Do all the concussions need to wreck us?

Source: diamondduste

I’ve been giving a bit of thought to all the reports of concussions in the news, lately. Football players, ice hockey players, soccer players… not to mention all the reports of kids heading to the ER. Conflicting as those reports may be — some say more pre-teens are being treated, some say more high-school age teens are being treated — the picture is still pretty significant. And the concern is increasingly palpable.

The message, like in a recent blog post of the Chicago Times Union, frames the issue from a concerned parent’s point of view. This isn’t an isolated case, either. Soccer/hockey moms/dads are becoming increasingly vocal about concussion risks in youth sports, and plenty of times there’s an accompanying dismay at the apparent cluelessness of the coaches regarding the risks of unsafe return to play.

Here’s the thing, from where I’m sitting — as a multiple concussion survivor and a former student athlete myself: If we funnel all our energy into fear and avoidance and attempted prevention of injuries like concussions, aren’t we possibly missing a big lesson that sports can teach us, in the first place — namely, that it’s part of human experience to get hurt… and it’s vital that we learn to pick ourselves up, dust ourselves off, and head back into the fray, facing our fears and dealing with what is.

Getting bent out of shape over concussions is understandable, but does it need to derail the very important process of learning from screwing up that often comes from childhood and youth? Since when did we start believing that all the lessons we can learn should be framed in positive terms, with no harm or danger involved? I would argue that by avoiding and trying to prevent risks, we are depriving the next generation of really critical lessons they need to learn, in order to deal effectively in the world.

If they don’t learn how to handle injury and adversity now, when they are relatively safe within the fold of their parents’ house, how will they handle it when the shit really hits the fan?

It inevitably does, you know. No parent can prevent that, hard as they  may try.

Now, I’m sure that there are plenty of parents who will take issue with this attitude. And coming from a multiple mild traumatic brain injury survivor, I realize that credibility is an issue. How can someone who’s gotten clunked on the head as often as I have be a trusted source for judgment about how to deal with sports concussions? I’ve talked about my judgment around risk being a bit impaired in the past, so why listen to me now?

Here’s the thing — it’s not that I’m advocating that we put our kids in harm’s way and not give a damn about their safety. Far from it. But at some point, the helicoptering starts to genuinely prevent the most valuable part about childhood and youth — the learning gained from trying and failing and trying again. That includes the learning gained from falling down, getting hurt, getting up and assessing the severity of your injury, letting yourself heal, and then getting back into the game when it is genuinely safe to do so.

Granted, with concussion, the threshold of safe return to play is often elusive and unpredictable.  But the opportunity — indeed, the teachable moments — that healing from an injury provides, can be invaluable in later life.

Concussions happen. They happen a lot. And I suspect they’ve been happening since the beginning of time — we just haven’t always had emergency departments at the ready to accept the steady stream of kids whose parents have good enough insurance and the level of understanding and concern to get them there.  I’m not sure there are more concussions happening today than before — we’re just more keenly aware of them. And this increased awareness means we’ve got a shining opportunity to learn all about the injury — as well as how to heal.

And learn we must. It’s not enough to wring our hands over all those mild traumatic brain injuries. It’s not enough to rush the kids to the ER and lecture the coach about their insensitivity and putting our kids in danger. It’s not enough to turn our heads away from danger and injury and/or do everything in our power to prevent it. We must learn to deal directly with this in a way that actually works, so that it doesn’t get the best of us. We need to learn to face up to the danger, the risk, the harm, the inevitable hurt, and master our skills in overcoming it.

After all, if concussions are endemic to the human experience and people have been experiencing them since the beginning of time (which I believe is accurate), and we’re all still here (more or less) and we haven’t all died off due to chronic traumatic encephalopathy and our societies haven’t completely disintegrated into a dust cloud of demented violence (or maybe we have?), isn’t that at least some evidence that concussions can and do heal — and that we can probably find a better, more effective way to heal than we’ve seen in the past 50 years or so?

Rest alone won’t always do it.  Concussion and TBI experts tend to agree that resting (and doing nothing else) doesn’t always fix the problems that come from post-concussive syndrome. Exercise, on the other hand, has been shown to clear issues with people with remarkable success — as SUNY’s University at Buffalo Concussion Clinic has found. Even professional ice hockey players are turning to them for help, and it appears to be helping. After decades of partial solutions, we’re getting to a point where we’re learning new ways of dealing with the somewhat staggering numbers of head injuries, and we should use them.

Let’s use them. Let’s deal with the issues around concussion — both the prevention of needless injury, and the healing from the hurt. Short-term recovery should be actively evolved and pursued and talked about in every public forum, from youth/amateur sports to professional circles. And long-term recovery should be addressed as well. Nobody who’s sustained a concussion (or more) should have to live under the dark cloud of the depression, the mood disorders, the behavioral issues, and the cognitive problems… not to mention the public stigma that comes from being considered “brain damaged”.

Concussions happen. But they shouldn’t have the last word.

At least, that’s what I think.

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Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

4 thoughts on “Do all the concussions need to wreck us?”

  1. BB –

    I think your point is important but there are some key elements that need to clarified –

    Up until recent years concussions were treated as insignificant, a badge of honor and players would indeed just get up and go back into the game – and get ‘dinged’ again. These repeated blows, with no recovery time between them create a cumulative effect that leads to cognitive and emotional problems and yes, sometimes CTE. Unfortunately we do not know the incidence of CTE because it requires a post mortem autopsy which most of us do not have. It is this disregard and even worship of the concussion that needs t o be changed.

    The lesson of getting up and getting ‘back in the game’ does not have to be taught at the expense of cognitive skills or emotional stability. Indeed the mindset of ‘being tough’ by not letting a little blow to the head effect you is what has impelled so many to ignore the serious consequences of their concussions and to keep playing. Interestingly it seems that the functions that are needed to play contact sports are less susceptible to damage than the skills to function in our high speed, multi-tasking complex environment. So we don’t see the impact to lives so long as the player is still playing well.

    Like it or not our society is changing and we place increasing demand on our frontal lobe functioning – the very area that is most vulnerable to blows. Evolutionarily speaking we are not designed for car crashes, head buts while chasing pigskin or smashing our beanies into walls whilst chasing a puck. Human beings have changed the name of the game but we are designed for it.

    Yes, human beings have for a long time been getting hurt and we are still here. However for much of our existence we died by age 30 or 40 due to so many things that it is impossible to tell how much brain injury may have existed. Certainly in the past decade there has been a huge increase in the number of kids diagnosed with ADD and with learning disabilities. There are a multitude of factors involved in that (drug companies, the APA, cultural changes, etc) but it is also possible that some of that is a side effect of the increased number of head injuries that came about as contact sports grew more popular at ever younger ages (and more aggressive with a lot of type A mom/dads pushing junior).

    Sports and exercise are good and important. There are non-contact sports which can provide many of the same positives as football or hockey. However some folks really enjoy playing football, hockey, soccer and in those cases knowledge should be used wisely through such means as:

    • Better treatment and response to any concussive incident

    • Discouragement of excessive brute force (which is usually illegal but tolerated) in these sports

    • Improved head gear and more consistent use of head gear. Yes, it’s ugly and uncomfortable but if it keeps you from brain rot in 20 years then I am for it. Just like I encourage folks to quit smoking even though smoking doesn’t kill you immediately.

    • Recognition that if your child begins to demonstrate cognitive and/or behavioral issues after injury or injuries it is time to pull the plug. It’s not easy to do that but it’s a serious issue and there is no guarantee that you can recover. There is a limit to the price one should pay.

    • Perhaps more baseline testing or evaluation can eventually be included in the ‘pre-season medical exam’ as a standard of practice. A full battery of neuropsych tests is pretty expensive and timely but some modified version might be helpful – even though it should be clear that neuropsych tests are not the be all and end all. I would also consider including a simply psychological exam – but that will raise huge controversy.

    • And of course – always – a continued effort to understand how to better enable folks to rebuild, recover, and get beyond head injury.
    It is difficult to walk the line between safety and wisdom and paranoia – we cannot control everything and people must live. Athletic sports – be it football or snowboarding, skateboarding or hockey can be dangerous. Even bike riding and roller blading have potentials for serious head injury. And statistically speaking texting while driving (or lack of sleep while driving or driving under the influence) is more likely to result in harm (at least from what we know now). I see a zillion kids in my neighborhood who ride bikes without helmets because ‘there aren’t a lot of cars’, I know people who take off their seatbelts when they get close to home because there isn’t much traffic and I know the roads, and I know plenty of adults who text and drive. And there are still plenty of smokers – and plenty of folks who will drink aspartame and overeat despite the known dangers of obesity or chemicals. We don’t always have a clear sense of what is dangerous and what is not, we get overly cautious and overly confident, we live in the moment and do not see the bigger picture.

    So we keep trying to find balance.

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  2. Indeed – the elusive balance… You make some excellent points, and yes, there is need for clarification. I think that it’s tremendously important for folks to realize the significance of head injury. And likewise, to realize the value of a common-sense approach to dealing with it — not running willy-nilly from it, but facing it and dealing with it with all the force of wisdom and sound judgment.

    Where and how to find wisdom and sound judgment are yet more pieces of the puzzle we’re putting together.

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  3. In regards to the post on head injuries. I have been doing a lot of research on the subject and it seems there are many studies now suggesting that if our children wear a custom fitted mouth guard it may reduce or possibly prevent concussions. So the key here is simply to protect them the best possible way.

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  4. supermom68 –

    The practice of preventing concussions with mouthguards is a controversial one — please remember that concussion has to do with the brain being shaken and damaged by impact/velocity. A mouthguard cannot protect a student athlete from the force of an impact, so it’s important not to treat this as a silver bullet. Also, consider the source of the information about this “protection” — does it come from the people who are selling them?

    Just something to keep in mind.

    Be well
    BB

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