article Fall 2016

Concussions: A Difficult Diagnosis

By Alex Chay

As a sports fan, not much is scarier than seeing a fan favorite lying on the turf, motionless, from the effects of a concussion. Not only are the causes of concussions especially gruesome, but the long-term effects can also be equally as terrifying. Numerous ex-football players have filed lawsuits against the NFL for hiding the traumatic effects that concussions leave on the body and the mind. A prominent example of the alleged long-term effects occurred in the case of deceased linebacker Junior Seau. At the age of 43, Seau committed suicide, and it was later found that he suffered from chronic traumatic encephalopathy — a condition stemming from concussion-based brain damage. As a result of these injuries, a concussion protocol has been implemented for all levels of athletes ranging from high school to professional. There has also been an attempt to redesign helmets and to change the rules of football to punish helmet-to-helmet contact.

Tim McGuine, an orthopedic researcher and manager of the UW Health Sports Medicine Center, specializes in identifying and understanding the risk factors, prevention, and outcomes of sports related injuries. McGuine has spent time researching concussions in high school athletes and has found numerous trends relating to concussions in high school athletes — some of which may surprise. McGuine found that the sport with the second highest rate of concussions was girls’ soccer. The concussion rate for girls’ soccer players is about 40% the concussion rate of football players, despite it often being considered a less violent sport. McGuine attributes this to girls’ soccer players playing far more games than a football player would in a year, explaining that the risk factor is so high as more time on the field increases the likelihood of a concussion. McGuine states, “The pendulum has shifted from concussions being a very innocuous injury to being a more serious concern, but I think we have to be careful we don’t swing the other way.” Through his research, McGuine has found that various trends in concussions. For example, an individual who has previously suffered a concussion is more likely to suffer a second one. The most telling of the trends is an increase in full contact activity leads to an increase in concussions.

“The pendulum has shifted from concussions being a very innocuous injury to being a more serious concern”

Though concussions are part of contact activity, they still need to be heavily monitored. While using better technology and newer helmets is helpful, the best way to reduce the likelihood of concussions is to reduce the amount of full contact activity. Reducing the number of games and limiting the amount of full contact practice would be the best first step to help to reduce the number of concussions athletes suffer. However, the difficulty of diagnosing concussions needs to be addressed as well. Several potential solutions have been discussed; however, no real progress has been made on these solutions. One potential way to diagnose a concussion is to use an electrocardiogram (EKG) scan that detects a specific reaction in the brain for concussions. Another potential solution is to take a blood sample to test the blood for specific compounds that form in the presence of a concussion. Both of these solutions require more research into how the body reacts to a concussion before these solutions can be implemented.

While concussion protocol in sports has progressed, McGuine believes some tweaking is still needed. The concussion protocol for the Wisconsin Interscholastic Athletic Association (WIAA), the governing body of high school sports in the state of Wisconsin, states that an athlete must complete a 5-step program while remaining symptom-free before returning to active competition. According to McGuine, measuring symptoms and defining whether an athlete is concussion-free is difficult. Many of the baseline tests used to declare an athlete concussion-free are not very reliable. A healthy person can take a baseline test two different days and the results could change dramatically, making it hard to determine whether or not a person is symptom-free. McGuine believes that the increased media attention and the ambiguity of concussion diagnosis lead to false positives. At the high school level, 40% of girls’ soccer teams have had a player diagnosed with a concussion by a medical practitioner, which is likely due to practitioners erring on the side of caution with concussions. Perhaps if a more sophisticated way of diagnosing concussions were found, incidents like the death of Junior Seau and players retiring out of fear for their health, as was the case with Chris Borland, could be avoided and treated.

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