Crusading Against Concussion

Thomas Jilk

Speaking at a football coaches’ seminar, Nicholas Murray looked out into the audience to see sparse attendance. He knew more coaches were at the event. He knew some had decided to skip his presentation.

They would rather mingle in the hallway than face an issue threatening public opinion about the safety of the South’s most coveted sport.

Murray is no stranger to the concussion stigma. The Georgia Southern University kinesiology professor and director of concussion research has been confronting the effects of concussions head-on since his arrival from the University of Texas-El Paso in 2014.

“A lot of people don’t want to hear it,” Murray said. “They want to ignore it, and I know people still, to this day, even at the higher levels of sport who just say ‘well, concussions are a myth.’ I’ve had coaches recently tell me that. They go ‘everything you do doesn’t really matter because it’s not real.’”

But Murray understands that just because the growing field of research surrounding concussions is still in its infancy, that doesn’t mean the research isn’t real.

The team

Murray’s mind is not the only one at GS set to the task of broadening the body of knowledge concerning the effects of concussions. He is joined by other GS professors: Tamerah Hunt, Ph.D, from the athletic training program and Barry Munkasy, Ph.D, of the kinesiology department.

The professors work closely with the athletic training staff, especially the associate athletic director for sports medicine, Brandy Clouse.

A group of graduate assistants conduct evaluations in the biomechanics lab – on the bottom floor of the Hanner Building – recording and analyzing a plethora of concussion research data.

Aside from conducting original research, the team assesses and monitors GS athletes who have suffered head trauma and allows members of the community, including children, who are affected by blows to the head, to be analyzed.

Hunt explained that the work done in Statesboro is well-rounded compared to other universities.

“The testing that is occurring here at Georgia Southern is comprehensive in nature,” Hunt said. “It takes into account multiple factors, so we’re looking at balance and posturography, we’re looking at visual tracking, we’re looking at cognitive abilities. We’re looking across the board, not just one or two pieces of the puzzle.”

The team’s contributions range from tangible, published research to intangible and insightful advice to parents wondering aloud if they should let their kids play football.

Murray underscored the importance of working collaboratively with the athletic training staff to make sure all head injuries are treated properly. He said the access that GS researchers have to their community is unrivaled in the country, and that their work is on the cutting edge nationally.

“Our sports medicine staff is outstanding,” Murray said. “We take it very seriously that we invest a lot of money and tools and things to help us with a diagnosis.”

Sensors are in the GS helmets in practice and in games, and if a hit on a player reaches a certain force threshold, that player is assessed for a concussion. The team is always watching.

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What do we know?

By using the Wii Fit Soccer heading game, Murray and Munkasy discovered in a groundbreaking 2016 study that athletes who had suffered a concussion 24-48 hours prior to testing exhibited excessive eye movements compared to non-concussed subjects.

“We discovered that vision actually plays a role in all this,” Murray said. “When you have too many of those movements of your gaze, they become error-ridden and you don’t get the information from the environment that you need.”

In other words, if a running back suffers a concussion and insists on staying in the game, he may not see a linebacker coming from his blind side because his gaze is averted elsewhere, making him susceptible to further injury.

Murray said the consequences of constant eye movements could contribute directly to a host of on-field issues “like colliding with another player or balance problems or not being able to see the hurdle that you’re going to jump over, or missing the ball or missing the tackle.”

In about 90 percent of sport-related concussions, regardless of age or gender, the athletes exhibit visual abnormality to some extent, according to Murray. The question then becomes about how long the effects can last.

It remains unclear, although Murray said certain noticeable symptoms seem to hang around for a month or more.

“They’re still very elevated in terms of their abnormalities in their balance and posture,” Murray said. “They’re at day 30 and they still haven’t recovered.”

Hunt is zeroed in on educating young athletes and parents, and one of her studies quantified how a concussion-education video is an effective tool to steer injured athletes toward reporting symptoms rather than trying to hide them.

According to the study, Hunt found “an increase in the reporting of concussion history and knowledge of symptoms after watching a concussion-education video.”

This is based on the idea that a majority of high-schoolers are unaware of the potential consequences of concussions. These include the degenerative brain disease known as chronic traumatic encephalopathy (CTE) that has been discovered in the brains of 99 percent of NFL players who reported symptoms during their lifetimes. CTE has been blamed for the suicides of prominent football stars like Junior Seau and Aaron Hernandez.

Hunt is part of a team that was recently given a Centers for Disease Control grant to explore how to change the perception of head injuries.

“What this grant is going to look at is how we educate the parents, the coaches, the referees, the athletes,” Hunt said.

Uncharted territory

While certain studies reveal troubling results for athletes involved in violent sports like football and boxing, the researchers’ understanding is still too incomplete to steer kids away from these sports.

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“There’s no longitudinal study that studies a student-athlete from the age of 5 when they may start playing sports and then tracks then through retirement from a professional sport, so we don’t know.”

She added that some studies, including the recent one that received national media attention for resulting in 99 percent diagnosis of CTE in former NFL players, have biased samples and cannot be completely trusted.

“Until we know the true long-term effects … I think it’s hard to make just a blanket statement that this is what’s happening,” Hunt said.

Murray acknowledged that the science is opening eyes for some people, if not for the coaches in denial refusing to listen to his presentation.

“Contact football participation is dropping, and I think it’s primarily because the parents are scared,” Murray said. “Or they know, maybe, the facilities don’t have access to appropriate health providers and medical care.”

Hunt cited the benefits of football, including “socialization, team sportsmanship and discipline,” as – for now – outweighing the negative effects of repeated blows to the head.

Murray, a die-hard Los Angeles Chargers fan, agreed: “Take away football from our lifestyle, it changes the way that we act, I think.”

He said kids learn to become better adults when they play sports, but that accessing children in order to study them is a huge challenge. Another challenge, he said, is getting people to acknowledge the science.

According to Murray, some college football programs report having zero concussions every year, which he thinks is “really, really farfetched” and a result of the stigma of being injured in football. Players don’t report because they don’t want to be seen as weak, and coaches don’t report symptoms because they aren’t looking for them.

“We listen to the science and we apply the science,” Murray said.

Big picture

In an incisive column for The Washington Post, legendary journalist George Will wrote, in light of recent research, that the sport of football would never again be “the subject of uncomplicated national enthusiasm.”

The fact that players consistently top 300 pounds nowadays makes collisions that much more dangerous because – thanks Isaac Newton – as mass increases, so does force.

Dr. Bennet Omalu, the researcher credited with discovering CTE portrayed by Will Smith in the major motion picture “Concussion”, has said that letting kids play football should be considered “child abuse.”

Tom Brady has been under fire for telling reporters that his concussion history was none of their business.

The issue has stepped onto the national stage over the past ten years. As researchers publish findings and prominent figures weigh in, the concussion research team at GS remains steadfast in its contribution.

Hunt said, “As things are coming out and the world is evolving, Georgia Southern is staying up with the times of the evolving world that is concussion.”