In all full collision professional sports (football, hockey, boxing, ice skating, Australian Rules football, soccer, cycling, skiing, snowboarding, martial arts, gymnastics), head trauma occurs a lot more than what is reported. The awareness level has grown in the past several years due to the sudden death of professional players, the mounting cases of early onset dementia, not to mention suicides.

A concussion is a traumatic brain injury that generally results in a severe headache, altered levels of alertness, and even unconsciousness. The trauma to the brain temporarily effects functionality including short-term memory loss, judgment, reflexes, speech, balance, coordination, and sleep.

A concussion can result from a fall, sports activities, and car accidents. Significant movement of the brain (called jarring) in any direction can cause you to lose alertness (become unconscious). How long you remain unconscious may be a sign of the severity of the concussion. Many years of studying concussions have shown that individuals sustaining a concussion don’t always involve a loss of consciousness. Most people who have a concussion never black out. You can have a concussion and not realize it.

Concussion Symptoms

Altered level of consciousness (drowsy, hard to arouse, or similar changes)

Confusion, feeling spacey, dizzy or not thinking straight, can’t account for lost time

Severe long term/short term headaches

Loss of consciousness

Memory loss (amnesia)

Nausea and repeated violent vomiting

Seeing flashing lights

Changes in alertness and consciousness

Convulsions (seizures)

Muscle weakness on one or both sides

Persistent unconsciousness (coma)

Unequal pupils

Unusual eye movements (uncontrolled eye-lid movement)

Walking problems

According to my medical sources, when recovering from a concussion, the athlete or anyone may have some of the following issues for short periods of time, and depending on the severity, could be an extended amount of time.

Withdrawn, easily upset, or confused

Have a hard time with tasks that require remembering or concentrating

Less tolerant of noise

Signs and tests

As I have witnessed while doing my job as the sideline reporter for 101 ESPN, the flagship station for the St. Louis Rams, NFL trainers and doctors will perform a physical exam and check a player’s nervous system. They look for changes in their pupil size, thinking ability, coordination, reflexes and the ability to regurgitate and repeat a short conversation. Other tests that may be conducted once a player is removed from the sidelines are EEG (brain wave test) may be needed if seizures are happening; head CT scan; MRI of the head. Treatment.

Some players struggle on returning depending on the severity of the concussion. When treating head trauma or a concussion the following may be included as treatment:

Eating small light-weight meals

Avoiding heavy exercise (weight lifting, no heavy running)

No alcohol beverages until completely recovered

All players should be monitored up to 24 hours after major or minor concussions. While allowing a player to go to sleep, trainers and doctors suggest that the player be awakened every 2-4 hours for the first 12 hours after the concussion.

Prognosis

There have been several NFL players put on injured reserve in 2011. Healing from brain trauma takes time and a lot of rest depending on the severity. There is no timetable, and depending on the person, it could take weeks and even months. During this timetable, the player may become very irritable, have trouble concentrating and completing minor tasks, have headaches, dizziness, and blurred vision that will come and go not to mention vertigo.

Major complications include the following: Bleeding in the brain (intracerebral hemorrhage), the second impact syndrome (SIS) is when a player or athlete receives a second concussion while still having symptoms from a first one. This raises the risk for brain swelling, which can be deadly.

Former St. Louis Rams and now Washington Redskins linebacker London Fletcher, who has never missed a game in 13 seasons, said some organizations follow the new rules stringently. But he said other teams still allow players to diagnose themselves.

“The NFL is taking concussions seriously for the first time in my career,” Fletcher said, “but there are still too many gaps in the new rules. Players being players are taking advantage of those gaps.”

“You know, that’s the fear I think that any player faces,” said Pittsburgh safety Troy Polamalu, who in many ways has become the poster child in the concussion battle. “And that’s the fear that any individual faces, overcoming any certain fears of being a coward, you know, and letting your teammates down or turning down a hit. That’s the beautiful thing about sports is these fears are right in your face and it’s pretty obvious if you turn them down or not.”

Asked if he worries the next hit will cause an even worse concussion, Polamalu says, “Oh, I have the fear, no question about it. But I’m willing to fight it, for sure. In the situations I had this year, I don’t think I would do anything differently. Third-and-1 with (Jacksonville’s) Maurice Jones-Drew, either let him get the first down or not? That’s the type of internal battle we fight as athletes.” Polamalu has had a reported up to seven concussions dating as far back as high school.

He said, “To this day, I don’t remember what happened. I woke up on the sideline, shook it off, and went back in.”

NFL spokesman Greg Aiello told CBSSports.com: “Part of the ongoing culture change in our game is making sure players buy into the health and safety priorities that we have established. Those priorities are an important part of the new CBA and the players deserve credit for that. But it is an ongoing challenge when you are dealing with competitive, tough-minded athletes and we have to keep working at it with the players.”

With today’s bigger, stronger, faster athletes especially when you’re talking football players, the threat of concussions have never been higher or frightening for these modern-day gladiators. Doctors and brain researchers are finding that a disease called chronic traumatic encephalopathy, or CTE, is a kissing cousin of Alzheimer’s. The disease CTE has been found in almost two dozen deceased NFL players.

Several lawsuits have been filed by former NFL players and I’m sure there are many more to come. Within the paperwork filed in federal court, players are saying they received Toradol, a very powerful anti-inflammatory drug that masks any and all concussion symptoms or injuries as well. The suit alleges that players who might have suffered concussions were given the drug and then returned to the field.

NFL trainers and doctors must also protect the player from the player. The new rules were designed to help protect players from some of these dangers and alleged abuses. Changing the mentality and culture of the NFL locker room through education and the dangers of playing with concussion symptoms, and the new NFL rules approved by the NFLPA, work to protect the players.