Head Trauma: How Soldiers and Football Players are Being Helped

Some of the big players working to learn more about head trauma and assist those impacted by it are the United States military, Boston University's Sports Legacy Institute and the Brain Injury Association of America. The National Football League has also joined the movement to prevent head trauma.

After receiving a great deal of criticism about its handling of concussions and other head traumas among soldiers in the field, the military has made great strides in treating soldiers who have already been affected. The military has established a new policy that requires the establishment of a database to track each injury and the details surrounding it. This is intended to help with soldiers get the medical treatment they need if they are still experiencing symptoms months or years later. Their medical records often contain no information about a head injury or mild traumatic brain injury. The database could be essential in getting them help regardless of when their symptoms arise.

The Department of Defense and Department of Veterans Affairs have partnered to open a national treatment center on the National Navy Medical Center grounds in Bethesda, Md. Active duty soldiers from across the country who are not recovering through current therapies are sent to the center for treatment. They and their families spend two weeks at the facility for multidisciplinary assessment and care. They return home with a new treatment plan and continue to be followed by the center. The center researches traumatic brain injuries, develops new treatments and learns about how the chronic stress of combat affects the brain. They are also working to develop an objective measure of mild traumatic brain injury using neuroimaging because no such standard currently exists.

The Sports Legacy Institute (SLI) was founded in 2007 to address the concussion crisis in sports and the military by conducting research and promoting education and prevention. The SLI partnered with Boston University School of Medicine in the fall of 2008 to form the Center for the Study of Encephalopathy. Encephalopathy is the study of any type of injury or disease affecting the brain. Although the name might suggest otherwise, the Sports Legacy Institute works on research and education involving not only athletes, but also soldiers and veterans. The organization's founders recognized that because mild traumatic brain injury is the signature injury of the wars in Iraq and Afghanistan, research into the condition would serve not only soldiers, but also athletes.

A huge focus of the SLI's efforts are focused on education. When the group was established just three years ago they wanted to fill the void of information about prevention of head injuries. They offer a Concussion Clinic, educate people to go into their communities and share the SLI message and use the SLI website to provide links to additional information, such as the Centers for Disease Control's Heads Up online training program, and share guidelines on concussion prevention and management.

The Brain Injury Association of America (BIAA), which was founded in 1980, educates and assists anyone with a brain injury and their loved ones. The BIAA has also been instrumental in disability advocacy and promoting protection for brain injury patients under federal law. They have helped obtain Americans with Disabilities Act (ADA) protection for brain injury survivors and millions of dollars of research money used to learn more about how to prevent and treat brain injuries. The BIAA has closely collaborated with the federal Traumatic Brain Injury Program on education and research efforts.

The BIAA website shares detailed information about how a healthy brain functions and how the brain can be affected by brain injuries. The site breaks down the different parts of the brain and describes the functions performed by each part. This information helps patients and their loved ones understand how an injury to a certain part of the brain can impact particular functions. The site also shares a great deal of information about diagnosis, treatments and types of treatment centers.

The National Football League (NFL) has responded to increasing concerns about head injuries among former and current football players by adopting stricter rules about certain types of hits. If a player leads with his head and makes contact with a quarterback or unprotected receiver's head, the team will be penalized for unnecessary roughness. Additionally, some players have received fines of thousands of dollars in an effort to encourage them to be more careful on the field. However, some commentators believe the NFL hasn't done everything it could to prevent this type of dangerous hit. Although officials on the field always have the authority to remove a player from the game, it would be a difficult decision. In the heat of play it is almost impossible to know whether the hit was egregious without a lengthy review of game tape. Until the ejection issue is made a priority it is unlikely a player will be removed for that kind of hit. Furthermore, the current rule applies to very few players.

Based on what we know now about concussions and their effects, if a concussion is suspected athletes and soldiers should be told to sit out of activities, be evaluated by a medical professional and returned to activities only after approval by a medical professional. The military has adopted specific guidelines to this effect and the American Academy of Neurology (AAN) has published a position statement recommending all athletes at any level follow similar guidelines. The AAN also suggests that state legislatures that are contemplating new laws consider adopting these guidelines to protect student athletes.

This piece is the third in a series of three articles about the impact of concussions on football players and soldiers, research on how to treat people who have already been affected and the efforts to learn how to prevent them.

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