Rayna Bernstein

Sports injuries – we’ve all had them. Whether it was breaking an arm in hockey, twisting an ankle in soccer or basketball, or falling off your mountain bike and getting some cuts and bruises. We’ve all felt a little embarrassed when it happened, followed by some pride telling the stories to our friends after the pain is masked and the blood is washed away. This feeling of pride gives us a sense of toughness, durability. We feel pretty good knowing we came away from that injury with minimal tears and maximal healing ability. Unfortunately, this is not the case with all injuries, specifically those affecting our brains – concussions.

Concussions

Concussions occur when we receive a blow (force) to our head, neck, face, or even a large enough blow to the body, causing the brain to be forcefully moved inside the skull (McFadden, 2016; Ontario.ca, 2019).  Signs and symptoms of concussions may include “Headache or feeling pressure in the head, temporary loss of consciousness, confusion or feeling as if you’re in a fog, amnesia surrounding the event, dizziness or seeing stars, ringing in the ears, nausea, vomiting, slurred speech, delayed response to questions, appearing dazed, fatigue” (McFadden, 2016). Despite this extensive list, there are other signs that may not be recognized, or may appear at a later time. Certain signs and symptoms may occur days after getting hit. “Some of these include concentration and memory complaints, sensitivity to light and noise, sleep disturbances, disorders of taste and noise, and depression.” (McFadden, 2016). It is important to treat every blow to the head as a serious injury, as any injury to the head has the potential to cause serious damage, whether immediately or later in life.

Treating concussions

To add in a little personal anecdote, I took a standard first aid and an advanced first aid course in high school (so 4 and 5 years ago), and I learned in those courses that concussions were graded on a scale of 0-4, 0 being a small blow to the head with no apparent damage, and 4 being loss of consciousness for some time, likely accompanied by retro-and-anterograde amnesia (loss of memory before and after the injury). Until doing research for this chapter, I had always thought of concussions this way. However, this is no longer a valid method of assessing concussions. Completeconcussions.com  provided me with new information stating that concussions are not graded anymore (Complete Concussions, 2019). Every person with a concussion needs to be treated according to their specific situation and all concussions are to be taken seriously, no matter the force of the blow or the intensity of the symptoms (Complete Concussions, 2019). Brain injuries are all significant, as small blows can lead to significant brain damage in the future, as can be seen with many professional football players and other athletes.

To give you some context, the statistics on concussions really lay it all out. The sport with the most concussions (reported) is football, at 47% (McFadden, 2016). “According to HealthResearchFunding.org, concussion rates for children under age 19 who play tackle football have doubled over the last decade, most occurring during practices” (Helper, L. n.d.). “Between 1.7 and 3 million sports- and recreation-related concussions happen each year. Around 300,000 are football-related” (UPMC, n.d.). This is in the United States alone. “2 in 10 high-school athletes who play contact sports — including soccer and lacrosse — will suffer a concussion this year ” (UPMC, n.d.).

Now for the scary part – the medical side. Chronic traumatic encephalopathy (CTE) is a degenerative brain disease, which is found most prominently in athletes (Helper, L. n.d.) It can be caused by concussions, or by “subconcussive hits”, which are repeated blows to the head that are not forceful enough to cause concussions (Helper, L. n.d.). If left untreated, these subconcussive hits accumulate and cause “damage to their brains at the cellular level that eventually accumulates to result in irreversible brain damage; CTE” (Helper, L. n.d.). CTE is a serious disease that can become disabling or even fatal over time. “Unfortunately, a 2009 analysis of 51 people who experience CTE found the average lifespan of those with the disease is just 51 years.” (Disabled World, 2013). Aside from this study, there are many athletes and other people world-wide who suffer from CTE, including many who have died from it. Included in this list are professional football player/NFL star Aaron Hernandez, and high school rugby player Rowan Stringer. Aaron Hernandez was convicted for murder of a friend, and later committed suicide in prison. After he died it was found that he had been suffering from CTE (Biography.com, 2014), likely part of the reason for taking his friend’s, as well as his own life. Rowan Stringer played rugby at her high school in Ottawa, Ontario. She died after receiving three untreated concussions in six days. The image above highlights some concussion statistics in America. The part that you should really be drawn to is the middle section highlighting that “cumulative concussions are shown to increase catastrophic head injury leading to permanent neurologic disability by 39%” (McFadden, 2016), as it relates to these cases. Aaron and Rowan are not alone, there are many other people who have died or been seriously disabled due to multiple blows to the head. Blows to the head have the potential to cause severe damage whether treated or untreated, reported or unreported.

Toxic masculinity and sports related injuries

The problem here does not start simply with concussions. The problem starts with toxic masculinity in our society. Toxic masculinity is defined as “a cultural concept of manliness that glorifies stoicism, strength, virility, and dominance, and that is socially maladaptive or harmful to mental health” (Dictionary.com, n.d.). You may begin to get the bigger picture from this definition. Toxic masculinity has caused athletes of all ages and genders to play through injuries of all types, as it creates a mindset where the individual thinks they have to act in a certain “tough” or “manly” manner. Unfortunately, due to this mindset, many concussions go unreported, or mishandled as a result of the athlete playing it down, pretending it didn’t happen, or simply not knowing that they actually have a concussion. Athletes feel pressured to play through pain and injuries of all types, not just brain injuries, because they may want to seem tough, or avoid disappointing their team, coaches, or parents. In the case of most injuries, this may result in a slightly longer healing process, or dealing with severe pain prior to seeking medical attention. In the case of playing through brain injury, the athlete risks severe and irreparable brain damage, possibly leading to a degenerative brain disease that could end their life. It is with this severe damage that people have begun to realize that there may be more to this problem.

Athletes often feel pressure to play through injuries, specifically concussions because they know that there is a long return-to-play process. This means that they may miss important games and may feel that taking time off to recover makes them look weak, unmanly, or feel like they are a disappointment to their peers or authority figures. This stems from a “toxic masculinity that values toughness over all” as said perfectly by Bob Cook (2017). Or, as Kyla Bills (NYU Local Newspaper) puts it: “Oftentimes, the trade-off in football is to either be safe with less praise or to play it safe and be “emasculated.” It’s a microcosm of a larger societal issue of toxic masculinity.” This toxic masculinity has caused many athletes worldwide to become ill, mentally unstable, and even end their life in the most severe cases, as a result of improper concussion management. Failing to report concussions means that athletes are not being treated properly or early enough, which puts them at risk for further brain damage and prolongs recovery time. What athletes don’t realize about this is that when they play through a concussion, they a) cannot play to the best of their abilities, and b) will not be able to play properly for a longer period of time, possibly the rest of their life due to accumulation of unhealed brain damage.

What we need to do

If there’s one thing you get from this, it’s that the main goal is education on the consequences of concussions and toxic masculinity. Lack of education combined with toxic masculinity is what is causing the severity and high incidence rate of these concussions. Many people, including athletes, teachers, coaches, and parents are uneducated on the topic of concussions. Like in the case of Rowan Stringer, athletes may not even know that they have been concussed. No one knew that Rowan had received three concussions, within the time span of six days, which were left untreated. The repetitive trauma to Rowan’s brain caused secondary impact syndrome, which resulted in her death. This syndrome causes swelling in the brain as a result of receiving a brain injury prior to a previous brain injury being fully healed (Government of Ontario, 2019). Another point to make in this case is that Rowan was a female, identifying as a woman, and toxic masculinity still affected her. Just like how feminism is for everyone, not just women, toxic masculinity is a harmful concept that can affect anyone, no matter their gender identity. Despite the fact that Rowan may not have known she was concussed, she still suffered multiple blows to the head, and would likely have felt injured to some extent. It is likely the toxic masculinity which is present in sports and other areas of our society that made her choose to keep playing, despite the fact that she knew she had gotten hit, multiple times I might add. The takeaway from this story is that toxic masculinity along with improper or lack of education create a literally lethal combination. Educating individuals, coaches, athletes, and parents on the severity of concussion related brain damage, treatment and prevention methods, and safety in sports is essential, but educating everyone on what toxic masculinity is and how there is a need to reduce the amount of toxic masculinity in sport as well as society is equally as important in combatting this issue.

References

Bills, K. (2014, December 4). Football’s concussion problem needs us to take a long, hard look at masculinity. https://nyulocal.com/footballs-concussion-problem-needs-us-to-take-a-long-hard-look-at-masculinity-9c82af98e8e7

Biography.com. (2014). Aaron Hernandez biography. A&E Television Networks. https://www.biography.com/athlete/aaron-hernandez

CNN. (2020). NFL concussions fast facts. https://www.cnn.com/2013/08/30/us/nfl-concussions-fast-facts/index.html

Complete Concussion Management. (2019). Top reasons why athletes don’t report concussion. https://completeconcussions.com/2019/01/09/top-reasons-athletes-dont-report-concussion/

Cook, B. (2017, January). Concussion awareness is also about being careful with these words: “be a man.” https://www.forbes.com/sites/bobcook/2017/01/15/concussion-awareness-is-also-about-being-careful-with-these-words-be-a-man/?sh=44a14a38471a

Dictionary.com. (n.d.). toxic masculinity. Retrieved November 11, 2020, from https://www.dictionary.com/browse/toxic-masculinity

Disabled World. (2013). Chronic traumatic encephalopathy (CTE). https://www.disabled-world.com/health/neurology/cte.php

Government of Ontario. (2019). Rowan’s law day. https://www.ontario.ca/page/rowans-law-day

Government of Ontario. (2019). Rowan’s law: concussion safety. https://www.ontario.ca/page/rowans-law-concussion-safety#section-1

Helper, L. (n.d.). Football & concussion: worth the risk? Retrieved November 10, 2020, from https://www.choc.org/news/football-concussion-worth-risk/

McFadden, J. (2016, October 17). At the head of the issue. https://iaedjournal.org/at-the-head-of-the-issue/

University of Pittsburgh Medical Center. (n.d.). Concussions facts and statistics. Retrieved November 10, 2020, from https://www.upmc.com/services/sports-medicine/services/concussion/facts-statistics#:~:text=Concussions Statistics&text=Between 1.7 and 3 million,suffer a concussion this year