Strong, Frequent Hits to the Head aren't Good for the Brain

Strong, Frequent Hits to the Head aren't Good for the Brain

This may be one of the dumbest headlines we have written ever.

Who wouldn't guess that hitting your head hard, and often, could increase the chance of brain damage?

But it turns out to be very big news for any person who plays football or has a child who plays football, or other head impact sports.

The Journal of Neurotrauma has just published a study that shows that the number of times your head is snapped back during sports play after your body (not just your head) is hit, predicts later loss of brain function better than the number of concussions.   http://online.liebertpub.com/doi/abs/10.1089/neu.2016.4413

The New York Times has a summary of their findings.  http://www.nytimes.com/2016/04/01/health/study-focuses-on-repeated-hits-not-concussions.html?rref=health&module=Ribbon&version=origin&region=Header&action=click&contentCollection=Health&pgtype=Multimedia

The findings, although very plausible, are very disturbing.  The key findings were as follows:

• The risk from snapping of the head to the brain begins in high school.  It is not an NFL only problem.   Head injuries and high school and college can cause lifelong impairments.
• The harm to the brain can come from direct hits to the head, or body blows that snap the brain.  It is the acceleration of the head, moving suddenly, even more than a blow to the head that hurts the brain.
• The life-long impairments following such blows to the body and head include:
• Loss of the ability to think clearly (cognitive impairment)
• Impaired ability to complete tasks at home and work (impaired executive function)
• Depressed mood and energy levels (depression)
• Loss of interest in life (apathy)
• The development of outbursts of abnormal behavior (behavioral dysregulation)
• These impairments can start to show up anywhere from age 25 to 85, well after the person stops playing the sport that causes the head injuries.
• Even if the person experiences few or no concussions, these head snapping injuries still are associated with all these impairments.

BOTTOM LINES

• Sports are not free of risk- the most worrisome risk is the risk of losing brain function from sports that ask our kids to hit or snap their heads, hard
• Loss of brain function can be set in high school and college
• Sports that involve injuries to the brain may cause impairments in thinking, mood, even ability to be effective in the world that can last a lifetime and appear long after the person leaves high school and college.
• Football in particular stands out as a sport that can hurt the brain, even in young people, even in high school and college, not just the NFL.  In many ways, the impact of football on the brain is being revealed as more and more like boxing.
• The choices are also becoming very clear:
• Change football so that the brain is no longer hurt
• OR, protect our youth from these injuries by not playing football.
• Football is not alone, heading the ball in soccer, and other sports that require hitting the head in the sport should change their practices, and avoid brain injury.
• Since tracking concussions may miss most of the harm done, it becomes all the more important to focus efforts on making sure our children don't engage in activities that hit their head frequently.
• THE BOTTOM LINE:  The brain is important.  Frequent hits to the brain may cause permanent damage.  Some responses are inadequate, including trying to treat these injuries.  The only approach that makes sense is to stop the injuries from happening to begin with.

To your health,

Dr. Arthur Lavin

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