Concussions and Brain Injuries on the Field: Better Communication is Deterrent to Sports Tragedies

A few months ago, the country was shocked after three separate cases of high school football players dying suddenly after games.

Isaiah Lavont Langston, 17-year-old linebacker at Rolesville High School, N.C., died on Sept. 29 after collapsing on the field. 17-year-old Demario Harris of Troy, Ala., died on Sept. 28, two days after a tackle in a game for his high school, Charles Henderson. And Tom Cutinella, a 16-year old varsity football player from Shoreham-Wading River High School in New York, died on Oct. 1 after suffering a head injury in a game. While not all autopsies concluded traumatic brain injury as cause of death, at least one did, and all the players suffered some from hits to the head.

Then, just after Thanksgiving, former Ohio State football player Kosta Karageorge was found dead from a self-inflicted gunshot wound. In a suicide note left to his mother, Karageorge spoke of being embarrassed about the long-lasting effects left by multiple concussions.

As these tragedies unfold, more research is published connecting traumatic brain injury to concussions, concussions to mental health disabilities, and disabilities to depression and suicide.

Sports collisions are one of the leading causes of traumatic brain injuries. An estimated 1.6 million to 3.8 million sport-related TBIs occur a year and 52,000 people die annually from them. Even without concussions, athletes come away from a season with evidence of brain changes, a new study recently found.

So why, in a time of hitchhiking on comets, researching stem cells and flying solar-powered aircraft, can't we figure out a way to stop sports-related traumatic brain injury from ruining, and sometimes ending, lives?

Some may say the problem is the game itself. Football players inevitably follow the "get back in the saddle" mantra, thanks to the game's zealous fans and passionate players. Breaking into the beloved pastime and changing its ways seems impossible.

In a society where athletes are revered as demigods within their microcosms -- be it high school, college or the professional leagues -- the "shake it off" mentality gets in the way of communication about injuries. A recent study conducted at Harvard shows that only one out of every 27 sport-related head injuries is reported. Athletes suffer from hits to the head but don't go in for medical evaluations, leading to longer-lasting harm.

Which is why, instead of changing the game, we should change the way we communicate in it.

This past September, University of Michigan quarterback Shane Morris was injured in a helmet-to-helmet blow in a game against Minnesota. Convinced Morris's wobbling was caused by an ankle injury he'd taken earlier in the game, and having missed seeing the actual head impact, the team's athletic trainer cleared Morris for another play. Meanwhile, the team's neurologist, who had seen the head blow, considered taking Morris in for an evaluation. Due to a lack of communication, the neurologist was unaware that Morris was returning for another play, and the athletic trainer was unaware that Morris may have sustained a head injury that would only be exacerbated by playing.

The university's athletic director later apologized for the mistake -- it turned out Morris had suffered from a concussion. Had the communication pathways been open, perhaps Morris could have had an immediate evaluation.

How can we make sure athletic trainers and medical staff know a player has been hit severely enough to raise alarm? Often, trainers rely on recorded replays to note injuries. But this dependence isn't safe, says Jesse Harper, CEO of i1 Biometrics, a Seattle-based wearable technology company developing a way to ensure that everyone on the sidelines knows about head collisions as soon as they happen.

While researchers, physicians and companies collaborate to come up with protective gear to prevent these injuries in the first place, they may be skipping over the one problem that is immediately solvable with wearable technology -- communication, or the lack of it.

So Harper and i1 Biometrics' new impact-sensing technology aims to focus on closing the communication gap. I sat down with Harper to discuss the company's latest development and how it could potentially change the face of contact sports.

The key to at least alleviating the consequences of head collisions in sports is communication. To know when a player has been hit hard enough to warrant a medical evaluation, trainers and medical staff need to know where, when and how hard he or she was hit.

i1 Biometrics found that the best way to get answers to those questions was through a mouth guard -- but not just any mouth guard. This piece of equipment measures a head collision impact and sends that data straight to the athletic trainers and medical staff on the sidelines of a game, where they use handheld devices to receive the information.

The Vector MouthGuard, using the Impact Intelligence System, "detects in real-time...the magnitude of how hard the hit was as well as the location on the head of the athlete, then broadcasts that to the sideline, for both medical staff as well as coaching staff...to account for whether or not to pull a player out of evaluation," Harper says.

The data collected by the mouth guard and sent to the staff on the sidelines will be indisputable. The technology is equipped with microprocessors, triaxial accelerometers and triaxial gyroscopes that measure the linear acceleration of the impact as well as the rotational aspect. Using these measurements, the mouth guard zeroes in on the exact location of the hardest impact to the head and alerts those who need to know.

What about potential noise? With all the microprocessors, the mouth guard must be highly sensitive. If players gnash their teeth or the equipment falls out and hits the ground, would the impact add noise to the players' actual data?

No, because i1 Biometrics prepared for such possibilities -- the mouth guard is equipped with the technology necessary for the spontaneous nature of contact sports.

"When players take [the mouth guard] out of their mouth," Harper explains, "the mouth guard shuts off. [It's] not going to collect erroneous data."

"Players want to play. They want to be bigger, faster, stronger," he says. If the risk of a concussion from a head impact doesn't seem high, the possible consequences of going through concussion protocol may deter players from reporting possible symptoms. The Vector MouthGuard, which Harper says will be commercially released in time for 2015 spring football, could vastly reduce the numbers of athletes suffering quietly from recent and not-so-recent concussions. By allowing the coaching and medical staff this intimate access to players' head impacts, the mouth guard could drastically shorten the time between the hit and the treatment of a possible injury.

The brain is strong and resilient, but it is a soft organ in a hard shell, bound to take bad hits when one is running at unbelievable miles per hour speeds at another person. While preventive gear is still in the works, and physicians and researchers try to understand the still-unknown mechanisms of injury behind concussions, i1 Biometrics' impact-sensing mouth guard could pave the way for better dialogue between players and coaches and fewer long-lasting traumatic brain injuries. Mostly, however, it could help shape a safer future for contact sports, without sacrificing the things we love most about the games.

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