Heading in the right direction: A look at concussions in major league sports.

Donovan Maudsley - 3N Mechanical
Posted on: October 22, 2016

For all that we humans know about the world around us (how high the sky goes, how deep the ocean is, how many twinkies the average person can fit into their mouth) we still don’t understand how we’re able to know these things. How does the brain work? Off the top of my head, I know that given lots of rest and nutrients that the brain can perform better. I also know that getting hit in the head continuously can cause long term damage to it.

A concussion is an injury to the brain caused by the brain cells stretching and bouncing around inside the skull. This is often the result of a hit to the head or the body. The physical damage caused by a concussion is not actually the worst part, though. During the rapid changes in position within the skull actually cause changes in the natural chemicals in and around the brain cells. These changes cause the brain to be more susceptible to damage until the concussion has fully healed. The common changes in chemical makeup also make the brain more sensitive to stress.

Concussions can cause both short and long term health problems. The most commonly associated symptoms include memory loss as well as nausea and vomiting. Many also feel confusion, as though they are in “a fog”. Technically every person is at risk of concussion every day. Missing a step on a staircase, slipping on the sidewalk, or a minor car accident could all lead to life changing injuries. The risk for concussion greatly increases during any type of physical activity and, as is to be expected, greatly increases during contact sports. The increased physicality of professional sports further increases the risk of concussion.

Professional sports leagues all have guidelines and protocols surrounding injuries and concussions, but the first priority of the league is to make money. More people are going to pay top dollar to see a team with an amazing player, even if he has been recently injured, than a nobody. In recent years this issue has come to the media forefront regular occasions. The list of ex-NHL enforcers who have died of causes related to chronic depression caused by frequent head trauma is far too long, and many players quickly find themselves back on the injured reserve list after returning too quickly from an injury. Players also typically see a drop-off in production when returning from concussions.

On New Year’s Day 2011 while playing in the NHL Winter Classic, All-Star Sidney Crosby left the game with a head injury. No blood on the ice, no cracks in any x-rays, and no way to know how serious it might be. Crosby however didn’t take much time off, and ended up taking another big hit four days later. It wasn’t until flying to Montreal that his symptoms began to pile up and he was officially diagnosed with a concussion. Three months later he returns to the ice in a practice setting, and stops days later when his symptoms return. Crosby did not return to regular games until the 2011-2012 season. He missed the first twenty games before returning (and quickly scoring two goals). Seven games later his symptoms returned, and although he was able to pass all league mandated concussion testing he decided to sit out and “listen to [his] body”. Sidney returned later in the season and led his team to the second round of the playoffs.

The story of Crosby’s injury outlines a few things I’ve touched on so far. The combined effects of the separate hits he sustained likely worsened the state of his injury. The concussion protocols of the league failed in protecting the player from further injury.

The NHL is employing a brand new concussion protocol this season. Impartial concussion spotters watching the game both in the arena and remotely can choose to pull any player from the game, given cause. This player is unavailable to return to the game, even if cleared by team trainers. The league and player’s association are making it clear that they’re serious about this policy. A $25,000 fine to the organization follows the first offense of not removing a player, but the fine increases significantly after that.

The protocol was enacted during a game in Edmonton on October 16th. Goalie Cam Talbot had struggled all game and was replaced with Jonas “The Monster” Gustavsson. Gustavsson had only played for minutes when he collided with his teammate Adam Larsson. Gustavsson’s neck snapped back and he lay on the ice for minutes while he was examined by trainers. Play then re-commenced until a concussion spotter in the arena said Gustavsson needed to be pulled from the game. He was, and the struggling Talbot went back into net.

The NFL also employs a Sideline Concussion Assessment Test (SCAT) which assesses fine motor skills, problem solving and general IQ. Each player takes a baseline test, to which the results of their SCAT are applied against to determine the seriousness of their potential injury. This is a fairly advanced testing strategy and is recommended by most experts except for one problem; some players have admitted to purposely doing poorly on their baseline tests to avoid being pulled from a game.

The NFL has even more strange points in their concussion protocols. A new feature this season is the addition of a non-team affiliated concussion expert to the sidelines for each team. The reasoning behind this is that the unbiased professional will make the correct medical decision no matter what. The problem I see with this strategy is that this impartial advisor doesn’t make the final call. The team’s concussion specialist is responsible for whether or not a player can return to the field.

Moving on from the NFL, we come to the MLB. This season found the league implement a new 7 day injured reserve for potentially concussed players, with the ability to retroactively change this to a 15 day injured reserve. This change allows the injured player and their physician time to properly monitor symptoms and diagnose injuries.

Surprisingly, one of the leagues with the best track record when fighting concussions is the UFC. UFC fighters sustain heavy head trauma during each bout, but are always allowed the proper amount of time to recover from their injuries. Bouts are scheduled once a month, and the scheduling is not done that much in advance. This allows the league to give fighters time to fully recover from any injuries. Fighters also go through rigorous physical testing before signing on for a match, allowing the league to determine if they are indeed fit.