How to Fix Sports' Concussion Crisis

An interview with Linda Carroll and David Rosner, authors of a book on the brain injury epidemic

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Once considered nothing more than boo-boos to spittle-spewing coaches everywhere, concussions are finally being acknowledged for what they are: contact sports' nastiest byproducts. The long-term effects of head injuries, particularly in retired football players , are proving to be absolutely terrifying.

Linda Carroll and David Rosner, co-authors of The Concussion Crisis: Anatomy of a Silent Epidemic, are well versed in the subject. The recently-released book includes eye-opening stories of athletes, soldiers and everyday men and women who have struggled with concussions.

The authors have written about health, sports and science for a variety of publications, including MSNBC and Newsday. In this Q & A—conducted via email—the authors discuss concussions and their impact on sports, especially football.

Note: In her email, Carroll said she and Rosner "attacked all of [the questions] (with the obvious exception of the last) together."


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Simon & Schuster

In the early 1900s, college football players were literally dying on the field. Theodore Roosevelt had to step and demand rule changes that would make the game safer. In 2011, do we need a similar reformer? And if so, who would you like to see fill that role?

Not to diminish Teddy Roosevelt's role in reforming what was then an embryonic sport, but he simply urged college football's leading coaches to make changes before their own administrations chose to ban it (as indeed was already happening on some campuses). To now reform a mature sport that's grown into a national obsession at all levels of play—from the NFL on down to Pop Warner—will take constant pressure not from just one reformer but from all sides: parents, legislators, doctors, brain scientists, and so on. Change can come at the student-athlete level if there is a groundswell from parents who want to see their kids play a safer game.

Why is there still some reticence among former players, even ones who've struggled with concussions like Troy Aikman and Steve Young, to speak up about what they've gone through?

One of the reasons that concussions are called a "silent epidemic" is that most people who've suffered a traumatic brain injury prefer to keep quiet and to keep hidden any cognitive symptoms they may have struggled with. No one wants to be perceived—and perhaps stigmatized—as being brain-damaged or cognitively impaired. That's why it was important for us to also tell the stories of those Hall of Famers who are willing not only to speak up about what they've experienced but also to become outspoken advocates for concussion safety, such as football's Harry Carson and hockey's Pat LaFontaine. And that's why we're in awe of those everyday people who were willing to share their stories and struggles with us in hopes of helping other sufferers and of bringing this hidden epidemic out of the shadows.

Youth and high school football are incredibly popular. But after researching concussions and writing this book, do you think ANY kids should be playing football?

The dean of concussion specialists, Dr. Robert Cantu, recently advocated that no kid be allowed to play collision sports before age 14 because developing young brains are more vulnerable to concussion—and we agree with his bold proposal. For those who do play a collision sport like football, we offer these suggestions to keep players safer: No high school or middle school should field a team without a certified athletic trainer educated in concussion recognition and management, without a physician or EMT present at every game, without strict protocols requiring return-to-play clearance from a neurologist or other specialist, and without a neuropsychological testing program in place to help determine when it's safe to resume activity after a concussion.

Do you expect participation numbers to drop over the next decade?

Without a crystal ball, no one can predict what will happen as information about the dangers of concussions becomes more widely known. Some have expressed concern over how recent concussion stories might impact grassroots growth of football. We expect—and hope—that sports participation continues to rise. In a nation with obesity on the rise among its children, the benefits of sports are undeniable. We just hope that sports will continue to grow in a safer way and that people will follow the emerging science as they make their individual decisions about whether they want their kids to play collision sports like football.

You describe the outbreak of concussions an "exploding epidemic." But because we know that 20, 30, 40 years ago, concussions weren't reported as frequently as they are now, is it possible the problem was just as great back then?

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Alan Siegel is a freelance writer in the Washington, D.C. area. His work has appeared in Slate, Deadspin, and several other publications around his native Boston.

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