During my morning exercise bike ride, I checked out The Concussion Blog on my PDA (thankfully, there’s a mobile version of the blog, so I don’t have to scroll through all kinds of formatting stuff), and I came across a few interesting threads that might have some bearing on each other.
The first was a comment at the post about how Nowinski is leaning towards the “more rest” position of Omalu, and concussion — while widely attributed to the brain being shaken inside the skull — can also be attributed to jaw impacts
where the brain hits off the side of the inner skull like a piece of jello, here the medial temporal lobe is traumatized when the end of the jawbone pierces the temporal bone. The end of the jawbone rests on the skull base, cushioned by a dime sized piece of cartilage, once this cushioning element is displaced, it becomes dangerous. Its been documented in boxers with a “glass jaw”, when this cartilage disk slips out of place, it creates a bone on bone condition allowing hard bone to hammer the area of the medial temporal lobe where CTE manifest. This is diagnosable and documented in research with boxers and now NFL and NHL players.
Hmm. I had heard some discussion about how mouthguards supposedly guard against concussion. I’ve heard a number of people dismiss mouthguards, saying that they can’t protect against the brain banging againt the inside of the skull, and I myself have been skeptical. But seeing it explained — and taking a look at the location of the jaw in relation to the medial temporal lobe — I’m more convinced. Especially after reading that CTE manifests in that exact area.
This is getting my attention.
What’s also getting my attention is another post over at The Concussion Blog where fighting in the NFL is discussed. And after watching some hockey over the past week and seeing all the fights that are not stopped by the refs (and are egged on and celebrated by cheering fans), I wonder how much these fights — with more than a few hits to the jaw — contribute to the cumulative risk of concussion.
Let’s be clear about something — concussions/head injuries/TBIs all add up. Their effect is cumulative. And I can’t see how encouraging and allowing all the fistfights to escalate and play themselves out until someone goes down on the ice can help matters. Concussion awareness, I think, needs to reach beyond the “head hitting against the bony insides of the skull” and expand into the effects of the jaw hitting against the medial temporal lobe. And I’d also like to see/hear more consideration of not only the dangers of sports, when it comes to concussion, but the dangers of fights and getting clocked in the jaw, time after time.
I watched the March 5th ‘The Hotstove’ where Mike Milbury suggests hockey take a look at the level of violence, and how opposed the rest of the panelists were against it. Fighting seems to be endemic to hockey, but I heard once that hockey didn’t become a violent sport until it migrated south to areas where people couldn’t understand the game, and the league turned to fistfights to attract crowds. Apparently, the strategy worked. Now, can the NFL survive its own success? I wonder.
I think it would be quite interesting to do some data analysis on logged concussions and the frequency and types of fights that hockey players get into. I’d also like to see data on the coincidence of recorded fights and concussion in contact/collision sports athletes. It might shed some light on this, and also help us see other contributing factors, such as behavior choices in everyday life, which can jeopardize the safety and future of student athletes — not because of what injuries they cause, but because of the injuries that they may contribute to.