The Concussion Discussion

When is it OK to return to play?

St. Louis OrthopedicsWith a snap a 320-pound Charger kicks up his front limbs and hurls forward with mighty determination only to lose the battle to an oncoming jumbo jet that jarred his head at over 80 G’s.

No this is not a horse race or a flight simulation, but rather an NFL football game in which San Diego Charger’s linebacker Kris Dielman received a concussion on Oct. 23rd, which sent him in to a seizure on the airplane hours after the game. This was after his team deemed him fit enough to remain in the game even though he wobbled and appeared disorientated and cleared him for the flight home.

So what constitutes a concussion and how hard is too hard when getting “your bell rung” in contact sports such as football?

Benching the Brain
A concussion is typically caused by a severe head trauma during which the brain moves violently within the skull. The brain cells all fire at once, much like a seizure. Some studies show that patients who suffer a concussion appear to have the brain activity of people in a coma. Some blows produce unconsciousness and others may not depending on the person and the type of blow sustained.

HITS System hits back
Some concussion’s can be compared to suffering an impact at speeds similar to a serious car wreck and the same technology that deploys airbags and saves lives on the street is now being used to save lives on the field.

Riddell, which is the official helmet worn by NFL players, created a Head Impact Telemetry (HITS) System to a test and diagnose concussions through helmet impact by measuring the location, magnitude, duration and direction of head impacts and impact accumulations. This data is transmitted wirelessly to the sideline to provide coaches and medical staff with valuable information – in real-time if they choose – that can be used to identify potentially dangerous head impacts.

The resulting reaction force is expressed in g-force (with one g being equal to the force of gravity). The NFL began using this technology during the 2011 season and research conducted by them has determined that 98 G’s is the threshold for concussions.
Apart from the data, concussion symptoms may include: Confusion, disorientation, memory loss, unconsciousness, unequal size pupils, headache, dizziness, tinnitus, nausea, vomiting or vision changes. In any case, which these symptoms are evident the brain must be put through a battery of tests and before continuing with play.

St. Louis OrthopedicsDiagnosis of ImPACT
The ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) program is currently used at many high schools and colleges, as well as the National Football League and National Hockey League. It is a 20-minute test that measures attention span, working memory, sustained & selective attention time, response variability, non-verbal problem solving and reaction time.

ImPACT has also designed a new app you can download. This free application consists of educational material regarding the prevention of concussion and mild traumatic brain injury, and a brief quiz designed to teach athletes, parents and others about the injury and to correct some of the misconceptions about the injury.

Taking on Technology
To date, the HITS system has gathered data on over 1.5 million head impacts giving them the knowledge to create more effective equipment. Thus, in January 2011, Riddell debuted their new Riddell 360 helmet in the National College Championship. The new helmet was redesigned to address key aspects of the helmet including the upper front of the helmet and facemask to better protect its front section. “The helmet reduces the force of impact to the front of a player’s head, where 70 percent of hits occur,” said Thad Ide, Riddell’s senior vice president of research and development.

Faceguards, which are usually made of carbon steel and attached the upper front of the helmet, now has a carbon steel hybrid, which is attached to the side of the helmet with hinge clips, allowing the faceguard to flex on impact, absorbing more of the energy before returning to its original shape. There is also a continuous padding arrangement on the inside of the helmet with a hexagonal design that forms to the player’s head via an inflatable liner in the side and back for a custom fit. This will prevent a player’s head from moving around inside the helmet, and keeps the helmet from popping off.

The Game Changer
Now football is just one sport this article focuses on, but concussions can occur in just about any sport or even a simple slip and fall accident and if not treated properly the brain can endure serious long-term effects, such as memory disturbances, poor concentration, irritability, sleep disturbances, personality changes, depression or fatigue. And when 10% of high school athletes sustain a concussion each season the chance of having a serious brain injury is a higher possibility, which may not just change the game, but also their lives.