“Concussion,” the Will Smith film recounting Dr. Bennet Omalu’s quest to reveal the consequences of traumatic brain injuries in sports, is the latest headline-grabbing item about sports head trauma. It follows multiple real-life tragedies of sports heroes like football Hall of Famer Mike Webster, as well as a stream of research that links repeated sports head injury to lifelong impairments.
Over the past two decades, the general public’s awareness of concussions has fundamentally changed. Once considered trivial, “getting clocked” or “getting your bell rung” has become known as a serious condition requiring careful diagnosis and treatment. Two University of Texas Health Science Center at San Antonio clinical faculty members, who manage sports injuries, are at the medical forefront of dealing with concussions.
Dr. Jaime R. Garza, clinical professor of surgery and otolaryngology in the School of Medicine, is a medical consultant to the NFL and NBA, as well as a UTSA team physician. He has personal experience with head trauma, having earned during a storied football career spanning high school, college and the NFL. He received his first concussion as a high school junior, a bad blow that resulted in an extended hospital stay and partial paralysis. He recovered completely, but his experience with head injury had only begun.
“I can’t even tell you how many concussions I suffered,” Garza said. But, he admits, there were at least six more times he was knocked unconscious and at least two more hospitalizations. He suffered his final concussion at a New Orleans Saints NFL training camp, when he remained unconscious for over twenty minutes.
Garza’s attitude as a football player is typical of today’s serious athlete: driven to excellence, even in the face of injury. New medical discoveries, however, have proven long-term consequences can outweigh the desire to dive right back into the game.
Dr. Paul S. Saenz, a adjunct clinical professor with the Departments of Family Practice and Physical Medicine and Rehabilitation, and team physician for the San Antonio Spurs, has seen significant change in his 27 years of experience treating concussions.
A founding partner of Sports Medicine Associates and one-time ringside physician, he recalls the early stages of concussion awareness. In the past, doctors categorized concussions as mild, moderate, or severe.
“Now we know each player is different, and each injury is different. It’s almost like every brain has its own fingerprint,” Saenz said.
This new understanding shapes the way modern medicine assesses and treats concussions. First, a trained physician conducts a thorough examination that considers many aspects of brain function.
Often, the physician will compare examination results to test scores taken previously as a baseline. Professional sports have already adopted the practice of recording baseline brain function before injury, and colleges and high schools are quickly following their example.
After a concussion diagnosis, the player starts with limited physical and cognitive activity until regaining baseline brain function once again. A physician then prescribes an individualized Return to Play protocol, which gradually increases an athlete’s activity up to the normal level. Regular testing during the Return to Play process ensures effective brain healing.
While breakthroughs in treatment are one method of preventing the long-term effects of brain trauma, there are other ways, too. According to Garza, “sports training and nutritional research have increased the speed and power of today’s athlete, but safety research just hasn’t kept up.”
Rule changes, such as those addressing soccer ball-heading and football tackling techniques, address concussion risks by decreasing the frequency of head trauma-causing events.
Equipment improvements are another means of combatting head trauma’s effects. Current research involves the use of helmet sensors, energy dispersing materials and construction – and even laboratory studies on animals that endure repeated head impact, like rams and woodpeckers.
Still another way is improving diagnosis. Texas law now requires concussed student athletes to get an evaluation by a licensed physician, rather than a trainer, coach, or parent. And high-tech methods such as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) also help accurate assessment, and aid in the drafting of a Return to Play protocol.
Dr. Garza sees particular promise in regenerative cell therapy. In conjunction with Sports Medicine Associates, he published work on the use of regenerative cells for the treatment of human knee osteoarthritis. Recent research indicates regenerative cells hold potential for the brain, too. He envisions a time when athletes will bank their own regenerative cells at the start of the season and, if concussed, receive an injection to prevent or minimize brain damage.
Athletes and fans alike are hopeful that these methods of addressing head injury will make sports safer – and more likely to survive. “I don’t want to see football go away,” said Garza. “I just want to see concussions go away.”
And with the research and educational efforts already in progress, that might happen sooner than many had thought, finally ending the controversy in which Will Smith’s Concussion is only the latest chapter.
*Top image: Computed tomography of human brain by Department of Radiology, Uppsala University Hospital.Licensed under CC0 via Commons.