Traumatic Brain Injuries – Football Season

Traumatic brain injury can include a range of injuries to the head and brain including the most common type of injury- a concussion. Brain injuries can come from any number of causes such as falls, impacts, blunt trauma to the head, or a violent attack. Unfortunately, almost all causes for a concussion of other TBI can be found within the realm of sports, football being the most widespread and most talked about.As football season gets under way, it is important to take time to talk about brain injuries and how they are related to the sport the impact they have on players, and what can be done to reduce the occurrence and severity of these potentially devastating injuries. It is a common issue that is still not being given the attention it needs!

“Most people do not realize how prevalent cases of TBI are or how truly overwhelming injuries of this nature can be. TBI is often missed during initial treatment and diagnosis due to the fact that simply trying to stabilize a person and save them is the most urgent objective at that time.The death rate from traumatic brain injuries at one time in our history was very high. This was due to the fact that there were no fancy machines to monitor the brain and surgery techniques were crude and rudimentary. Many people died due to pressure on the brain or because of impalement, bruising, and the disruption the injury caused to major functions of the brain such as breathing and heartbeat. Although the methods for diagnosis and treatment have advanced significantly, TBI can still have a significant and long-lasting impact” (Brain Injury and Trauma).

TBI has two classification categories: mild and severe

Mild injury to the brain is usually diagnosed when the individual experienced confusion, blacks out, or shows signs of a concussion or other trauma for less than 30 minutes from the time of injury. Severe brain injury is most often diagnosed when the loss of consciousness last for more than 30 minutes and memory loss, confusion, or other symptoms that linger for more than 24 hours from the time of injury. The individual symptoms and side effects of the TBI will depend on what trauma was experienced, what area of the brain was affected, and other factors so it is important to carefully watch the patient and look for worsening symptoms or any new symptoms that may arise later on.

Effects a TBI Can Have

The effects of TBI can be profound and for those with severe brain trauma the long-term rehabilitation that is often necessary can be just as devastating as the injury itself. Profound changes in brain function that are brought on by a concussion or other brain injury can deal a significant blow that can affect the patient, their family, their job, their social life, their romantic life, and many personal aspects of life. Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later. This is why it is important to be watchful with any adult, teen, or child is thought to have possible suffered a blow to the head. Even a mild TBI can have far reaching effects!

• Mild traumatic brain injury
  The signs and symptoms of mild traumatic brain injury may include:

Physical symptoms

• Loss of consciousness that can range from just a few seconds to up to 20 minutes
• No loss of consciousness, but being confused, disoriented, dizzy, or ‘off’
• Headache that can start mild and intensify or can come as a full migraine
• Nausea or vomiting, particularly right after the injury or when standing or moving
• Fatigue or drowsiness, inability to stay awake, wanting to lay down and sleep
• Problems with speech, slurring words, stuttering, unable to say certain words
• Difficulty sleeping, being restless, waking frequently, having nightmares

 Sensory symptoms

• Blurred vision or changes in normal vision
• Ringing in the ears, loss of hearing, or buzzing in the ears
• Bad taste in the mouth or changes in the ability to smell
• Sensitivity to light or sound or movement

 Cognitive or mental symptoms

• Problems with memory, recall, concentration, logic, or rationalizing
• Mood changes or experiencing sudden or drastic mood swings
• Feeling depressed, paranoid, nervous or anxious for no reason 

• Moderate to severe traumatic brain injuries
  Moderate to severe traumatic brain injuries may show any of the previous symptoms as well as advanced symptoms that can arise hours or even days after the initial injury occurred:

Physical symptoms

• Loss of consciousness that lasts more than a few minutes
• Persistent mild to moderate headache or headache that worsens
• Repeated vomiting or nausea hours after the initial injury occurred
• Signs of any sort of convulsions or seizures
• Dilation of one or both pupils of the eyes or unusual eye response to light
• Clear fluids seeping from nose or ears
• Inability to stay awake or being unable to be woken up from sleep
• Weakness or numbness in the hands or feet or in the fingers or toes
• Loss of coordination, poor balance, stumbling, poor motor control 

Cognitive or mental symptoms

• Profound confusion, memory loss, speaking nonsense
• Agitation, combativeness or other unusual behavior
• Slurred speech, inability to speak, problems eating or drinking
• Coma and other severe disorders related to loss of consciousness 

• Children’s symptoms
  Infants and young children who might have suffered a head injury such as a concussion usually are not be able to communicate the common symptoms such as headaches, sensory problems, confusion as effectively as older children and adults can.In a child with a TBI, you may observe any of the following symptoms:

• Changes in their normal feeding or nursing habits and abilities
• Unusual crying or easy irritability that is difficult to console
• Change in ability to pay attention or focus on normal tasks
• Change in their normal established sleeping habits
• Seizures or any apparent loss of consciousness
• Sad or depressed mood or sudden changes in mood without cause
• Drowsiness, inability to stay awake, not wanting to wake from naps
• Loss of interest in playing with favorite toys or doing normal activities
• Any other odd, unusual, or concerning signs observed

Making Sports Safer from Brain Injuries

For those who love football, both watching and participating, it can be hard when you want to make the game safer but do not want to lose the enjoyment the game brings. Thankfully, there are changes that can be made that will make football safer without drastically changing how the game is played or enjoyed. Some of these, which were highlighted in an article in The Post and Courier, include the following:

• Mandatory medical staffs
  Requiring all football teams at the college and professional level to maintain medical staff presence and go a long way in keeping players safe. Having staff retained in medical care and diagnostics can help players detect injuries sooner and get better treatment so symptoms can be less severe and shorter in duration.
• Flag football until high school
  At a young age the brain is much more susceptible to trauma and injury. So, by reducing contact sports and keeping football games to a non-contact or minimal contact way of playing can greatly reduce childhood brain injuries. This will also go a long way in helping these would be players have a better life as teens and adults.
• Non-contact practices
  Pro football teams put a great deal of emphasis on practices and when you consider all the hours spent in practice and then ad don the game play time, the number of impacts each player receives is truly staggering. Making practices non-contact can greatly reduce the number of opportunities for TBIs right from the start.

• Mandatory brain trauma education
  When players, coaches, parents, and others involved in high school, college, and pro games understand that impact brain injuries can have and how they can occur, they can better protect against them. Education is key to making football, along with other contact sports, safer for everyone who loves the game.

• Create a licensing board
  Some sports, such as boxing and professional wrestling, require athletes to be approved by a medical board and to be properly trained, licensed, and evaluated before they can play. If there are signs of injury or mental problems then that player is not allowed on the field to keep injured players from hurting themselves worse.
• Mandatory removal for concussion signs
  The final way we can make football and similar high impact sports safer and more brain friendly is to institute rules that forbid players who have a concussion or who are suspected to have suffered a blow to the head from playing. Repeat hits after a concussion only worsen the injury and make symptoms more devastating.

As football season gets under way, it is important to take time to talk about brain injuries and how they are related to the sport the impact they have on players, and what can be done to reduce the occurrence and severity of these potentially devastating injuries.