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Fall Concussion Season can cost $2,000,000 per concussion.

Fall Soccer, Football and, therefore, concussion season has started again. Annually, US emergency departments (EDs) treat an estimated average of 173,285 sports- and recreation-related TBIs ages 19 and younger. Youth sports participation continues to grow. The incidence of brain injury increases too. Many athletes who suffer brain injuries experience increased propensity for reinjury, cognitive slowing, early onset Alzheimer’s, second impact syndrome, and chronic traumatic encephalopathy. These injuries can severely limit future career opportunities, reduce work life and life expectancy and reduce future earning capacity. Even though people may functionally recover, it is important to realize that these injuries are permanent. The injury is not completely erased, reversed, or repaired. The financial damage is significant.

In my private practice and as a professional and collegiate soccer coach, I have seen several young athletes that suffered concussions. Initially injured persons may experience sleeping problems, headaches, nausea, and flu-like symptoms. Soon after the concussion, the athlete may show significant improvement. But many years (5-10) after the initial concussion they may be diagnosed with concussion induced Traumatic Brain Injury [TBI], cognitive impairment, ADHD, and organic affective disorder. Some players have become at risk for neuro-endocrine dysfunction as part of this TBI. The ex-athlete may become depressed, develop an anxiety disorder and have problems with attention and concentration.
As time moves on, damage continues spreading throughout the brain, due to axonal damage beyond the original injury. Concussion is brain damage. In 1969, the Royal College of Physicians of London and the House of Lords of England confirmed that following exposure to subconcussions and concussions, incapacitating neurological symptoms may begin to show up to 40 or more years after documented violent blows to the head. Many injured athletes are expected to progressively lose their quality of life and ability to perform work. Persons may not reach their full potential of the talents that they were born with. Life expectancy can be shortened. TBI patients have an increased risk of suicide compared to the general population.
The financial consequences of such a situation are significant. Take a high school football player who suffered a concussion during a game. A tough kid. Shakes off the pain and goes back into the field. Gets hit again. He has some mild issues but seems fine. He finishes high school. He graduates from college with an education degree. He starts teaching, and after ten years he makes $65,000 per year. Teaching is a skilled job with a Special Vocational Preparation (SVP) of 7. During the first 5 years, the work goes very well. He is beloved by students and colleagues. He gets married and has 2 children. After ten years though, he loses his job as a teacher for repeatedly getting into trouble with students at age 35. He makes inappropriate remarks, gets into fights and misses unscheduled days. It is decided that he can no longer perform this skilled work. Working with children and people is too much for him. He takes a job as a router. This is an unskilled job with an SVP of 2. In this job he can earn $30,000 per year. He works in this job for 5 years but then he is off task for 2 hours per day where he cannot manage the job at age 40. He misses 3 days per month. He doesn’t even call off. He files for Social Security Disability which is awarded to him. 5 years later he commits suicide at age 45.
The financial consequences are roughly 5 times ($65K-30K) = $175K when he becomes a router. Then he has 5 years until his death where he loses $325K and another 15 years of lost Work Life Expectancy at $65K is $975K. The wage loss is therefore $1,475,000. Add 20% of lost fringe benefits for social security retirement, and health insurance, or $295,000. The total lost earning capacity is $1,770,000. Add to this the loss of household services for his family, the loss is around $2,000,000. The cost of medical care can also be in the millions.
While I coached, awareness of the severity of head injuries grew during the last 20 years. At least at the collegiate level, baseline IMPACT testing was introduced. Assertive trainers would make sure that injured players would not return onto the field and their IMPACT test would be an important factor in the concurrent treatment protocol.
Many of the players minimize the symptoms and that makes the process difficult for club and high school coaches who do not have the sports medicine support that professional clubs and colleges have. Coaches and parents need to realize how important it is to treat possible concussion situations with great care. There is potential for enormous personal and financial suffering. It is important to say to a kid, “NO” when he states on the sideline, “Coach I’m ready.”

By jeroenwalstra328, ago