The majority of D1 college football athletes are focused mainly on making an impact on the field for their team and making it to the next level. What they don’t consider enough is the fact that ignoring the signs of a concussion or playing through the pain can cause severe harm to their health not only in the present, but also in the future as well. The importance of an in depth concussion protocol for college athletes and especially football players is critical to not only their immediate physical and mental health, but also their future physical and mental health as well. Having a strict, thorough concussion protocol in place may sometimes affect your team by keeping an important player out, but in the long run they will thank you. It has been medically proven that concussions greatly increase the risk for future development of seizures, epilepsy, stoke, etc. due to the increase in S100B levels in the blood. Many coaches and athletic programs will argue that they have spent large amounts of time implementing an extremely strict concussion management plan to protect the safety of their athletes, and would never put them in a situation that could greatly harm their health. The majority of college coaches don’t purposely mean to increase their players risk of future harm, but they don’t understand the full outcomes of ignoring what may seem like nothing. The player’s might think that they can play through the pain and help compete with their team, but it can have a serious affect on their health in the future. This is why it is extremely important for the coaches and school to have a strict and thorough concussion management protocol to minimize the risk of repeat concussions and future health problems.

The purpose of having a strict concussion management protocol is to protect the player’s physical health. It is extremely important for the team and coaches to strictly adhere to whatever protocol is in place, and for the players to listen as well. A test study was done on the average recovery time of a sports related concussion(SRC). The study found that obvious symptoms showed the greatest improvement within the first 2 weeks of the injury, but neurocognitive impairment lingered in many subjects up to 28 days after the sports related concussion occurred (Henry L.). In order to minimize any repeat harm, it is necessary for the player to follow the steps to recover from the injury and not try to cut any corners to return to the team faster. This not only put’s the player at risk of repeat concussions and physical harm, but can harm the team as well if he gets re-injured and is out for an extended period of time. Once a player has had some kind of head trauma or concussion, they have a window of vulnerability immediately following the injury, in which continued activity or stimulation may have an impact on prolonged neurobehavioral recovery (Asken BM). So for all of the players that have gotten hit and have been told just to shake it off, or decide on their own that they are fine are putting themselves at greater risk for worse/longer symptoms and an increased risk of other potential side affects from the concussion. Although the player may seem fine or say he is fine, immediate physical symptoms may not be shown, but there could still be some kind of concussion or head trauma that occurred. That is why it is so important for the coaches and players to go through the steps of the concussion protocol before re-entering physical activity. In a study performed with 97 athletes that sustained a sports related concussion, the athletes that had a delayed removal from activity were 2.2 times more likely to have a prolonged recovery time and also puts them at a higher risk for neurological issues related to concussions and head trauma later in life, compared to the athletes that had been removed from physical activity immediately (Asken BM). A vast majority of players are able to return to play relatively quickly when removed immediately from physical activity. This shows that by leaving the player in the game you put the players health and recovery time at risk.

While playing football, you are accustomed to seeing many different types of physical injuries, many being very gruesome. Players have broken bones, destroyed knees, torn ligaments, and these injuries can physically make you unable to play. Concussions are extremely common in football because of the physicality of the sport, but it is an injury that cant really be seen by the naked eye. Although other injuries may be more painful or more gruesome, a concussion is an injury to the brain, the most important organ in your body. A strict concussion protocol has to be in place and has to be followed by the coaches and players to help reduce the risk of developing neurological issues later in life. You can recover and heal from a broken bone or surgery, but if your brain doesn’t heal properly you can develop serious and deadly neurological issues related to concussions.

One of the reasons concussions and head trauma put the player at greater risk for neurological issues is because of something called blood-brain barrier failure (BBB). It has been proven that concussions/head trauma cause a greater risk of blood-brain failure. It was shown that concussions and head trauma could cause an increase in the S100B levels in the blood. This increase in S100B levels in the blood have been shown to cause and correlate to blood-brain barrier disruption. In the study seizures, epilepsy, stroke, and traumatic brain injury were all conditions correlated to a disruption in the blood-brain barrier function. “A direct cause-effect correlation between BBBD and motor seizures can be ascribed to disruption of brain homeostasis in proximity of the vessels where BBB was breached.”(Marchi N). This helps prove that increased head trauma can cause not only those immediate symptoms, but more serious neurological issues if not taken care of and treated accordingly. Increased head trauma causes an increase in S100B levels in the blood which is what can be tied to blood-brain barrier disruption. When a head trauma occurs, if not taken out of physical activity, the player could sustain worse head trauma which can cause an even greater increase of S100B serum levels in the blood, once again leading to a greater risk of BBBD. As of now, there has been no information proven that impact magnitude and impact location have a correlation with different levels of head trauma. A study used accelerometers embedded in football helmets of college players to collect head impacts sustained between 2004-2006. Of the 13 recorded concussions, there was a wide range of impact magnitude from 60.51-168.71g. This showed no correlation between the impact magnitude and location and the symptom severity, postural stability, or neurocognitive function (Guskiewicz KM). This shows that concussions sustained in football occur at a wide range of magnitudes, making it independent from affecting symptom severity. There is such a wide range in which concussions can be sustained, and correlating symptoms can be different for everyone. A 6 year study was performed to determine the signs, symptoms, and management of repeat concusssions in the NFL. Data was collected from 887 concussions that occurred involving 650 players. 60 players experienced repeat concussions, with 51 of those having 3 or more during the period this test study took place. It was shown that similar signs and symptoms are reported with single and repeat concussions, but there was a higher amount of somatic complaints in players that had repeat concussions (Pellman EJ). It was concluded that to appropriately manage concussions, the main thing needed was rest.  Although the severity of concussions may vary, its still extremely important to follow the steps necessary to recover to help heal fully.

Even though there is a large amount of players who play through the pain of a head injury or coaches allowing the player to continue physical activity after the injury is sustained because the player seems fine, there is a large amount of coaches and coaching staff that will argue they follow a strict and thorough concussion management protocol. A study emailed surveys to coaches and medicine clinicians to all 1066 NCAA member institutions. 907 individuals participated in the survey, and 92.7% said their school had a concussion management protocol in place. 91.2% reported that it required athletes to acknowledge their responsibily to report concussion symptoms. Almost all institutions, 98.8%, believed that their school had a concussion management protocol that protected their athletes “well” or “very well” (Baugh CM). One percentage in particular is alarming. 76.1% of respondents said that their school had a process for annual athlete concussion education. One reason that many players will continue to play through the pain or not report concussion related symptoms is because they believe its not physically preventing them from playing, and they are better off helping the team. But many players don’t know the severity a concussion can have on the body. Many players may not know about the associated risks involved with not removing themselves immediately from physical activity. Many don’t know the neurological issues that can occur due to head trauma/concussions. The school not only needs to have a good concussion protocol in place, but the players need to be educated on concussions and head trauma as well. Although most coaches will say they have a good concussion management protocol in place and they would never put a players health at risk by allowing them to continue physical activity after a head injury occurs, it happens a good amount, whether they know it or not. On the survey sent out, there was a category for improvements. The top areas of improvement in the survey sent back were better coach education, increasing sports medicine staffing, and better athlete education. Although many players continue to play after some kind of head trauma or concussion, it may not always be purposefully. Not every school has the same kind of funding available to put towards having a well equipped training staff, or the technology for a thorough strict concussion management protocol. The vast majority of coaches and coaching staff will argue that they implement a strict protocol to keep their players safe and would never put them at risk, it still occurs whether intentional or non intentional and either way it can be detrimental to the players present and future health. 

A strict and thorough concussion management protocol needs to be in place at every University in the nation not to punish the players but to protect their health. The importance of players and coaches adhering to the concussion protocol is very important. It has been proven that by not being removed from physical activity after a head trauma is sustained, can put you at over twice as likely to have prolonged recovery time as well as a greatly increased risk of neurological issues related to concussions. This is just one of the many reasons to strictly follow the necessary management protocol in place. When a player who has sustained a head injury stays in the game, they are at a greater risk to have another head injury take place. Once a head injury occurs, the S100B serum levels in the blood increase with the severity of the head injury. The S100B levels is what correlates to the blood-brain barrier disruption. The blood-brain barrier disruption is correlated to serious neurological issues including seizures, epilepsy, stroke, and permanent traumatic brain injury. A strict concussion management protocol would help prevent from any player putting themselves at greater risk for prolonged recovery time or increased risk of neurological issues related to the concussion by simply just keeping them off the field until cleared. As proven in a study, the first 2 weeks after a concussion is sustained are the most critical in helping to fully recover. Those first 2 weeks are where a player is must vulnerable to either recovering or having prolonged recovery time. As stated previously, those players that are not immediately removed from play are at an extreme risk for extended recovery time and neurological issues occurring compared to players that are immediately removed from physical activity and follow the protocol and steps to help recover. Even though all coaches care about their players health, and would probably not intentionally mean to put their players at a high risk for harming their body, it happens either because the coach/player is not correctly and fully educated on the seriousness of concussions or the program does not have a good concussion management protocol in place to protect their players. Every coach needs to make sure that the concussion management protocol is in place and strictly adhered to, as well as making sure the players know the importance of reporting their concussion related symptoms in order to allow the coaches and medical staff to properly treat and heal the injury. Having the protocol in place will help greatly reduce the risk of the players having serious and possibly deadly neurological issues related to concussions, which will overall benefit the players and team whether it may seem like it or not.