I am always pleased when the news cycle shifts to concussion and brain injury because that raises public awareness that concussion means brain injury and that brain injuries can cause permanent brain damage. Thus, the NFL being grilled by Congress as to the safety of its players is a very good thing. Likewise, the greatly increased awareness of brain injury coming out of all the publicity that the Iraq and Afghanistan wars brain injuries is also increasing public awareness. But I always worry that people will think that because athletes recover from concussions so quickly, that accidental concussion does not have the potential to permanently injure someone.
The bigger problem in the legal arena is that there is some very bad research being published now that would directly correlate a young athlete’s recovery from a concussion to real world brain injuries. (I apologize to those who see the obvious that sports is also part of the real world, but I find the phrase works to distinguish better than the use of other terms, such as civilian, because of course athletes are civilians, too.)
So, before we spend the next several blogs commenting on the NFL Congressional hearings, I think it is important to discuss what makes accidental (real world) concussions potentially more serious than sports injuries. Here is a partial list.
Sport Concussion a Young Person Injury. First, sport concussions typically happen to those with the greatest chance of a good recovery from concussion, young and athletic people. If we were going to list the three or four most common risk factors for a bad result from concussion, age would be at the top of that list. The reason for this is multiple but includes the fact that younger brains have a gene that stimulates neuronal regrowth that just does not exist when a person is over 40. The closer someone is to 40 at the time of the concussion, the more likely they will have persisting deficits from the brain injury.
Men Are at Less Risk. Most sport concussions happen to men and men are at less risk of poor outcomes from brain injury. This may be seem politically incorrect to say, but women are just simply more vulnerable, not just because they are not as strong, but also because concussive type forces are more likely to damage the white matter of the brain and women are more white matter dependant in there thinking. Complicated topic for another blog.
The Blow is Expected. Sport concussions happen to people who most times are prepared to get hit. The sport concussions that are the most serious are usually to someone who is surprised or motionless at the time of the blow. In contrast, almost all accidental concussions are a surprise. When the body knows it is going to get hit, it protects itself, considerably reducing the extent of and the arc of the acceleration/deceleration.
Athletes are Stronger. Sport concussions happen to people whose bodies have stronger muscles, which also significantly reduces the speed and the length of the acceleration/deceleration arc. When I speak about arc, I am speaking about how far forward, backwards or sideways the head will move on the neck, after being hit. It is this motion that accounts for most of the force on the brain’s axons.
There are about another half of dozen things I could add to this list, but the point of this blog is to remember when you hear about permanent brain damage to professional athletes, there is a far higher risk of that occurring to a 40 year old person who is in a motor vehicle wreck.