James Loy:

This is Reframe, The podcast from the College of Education, Health and Society on the campus of Miami university. 

In recent years, concussions have gained more and more media attention. However, there is still so much we don’t know. So in this episode we look at some of the work being done to explore the effects, the lasting repercussions, and the need to do more.

James Loy:

Before she witnessed the aftermath herself, Megan Loftin, like many people, was unaware of what sustaining a serious concussion really meant, and just how traumatic the injury can be.

Megan Loftin:

I ended up having a friend who sustained a concussion while skiing, and it ended up being incredibly serious. And he got pulled out of school and, like, I saw all this bad stuff happen. Even, like, now he struggles with voice issues, with seeing and all of this stuff. And I knew him kind of before this happened and seeing, like, he was this happy go lucky guy all the time and then he had his injury and I saw his personality change. And there was something about this injury that I feel like we were not quite understanding. There was some sort of psychological aspect going on.

James Loy:

This experience fueled a passion to learn more, and it lead Loftin to an original line of research focused on the ongoing psychological effects often triggered by such an injury. 

Now she is on a mission. As a Sport Leadership graduate student, Loftin is exploring the academic and social lives of former athletes who were forced to quit high school and college sports after experiencing a serious concussion. 

Her research involves conducting in-depth interviews to gain a better understanding of what the injury is really like and what the experience has meant to each participant. It’s a qualitative approach that could eventually lead to better concussion assessments and treatments, and it’s already won her a finalist position in Miami’s recent Three Minute Thesis graduate student competition. 

Megan Loftin:

I want to change the way we are treating athletes, because I think we are missing that psychological aspect. I think we have . . . there is so much research about the physical and return to play and all these things, which is fantastic and great, but I think we are missing a little bit of that psychologically, like, are these athletes, if they are dealing with irritability and depression and anxiety, if they are having those symptoms, are we treating that as well? Are we helping these individuals with, you know, that other side of the concussion that occurs?

James Loy:

Suffering a concussion has always been a potential risk of playing sports. This is not a new phenomenon. But what is new is the amount of attention increasingly surrounding their occurrence. 

Until fairly recently, concussions were often seen as a “bump” or a “ding.” For decades, especially in light of the dominate cultural ideologies and masculinity-based stereotyping that still often pervades many sports today, many athletes often felt social pressure to simply “walk it off” or to “tough it out.”

Medical science, however, is beginning to differ, and public opinion is swaying as well. 

Concussions have recently been re-classified as mild traumatic brain injuries or MTBIs. And thanks to the pioneering research of neuropathologist Bennet Omalu, who first noticed that repeated MTBIs led to a degenerative brain disease he named “chronic traumatic encephalopathy,” many professionals, players, and fans now recognize the inherent danger. 

Here’s Sam Morris, Miami University Sport Leadership and Management clinical professor:

Sam Morris:

The symptoms of chronic traumatic encephalopathy are very . . .  there is a distinct pattern. People who just, essentially, have all sorts of . . . they are beset suddenly, usually fairly suddenly by memory problems and inability to control their emotions. So they have these sort of wild outbursts and erratic behaviors, and unpredictable and uncharacteristic behaviors.

James Loy:

Morris teaches several ethics-related sports leadership courses at Miami, and he often focuses on the risks associated with athletics and coaching.

Sam Morris:

So it has been an imperative of mine, through that ethics course and through that module on youth sport in my other course, to do a better job of helping our student fully understand and appreciate the knowns, the known unknowns, and the unknown unknowns. So it has been an initiative of mine to broaden the knowledge base of our students about what MTBIs in sports are, what the likely outcomes are, and what you are truly risking.

James Loy:

At Miami, students will get this message in Morris’ classes. And it’s also an issue that EHS has consistently addressed through various interdisciplinary efforts including a number of events organized by Miami faculty. For the past several years, for example, a variety of notable guests have shared their personal experiences and professional expertise surrounding sport-related head injuries. 

Last year, the Miami University Lecture Series invited Dr. Omalu, currently a professor at the University of California, Davis, to speak about his discovery of chronic traumatic encephalopathy. And during this year’s Alan G. Ingham Memorial Lecture, University of Colorado Denver associate professor Sarah K. Fields spoke about the movie industry’s unrealistic and blasé portrayal of concussions.

Previously, the Departments of History, Psychology, and Kinesiology & Health also collaborated on a lecture featuring former NFL rising star Chris Borland, who made national headlines, and who was called the “most dangerous man in football” by ESPN, after he suddenly and voluntary quit after sustaining a head injury. Borland called his abrupt retirement a preemptive move to avoid brain damage and a lot of people noticed. 

So overall awareness is growing, but even so, many people still have a false sense of knowledge. Conceptually, the dangers of sport-related head injuries have entered the zeitgeist of mainstream culture. The message is “out” there so to speak. And in general, the public at least claims to acknowledge the risks, even if many do not yet grasp the full significance.

Sam Morris:

The students have a sort of false sense of knowledge about what the risks of that truly are. Because so many of our students, when I talk about this will say things to me like, “Well, we know what we signed up for.” You know, you are saying, “We know what we signed up for.” And I want to go, “Really?” Because there is team of medical researchers at Boston University who have been studying this for more than a decade now and they don’t know. They don’t know the answers to these questions and you are telling me that you do?

James Loy:

Throughout her research, Megan Loftin found similar trends among the former high school and college athletes that she’s interviewed. Until, that is, they learned the hard way.

Many say they were unaware of the dangers of concussions until they sustained them, which then really opened their eyes. Afterwards, many mentioned educating themselves, to understand why a concussion is serious and the long-term consequences. And for Loftin, on both a professional and a personal level, this notion also resonates deeply.

Long after her friend had experience his brain injury on the slopes, and even after her concussion research at Miami had begun, she too experienced a serious sport-related head injury, which brought this harsh reality clearly into focus.

Megan Loftin:

And then I got this concussion last semester and, like, it clicked for me. I felt like now I know what it is really like to have a concussion. So when I am talking with the people that I am talking with now for my thesis, I feel like I have that insight that I didn’t have before, of what it is really like to feel what you are feeling and that irritably and all those physical and emotional and cogitative symptoms and how much it impacts your life.

James Loy:

Her work now aims to bring this level of subjective understanding to everyone, especially to those on the other side, those of us who have luckily not gained this knowledge first-hand. And, surprisingly, research from this perspective is starkly lacking. 

Currently, most sport-related concussion research is almost exclusively quantitative, which is helpful when measuring various return-to-play metrics or objectively assessing structural damage. However, it is far less able to target the psychological links between a history of concussions and depression, for example, or how physical symptoms can exacerbate a host of emotional symptoms that can last for years afterwards.

Megan Loftin:

 I think still if you haven’t had a concussion you don’t really know or understand what it is. So that can still . . . like, that’s a barrier. How can you really help someone dealing with this if you don’t quite know or understand what it is? Because that’s part of what a concussion is. It is so unique and whatnot.

James Loy:

So through her qualitative approach, Loftin is striving to overcome the disconnect between those who have experienced a concussion and the inadequate support system that still fails to perceive, and therefore treat, all sides of this injury.