"Giving your brain a rest" is the prevailing wisdom for treating concussions. That message is backed by major Wisco research initiatives that bode well for advancing brain science.
With her hair pulled into a ponytail and No. 11 stenciled across her green road jersey, Tori Albrecht ran onto the soccer field with her Wisconsin Lutheran College teammates at St. Norbert College. The sun set on a picturesque early fall evening as the teams took their positions for kickoff on the DePere campus.
St. Norbert jumped out to an early lead over the Warriors and was attacking again toward the end of the first half. As the 5-foot, 8-inch Albrecht retreated on defense, a St. Norbert player blasted a ball into the right side of her face from point-blank range. Spectators groaned.
Albrecht remained in the game, sporting a red mark on her cheek, her skin tingling where the ball struck her.
But she stayed on the sideline for the second half, despite her repeateded efforts to get back into the match. Later, traveling back to Milwaukee on the team bus, she fought to stay awake.
“I ended up falling asleep and feeling even crappier when I woke up,” Albrecht says.
The next morning, Albrecht climbed out of bed feeling nauseated and dizzy. She skipped her morning classes and had no appetite throughout the day. Her father took her out to dinner that night. But after a few bites, she retreated to the restaurant’s restroom and vomited. Her coach texted to see how she was feeling, and later that night, she went to see the team’s trainer.
Albrecht was sidelined for about 10 days with a concussion, and she missed multiple practices and games.
Back on the field a few weeks later, Albrecht collided with another player while attempting to head a ball during a home game against Concordia University. She fell hard to the turf, the back of her head absorbing the impact. She remained in the game but visited the team trainer immediately afterward. As a precaution, she was told not to drive herself home and to check in with the trainer the next day.
“I wanted to finish. It was our last game,” Albrecht says, looking back. “Athletes are pretty stubborn.”
The concussions not only kept her off the pitch, but caused her to miss several classes.
“I couldn’t look at a computer screen for more than 20 minutes before I would get a headache and get exhausted,” she says. “I wasn’t able to focus, and it was hard to get up in the morning without feeling sick or dizzy.”
Trainers and coaches took a cautious approach with Albrecht before allowing her to return to action, as has become more commonplace in athletics, the result of a growing awareness of concussions.
But that wasn’t the case just a few years earlier, when she sustained a head injury in a match during her junior year at Pius XI High School. Albrecht vaguely recalls being shoved before falling to the ground and landing on the back of her head.
“It wasn’t considered as serious back then,” recalls Albrecht, a senior studying nursing and sport-and-exercise science. “My doctor didn’t make a big deal out of it.”
The Milwaukee native had battled migraine headaches as a youngster. The headaches returned after the recent concussions, leaving her to wonder if there was a connection. Despite it all, Albrecht is in uniform for the current fall soccer season.
“I think I’ll be all right,” she smiles. “I have a hard head.”
An estimated 3.8 million concussions occur annually in the United States during competitive sports and recreational activities, according to the American Medical Society for Sports Medicine. The numbers are even more astounding considering that as many as 50 percent of concussions likely are not reported.
From professional sports to college, high school and beyond, concussions have become a hot-button topic of debate. The attention is prompting a slow but sure shift away from the play-at-all costs attitude that has pervaded sports at all levels.
The debate surrounding concussions is fueled in no small part by the plight of former NFL players, a large group of whom have sued the league. The NFL reached a settlement with those former players one week before the start of the 2013 season, agreeing to pay $675 million, in addition to legal fees. Critics viewed the settlement as “chump change,” given that the NFL is projected to have revenues of $27 billion by 2025.
In June, the NFL agreed to remove the $675 million cap on damages from concussion-related claims after a federal judge questioned whether there would be adequate funds to cover as many as 20,000 retired players. Under the plan, certain individual payouts would be capped. For instance, former players with chronic traumatic encephalopathy, or CTE, a degenerative brain disease, could get a maximum payment of $4 million.
The NFL has been refining its concussion procedures while dealing with the fallout from accusations leveled by scores of ex-players. They say they’re suffering myriad health issues stemming from head injuries sustained during their playing days.
The topic has landed squarely on Wisconsin turf. On a frigid January evening earlier this year, in an intense wild-card playoff game at Lambeau Field, Green Bay Packers rookie offensive lineman David Bakhtiari strapped on his helmet and ran back onto the field, ignoring the team’s medical personnel, who were convinced he had a concussion and had ordered him to remain on the sideline.
On a play moments earlier, Bakhtiari stumbled, and as he fell to the ground, his head collided with the knee of San Francisco 49ers linebacker Patrick Willis. Bakhtiari sprawled face down on the frozen Lambeau turf, his glove-covered hands clutching his helmet.
The 300-pound tackle eventually made it to the sideline for medical treatment, after which his rebellious return to the field lasted but a single play.
The NFL’s head, neck and spine committee sent a letter to all team doctors and trainers acknowledging that Bakhtiari had violated concussion protocol. The committee found no fault with the Green Bay medical staff, and although it essentially blamed Bakhtiari, neither the player nor the team was fined. The Packers didn’t address the issue at the time and Bakhtiari has never commented publicly. A Packers spokesman declined to comment for this story and wouldn’t make Bakhtiari available for an interview.
While revamping its concussion policies, the NFL also has been doling out millions of dollars to support concussion-related research, a key portion of which is taking place in southeast Wisconsin.
In January, General Electric Co. and the NFL announced the awarding of 16 grants, part of the first phase of a $20 million “Head Health Challenge.” Awardees included the Medical College of Wisconsin, which is receiving $300,000 to use innovative magnetic resonance imaging (MRI) technology to determine the direct effects of sports-related concussions. The aim of the Medical College study is to find more objective ways of diagnosing concussions, as well as to determine when an athlete’s brain is fully recovered.
The programs are part of an overall four-year, $60 million collaboration between GE and the NFL to speed diagnosis and improve treatment for mild traumatic brain injury.
“These studies hold the promise of advancing brain science in important ways,” NFL Commissioner Roger Goodell says in a statement.
Sports memorabilia adorns the Medical College of Wisconsin office of Dr. Michael McCrea. There’s a Green Bay Packers helmet and a variety of Wisconsin Badgers items. His children’s artwork also is on display. But McCrea doesn’t spend much time at this office. He’s usually found on athletic fields around the region. The affable McCrea often is seen joking and making small talk with coaches, players and athletic directors, all while conducting the precision work to advance the knowledge of traumatic brain injury.
McCrea – a professor of neurosurgery and neurology, and director of brain injury research at the Medical College – has been studying sports-related concussions for nearly 20 years. But until recently, he had done so in relative anonymity.
“My cocktail party discussions literally have gone from, ‘You’re studying what?’ to, ‘Isn’t it unfortunate about what’s happening to all of these young athletes,’” McCrea says.
With closely cropped hair and thin-rimmed glasses, McCrea usually is clad in dress pants and a dress shirt, most often with the sleeves rolled up. Every so often, he’ll don a pair of jeans, but a nice shirt is always part of his ensemble, even when he’s on the sidelines at a football field.
McCrea’s relaxed demeanor and his profound love of sports likely has helped him get athletic programs at various levels to participate in his research over the years.
His research has been game-changing. “We have a much better recognition of concussion epidemiology and how common the injury is,” he says. “We have a much better understanding of the potential seriousness of clinical signs and symptoms, and how important it is to allow athletes adequate recovery time before they return to play.”
This has involved a drastic change in culture, even at the high school level.
The painstaking research – he has conducted baseline studies on thousands of athletes – has yielded many key findings, including that 85 to 90 percent of athletes make a complete recovery from a concussion in seven to 10 days.
“This isn’t based on what the athlete tells us,” McCrea emphasizes, speaking in a steady, even manner, “but on performance-based measures where we have a baseline on them before their injury,” “That’s a major finding, not only scientifically, but if you’re a sports parent, like myself, that’s pretty good news.”
Key findings also have been generated in the drive to make athletes less susceptible to suffering multiple concussions. The seven- to 10-day window for recovery is when an athlete is at the greatest risk for repeat injury. “You take those things together, and you’ve got some great science to start driving policy on clinical management,” he says.
Under what is becoming increasingly standard practice for local colleges and high schools, once an athlete achieves or nears clinical recovery, he or she is then put through a program of graded exertion before returning to competitive practice or game action.
“We used to just tell athletes to go back to practice. Now, we put them on a treadmill or elliptical and graduate them back to full participation,” McCrea says. “During that period, you’re creating a timeline that is moving the athlete out of the period of vulnerability.”
Zach Davis, an offensive lineman for Wisconsin Lutheran’s football team, stands 6 feet, 6 inches tall and weighs nearly 250 pounds. His size makes him a formidable presence in the line-of-scrimmage trenches. Davis, who has been sidelined twice by concussions, is aware of the potential health threat posed by sports-related head injuries and has followed a medical trainer’s strict orders that he sit until fully healed.
Nonetheless, he sympathizes, to a degree, with Bakhtiari, who earns his living playing football.
“That’s his job, so it’s a little different,” Davis says.
Davis, a junior from East Troy, sustained a concussion during a practice last October when he and a teammate butted heads in a forceful collision during a drill. “My neck got really tight,” he recalls.
Davis also suffered a concussion during his freshman year of high school, when, playing as a defensive end, he fell on his head while trying to make a diving tackle.
As a result of his most recent concussion, Davis missed three games and routinely would get headaches. The aftereffects of the blow to the head also affected his performance in the classroom. “I had a class where I had to do a lot of reading and I got headaches,” says Davis.
Today, the 19-year-old Davis says that he’s experiencing no ill effects from the concussions and plans to continue playing football at Wisconsin Lutheran. “I don’t worry about it. It’s out of my mind,” he says.
Although some athletes seem almost indifferent about the issue, coaches have become more proactive in an effort to protect the health of their teams.
Mike Fossum, assistant head football coach at Wisconsin Lutheran, says the protocol for treating concussions is evolving and becoming more formalized. Wisconsin Lutheran competes as a National Collegiate Athletic Association Division III school, meaning that only in the rarest of instances will any of its athletes ever compete professionally. As a result, Fossum feels less pressure to rush a player back into action. “The sport they play doesn’t impact their professional careers,” he says.
At Wisconsin Lutheran, and many other institutions, student-athletes dealing with concussions also are granted permission to miss classes and reschedule examinations if needed as they recover.
“I’ve always erred on the side of caution,” Fossum says. “If I’m told during a game that a player might have a concussion, I move on to the next player.”
The long-term impact from repeated concussions can be devastating. Former Chicago Bears and Green Bay Packers quarterback Jim McMahon, 55, admits he has had serious memory problems. Legendary Packers quarterback Brett Favre, 44, appeared virtually indestructible during the majority of his 20-year career, during which he rarely missed a start. He, too, has complained of memory loss that he believes stems from playing football. And the suicides of players like Junior Seau and Dave Duerson brought the relationship between concussions and depression to the forefront of public discourse.
In an effort to address the concussion crisis, the NFL has partnered with GE Healthcare, which has major operations in the Milwaukee area.
The collaboration, which began in March 2013, “is recognition that we were missing an opportunity to apply great technology to a big health concern,” says Baldev Ahluwalia, healthcare product manager based at GE Healthcare’s Waukesha County operations. “The NFL is a huge brand and carries a lot of weight with it. We have a big brand as well.”
The four-year project is multifaceted, with a goal of stimulating the marketplace to advance technology, Ahluwalia says. The partnership, the NFL’s largest private-industry collaboration ever, aims to develop and improve concussion-detecting imaging technology. Some of the research and development will be carried out at GE Healthcare’s Waukesha County facility, which is the headquarters for the company’s MRI business. GE has about 650 employees, including more than 350 engineers, at the site.
To fast-track the project, studies will be conducted at numerous GE Healthcare-sponsored sites. An initial study is already underway at NewYork-Presbyterian/Weill Cornell Medical Center, with another planned for the University of California-San Francisco Medical Center. In the end, MRI equipment will be custom-designed and developed to diagnose concussions.
About $10 million from the partnership is being applied to clinical trials and nearly $30 million to product development.
“The technology we are putting in place isn’t just for concussions but will have a significant play in how we manage Alzheimer’s disease, neurodegenerative diseases and Parkinson’s,” says Ahluwalia.
MRI scans are the most advanced way to examine the brain, he says. “We can look at structure, function, flow, metabolism and connectivity. There is no other imaging modality that can do that. The ultimate goal is to make sure we can provide physicians the best quality and right amount of information so they can determine the best treatment for the patient.”
As for the timing of the partnership with the NFL, Ahluwalia says: “The intent we see from the NFL has been very positive and focused around improving the science and technology. All of the discussions we’ve had with the NFL have been very genuine.”
The NFL-GE partnership, however, took root as the league felt the sting of revelations in the book League of Denial. Authored by investigative reporters (and brothers) Mark Fainaru-Wada and, Steve Fainaru, the book revealed how the league, over a period of about 20 years, denied and sought to cover up mounting evidence of the connection between football and brain damage. League of Denial, which was made into a documentary film, spurred more investigations and created a black eye for the NFL that ultimately pushed the league to act.
It’s not just the NFL that has been pushed to action. In late July, the National Collegiate Athletic Association agreed to provide $70 million for concussion testing and diagnosis of current and former college athletes as part of the settlement of several consolidated concussion-related class actions.
And in late August, a group of soccer parents and players filed a class-action lawsuit against FIFA, the sport’s international governing body, and other organizations accusing them of negligence in the treatment and monitoring of head injuries. The suit, which claims that nearly 50,000 high school soccer players in the U.S. sustained concussions in 2010, seeks rule changes in the sport.
The NHL also is facing a concussion-related lawsuit brought by retired players.
Concussions often consume the daily thoughts and work of Dr. Kevin Walter, director of pediatric and adolescent sports medicine at Children’s Hospital of Wisconsin. It was during a sports medicine residency at the University of Akron from 2002 to 2004 that Walter experienced a career-defining moment. Positioned on the sideline, he witnessed an Akron football player stagger off the field during a game.
“He had a headache, was dizzy, and couldn’t stand right,” Walter recalls. “The old-school rules were, if this was concussion No. 1 and you can resolve it in 15 minutes, you can go back and play.”
A short time later, the player insisted that he felt fine.
“You do some easy cognitive tests and have him run up and down the sideline a few times,” Walter says. “I was thinking that, literally, 15 minutes ago, you could barely walk because you had a brain injury, and I’m supposed to think that your brain healed and you are good enough to go back out on the field. This just doesn’t make sense, but that was just where medicine was at. I remember thinking there is no way in hell this can be right.”
Walter created a small concussion program while working in private practice after his fellowship. He returned to Milwaukee in 2007 and started developing a sports medicine program at Children’s Hospital, which launched in 2008. A year later, he formed the concussion clinic at the hospital with Dr. Jennifer Apps, a neuropsychologist who worked as a research assistant from 1997 to 2003 on an NHL concussion study that involved the Dallas Stars. She was working toward her doctorate at the University of Texas Southwestern Medical Center at the time.
“She had a background in sports concussion,” Walter says. “There was a little serendipity.”
They also formed a partnership with the Medical College’s McCrea, whose research skills complemented their clinical expertise.
Awareness of concussion and its symptoms is becoming more prevalent, Walter says. In 2012 – with the backing of a large coalition including Children’s Hospital, University of Wisconsin Hospitals and Clinics, the NFL and the Green Bay Packers – Wisconsin enacted legislation dedicated to youth safety in contact sports.
The Sideline to Safety law, which went into effect in April 2012, requires all youth athletic organizations to educate coaches, athletes and parents on the risks of concussions and head injuries. It prohibits participation until the athlete and parent or guardian has returned a signed agreement sheet. The law also mandates immediate removal of a participant if symptoms indicate a possible concussion. The athlete may not return to action until being evaluated and receiving written clearance from a health care provider.
By 2013, all 50 states and the District of Columbia had enacted similar legislation. Even so, the cultural shift has proven to be anything but speedy.
“I won’t be satisfied until everybody reports it,” Walter says. “If you broke your leg, you aren’t going to run around and play. You are going to report it. Common sense says that if you have a brain injury, of course you should report it, too.”
The increased publicity has its benefits, but there’s also a downside, Walter warns. “The beauty of the NFL is that the media exposure has been huge in generating awareness,” he says. “But some of the stories are very sensationalistic. People see those terrible stories and then parents worry whether their 13-year-old kid is going to end up like Dave Duerson.”
A hard-hitting safety, Duerson spent 11 seasons in the NFL, including seven with the Chicago Bears. After retiring in 1993, he bought Brooks Sausage, later known as Fair Oaks Farms, which has a plant in Pleasant Prairie. He sold his interest in the business and founded Duerson Foods, which also had its operations in Kenosha County.
The new business put Duerson into financial ruin and he shuttered the operation in 2006. Five years later, at the age of 50, Duerson committed suicide with a blast to the chest from a .38 Special. He left messages for his family, including a flurry of texts in the final hours of his life, many stating his desire to have his brain donated for research focused on neurodegenerative disease. In his final act, Duerson pointed the revolver at his heart, not his head, so that his brain could be preserved for study.
Testing later revealed that Duerson suffered from CTE, which is linked to concussions. This left many to speculate whether there was a tie between his personal and financial difficulties and the brain damage he suffered during his football career.
Junior Seau, one of the best linebackers in NFL history, retired in 2010 after a 20-year pro career. He killed himself in 2012, also with a gunshot to the chest, and also was later found to have CTE. His star status and tragic end combined to refocus and intensify public attention on the NFL’s concussion issues. Seau’s family filed a wrongful death lawsuit against the NFL in January 2013, and as of early September, it had yet to be resolved.
And still, Walter cautions, there’s often a misconception that all concussed athletes will have long-term health issues. “That hurts because then a lot of time is now spent talking families off the ledge. A few years ago, I’d have to argue and use scare tactics to explain to parents why they need to take this more seriously and tell them that their child has a brain injury and could die.”
Most athletes who sustain a concussion resume normal activity and return to their respective sports, he says. Yet, in some instances, the risks associated with a return to action become too great.
“There comes a point when either you get too many concussions or you haven’t completely recovered or you have symptoms for too long,” he says. “That’s when I start talking about needing to change your outlook on sports. Most of us get to that point after high school anyway. With concussions, we just force kids to love sports in a different way earlier than they want to.”
Walter claims that some coaches have blackballed him for his highly cautious approach by urging players to see other doctors, ones who might be more willing to allow a quicker return to action.
“The athletes get scared because they are out of action. You are taking away a part of their identity,” Walter says. “Then they worry about their spot on the team and what their friends think. … But if you don’t take care of it, it could have a lifelong impact.”
Although football and soccer garner the lion’s share of attention, the concussion issue pervades a wide variety of sports, including lacrosse, which continues to gain popularity. More than 60 new college lacrosse programs were added in 2013, with nearly 40 more expected this year, according to U.S. Lacrosse, the Baltimore-based governing body for the sport.
Danny Morse began playing competitive lacrosse seven years ago. He honed his skills and earned a spot on the team at Carthage College in Kenosha, where he became a four-year starter.
During a scrimmage in the fall of 2013, Morse slithered through defenders and cocked his lacrosse stick while quickly surveying the field through his facemask. He uncorked a shot that screamed past the goalie then raised his arms in celebration.
For Morse, the exuberance of scoring quickly faded when an opponent, seconds after the ball nestled into the net, violently drove his shoulder into the side of Morse’s helmet. The hit leveled the 5-foot, 10-inch, 177-pound midfielder.
“He cheap-shotted me,” Morse says.
Stunned, Morse retreated to the sideline, where he underwent concussion testing. A short time later, he rushed back onto the field after being cleared to return to action. Immediately, he realized that he wasn’t physically able to perform. “I was seeing so many stars, it was blinding,” he recalls.
Morse later became sick to his stomach and missed classes the next day. He sat out two weeks after being diagnosed with a concussion. His symptoms became so bad that he couldn’t even watch television.
But when it comes to contact sports, few match the rugged nature of rugby, in which players wear little or no protective gear.
Taylor Bragg-Brock, a starter on Divine Savior Holy Angels High School’s powerhouse rugby team, prepares for battle on the field with a lone piece of protection – a mouth guard. She opts to go without a “scrum cap,” which provides padding for players’ ears.
Wearing a Divine Savior rugby sweatshirt, she smiles brightly during a meeting at a bustling Wauwatosa coffee shop as she recalls how her desire to be involved in contact sports took root.
“I was out there on the playgrounds during recess when I was younger, the only girl playing football,” she recalls.
Bragg-Brock has little recollection of the circumstances that led to her concussion in a 2013 fall match. “Basically, I don’t really remember specifics, but I hit my head and I came out and I was a little dizzy,” the 17-year-old senior says. “I apparently was running with the ball and someone tackled me. I hit the back of my head on the grass.”
Convinced she didn’t have a concussion, her initial response was to fight to get back on the field.
Later, the Milwaukee resident went to the Medical College to be examined, and she scored much lower than she had on an initial baseline test prior to the season, a red flag indicating a possible concussion. She went to class the next week but was excused from tests and quizzes due to a lack of concentration, which stemmed from the concussion.
Bragg-Brock recovered in time to play the next weekend, when DSHA captured its 12th consecutive state championship.
Kat Hilgeman, a clinical athletic trainer at the Sports Medicine Center – which is jointly operated by Froedtert Hospital and the Medical College – says ignorance of the symptoms along with a failure by student-athletes to report problems previously led to scores of undiagnosed concussions.
“Before, it was a denial thing,” says Hilgeman, who has served as Divine Savior’s head athletic trainer since 2011. “I think we’ve scared people enough that they come forward more readily now.”
The Medical College performs baseline tests on Divine Savior athletes in order to allow for better diagnoses of possible concussions. Students initially balked at the test, which can take upward of two hours to complete.
The attitude has since changed. The larger issue, Hilgeman says, has been dealing with coaches who display “an old-school mentality.”
Hilgeman is on the sideline for the games of most contact sports at Divine Savior. She is the first line of evaluation for student-athletes suspected of having a concussion. In most cases, she is able to handle the treatment but will refer an injured player to a physician if issues arise.
Bragg-Brock says she understands that her coaches and trainer were looking out for her best interests in keeping her off the field. “What I love about our coaches is that they care more about us than they do the game,” she says. “Our head coach, John Klein, says that we all have the potential to do something with our lives. Don’t let any injury inhibit you.”
A play-at-all-costs mentality is becoming a thing of the past, she insists.
“When you see the news that ex-NFL players are suing the league for brain damage, it was back then that they had those types of coaches,” Bragg-Brock says. “It’s sad, because if coaches only had the knowledge that they do today, I’m pretty sure that would have changed.”
Concussions aren’t limited to the obvious contact sports. In recent years, the greatest incidents of concussion among girls’ sports at Franklin High School occurred in basketball and swimming, not soccer or rugby, says athletics and activities director Sara Unertl. Swimmers, Unertl explains, are sustaining blows to the head when colliding with the pool wall. In basketball, head trauma often stems from elbows to players’ heads.
Steve Staab was a standout member of the Carroll University football and track teams as an undergrad. Today, it’s his job as Carroll’s head athletic trainer to make sure that athletes are in tip-top condition. Among his most important duties is dealing with head injuries.
Growing awareness of the seriousness of concussions, Staab says, has been a crucial step toward allowing for better assessment and treatment. Advancements in testing have “taken some of the guesswork out of our hands,” he says.
Carroll athletes are tested in multiple areas if they are suspected of having sustained a concussion. The examination includes computer testing and takes into account physical, cognitive, long- and short-term memory, balance and neurological assessments.
Athletes need to be forthright about their symptoms for the tests to be most effective, Staab says.
When Staab first became trainer at Carroll several years ago, a much more aggressive attitude toward returning to play persisted, he says. Now, Carroll has a five-step program that requires an athlete to be symptom free for 24 hours before even being permitted to do light aerobic activity. That’s followed by more intense activity, practice with light contact, full-contact practice and then a return to game action. If all goes well, the process tends to take five to seven days, Staab explains.
It has become increasingly clear that head trauma in football players can occur from many smaller hits and not always a massive, dramatic blow, he adds. A study conducted at Dartmouth College in New Hampshire and published late last year in the journal Neurology indicates that head blows that don’t cause concussions can result in differences in athletes’ brains.
Staab noted that, on average, Carroll’s football team runs about 75 offensive plays per game, combined with five days of practice. “Those numbers add up,” he says.
Staab, who is on the sidelines for every football practice and game, credits the Carroll coaching staff for also implementing measures aimed at reducing the chance of concussions, including limiting contact in practice.
“There is a little bit less of a tough-it-out mentality now,” he says. Even so, players still have mixed feelings on the issue. Staab has had to lock players’ helmets in a sideline case when they insisted on returning to games without medical clearance. “We also have a lot of them that still try to hide their symptoms,” Staab admits. “Sometimes, in the chaos of a game, a player may even try to sneak onto the field.”
A former defensive back, Staab wasn’t the most athletically gifted player on the field, but he prided himself on using proper technique, leading with his shoulder pads when making a tackle.
He’s convinced that improper tackling, fueled by the desire to make “highlight-reel” hits, is a factor in concussions. Youth football leagues have been introducing new strategies aimed at getting players to not lead with their heads when making tackles.
The intensified focus on concussions is “good for the long-term health” of contact sports, especially football, says Mike Yeager, head football coach at Carthage College in Kenosha. He notes that it helps convince parents that football is safe so that children can continue to be exposed to the game and fill the pipeline.
“If you’re smart with concussions, the game of football can survive,” says Yeager, a three-year letterman who played linebacker at Miami University in Ohio. “Back then, if you got your bell rung, as long as you felt OK the next day, you were good. I had two concussions. Probably more. Fortunately, there haven’t been any long-term ramifications yet, but you never know.”
Now, the prevailing view is that “you have to give your brain a rest,” Yeager says. “Players don’t fight coaches as much anymore on the decision to sit them out.”
Yeager describes the Carthage football players as willing “guinea pigs” for the Medical College’s research. Sixty of them will be wearing computer chips in their helmets for each practice and game this season that will register the impact of blows to the head.
McCrea has no plans to rest on his laurels, and he continues to maintain a frenetic pace with his research. Over the course of 20 years, McCrea and his medical school colleagues have enrolled more than 25,000 athletes in baseline studies, including 10,000 in southeast Wisconsin. Nine high schools (Marquette University High School, Divine Savior Holy Angels, Wauwatosa East, Wauwatosa West, Wisconsin Lutheran, Milwaukee Lutheran, Whitefish Bay, Franklin and Pius XI) and four colleges (Carthage, Carroll, Concordia and Wisconsin Lutheran) are taking part in a current concussion study tied to the GE-NFL Challenge grant and a grant from the U.S. Department of Defense.
In a similar line of research, the Medical College is taking a prominent role in a $30 million national study on concussions and head-impact exposure, which was announced in May by President Barack Obama at a White House summit focused on head injuries among young athletes. The Medical College, the University of Michigan and the Indiana University School of Medicine will take part in the study, funded by the NCAA and the Defense Department. About 1,200 NCAA athletes will be studied over three years.
The aim is to generate more scientific evidence in the reporting, diagnosing and treatment of concussions. Athletes will be outfitted with sensors to gather data on head impacts. The sensors, which cost about $125 apiece, will be worn behind the ears of athletes in contact sports in which a helmet isn’t required. For sports that require a helmet, the sensors will be built into protective equipment.
Earlier this year, the Medical College launched a four-year study that will examine a group of former NCAA athletes originally studied in the late 1990s.
The research in which McCrea has been involved has gone beyond the field of play to include military personnel, who can suffer concussions when bombs explode. “Even though the stakes are dramatically different – a Friday-night high school football game versus a war setting in Afghanistan – the exercise is pretty much the same,” he says.
Today, after nearly two decades, the once-shunned concussion researcher finally is being heard.
“In the past, I couldn’t get anybody to listen to this topic. Now, everybody wants to talk about it,” McCrea says.
He pauses for a moment, reflecting on what has become his life’s work. There’s little, if any, outward arrogance as he chooses his words.
Yet McCrea is wholeheartedly convinced that the efforts of his colleagues and himself have changed the discussion about concussive brain injuries.
“There’s no doubt about it. We’ve affected the landscape.”
Email contributing writer Rich Rovito at firstname.lastname@example.org.