In the past two weeks alone, University of Michigan football coach Brady Hoke has been criticized from one end of the country to the other for how he handled an injury to one of his players, and the organizing body of the world’s biggest sport bent to mounting public pressure to change how it operates.
The common issue they faced? Identifying and treating concussions in sport.
Hoke blamed miscommunication to explain how he allowed clearly woozy backup QB Shane Morris to play an additional play against Minnesota on Sept. 27. The 2014 World Cup in Brazil proved an incredible spectacle, yes, for the popularity of the beautiful game, but also for seeing the governing body of the world’s largest sport play fast and loose with head traumas.
The problem in pushing for better diagnosis and treatment of head trauma—in sports, in warfare, in every day life—isn’t understanding the medicine or physiology off the field.
We know concussions are dangerous. Rebound concussions (a second head injury before the first is fully healed) are more dangerous, and multiple concussions are capable of eroding one’s physical and mental health over the long haul.
People like Kevin Guskiewicz at the University of North Carolina, Chapel Hill and former Harvard football player and pro wrestler Chris Nowinski have dedicated themselves to laying out the science and pushing for a universal protocol to deal with head trauma.
The problem is changing the attitude on the sideline. FIFA’s protocol was outed as a sham over and over again in Brazil. During the group stage, we saw Alvaro Pereira of Uruguay get kicked in the head against England and lay prone on the field. He appeared out for the game but came to minutes later and convinced team doctors that he would play on.
During the semifinals, Argentina’s Javier Mascherano continued to play against the Netherlands despite knocking skulls with a Dutch opponent while trying to head a ball in the air.
During the final between Argentina and Germany, 23-year old Christoph Kramer, making his first international start for Germany, collided with an Argentine player and promptly lost all memory of the hit, playing another 14 minutes, the sideline evaluation, getting to locker rooms, and all of halftime. In Kramer’s case, the referee and German team captain Bastian Schweinsteiger proved instrumental in eventually getting Kramer off the field.
In international soccer, strict substitution and timeout limits make any lineup change a huge deal. Competitive tension undercuts the communication necessary to properly handle head trauma. Who has the final authority to say a player must leave a game? A team or independent doctor should. Yet, we still see people hesitate in the heat of competition.
Here in the United States, we have mulled over the issue with extra fervor for the past decade, prompted by high-profile suicides of former National Football League players following playing careers filled with concussions. The NFL, for years denying the long-term effects of multiple concussions—depression, cognitive impairment and neurological damage—finally began changing its tack.
Football is a macho sport. Players rarely flinch when they have to play hurt. That culture doesn’t nurture the necessary trust between players and doctors needed to keep players safe. Men lose jobs and their livelihoods when they can’t play. Lying to play is the norm.
Why do we have to wait for these major bodies to do something about the problem? Because we’re talking about a cultural shift, a change in attitude. The NFL, FIFA, the NCAA—these organizations have the reach to set that in motion. They also have a moral responsibility to do so.
Which brings us to health communication. Protecting athletes when they’ve experienced a head trauma starts on the sideline with strong communication—clear, concise and firm, with the proper authority backing it—to do any good. Whether acting professionally or personally, we can always advocate for the health of the athlete.
Saying, “No. You cannot play,” is hard. We love our sports. Youth is fleeting and our opportunities to physically perform are limited in a beautiful, achingly melancholy way.
Still, we know what to do when skulls hit hard surfaces. We cannot hesitate. We must stop. We must follow the protocol following a concussive event.
We must say no.
Luciana Chavez is a graduate of UCLA with a master’s of science in health communication from Boston University. She first began wring about sports concussions while covering college sports in Raleigh, N.C. She covered football at all levels during her journalism career.