The lasting impact of concussions

The lasting impact of concussions
The Yankees' Lou Gehrig at bat in 1935

Justin Morneau(notes) took batting practice Tuesday. He hit four home runs. His head still hurt.

"I haven't made it through a day yet without symptoms," Morneau told reporters in Minneapolis, and that makes 41 in a row dealing with the after-effects of a concussion suffered July 7 when he slid into the knee of Toronto's John McDonald(notes) trying to break up a double play – 41 days of pain, of fear, of hoping he doesn't turn out like someone he knows well.

On July 5, 2006, nearly four years on the dot before Morneau's concussion, Corey Koskie gave chase for a harmless pop-up. He twisted and turned, the ball's loop-de-loop spinning him to the ground. It looked so benign. It felt that way, too, until nine days later, when Koskie took batting practice for the first time, felt dizzy, went to his hotel and never returned to a major-league field.

"It felt like somebody was punching me in the middle of my brain and it was exploding out," he said in an interview with Yahoo! Sports on Tuesday. "I felt like I got hit by a Mack truck. I thought I was going to throw up. I was getting these waves of nausea. It was miserable."

After years of neglect due to ignorance, professional sports organizations are beginning to recognize that concussions – in simple terms, the brain rattling against the skull; more technically, the premature death of brain cells from trauma – are not only a threat to players' health but the sports themselves. A group of Boston-area doctors concluded in a study released Tuesday that the after-effects of concussions can lead to considerable degeneration in a person's brain function that manifests itself in the same fashion as amyotrophic lateral sclerosis, better known as Lou Gehrig Disease, or ALS.

As baseball wrapped its noodle around the possibility that Lou Gehrig – sufferer of a handful of concussions – didn't actually have Lou Gehrig's disease, a number of troubling cases presented themselves across the sport. In addition to Morneau, Milwaukee Brewers outfielder Carlos Gomez(notes) is ready to return after a beaning concussed him. And New York Mets outfielder Jason Bay(notes) remained on the disabled list after running into an outfield wall – and returning for two games before a doctor diagnosed his concussion, leading the team to consider revising its head-trauma policy, according to The New York Times.

Though the violence of football and hockey is well-documented, baseball has also dealt with a spate of concussions over the past half-decade. Koskie's career ended because of one, as did catcher Mike Matheny's. The Mets seem particularly vexed, with David Wright(notes), Ryan Church(notes) and Mike Cameron(notes) spending time on the disabled list because of them in recent years. During spring training every season, Major League Baseball forces clubs to administer a baseline test to have a measure doctors can use for players with traumatic injuries.

Not only are there various degrees of concussions, the fashion in which people react to brain injuries fluctuates widely. Robert Friedlander, chairman of the neurological surgery department at the University of Pittsburgh Medical Center, compares it to cancer patients: Some people can smoke three packs of cigarettes a day for their life without getting lung cancer, while others' predisposition to forming cancerous cells makes even the slightest cigarette use a death wish.

The problem: Doctors still can't pinpoint who is prone to what. Friedlander studies how cells in the brain die. Down to the level of mitochondria – the tiny energy center inside a cell – researchers have traced the release upon trauma of a protein that kills cells in the brain. Friedlander knows of a drug used to treat acne, minocycline, that in animal studies blocked the protein. He thinks there is potential in humans. Unfortunately, it will take years to determine what might work.

So if the research in Boston is accurate – the paper's peer review and other doctors' excitement is promising – the effects will be far-reaching. Already the NFL has instituted a strengthened concussion policy to prevent players from re-entering games after suspected brain trauma, a practice believed to severely worsen such injuries. Whether the future holds preventative prophylactic treatment, superior equipment or another innovation that precludes concussions, it is obvious sports can no longer disregard the issue.

"The work that group and others have done at looking at the effect in humans is very important," Friedlander said. "We're not getting to the bottom of it yet. This is the tip of the iceberg. We're just starting to understand trauma is not so innocuous. You pay a toll."

Koskie's toll lasted 2½ years. When he walked, he felt drunk. When he talked, words refused to come to him. He slept a lot. Too much. Only when doctors began treating Koskie like a whiplash patient did his symptoms start to improve, enough so that he attempted to come back in 2009 before retiring.

"If I was in Justin's position, where you're in a playoff race and get these setbacks, I'd be frustrated," Koskie said. "I had no pressure when I was feeling better. I just wanted my life back. I wanted to be able to play with my kids without getting sick."

Within the first week of Morneau's injury, he spoke with Koskie, a teammate his first two seasons with the Twins. Koskie tried to assure him the headaches would subside, the fear would vanish and his career would be fine. Morneau went through a four-hour workout July 24 in hope he would soon return. He didn't. He was supposed to take batting practice last week in Chicago and start a rehabilitation assignment soon after. He didn't. His swings Tuesday were the closest he has come to the major leagues, and, as Twins manager Ron Gardenhire said Tuesday: "That doesn't mean he's getting ready to play baseball."

Minnesota is handling this right. Because no one – not even the Twins' doctors – can say how Morneau is wired. Did his brain absorb the trauma deeper than another brain would have? And if it did, how would the death of brain cells manifest itself? Those are horrifying questions. Never mind that Morneau is one of the best hitters in the American League, his .346/.437/.618 line baseball's best alongside Josh Hamilton(notes) and Miguel Cabrera(notes). He's 29 years old.

There are games, and there are lives, and never should anyone be so blithe as to confuse them. Ignorance no longer is an excuse. If athletes and teams need more scared-straight ads, they're readily available in academic studies, cross-sections of damaged brains and the number of coffins filled with men broken by the sport they loved.