Friday, May 4, 2012
Seau's death makes concussion talk timely
By Ted Miller
PHOENIX -- The first reaction was shock: Junior Seau dead at just 43, his death ruled a suicide. Quickly came grief: An all-time USC and NFL great, a good guy known for his accessibility and philanthropy away from the field who didn't want to live anymore.
Then shortly thereafter: Anger. Another football player dead before his time. Surely head injuries -- concussions -- were to blame. Surely the game is to blame. These three stages have been repeated too often of late, and their repetition threatens our love affair with a sport that obsesses our country like no other.
We can't make you feel any better about Seau. That's a still-resonating tragedy. We can only note it's premature to arrive at any overriding conclusions as to why he did the unthinkable.
Specialists are trying to determine whether Junior Seau's suicide could be related to the growing link between football and concussions.
But we might be able to make you feel a little bit better about football.
The takeaway from a timely Fiesta Bowl Summit panel Thursday, "Sports-Related Concussions: Facts, Fallacies and New Frontiers," was twofold: 1. The NCAA and NFL, after the media forced them to pay attention, have been working hard to get their arms around the issue; 2. It's not unreasonable to believe they can.
Of course, there always will be head injuries in contact sports, and repeated head trauma can lead to long-term health problems. This knowledge isn't new. Doctors were aware of boxers becoming punch drunk -- dementia pugilistica -- in the 1920s.
Understanding concussions and how best to prevent and then treat them, however, isn't easy. As Dr. Margot Putukian, one of four panelists at the Arizona Biltmore, said, concussions are "a moving target." Each one is different, and each person is different. They are not anything like a torn ACL.
Yet there has been recent research progress that is particularly meaningful for football. Said Dr. Michael McCrea, "The news is promising."
McCrea's research found that 28 percent of athletes suffering a concussion no longer show symptoms from their injury after 24 hours. Sixty percent are asymptomatic after a week to 10 days. So nearly 90 percent of athletes passed tests that showed their symptoms were gone inside of 10 days. But that's not the good news. Passing tests that show symptoms are gone doesn't mean the brain has fully healed -- achieved full clinical recovery.
The good news is this: Those numbers, it turns out, do indeed run roughly parallel to a full clinical recovery. Using a multi-dimensional approach -- symptoms tests as well as MRI -- for assessing the recovery process can, McCrea said, "take the guesswork out of concussion management."
These numbers should make it easier to convince athletes who are eager to get back on the field and coaches who want them there to be patient. Simply, coming back too early greatly increases the risk of another concussion, and a second concussion almost always requires a far longer recovery time. Waiting the full seven to 10 days -- and missing a game -- greatly reduces the risk of re-injury, McCrea said. Ergo, there are now specific numbers that show it's better for athlete and team not to rush things.
But the issues with concussions extend beyond understanding them, treating them and even preventing them. Every institution needs well-drilled standards and procedures for dealing with them: A concussion management plan. And coaches and training staff need to know them and know them well. Putukian asked a rhetorical question that all parents of athletes should be asking coaches (non-rhetorically): "What medical personnel do you have there, and what do you do in case of emergency?"
How many layers of procedure are involved here? Lots. Here's one you probably didn't think of: Academic accommodation. A player who suffered a concussion on Saturday might have issues taking a test the following Wednesday.
There was a consensus among the four doctors about how the NFL and NCAA can continue to improve their approach to concussions.
Education: Players and coaches need to understand how serious head injuries are, and the potentially harmful long-term consequences for returning to play too soon. This could include, for example, coaches deciding to limit contact during practices.
Equipment: There are no helmets that prevent concussions, and there won't ever be. That doesn't mean some helmets aren't better than others. Virginia Tech has devised a respected helmet ratings system, and the Riddell 360, Rawlings Quantum Plus and Riddell Revolution Speed all achieved five-star ratings.
Rules changes: Obviously, an emphasis on stopping head-to-head collisions has been front-and-center. A lot of attention also is being paid to when concussions are most likely to happen in a football game -- on special teams, in the open field and for specific positions.
Culture change: This might be one of the most difficult to enact -- see the bounty scandal involving the New Orleans Saints. Football is a physical game. That's why it's fun to play and to watch. But there needs to be a recognition that brutality for brutality's sake, a zeal for hurting opponents, can have horrific ramifications after the cartoonish strut and taunt end.
Coaches seem to be taking this issue seriously. Among those who attended the concussion summit, which was presided over by NCAA president Mark Emmert, were Stanford's David Shaw, Wisconsin's Brett Bielema and Texas Tech's Tommy Tuberville. When it was over, UTEP coach Mike Price stood up to say it was the best talk on the subject he'd heard.
Concussions are a serious problem in football. The first step toward solving a problem is recognizing it. The concussion panel this week suggested that football now might be taking a second and perhaps third step.