World Football: Erasing the Stigma of Playing (and Living) with Concussions

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World Football: Erasing the Stigma of Playing (and Living) with Concussions
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"They still can't say what's going to happen to me when I'm 50."

Can you imagine going through life not knowing what will happen to your brain over the next 15 years? The number of athletes, at all levels, who suffer through post-concussion complications is staggering. Thousands of athletes—many who continue to play without any medical treatment or diagnosis—struggle through simple, everyday activities because their brains have been battered and bruised for far too long. 

Thankfully, people are starting to address the rising concern about concussions head on (please pardon the pun). In soccer, the issue is as serious as ever.

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Jimmy Conrad fighting for a ball in the air during his time with Chivas USA.

Former MLS Defender of the Year Jimmy Conrad is one of a growing number of soccer players in the United States—and around the world—who had to end his career prematurely because of concussions. (That's his quote at the start of the article.) Conrad was smart, though. He got out when he could live a pretty normal life, suffering from occasional headaches but still able to work out and play pickup games without any serious day-to-day medical concerns.

Other players aren't so lucky.

Take Taylor Twellman, for example. The former U.S. International and MLS Most Valuable Player hasn't been able to work out in three years. Now working TV for ESPN, Twellman is able to travel around the world calling soccer matches, but he can't so much as run on a treadmill without suffering from debilitating post-concussion symptoms.

Twellman told me:

Right now I'm at a strong limitation. I can't do anything consistent with my heart rate over 125. I told myself, 'I'm going to give up the working out part to let this brain heal and see if that works, because no one else has done that.' Most athletes would say they are going to work out and rather have a headache. I say I'd rather have no headache.

 

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Taylor Twellman was an MLS All-Star and U.S. Soccer team member before retiring from the game due to concussions.

Twellman is extremely outspoken about concussion prevention and research, recently creating a foundation to raise money and awareness for the growing concern in sports.

There has been so much talk about concussions and other brain injuries in the NFL this offseason—from thousands of lawsuits filed by former players to issues of depression and even suicide—the spotlight needs to be on protecting the brain for all athletes, especially those who go onto the field of play with no protection on their heads at all.

There are more concussions in soccer than any sport but football, and still to this day many of those injuries go unreported, misdiagnosed or completely mistreated.

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Bryan Namoff recently filed suit against his former club after ending his career because of a head injury.

Former D.C. United defender Bryan Namoff filed a $12 million lawsuit this week against his former team, claiming medical negligence that led to the end of his career. Namoff was hurt in a game on Sept. 9, 2009, and played three days later, the last game of his career.

Three years removed, Namoff is still suffering from the effects of his injury, telling a reporter after speaking to a group of high school kids, "every minute of every day, I have a headache. It’s the invisible nightmare."

Maybe Conrad was lucky to get out when he did, playing a full career in MLS despite suffering side effects from multiple concussions during his years on the field. Still, he has no idea what his brain will look like when he's older.

A fun-loving character in the sport who now shows off his personality working for KickTV, Conrad seemed oddly somber when speaking to me about his future, explaining that doctors cannot tell him what his life will be like over the next stage of life. At 35 years old with two young daughters, he is left pondering what he may remember of high school graduations, weddings and grandchildren.

Sadly, Twellman, Namoff and a host of other former athletes can't look that far ahead. They are still more worried about tomorrow. 

Twellman has a burgeoning media career as the lead soccer analyst in the United States for ESPN and is using his position to not only help grow the game, but raise awareness for an issue that ended his career and changed his life. 

Everyone says 'back in the day,' but that's BS. This was 2008 and I had every symptom you see out there—sleep apnea, sleeping too much, headaches in and out, nausea, dizziness—I had it all, but I could still walk onto that soccer field at 60 percent and score five goals in eight games after being punched in the face, so people said, 'eh, you are fine.'

Obviously, we know now that he wasn't fine. He may never be fine again.

Gail Oskin/Getty Images
Twellman is now the lead soccer analyst in the U.S. for ESPN.

The problem in soccer is that without sweeping changes to the way the game is played, there aren't too many ways to prevent what causes concussions.

In the history of American football, players went from unprotected heads to leather helmets to rudimentary hard-shell helmets to adding facemasks to the state-of-the-art protective headgear players wear today. Still,  nothing is good enough to stop players from getting occasional concussions when colliding with each other.

Soccer players are still in the Stone Age when it comes to protecting their heads on the field. Will soccer start to implement helmets at the youth levels? Some youth teams have voluntarily started wearing the soft helmets that international players like Chelsea keeper Petr Cech wear. Still, nobody can guarantee those soft helmets prevent much of anything.

Twellman said:

If you want to wear the helmet and you are 100 percent asymptomatic and symptom-free, I am for that helmet. But right now we have this logic that says, 'well, I have this concussion problem so I'm going to wear the helmet.' No. It's not going to stop you from getting another one.

If you want to wear it, that's fine, but we can't tell parents their son or daughter has a concussion and throw the helmet on and they are going to be fine.

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Carlos Valdes of the Philadelphia Union wears a padded headband during matches.

When I asked Conrad if he ever wore protective headgear during his career, even the padded headband like Philadelphia Union All-Star Carlos Valdes wears this season after suffering a head injury at the start of the year, Conrad said no, but joked, "if I did, I would probably remember your name right now." 

MLS has done a lot more in recent years to protect and inform players of the perils of concussions. The league has reached out to youth organizations and schools to make sure they understand how to properly diagnose and treat a concussion.

It doesn't matter much if a player is concussion-free in the pros if the guy had 10 before he gets there. An elbow in high school—heck, an elbow at five years old—is more dangerous than one as an adult.

The human brain isn't fully developed until we are mid-to-late teenagers. Yet youth groups routinely practice drills with kids getting balls kicked or thrown at their heads, all in the name of learning proper technique. It turns out that may be doing more damage than good. And that fails to mention in-game injuries at the youth level, where a bump on the head is often treated the same as a scrape on the knee.

Still, with all the research and all the treatment plans and all the warning signs, it is hard to know what to do in each case. Should kids sit out for a mandatory month after a concussion? Should they sit out longer? Seasons just aren't that long, and if a top youth player says he or she feels fine and looks symptom-free, what can a coach do but put the kid back in the game?

Rub some dirt on it, right? Wrong. Parents are getting smarter than that.

Twellman cautioned:

The 'injury' of concussions has legs that are scaring the living crap out of some parents, and rightfully so. Now when kids hear that, it's okay if a kid wears a helmet.

This article was going to be a pound-the-desk plea to have soft helmets mandated across the sport. Then I realized I never wore a helmet and I played soccer for decades without getting a concussion. We shouldn't be over-reactive by encasing our kids in bubble wrap, but we do need to make sure we are prepared for situations when warning signs show up.

Giuseppe Cacace/Getty Images
Shin guards are mandatory. Why not brain guards?

That said, we mandate that kids wear protection for their shins, why not their brains?

That we keep reporting on the NFL lawsuits and discussing this topic and getting quotes from former players means there is a chance some kid somewhere may stop and think about the headache he got in practice and tell his parents about it. He may do that instead of running out onto the field the next day and the day after that until he gets double vision and can no longer walk straight. 

It is true this article is a bit self-serving; as a youth soccer coach, I hope every parent in the country reads this, not just to nod along with my words, but to read what Twellman and Conrad say, to see what Namoff is going through and realize they need to provide a safe path for their kids.

In most cases, a broken leg will heal. We have come a long way in the last few years, but still, nobody really knows how to heal a broken brain.

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