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Wednesday, October 31, 2012

End Game: Brain Trauma And The Future Of Youth Football In America | ThePostGame



One of the most frightening sports articles I have read in quite some time. The big question: "What if the risk can't be managed?"

from ThePostGame.com
End Game: Brain Trauma And The Future Of Youth Football In America | ThePostGame:

Football has a problem. The game harms the human brain. The danger is acute at the professional level, where large men smash each other for large sums of money; the hazard is less publicized, but greater still, at the high school and youth level, where an estimated 4.8 million children -- sons, nephews and little brothers, most between the ages of 6 and 13 -- batter each other's heads for fun, for the sheer giddy sake of sport.

Once upon a time, we called football-induced brain damage getting your bell rung. We treated it with smelling salts. We kept on playing, kept on loving our Friday nights. Times change. The deaths are real. The damage no longer can be ignored. We are starting -- at long last -- to get a clue. Ours is an era of enlightenment, of concussion awareness, which is another way of saying risk management. Stories like Rickerson's -- and other stories that are much, much worse -- have spurred reform. A collective effort to make football safer. We pass laws. Change the rules. Better identify and treat the victims. Lower the odds of catastrophe. We still love Friday nights. Only looming beneath the well-meaning correctives is a darker, more troubling question, one with grave implications for the sport and the children who play it, for every parent looking on from a grandstand: What if awareness isn't enough?

What if the risk can't be managed?

Rickerson's story is hardly unique. According to the American Association of Neurological Surgeons, between 4 percent and 20 percent of college and high school football players will sustain a brain injury during the course of one season; a report cited by CNN medical correspondent Dr. Sanjay Gupta estimates that about one in 10 high school players suffers a concussion. The Boston Globe recently reported that emergency room visits for youth sports-related traumatic brain injuries went up 62 percent from 2001 to 2009. The Centers for Disease Control and Prevention, which has labeled sports concussions "an epidemic," reported last year that roughly 122,000 youths between the ages of 10 and 19 went to emergency rooms for nonfatal brain injuries. For boys, the top cause of injury was playing football.Disturbing as they are, Chicago-area sports medicine expert Krystian Bigosinski believes current statistics may understate the problem.
"A number of studies have compared the number of concussions athletic trainers report versus anonymous self-reported studies by players," says Bigosinski, who works at the Rush University Medical Center and is a team doctor for the Chicago White Sox, the U.S. Ski and Snowboard Association and DePaul University athletics. "It's 5-10 percent by trainers, but self-reporting by players went up to like 40-70 percent had a concussion in the past season. That means you are missing nine out of 10 concussions sometimes. Someone didn't recognize the injury, or the player didn't tell anybody. That is a huge issue."

A concussion is not a bruise. It is a temporary interruption of brain function that typically occurs when rapid acceleration causes the brain to slam against the inside of the skull, often from a violent blow to the head. It may or may not accompany a loss of consciousness. Symptoms can be physical (headaches, light sensitivity), cognitive (confusion, lack of focus) and emotional (irritability, loss of interest in favorite activities). While the exact nature of the injury is not understood -- scientists know more about deep space than the workings of the brain -- some things are clear:

(a) With rest and a gradual return to regular activity, athletes who suffer a single concussion generally experience no permanent ill effects;
(b) Some athletes suffer post-concussion syndrome, in which symptoms persist for months and years, sometimes permanently;
(c) Having one concussion significantly increases the risk of suffering another;
(d) Multiple concussions are associated with an increased risk of post-concussion syndrome, as well as developing mental health problems such as depression, memory loss and Alzheimer’s disease.

Because their brains are still developing, youth football players are particularly vulnerable: According to the CDC, Ayounger persons are at increased risk for [Traumatic Brain Injuries] with increased severity and prolonged recovery." Again, multiple concussions are worse than one. Studies have found that athletes who have suffered two or more concussions experience a higher rate of mental problems -- including headaches, dizziness and memory problems -- and also are likely to suffer in the classroom. A history of concussions also is associated with chronic traumatic encephalopathy (CTE), a neurodegenerative disease found in people who have suffered brain trauma, including a number of deceased football players. Symptoms include mood swings, erratic behavior and memory lapses, followed by dementia. CTE was found in the brain of former Pittsburgh Steelers lineman Terry Long, who slid into depression before killing himself by drinking antifreeze. The disease also was found in the brain of Owen Thomas, a 21-year-old University of Pennsylvania football captain who hanged himself, and in the brain of Nathan Stiles, a deceased 17-year-old high school football player from Kansas.A more immediate reason for alarm is second-impact syndrome, in which an athlete suffers a second concussion while still recovering from a previous one. Though the precise physiological cause is uncertain, the outcome is not: the brain swells rapidly and catastrophically, causing severe disability or death. Case in point? Jaquan Waller, a high school running back from Greenville, North Carolina, who in 2008 suffered a concussion in practice, played in a subsequent game and died after enduring a second hit. A year later, a national survey of high school trainers found that more than 40 percent of concussed athletes return to play too quickly, and that 16 percent of players who lost consciousness after being hit returned to the field the same day.

The first time Drew Rickerson heard of second-impact syndrome, he was in his neurologist's office. He thought back to the night of his concussion, the foggy conditions and the mental haze, the fact that he took nine additional snaps – snaps he could barely remember, nearly a dozen violent plays in which he somehow went untouched.

"I really dodged something," he says. "That scared the [expletive] out of me."
Protect our national pastime. Protect our children's brains. The hope is that we can do both. Biology and physics suggest otherwise. Safer does not mean safe. In locker rooms and school board meetings, quiet funerals and noisy grandstands, the future of youth football may not be matter of risk management. It may be a matter of risk acceptance. Roll the dice.

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