Head Games

Unecessary Roughness

Concussions are the talk of sports these days.  Ex-NFLers are filing suits against the league saying it is clear that the league knew about the dangers of head trauma, knew them a long time ago but, did nothing.  Parents in the U.S. and Canada are starting to pull their elementary and junior high kids out of tackle football and hockey leagues that permit body-checking.  Even the President has talked about his own experience with concussions (mild he was quick to note!) and convened a high level summit at the White House of all the movers and shakers in the field to discuss the problem.

The NFL is so freaked out about the threat concussions pose to the long-term profitability of the sport that they are trying to calm worried moms with ad campaigns that tout the certification of coaches who teach the ‘safe’ way to play (good luck with that).  And arguments are breaking out about whether there is too much emphasis on football and men’s hockey when wrestling, lacrosse, soccer, martial arts, and women’s basketball have their own problems with keeping player’s heads intact (kind of an odd form of anti-discrimination).  Some sports experts are even bemoaning the fact that the emerging obsession with preventing, diagnosing and treating concussions is diverting too much attention and resources away from other serious health issues that athletes face including bullying, eating disorders, orthopedic injuries and the abuse of legal and illegal drugs.

What has not been acknowledged in all the fuss about concussions is how many people are starting to make money from them. A lot of money.

According to Variety, Will Smith is the biggest name in a parade of Hollywood film and television folk ready to transform bashed brains into big bucks.  And the number of companies who are now peddling concussion related products from designer mouthguards to specialized helmets to voodooesque headbands is staggering.

So is the number of medical centers who are opening concussion programs, centers and institutes (my own institution, NYU, among them).  The less scrupulous of these institutions are offering remedies which, to put it politely do not rest on a whole lot of evidence but, cost a tidy chunk of change.  These include hyperbaric oxygen (no evidence), EEG and other forms of biofeedback (next to nothing) to acupuncture, deep tissue massage, myofascial release trigger point injections and laser therapies (really?).

Add in a passel of lawyers with class action, malpractice and malfeasance suits in their eyes, those on the lecture circuit offering advice on what to do about concussions, and software designers eager to peddle quick concussion diagnoses via phone, computer or video and you have the makings of a full-blown, here-to-stay, big-time concussion industry.

What can be done to trim the sales of those looking to profit off of the legitimate worries about and all too real problems associated with concussions?  It is time for the medical, legal, insurance and athletic industries to call for evidence-based standards.  And it is time to insist that those involved with concussion in sports admit what they don’t know as well as what they might know.

Concussion promises to be the sports health issue of this decade.  Those involved in health care need to be called to account not to overpromise when it comes to concussions.