When will attitudes catch up to the science? TBI, sports and machismo

A couple of years ago, my husband and I attended a college football game.

Midway through the game’s second quarter, one of the home team’s players went down after a hard hit. The whistle blew, the trainers ran out on the field, and for several minutes the crowd and players watched as the staff tended to the injured player. Not long after, the player got up and, with some help made it off the field.

I was stunned when the same player who couldn’t get off the field without help in the second quarter jogged onto the field in the third. For years, the medical establishment has been warning parents and coaches to take sports neurotrauma seriously, counseling them to keep any player exhibiting signs of concussion on the sidelines for the rest of the game. The player in question had his bell rung hard enough that he couldn’t walk without support, a clear sign that he may have suffered a concussion in the hit—yet the coaches let him go back in the game in the next quarter! It’s not as if the collegiate football community isn’t aware by now of the risks of concussions and neurotrauma, and it’s not as if the player’s college as an institution isn’t aware. The knowledge is there.

So why did this young man go back into the game?

I don’t think the reason has anything to do with knowledge of the science, but rather with social attitudes.  In many of the fields of human endeavor where brain injuries are common—sports, law enforcement, construction and industrial trades, and of course the military—there is a culture of machismo. Of course, women have entered into all of these fields, but in all of these areas, a culture of masculine toughness still prevails that privileges endurance, resilience and self-sacrifice over caution and self-care.

Team sports in particular commonly posit a warrior ethos, and players feel a commitment to their fellow players to grind through adversity for the benefit of the group. Even if the coaches aren’t pushing players back into the game, the players themselves may be reluctant to sit out lest they appear weak or wavering in their commitment to the team. And so players ignore their bodies’ own warnings (never mind those of the medical establishment) and “play through,” which in countless cases leads to longer healing times and repetitive traumas that are more damaging than the original injury was.

“Playing through” puts a player’s health at risk. Players should be assured, both by coaches and fellow players, that’s okay to sit the rest of the game out after a hard hit. Self-care is no dishonor. A warrior who takes care of his mind and body lives to fight another day.

The science is there—it’s the attitudes that need to change.