Head injuries are a major problem in all sports and have been since they were created.  As sports such as football become more advanced, new methods of training and conditioning are created and players are becoming faster, stronger, bigger, and hitting each other with greater force.  As a direct result, head injuries are increasing and becoming an everyday risk players must face.  In fact all athletes playing any sport should be aware of the dangers present.  Head injuries are a life threating part of sports that athletes at all levels must be aware of.  They are known to cause deaths, life changing events, and problems in the future for retired players.  The culture of sports has a large impact on the way players handle pain and makes them feel they can play through anything.  This has made it very difficult for anyone to prevent serious damage caused by trauma to the head.  There are many questions that arise because of this involving ethics, decision-making, and safety precautions.  Players, coaches, officials and everyone involved with sports must realize how dangerous head injuries are and must understand the problems they may lead to in an attempt to create a safer playing field for players.

Traumatic Brain Injuries (TBI's), also known as a concussion, are an everyday threat to players of all sports that can result in permanent damage, death, and complications in the future.  A concussion or TBI is the banging of the brain against the skull, or excessive movement causing confusion, headache, sometimes bleeding and other quandaries (Sahler).  Concussions are a common injury in contact sports like football, hockey, and boxing where players travel at a fast pace and hit each other with great force.  There are various signs and symptoms that will help medical personnel determine whether or not a player has a head injury or not.

"Symptoms of TBI may include blurry/double vision, confusion, dizziness, excessive drowsiness, sleep difficulties, feeling hazy, foggy, or groggy, headache, inability to focus or concentrate, nausea, vomiting, and photo- or phonophobia."(Sahler)

Players must be careful of head injuries through out their career, middle school, high school, college, and professionals.  If any athlete receives a blow to the head and displays any thing similar to the symptoms listed above they should be taken out of the game and should not be put back in until they are cleared by a doctor.  If they are put back in they may suffer from Secondary Impact Syndrome or SIS.

"Second Impact Syndrome (SIS) consists of two events. Typically, it involves an athlete suffering post-concussive symptoms following a head injury.2 If, within several weeks, the athlete returns to play and sustains a second head injury, diffuse cerebral swelling, brain herniation, and death can occur. SIS can occur with any two events involving head trauma."(Bey et al.)
 
If an athlete renters the game too soon, he or she may suffer from Secondary Impact Syndrome.  When the brain is not fully healed it is more sensitive and susceptible to be critically damaged, "This makes the brain more vulnerable and susceptible to death after a second sub-lethal insult of even less intensity," (Bey et al.).  It is very dangerous to return to the game before the brain is fully healed and can lead to death.  Concussions have effected some retired players for the rest of their lives.
Multiple head injuries and constant impact to the head may lead to major problems for athletes later in life.  There are many retired football players that complain of massive headaches, dementia, and depression (OTL).   What they found was a disease called CTE.  Chronic Traumatic Encephalopathy is a progressive neurological degradation caused by repetitive brain trauma in a person.

"Repetitive mild traumatic brain injury can trigger the development of chronic traumatic encephalopathy (CTE), a progressive neurodegeneration characterized by the widespread deposition of hyperphosphorylated tau (p-tau) as neuro?brillary tangles."(McKee et al.)

Repetitive brain trauma causes atrophy or the wasting away of various parts of the brain in CTE including the cerebral cortex, medial temporal lobe, and p-tau neurofibrillary tangles, a type of protein, through out the brain (McKee et al.).  When these proteins are defective and tangle, dementia will result.  With multiple hits and concussions to the brain, these tangles occur and inflammation of the brain persists.  "CTE is clinically associated with symptoms of irritability, impulsivity, aggression, depression, short-term memory loss and heightened suicidality that usually begin 8 -- 10 years after experiencing repetitive mild traumatic brain injury," (McKee et al.).  This is a serious disease that is affecting many retired football players with a history of traumatic brain injuries.  Is there any way we can prevent this disease from forming?  Should rules be put in place to reduce the risk, such as not being allowed to hit above the shoulder?

There have been instances where impacts to the head have lead to permanent damage and even death.  Most of these catastrophes happen at a young age when players are at the High School level.  Most likely due to lack of knowledge about the subject, players not speaking up, the lack of proper precautions, and returning to the field of play too early.      In one case, a boy named Nathan Stiles was playing a high school football game and was roughed up but did not tell anyone that he had been feeling strange during the game.  The next day, and for four days after the game, Nathan began experiencing bad headaches and felt strange (Nathan).  He eventually went to get checked out and was diagnosed with a concussion and was ordered to sit out for a week.  When he went back to be checked the doctor recommended he sit out another week but he said he felt fine.  The next day he played in a game and dropped dead of a blood clot in his brain (Nathan).  If he had followed doctors' orders his brain may have healed and he may not have died.   Another high school football player named Zack Lystedt had a similar occurrence.  He was playing a game and hit his head hard but continued to play and after the game his head suddenly started hurting him (Lystedt).  It progressively became worse, he fell to the ground and fell into a coma for 9 months.  His brain had bled and the blood had prevented oxygen from reaching his brain.  He is now mentally disabled for the rest of his life and has to relearn how to walk (Life Changed).  The two boys suffered from Secondary Impact Syndrome.  The boys had injured their heads in a previous game, or earlier in the game, their brain was injured, their brains did not fully heal, they kept playing and their brains were severally injured as a result.  How can we prevent this from occurring? Can we prevent players from playing even when they feel they are ready and healed?  What precautions can we take that will prevent this from occurring?  Many retired Players with a history of head injuries have developed CTE and have had many problems that affect their everyday lives.  A few have even committed suicide because of the pain and the way of life that had resulted from head injuries.  Last year Junior Seau, a former all star football player, committed suicide by firing a bullet into his chest.  Many believe he chose the chest so his brain could be studied after his death.  So many athletes have complained of this that researchers and scientists have begun examining and analyzing peoples brains who have died and donated their brains to science with a history of head trauma.  

The culture of the game has a great impact in all sports that pushes players to the limit, sometimes producing greater injury and injuries that will stay with players for the rest of their lives.  The culture of football for instance is all about sacrificing the body, physical and mental toughness, and playing through being hurt.  When an individual first starts playing the game of football, one of the first things they will hear come out of their coaches' mouth is that being hurt and being injured are two different things.  You can play through being hurt, but injuries are a different story.  Coaches will yell at and push players convincing them that they can carry on and play through pain.

"Ellen Marmer, the team physician for Rockville High School in Vernon, Conn., said that after she determined an offensive player from the opposing team was unfit to play after a concussion, his coach had him switch uniforms to try to play defense."(Schwarz)

This gives young players the wrong idea.  Players become frightened to admit something is wrong and ignore their bodies warning signals.  They try to fight through the pain just as their coaches say, sometimes even when it is excruciating.  Some coaches even tell their players not to go to the doctors if they get hurt, because they know they will have to sit out for a long period of time.  Is the culture of football and other sports causing greater problems and risk of serious injury?  How can we get coaches and staff on the same page as medical professionals and researchers? Maybe coaches should have to take a class every year on the signs of concussion and other head injuries.  Maybe that will prevent further life threatening injuries.  In other instances athletes are so dedicated and into the game that they refuse to sit out and try to play through the pain and injury.  Many times they don't even tell coaches or medical professionals about pain or problems they are having.  "Matt Selvaggio, who plays with Jasmon on both lines, said: "Our coaches would take us out in a second. So why would we tell them?"" (Schwarz).  This is a major problem in all sports at all levels.  If players do not tell coaches, and coaches push players even if they are complaining, how will we prevent these incidents and deaths due to head injuries from happening?  This happened to me in High School.  In one of the first games of the season I broke my index finger while playing on the offensive line.  I loved the game of football and did not want to miss or sit out any of the games of my senior season, so I didn't get it checked out, I wrapped it up and continued to play.  After the season I went to the doctor and found out I had chipped a piece of the bone and it had attached back onto the wrong place of my finger.  There was no way I could fix it besides surgery, which is very expensive.  And now I have an index finger that is huge and that I have very limited mobility with.  My grip is terrible, it is hard to open things such as soda bottles and jars, and many times I unconsciously don't even use it any more.  Its like I am missing a finger.  The thing is I didn't want to miss my senior year of football, the last time I would ever play, so I refused to even get it checked out.

The culture of the game, coaches influence, players dedication, and careless precautions create problems in sports and have led to many fatal head injuries that could have been prevented.  Deaths and problems later in life are resulting from traumatic brain injuries and it is very hard to prevent.  Sports are brutal; players hit each other with an immense amount of energy, strength, and force.  There is really no way to prevent head injuries from occurring.  Equipment is being upgraded, rules are being created, and better safety precautions are being put into affect, however, athletes will always be at risk of falling victim to these ailments.  What are the problems that result from head injury?  How can we, officials of the sports, the government, parents, coaches, any person associated with the games, protect players from these threats?  Is it possible to protect them?  How does the culture of the game affect player safety?  What are the necessary precautions we must take?  Who really has the ultimate decision on whether or not the player can return to the game; the medical professional or the individual?  These questions all serve a purpose in the ability and effectiveness of the effort to prevent and protect players from head injuries in sports.
