Concussions may spell later trouble for football players
The first scientific survey of head injuries in professional football players suggests that head trauma from the sport may lead to later neurological problems.
Research presented at the American Academy of Neurology's 52nd Annual Meeting in San Diego, CA, April 29 -- May 6, 2000, indicates that more than half of retired players surveyed had experienced concussions. As a group, these players were more likely to have neurological complaints, ranging from memory problems to numbness in their extremities, later in life.
"Although a great deal is written in the lay press about this issue in football, there is little documentation in the medical literature," said Barry Jordan, MD, director of the Brain Injury Program at Burke Rehabilitation Hospital in White Plains, NY, and primary author of the study. "Our investigation was undertaken as a first step in determining the magnitude of the problem among retired players."
Concerned that football players may suffer lasting damage from the repeated head blows and occasional concussions unavoidable in the sport, the National Football League Players Association provided the funds that allowed Jordan and coauthor Julian Bailes, MD, of Orlando, FL, to survey 1,090 former pro players.
According to the surveys completed by the players, 60 percent had suffered at least one concussion during their amateur or professional careers, and 26 percent reported three or more concussions.
When compared to players who did not report any concussions, the group with one or more concussions reported significantly more neurological symptoms. These included problems with memory and concentration, confusion, speech or hearing difficulties, numbness or tingling in extremities, and headaches.
The researchers point out that the survey form covered a range of general health questions. The players were not told that it was designed to uncover neurological problems, so it is unlikely that players who reported concussions were over-reporting neurological symptoms.
Concussion, by the current medical definition, is a temporary and completely reversible malfunction of the brain following a head trauma that does not produce an obvious injury, such as intracranial bleeding or bruising. Some researchers believe loss of consciousness, motor problems and disorientation that can follow the head trauma do not signal any long-term effects on the brain. However the cumulative and long-term neurological effect of repeated blows to the head has become a major medical concern in contact sports.
Many neurologists are convinced that concussions, as well as repeated blows to the head, do lasting damage, even if the evidence for it is still only anecdotal. The most commonly cited anecdotal example is the "punch-drunk" syndrome of speech and movement impairments and other abnormalities seen in some retired boxers.
"Our results should be interpreted with caution because they were obtained from a questionnaire," said Jordan. "Further research is needed, and the next step would be to conduct a follow-up study on football players reporting neurological problems to determine if they exhibit clinical evidence of neurological impairment. Those with impairment would be compared to those without impairment in order to determine possible risk factors."
If the results of this study are borne out by follow-up work, said Jordan, it would mean that football players need to be tested regularly to determine whether they are experiencing neurological symptoms.