Thursday, September 16, 2010

News Analysis - N.F.L. Concussion Raises Questions at All Levels of Football - NYTimes.com

On Sunday afternoon, more than 28 million people were watching Fox's national broadcast when the Philadelphia Eagles' Stewart Bradley rose woozily, stumbled and then collapsed onto the turf. The Fox announcers Joe Buck and Troy Aikman expressed concern and even horror. Players waved frantically for medical assistance.

Less than four minutes later, Bradley, a linebacker, was sent back into the game.

Only at halftime was his injury diagnosed as a concussion.

The Eagles said afterward that they did not permanently remove Bradley at the time of his injury — per new N.F.L. rules — because their sideline exam revealed no concussion and also because no medical person saw either the hit Bradley took or his collapse to the turf.

Considering that doctors and trainers are well represented on N.F.L. sidelines and that the league has made concussion awareness an issue this season, the Eagles' handling of Bradley's injury raises a stark question: If a concussion this glaring can be missed, how many go unnoticed every fall weekend on high school and youth fields, where the consequences can be more serious, even fatal?

According to the National Athletic Trainers' Association, only 42 percent of high schools in the United States have access to a certified athletic trainer, let alone a physician, during games or practices. In some poorer rural communities, concussed players are taken to doctors with no experience with head injuries. Youth leagues with players as young as 8 and 9 rarely, if ever, have any medical personnel on hand; when a child is hurt, a parent, assuming one is present, walks out on the field, scoops up the child and carries him or her off.

The cost of hidden head trauma among children was driven home Monday, also in Philadelphia, as a University of Pennsylvania lineman who hanged himself in April, Owen Thomas, was found to have died with the same progressive brain disease found in more than 20 N.F.L. players. Playing since age 9, Thomas never had a reported concussion; his disease silently developed either through injuries he did not report or by thousands of subconcussive blows that accumulated over time.

Research suggests that 10 percent to 50 percent of high school football players will sustain a concussion each season, with as many as 75 percent of those injuries going unreported and unnoticed.

"Here in Rhode Island we have a state law that an athletic trainer must be at contests, but most schools are in violation," Dr. John P. Sullivan, the University of Rhode Island's sports psychologist, wrote in an e-mail Tuesday. "The risk is real."

Dawn Comstock of Nationwide Children's Hospital in Columbus, Ohio, is the nation's principal researcher of injuries among all high school athletes, having overseen the collecting of data that suggest about 70,000 concussions occur each year in high school football. Those that are reported, that is.

"We have very little about what happens to high school brains during these hits," Comstock said. "We have no idea at all what's happening in kids' brains while they're on the youth field or community rec field."

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http://www.nytimes.com/2010/09/16/sports/football/16concussions.html?_r=1&th&emc=th