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Mackie Shilstone
Sports Performance Manager, MA, MBA

Mackie Shilstone

Executive Director, The Fitness Principle with Mackie Shilstone at East Jefferson General Hospital

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Today, I read with interest various media reports regarding football brain injuries, which is coming to a head as the House of Representatives Judiciary Committee convenes to discuss the issue.

Testifying before Congress was NFL Commissioner Roger Goodell and DeMaurice Smith, executive director of the player's union, along with physicians who have found significant brain damage in deceased NFL players, physicians from the NFL Concussion Committee, who have downplayed findings that NFL players have significant brain damage after their NFL career is over.

While the battle of the NFL docs versus the other docs rages, football players, from peewee to pros, are going down with head trauma, as a result of the weekly train wreck that is football. While all the experts weigh in before Congress, all of us might want to spend our time gaining a better understanding of the definition of the problem -- the concussion -- what is it, what are its grades of separation and what are the symptoms? It is ironic that my hospital, East Jefferson General Hospital, just devoted a major article in its quarterly publication to concussions.

According to the American Academy of Neurology, a concussion is defined as a "trauma to the head which induces alterations in mental status that may or may not involve loss of consciousness." Do you think Tim Tebow, the great Florida quarterback, defines the concussion with his recent knockout blow that had him down for the count? Was it heroic for Tim to return to play against LSU and take what I saw to be more big hits? Glad I am not his doctor ten years from now.

As a person sustains a blow to the head "the brain sloshes inside the head." As a result, the jostling back and forth disrupts the neurons needed for normal function by interrupting the impulses between the brain and the brain stem.

The American Academy of Neurology and the National Athletic Trainer's Association usually grade concussions based on a severity scale. A concussion can be rated a Grade 1, 2 or 3 with Grade 3 being the most severe. "Assigning a grade level to a concussion is not always clear cut and is based on observing the individual for symptoms such as dizziness, headaches, nausea, vomiting, memory loss and an unresponsive state."

The individual might experience chronic headaches , fatigue, emotional or personality change, trouble sleeping, depression and an inability to concentrate for days or even weeks after the impact. As the concussed athlete recovers, it might be best to limit the amount of mental stressors, like studying game film or plays of your next opponent, to speed the healing process.
According to Wendy Jamison, M.D. Chief of Neurology at East Jefferson General Hospital (my facility), the only treatment for a concussion is "time and rest. You can treat the symptoms with medication but the concussion simply needs time to heal. Most people recover fine but, until they do, they should be monitored closely to make sure symptoms are not worsening."

Time is money in the NFL and college football. Keeping a player out for an extended period of time haunts both the player and management, as it pertains to wins and future contracts -- both motivating factors to get back in action.

Here is where the problem lies-- the second concussion. Studies seem to point to the fact that you are at greater risk to sustain a second concussion after your first if you are not healed from the first impact. Known as Second Impact Syndrome, the situation may lead to permanent brain damage and can cause the brain to swell.

We might need to wait several years until the NFL tells us that there is no greater risk to dementia from and NFL career than that of the average man on the street. Are you willing to risk your son while you wait for the answer? Many parents will probably roll the dice for the financial rewards of an NFL contract. There is much at risk on the NFL side to continue to shoot down not only their own studies but also those of other leading experts who contend that the NFL weekly train wrecks are mentally hazardous.

I think we need to reflect on the NFL game itself and what it represents to many fans - the revenue generators. Fans, I suspect, want to see the big hits. Much like a boxing match where the goal is to stop your opponent (knock outs, TKO's, cuts, and etc.), boxing fans want that knock out. Therefore, it is hard to take out the hard hitting action. You cannot turn down the intensity of the hit, when you are heading full speed toward impact of the ball carrier. As a former wide receiver in college, I knew the DB was going to hit through me when I ran the curl route and the pass was high.

Without great hits, the NFL game would just be mediocre at best. You can change the rules to make it touch football but will the fans turn in or come to the stadium. Our time is better spent improving protective equipment to withstand the blows much like the armed forces have created better armor for our troops.

While football is a game, it still has human beings being torn apart for our entertainment. The good news is that players in sports, like the NFL, do not age on the job, because you are always going to have another player to take his spot after the commercial. The bad news is that, for many former players, the rest of your life can be filled with medical challenges outside the crowd roar.

Let's all pray for those players who gave us some great memories. Better yet, let's help them to enjoy the greatest moments of their life while they are still alive.

By Mackie Shilstone  |  October 29, 2009; 12:11 AM ET  | Category:  Concussions Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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