I think we have all seen it before. That scene in various movies where somebody takes a hit to the head, and the coach comes over and asks “How many fingers am I holding up?” When they happen to guess correctly, that means they are still okay to keep playing. Of course, this practice is not widely accepted today, however, the theme behind these actions may still perseverate throughout our culture. I mean, who really knows when you’re actually good to go? It’s exactly this problem that leads to the ill effects that are becoming more and more common in many sports today, especially football.
The truth is it is actually very difficult to determine when a person can safely return to competition, and frankly the system we have in place right now isn’t really working. Many times, the physical symptoms of headache, dizziness, and nausea go away before the brain is actually done healing. If a person then returns to competition preemptively, they risk getting second impact syndrome which can result in severe brain damage and even death.
The brain contains many different neurons and glial cells that can pretty easily become damaged or stretched during a sudden impact. The damage to these neurons is what causes the symptoms seen in concussion, although sometimes the symptoms do not necessarily portray the full extent of the damage. In this case, the damage might not even show up on your typical MRI or CT scan. There are new imaging techniques that have recently become available called MRS, MRE, and DTI that are much better at visualizing the damage in a concussion, but right now they are still very uncommon. I think some research and development definitely needs to be done in order to make these techniques a little more common.
There definitely has been some steps in the right direction in the last decade. For one, I think many more people have been educated about concussions and their potential severity. This, however, is just the first step in preventing concussion. Now the scientists and researchers need to get some hard evidence to show what is really going on in a hard impact to the brain. There are new technologies that could make it possible to detect how hard a person gets hit in games like football and hockey, but the research hasn’t determined the physical threshold that when passed, a person must sit out. Obviously, there are also many ethical and legal questions that get raised when trying to implement something like this, but first we need to focus on getting the real data. Only then can we move in the right direction.