Sports-related concussions - media, science and policy

Abstract

Although growing awareness about the potential long-term deleterious effects of sport-related concussion has led to increased attention to the risks of collision sports, calls to ban these sports, such as American football, might be premature. Collision sports have a relatively high incidence of concussions, but participation in these sports also confers a host of benefits. In addition, the associated risks of participation, including concussion, have not been definitively shown to outweigh the benefits they provide, and the risk-benefit ratio might vary among individuals. The risks of concussion and repetitive concussions associated with collision sports are unknown in the general population and not well characterized even in elite athlete populations. In this article, we discuss current knowledge on sports-related concussion, its neurological consequences, and implications for regulation of the practice of collision sports.

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Figure 1. From concussion to CTE — sequence of events and knowledge gaps

Data from clinical case series and animal models suggest that athletes who sustain concussions could develop a form of tauopathy, chronic traumatic encephalopathy (CTE), which leads to the deposition of fibrillary insoluble proteins and progressive deterioration of brain function. A definitive causal link between concussion and CTE has yet to be established, however.

Figure 2. Rates of concussions linked to main collision sports in student athletes

The rate of concussions (25 sports) and recurrent concussions (17 sports) per 10,000 exposures was measured by the National Collegiate Athletic Association Injury Surveillance Program from 2009–2010 to 2013–2014 in student athletes, during practice and competition. Adapted with permission from SAGE Publications Ltd © Zuckerman, S. L. et al. Am. J. Sports. Med. 43, 2654–2662 (2015).