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Football Head Hits May Need More Than Off-Season to Heal

Diffusion tensor image of brain

Diffusion tensor image of brain showing white matter connections (NIBIB/NIH)

17 April 2014. Researchers at University of Rochester in New York found college football players may need more than the standard six months from the end of one season to the start of the next for their brains to recover from blows to the head. The team led by Rochester’s Jeffrey Bazarian, a professor emergency medicine, published its findings yesterday on the online journal PLoS One.

A concussion is a type of traumatic brain injury caused by blows to the head or even the body — typical in the course of the game of football — that cause the head and brain to rapidly move back and forth, causing the brain to bounce and twist inside the skull. The sudden movement can stretch the brain, causing damage to brain cells and chemistry.

Recent revelations of an association between concussions and and long-term degenerative brain conditions, sometimes with tragic outcomes, sparked a debate among players and coaches at all levels about ways to reduce concussions. Even without concussions, the stress from these hits can make the brain more vulnerable to further damage until the initial recovery is complete.

Bazarian and colleagues — from Rochester, Cleveland Clinic, and Hamilton College — studied 10 football players at University of Rochester, a division 3 NCAA team, as well as 5 male non-athletes for comparison. The participants under went a series of physiological, cognitive, and balance tests, at the beginning and end of the 201-20121 season, and after six months of no-contact rest. The football players wore accelerometers inside their helmets supplied by Riddell, a helmet manufacturer, that tracked every hit.

The study participants were also given diffusion tensor imaging scans of their brains, a type of MRI. Diffusion tensor imaging can produce detailed two- and three-dimensional images of connective tissue in the brain known as white matter.

The researchers found the 10 football players sustained between 431 (running back) and 1,850 (center) head blows during the course of season, covering both daily practices and game action, but none causing a concussion. The hits ranged from mild jolts incurred during practice to dangerous rotational acceleration hits that can result in a concussion.

The results show about half the players experienced changes in the white matter of their brains, which suggest mild traumatic brain injuries occurred during the season. However, the brain trauma that the players suffered during the season, although mild, did not completely return to the preseason state after six months without contact. In addition, higher levels of inflammation biomarkers in blood tests among the players also correlated with the lack of complete recovery during the six-month off-season.

“At this point we don’t know the implications, but there is a valid concern that six months of no-contact rest may not be enough for some players,” says Bazarian in a university statement. “And the reality of high school, college and professional athletics is that most players don’t actually rest during the off-season. They continue to train and push themselves and prepare for the next season.”

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