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Tackling Concussion Head On in the NFL

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Tackling Concussion Head On in the NFL

After decades of permitting on-field violent play, numerous well publicized cases of brain injury, and a multimillion dollar settlement with former players, the National Football League has begun making significant strides in improving the safety of the game and minimizing head trauma among players.

"The publicity about concussion in football has had a huge impact, greatly increasing awareness that you have to treat head injury differently than injuries to any other part of the body and that there are dire consequences to mismanagement," said Robert C. Cantu, MD, co-director of Boston University's Center for the Study of Chronic Traumatic Encephalopathy, who is senior adviser to the NFL's Head, Neck, and Spine Committee.

In the past it was common for a player to return to the game after a hit to the head if he hadn't lost consciousness. "Today there's a much greater recognition that we need to keep concussed players off the field for a longer period of time," Cantu said.

Today a player with a suspected concussion not only can't go back in the game, but he has to be evaluated according to a concussion protocol by the team's medical staff and also by an independent medical consultant.

But that isn't enough, said Tanzid Shams, MD, director of sports neurology at Tufts Medical Center in Boston. "In an ideal setting, the clinicians on the field should have no financial relationship with the teams. Instead, they should function as independent observers similar to referees. This model would take out the conflict of interest," Shams argued.

"We now understand that concussion symptoms are subtle, and the derangement in brain metabolism after trauma can last for days to weeks," he added.

Much more needs to be done, experts agree, particularly in the area of mild concussions and subconcussive hits to the head.

Probably 80% of mild concussions are missed from the sideline, according to Cantu. "It's very easy to hide your symptoms if you have 30 seconds to stand around and collect your thoughts. Even if you're a little off balance or slow or didn't get the play quite right, unless you're the quarterback, it's unlikely that people would even notice," Cantu said.

To aid in identifying hits to the head that might have been overlooked by sideline observers, in each game during the 2013 season a certified trainer sat in the stadium box watching and reviewing television replays.

References and further information

This article was originally produced by MedPage Today

 

Article written by Nancy Walsh, Staff Writer, 

 

Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

 

View the rest of the article here http://www.medpagetoday.com/SportsMedicine/EliteSports/44047?xid=nl_mpt_DHE_2014-01-31

 

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