No Apology Necessary

A physician should not have to apologize for protecting the health of an athlete. Football at the university level, like professional football, is a multi-million dollar business. With all of the emphasis on television, bowl bids, gate receipts and coaching contracts, the athlete is often left as a pawn with the medical staff serving at what seems like his only advocate. Ed Wesley, TCU running back, suffered a concussion against SMU on September 24. After Wesley was diagnosed with a concussion with a brief loss of consciousness, TCU Head Football Coach Gary Patterson confronts and proceeds to berate Dr. Haraldson for not allowing Ed Wesley to return. The day after the game, Coach Patterson told a journalist for ESPN Dallas that Ed Wesley was ”fine 10 minutes after he got hurt”. On October 21, ESPN revisited the story by reporting that Dr. Haraldson apologized to Coach Patterson. Possibly the greatest mistake that a coach can make is to compromise an athlete’s health. A public disagreement between a coach and physician such as this may place athletes in a position where they may not truthfully report injuries. That is a true disservice to the athlete.

In football, a mistake may be catastrophic

Lest we forget, football is a dangerous game. Most injuries in football like all other sports are a result of a mistake. If injuries are to be prevented, the mistakes must be identified and then eliminated. Eric LeGrand from Rutgers University, unfortunately made the mistake of lowering his head during a kick-off during the 4th quarter of a game against Army. This mistake resulted in the axial loading of the cervical spine and in his case resulting in catastrophic damage to the 3rd and 4th cervical vertebrae. When the cervical spine is straightened by lowering the head, it turns into a segmented column. Axial loading through this segmented column may then result in displacement of one or more vertebra, which in turn damages the spine. New York Times published a thorough article illustrating Eric LeGrand’s injury and then follow up with an article referring to Adam Taliaferro’s cervical spine injury while playing football at Penn State in 2000.

Can we save football from ourselves?

Football is a sport where the excitement of the game is based on simple physics. Much effort is put into increasing the size of the athlete (to increase mass), increasing the athlete’s strength (to increase acceleration) and increasing the speed of the athlete (the velocity of the moving mass). During the course of the game/practice, it is not uncommon that these three properties come into play in the form of a projectile. As has been widely published lately, many of these projectile collisions are violent enough to create a cerebral concussion. The effect of multiple concussive forces has been demonstrated by the development of CTE (Chronic Traumatic Encephalopathy) in athletes. More recently, sub-concussive forces to the head are being studied. The New Your Times published a story regarding the thousands of sub-concussive forces during the course of a season in college football. The Chicago Tribune has also recently published an article referring to the thousands of sub-concussive forces during the course of a high school season. Then on October 7, 2010, USA Today published an article on the seemingly trend of football helmets inadvertently coming off during the course of the game. If we can step back (and think about the concept that injuries are caused by a mistake) and take a look at all of the contributing factors (mass, acceleration, speed, excessive hitting in practice, properly fitting helmet, etc), it is possible to save the game before we destroy it.