A Concussion Crisis: The Sports Concussion Epidemic by Michelle Nguyen

This is the night of all nights. You have been excitedly anticipating this night throughout the entire season. As the star quarterback of your high school varsity football team, it is your responsibility to lead your teammates to victory. You hear the whistle blow, a few seconds go by, you are scanning the field looking for an open receiver. Before you know it, you are waking up on your back. It is all a blur; the only thing you remember is seeing some blinding bright lights then everything went black. Above you now stands the trainer, asking you what your name is and what is the score of the game. You feel fine; you are not in much pain and you must be alright to continue playing, right? The answer to that question is, most likely, no.

When it comes to football, it is not all fun and games; there exists a troubling epidemic behind America’s favorite pastime. Sports concussions have been a topic of interest in medicine, as well as a public health concern over the past couple decades. It is an epidemic that affects athletes of all ages, however it does cause heightened concern within a certain demographic – the youth population. According to Moser, “[f]rom 1997 to 2007, visits to emergency departments for sports concussion doubled in the 8–13 year old group; in 14–19 year olds, the incidence had increased by more than 200%” (Moser 1). Concussions cause disturbances in “normal neurological functions of the brain,” but can have even worse consequences on the developing brains of young athletes (Hunsucker 805). As a society, we must protect and preserve the minds of the upcoming generations; one portion of this task is to find a solution to the sports concussion epidemic.

History

            The sports concussion epidemic, also known as the “concussion crisis,” emerged in the early 21th century (Harrison 823). It was first referred to as a “‘silent epidemic’ in a 2003 report by the Centers for Disease Control and Prevention (CDC)’ (823). It was called a “silent epidemic,” because the long-term effects had only begun to gain interest from medical professionals (Abrams 1). The epidemic was caused by a variety of factors, including an increased participation in youth sports and recreation activities, an aggressive sports culture, a better understanding of concussions and their diagnosis, and an outdated set of rules and regulations. While a relatively new epidemic, its roots date back to the early 20^th century and the death of 18 college football players in 1905 (Abrams 1). Most of the deaths were caused by traumatic brain injuries, such as concussions or skull fractures (1). These tragic deaths sparked the realization that changes needed to be made in terms of safety rules. A summit was held at the White House and led to the creation of the NCAA (1). This was the first of many preventative measures to reduce the likeliness of injuries among athletes. However, even though these measures are in place, the epidemic continues to

persist.

Effects on Society and Examples

Concussions are “a form of traumatic brain injury (TBI) defined as a ‘complex pathophysiological process affecting the brain, induced by biomechanical forces’” (Russell et al. 2). For mild cases, they can negatively affect an individual’s cognitive, emotional, and social functioning, which in the broader scope of things, can have long-term implications. Among high school athletes, concussions have been “associated with short-term cognitive impairment [and] altered neurochemistry” (Sprouse 544). This could hinder the athlete’s academic performance and interaction with others within their society. Each individual within a society is tied to many others, in a way that is similar to a network or web. When one individual is no longer able to operate and contribute to society the way they were meant to, it affects the lives of those they are connected to.

The repercussions of a concussion can also vary vastly; in most cases, the symptoms are mild and are resolved within a short time frame, but they can also result in tragedies. In 2006, Zachary Lystedt suffered a concussion during a high school football game, but was returned to play twice during the reminder of the game (Mukand 16). After the supposedly mild injury, Zachary couldn’t speak for nine months (16). Four months later, he could move his left arm a little, and after two years he was finally able to remove his feeding tube (16). Tragedies like Zachary’s are examples of the severity of the epidemic and serve as reminders that concussions shouldn’t be taken lightly.

The human brain is not fully developed until around the age of 25, therefore brain injuries can deter normal development. A new study presented at the American Academy of Neurology 2016 Sports Concussion Conference, has shown significant alterations in the white matter of the brains of high school and college football players six months post-injury (Sprouse 544). The developing brains of the youth population is more susceptible to severe brain injuries and the recovery process is more complex, therefore putting them at risk for severe symptoms and cognitive decline (Mukand 17). Lastly, there are also long-term medical complications, such as “chronic traumatic encephalopathy (CTE) and chronic neurocognitive impairment (CNI)” (Sprouse 544). Sport-related concussions can have a cumulative effect that can affect those on a world-wide level. They can cause impairments to the athlete which can alter their future roles and ability to contribute to society. As the saying goes, the youth of today are the leaders of tomorrow, therefore if their minds are negatively affected, that affects all our futures.

Solutions

The sports concussion epidemic is not one with a clear path of resolution. The obvious solution would be to eliminate the means by which sports concussions occur – participation in sports. However, this solution is not viable nor realistic. Sports and recreational activities have become a staple among the American population with over “44 million young people participating in sports activities” annually (Sprouse 538). Currently, a couple solutions have already been implemented, however there is still room for improvement. The first solution brings a legal perspective to the concussion crisis, by introducing return-to-play (RTP) legislations which have been incorporated into many state laws (Bachynski 324). The first RTP guideline, Washington State’s Lystedt Law, was legally mandated in 2009 following the tragic TBI endured by Zachary Lystedt (325). These guidelines usually require that any athlete with symptoms of a mTBI (minor traumatic brain injury) be withheld from play and examined (324-325). Often in accompaniment with these laws is the requirement to educate athletes, parents, and coaches about the detection of mTBIs (324). This solution is not one that eliminates the occurrence of concussions, but can reduce the risk of further damage.

The second solution is the use of protective equipment, in particular, helmets. Helmets have been readily associated with contact sports such as football and ice hockey for years. Although they provide some protection to the athlete, the practice is severely flawed. Helmets have been proven to only protect the upper part of the skull, therefore providing the athlete with very limited protection (325). They have been proven effective in preventing head injuries like skull fractures and intercranial hemorrhaging, however are ultimately not designed to protect against mTBIs (326). According to Kevin Walker of the American Academy of Pediatrics’ Council on Sports Medicine and Fitness, “[a]t this time, no protective equipment can prevent concussion[s]” (326). This is troubling since helmets are marketed as one of the most prominent strategies to avoid head injuries. Furthermore, the regulatory bodies of both football and ice hockey have yet to implement standards on helmet design (325). Thus, leaving the responsibility on the shoulders of the corporations who manufacture and sell them. To this day, there is insufficient research in terms of helmet design. In order for helmets to prove an effective solution, further research must be done to develop helmets that can and will protect against concussions (Erdtmann 124).

A third solution would be to change the sports culture surrounding contact sports. The current culture “negatively influences athletes’ self-reporting of concussion symptoms and their adherence to return-to-play guidance,” putting themselves at risk (124). According to Sprouse, four out of ten concussions incurred by high school athletes were never reported to medical professionals (Sprouse 538). This mindset poses an increased health threat to athletes and has the potential to be improved. Through education and repetitive emphasis of the harmful effects of concussions, the health threat can be drilled into the sport culture exhibited by athletes, parents, and coaches. To resolve this epidemic there is no one solution, rather a number of different solutions that if implemented and adhered to can provide a resolution.

Camus and Absurdity

            Camus believed that life was full of absurdities and had no meaning, leading him to ponder on whether or not physical suicide was a plausible response to the absurdities of life (Maguire 1). Ultimately, he argued that even though our endeavors and efforts in life are futile, “the task of living should not merely be accepted, it must be embraced” (Simpson 1). With this perspective in mind, Camus would’ve seen the sports concussion crisis as an epidemic. If we are supposed to persevere and continue living life, then we must take preventative measures to ensure we are able to do so.

In addition, Camus was known to be an outstanding athlete. At one point in his sports career, he played the position of goaltender “for the junior team of Racing Universitaire d'Alger (RUA), a national soccer organization” (Silver 1). However, his career was cut short at the age of eighteen due to a bout of tuberculosis, which left him with damaged lungs (1). Nonetheless, he attributed sport as a factor in his way of thinking, “[e]verything I know about morality and the obligations of men, I owe it to football (soccer)” (“A Quote by Albert Camus”). Due to his interest in sports, this epidemic would definitely have been one that caught his attention.

Lastly, the adherence and acceptance of the culture surrounding contact sports would have intrigued him as it can be viewed as a branch of philosophical suicide. Camus argued that the worst kind of suicide, is when one ceases to think for themselves and just accepts a predetermined set of beliefs. The current sport culture has resulted in an alarming percentage of non-reported concussions, thus posing a health threat to many athletes. There is a troubling mindset that being put into play is the most important thing, even if that means putting yourself at risk. The thought process really isn’t the most logical, by making this decision you could be sacrificing your future for a few more minutes in play, yet it is readily followed by many.

Conclusion

Sport concussions are a modern-day epidemic that has existed for over a century, yet has only begun to gain interest. Although contact sports such as football and ice hockey are usually attributed as concussion risks, they can occur while participating in a variety of sport and recreational activities. Concussions may not seem very malicious at the time of infliction, but have the potential to become tragic. Although this epidemic affects athletes of all ages, there is increased concern among the youth population as they are at the greatest risk. Their brains are still developing; therefore, head injuries are more likely to cause devastating long-term effects. As a society, it is our responsibility to push for solutions to this epidemic and protect the minds of the future.

             

Works Cited

"A Quote by Albert Camus." Goodreads. N.p., n.d. Web. 02 Aug.

Abrams, Douglas E. "Confronting the Youth Sports Concussion Crisis: A Central Role for Responsible Local Enforcement of Playing Rules." By Douglas E. Abrams :: SSRN. University of Missouri Law School, 22 Aug. 2012. Web. 19 July 2017.

Bachynski, Kathleen E. and Daniel S. Goldberg. "Youth Sports & Public Health: Framing Risks of Mild Traumatic Brain Injury in American Football and Ice Hockey." Journal of Law, Medicine & Ethics, vol. 42, no. 3, Fall2014, pp. 323-333. EBSCOhost, doi:10.1111/jlme.12149.

Erdtmann, Frederick. "Sports-Related Concussions in Youth: Improving the Science, Changing the Culture." Military Medicine, vol. 180, no. 2, Feb. 2015, pp. 123-125. EBSCOhost, doi:10.7205/MILMED-D-14-00516.

Harrison, Emily A. "The First Concussion Crisis." American Journal of Public Health, vol. 104, no. 5, May 2014, pp. 822-834. EBSCOhost, doi:10.2105/AJPH.2013.301840.

Hunsucker, Josh. "Buckle Your Chinstrap: Why Youth, High School, and College Football Should Adopt the NFL's Concussion Management Policies and Procedures." Mcgeorge Law Review, vol. 45, no. 4, Dec. 2014, pp. 801-833. EBSCOhost, ezproxy.com.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=109093428&site=ehost-live&scope=site.

Maguire, Laura. "Camus and Absurdity." Philosophy Talk. Stanford University, 27 Feb. 2015. Web. 02 Aug. 2017.  

Moser, Rosemarie Scolaro, and Philip Schatz. “A Case for Mental and Physical Rest in Youth Sports Concussion: It’s Never Too Late.” Frontiers in Neurology 3 (2012): 171. PMC. Web. 19 July 2017.

Mukand, Jon A. and Marilyn F. Serra. "Concussions and Brain Injuries in Youth Sports." Rhode Island Medical Journal, vol. 98, no. 12, Dec. 2015, pp. 16-19. EBSCOhost,ezproxy.com.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=111425754&site=ehost-live&scope=site.

Russell, Kelly, et al. "Academic Outcomes in High-School Students After a Concussion: A Retrospective Population-Based Analysis." Plos ONE, vol. 11, no. 10, 20 Oct. 2016, pp. 1-12. EBSCOhost, doi:10.1371/journal.pone.0165116.

Silver, Carly. "Albert Camus Almost Became a Star Soccer Player." History Buff. Disqus, 26 Sept. 2016. Web. 02 Aug. 2017.

Simpson, David. "Albert Camus (1913—1960)." Internet Encyclopedia of Philosophy. N.p., n.d. Web. 02 Aug. 2017.

Sprouse, Ryan A., et al. "Sport-Related Concussion: How Best to Help Young Athletes." Journal of Family Practice, vol. 65, no. 8, Aug. 2016, pp. 538-546. EBSCOhost, ezproxy.com.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=117399455&site=ehost-live&scope=site.