A “concussion crisis” in American sports, trickling down from the highest levels of professional sports to sports in middle schools and high schools, concerns long-lasting damage from head injuries. Fears of irreparable damage have some parents wondering whether their kids should play contact sports like football and lacrosse.
A screening of the documentary “Head Games” and a discussion with neurosurgeon Gail Rosseau MD of NorthShore University Health System will take on such concerns as who is responsible for keeping athletes safe and how to balance the known benefits of team sports with its risks. The event will be held at 7 p.m. on Feb. 26 in the Community Meeting Room of the Evanston Public Library, Main Branch, 1703 Orrington Ave.
“Head Games,” directed by Steve James, who also directed “Hoop Dreams,” combines medical evidence, emerging head trauma science from the nation’s leading medical experts, and first-hand accounts from professional and youth athletes.
Dr. Rosseau, a neurosurgeon who is the daughter, wife and mother of football players, has a special interest, both personal and professional, in sports concussions. She serves on the board of directors of USA Football, the organizing agency for youth football, where in her role as medical advisor, she hopes to use the popularity of football to help make all sports safer. In addition, part of her daily work life includes “return to play” post-concussion evaluations for Northwestern University’s scholarship athletes. Next year, her son will be a varsity captain of the football team at Phillips Exeter Academy in New Hampshire.
In the interview below with the RoundTable, Dr. Rosseau recently answered questions regarding the latest thinking on concussions and the importance of youth sports.
What are some common misperceptions about concussions?
It’s important to have our facts right. Today, the sport that causes the most concussions is biking. No one is saying we shouldn’t let people bike. The heightened awareness of sports concussions, though, is appropriate, as well as is the broadening of the definition of a concussion. When I was a medical resident, concussion was defined as a loss of consciousness due to a blow to the head. Today, you don’t need to be knocked out to have had a concussion. In fact, only 10% of concussions include a loss of consciousness. Today we say that a concussion is a change in brain function as a result of a trauma to the head. This can include symptoms like headache, nausea, dizziness, changes in vision or balance, irritability or difficulty concentrating.
So how does one figure out if a blow to the head merits medical attention?
We need to work toward diagnosis that isn’t defined only in the medical realm. There’s a common-sense aspect that better education can help define. How does one know when to see a doctor after a blow to the head? We get insecure from the scary stories we’ve heard about deaths following what appeared to be minor head injuries, like in the case of actress Natasha Richardson. It’s important to consider things like: the speed at which the head was hit, the place on the head which was struck. The forehead, for example, is a very strong bone buffered by air-filled sinuses. A blow there may turn out to be less urgent. The side of the head is less well protected. When one hits the back of the head, often one doesn’t have the benefit of breaking the fall with the hands. It helps to be self-aware or aware of changes in an injured child. If a child generally doesn’t complain, but is now reporting nausea and dizziness, that’s worth attention. Losing consciousness implies a harder blow. And sometimes, if witnessed, a blow to the head might cause one to think “that looked really bad” and give reason for being attentive.
What would you say to a parent reluctant to allow their child to play contact sports, like football?
There is a lot of data that shows that the scholar/athlete is a better scholar, [that] one is more likely to do better academically if he or she plays sports. We also have a crisis of youth obesity and a trend toward a sedentary lifestyle. So while we want to prevent damage from concussions now, we also want to protect children from heart disease and diabetes in the future. Sporting activities are an important part of lifelong healthy habits. The sport doesn’t have to be football or lacrosse, but it might be. I want people to feel empowered on this topic with the best data, the best definition of concussion, and the understanding of what can be done to prevent, recognize and treat concussions. I encourage any parent who cares about a child’s intellectual or physical health to attend this program, as well as youth athletes.
Do you think those in charge of youth team sports are adequately protecting children and teens from concussions?
Today we have the Zack Lystedt Laws which were rapidly enacted in 49 states after the 2006 injury of Zackery Lystedt. He was a middle school football player who developed permanent brain damage after returning to game play after one concussion to then suffer a second concussion, which led to second impact syndrome and permanent brain damage. The law has several components, including the requirement that any youth athlete be removed from a game if a concussion is suspected, only to return after written clearance by a medical professional. In addition, the law requires concussion education for coaches, players and parents. I’ve had to tell middle school and high school athletes that not only are they doing a dangerous thing by playing with a concussion, they have also broken the law. In the same way youth athletes pledge to play fair and not use drugs, they also have a shared responsibility in caring for themselves and their sport: They must promise to take themselves out of the game, if necessary.House Bill 200, which recognizes the dangers associated with head injury and concussion, became effective on July 1, 2011. The legislation also requires IHSA member schools to adopt a policy regarding student-athlete concussions and head injuries that is in compliance with the protocols, policies and by-laws of the IHSA. Information on the school’s concussion and head injury policy must be a part of any agreement contract, code or other written instrument that a school requires a student athlete and his or her parents or guardian to sign before participating in practice or interscholastic competition.
A student athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from participation or competition at that time.
A student athlete who has been removed from an interscholastic contest for a possible concussion or head injury cannot return to that contest unless cleared to do so by a physician licensed to practice medicine in all its branches in Illinois or a certified athletic trainer.
If not cleared to return to that contest, a student athlete cannot return to play or practice until the student athlete has provided his or her school with written clearance from a physician licensed to practice medicine in all its branches in Illinois or a certified athletic trainer working in conjunction with a physician licensed to practice medicine in all its branches in Illinois.