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The Medicine Behind Head Injury in Football.

Submitted by on May 27, 2012 – 11:59 PM

Football undoubtedly is the most popular sport around the globe and the talk of head injury associated with it is indeed a cause of great concern.  Yes, football causes head injury and the scientific name of this kind of head injury is “concussion”.

 

Concussion is defined as a sudden-onset, transient alteration of functional and/or structural brain equilibrium following a physical impact to the brain. This is most commonly manifested as transient loss of consciousness immediately after trauma (See Chart Below for Symptoms/Signs of Concussion: Adapted from CDC Concussion Fact Sheet). In simple terms sudden accelerations/de-acceleration caused by abrupt jerks to the head while playing harms the brain which is held inside a box-like cranium. These are not associated with any external bruise or swelling in the head, nor are there any radiological evidence of concussions. It is just that the violent shake of the head disturbs the fine balance of neurotransmitters and the brain goes haywire for some seconds. The long term sequlae of concussion is Chronic Traumatic Encephalopathy (CTE). Cumulative effects of CTE in addition to depression, anxiety, dementia

includes a whole spectrum of neuro-psychiatric and behavioral conditions. Depression and anxiety symptoms have been seen in 15%–60% of subjects after traumatic brain injury in footballers with history of concussion. Concussions are not rare either. Different studies have indicated that a history of concussions is found in20% to 60% of players.

 

Moreover research clearly indicates that footballers who had a single bout of concussion are likely to have more such bouts in the future. Repeated concussions occurring within a span of weeks cause long term sequale. Rarely, it might even cause death. Concussions have been known to doctors for decades and have been associated with boxing and other contact sports- that too in retired sportsperson. However newer evidence clearly points to affection of younger and even amateur footballers. Also younger children and teenagers are more likely to take a longer time to recover than adults and have worse prognosis than adults.

 

A lot of research has gone into the phenomenon of concussions and different guidelines have been adopted successfully by some sporting bodies. However most of the football associations, coaches and players in developing nations are completely unaware of the existence of something called “concussion”. A patient who is suspected to suffer from concussion should be immediately brought to the bench and rested for further play till cleared by a doctor. The American Academy of Neurology has clearly elucidated this in its position statement on football concussions.

 

FIFA researched and analyzed every reported concussion episode and introduced the policy of red cards for elbows to the head. This has drastically reduces the concussion rate among footballers. Moreover FIFA coaches are now training footballers to play football with the “head up” and training on more proper techniques in blocking and tackling. An interesting point that research has yielded is that it is often the player making the tackle who suffers from concussion rather than the player who is tackled. Research thus proves that sportsmanship is still the gold standard for “healthy football”.

 

Symptoms reported by Footballer

• Headache or “pressure” in head

• Nausea or vomiting

• Balance problems or dizziness

• Double or blurry vision

• Sensitivity to light or noise

• Feeling sluggish, hazy, foggy, or groggy

• Concentration or memory problems

• Confusion

• Does not “feel right” or is “feeling down”


Signs Observed by Coach/Fellow Footballer

• Appears dazed or stunned (such as glassy eyes)

• Is confused aboutassignment or position

• Forgets an instruction or play

• Is unsure of score or opponent

• Moves clumsily orpoor balance

• Answers questions slowly

• Loses consciousness (even briefly)

• Shows mood, behavior, orpersonality changes

• Can’t recall events prior /after tohit or fall

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The article is the second in the popular medicine series titled Football & Medicine.

To read the previous post in the series click: Cardiac Defibrillators In Football : A High Time To Act

Coming Next in Football & Medicine: Promoting Health with Football, Preventing Lower Limb Injury and more….

 

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