Dear Dr. Del Rye,
I enjoy all of the Helmet Hut features and I learned a lot looking back at the Helmet News explanation of concussions and injuries. I know that the columns were written for the average fan but with concussion such a hot topic, is there a simple and short explanation for guys like me who are just regular guys? I would like to talk about it as if I knew something and I think I do know a little but is there an easy summary? Thanks, I know this is not really a helmet type of question but an answer would be great.
Very truly yours,
Thank you for the question and I agree that anything related to the game of football, helmets, and concussion certainly is “the” topic of conversation among fans, players, front office personnel, and medical professionals. The series of articles in the HELMET NEWS section that began in February 2004 and ran through December of 2004 is a concise summary, written for the “non-professional” but I will attempt to give a shorter summary, one that can be “carried” into normal, every day conversation with fellow fans.
As early as 1960, Dr. John Mealy, as reported in the Journal of The Indiana Medical Association of March 1963, noted that “the etiology of the rising incidence of football head injuries is external trauma transmitted through the helmet to the skull and brain. Increasing numbers of heavier and quicker athletes, head up tackling and ball tackling are some of the recent factors in the sport that could contribute to the increased number of serious head injuries. These factors would provide for greater collision impacts and potentially more lethal types of injuries. However, the most widely held opinions suggest that the design and construction of the rigid plastic helmet, with its projecting faceguard, unpadded occipital rim, and inner sling suspension is deficient. This type of helmet may well serve to increase rather than decrease the likelihood of serious cranio-cerebral trauma, as well as cervical cord injuries.”
“Head Up Tackling” or blocking as noted by Dr. Mealy often translated to “head down” and excessive compression on the head and spinal cord
After stating that we would provide an easy to understand summary of concussion in football, this might seem an unlikely way to do so but this published medical statement is significant because Dr. Mealy, more than fifty years ago, identified most of the on-the-field problems we still have today! Despite the fact that the influx of money now available for football related concussion has made this a little talked about and behind-the scenes “big business,” and every legitimate and self-appointed expert has reason to push forth their own agendas, most professionals agree that the actual cause of concussion is a shear-strain or stretch type of injury. The old thought was that one’s brain was “crunched” or compressed with hard contact but as the series of HELMET NEWS articles points out, the uniform density of blood, nerve tissue, and cerebrospinal fluid, the relative inability to actually compress the brain, and the brain’s “willingness” to provide minimal resistance to changes in shape relative to the resistance offered to changes in size, all point to “stretch injury.” Certainly the brain can be bruised due to contact, especially if the brain strikes the inside of the bony skull but think about the elements of the brain being pulled apart or stretched to the point where nerve cells can no longer function normally. This is considered the more frequent cause of concussion. Once this occurs, there is a chemical response that also alters brain function. The damaging stretching and subsequent chemical reactions in the brain equal “concussion.” I believe in any every day conversation among your friends and fellow fans, this would be a very accurate summary:
- the brain can be damaged or injured by a direct impact
- the brain can be damaged or injured if it strikes the hard inside surface of the skull
- the brain can be injured if the nerve tissue pathways are stretched or pulled apart beyond a certain point
- the brain’s function is altered if the stretch of the tissue is enough to cause chemical reactions
The no longer seen picture perfect shoulder block of the mid-1950’s
The points that Dr. Mealy made resonate today:
“Head up tackling” which very much came with the introduction of the face mask often places the head and neck in a dangerous position when contact is made. Mike Ditka has strongly advocated the removal of the face mask from helmets which would cause tacklers to make initial contact with the shoulder.