Over the past few months, concussions have been gaining more and more attention in the media, schools, sports leagues, and the medical world. FRONTLINE recently aired League of Denial: The NFL’s Concussion Crisis, which left viewers reeling about the subject. Around the same time, Lacrosse Magazine published a few stories on concussions, including one featuring former Duke and Cannons stand-out Brad Ross.
For the past year and a half, I have been working as a researcher at the Boston University Center for the Study of Traumatic Encephalopathy, a group responsible for a number of the studies on former football players’ brains that have been mentioned in the media. We focus on the long-term effects of repetitive head trauma and, more specifically, chronic traumatic encephalopathy (CTE), a degenerative brain disease that has been described in a number of former boxers and football, hockey, rugby and soccer players.
Through an affiliate, I have had the opportunity to present to local schools and sports teams about concussions – what they are, why we should care about them, and what we should do about them. This post is the first of what will be a three part installment on concussions, covering the above issues, and how they relate to lacrosse.
One of the major issues that arises when discussing concussions is that most people don’t know what a concussion really is. This is often true of athletes (at any level of competition), parents, coaches, and sometimes even athletic trainers and hospital staff. A common misconception is that a concussion requires a loss of consciousness – picture those big, full-speed, open field hits on midfielders where someone is knocked out cold on the turf.
Although these injuries are concussions, being knocked out is NOT a requirement for a head injury to be a concussion. A concussion occurs anytime you have a hit or jolt to the head that causes you to experience symptoms for any amount of time – even if it is for only a few seconds. The symptoms can include blurred or double vision, seeing stars, sensitivity to light or noise, headache, dizziness or balance problems, nausea, vomiting, trouble sleeping, fatigue, confusion, difficulty remembering, difficulty concentrating, or loss of consciousness. Also note that some of those symptoms (especially changes to sleep pattern or cognition) may not present until minutes, hours, or days after the hit.
I’ll be the first to admit that growing up as an athlete, I never thought I had suffered a concussion… until I began working here at Boston University. After learning the medically-accepted definition of a concussion, I realized that I have had a handful of my own that went undiagnosed during lacrosse games, and practices.
A concussion is a perfect scenario to which we can apply the “injured versus hurt” argument. I grew up with coaches telling me I could play if I was hurt; but I could not play if I was injured. When a concussion occurs, your brain is always injured, not hurt.
Why is the above true? Because in your brain, you do not have the same nerves as you do in the rest of your body.
Rather than telling you there is pain, like with a sprained ankle or pulled hamstring, your brain cells just don’t function the same way – and that dysfunction results in the aforementioned symptoms and can make school, work, or exercise impossible. Concussions have been called “invisible injuries” in that it can be tough to tell if a friend or teammate has one, whereas a muscular or orthopedic injury is more obvious because it makes us limp and wear some type of brace or wrap for support. As in the case of a torn muscle, playing with a concussion risks further injury – only it is your brain, arguably your most important organ, that we’re talking about.
Think of how cautious we tend to be with knee injuries. Do we have the same urgency with head trauma?
Another misconception is that a concussion requires a direct hit to the head – a high hit (see the 0:38mark of the video below), a cross check to the back of the helmet (2:49), or your head slamming the turf after being knocked down (1:48). Yes, those are all common causes of concussions. However, a concussion is an injury sustained when your brain (which is similar in consistency to Jell-O) smacks against the inside of your skull.
For the above to happen, your head just needs to be jolted with a sufficient amount of force. That means you could experience a concussion from a body check, especially if your head and neck whiplash in response to that hit, without anything touching your helmet (try the hit at 1:38).
It also does not take a huge, highlight reel hit to cause a concussion. The first concussion that I can recall suffering was during a high school game, where I had climbed the ladder and was heading towards the goal on a downhill dodge. As we neared each other, my defender jumped up and checked me, gloves together, in the face. I wasn’t knocked down and he barely even altered my dodge, but I immediately felt like something was wrong. I pulled back out of traffic, moved the ball down to my attackman, and subbed through the box.
I had a strange, pressurized headache for a minute (at most) but was otherwise unaffected, so I actually went back in the game. Although I turned out fine, going back in was a big mistake in retrospect. I did not know any better because I was largely uneducated about concussions. I hope this personal story has shed some light on just how tricky these symptoms and issues can be.
The next two installments will, in a more in-depth way, cover why we should care about concussions and what we should do about them. I will once agains speak from my own experiences, and explain how and why I should have taken care of myself after that mid-game hit.