Time after time

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?I?m hit, knocked groggy. The feeling is like being half awake and half dreaming. And your awake half knows what you?re dreaming about?..you see neon, orange and green lights blinking. You see bats playing trumpets, alligators playing trombones, and snakes are screaming. Weird masks and actor?s clothes hang on the wall.?

Muhammad Ali?s description of the ?the half dream room? he experienced when hit hard describes the effect of brain injury, or as it?s more commonly known: concussion.

Noticeable concussion is brain injury, usually caused by a head hitting something hard, or visa versa. Injury results in a range of symptoms from headaches, dizziness and confusions, to vomiting, blurred vision and loss of balance, to unconsciousness even coma and death.

Cumulative concussion is caused by repetitive concussions, sometimes small and not noticeable but continuous instances of brain injury.

There?s two basic effects, where the brain?s electrical currents get disrupted and when blood vessel and cells rupture and leak. Repeated concussion can compound the effect on the brain and lead to dementia, deafness, and Parkinson's disease. Anyone who?s seen elderly old-time boxers will understand the strange behaviours, forgetfulness and shaking or loss of body control.

The brain is the most fragile and unforgiving body part - a complex collection of special cells and electrical currents pulsing around in a sea of fluids. There?s layers of evolutionary growth, a reptilian ?core? brain extending up from the spine, with the next layer on top and at the rear for basic coordination and balance, and lastly, layers of growth for cognitive, spatial and visual functions. Throughout these layers is a range of functions that help us reason, emote, feel, experience and grow.

The brain?s fragility is protected in two ways. The first is the skull, hard and strong, and the second is a cushion of thick fluid that surrounds the brain. The brain is suspended in this fluid inside the hard casing of the skull to protect the brain from everyday life.

Running at about 30 kms per hour (and faster) and smacking into a solid object heading in the other direction at the same or greater speed is well beyond the normal life that the brain and its protection was evolved to cope with. League players do this often, game after game.

It?s not just the swinging arms to the head, or the head clashes or even head-slamming that?s a problem for league players. It?s the cumulative and repetitive impacts on the brain - sloshing around, bumping into the skull, when the player?s momentum is stopped. Usually it?s the front of the brain ? the frontal lobes, that take most impact as the brain keeps moving forward (luckily a bit slowly in its thick protected fluid) into the skull as the body is radically stopped.

Every time players like Martin Lang and Nathan Long get tackled and we see their heads fly all over the place, their brain is getting bumped around in their head like a passenger in a car accident without a seat belt. The speed of today?s game, the fitness of players and their ability to hit harder and more often means that today?s players are getting greater damage than the players of the past. Even with the past?s head high tackling, today?s repetitive hard hitting of players is going to cause real problems as they get older.

The NRL has taken action by trying to stop tackles above the shoulders with harsh penalties, in the same way attempts to protect the neck and spine have outlawed spear tackles. What can?t be eradicated is the constant jarring and impacts on the brain from tackling. Every tackle, beyond a hard-to-determine strength, is going to cause some degree of damage.

We love to see the real ?bell-ringer? tackles like the Harragon-Carrol truck smashes or the front-on sledgehammer tackles. What we tend to forget is that each instance of tackling where the player is suddenly stopped, is likely to cause a little bit of damage. Time after time, this damage leads to small to medium level damage.

When that smashed player gets up and faces the wrong way to play the ball, or wanders around in a daze, everyone knows their brain is suffering. What we can?t tell is how badly league players? brains are affected as those common match day impacts start to mount up, week after week and the little injuries compound again and again.

I guess we won?t know until they get older, hey ?

References: The Greatest: My Own Story ? Muhammad Ali 1976 Brain Injury - Rosemary Boon and Gregory J. de Montfort 2002 http://health-guides.nzpages.co.nz/default.asp?m=hs&id=99 http://abc.net.au/science/news/health/HealthRepublish_991979.htm http://www.ama.com.au/web.nsf/doc/SHED-5EXHF5 http://www.theage.com.au/articles/2004/07/22/1090464796868.html?oneclick=true http://www.health.gov.au/nhmrc/publications/pdf/si1.pdf

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