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SANJAY GUPTA MD
Dangers of Concussions
Aired January 28, 2012 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Oh, man. It's -- he's laying on the bed and his head is swollen. He's not moving. He's not talking. He needs help breathing from this, you know, this respirator. Man, I just lost it.
DR. SANJAY GUPTA, HOST (voice-over): Ten-fifty a.m., less than 72 hours after his first concussion, 16-year-old Jaquan Waller died.
The autopsy would reveal this: it could have been prevented.
(END VIDEO CLIP)
GUPTA: Hello and thanks for joining us. That's a glimpse of the documentary, "Big Hits, Broken Dreams."
You know, this morning, we are talking about this fascinating topic and all the latest findings on concussions, I think most importantly, how to prevent them. What do young players, their parents and their coaches really need to know?
And, by the way, it's not just football. It's other sports as well. In fact, not far behind is soccer, where, in fact, there are more head injuries in girls.
So, we invited soccer legend Brandi Chastain to join us. She's going to show us what she teaches her players to keep them safe.
First, though, on to the NFL. There was a hearing in Miami this week in federal court with more than 100 players and their families. They are suing the league over concussions. Right now, the judges are trying to decide on whether to combine these suits into a single case.
Meanwhile, the Super Bowl is set, Giants versus Patriots. Now, here's something you may not know. After the Giants won in overtime last weekend, some of the players talked about the 49ers kick returner who had two critical fumbles. The Giants said they had targeted him, his name is Kyle Williams, they targeted him, to knock him out of the game because they knew he had a history of concussions, including one just last month.
Now, all of this comes after a season where the NFL has taken many steps to try to fight back the tide of head injuries.
So, joining me to talk about this, from Seattle, is Dr. Richard Ellenbogen. He's co-chair of the league's Head, Neck and Spine Injury Committee.
Thanks for joining us, Dr. Richard Ellenbogen.
Again, and I want to talk about that Giants/49ers game in just a moment. But, you know, we have been investigating these concussions in football for some time and one of the things that was brought up to me while we were making this documentary was that, look, there is a culture. Players want to stay in the game and win.
That's no surprise. I mean, this is a competitive sport.
But if the doctors and the medical team are also part of the team, so to speak, they are the team doctors as you call them, does that culture extend to them? Are they empowered to pull a player of the field and keep them off the field?
DR. RICHARD ELLENBOGEN, CO-CHAIR, NFL HEAD, NECK & SPINE CMTE: You know, I can only tell you from my observations. I have not seen -- I have not seen where a coach has interfered with the team physicians. I think the commissioners made it pretty clear that the team physician's decision and the Professional Athletic Trainers' position on the field is not trumped by anybody.
And I haven't seen any evidence to the contrary. I can't speak to what happened in the past. But it's pretty clear now that the team physicians are making the final determination of who stays in the game nowadays.
GUPTA: Do you think there's any having that person be an independent person? Maybe a sign that every game, an independent medical professional to make that decision?
ELLENBOGEN: This team physician job as a warning is a huge job. They have to see them all through the season. Get a baseline on them, because you can't tell if a player is concussed unless you know what their baseline.
I think there's no better person than to take care of these players than the person who's seen them before the game, after the game and throughout the entire season.
GUPTA: One of the things that threw a little bit of cold water on all, and I know you knew about this. But the Giants/49ers game that we mentioned earlier -- essentially, the Giants players, at least one player said they were targeting one of the 49ers because they knew that player had four concussions. The NFL said, look, nothing illegal was done here. There was no illegal hit or anything like that.
But what did you make of that? I mean, targeting another player because they knew he had four concussions, it's like going for someone's bum knee, you know, in mixed martial arts or something like that.
ELLENBOGEN: Yes. You know, I read the same media reports you folks did as well. But I don't have any -- I don't have any firsthand knowledge of what happened. I watched the game like everybody else. And so, I can't really specifically comment on that event.
GUPTA: A couple of things that I just want to point out real quick, Michael Vick, Colt McCoy -- I know you're a football fan -- kind of high profile incident this year where the quarterbacks suffered a head injury and were seemingly back in the game pretty quickly. I mean, it seemed like from what we have been talking about, that's what's supposed to be prevented.
And these players looked like they had -- they got hit pretty hard. They got concussed and yet they were back in the game. How could that happen?
ELLENBOGEN: Well, you know what? So, the first game, we had a spotter. I was both on the field and up in the media box. I actually see how it can happen.
It's like looking through a microscope. You have a very small field. When you are on that field, you see only the ball and the person running with the ball. You don't see the entire field.
And once you are up in the media box, you get a 360 view of the field.
So, I think it's very easy not to see all 22 players all the time on the field when you are on the sidelines and there are 6'8" guys standing in front of you. I think it's a lot different when you add professional athletic trainer in the media box who's looking down and sees everything. He knows both football and he knows, you know, medicine. And they can spot that.
GUPTA: It's -- you are painting some of the realities of again, some of the evolving signs, but some of challenges still ahead.
Quick, last question, do you got a pick for the Super Bowl? Are you allowed to even talk about that being on the committee?
ELLENBOGEN: Yes, no, I've -- you know what? You know, I was born in New York City and I was raised -- I mean I was trained in New England. Now, how about that for having a schizophrenia about who you should root for?
GUPTA: I applaud your work. I hope we can continue to talk to you. And go Giants and Patriots, I guess.
ELLENBOGEN: Yes, that's right. Thank you so much Sanjay. Take care.
GUPTA: Thanks, Dr. Ellenbogen. Appreciate it. Thank you.
And coming up, I'm going to show you what parents and coaches, not to mention young players as well out there, really need to know about concussions and how to keep everyone safe. That's next.
Every season, according to the Sports Concussion Institute, one in 10 high school football players get a concussion. Thirty-five percent get more than one.
(COMMERCIAL BREAK) (BEGIN VIDEOTAPE)
GUPTA: A concussion is a brain injury. People think of it as getting your bell rung or getting a ding. But the truth of the matter is, that it's a brain injury.
The biggest cause of a concussion is getting hit to the head. But it can happen in all sorts of different ways. It can happen certainly on the sports field, on a helmet to helmet collision, for example.
But it also can happen in ways that you might not expect. For example, in a car accident, even if your head doesn't hit the dashboard or hit the windshield, just the violent moving back and forth of the brain within the skull during a car accident for example, can cause a concussion.
People think, for example, if this is the brain, around it is a skull and then you have a helmet. If there's a blow, you just get a blow to the brain.
That's not exactly what's happening. Typically, if all of a sudden this brain is moving this direction, another helmet, for example, is moving this direction, then they both suddenly stop, what happens is brain keeps moving within the skull, bounces back and forth, almost like a beach ball in a swimming pool.
Now, at the same time that's happening, the brain is actually elongating. It's like almost a fluid medium. It feels like just -- almost like jell-o. And it's going back and forth and stretching out at the same time. And that's really what ends up causing that concussion -- the back and forth, the stretching out.
One thing to keep in mind about concussions, they don't mean that you necessarily lost consciousness. People can have concussions and have been awake -- a really important point. Typically, someone is just going to feel a little bit out of sorts. They may have a hard time figuring out where they are, what their surroundings are, they may be seeing stars, especially in the outside of their vision, the periphery of their vision, things may sound hollow because their hearing is not quite intact right after a concussion.
But, typically, it's people around somebody that has had a concussion that are going to notice the most.
All people recover differently from concussions. Some people could take weeks to recover. Some people may take just a few days. But the key is that they have to be absolutely symptom free. They can't have any symptoms at all, because what that means is the brain is not completely healed. And if the belt is not completely healed and the person gets a concussion, then all of a sudden, you have taken a problem that someone can recover from and turn it into a potentially fatal problem.
Now, the brain needs rest. That means lots of things. No texting for example. No screen time. Reading puts a strain on the brain. So, tell people to really, completely do nothing at least for several days until all their symptoms have gone away then you slowly resume activity.
GUPTA: Now, I tell you, I have seen this quite a bit as a doctor, but I also learned this from my investigation of head injuries and looking at young football players in particular.
For example, you know, a lot of discussion about helmets like this one -- the way to think about that, they work great to protect your skull. But when you are hit hard, your brain is what's moving back and forth from the shock wave inside the skull. It's moving back and forth and the helmet can't do anything to stop that movement. So, as a result, a helmet cannot fully protect against concussions.
Also know that forward thinking schools and teams all across the nation now give baseline cognitive exams to players at the beginning of the season. This is important. Why? Because later, if a player is hit but says they feel just fine, you can re-examine them to see if they really back to 100 percent. If not, it's a sign you need to give the brain rest before putting him or her back in the game.
And next, we are going to talk about a different sport, one that I love to play as well, soccer. Among high school athletes, it's a number two sport, though, for concussions. This will surprise you but girls are in fact more at risk.
So, in just a moment, we are going to this lay here, Brandi Chastain, U.S. soccer team sensation. A lot of people know you, Randi, I don't know if you can hear me. But hello.
We'll be with you in just a moment --
BRANDI CHASTAIN: Hi.
GUPTA: -- to hear how you are going and to get some tips as well about preventing concussions in soccer.
Stay with us. It's right after the break.
GUPTA: With flavors like glacier freeze and riptide rush, you have to wonder, what really goes into a sports drink.
LAUREN ANTONUCCI, DIRECTOR, NUTRITION ENERGY: There are three things a sports drink needs to contain: fluids -- which is a pretty easy one -- and the right amount of sodium and the right amount of carbohydrates.
GUPTA: It doesn't have to be fancy. You could drink pickle juice. ANTONUCCI: Pickle juice has a ton of sodium. They have done studies on it now showing how it relieves muscle cramping once athletes are already dehydrated and cramped up.
GUPTA: Call me old fashioned but a Gatorade shower sounds a lot better than a pickle shower.
Another choice, coconut water, all natural and lots of potassium.
And when you are done with the tough work out, how about a big cool glass of chocolate milk?
ANTONUCCI: Most people use it as a recovery drink. It's trendy. People love the fact they can drink chocolate milk, do your exercise, you drink your chocolate milk. It does have what's needed, which is carbohydrate fluid and a little bit of protein.
GUPTA: Drink up. That's "Food for Life."
GUPTA: Lots of good advise there for any athlete.
You know we have been talking about a lot of concussions and football. But as a father of three girls, you know, one of the big takeaways I have with my "Big Hits" investigation is that women and girl athletes are, in fact, more susceptible to concussions as compared to men and boys. It takes a tool.
In fact, in a national study in high school team sports, girls soccer had the second highest number of concussions, about as many as in football. The biggest risk comes when these players to head the ball.
And learning this, I thought to myself, who better to talk to than Brandi Chastain. She has a lot of information.
She's joining us from Santa Clara where she nowadays works with players on the college team there.
Welcome, Brandi. So good to see you.
BRANDI CHASTAIN, 1999 WOMEN'S WORLD CUP CHAMPION: Well, thank you so much for having me. I appreciate it.
GUPTA: I think, I have to say, you know, I think almost everyone remembers you serving from the penalty goal. You scored in the 1999 World Cup Final and celebrated it, those famous images of tearing off your shirt. The magazine covers were everywhere.
You know, back in that 1999 game, your teammate Michelle Akers, actually had a concussion and I wonder, first of all, at that time, you know, just watching a teammate go down, it must have been really hard.
How much did you know about concussions? How concerned were you about that? CHASTAIN: It was difficult to see her go down from a standpoint of she's important to our team, not so much into -- oh, this is a concussion and this is what that exactly means, because the information wasn't as out there as it is now about, you know, what it means to have a concussion and what literally happens to the brain when there is a concussion. So, I don't think we were as educated.
GUPTA: One of the stats as well -- frankly, I learned -- I don't know if you know this, Randi, but they say in a study, take soccer for example, for example, as a sport, if you compared girls and boys or men and women, women are 68 percent more likely to have a concussion playing soccer as compared to men who play soccer. Basketball, women are three times more likely to have concussions as compared to men who play basketball.
So, do you have any idea -- has anyone ever told you that? Do you have any idea why that might be?
CHASTAIN: It's a shocking statistic in terms of the disparity. But it's not surprising to me because when I watch young girls and watch young boys when they're first learning about being physical and being on an athletic field, it seems that the boys are a little bit more aware spatially than young girls.
And part of it for me is not so much about hitting the ball. It's more about how fast is an opponent coming, where is your body in space? How do you protect yourself?
And I don't think there's actually enough education about not too much preventing concussions, so to speak, what happens when you get your head hit, but how do you protect yourself in space so you might not have that head first collision and, you know, go on and be able to be happy and play in the game. So I think that's something we should talk about more.
GUPTA: Now, Brandi, since this is something that you teach and you coach, as well, can you show us a little bit about how to prevent these concussions?
CHASTAIN: Well, I think the first thing we do, Sanjay, is we teach the players about their spatial awareness when other people are kind of trying to infiltrate their space. So, we have four players here that are showing a little bit of shielding the ball. And if you notice that they have their arms out creating a barrier between themselves and the defender to keep the ball away.
That's it, girls, now, let's take the ball and we'll put it into the air. So, that's something that happens when the ball is on the ground. We still want to have the kids protect themselves because they don't want to get close to anybody's head.
So, now, as we know, the ball and soccer gets into the air a lot. We've asked Kate and Morgan to show how to protect themselves, how to get away and separate themselves from the defender. Good. Morgan has created some space for herself. So it's Kate and Katie. Good. And, Lauren. Good. Notice they have their arms out, protecting themselves and this is something that you can do with your kids on a regular basis out on the field. Get them to get their arms out so, again, when the ball is in the air, Morgan separates herself from Kate.
You know, we got two very tall players, very good in the air. They seem to be dominant over -- not that (INAUDIBLE) that tall. You know, she's a good 5'1", but, you know, it's important for them as much as it is for Lauren to be able to protect herself when the ball comes into the air. Good.
GUPTA: There's one thing really quick, Brandi, before I let you go -- 1,300 hits per season a head -- per season, I hear, for each player on average. That seems like a lot of heading of the ball and a lot of that takes place during practice, I imagine.
Is that necessary? Because we heard about these minor hits to the head also being problematic in the long run.
CHASTAIN: Absolutely. And I'm glad you brought that up, because I think the actual heading technique is really important. If you watch each one of these players as I throw the ball to them, the space they're hitting the ball is right here.
I think with young kids, they get a lot of balls that are up on the top of their head, maybe to the side of their head, coming across the ball, using their neck. These players are technically really gifted, so they know that there's a space that just above your eyebrow, that if you attack the ball, hitting it here, it creates almost -- you almost don't feel it. It's like when you have a good golf swing and you hit the ball just right.
So, again, we'll show Morgan, nice right with the space right above the eyebrows. Good, Katie. That's it, Lou.
So, again, I think good technique, good technique on the ball.
GUPTA: Right, right.
CHASTAIN: You know, with I think education is everything and it's a good thing that you're bringing it up. You know, the NCAA puts out information and each university has their own protocol on how to deal with a concussion after it's happened.
But we haven't talked a lot about how to prevent it. I think if we educate our players about spatial awareness, good technique with how you actually head the ball and with what space, I think we'll see those numbers go down.
GUPTA: Well, it's fascinating. I could watch it all day. Again, it's so great to see you and see what you're up to your players, as well.
Brandi Chastain, thanks so much. We appreciate it.
And coming up, though, we have a former NFL player who found a sense of mission when he learned what these head injuries can do.
But before we go to the break, here's a little bit more of the documentary called "Big Hits, Broken Dreams."
(BEGIN VIDEO CLIP)
GUPTA (voice-over): Sub-concussive blows are the everyday hits, small hits. They don't cause concussions. An average high school player sustained more than 650 of these hits per season.
(on camera): You're talking about people in their -- you know, young, in their 40s developing dementia, almost Alzheimer's-like diseases. It could be a result of many smaller hits over their career.
UNIDENTIFIED MALE: A series of those sub-concussive insults to the head that add up over time.
(END VIDEO CLIP)
GUPTA: At the University of Wisconsin and then on to the Detroit Lions, Lamar Campbell was known as a fast, tough defensive back. He played corner back and safety. And he knew the drill.
He was expected to hit people and hit them hard. If he got hurt, you shook it off and you just got out there on the field. Simple enough.
But when he left the game in 2002, he learned that that hurting, it wasn't done.
GUPTA (voice-over): Lamar Campbell has achieved what many young men only dream of. After four years starting for the University of Wisconsin, he made it to the pros.
LAMAR CAMPBELL, HOST, LIFE AFTER THE GAME: I got offered to come to camp for the Detroit Lions as a free agent in 1998. I made the team and played with them for five years.
GUPTA: Injuries ended his NFL career. But Campbell successfully found a new life after the game -- as a real estate broker. And radio talk show host on the Voice of America's sports network. It's a platform he uses to educate other players about transitioning to life after football, as well as the dangers of injuries he can't really see -- repeated hits to the head.
CAMPBELL: It's the perception of what a concussion was, was different. I don't think you had a concussion until you were knocked out on the field, and we looked at it as a budge of honor.
GUPTA: As a player, he didn't know that concussions could cause serious injury to the brain. Now, Campbell says playing football takes years off a player's life.
CAMPBELL: I wake up with cramps all over my body and headaches and migraines.
GUPTA: He says he's also suffered some memory loss.
CAMPBELL: There were situations where with I didn't remember certain series. I would be out there and not realize exactly what was going on.
GUPTA: While he was never diagnosed, looking back, Campbell believes he had over 10 concussions in his football career. And he believes players today need to recognize the symptoms and be willing to let their brains heal.
CAMPBELL: I think the education of it is what I would like to change. Let guys know how to play the game safely. You can still have a great hit. You'll still be as successful as you want to on the football field.
GUPTA: He hopes the culture of the game will soon change, so if his son wants to follow in his footsteps, it will be a safer game.
GUPTA: That does it for SGMD. Thanks for being with us this morning.
You can stay connected with me, by the way, throughout the week on my Lifestream at CNN.com/Sanjay. Also, join the ongoing conversation on Twitter @SanjayGuptaCNN.
Time now though to get you a check of your top stories in the CNN Newsroom.