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Peter Rappa
Peter J. Rappa M.D.
Sport and Competition

Concussions and Sports

A physician's and former collegiate athlete's view on this topic.

Today there's definitely a spotlight on concussions in sports particularly in NFL football players. However, the key medical point to be made is that it's not just concussions that are a risk factor but also sub concussive impacts that play a part in future brain injury and future disability. Chronic traumatic encephalopathy has been a well documented medical condition dating back to 1928.

In 1928 HS Martland authored an article called "Punch Drunk". The findings reported boxers with dementia and concluded that the dementia was related to repetitive blows to the head. He called the condition Dementia Pugilistic ; Dementia Pugilistica is mental deterioration, confusion, slowing of speech and Parkinsonian symptoms like tremor and difficulty with coordination. As is often the late effects of too many blows to the head, Dementia Pugilistic is probably recognizable in a former world heavy weight champion currently still alive.

Today medical specialists working with brain injury call the condition cumulative traumatic encephalopathy or CTE. CTE It is most likely discovered via autopsies. With scientific study, we find repetitive blows to the brain are linked to cellular injury that can then lead to functional impairment. Brain cells that become injured from repetitive blows to the head can become tangled — doctors call these 'neurofibrillary tangles' — as when viewed pathologically they look like tangled clumps of hair. Repetitive head blows are clearly related to cumulative traumatic encephalopathy and have effected not only past boxers, but football players, hockey players, as well as wrestlers. But as I said earlier , today we understand that CTE is related to both sub concussive as well as concussive brain impacts.

While there is a bright spotlight on concussion in NFL players, the medical science tells us that athletes with high total numbers of brain impacts — not necessarily injuries powerful enough to cause the symptoms of concussion — are at risk for CTE.

The national spotlight offered by the NFL has brought awareness to a type of brain injury — and I am optimistic that future trends in medicine will now become accelerated to help prevent and treat CTE as well as other brain conditions.

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About the Author
Peter Rappa

Peter J. Rappa, M.D. is the author of Healing Heart to Soul, which recounts experiences he has had as a healthcare professional.

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