Concussions: Get Your Head In or Out of the Game

By Ella Harrison

The booming crowd hushed on September 29, 2022 when Tua Tagovailoa, Dolphin’s quarterback, crashed to the field slamming his head into the turf. After taking a hit from Bengals defensive lineman Josh Tupo, Tua displayed a fencing response, a neurological reaction in which someone’s arms or hands go unnaturally rigid. The 25-year-old quarterback was carted off the field on a stretcher and did not return to the game. Later, medical staff confirmed that Tua had suffered a concussion.

The most concerning part for football fans was that just 4 days before the Bengals game, Tua experienced a similar head injury. The young quarterback was clearly rocked and demonstrated signs of a concussion. Despite this, Miami medical staff allowed Tagovailoa to return to the game in the second half.

In the span of 3 months, Tua suffered two confirmed concussions and one suspected concussion. This caught the attention of the nation and caused many to question concussion protocol and whether continuing to play a sport is worth risking one’s life.

SPORTS RELATED CONCUSSIONS

A sports related concussion (SRC) is defined as representing “immediate and transient symptoms of traumatic brain injury” by the 2017 Concussion in Sport Group international conference. SRCs are caused be either a “direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.” Typically, concussions result in the rapid onset of short neurological impairment that resolves itself eventually.

However, in their published consensus, members of the CISG recognize that concussions are one of the “most complex injuries in sports medicine to diagnose, assess, and manage.” One of the most important steps in concussion protocol is recognition of symptoms. Common symptoms include:

- Headache

- Feeling like in a fog

- Loss of consciousness or amnesia

- Unsteadiness

- Irritability

- Slowed reaction times

According to the CISG, if a player displays any of these symptoms after a blow to the head, coaches and medical professionals should remove, re-evaluate, rest, rehab, refer, and recover their athlete before ever returning to the sport.

CONCUSSION RATES IN SPORTS

In a study published by the American Academy of Pediatrics in November of 2019, 9,542 concussions occurred in high school sports between the 2013-2014 and 2017-2018 school years. From this data, the top three sports with the highest concussion rates were as follows:

1. Boys’ football (10.4 concussions per 10,000 athletes)

2. Girls’ soccer (8.19 concussions per 10,000 athletes)

3. Boys’ ice hockey (7.69 concussions per 10,000 athletes)

Timothy Utt, the current athletic trainer at my former high school, Morristown East, corroborated this data. Coach Utt received his Masters in Sports Administration from Morehead State, is National Athletic Trainers Association certified, and has been licensed in the state of Tennessee as an Athletic Trainer for 23 years.

Utt explained that in a typical school year at East, football typically has the most concussions because it is truly a collision sport where two objects are generating force and then colliding together.

Due to lack of funding, my high school no longer provides baseline concussion testing, but Coach Utt explains that having “measurable data is always a positive dynamic to evaluation.” However, he clarified that ultimately it is a case by case evaluation because if an athlete has been tested before, they can dilute or falsify the results.

When caring for an athlete who has suffered multiple concussions, Utt always refers them to a neurologist. He stated that neurologists must release the athlete before they can return to competition. In many cases, if the athlete has undergone several head injuries, the participant will most likely be disqualified from athletics.

ONE MORE STRIKE, AND YOU'RE OUT

Joanna Lunsford, sophomore cheerleader at Furman University, is just one concussion away from never being able to participate in sports again. In the past three years, she has suffered 6 concussions; 4 of them were cheer related.

In an epidemiological study conducted by the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, researchers found that stunt related injuries are responsible for half of total injuries in cheer and almost all the total concussions in cheer. Out of all the stunt positions, the study found that bases and spotters were most likely to get injured during stunts. Therefore, as a base, Joanna is statistically more likely to get a concussion than I am as a flyer.

Joanna worked as a trainer her freshman year at Furman with the sports medicine program. She explained that during her time as a trainer, she learned there are even more studies being conducted now than in the past.

She also became more aware of the fact that athletes are developing Chronic Traumatic Encephalopathy, commonly known as CTE. CTE is a neurodegenerative brain disease that is a result of repeated head injury which can start to develop months, years, or decades after the last athletic involvement.

Joanna expressed that this knowledge does frighten her sometimes. She has seen both trainers and neurologists who have advised her to stop cheer all together or limit her activity. Lunsford took a step away from cheer during the 2021-2022 season but decided to return this year.

I asked her why she continued to participate in athletics even though she is aware of the possible long term health repercussions. She answered in a way that I feel many athletes would.

“My motivation to continue cheering is my love and passion for the sport. I started cheering competitively at a young age, and although there were times I thought I was over it, I have never regretted a season.”

Lunsford states that she is more cautious and knowledgeable about concussions now. Her approach to cheer is to be confident in the sport and not to constantly worry. In cheerleading being nervous about a skill makes you more likely to get hurt.

IS IT WORTH THE RISK?

In 10 years of cheerleading, I have personally never gotten a concussion. This puts me as a rarity in student-athletes across campus. In all sports, there is concussion risk which is why it is so important that athletes know the common symptoms, and medical staff take the proper steps in removing athletes from practice and competition when concussions are suspected.

Tua Tagovailoa is just one recent example of concussion protocol perhaps being mishandled. That was at the professional level, so there is no doubt that there have been mishandled cases at the high school and college levels.

Although athletes can be cautious, the reality is that concussions are going to happen. They happen at all levels of athletics – professional, semi-professional, collegiate, high school, and recreational. Concussions can be life altering injuries with lasting effects. Athletes must decide whether the risk is worth it to continue doing the sport they love.

For me, it is. For Joanna Lunsford, it is. For you? Well, you must use your own head for that one.