Russell Gage’s injury highlights the NFL’s concussion problem and how it hurts players long-term

Only two weeks after Buffalo Bills safety Damar Hamlin was rushed off field due to cardiac arrest, Tampa Bay Buccaneers wide receiver Russell Gage was hospitalized with a concussion and neck injury after a hit during Monday’s playoff game against the Dallas Cowboys. This incident highlights the concern over concussions, player safety and the National Football League.

Although the number of reported concussions in the NFL has declined since it started tracking them during the 2015 season, the protocol was once again called into question following Miami Dolphins quarterback Tua Tagovailoa’s multiple head injuries earlier this season. One of those injuries was later removed. reported by the team to be a “back injury,” prompted the league to revisit its concussion protocol.

In the revised policy, ataxia, or “abnormality of balance/stability, motor coordination, or dysfunctional speech” as a result of a concussion–which Tagovailoa demonstrated after returning to the game in Week 3–has been added to the list of “no-go” signs and symptomsThese symptoms are considered to be serious and will prevent any player from returning to the game.

In essence, revised protocol closes a loophole that allowed players who had gross motor instability to return to the game if doctors determined the player’s stumbling was caused by something other than a head injury.

“We want to ensure that all of our medical professionals not only adhere to the protocols as written, but also understand that they serve the players as patients,” the NFL Players Association Responded to the most recent changes

However, it is still to be determined if these changes will suffice and if they will keep players safe in such high-contact sports like soccer. Although the severity of concussions varies, they are considered to be a subset mild traumatic brain injury. Rest is the best treatment. However, too much rest can slow down recovery.

“Typically too much activity makes symptoms worse, but too little activity can have the opposite effect, by not allowing the brain to heal as quickly,” explains Dr. Richard Figler, director of the Concussion Center and staff physician in the Center for Sports Medicine at the Cleveland Clinic. “We’re really trying to find that sweet spot where people can do things without provoking their symptoms … There’s good evidence to suggest that early exercise, that does not provoke symptoms is beneficial, and will help aid in recovery faster than no exercise. This may include going for a light walk, or getting on an exercise bike, but if the symptoms worsen, slowing down the activity to a point where there are minimal to no symptoms at that level of exercise.”

Figler says that most concussions related to sports involve a gradual recovery process over a period of one to four weeks. A 2018 study by Christopher D’Lauro, a cognitive neuroscientist at the Air Force Academy, and his colleagues found that “elite athletes,” such as NFL players, are able to recover from concussions faster than non-athletes. Their study Research shows that the average return-to-play time for professional sports athletes is five to seven business days. This compares to the seven to 10 days required for collegiate athletes, and around 30 days for high school students.

But a shorter recovery time doesn’t equate to fewer long-term effects.

According to a 2016 studyBased on MRI scans, more than 40% retired NFL players showed signs of traumatic brain injuries. At the time, study author Dr. Francis X. Conidi of the Florida Center for Headache and Sports Neurology and Florida State University College of Medicine in Tallahassee, Florida said, “The rate of traumatic brain injury was significantly higher in the players than that found in the general population.”

Concussions can have long-term implications, including the possibility of permanent brain damage. increase in neurological diseases such as dementia and Parkinson’s. There is no limit to the number of concussions that a person can sustain. 2018 study The University of California San Francisco discovered that even one concussion can increase the likelihood of developing dementia.

Even if someone does not sustain a concussion another person can. 2018 study found that repeated hits to the head, or “subconcussive hits,” can increase the risk of later development of chronic traumatic encephalopathy, otherwise known as CTE, the degenerative brain condition that was found in the nearly all of deceased former football players whose brains were donated for research purposes.

The Football Players Health Study at Harvard UniversityThe 10-year-old initiative was launched in 2014. It has already identified three breakthroughs that could lead to the slowing of and reversed the buildup of tau protein in the brain. This can lead to CTE. These treatments include light treatment, which can improve sleep quality and reduce post-traumatic stress disorder symptoms, an antibody that can prevent the spread of Tau protein and devices that measure the impact of hits on your brain.

While there’s no surefire way to prevent concussions, especially in high-contact sports, such as football, hockey, and soccer, there are changes that can help protect the brain, head, and neck from significant trauma. Figler suggests that neck-strengthening exercises can help reduce force to the head from these traumas. Helmets that are in good condition can also be helpful in reducing concussive risk.

The most important changes to the game may be to the rules. Figler mentions that adjustments to the rules can reduce concussions in certain sports.

“This is based on good data from injury reports that help foster rule changes that make sports safer,” he says.

This story originally appeared on Fortune.com

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