OrthoVirginia Blog

A doctor's view of concussions in football

Original Article
I appreciated the article on concussions in the Sept. 16 Sports section. The increased awareness of these injuries has certainly benefitted the well-being of our athletes. As an athlete I have sustained concussions, as a parent I have painfully observed one, and as an orthopaedist I frequently treat them.

The diagnosis and treatment of concussions has improved dramatically from the days of “getting your bell rung” and being sent back into the game, to today’s emphasis on prevention and treatment. We are fortunate to have a concussion expert in our community, Dr. Omar Elkhamra, leading these efforts.

It may seem like there has been an increase in the incidence of concussions, and due to the increased mass and speed of today’s athletes, there probably has been. However, much of the increased incidence is due to our heightened awareness of concussions, as well as less stringent requirements for diagnosis. For instance, the “bell-ringer” of yesteryear, would be classified as a concussion today.

Paradoxically, our increased understanding of this condition reduces participation in sports, specifically football, and threatens its future. Whereas we were previously woefully unaware of the consequences of these injuries, now we are acutely aware of them. What we fail to appreciate about concussions is that although the number of them is vast, the devastating sequelae are rare, but highly publicized. If we reduce the incidence of these injuries via rules and techniques and combine that with infinitely better diagnosis and treatment, it would follow that any long-term effects should be reduced relative to those of previous decades of athletes.

The benefits that generations of football players, including myself, have enjoyed, including teamwork, sportsmanship, dedication, and discipline are threatened by failing to recognize that our increased understanding of concussions should give us greater confidence in participation, not less.

For many boys, football has not only enriched their childhoods, but has altered the entire trajectory of their lives. Middle-class children may still succeed without football, albeit with less rich childhood experiences. However, for many children, their opportunities without football would be drastically different.

I in no way intend to minimize the seriousness of concussions but believe that overall, the net effect of football over 100 years, weighing the benefits of participation versus the sequelae of concussions has been overwhelmingly positive. With our increased awareness, prevention, detection, and treatment, the net benefits should only improve.