Football, Concussions and Orthopedic Surgeons

American football helmet in the colored smokeYou’ve probably heard about the whirlwind of controversy that has surrounded the NFL in the past year regarding concussions and game-related brain trauma. Lawsuits have been filed and, rumor has it, there’s a Hollywood film in the works on this very subject.

As an orthopedic surgeon, I have been involved in sports medicine for many decades and while treating brain trauma is outside of our specialty, I think it’s important for an orthopedic surgeon practicing as a team doctor on any level of high school, college or professional football to understand the basics of the issue, know how to spot the possibility of a brain injury, and follow initial steps to protect a player who may have been injured.

The Birth of a Scandal

The history of concussion scandal within the NFL can best be summarized by more and more former players coming forward with reports of neurological disorders including memory loss, chronic traumatic encephalopathy (CTE) and severe depression that they attribute to head trauma incurred during their professional football career. Many speculate that the NFL knowingly misled its players about the long-term dangers the game presented with regard to head injuries, and the finger-pointing and lawsuits ensued.

It is reasonable to assume that if professional players are experiencing symptoms of brain injury after their careers, many tens of thousands of other college and high school football players may also be at risk. This is where orthopedic surgeons standing on the sidelines put themselves in the best position to provide comprehensive care if they recognize how important it is for players who may be at risk of brain trauma to receive prompt testing and treatment.

New Safety Guidelines

The NFL has taken many steps to prevent and manage game-related head trauma, starting with a neurological analysis of each player before each season. Before training camp begins, doctors clinically assess the brain properties that would likely be affected by a concussion in order to develop a baseline for each player. Having a point of reference for brain function is beneficial in determining if a later injury has in fact resulted in a concussion.

The new safety measures also include a stringent sideline protocol that’s conducted by the team’s sports medicine specialist if a concussion is suspected. If it’s determined a concussion has occurred, the player must leave the field and go to the locker room immediately for further neurological evaluation. In the days following the injury, the player will continue to be evaluated by concussion experts who are independent of both the NFL and the Players’ Association. The player will only be allowed to return to practice and play when his brain returns to baseline functioning.

In the years ahead, we are likely to see more and more of these protocols make their way onto the fields of colleges and high schools. I have been following this issue closely, and I encourage all orthopedic doctors who are in a position to provide frontline care for football players to get as educated as possible on the latest science and advocate for the best possible care for the players they serve.