Why a Concussion Is the Worst Kind of Sports Injury

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Your team winning the World Cup is a rare moment to savor as player, a feeling that will last a lifetime. Unfortunately for German midfielder Christoph Kramer, he cannot recollect much of the event. “I can’t remember that much from the game,” The Guardian reports Kramer as saying. “I don’t know anything from the first half. I thought later that I went straight off after the incident. How I got to the changing rooms I do not know. I don’t know anything else. The game, in my head, starts only in the second half.”

Kramer’s inability to remember what happened is due to a collision the German had with Argentine Ezequiel Garay around the 19-minute mark in the World Cup final. Kramer went down after his jaw forcefully met Garay’s shoulder as the two vied for the ball. Kramer was treated and was allowed to continue playing. His substitution did not occur until 31 minutes of the match had passed. Then, Kramer unsteadily left the field, replaced by André Schürrle.

The episode, unfortunately, was not the only controversial concussion-related event. During the Uruguay-England match in June, Uruguay’s Alvaro Pereira took a knee to his head from England’s Raheem Sterling. For a short period, Pereira was knocked out, but after an equally brief treatment on the sidelines, was allowed to return to the game. As a result, the World Players’ Union, FIFPro, called on FIFA to investigate the body’s concussion protocol.

“The World Footballers’ Association is seeking urgent talks and immediate assurances that the Fédération Internationale de Football Association (FIFA) can guarantee the safety of the players, which must be priority number one,” FIFPro said in statement. “In the absence of that, FIFPro is considering alternative solutions such as independent medical practitioners appointed by FIFPro for all future FIFA competitions.”

The incident caught the attention of Lancet Neurology as well, which stated that cerebral concussions are “the most common form of sports-related traumatic brain injury (TBI).” The journal expanded on the implications of the failure of FIFA to have a standard procedure in place for handling concussed players, and the danger of concussion regardless of how it occurs.

The Pereira incident was evidence that FIFA’s “recognize and remove” policy for concussions had failed. Since TBI can have long-lasting effects, such as dementia, this is a failure not only in protocol but for the health of players, as well. This isn’t only an issue for soccer, a fact highlighted by the Lancet. It cited the recent agreement in the Unites States by the National Football League to remove the $675 million cap on damages from concussion-related claims by former players.

Public education and continued research are essential tools for preventing concussions in the first place, as well as properly addressing them when they do happen. The Centers for Disease Control and Prevention (CDC) explain that the health concerns arising from concussions are not only the purview of professional sports or even sports in general. When analyzing visits to the emergency room, activities most commonly associated with TBI were bicycling, football, playground activities, basketball, and soccer. Concussions are of particular concern for youth, because they are more susceptible to the long-lasting effects of a concussion or brain injury, even when the situation appears to be mild.

The CDC states that following a “bump” to the head, should a player feel dizzy, become nauseous, experience sensitivity to light, have a headache, become confused, or not feel “right” in general, they should not be permitted to play on. Coaches and those on the sidelines need to be on the lookout for confusion, forgetfulness, and unconsciousness by athletes. Most importantly though, no one can see a concussion — immediately grasping the situation as you would a broken bone is not possible. The injury is to the brain, and a concussed person may not show signs until days or weeks after the incident. A healthcare professional is essential for the evaluation and diagnosis of a person’s state after they have hit their head.

The World Cup has pushed this debate back into the international conversation, and rightfully so. Athletes of all ages need to be aware of the potential dangers from concussion, and sports leagues need guidelines for how to handle this potentially serious health risk. Lacking this basic regulation, a negative standard is allowed to perpetuate.

“I’m worried about how many kids emulate these athletes. It wasn’t just one athlete hurt; it was one multiplied by 1 million,” concussion expert Chris Nowinski told the Associated Press. “They didn’t even use a bully pulpit and say: ‘This is unacceptable.’”