Concussions are a problem in today’s athletes. Concussions are difficult to diagnose and their severities can vary greatly. The long term effects of frequent concussions in athletes (especially football and boxing) are starting to be known with the growing number of former athletes found to have permanent brain damage. With this knowledge becoming more known, questions have been raised. Should boxing/ ultimate fighting be banned? Should young children not play football?
Concussions can lead to brain damage through various cellular pathways. The two I’ll focus on here are the production of NFTs as well as ATP depletion leading to acidosis and edema.
Concussions occur due to the rapid acceleration and deceleration forces put on the brain during trauma. Trauma causes stretching and disruptions of the neuronal cell membranes leading to unregulated influx of calcium ions and an efflux of potassium ions. This rapid depolarization leads to hyper-phosphorylated pathways leading to hyper-phosphorylated human tau proteins causing microtubule and microfilaments in neurons to aggregate and form neurofibrillary tangles (NFTs). When NFTs form in neurons, the microtubules and microfilaments are no longer effective with transporting necessary cell components down the axon of the neurons.
The ATP-active membrane pumps on cell membranes are used for maintaining cellular ion concentrations necessary for proper neuronal function. Rapid depolarization of the neuron due to cellular stretching and disruptions in the membrane cause ATP-active membrane pumps to activate and restore the cell back to normal ion levels. However, because of the disruptions in the membranes, normal ion concentrations are difficult to achieve and thus these pumps run constantly, depleting the neuron’s ATP stores. The cell relies on the mitochondria to replenish its stores of ATP through oxidative metabolism; however this process relies on very important concentration gradients of ions within the cell and the organelle itself. The rapid influx of calcium causes impaired oxidative metabolism in the mitochondria because it disrupts ion concentration gradients already established for effective metabolism, thus ATP must be generated through anaerobic glycolysis which leads to accumulation of lactate. The high levels of lactate accumulation cause acidosis and edema in these affected neurons.
NFT production, as well as depletion in ATP stores in neurons both leads to neuron death. Concussions are so dangerous because of these processes (as well as others not touched on here). Long term effects set in from the damage to neurons when re-injury occurs before proper healing has had a chance to run its course. The problem seen with so many athletes today stems primarily from cultural tendencies. In college sports, coaches need to win to keep their jobs. If one of their best players goes down due to concussion, the coach is pressured to get him/her back in the game ASAP in order to win. Pro-athletes are pressured to fight through concussions because there’s millions and millions of dollars on the line every time they sit out. On top of all of the pressure imposed on others to get athletes back into the game, athletes themselves are faced with inner struggles about how long to sit out.
As an athlete, I love to compete. There is something so special about being able to give everything you have for yourself and your team in an effort to achieve a common goal. Athletes love being able to see how they match up with their opponents and want to be able to go to battle whenever they can. Concussions are tricky injuries because they’re the definition of “grey area” as far as “how long is long-enough to sit out”? With a lack of accurate testing available for diagnosis of concussions, doctors are reliant on the honesty of their patients. However, like I stated above, athletes want to compete, not sit out. This inner struggle causes many athletes to down-play their symptoms and get back on the field. Having a knee injury or shoulder injury is pretty obvious about when the right time is to compete again. The athlete can visually and physically see they aren’t ready. Head injuries are difficult because even though you may feel fine, your brain is still in its “healing stage”.
People who claim that sports like football and boxing/ultimate fighting should be banned or kids shouldn’t become involved in them should recognize that the sports aren’t necessarily the entire problem. Many injuries former boxers/fighter and football players are seeing were caused because they didn’t take the proper time to heal after initial concussions. They started competing again too early leading to long-term problems. It’s more of a cultural problem or an inner-athlete problem because athletes hate being told “you are not ready to play” or “you have to sit out”. Therefor athletes are competing too soon after injuries and causing permanent damage upon frequent head traumas.
Until next time,
Sebastian
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