By Jonny Lupsha, Wondrium Staff Writer
Concussions and other head injuries have plagued sports for decades. From football to lacrosse to baseball, players often develop debilitating or even fatal health complications from physical impact. Advancements in helmet design may help.
In sports, player safety has been an increasing concern. Laws restricting full-contact youth football have passed; the Will Smith film Concussion (2015) addressed controversies over player injuries in the NFL; and so on. Although expensive helmets have often promised the Moon, a new design by sports equipment company Riddell claims to be the real thing. It’s custom-made for each football player after a phone app scans the athlete’s head and offers better visibility from within the helmet as well.
The actual benefits of the new helmet, dubbed Axiom, remain to be seen. But in the meantime, what happens when an athlete gets a concussion? In his video series The Skeptic’s Guide to Health, Medicine, and the Media, Dr. Roy Benaroch, Adjunct Assistant Professor of Pediatrics at the Emory University School of Medicine, explains the well-known traumatic head injury in-depth.
Rocked Hard
Why do injuries like concussions occur? According to Dr. Benaroch, the brain—which is soft, like Jell-O—gets its protection from the skull, which acts like a rigid helmet. It’s also separated from the skull by three to five millimeters of fluid and membranes. This is where physics enters the equation.
“Imagine this: The head is struck, hard, and it accelerates quickly from the blow,” he said. “The brain, inside the head, doesn’t move immediately—it stays in place, because of momentum, and ends up slamming into the inside of the moving skull.”
The opposite scenario works the same way. If a motorcyclist is riding at 60 miles per hour (mph), their brain and head are moving at that speed along with them. If they suddenly hit a tree, the body stops moving but the brain hits the skull at 60 mph. As Dr. Benaroch put it, “change the movement of the head quickly enough, and the outside of the brain is going to hit bone, and it’s going to hit hard.”
“When the brain is suddenly jarred or moved, the tissue twists and stretches,” he said. “The nerve cells themselves are stretched, or pulled away from each other, and this causes a chaotic release of neurotransmitters along with an uncontrolled depolarization of each cell’s electrical charge. The cells can’t communicate with each other, and they’ll need a lot of energy to repair and rebuild and to reestablish normal physiology.
“If they can’t get that energy, some cells may be irreversibly damaged.”
Making Molehills Out of Mountains
Concussions often go undiagnosed. Players refuse to report injuries in order to keep playing, or those injuries are written off with colloquialisms like “a ding” or “getting your bell rung.” In fact, according to Dr. Benaroch, college football players say they’ve had six suspected concussions and 21 “dings” for every diagnosed concussion. Every single one of these injuries are concussions, and the undiagnosed ones result in the worst consequences.
“None of this damage can be seen on a typical MRI or CT scan—this is damage on a microscopic, cellular level,” he said. “Depending on which cells are damaged, symptoms after a concussion can include problems with balance, trouble concentrating, difficulty sleeping, headaches, anxiety, or depression. Sometimes these symptoms can linger for weeks or even months.”
Dr. Benaroch said that any player who exhibits neurologic symptoms after a hit has had a concussion and needs to come out of the game or practice to be evaluated. Any hit that suddenly changes the direction and speed of the player’s head movement should be examined closely, whether or not the head took a direct hit. Additionally, the greatest factor in predicting a future concussion is if a player has already suffered one.
“There are multiple reasons for this,” he said. “Some people are genetically more vulnerable to concussion, and some people, because of personality or education or increased self-awareness of symptoms, are more likely to report concussion. Past concussions, even if the symptoms have been completely resolved, may leave some damage behind, predisposing the brain to more easily be damaged again.”
The other reason all concussions should be evaluated is due to “second impact syndrome,” which sometimes occurs when a player with a concussion takes another hit before the first concussion is healed. Even a minor hit can cause second impact syndrome, which has a 90% fatality rate.
Improvements in equipment and regulations may improve player safety, but traumatic head injuries in sports should always be taken seriously.