ALLENTOWN, Pa. — The question of how many concussions are too many has been asked recently as NFL players suffered head injuries during games.
The Miami Dolphins' quarterback and a Philadelphia Eagles' wide receiver are among the latest to undergo concussion protocol.
Dolphins quarterback Tua Tagovailoa suffered a concussion this month, leading to calls for retirement. Then, last week, the Eagles’ DeVonta Smith was sidelined by a concussion.
"There are no guidelines on how many bad concussions, and in a matter of fact, things that play a part to the decision-making, it's multifactorial."Dr. Faisal Al Alim, sports physician, Lehigh Valley Orthopedic Institute
“There's no set criteria," said Dr. Faisal Al Alim, a sports physician with Lehigh Valley Orthopedic Institute.
"There are no guidelines on how many bad concussions, and in a matter of fact, things that play a part to the decision-making, it's multifactorial.”
Al Alim said concussion diagnosis is based on symptoms, including cognitive behavior. There is no blood test or scan for the injury; it’s diagnosed based on observation.
He said it’s not simple to say if and when a player should retire.
“It's easy to right away jump into that, but it's really not that easy, because, yes, there is a repeated head trauma," he said. "There's repeated injury to the brain, but there's more to it than just what to do next. It's a multidisciplinary approach.”
Local treatment
Al Alim said doctors have to examine different aspects of the injury to determine if the player should stop.
“Every concussion has a talk,” he said.
"It’s how many concussions you've had in a period of time. How far apart, like are [they] in a short period of time? Are they in a time frame that were too close?”Dr. Faisal Al Alim, a sports physician with Lehigh Valley Orthopedic Institute
“Whether it's your first, whether it's your second or your third, but to me, or to a lot of sports physicians and people who treat concussions, it's more into it than just the 'how it looked' after a concussion.
"It’s how many concussions you've had in a period of time. How far apart, like are [they] in a short period of time? Are they in a time frame that were too close?”
He said Lehigh Valley Health Network offers an array of treatments and therapies for concussions, such as vestibular concussion therapy for balance, cognitive therapy for thinking and memory, cervical spine therapy and vision therapy.
The fear is that too many concussions will lead to more severe health problems later in life.
“Repeated injury to the brain will lead to what’s now been diagnosed as something called a CTE, which is chronic traumatic encephalopathy,” Al Alim said.
He noted that well-known NFL star Brett Favre recently said he’s been diagnosed with Parkinson’s disease. Favre was undergoing concussion therapy when he got the diagnosis.
Al Alim said it’s hard to definitively say whether Favre’s time in the NFL caused Parkinson’s, but it likely has some correlation to the player’s concussions.
Both Tagovailoa and Smith are still out of the game because of their injuries.
