Dr. Javier Cardenas, neurologist and member of the NFL Head, Neck & Spine Committee, dropped by CBS Sports Radio to discuss concussions and player safety, among other topics.

Cardenas explained that concussion awareness has clearly increased in recent years, which is, of course, a good thing.

“It’s been tremendous, the amount of attention that’s paid to concussions,” Cardenas said on After Hours with Amy Lawrence. “It’s pretty evident that every professional sports organization – whether it’s the NFL, the NBA, Major League Baseball, NHL – (has) a protocol that is well-defined and really that is structured for their particular sport. It’s tricked down to the NCAA level, to the high school level, even to the youth level. It’s pretty impressive how far and how wide this issue is.”

Cardenas said that the treatment of concussions is also evolving. In the past, rest was considered the best and primary treatment technique. That, however, is changing.

“Physical activity can be a treatment for concussions,” Cardenas said. “There are medicines that can help with the symptom associated with concussions. There are therapies, vision therapies, cognitive or thinking therapies that can actually help improve the outcomes, both in the rapidity in which they get better and the completeness of their recovery.”

It is extremely important, of course, that concussions are accurately diagnosed during games. Cardenas said that in-game procedures are much more sophisticated than they were five or six years ago but that they’re still not perfect.

“We’re looking for those athletes who get up unusually from a hit to the head, who may stumble when they bounce off the ground,” Cardenas said. “We’re also looking to see if we’ve evaluated them on the sidelines and (even if) there wasn’t evidence of a concussion that we are still watching the athlete for signs or symptoms because it can take a little time to present.”

While early detection is key, so too is equipment.

“Equipment is incredibly important,” Cardenas said. “And many people think, ‘Well, if I have the newest helmet or the newest set of shoulder pads or even a mouth guard, then that is really going to provide the most protection.’ While the materials are definitely getting better, they are now absorbing a lot of the energy keeping it away form the head. What is still most impotent is that fit of the helmet. So when we have our athletes at the beginning of the season, we make sure we tell them make sure your chinstraps are fastened and make sure that helmet is fit very tightly.”

That is why players must exit a game for a play if their helmet falls off. It’s all about breaking bad habits and helping to ensure long-term safety.

Despite progress, however, the war against brain damage, sadly, is just beginning.

“What we know is actually very little,” Cardenas said. “There is clearly an association with multiple concussions and CTE, which is currently only able to be diagnosed by pathology after death. What we are trying to understand, No. 1, is what does this look like for somebody that is still alive? And the second thing is are there elements of this problem that are still treatable? So for example, somebody who is suffering from depression and is suicidal, are they still going to respond to anti-depressants and counseling so that they don’t get to the point of committing suicide? Are they able to respond to things like cognitive therapy if they are having trouble with their memory and thinking? Is this purely a degenerative disease, or do they have this decline in their function of the brain and does it stay at a low level? Those are all questions that still need to be answered. But what is particularly concerning to me is whether or not hits to the head that don’t cause symptoms of concussions will result in the same type of damage that we see in those who have concussions.”


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