The Next Big Steps to Help Prevent Sports-Related Concussions

Christopher Nowinski explains that big concussions in sports are finally being appropriately diagnosed, but 80-95% of the "littler" ones are still going undiagnosed.

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Right now I think we're doing a better and better job of managing concussions when they happen partially because doctors are getting better, partially because tools are getting better, and partially because the laws are requiring that you have to see a doctor. But what the big missing piece that no one is talking about nearly enough is the fact that we simply aren't diagnosing enough concussions. No matter how you slice the data, it's clear that somewhere between 80-95% of concussions are not diagnosed. If you don't believe that it's because you haven't done your work reading the literature. Or you haven't talked to enough athletes. But, if that's the case, if we all truly believe that everyone needs to rest and the biggest problem is window of vulnerability, we are doing a terrible job. A terrible job of making sure kids are safe. We're catching the big concussions. We are not catching the little ones. We are not catching the little dings. Not even to mention the problems with subconcussive hits that are clearly there, and that's going to be the new area of reasearch. That gee that 100 g hit that caused symptoms. That's a problem, but that 99 g hit that they say they're fine. Guess what? It's also a problem. The brain still can't accept that much force. We have a lot of work ahead of us, but I think the next one is getting people off the field, and getting them to understand that every ding is serious. The culture is changing, and the suck it up and get back in there is changing. It's not where it needs to be, but this sort of thing takes time because we are changing the message that we have been giving everybody for the last 50 years which is your fine if you suck it up, and in fact you are a hero if you get knocked out and you come back in the second half and you play. To change that, it takes time, but there are analogies that have shown that you can do this. For example, we don't ask players to tough their way through neck injuries. Some point along the way we learned that will get you paralyzed, and therefore every athlete knows from a young age. Their parents tell them. Their coach tells them. If your neck hurts, you can't feel your arms, you can't feel your legs, don't try to be a hero. Don't try to play through it. Get off the field. If we can do that with the neck which doesn't bleed and which doesn't cause traumatic pain, which doesn't impair you immediately if its just a small fracture of your neck, we can do that with the brain. It will take putting that in kids heads and then living that. It's good that we no longer glorify the NFL players and the hockey players that say, "I would play through it." Luckily guys like Brian Urlacher who said they had concussions, he was rightfully called an idiot for saying that publically because kids do look up to him. Even though apparently they shouldn't because we try to model our behavior after them. People are aware of what they're saying and the message we are sending to kids. Even though opportunities like we were able to convince EA Sports to change how they handle concussions in Madden football, and work with the CEO to say look, 6-year-olds are learning football not from watching games but from playing your game. If you let people go back in with concussions, which they currently did, that will send the wrong message. We talked to them and told them they can educate through it, and thank goodness they agreed. Now the first exposure often kids have to learning the rules of football, they learn concussion, you're out for the day. The announcers say what a great idea it is to sit out.
Posted on BrainLine September 20, 2012.

Produced by Victoria Tilney McDonough and Erica Queen, BrainLine, and Dan Edblom.