Concussion Update (Part4)

There have been a number of developments since my last concussion update.

Arsenal actually got back to me in response to my e-mail about the Laurent Koscielny incident.  They informed me that he was removed from the game not due to a concussion but due to significant discomfort caused by his stiches and head dressing.  The American TV broadcasters told us it was a concussion, but post game reports stated that it was not.  I did try to search for those reports them when I wrote my prior post, but I did not find them at that time.

That being said, Koscielny was exhibiting the symptoms of a possible concussion so I hope that he was properly checked out before being allowed back on the field.  And, as always, I am concerned about the speed with which players are checked out and allowed back into the game.  Of course, since Koscielny did not have a concussion, allowing him back into the game, even prematurely, would not have presented the significant  health risks involved in a second concussion.

I found an interesting website that deals with concussions called the concussion blog.  I highly recommend it.  The link is in the side bar of my blog.

A class action lawsuit has been filed in California against FIFA, American Soccer, and the American Youth Soccer Organization over brain injuries and concussions. The lawsuit has the potential to be very significant or to be a complete nothing.  I will comment on it more in a future update after I get the chance to look at the documents.  Since it was filed in a California court I will have a fair chance of understanding what is going on.

Apparently, research performed by the Medical Director of the State University of New York at Buffalo’s Concussion Clinic, John J. Leddy, and others has found that it is difficult to distinguish between concussions and neck injuries based purely on the symptoms. (See here and here.) 

The research concluded that some patients who were told they had suffered a concussion and whose symptoms persisted for several months may actually have suffered a neck injury instead of or in addition to a concussion.  They concluded that there is no way to separate out the two types of injuries based solely upon their symptoms.  Moreover, the appropriate treatment for a neck injury and for a concussion is completely different so an accurate diagnosis would be helpful.  As a result, they recommended that people who have suffered symptoms of concussions over a long period of time should be examined for a neck injury by a qualified doctor.

Of course, this does not mean that it is safe to return injured players to the field faster simply because they might have a neck injury.  Presumably, someone with severe neck injury that mimics a concussion probably should stop playing football for at least one day.

However, if I understand their recommendations, they are only recommending that people who suffer symptoms for several months be checked for a neck injury.  This seems strange.  If the neck injury can be detected earlier, the appropriate treatment could be started earlier.  However, I am not a doctor so possibly I am misunderstanding the recommendation or something else.

There have also been several more possible concussion incidents in BPL games I watched.  The first happened in the 13 September 2014 Southampton-Newcastle game.   Shane Long was whacked in the head by the Newcastle goalkeeper.  It was clearly a penalty, but apparently the official did not see the head contact.  This may explain why the referee did not stop the game and have Long examined for his head injury.  He probably thought Long was faking his injury.

In any case, Long went down at 3:04 but was up and moving around by 3:14.  I don’t know exactly when he stood up because the camera was not on him the whole time.  Instead, they were showing replays of the incident--at least on the version of the game shown on the NBC American mobile app.  Sometime in the 28th minute, play was stopped and Shane Long was walked off the field in the company of physios.  At 28:07, his vision was checked with the finger moving back and forth in front of the face test. He was allowed back on the field around 28:55.  He was removed at half time in what Ronald Koeman characterized in a post-match interview as a forced change.

Once again, it appears that the new concussion rules were not followed.  Long was displaying symptoms of a potential concussion.  He should have been checked immediately to see if he had a concussion.  Yet, he was allowed to play on for approximately 24 minutes.  Then his status was checked in a matter of seconds before he returned to play.  Yet, at half time they decided that he had suffered a serious enough injury to require removal from the game.

I have checked the internet but have found no official statement that Long suffered a concussion.  However, at least one website reported the injury as a concussion.  At the 18 September 2014 press conference Ronald Koeman said that Long had suffered a head injury, had been back in training for three days, and could play on Saturday.

There were also two incidents in the 27 September 2014 Southampton-QPR game.  The first involved Sandro. The protocol was correctly followed and Sandro was removed from the game immediately.  The second involved a clash of heads between Wanyama and Eduardo Vargas at 37:13.  Vargas walked off the field holding his head at 37:40.  He was bleeding. He returned to play at 38:27.  Presumably, this means he had a cut, not a concussion.  Again, the evaluation seemed overly fast to me.

Finally, there was a head injury incident involving Dejan Lovren.  However, I have misplaced my detailed notes about the incident and, in any case, the people who read my blog probably have a limited interest in wellbeing of Dejan Lovren’s head.