Get Started
Get Started

Health & Exercise Forum

Concussions in Football: Part 1 of 2

Aug 22, 2016


Victoria Wrightson, SPT

Victoria Wrightson, SPT

Guest Contributor: Victoria Wrightson, SPT

Football fan or not, you have probably heard of the 2015 movie, Concussion, that caused somewhat of a headache (no pun intended) for the NFL. Based on a true story, the movie highlights the discovery of a degenerative brain disease found during the autopsies of professional football players now known as chronic traumatic encephalopathy, or CTE. The Mayo Clinic defines CTE as brain degeneration caused by repeated head trauma. Symptoms include difficulty thinking, impulsive behavior, depression, emotional instability, and substance abuse, to name a few, but the full list of symptoms remains unknown. As a student physical therapist, I learn a great deal about the anatomy of the brain and serious consequences of brain injury. As an avid football fan, I have great interest in the treatment, rehabilitation, and more importantly, the prevention of sports injuries. With football season quickly approaching, it is important for coaches and parents to consider the safety of their players while at practice and during competition. Although the topic of concussion isn’t new, I think it is important to remind readers of what a concussion are the potential long-term effects of concussion, and what actions can be taken to keep athletes safe.

“Traumatic brain injury.” Sounds scary, right? In fact, this is exactly what a concussion is - the most common form of brain injury. Concussions are caused by blows to the head or by hits to the body that cause the brain to move around, forcefully bumping the skull’s inner walls. This leads to altered brain function and to symptoms that may not be immediately obvious. While symptoms typically appear soon after the injury, some may not become apparent for hours or days later. Common signs and symptoms of concussion include:

  • headache
  • temporary loss of consciousness
  • confusion and/or memory loss
  • dizziness
  • nausea and/or vomiting

Concussions are graded based upon severity. Researchers in sports medicine have developed a system to grade concussions based upon loss of consciousness, post-traumatic amnesia, and symptoms such as the ones mentioned above. This system, known as the McGill concussion grading system, is described in Table A.

Just how common are head injuries in football? According to researchers at the University of Rochester, repetitive head impacts in a single football season range from 244 to 1,944 impacts per player. According to the 2015 NFL Injury Report, 271 concussions were diagnosed during preseason and regular-season practices and games combined. With the high rates of head impact in football, it is important to realize what long term effects may result.

Concussions may lead to serious long-term consequences, and even worse effects may be seen in those who suffer from more than one. Studies have indicated that deficits in memory, attention, and concentration can be seen long after the time of initial injury. One study found that measures of attention and concentration were significantly worse in high school athletes who had suffered from a concussion in the past. This study also found that high school athletes with a history of concussion had a significantly lower GPA than their peers. As previously mentioned, repetitive head trauma can lead to a serious condition known as chronic traumatic encephalopathy (CTE).

Next week, in “Concussion Part 2” we will discuss prevention of concussions in football.

TABLE A: McGill Concussion Grading System

GRADE Characteristics
1 No loss of consciousness, no post-traumatic amnesia
1A No post-concussion symptoms, only seconds of confusion
1B Post-concussion symptoms and/or confusion that resolved in 15 min
1C Post-concussion symptoms and/or confusion that does not resolve in 15 min
2 Post-traumatic amnesia for less than 30 min. and/or loss of consciousness for less than 5 min.
3 Post-traumatic amnesia for more than 30 min. and/or loss of consciousness for more than 5 min.

Source: Leclerc S, Lassonde M, Delaney JS, Lacroix VJ, Johnston KM. Recommendations for grading of concussion in athletes. Sports Medicine. 2001;31(8):629-636. doi:10.2165/00007256-200131080-00007.

Guest Contributor: Victoria Wrightson, SPT, Temple University, Doctor of Physical Therapy Student 2018. Victoria a native of Scranton, PA is an intern at Mackarey & Mackarey Physical Therapy Consultants, LCC

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune: Concussions Part 2 of 2. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.