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AFM Magazine


The Last Rep

Concussions - Part I
by: Aaron S. Lee
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With each snap of the ball, football players are at constant risk for career-ending concussions. American Football Monthly has gathered seven of the industry’s top experts to discuss this epidemic in a Last Rep two-part series. AFM encourages coaches to use this platform as a first step in their continuing education on player safety. Please contact medical experts and gear manufacturers to learn the latest safety measures in dealing with concussions.


What is a concussion?

“The word ‘concuss’ in Latin means ‘to shake violently.’ A concussion is a metabolic change in the brain, it is not a structural injury. A CT scan or MRI is not going to show anything with a concussion. The most important point to make is the best way to prevent concussions and the cumulative effects of concussions is to manage it properly when you have one.” – Micky Collins, Ph.D., Assistant Director, UPMC Sports Concussion Program

“A more difficult question than you might think. Technically: Damage to the brain caused by a violent jarring or shaking such as a blow or explosion (From Mosby’s medical Dictionary Fifth edition) More to the essence of the question the answer is like this: a loss of neurological function with or without loss of consciousness that is immediate in onset, transient in duration and presents no visible anatomical change. It is caused by tissue distortion. Remember a concussion can be fatal, however to avoid confusion we have been referring to the typical athletic concussion as Mild Traumatic Brain Injury, or MTBI. MTBI does not result in death but repeated MTBI can result in long term functional loss of neurological function.” – Dave Halstead, Director, Sports Biomechanics Impact Research Laboratory & Technical Advisor, National Operating Committee on Standards in Athletic Equipment (NOCSAE)

“A concussion is any neurological dysfunction resulting from a mechanical force. They are graded in level of severity by their neurological signs and systems. The three most widely used sports concussion guidelines for grading the signs and symptoms are: Canter Grading System, Colorado Medical Society Guidelines and the American Academy of Neurology Guidelines.” – George Salvaterra, Head Athletic Trainer, Penn State

What causes a concussion?

“The cause of concussions is typically an acceleration or deceleration force coupled with rotational forces. These forces can cause coup and countercoup injury to the brain. The pathophysiology of neuronal tissue during brain trauma is continuously being studied on the neuronal metabolic level.” – George Salvaterra

“A concussion is usually caused by violent contact and/or impact between two (2) individuals or one individual and an object, e.g. the ground. It can occur when delivering a blow or receiving one. Concussions are usually caused by one of the following: violent contact helmet to helmet; violent contact helmet to facemask; violent contact helmet to body part; or violent contact helmet to ground.” – Billy Rice, National Promotions Manager, Schutt Sports

“A concussion can occur when a player receives a blow to his head or a sudden jolt to his body that results in a sudden acceleration/deceleration force to the head.” – Garry McNabb, Vice President of Finance and Owner, Adams USA

“Tissue distortion is the simple answer. Most are caused by impacts of relatively long duration and have a minimal risk of skull fracture. These injuries are a result of intracranial tissue distortions, involving compressive, tensile and shear strains.” – Dave Halstead

“A blow to the head or a collision involving the head. A severe whiplash effect.” – Dale Strauf, Head Equipment Manager, Cornell University, President Athletic Equipment Managers Association (AEMA)

“What you need to do is think of your brain like an egg yolk inside an eggshell ... with the eggshell representing the cranium, the egg white representing the cerebral spinal fluid and the egg yolk representing the brain. What happens when you shake an egg is that the yolk jostles all around inside the shell ... this also happens to your brain during an impact to the head on the football field, which can lead to a concussion.” – Micky Collins, Ph.D.

What are the symptoms of a concussion?

“The most common misconceptions about this injury are that concussions coincide with a loss of consciousness ... nothing could be further from the truth. A loss of consciousness is just one of the many signs of the injury ... there are other signs that are just as important – if not more important – such as: memory loss around the time of injury, confusion, headaches, dizziness, fatigue, sensitivity to light, sensitivity to noise, loss of concentration, personality changes, loss of balance, nausea. If an athlete has those symptoms after a blow to the head, they should not be playing.” – Micky Collins, Ph.D.

Can concussions be prevented?

“Some concussions may be prevented, simply by better educating the athlete as to what the helmet has been designed to do. The helmet was designed to protect the head only, not the neck of the person wearing the helmet. It was not designed to be used as a weapon or as a battering ram ... there is no concussion proof helmet available in today’s helmet models! All helmets are designed with the intent to reduce concussions, but no helmet will prevent all concussions.” – Billy Rice

“There is no panacea (or magic bullet) that is going to prevent concussions ... there is no medication that can be given to prevent a concussion.” – Micky Collins, Ph.D.

“Concussions cannot be prevented. They are a part of participating in any type of contact sport.” – Garry McNabb

“The potential for concussions will always exist in any contact sport. One of our goals as a helmet maker is to reduce the risk of concussion to the player.” – Thad Ide, Vice President of Research and Development, Riddell

“No, some do not require impact to the head. Actually ‘yes’ is the right answer. Remain healthy and never move your head. MTBI can be minimized by playing technique and headgear. No headgear will prevent MTBI.” – Dave Halstead

“Some concussions can be prevented by the proper fitting of equipment that has been certified or reconditioned and re-certified for its use with the appropriate sport. The maintenance and fitting of helmet, chin strap and mouthpiece are major factors in prevention ... hiring of an ATC is also an important factor. ATC are trained to properly fit equipment and the proper recognition and management of concussions.” – George Salvaterra

If concussions cannot be prevented, what measures can be taken to help reduce the possibilities of concussions?

“Last year, Riddell introduced the Revolution, a football helmet that uses new technology intended to reduce the risk of concussion. Keep in mind that this technology is not intended to be a prescription for players who have had a concussion or for someone seen as susceptable to concussions. Follow the advice of your physician and do not return to play until all of your symptoms have resolved following a concussion.” – Thad Ide

“The risk of sustaining a concussion can be lessened if a player follows the proper technique, refrains from using the helmet or face mask as a point of contact and follows the proper rules of play.” – Garry McNabb

“All helmets used should be NOCSAE certified and re-certified periodically. Helmets should be properly fitted and maintained. Certified Athletic Equipment Managers are trained to perform this task. Student-athletes should be taught blocking and tackling techniques that avoid direct contact with the helmet.” – Dale Strauf

“Several steps can and should be taken to reduce the possibilities of sustaining a concussion: 1. Education of the Athlete (on what the helmet is designed to do) ... 2. Helmet “Tri-fecta” (properly fit helmet, hard cup chin-strap and mouthpiece) ... 3. Proper Technique - proper form tackling, keeping the head up, ‘seeing what you hit,’ and not using the helmet as a weapon ... 4. Better rules enforcement - officials must be very strict and call rules violations, such as butting, ramming and spearing, e.g., whenever it occurs ... 5. Ongoing research - all current helmet manufacturers are constantly striving to make their products better. Constant research is being done on current materials as well as on those, which become available to see if the product can be improved. Schutt, for example, has made almost 100 changes to the football helmet in the past decade, all designed to improve the product.” – Billy Rice






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