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You may know the tales of former National Football League players affected by too many hits to the head.

Former Cowboys star Troy Aikman’s career was cut short by concussions — a small price to pay compared to the depression and suicide of 44-year-old Andre Waters, whose hard-hitting play transformed his brain tissue to that of an 85-year-old man with early Alzheimer’s disease.

But hanging in the shadows of these famous cases are distressingly high numbers of young football players racking up brain injuries, which can contribute to lasting damage or, in a few high school players last year, death.

The NFL has finally succumbed to pressure from the media and Congress and implemented an improved concussion policy, but such safety measures have not trickled down to the college and high school levels. Policy changes should be made swiftly to protect young athletes who at greater risk for severe damage.

Kevin Guskiewicz, chairman of the department of exercise and sports science at UNC, said young brains are particularly vulnerable to head injuries from football.

Teens might not show symptoms like headache, dizziness or short-term memory deficits, and they recover more slowly from brain injury than older athletes. Most frightening is the rare “second impact syndrome,” in which a second hit to the head, even a small one, can set off a metabolic cascade resulting in brain swelling and potentially coma and death.

How do we prevent such tragedies? The new NFL policy to keep players on the sideline until they show no signs of concussion shows progress but has the potential to make things worse.

Accurate diagnosis relies on honest answers from players who may lie about symptoms to stay in a game. A survey of high school football players in Wisconsin revealed that less than half of those sustaining a concussion reported their injury.

“Asking a player whether they are having concussion symptoms is like asking a drunk driver whether they’ve been drinking,” Guskiewicz explains. The only difference is that police officers have Breathalyzers to detect alcohol use — unlike concussions, which are not visible on MRI or CAT scans.

Schools can hire certified athletic trainers who can spot concussion symptoms and make return-to-play decisions, but many do not have this luxury.

Only 42 percent of high schools in the United States have an athletic trainer on staff, and this number is even lower in North Carolina, although state legislation has been introduced to provide the money to make trainers mandatory.

While such policy changes should be made promptly, they do not put the issue to bed.

It is conceivable that football players taking countless, seemingly minor hits every day accumulate brain damage over time.

Guskiewicz, who is researching these “subconcussive impacts,” said that keeping the game safe by studying new protective helmets and potential risk factors for long term damage is the next step.

“We all bear the responsibility and burden for protecting the athlete and the sport of football,” Guskiewicz said.

If it cannot be made safer, people will eventually demand a ban on football, he said.

“I certainly don’t want it to get to that level,” Guskiewicz said.

With matchups like Colts-Saints and classic Super Bowl ads on the line, he is surely not alone.

 

Moon is a second-year medical student from Durham.  You can contact Moon at E-mail: andrew_moon@med.unc.edu

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