That’s a Red Card!

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Most of the globe is currently watching the World Cup and although football gets the lion’s share of the headlines about concussions, the June 19 soccer game between Uruguay and England is sure to land FIFA in some hot water. During the second half of the match, Álvaro Pereira, one of the stars of Uruguay’s national team, laid unconscious (below) on the field after taking a knee to the head. He fell to the turf and took at least 15 seconds before he showed any signs of consciousness.

Image

Richard Heathcote / Getty Images

It was clear to everyone—the players, the referee, the TV commentators—that Pereira was unconscious. At this stage, there’s no further diagnosis necessary. You will often read that doctors disagree about when to diagnosis a concussion or mild traumatic brain injury but once there is a loss of consciousness all doctors agree that a concussion or mTBI has occurred.

Pereira should not have been let back onto the field. His coach, his team physician and the FIFA physician all should have stopped him. But Pereira insisted on returning to play for the remainder of the game over the objections of his team’s doctor, while FIFA doctors didn’t even examine him until after the game was over.

Sure, any player would be upset but irritability and mild aggression are normal responses following a head trauma. Pereira should have been lead off the field and if the team didn’t get him off the field, they should have been issued a yellow card.

FIFA needs to do more in terms of educating international coaches, players, fans, and their medical staff. Mr. Pereira was cleared an hour after the game by FIFA physicians as being apparently concussion free; no return to normal cognitive activity and no return-to-play protocols needed. That’s a red card!

Advertisements

Helping Our Athlete’s Make the Right Decision to Sit It Out!

There is no doubt about it whether it is football, soccer, wrestling, cheerleading, tennis or race cars, athletes love their sport. Therefore, the last thing they want to do is sit out of a game, match, competition, or race.  It is a hard but necessary step in recovering from a concussion and preventing second-impact syndrome.

Dale Earnhardt Jr. is learning this first hand. In late August he had his 1st concussion from a crash on a raceway in Kansas. He thought he was okay. He felt good, but on October 7th, he sustained another concussion from another, less severe crash. His symptoms returned. He saw his doctor for a headache that would not go away. Dr. Perry made the right decision and would not allow him to race last weekend or in the race this weekend either. Perry wanted Earnhardt, Jr. to be evaluted by professionals, and Earnhardt, Jr. is lucky to have such a proactive team. They spent Tuesday at University of Pittsburgh Medical Center’s Sports Medicine Concussion Program consulting with Dr. Micky Collins, a concussion specialist, formulating a return to play that included ImPACT testing before returning to the raceway.

 

Earnhardt talks about needing someone else (his doctors) to make the decision for him not to race because the love of racing would keep him behind the wheel even though he knows that concussions are serious.  Our athletes are no different. As parents and coaches, we owe it to our athletes to be that “voice of reason” when we suspect a concussion. From the moment we even think our athlete has sustained a concussion, they must SIT IT OUT!  Even though it is hard, we must be proactive in protecting our brain…we only have one for life.

‘Head Games’ Documentary Takes Detailed Look at Sports Concussions

A new documentary is being released nationwide today that could launch the concussion issue into the stratosphere. Head Games, from producer Steve James (Hoop Dreams, The Interrupters) and producer Bruce Sheridan, takes an in-depth look at the devastating and long-term effects of concussions in all sports.

As a feature-length film, Head Games has time to venture farther into the topic of concussion than most websites, articles or public service announcements. The trailer features compelling scenes about what professional and young athletes are willing to risk to play the game, and the consequences of their decisions.

The movie is heavily centered on the story of Harvard-educated former professional wrestler Christopher Nowinski, who, when diagnosed with post-concussion syndrome, began a quest to better understand the condition. After a visit with renowned neurosurgeon Dr. Robert Cantu, Nowinski began to learn the medical reasoning behind his traumatic brain injury.

Nowinski co-founded the Sports Legacy Institute with Dr. Cantu and, in addition to serving as SLI’s executive director, is co-director of the Center for the Study of Traumatic Encephalopathy (BU CSTE) at Boston University School of Medicine.

Head Games calls concussions “the public health issue of our time” — a statement that’s truly more fact than opinion. Like the crises of seatbelts and smoking in years past, and their subsequent legislation, traumatic brain injuries have been called an “epidemic” by the Centers for Disease Control and Prevention (CDC) and dozens of states have related laws to protect children. Consequently, while this film is one of the first documentaries to seriously examine the issue of concussions, it will hardly be the last.

Visit the official Head Games website for more information, including a list of theaters and On Demand providers.

White Sox’s Konerko Felt Helpless & Depressed After Concussion

Last month, Chicago White Sox first baseman Paul Konerko suffered a concussion after being struck in the right temple by Kansas City Royals outfielder Jarrod Dyson. After a gradual return to play, which included working out a little more than a week after the concussion, Konerko is now back on the team in full force.

What’s refreshing about Konerko, aside from the fact he took his concussion seriously enough to stay out of the game until he healed, is his honesty about the alarming effects of concussion.

In a video interview with Comcast Sportsnet, Konerko described feeling helpless, depressed, unmotivated and lethargic immediately after his brain injury.

“You just feel like a different human being. You just feel like out of the world. It’s just a weird feeling,” said Konerko, who took the ImPACT test after his injury to help diagnose the concussion. He described his emotional state not feeling like himself. “You almost feel, you don’t care about anything.” Konerko also said it hurt for several days just to shift his eyes.

In the video below (will open in a different page), Konerko provides an incredible glimpse into the physiological and psychological symptoms of brain injury.

The one part we take exception to is Konerko’s account [beginning at 1:16] of being blindsided by the actual impact which allowed for a “better chance of getting rattled and the brain moving.” The fact is we know that nothing, not even anticipating a blow, can prevent the brain from moving inside the skull.