Concussions: Protection and Prevention
By James Beauchamp, D.C.
The odds of fully recovering from a single concussion, while not 100 percent, are fairly decent. If you get a second concussion while still recovering from the first though, those odds drop and you are even more likely to experience long term, perhaps even permanent residual damage. There are times, however, when the brain is routinely exposed to one of the worst possible scenarios: frequent, repetitive subconcussive hits (resulting in mild traumatic brain injury, or mTBI) over a protracted period of time. This is common in many sports, most notably football. In the course of a single season, football players may experience thousands of such hits. Chronically repeated mTBI causes a progressive degeneration of neurological function over time, eventually leading to Alzheimer and Parkinsonian-like diseases, dementia, social difficulties, emotional and motor control problems. This is referred to as chronic traumatic encephalopathy, or CTE. It has come to national attention because of its very public exposure through professional football.
What does CTE look like in real life? Imagine a hypothetical pro-football player. He is six foot three inches in height, 260 pounds, and a virtual human hurricane. Inured to pain, he trains brutally hard, pushing himself past the limits of what most men can endure. He is focused, determined, driven and single-minded. Imagine that this player has retired, but gradually begins to change. He becomes forgetful and moody. He starts yelling at his kids, can’t concentrate or focus, and is probably plagued by chronic headaches. These are early symptoms of CTE. But this is just the beginning, because eventually even basic judgment starts to become impaired. He becomes socially unstable and starts to experience severe memory loss. By the end, long before his body would have failed, brain damage has reduced this hero of professional sports into someone who may be so severely compromised mentally and physically that he is unable even to care for himself.
Concussion and CTE are endemic to the sport of football. It is ironic that the National Football League (NFL), the top of America’s football food chain, has downplayed the effects of concussion and then refused to provide the players benefits through the very retirement plan which it set up to help those players. According to the book League of Denial, this program was “…the place where [the players] pleas for help went to die…”. Only 317 of 10,000 claims have ever paid to players injured in the NFL, according to that book. The way this retirement plan is described reminds me a lot of my experiences with state workers’ compensation insurance companies. Each organization was set up to help their injured constituents. Both types of organizations (the NFL and workers’ comp insurance companies) have millions of dollars in the bank. Both employ a complex bureaucracy seemingly designed more as a roadblock rather than anything remotely helpful. Both groups routinely deny care and dispute a huge percentage of claims. Both use hired-gun doctors who perform ‘independent’ examinations that almost always find nothing wrong with the patients. Both groups therefore put their respective injured workers’ physical and financial health at risk, oftentimes with disastrous results. It is no wonder that football players and injured workers alike often view these programs with contempt, and why they are forced to turn to legal counsel in order to pursue their legitimate claims.
It is the nature of large organizations swimming with money to look to their own interests first rather than those of the people they were originally designed to serve. Fortunately, the torrent of medical research on concussion has brought the reality of the problem home, even to a group as rich and powerful as the NFL. It should no longer be taken lightly. Over time, hopefully a balance will be found between the necessary toughness required to play professional football and the very real frailties of the human brain. The real issue then is prevention and aftercare, because there is no cure for CTE. It is in preventing CTE from happening in the first place where real progress can be made.
While every brain responds in a unique way depending on the mechanism of injury, all brains also need time to recover from mTBI or clear cases of concussion no matter the activity that causes them. Some people are more susceptible to CTE than others, so it is important that medical care be tailored to the specific needs of the individual. I believe the NFL and state level workers’ compensation can fairly and competently treat their injured charges, but not with an attitude of denial and the tacit assumption that injured people are just in it for the money. The truth is more likely the opposite: they are making claims they well deserve.
Dr. James Beauchamp is a Multi-Specialty HealthCare provider specializing in Chiropractic Care. He is certified in spinal trauma, manipulation under anesthesia, and as an automobile accident reconstructionist. He is also a member of the advisory board for Operation Backbone.
References available by request. Copyright James W. Beauchamp, DC