able to diagnose concussion so easily during halftime should be made available throughout the game. There’s no safe amount of time a player can “play hurt” when the injury involves the brain. The NFL’s concussion poster ends with these lines: Work smart. Use your head, don’t lead with it. Help make our game safer. Other athletes are watching…

Hey, NFL:  You’re right…we’re watching…and we don’t like what we saw on Sunday. Brain damage is forever.

To read the full New York Times article, click here: The Return of a Stumbling Eagle Raises Concerns

The evolution of the “meaning” of concussion has just taken another step…and it’s a frightening step.

Back in the day, concussion was viewed as a mild bump on the head, getting your “bell rung.” No one paid it much mind; take the hit and get back in the game.

Recently, doctors have warned that concussion is more dangerous than that. In fact, pediatricians have been lobbying to have it renamed, from concussion to the more accurately descriptive “mild traumatic brain injury” (MTBI).

Earlier this year, scientists made the disturbing discovery that people who suffer repeated head injury (such as football players and soldiers) develop a type of brain damage that mimics amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease. This was the discovery of a new disease syndrome that causes brain damage, central nervous system damage, dementia, and eventually death. It is called Chronic Traumatic Encephalopathy, or CTE, and it is only caused by repetitive brain trauma.

Today, The New York Times reports that the autopsy of a 21-year-old college football player who died of suicide revealed that he had the early stages of CTE. This young man, Owen Thomas, had no history of depression, but suffered what was called a “sudden and uncharacteristic emotional collapse” before taking his life in April 2010. Thomas is the youngest football player, and first amateur football player, to be found with clear CTE. If he hadn’t killed himself, the brain injury wouldn’t have been discovered for years, if ever. But the circumstances of his death demanded autopsy.

Although there is no way to definitively link his suicide to the brain damage, the connection is certainly possible, if not probable:

“It’s not unreasonable that aspects of his behavior were related to the underlying brain disease that was detected,” said Dr. Perl [Daniel Perl, professor of pathology at Uniformed Services University of the Health Sciences], adding that he was speaking as an experienced neuropathologist and not on behalf of his organization. “This is real.”

Dr. Perl added that this finding showed that CTE is possible earlier, and at impact levels lower than those experienced by professional football players.

Right now, no one knows how many hits…how frequent the hits…or how hard the hits have to be before “several concussions” becomes “irreversible brain damage.”  The only thing that is clear is that we need to do more to protect the brains of young athletes. If CTE was found in the brain of an otherwise healthy 21-year-old man, when did it start? In high school? Junior high? Pop Warner Youth Football?

Just last month, we reported about the virtual explosion in the number of head injuries experienced by children while playing sports: In just 10 years, kids ages 8-13 had double the number of concussion-related hospital emergency visits. Kids ages 14-19 had quadruple the number. Unless we take action now, some of these children may end up with permanent, debilitating brain injury.

What can we do? We wrote about that, too…just last week. (Click here to read that entry: The Head Game of Youth Sports.)  And you know what? We’ll continue to write about concussion and brain injury until there is nothing left to write about. Football season is here…let’s keep all players safe.

If you want to read the full article from The New York Times, click here: Penn Football Player Had Brain Disease, Autopsy Shows

I just read a fantastic editorial about head injury and concussion in youth sports, written by someone who knows and cares: Neurologist Richard C. Senelick, M.D., Medical Director of the Rehabilitation Institute of San Antonio. He is also a father and a grandfather, so this topic is more than just an abstract medical exercise to him.

We have written extensively about the dangers of concussion–what doctors now refer to as “mild traumatic brain injury” or MTBI. So far, this has been a watershed year in how concussions are viewed. This year, we learned that a person who receives multiple concussions is at risk for developing Chronic Traumatic Encephalopathy (CTE), which leads to early dementia, depression, personality changes, and death.

We also learned this year that some cases of amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s Disease) may be due to head trauma, not disease process.

This is also the year that we found out that the number of head injuries in children’s sports have doubled or even quadrupled in the past 10 years. MTBI awareness has even reached that most hard-headed group, the National Football League, which has mandated that an educational poster about concussion be hung in every pro locker room.

As Dr. Senelick states:

Although the population of NFL players is important, there are only 1,900 active NFL players each season. There are more than 3 million children playing football at the youth level and 1.2 million more playing high school football. This doesn’t even begin to count the number of kids playing soccer (heading the ball) and hockey (body checking). We have to ask whether we are taking adequate steps to protect our children – to change not just the equipment but the rules so that we reduce the chances of the players experiencing traumatic brain injuries.

What does he suggest? The same things experts and investigators have been suggesting for years:

1. Change the rules of the games to make head injury less likely.
2. Change the equipment, helmets and the equipment that makes dangerous projectiles of balls and pucks.
3. Mandate certified trainers in schools and for all organized sports activities.
4. Change the culture, so that we value health over winning a game…especially when our children are young, their brains are developing, and the games will be forgotten by morning.

None of that will be easy. Think how difficult it is just to get people to use a seat belt in a car, or to wear a helmet while cycling. Dr. Senelick notes that in Idaho…

We have an increasing number of bear attacks because people foolishly approach a bear, thinking it is safe to get that close-up picture. I recently read the following analogy:  If people are in the ocean and hear someone yell “shark” they race out of the water. If someone yells “bear” in Yellowstone, everyone races to get a close-up photograph. They have not been properly educated on the dangers of close encounters with a bear.

The same is true for youth sports and brain injuries. There is a bear out there and people need to be educated and the rules need to be changed.

He ends his editorial with this sentence:  ”Our children are getting injured and dying — it is time to wake up.”  Given the traumatic head injuries we have seen, we agree.  The only thing more heartbreaking than seeing a child with a head injury is watching the agony of that child’s parents. No one gets over it…not the child, not the parents, not the grandparents, not the community. We owe it to…well, everyone to help protect our children from head injury.

If you want to learn more about concussion and other traumatic brain injuries, visit our website at www.lawmed.com. If you have questions, HensonFuerst has answers.

Our previous blogs on concussion:

Football Concussion Poster

Youth Concussion Rates Skyrocket

Metal Bat Controversy in Youth Baseball

Head Injury and Lou Gehrig’s Disease

To read Dr. Senelick’s full article, click here: Head Games and Youth Sports: Have We Gone Too Far?

To read a great Time magazine article, which has a link to a video of what football can do to the brain, click here:  The problem with football:  How to make it safer