Dr. Aaron Gray tackles perception that concussions happen only in football

Concussions don’t happen just in football, and Dr. Aaron Gray has the data to prove it.

Born and raised in Tennessee, Gray moved to Columbia, Missouri, full-time in 2011 for a multi-purpose physician role at the University of Missouri Hospital and Mizzou Athletics. Part of his decision to settle in Missouri was the opportunity for collaborative research on head injuries.

The 36 year-old exercised this opportunity when, in January along with a group of researchers from the University of North Carolina-Chapel Hill and Datalys Center Inc., he published a study that analyzed more than 3,000 severe injuries sustained by NCAA college athletes between the 2009-10 and 2014-15 academic years.

They found that, although football had the most concussions, an alarming number of head injuries occurred in other sports, such as men’s wrestling, men’s and women’s ice hockey, women’s basketball and women’s soccer.

“By the numbers, there’s more in football than there are in other sports,” Gray said, “but we’ll see concussions in baseball, in volleyball, in soccer.”

Gray is one of the most prominent voices on concussions in Columbia, devoting much of his time to promoting player safety in all sports, not just football. In his research on head injuries, Gray was able to quantify how many concussions were likely to happen in other sports, something that’s often neglected in this area of research and debate.

Dr. Aaron Gray promotes the message of player safety in sports when it comes to head injuries. Photo courtesy of Aaron Gray

Not just a football issue

Concussions hit the mainstream in late 2013 when League of Denial, a book by Steve Fainaru and Mark Fainaru-Wada, outlined the link between football and brain damage and highlighted the National Football League’s consistent denial of any such link.

The book has since been made into a movie, Concussion, featuring Will Smith, and it has been a regular point of debate in the NFL and among respected researchers.

Because of the high-profile attention football received, concussions in other sports often get overlooked. Gray said not enough people pay attention to this issue, as head injuries and concussions are sometimes inevitable in sports.

“They can happen from non-sports, sometimes they happen in car accidents and other things too, they just happen,” Gray said from his office at University Hospital.

Of the 25 sports Gray and his colleagues researched, an athlete sustained a concussion in 18 of them.

For example, soccer is a sport that may not come to mind when discussing head injuries, but sustained a significant number of concussions.

Dr. Aaron Gray and his research colleagues from the University of North Carolina-Chapel Hill and Datalys Center Inc. found that concussions occurred in 18 of the 25 sports studied. Above are the top six. Graphic by Daniel Levitt

So why does football receive the main share of negative headlines when it comes to concussions?

Being the nation’s pastime, the NFL has generated huge popularity and value, and has attracted most of the attention as a result, says Eric Hart, associate chair of the Department of Health Psychology at the University of Missouri and a colleague of Gray’s.

“It does tend to be singled out more, and part of that is just the nature of the competitive play that’s involved in football,” said Hart. “It’s a high-impact sport.”

As a result, Hart said, football has had a huge influence on the attention paid to concussions in other sports.

“Way back when, the reference to ‘having your bell rung’ really was a reference to a concussion,” Hart said. “So before, it was something that was overlooked, and not necessarily through the fault of a coach or athletic trainer or organization, but really because of the state of the science at the time.”

This underreporting of concussions in others sports is just one issue that Gray is trying to solve.

Technology big part in Gray’s life

When Gray wasn’t playing sports growing up, he was building computers and web pages.

The native of Columbia, Tennessee, enjoyed being active and exercising his love for learning the latest technologies.

“When I was in med school I was trying to figure out what I was going to do,” Gray said. “I heard someone talk about primary care sports medicine, which was something I didn’t even know existed.

“Being part of a select group that’s highly trained in taking care of athletes with concussions. … From that point on I decided that’s what I wanted to do.”

Now in his second stint in Columbia – the first coming as a resident physician in 2007 for three years – Gray’s interest in technology is still strong as he utilizes new technology to treat high-school and college athletes.

Since moving to Columbia full-time in 2011, Gray has focused on promoting player safety in all sports, as an attempt to counter the attention that football receives.

Much of Gray’s working week is devoted to pediatric sports medicine. The high-school athletes he treats predominantly come from Battle, Hickman and Rock Bridge high schools in Columbia, as well as athletes at Mizzou from sports including baseball and volleyball. He also treats adult patients with what he calls “weekend injuries.”

Gray has packed his online medical profile with videos promoting player safety, as well as information about the effects of brain injuries. A frequent user of Twitter, Gray uses the social media platform as a way of getting his message out to not only players and coaches, but also to parents.

“It’s really about making parents realize what are the signs and symptoms of concussions,” said Gray. And then if they suspect it, “the big thing they need to do is have their child evaluated by a healthcare professional, who’s trained in taking care of concussions. We’re trying to do more and more of that.”

All of this leads to the question of whether enough is being done, according to Gray.

Changes are being made

The NFL invested $100 million in 2016 on various programs and technologies to reduce brain injuries in football, including USA Football’s “Heads Up” program. The initiative aims to educate football players and coaches about the safest way to play the game.

A 2015 study by Datalys concluded that the program had reduced concussions by approximately 30 percent. But according an investigation of the data by The New York Times, the Heads Up program “showed no demonstrable effect on concussions during the study, and significantly less effect on injuries over all.”

Then in 2014, Major League Baseball made a rule change that catchers are no longer allowed to cover home plate when trying to tag out baserunners, a move designed to reduce the number of high-speed collisions.

The impact has been positive. Baseball statistics and analysis website FanGraphs found that there had been a significant decrease in the number of concussions in MLB since 2013, caused primarily by a fall in the number sustained by catchers.

Gray says some concussions are inevitable, but those who work with athletes should do as much as they can to prevent concussions through rule changes, education and proper tackling techniques.

Another of Gray’s colleagues agreed.

Michael Mohrland, a pediatric neuropsychologist at the University of Missouri who works with youth football and hockey leagues, said that coaches and officials he works with have made large strides to addressing the problem.

“Some of the regulation changes have been beneficial, but more beneficial than that is, [in] the football culture, especially the youth leagues, taking more of a conservative approach to brain injuries,” Mohrland said.

Mohrland added that there is more of an understanding that more high-impact practices are detrimental to the athletes.

Doctors like Gray who treat head injuries on the sidelines have been trying to shift the culture.

Decades ago when concussion research had not yet been conducted, there was a constant pressure from the coaching staff of schools, colleges and multi-million dollar organizations, Gray said. Today, players, coaches and players’ parents are more educated about the issue, which makes Gray’s job a lot easier.

“As a physician, your obligation is to the athlete, and the has to be the most important thing,” Gray said. “I try to be aware of my potential biases and conflicts, then if I’m aware of them, I feel like I can more properly set them aside and properly diagnose the problem.

“For me, it’s the athlete first, and if a team loses because a kid has to sit out with a concussion, they lose the game. What’s more important in the long run?”

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