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Spring 2014
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Ahead of the Game
The best defense against concussions is a good offense.
At six foot one, Alyssa Blood ’11 looks like she was born to play basketball. Lean and fit, a multisport athlete at the American School in London, she excelled on the hardwood, and was named team captain and MVP. When she was recruited back to the States to play for Brown, she finally achieved her goal of playing on a college team. But then a wayward ball turned that dream into a nightmare.

In Blood’s first year in Providence, another player bumped into her during a game, knocking her down, and the back of her head hit the court. “My mom could hear it across the stadium,” she says. It was her third concussion—she’d suffered two in high school, one playing tennis and the other in softball—and she was sidelined for six weeks. But, she says, she “recovered well.”

Less than a year later, as she was running off the court before a game, a ball slipped from a teammate’s hands and slammed into the side of her head. It was the beginning of a prolonged ordeal, and the end of her basketball career. “I really struggled to recover,” Blood says. “I was very sick for two and a half years. I was pretty much bedridden.”

The thousands of concussions sustained each fall on football fields across the country have shined the media spotlight on the dangers of that sport, as have recent class action lawsuits alleging the NFL and NCAA didn’t protect their players. But millions of other athletes, like Blood, put their brains at risk every time they step onto a court, jump in a pool, or hop on a bicycle. “Concussion is the most prevalent sports injury,” says Neha Raukar, MD, assistant professor of emergency medicine. “Every soccer mom knows about it.”

Yet there is also a harmful amount of misinformation, among the public and doctors alike.

A Growing Concern

In a concussion, the brain strikes the skull wall after a sudden blow to the head or, sometimes, a violent shaking, as in whiplash. The damage happens at the cellular level, often due to rotational forces twisting or tearing brain cell axons, causing the brain to swell. For most patients, that swelling subsides in less than two weeks. But for reasons researchers don’t yet understand, the recovery time for patients who have sustained at least one prior concussion is double or more that of patients suffering their first—something Blood learned the hard way.

Sports-related concussions are a serious concern; experts say estimates of 300,000 annually in the US are almost certainly too low. The Pentagon has said a roughly similar number of veterans experienced at least one concussion while serving in Iraq or Afghanistan, often due to blast exposure. But these figures pale in comparison to the 1.6 million to 3.8 million sustained annually in falls, traffic accidents, and assaults. “Anyone is susceptible to suffering a concussion,” Blood says. “Certain activities increase the likelihood, but you can slip on the ice—there’s still a chance you can get hurt.”

Not even wearing a helmet all the time would protect our delicate brains if they’re ricocheting around our crania. J.J. Trey Crisco, PhD, the Henry Frederick Lippitt Professor of Orthopaedic Research, uses an egg as an analogy: “it’s still jiggling around, but you can only protect the shell, not the yolk inside.” So if the head moves suddenly, the brain will, too, and won’t stop until it collides with the bone encasing it.

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