NFL officials have been criticized for ignoring brain injuries. But they’re not the only guilty ones. (WP)

NFL officials have been criticized for ignoring brain injuries. But they’re not the only guilty ones. (WP)

(Excerpts related to veterans)

Research I’ve conducted with my colleagues at RAND shows that brain injury is a serious problem among the nation’s veterans, too. . . .

We must collect more information about who experiences these injuries in various contexts — from youth football fields to men and women in combat zones —  and with what consequences. Too often, the schools, leagues and agencies that manage the settings in which these injuries occur don’t consider this type of research a priority, and there isn’t enough funding to enable proper studies. But it’s important for the health of our children, professional athletes and veterans that these institutions collaborate with researchers to track when and how brain trauma happens and to whom, so we can better understand what puts people at risk. That will allow us to engineer equipment and develop game rules that mitigate those risks. For instance, we don’t know if it’s safer for athletes in certain sports to play with helmets or without them. More data on how brain injuries are sustained in lacrosse and hockey would help us answer that question.

We also need more data on what trauma does to the brain. The NFL hasdevoted millions of dollars to improving the diagnosis and imaging of brain injuries. But the information that comes from that research needs to get to the hospitals, sports doctors, veterans agencies and others who are the first line of defense against concussions and their long-term effects.

Concussions are notoriously difficult for doctors to diagnose and far too many coaches fail to either recognize brain injuries or take them seriously. Delayed treatment causes longer recovery times and potentially increases the risk of long-term cognitive effects. While better imaging in the lab is a good start, we need better screening tools out in the field, too.

Finally, we need many more studies on the effectiveness of different treatments. Some of this research is underway now: The departments of defense and veterans affairs have developed a national action plan for brain trauma that details ways to reduce the number of veterans and military members affected by brain injuries and mental health issues. But we need a plan to ensure that health systems are providing the best possible care to athletes and others, as well. We don’t yet know what therapies work the best — cognitive remediation, pain medication, or simply rest. And even though organizations keep promoting these treatments, we don’t have the systematic evidence that they actually work. Health professionals need better, proven tools to ensure that they provide treatment that offers the most promise of full recovery. In addition to its focus on veterans, the federal government should establish partnerships with other entities that have the most at stake – namely the NFL, NHL and other major sports leagues – to create grants that back the critical research of brain-injury treatment.

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