Advancements in Understanding Head Trauma and Preventing Long-Term Problems

When I was training to become an orthopedic surgeon, one of the senior physicians said that the two best learning sources for orthopedic surgeons were football and war.  Over the past year I’ve been talking with friends and colleagues about another connection between war and football – how minor repetitive head trauma has long-term serious consequences.

It has become clear with the increasing reports about the neurological, cognitive and personality problems military personnel have experiences after repeated minor concussive events, (often from being inside vehicles hit by IEDs), that this is a real and serious situation.  While the VA health system has taken steps to understand the consequences of repetitive minor head trauma and work to provide appropriate diagnostic and treatment methods, I have been telling people that this new understanding of neuro-trauma will have implications for football.

There have been more than a few reports about former NFL players having neurological problems after retiring; In particular, former Patriot Ted Johnson, whose problems with post-concussive syndrome was reported 2 years ago in the Boston Globe.  And just today, the Boston Globe had an article about how the brain of an 18 year old football player, (who died from nonviolent causes), showed early signs of irreversible damage from repetitive head trauma – something that had not been documented in professional football players younger than 36 years old.

War is different than football: In war, the goal is to avoid head trauma and steps can be taken to avoid it or minimize its effects through better vehicles and helmets – and by taking people out of harms way after head trauma has occured.  Conversely, in football, the contact, hits and subsequent head trauma are essential parts of the game.  While helmets have been made better and players can be taken out of the action after even minor head trauma, football can’t be played with complete cushion suits like those sumo-style outfits used in late-night and reality TV shows.  Last summer I wrote about how professional baseball teams are becoming more aware of the lasting effects of concussions on their players – but baseball isn’t inherently a contact sport.  I wish I had a good answer for football and football players.  Unfortunately I don’t think switching to flag or touch is going to make it as an alternative to full contact football. I’m a fan, but I don’t have good suggestions, and understanding the long-term consequences of repetitive minor head trauma, often makes it difficult for me to watch a football game – professional, college or high school.

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