November 6, 2017
Thomas Penney

This is Part One of a multi-part series on head injuries in sports.

“He’s in the concussion protocol.”

“The concussion spotter has pulled him from the game.”

“I was rocked pretty hard early but I got through the fight.”

As sports fans, we hear all of these things. We know that concussions are annoyances. They keep an athlete from playing while some tests are run, usually on a frustrated player who can lie their way past the checkmarks and get back out there. They are damaging blows to the head, from a shoulder or fist or elbow or hard flat playing surface that leave a person unable to perform even basic actions.

However, because concussions are generally unseen injuries, we do not have the same reaction to them as we do injuries like dislocated knees and broken legs, which are obvious and immediately apparent injuries. Concussions seem to minor in comparison to the splintered bones and shredded ligaments, despite the fact they occur in the brain. The brain, you may be aware, is important in activities like chewing food and maintaining a heartbeat. Why then, do we understand so little when it comes to head trauma in sports?

Timothy Bradley, a fighter whose best quality was his inhuman ability to eat the type of goodnight punches that end fights without going down. Simply put, Bradley is able to stay on his feet, even box effectively while he is clearly concussed. After his fight against Ruslan Provodnikov, Bradley gave an eerie interview where he was clearly not fully there. His eyes can’t seem to follow the movement of his head, and he forgets things he said only moments earlier.

An excerpt from the recap of the fight on said “Bradley managed to barely survive a hellacious assault from Ruslan Provodnikov, fighting concussed from round two onward, and having to get off the canvas at the end of the 12th round, winning on scores of 114-113, 114-113, and 115-112. BLH [Bad Left Hook] had it 114-113 for Bradley.”

By the mid-point of round two Bradley, whose style can be best described as “willfully taking a beating in order to give out a beating” couldn’t use his legs. He would swing wildly at Provodnikov, and then throw himself backward into the ropes.

He settled down somewhat in the third, with Provodnikov somewhat tired from clubbing him over the head. By the 12th round, Bradley was barely there. His eyes weren’t right. He was, quite literally, slapped around the ring for the last two minutes of the fight. When Max Kellerman came to administer the always-enlightening aforementioned post-fight interview, wherein two men who have just pushed themselves to a point of physical exhaustion akin to driving your Toyota into a tree for 36 minutes try to be eloquent, Bradley was an obvious mess. Max asked him to repeat what he had just told him before coming on camera. “I forgot,” Max told him that he said he was concussed.

A ringside physician later told reporters that Bradley was sent to the hospital, but strictly for signs of amnesia. Post Traumatic Amnesia occurs after a traumatic brain injury, but surely this was no concussion. Still, because Bradley was not visibly dead, we can take the explanation of amnesia and keep it moving. We can’t see inside Bradley’s head to know the full extent of his injury. There is no bruise to examine.

Bradley is now inactive. He announced his retirement on July 27, 2017 at just 33 years old. After the Provodnikov fight, the previously undefeated Bradley went 3-2-1 in his next six fights. In speaking about the Provodnikov fight Bradley said this, “My speech was a little bit off. I was slurring a little bit. But after about two months, I cleared up and I have my wits about me now.” This was before he would go on to fight the first of his final six fights. He spent two months in a state of impairment from his head injury. Perhaps longer, as Bradley was trying to reassure officials that he was fit to fight.

In speaking with a researcher and professor of psychology, Jacqueline Blundell of Memorial University, much about the predictive value of repeated head trauma (RHI) was uncovered. Blundell, whose research focuses on Alzheimer’s and post-traumatic stress disorder, told The Muse that the only positive indicator that exists for Alzheimer’s right now is brain trauma. She stressed that little is known about the correlations between RHI and future impairment, mostly due to the lack of long-term studies. To truly look into the connection, there would need to be a 30 to 40-year study of patients, which no one seems to want to fund.

However, there is a growing consensus in the neuroscience community around brain trauma and long-term damage. From a review in the JAMA Neurology journal: “Available data, while limited and complicated by selection bias, indicate that exposure to RBT [repeated brain trauma] represents the greatest risk factor for CTE pathological features, although clinicopathological correlates and the nature of onset and progression of symptoms are largely unknown. Considering aspects of cognitive reserve is likely essential for both interpreting cognitive outcomes associated with CTE and for developing preventive treatment programs. Research on CTE would benefit greatly from incorporating principles established within other areas of neurodegenerative disease and the nuances of clinicopathological considerations.” The consensus is that blows to the head and long-term damage are related but still have not been definitively linked due to a lack of resources and historical data.

In the next part of this multi-part series, we’ll dive deeper into the controversies surrounding CTE research as it relates to the sporting world.