When it comes to head injuries, football still has a long way to go

Feb 5, 2010 4:41 PM

The first time I looked at a skull X-ray from a professional hockey player, I cried. The athlete had sustained so many facial-bone fractures over time that the normal bony features were a massive white blur. It was 1990. I had just begun to see patients as a neurology consultant for the New York Rangers.

But the National Hockey League sharpened its performance in 1997. Since then, every time a player gets a concussion, doctors conduct a battery of neuropsychological tests. Later, the team’s medical professionals give the player follow-up memory and motor-skill tests to make sure that he is back to his pre-injury level of mental performance before returning to the ice. The league has also made safety adjustments, such as installing more flexible glass around the rink.

In December the National Football League also tightened its guidelines, because it was widely criticized for allowing players with concussions to return to the field too soon. Players had been allowed to get back in the game if they hadn’t lost consciousness, but now they have to stay on the sidelines if they are having memory problems, dizziness, or a headache.

Still, in my opinion, football culture has a long way to go. In December, for example, Pittsburgh Steelers wide receiver Hines Ward was reported to have criticized his teammate, quarterback Ben Roethlisberger, for not playing because he had postconcussion symptoms. Roethlisberger had been diagnosed with a concussion after taking a knee to the head during a game.

This type of attitude is a real problem. Repeated concussions spread over months or years can be dangerous. Years later they can cause a neurodegenerative condition called chronic traumatic encephalopathy, which includes the types of memory impairment seen in those with Alzheimer’s disease.

One need only look at players like former Dallas Cowboy and current broadcaster Troy Aikman, former New England Patriot Ted Johnson, and former New York Jets wide receiver Wayne Chrebet to learn about the consequences of concussions. As Super Bowl XLIV approaches, I hope the NFL has gotten the message.

—Orly Avitzur, M.D., Consumer Reports medical adviser and medical consultant to the New York Rangers

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