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Secondary Head Injuries in Sports

Almost everyone has had an experience where they have bumped their head. People have smacked their heads while getting out of cars, or they have walked right into a signpost while they weren't paying attention, or they have simply tripped and fell. In most of these cases, the only thing really injured is the pride of the victim. You might get a minor bump on the head, but there probably won't be any real lasting effects.

But a concussion is a different matter entirely. The human brain is made of soft tissue, floats in spinal fluid, and is encased and protected by the hard bones of the skull. When someone is involved in a serious collision, the brain could slosh around inside the skull cavity, and even run into the interior of the skull. This can lead to bruising in the soft tissue of the brain, the tearing of blood vessels, or damage to any one of billions of nerve endings that serve important functions.

By their very nature, sports create conditions where concussions could easily be an outcome of a collision. A football player can lead a tackle with his head, or a hockey player can (and will) get checked into the boards, or a wrestler can get taken down the wrong way. The scenarios where concussions could occur in sports are practically endless.

Symptoms of Concussions

As concussions are injuries that occur quite often in athletics, coaches and athletic directors should be aware of the three major categories of symptoms.

1. Memory or Orientation Problems:

  • Unaware of time, date, place
  • Unaware of period, opposition, score of game
  • General confusion

2. Typical Symptoms

  • Headache
  • Dizziness
  • Feeling "dinged" or stunned
  • "Having my bell rung"
  • Feeling dazed
  • Seeing stars or flashing lights
  • Ringing in the ears
  • Sleepiness
  • Loss of field of vision
  • Double vision
  • Feeling "slow"
  • Nausea

3. Physical Signs

  • Poor coordination or balance
  • Vacant stare/glassy eyed
  • Vomiting
  • Slurred speech
  • Slow to answer questions or follow directions
  • Easily distracted, poor concentration
  • Displaying unusual or inappropriate emotions (e.g. laughing, crying)
  • Personality changes
  • Inappropriate playing behavior (e.g. skating or running the wrong direction)

If an athlete is showing any of these symptoms, he or she should be removed from the field of play immediately, and should be kept from playing until he or she is fully recovered.

Possible Effects of Multiple Concussions

In recent years, multiple concussions have been linked to a decrease in cognitive function, depression, and even suicide. A few unfortunate high profile cases have shed light on the dangers to the victims.

In November of 2006, former NFL player Andre Waters died of a self-inflicted gunshot wound. Waters had struggled with depression and memory loss after receiving multiple concussions over twelve years in the NFL. A neuropathologist at the University of Pittsburgh examined the 44 year old former defensive back's brain and found that the tissue was comparative to that of a man in his mid eighties.

In July of 2007, professional wrestler Chris Benoit murdered his wife and child in their suburban Atlanta home. A doctor that examined Benoit's brain found what he called "shocking" levels of brain damage that could have led to an episode of severe dementia, resulting in his lethal actions against his family and himself.

Second Impact Syndrome

Although most concussion victims can recover from the injury within a few days, there is a very real danger of further damage to the head. A secondary injury suffered by a concussion victim could be life altering, or even lethal.

When an athlete suffers a minor head injury or concussion and then receives another blow to the head before he has a chance to heal from the initial damage, the result can be a rapid, catastrophic increase in pressure within the brain. Effects can include physical paralysis, mental disabilities, and epilepsy. Death can occur approximately 50% of the time. This is called Second Impact Syndrome.

There is an ethos in athletics that encourages toughness and resilience in participants. On any given sports highlight show coaches, athletes and reporters talk about "taking one for the team," "toughing it out," or "playing with pain." Far from being laudable, this mindset is putting the lives and well being of athletes at risk, and it encourages school age athletes to behave the same way.

Coaches and even other players on the field should recognize the symptoms of a concussion. Considering the prevalence of concussions in sports, it would be the height of irresponsibility to have a team managed by someone that either doesn't recognize or chooses to disregard the signs and symptoms.

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