Concussions: The “Injury of 2018”

Concussions remain a dominant subject in the sport medicine literature and media at large — Photo: PET Scan Brain, Wikimedia

As 2018 winds down, the Clinical Journal of Sport Medicine, like so many of its sister media, finds itself in a reflective mood.

Time magazine, for instance, has just named its “Person of the Year”: a group of journalists the magazine notes has been ‘targeted’ for the work they do pursuing the truth.  Time calls them The Guardians. It is an interesting selection:  a media outlet honoring other professionals in its own line of work.

I thought it time that CJSM do its own version of “Person of the Year,” but with a sport medicine twist — Injury of the Year.

I’m naming “Concussion” the Injury of the Year.  In 2019, I’ll have my ‘act together’ and put out a Twitter poll in late November for reader contributions; but in 2018, I’ll have to play judge and jury, given that it’s nearly mid-December. Thanks for indulging me!

Like LeBron James of the NBA, who could probably be named MVP in any year he has played in the league, concussion is a sports injury which could probably earn this distinction in any year over the last decade or more.

In truth, 2018 was a red banner year for the injury, so to speak.  As an example, nearly our entire March 2018 issue was devoted to original research on various aspects of the subject, including a systematic review on the long-term consequences of traumatic brain injury in professional football players.  Continuing this line of reasoning, I would draw your attention to another noteworthy systematic review just published in our last issue of 2018 (November).   This one looks at the utility of blood biomarkers in the assessment of sports-related concussions (spoiler alert:  we have a long way to go in developing these for ‘prime time’).

The dominant theme of our 2018 podcasts was, again, concussion.  Our most popular, most downloaded podcast of the year was an interview with Dr. J. Scott Delaney of McGill University in Canada:  why do professional football players choose to under report their concussions. Another one of the most downloaded podcasts was courtesy of Chris Nowinski PhD, who offered his opinions on what FIFA did wrong with concussion management in the 2018 World Cup, and how they could work toward getting it ‘right’ in 2022.

Finally, we caught up with David Howell PhD and Christina Master MD, both of whom are well-known researchers and frequent authors in these pages; both of whom shared their insights on the CJSM Podcast into the original research they are doing into concussions.

Like so many of the past years of these ‘tweens’ of the third millenia, this has been a notable one for concussions outside of our journal pages, of course.  I plan to write a couple more posts this month which will return to issues surrounding the injury.  They include a commentary on the book Brainwashed, just published a couple of months ago, which I am in the midst of reading.  With the subtitle “The Bad Science Behind CTE, and the Plot to Destroy Football,” this book is sure to get a reaction.

In closing, I would like to direct you to a brief report just published in one of our sister journals, which makes for appropriate reading most especially in the context of the previous mention of the 2018 FIFA World Cup.  JAMA just published a research letter looking at video analysis of head injury evaluations in this past World Cup.  If you find you are only able to access the JAMA abstract, you may look as well at this commentary on the study courtesy of Emory University. These articles, too, probably need a spoiler alert:  despite efforts made to improve concussion management subsequent to the 2014 World Cup, FIFA still struggled to model up-to-date concussion identification and management practices in this most recent World Cup.

Arguably the biggest sporting event and the biggest stage on the planet — and we’re still getting it wrong.

Yes, indeed, 2018 was the Year of Concussions.  Who knows what’s in store for this injury in 2019?  Stay tuned to CJSM, as we’ll be sure to be contributing to the global advancement of our understanding of this injury.