Concussion research starting to make impact

Patrick Strohecker

Concussions are hardly a new revelation.

The constant head blows in football do not come without some serious risks.

However, their long-term health effects are, which is the main reason why the attention surrounding head injuries is at an all-time high.

It all started in 2002 in Pittsburgh with a little-known Nigerian doctor named Bennet Omalu. He's credited with discovering CTE, the degenerative disease in a human's brain caused by repeated blows to the head, when he examined the brain of deceased former Pittsburgh Steelers lineman Mike Webster. CTE is commonly found in the brains of boxers. Webster died suddenly at the age of 50 after struggling with years of mental impairment, depression, mood swings, drug use and suicide attempts.

Boys' high school soccer produces about a third less concussions than girls' soccer.

Curious as to what caused Webster to go into a fit of rage and depression following his football career, Omalu examined his brain. At first glance, there was no discernible difference with Webster's brain. But Omalu had the brain further examined, which revealed large amounts of tau protein, which causes mood changes and functions similar to Alzheimer's disease.

Omalu went on to publish his findings in the science journal Neurosurgery but said that more research had to be done to see if there was any true link between NFL players and the long-term health impacts on an athlete's brain. Omalu went on to find the same results in the brains of several other deceased NFL players, eventually linking CTE to the NFL, drawing the ire of the NFL, which constantly refuted his claims.

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The findings led to years worth of courtroom battles between Omalu and the NFL, as well as multiple in-depth reports on Omalu's work, including "League of Denial." In 2015, the Hollywood film "Concussion" profiled Omalu's path of discovering CTE in the brains of deceased NFL players and the legal battles he faced with the NFL.

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This image released by Columbia Pictures shows Will Smith in a scene from, "Concussion." The movie is about Dr. Bennet Omalu, who is credited with being the first doctor to investigate chronic brain injuries suffered by football players.

All of this led to the rapidly growing awareness of not only what football can do to the brains of athletes, but what many contact sports can do to the long-term health of a brain. The attention to it has only continued to grow, with most sports implementing new rules that penalize direct contact to a player's head, in the hopes of reducing concussions.

Yet, even as more information is gathered about concussions, the knowledge about how to handle them still falls short of other sports-related injuries.

"When we are educating the kids now, and they realize the way they were treated and the parents listening to it can direct that same care when they're on the field," OSS Health D.O. and certified ImPACT physician Dr. Jim Gilhool said, "understanding the way this is treated will certainly get to the point where it's common knowledge, just like if it's a sprain. Do you put ice on it? Do you rest it? Do you keep it elevated if it's a sprained ankle? We want that knowledge sent out to everybody with respect to concussions. One concussion, no big deal. But a concussion on top of a concussion? Then we're playing with fire.”

Dr. James Gilhool at OSS Health in York, Pa. on Friday, Jan. 29, 2016. (Dawn J. Sagert - The York Dispatch)

What constitutes a concussion: Before any extensive research started to get done on concussions, if a player suffered a head injury in a game, they didn't think too much of it. Unless the athlete was knocked unconscious, more often than not, the player would do his or her best to shake it off and get back in the game.

"When I was growing up playing football, it was you got your bell rung and got right back in there," West York athletic trainer Eric Rodgers said. "Back then, they used to use smelling salts, which they don't do anymore. It's just a lot of out-dated information that people are slowly coming around to right now."

For the most part, unless an athlete is knocked out, it can be tough to diagnose someone with a concussion. Aside from loss of consciousness, other signs and symptoms for concussions are: tiredness, vomiting, sensitivity to light, headaches and memory loss, among several others, according to WellSpan Health medical director of sports medicine Dr. Mark Lavallee. He said it's also worth pointing out that a concussion must have some sort of action that causes those conditions. A simple headache from inactivity doesn't constitute a concussion.

Dr. Mark Lavallee is a sports medicine doctor at WellSpan York Hospital. John A. Pavoncello photo

"It has to be in correlation to recent activity," Lavallee said. "So, you can be concussed with you standing still and a ball hitting you on your head, or you moving and you hitting your head against a wall. But you have to be moving. There has to be movement. I've had football players concuss themselves just by whipping their head around to catch a pass. No hit at all, but it's movement related."

National impact: The recent growing awareness about concussions has quickly made an imprint on the national sports scene, mostly at the youth and high school level.

According to the American Association of Neurological Surgeons, roughly 1.5 deaths occur each year because of concussions in sports. In 2014, there were four such instances. In most cases, the death is caused by second-impact syndrome, or when an athlete suffers a second concussion before the first one is fully healed. Second-impact syndrome is the result of the first concussion not being properly diagnosed, usually because of the athlete not disclosing that he or she has suffered a head injury to a team physician.

While there are tests out there that can raise awareness to if an athlete suffers a head injury, it ultimately falls on the athlete to be the first to bring attention to their health.

"One thing that people have to realize is that the younger the athlete, the more cautious you have to be with an athlete because their brains are still forming," Rodgers said. "Whereas younger kids, wrestlers for instance in the elementary level, they can get twisted up and cry for a little bit and then be all right and get back out on the mat. But it's not like that when you're dealing with the head. So people really have to be cautious with the younger athletes because they can really have some issues further on down the line. ... We have a couple subjective tests that we can do with them, but in terms of on the sideline, you have to be very succinct with what they're experiencing.”

— Reach Patrick Strohecker at