Heads up on concussions E-mail
Written by Mike Kane   

"It's just a ding." "Don't be a baby. Just walk it off and get back in there." "Everyone gets their bell rung. You didn't go out." The above phrases are commonly used to describe bumping one's head. All are now known by scientists to be dangerous myths. Knowledge about the consequences of concussions has entered a new era. With their research - including autopsies of former professional athletes - professors from Boston University, West Virginia University and the University of Pittsburgh have shed light on a condition called chronic traumatic encephalopathy, also known as CTE, that can result from head trauma, concussions and sub-concussive blows to the head.

To find out more about this research, and to share this knowledge with cops, APB talked to Chris Nowinski, founder of the Sports Legacy Institute, who is an expert in the policy issues surrounding head injuries, and Dr. Ann McKee of the Boston University School of Medicine and the Veterans Administration, a leading scientist studying the fallout of these brain injuries.

Nowinski has a personal connection to the issue. After graduating from Harvard, where he majored in sociology and played defensiv

From these experiences, Nowinski was inspired to found the Sports Legacy Institute, a Massachusetts-based non-profit designed to help parents, coaches and policymakers to better understand the consequences of concussions and head injuries and to prevent these injuries in youth sports. This work, however, crosses over logically to law enforcement personnel, who face the risk of head trauma in many different situations, both on the job and in off-duty athletics. Dr. Ann McKee, MD is the co-director of the Center for the Study of Traumatic Encephalopathy at Boston University.

Her research centers on how the brain is affected by disease and injury. She defines CTE as a condition marked by the loss of various mental abilities as the result of the breakdown of brain cells and axons - long nerve fibers that send signals from the brain to the rest of the body. Dr. McKee notes that while CTE cannot yet be diagnosed in living people, the research is advancing in such a way that she is confident that we will soon. This step, she asserts, is hugely important for public safety personnel, soldiers returning home from war, and former football players - all of whom face risks related to head trauma. A few key points have emerged in the conversation about head trauma.

New science tells us more Today, thanks to the research of Dr. McKee and others, we know that many common ideas of concussions are simply wrong. An important truth: one does not need to be unconscious to be concussed. Dr. McKee defines a concussion as a "mild traumatic brain injury with sufficient force to cause neurological symptoms."

That is, if your "bell gets rung" - that's a concussion, not a "ding." Dr. McKee notes that, within the skull, the brain sits in spinal fluid and moves quite a bit within the skull, and is impacted by the forces of acceleration, deceleration and rotation. When the head is struck, or moves violently, the brain moves against the skull. She observes that the brain isn't very compressible, but that it stretches and elongates. This stretches the nerve fibers and can cause breakdown of the structures of brain cells. When the "scaffolding" that supports a brain cell falls apart, the tau proteins that make up the "scaffolding" can start to break off and form clumps inside the brain. Given enough time, enough injuries and enough clumps of this tau protein, Dr. McKee says, the functioning of the brain will begin to diminish.

Keep your eyes peeled Dr. McKee notes that police - due to a variety of professional and personal factors including assaults and athletics - face risks in this area. Vigilance and prevention are important. Nowinski notes that individuals who have been concussed will notice headaches, confusion and dizziness, while their coaches, trainers and colleagues should be on the lookout for people with problems with balance, slow or impaired thinking, or who are holding their heads.

It's not always the big hit Surprisingly, great risk comes not only from singular, dramatic knockout blows, but from repeated injuries. Dr. McKee notes that even blows not quite serious enough to "ring the bell," but blows to the head nonetheless - can cause long-term damage. A way to understand this, she observes, is that brain injuries are cumulative. Over a lifetime, the damage builds up.

Smart is the new tough Nowinski asserts that there has to be a re-examination of toughness, and education is critical for this. That is, the desire to come back from an injury as soon as possible is strong, as is the desire in many cases to deny that an injury has taken place. With concussions, Nowinski explains, this is even more complicated as the injury does not shut down all functions, does not visibly bleed, and does not cause pain.

However, Nowinski says that it is important to recognize that impaired cognitive function and judgment, particularly in complex and dangerous situations, puts one's self and others at risk.

Take the necessary time to heal Nowinski warns that apparent symptoms will often fade well before the injury has fully healed. Dr. McKee reports that the short-term effects of concussions are also unpleasant. While 90% of people who get a concussion can return to normal activities within the range of two weeks to a month, about 10% of those concussed have lingering symptoms that continue beyond this period. Do not base your timeframe on just feeling better, but on being truly healed.

Prevent or reduce head contact wherever possible. Whether on the job or playing sports, equipment can provide some protection, but should not provide a false sense of security. Nowinski highlights the importance of avoiding situations that can lead to head injury. For example, when playing sports, do not lead with or use your head, and do not tolerate others attacking the heads of opposing players. Prevention is far more about the situation than the equipment.

New discoveries will bring us even more information on the prevention and treatment of head injuries. Our new-found awareness of the true long-term risks of concussions can help to promote greater safety on the job, on the playing field, and at home

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