Russell Gage’s injury highlights the NFL’s concussion problem and how it hurts players long-term

Just two weeks after the safety of the Buffalo Bills Damar Hamlin rushed off the field due to cardiac arrest, Tampa Bay Buccaneers wide receiver Russell Gage was hospitalized due to a concussion and neck injury after being hit during Monday’s playoff game against the Dallas Cowboys. The incident highlights ongoing concerns about concussions and player safety in the National Football League.

Although the number of reported concussions in the NFL has decreased since it began tracking them during the 2015 season, the protocol was once again questioned after Miami Dolphins quarterback Tua Tagovailoa’s multiple head injuries earlier this season. Those wounds, one of them later reported the team which is a “back pain,” prompting the league to revise its concussion protocol.

In the revised policy, ataxia, or “abnormality of balance/stability, motor coordination, or dysfunctional speech” as a result of a concussion-which Tagovailoa showed after returning to the game in Week 3-was added to the list on Signs and symptoms of “not going”.which means that any player who exhibits these symptoms will not be allowed to return to the game.

In fact, the revised protocol closes a loophole that allows players with severe motor instability to return to the game if doctors determine the player’s stumbling is caused by something other than a head injury.

“We want to make sure that all of our medical professionals not only follow the protocols as written, but also understand that they are serving the players as patients,” the NFL Players Association wrote in response to the new changes.

But it remains to be seen if these changes will be enough and if they will ultimately keep players safe in such a high-contact sport. While the severity varies, concussions are considered a subset of mild traumatic brain injury. Treatment usually involves rest; however, too much rest can prolong recovery.

“Usually too much activity makes symptoms worse, but too little activity can have the opposite effect, by not allowing the brain to heal quickly,” explains Dr. Richard Figler, director of the Concussion Center and staff physician at the Center for Sports Medicine at the Cleveland Clinic. “We’re really trying to find that sweet spot where people can do things that don’t trigger their symptoms… There’s good evidence to suggest that early, non-symptomatic exercise is beneficial , and can help aid recovery faster than no exercise. This may include walking lightly, or riding an exercise bike, but if symptoms worsen, slow down the activity to a point where there are little or no symptoms at that level of exercise. “

With most sports-related concussions, patients typically follow a progressive course of recovery over one to four weeks, Figler said. A 2018 study by Christopher D’Lauro, a cognitive neuroscientist at the Air Force Academy, and his colleagues found that “elite athletes,” such as NFL players, can improve from concussions faster than non-athletes. The number study shows that the time to return to play for professional athletes is typically five to seven days, compared to seven to 10 days for college athletes and roughly 30 days for high school athletes.

But a shorter recovery time does not equate to fewer long-term side effects.

According to a 2016 study, more than 40% of retired NFL players showed signs of traumatic brain injury based on MRI scans. At that time, the author of the study, Dr. Francis X. Conidi of the Florida Center for Headache and Sports Neurology and Florida State University College of Medicine in Tallahassee, Florida said, “The rate of traumatic brain injury is much higher in athletes than found in the general population. “

There are also long-term consequences of concussions, including a increase in neurological diseases such as dementia and Parkinson’s. While there is no known standard for how many concussions a person can sustain, a 2018 study from the University of California San Francisco found that the likelihood of dementia doubled after even one concussion.

Even if one person is unable to maintain a concussion, another 2018 study found that repeated blows to the head, or “subconcussive hits,” increase the risk of later developing chronic traumatic encephalopathy, or known as CTE, the degenerative brain condition found of almost all deceased former football players whose brains were damaged. donated for research purposes.

the Harvard University Football Players Health Study, a 10-year initiative launched in 2014, has already identified three breakthroughs that could lead to slowing and reversing the buildup of tau protein in the brain, which can lead to CTE. Those treatments include light therapy that can lead to better sleep and less post-traumatic stress disorder symptoms; an antibody that inhibits the spread of Tau protein; and tools to measure the in-game impact of brain hits.

Although there is no surefire way to prevent concussions, especially in high-contact sports, such as football, hockey, and soccer, there are modifications that can help protect the brain, head, and neck. from significant trauma. Neck-strengthening exercises can help eliminate head force during these traumas, and using helmets in good repair can also help reduce concussive risk, Figler said.

Ultimately, the most impactful changes may need to be made to the game itself as Figler cited rule changes as an effective way to reduce concussions in some games.

“It’s based on good data from injury reports that help develop rule changes that make sports safer,” he said.

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