An essay on concussions and MTBI for High Risk Sports

For all that’s been going on with the these NFL players retiring in their prime, Patrick Willis, Chris Borland even Jack Locker its starting a conversation about the NFL and injuries. I love this topic and I think overall awareness is the key to finding a solution. A few months back I wrote an essay on this this exact subject. It’s a relevant topic and a long paper I wrote, It’s a wednesday night and I’m sure you nightowls/early birds will enjoy this read. It’s an academic research essay, my first one, let me know if you want more, your opinions on the subject and if you disagree, lets spark a convo.

Sincerely Jay…
ps add me on snapchat (jayoverlorde)

In the world of sports we find that many athletes are eventually torn down by injuries. There are, of course, many explanations for this. Many sports are rough and move very quickly and this causes the potential for injury. Often they are very competitive and this encourages people to push harder than they probably should. Also, sometimes accidents simply happen, no matter how careful they are. However, it also seems that there might be other factors that explain this phenomenon of recurring injuries that could be changed or even reduced. This paper will examine one of these potential causes, the idea that in this world of sports there is subconscious mentality that the athlete has to be tough and play through the pain, as if winning is more important than general health. This is an even bigger problem in high impact sports such as hockey and football. Part of the explanation is because these sports are more physical and dangerous. However, it is also because these are predominantly “male” sports that enhance a stereotype of masculinity that encourages men and boys to ‘just tough it out’ and play through injuries. To truly understand why and how this happens we need to start at the bottom; basically when the child is developing relationships with parents, siblings, friends and coaches that demand them to surpass their physical limitations. Pressure from coaches specifically give the young male athletes a distorted view of accomplishment by reinforcing the idea of being tough, playing through injury which eventually leads to physical and mental complications later on in the athlete’s life. This paper will examine and pursue this issue. In this subject we do not find too much information about specific instructions by parents or coaches directly telling their children to put themselves at risk. Research by Siesmaa, Blitvich, Telford & Finch (2011) proclaim “…it remains unclear how sport injury impacts on children’s long-term involvement” (p.47). But we do see that there is a clear need for and want for children to participate in sport. The research involved focus groups with children that explained why they play sports, Siesmaa et el., (2011) found “…the most prominent reason to begin a sport was family influence, with children tending to take up sports that other family members currently play or had previously played” (p.57). This is a universal concept, you do what your parents did or like doing. In the case of North America our most popular sports are high risk; Ice Hockey and American Football, These two sports are played by children and in research by Bachynski and Goldberg (2014) support “…the most affected population is also the most vulnerable is also both physically and ethically” (p.324). This brings up a disastrous problem.The problem is concussions and mild traumatic brain injury (mTBI) that children get from these high risk sports. Hits to the head, “body checks” and the force of impact have such a tremendous effect on childrens health not only short term but long term as well. There is a trend to not only downplay the occurrence of mTBI but to deny it as well. They research conducted by Bachynski and Goldberg (2014) shows “ For instance, as of April 24, 2014, the website of Pop Warner Football asserts that “[i]n Pop Warner Football, there is absence of catastrophic head and neck injuries and disruptive joint injuries found at higher levels.”” (p.328). In light of this false admission we see that there is a clear cut denial of scientific facts, these kids experience these injuries because they play the sport more than any other age group on the planet. On a purely logical standpoint there is a clear correlation between mTBI and kids. The reason why they deny it is because they want to keep these children playing the sport, especially the star players, they are encouraged to play through injury by coaches, parents and social pressures. When we look at “Iron” Mike Webster a 16 year NFL player for the Pittsburgh Steelers who is considered one of the greatest football
players was highlighted in the Documentary “League of Denial” by Frontline which featured his life story of playing through mTBI and concussion. A doctor named Bennet Omalu who researched Webster’s brain found so much damage that he reported it to an NFL doctor who affirmed that If 10 percent of mothers in America found out about Omalu’s research that would be the end of football (Brinson, 2013). Moreover we see that the way risk is framed is significant, people from the outside looking in like coaches and parents do not understand the severity of this issue especially when it comes to concussions.
In the research by Cassonss, Viano, Powell & Pellman (2010) “The most frequent symptoms were headaches and dizziness; the most common signs were problems with information processing and immediate recall” (p.471). Comparatively to more recent times the NFL is more conscious of this epidemic by being more precocious with players return to play (RTP). But there was a mentality that returning to play was important and withstanding or playing through injury was acceptable there was a sense of denial. This denial affects the players long after their careers, like the example of Mike Webster
who had dementia, amnesia and depression. This is a common occurrence with players who have incredible brain damage sustained over a lifetime their standard of living is diminished and sometimes cut short like the case of “Iron Mike”. This pushing through and playing through injury mentality could be attributed to self-talk, in the research by Bauer, Mohiyeddini & LeBlanc (2011) “Self-Talk is one of the most frequently used cognitive strategies in athletes” (p.140) but the use of it during injuries at that level is insanity. So this leads to the conclusion that outside forces like coaches, peers, fans (or parents, when it comes to children) pressure these athletes to push beyond their limits and ultimately suffer the long term consequences. At one point Webster was living in his pick-up truck after a long career fighting in the “trenches” every sunday for the viewing pleasure of the public.
Additionally we can see that there has been research in the domain of concussion in the NFL and the data shows what is really happening especially when it comes to RTP. It is essential to find a solution and figure out where they went wrong in the first place. Cassons et al. (2010) show “There were 0.38 documented concussions per NFL game in 2002-2007–7.6% lower than the 0.42 in the earlier period (1996-2001). This shows that there is slight progress being made but it does not solve the issue. The number should be lower because that small percentage that experiences those concussions end up having a harder quality of life which could result in mental disease. These problems are not the type that are overt or noticeable at first glance. As previously mentioned when we look at “Iron Mike” case Dr. Omalu concluded that his mental struggles came from repeated injuries. It goes to show that these players have a subconscious mentality to push beyond their physical limitations so that they can prove to others that they are “tough” and these
“others” are coaches. In Cassons et al. (2010) research they found “A small number of players with brief LOC (loss of consciousness) had returned to play on the day of injury over the past 12 years” (p.480). Its fairly easy to understand why this small number of players did this it was because they felt the need to support their team, which is instrumentally good for a player to feel that way, but it is insane for us to deny that there are outside forces (coaches, trainers, fans) that influence these players to keep playing after sustaining such an injury. As a matter of fact this is what players feel pressured to do, because it is their job as professional athletes. At the same time it must be re-stated that children and adolescents are the age group playing these two sports the most. Theres no doubt that injuries have such a severe effect on an athlete’s journey (Bauer. Mohiyeddini & LeBlanc, 2011). Countless times we see them change because of an injury, weather the change be small or humongous. As an illustration we can watch the case of Bo Jackson an NFL Running Back that played for the Oakland Raiders from 1986 to 1991. He was the first pick in the 1986 NFL Draft and was hailed as a ray of hope for Raider fans, he was strong and surprisingly fast for his height and muscle mass. He was also a two sport athlete, playing professional baseball while being a professional football player in arguably the hardest position on the field. His football career was cut short because of a hip injury in the 1990-1991 season. The underlying narrative in this tragedy is that he had a mentality of not wanting to fail, so he pushed himself through most injuries to play two sports. Even if thistrait is strong in a positive light it is also tremendously dangerous once we look at it in a persons overall health. After Bo sustained this injury he focused on baseball but was visibly weaker in his playing style than before. He lives with an artificial hip at age 52. He admittedto having this mentality from a young age in a SportsScience interview (ESPN, 2013).This clearly shows the thought process that goes with injury experienced by athletes. A more contemporary example is current NBA player Derrick Rose, even though basketball would not be put under the umbrella of “high risk sports” we can see that there is a connection between injuries and this professional athlete. Rose was (and still is) a prominent NBA star, but in the last two seasons, from 2012 until 2014, he has experienced two career altering injuries. The first was an ACL tear in 2012 on his left knee which he sustained in a playoff game after an amazing most valuable player quality season. This injury sidelined him for a full year because of rehabilitation and also mental preparation for the future. Additionally we see the concept of overuse injuries where the athlete overuses his ability and gets injured from it, this phenomenon is more likely to happen with professional athletes who go through intensive training (Cook & Finch, 2011). When Derrick Rose returned a year later in the 2013-2014 season he torn his right knee meniscus in his second month of play after a full 12 months out of action, so he ended up missing the remainder of that season. In summation he played 18 games in two seasons (oryears) because of injuries. As shown above this is a perfect example of overuse, he worked himself so much that his healthy knee (the right knee) gave out like his left knee the previous year. The pressure from coaches and fans was so big that he had to come back and he hadto prove himself to be that MVP caliber player that he used to be, he had to disregard his own health just to entertain the masses. We see this happen before our eyes and giventhese points it would be interesting to see what the future holds for him, a player that has experienced life and career altering knee injuries at the tender age of 26. In the final analysis there is a solution that is at this table and it is proposed by Bianco “The athletes identified a number of individuals who were instrumental in helping them maintain and regain a sense of self-confidence, including coaches, physiotherapists, family and friends.” (p.262). Bianco was studying the support system around professional alpine skiers after they sustain an injury, this related to my topic because it enhances the power coaches, family, friends and other outside sources play in the role of athletes and injuries. This solution is half the distance, it addresses the underlying principle of helping the athlete at a base level, confidence, It is an important trait to have and it is exactly what is needed to stand up against those who encourage you to push beyond physical limitations. This is a small frame in the bigger picture of sports injury and this paper can not address the whole problem. Further research should be done on coaching methods and which ones are the most effectivewhen it comes to performance and injury in the hope that this becomes a problem of the past.

References

Kathleen E. Bachynski, Daniel S Goldberg (2014) Youth Sports & Public Health: Framing Risks of Mild Traumatic Brain Injury in American Football and Ice Hockey The Journal of Law: Medicine and Ethics 42 (3) 323-333

Ira Cassons, David Viano, John Pawoll, et el. (2010) . Twelve Years Of National Football League Concussion Data Sports Health: A Multidisciplinary Approach 2 (6) 471-483

Theresa, Bianco (1996) Social Support Influences on recovery from Sport Injury. Ottawa, ON, University of Ottawa

Brinson. Will (2013, October 8) Frontline PBS doc “League of Denial” examines NFL concussion problem CBS Sports. Retrieved from

http://www.cbssports.com/nfl/eye-on-football/24051122/frontline-pbs-doc-league-of-denial-examines-nfl-concussion-problem

Siesmaa, J, Emma, Blitvich, D, Jennifer , Telford, Amanda & Finch, F, Caroline (2011) Factors That Are Most Influential In Children’s Continued and Discontinued Participation And Discontinued Participation In Organised Sport: The Role Of Injury And Injury Risk Perceptions.
In Farelli, D. Anthony, Sport Participation (2011) New York, Nova Science Publishers, Inc.

Cook, Jill & Finch, F. Caroline (2011) The Long-Term Impact Of Overuse Injuries On Life-Long Participation In Sport And Health Status
In Farelli, D. Anthony, Sport Participation (2011) New York, Nova Science Publishers, Inc.

Bauer, Stehpanie, Mohiyeddini, Changiz & LeBlanc, Sara (2011) Individual Differences In Self-Talk And Its Relation To Sport Injuries And Rehabilitation
In Farelli, D. Anthony, Sport Participation (2011) New York, Nova Science Publishers, Inc.

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