Just two weeks after Buffalo Bills safety Damar Hamlin was rushed off the field due to a heart attack, Tampa Bay Buccaneers wide receiver Russell Gage was hospitalized with a concussion and neck injury after a hit during Saturday’s playoff game against the Dallas Cowboys. The incident highlights ongoing concerns about concussions and player safety in the National Football League.
Although the number of concussions reported in the NFL has declined since tracking began in the 2015 season, this protocol was once again called into question after Miami Dolphins quarterback Tua Tagovailoa suffered several head injuries earlier this season. The injuries, one of which the team later reported as a “back injury,” prompted the league to reexamine its concussion protocol.
Under the revised policy, ataxia, or “abnormalities of balance/stability, motor coordination, or dysfunctional speech” as a result of a concussion — which Tagovailoa indicated after returning to the game in Week 3 — has been added to the list of “no-go” signs. and symptoms, which means that any player displaying these symptoms will not be allowed to return to the game.
Essentially, the modified protocol closes a loophole that allows players with gross motor instability to return to the game if doctors determine the player’s stumbling is caused by a head injury.
“We want to ensure that all medical professionals not only follow the protocol as written, but also understand that they are serving the players as patients,” the NFL Players Association wrote in response to the new changes.
But it remains to be seen whether these changes are enough and whether they will ultimately keep players safe in such a high-contact sport. While the severity is variable, concussions are considered a subset of mild traumatic brain injuries. Treatment usually involves rest; However, too much rest can prolong recovery.
“Usually too much activity makes symptoms worse, but too little activity can have the opposite effect, by not allowing the brain to heal quickly,” said Dr. Richard Figler, director of the Concussion Center and staff physician at the Center for Sports Medicine. at the Cleveland Clinic. “We’re really trying to find a sweet spot where people can do things without causing symptoms… There’s evidence to show that early exercise, which doesn’t cause symptoms, is beneficial, and will help recovery more quickly than no exercise. This may include light walking, or riding an exercise bike, but if the symptoms worsen, slow down the activity until there are no symptoms at that level of exercise.
In sports-related concussions, patients typically follow a progressive recovery of one to four weeks, Figler said. A 2018 study by Christopher D’Lauro, a cognitive neuroscientist at the Air Force Academy, and his colleagues found that “elite athletes,” such as NFL players, recover from concussions faster than non-athletes. These studies show that the return-to-play time for professional athletes is generally five to seven days, compared to seven to 10 days for college athletes and about 30 days for high school athletes.
But a shorter recovery time does not equate to fewer long-term effects.
According to a 2016 study, more than 40% of retired NFL players showed signs of traumatic brain injury based on MRI scans. At the time, study author Dr. Francis X. Conidi of the Florida Center for Headache and Sports Neurology and Florida State University College of Medicine in Tallahassee, Florida said, “The rate of traumatic brain injury is higher in players than found in the general population.”
There are also long-term consequences of concussions, including an increase in neurological diseases such as dementia and Parkinson’s. While there is no known limit to how many concussions one can sustain, a 2018 study from the University of California San Francisco found that the risk of dementia doubles after a concussion.
Even if someone doesn’t suffer a concussion, another study in 2018 found that repeated hits to the head, or “subconcussive hits,” can increase the risk of developing chronic traumatic encephalopathy, otherwise known as CTE, a degenerative brain condition. found in almost all deceased former football players whose brains were donated for research purposes.
The Harvard University Football Players Health Study, a 10-year initiative launched in 2014, has identified three breakthroughs that can slow and reverse the accumulation of tau protein in the brain, which can lead to CTE. These treatments include mild treatments that can lead to better sleep and less post-traumatic stress disorder symptoms; antibodies that can block the spread of Tau protein; and a device to measure the impact on the game of a hit on the brain.
Although there is no way to prevent concussions, especially in high-contact sports, such as football, hockey, and soccer, there are changes that can help protect the brain, head, and neck from significant trauma. Neck strengthening exercises can help take the force off the head during such trauma and using a helmet properly can also reduce the risk of concussions, Figler said.
In the end, the most impactful changes may have to be made to the game itself as Figler called adjustments in the rules as an effective way to reduce concussions in certain sports.
“This is based on good data from injury reports that help foster rule changes that make sports safer,” he said.
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