Robert Hayden, DC, PhD, FICC
I was watching my team, the Alabama Crimson Tide, thrashing our good friends from Texas A&M University Saturday with great pride. Our defense smothered the Aggies while our offense racked up a lot of points. This description is common for a lot of Alabama football games, of course.
Part of the game (and any other contact sport) is injuries. In fact, Alabama lost an All-American safety, Eddie Jackson, with a broken leg. It is a shame to see great athletes on either side with these kinds of injuries.
One of the things that makes me cringe, however, is to see high-speed collisions involving helmets. Football helmets do not prevent all head injuries by any stretch of the imagination. There were several collisions that gave me concern for the players.
Concussions result from traumatic injury to the brain that changes mental status and causes other symptoms. You may not lose consciousness with a concussion, but there may be other symptoms, some of which may not manifest themselves immediately.
You may notice that after someone is hit on the head/helmet, they are taken to the sideline for attention from the trainer. A focused neurological exam will be performed to assess orientation to time, place, person, and situation. Short-term memory may be assessed by asking the score or status of the game. A player may be asked for a name, place of birth, date of birth, or his dog’s name. The trainer will also look at the player’s ability to focus on the question and the answer.
There are other symptoms that may be present. Changes in balance or the presence of dizziness, fatigue, emotional lability, irritability, and headache are all possible. Nausea, vomiting, light sensitivity, and visual disturbances are also possibilities. You can see that there is a wide variety of issues that may arise, but they all depend on what part of the brain is affected.
Think of the skull as a rigid vault. The bones that protect the brain are designed not to move. Particularly in the bottom or base of the skull, there are many bony projections that are small and sharp. A hard blow to the head causes the brain to compress toward the side of the initial blow, then expand and bounce to the opposite side. Consider the delicate structures on the underside of the brain scraping across those small, sharp projections. It is a wonder that anyone survives the kind of shocks that are sustained in sports, or a tumble down the stairs, or a motor vehicle accident. Yet, we do.
When an athlete or anyone else sustains a traumatic brain injury, they should be evaluated carefully by qualified personnel before resuming normal activity, especially athletic activity. If a person who sustains this kind of head trauma has a second injury before they are ready to resume activity, the second injury is sometimes fatal.
Should we stop sports altogether? Of course not. There is much that sports teach us in terms of values, teamwork, collective action, and sportsmanship that cannot be learned in a classroom experience. What we should do is use great caution when playing sports, not only to protect ourselves, but to avoid injuring teammates or opponents. Protective equipment and the judicious observation of rules and good sportsmanship will go a long way to preventing these injuries.
In my practice I see the aftermath of many head injuries. Postconcussion headaches require careful assessment and intervention. Chiropractic care has helped many athletes with these issues.
In the meantime, my idea of a perfect autumn includes crispy cool air, orange leaves, and an undefeated Alabama football team. This year is shaping up nicely, except for the cool, crispy air part.