Putting all the madness aside, Johnny Manziel recently suffered what’s called in the sports medicine world a Monday Morning concussion.
With this type of head injury, a player who takes a hard hit during a game — whether it be football, lacrosse or soccer — his symptoms may take 24 to 48 hours to present themselves.
We see this in high school athletes, where they won’t notice the symptoms until they go back to school on Monday when the brain is stimulated or even hyper stimulated during classwork.
This week, I spoke with 1590 WAKR morning show host Ray Horner about this head injury. We also discussed why there’s a difference in the number of concussions in Division I college football compared to the NFL.
Below is an audio file and transcript of our discussion.
HORNER: Joining us live in our studio, our good friend,
Dr. Joe Congeni, Sports Medicine Center, Akron Children’s Hospital. Saw all the pictures over the holidays with you and the kids and the family. Looks like you had a good gathering.
DR. CONGENI: Great, great holiday. Yep. We love it. Happy New Year to you and all your listeners, Ray.
HORNER: Thank you very much. And, of course, when your clan comes together, that’s a major trip to the grocery store.
DR. CONGENI: We had, you know, several groups that came almost on a nightly basis. So, in some ways as people say, you can take a deep breath when you get into January and, uh, relax a little bit.
HORNER: [laughter] You may have talked a little bit about this last week, but of course, Johnny Manziel when he got the concussion symptoms a couple of days later and then went through the protocol … and such. So, let’s move forward now and go to Johnny, he walks in I think 2 or 3 days after the game and was showing symptoms. Is that kind of [thing] normal? Does that happen, Joe?
DR. CONGENI: It’s not normal, but it definitely does happen. So, there is a teaching point there, all the other madness aside.
DR. CONGENI: There is a teaching point there. So, we call it a Monday Morning concussion and what happens is, uh, you know, during the time of a game — and again, whether it be … soccer, lacrosse or football. A lot of the focus has been on football, but any of those sports — people, you know, athletes sometimes just don’t feel right for the first 24 to 48 hours.
You know, the one thing that made it a little bit unusual with his maybe [was the fact that it was] even closer to 72 hours, but 24 to 48 hours and then all of a sudden they’ll start getting symptoms of, uh, light sensitivity, noise sensitivity, sick to their stomach, vomiting, dizziness, memory issues, uh, brain slowed down, headache.
All those kinds of 22 symptoms that can be, uh, attributable to a concussion may become more specific after 24, 48 hours later.
HORNER: I did not realize.
DR. CONGENI: Yeah, we call that a Monday Morning concussion. And, one thing that we see in kids that are school kids a lot — that’s what I’m focusing on, under 18 — is they go to school and that really brings this on.
DR. CONGENI: So, they’re at home. They don’t really have to be, uh, thinking a lot, or you know, um, doing a lot of things to stimulate the brain. But, they get into an environment where the brain gets stimulated or even hyper stimulated and they’re calling [home] on Monday morning or Tuesday morning [saying], “Hey, I’ve gotta be picked up,” at first or second period, “because I’m really sick to my stomach. I’m really dizzy.” And so, that is known in our world as a Monday Morning concussion.
HORNER: Not to get too in-depth on the medical side, but what would separate this type of concussion from the concussion that we would see on the playing field, whatever that is, the day of?
You see somebody get up, woozy and after the locker room, they’re in there kinda woozy and you say, “Oh boy, that certainly looks like one.” A couple of days later, is that more of an aggressive concussion?
DR. CONGENI: Not necessarily more aggressive.
HORNER: Is that the body makeup?
DR. CONGENI: Yeah, no. I think it’s like a lot of other injuries that we have is that initially there’s kind of a generalization to the injury and then later on it becomes more localized into what specific part of the brain was injured that’s giving you these symptoms.
It’s like a lot of our other injuries, and that’s why we tell people maybe take 2 or 3 days, rest it, ice it, you know, for other injuries, as well. And over time, it’ll kind of localize itself to where the real problem is. The same kind of issue is in the brain.
That’s what makes this, gosh, this is such a challenging condition to see because you would figure that you’d see these things right away in the first hour or 2, but that’s not the case, Ray.
HORNER: Dr. Joe Congeni with us in studio.
Here’s something I wanted to ask you today. When I was on vacation I had a chance to watch a lot of these bowl games and I normally don’t because I get up real early in the morning and I turn off the TV and go to bed, but I watched a ton of college football over the last week and a half. I did not see concussion protocol. I did not see a lot of these guys coming off the field with a concussion.
So, my question is, not that they’re doing a bad job because you have educated me as [they’re] doing a much better job, but why aren’t we seeing — or I’m just missing them — more concussions on the Division I college level compared to what we’re seeing in the NFL, where it seems like every NFL football game we’ve got 5 or 6 guys that are going through concussion protocol now?
DR. CONGENI: Yeah, you know, I think you hear about them the next day or the day after. It’s not always so obvious on the field, the staggering around, the person knocked out. You may not see that as frequently, but like for instance in the great comeback game. Did you see the TCU [vs.] Oregon game?
HORNER: I did. Turned that game around.
DR. CONGENI: … Their quarterback was knocked out and didn’t come back in the 2nd half. Maybe on the field you don’t see it and then they get in the locker room and they find out what’s going on symptoms-wise.
The camera doesn’t always pick these things up. It’s behind the scenes. And so, it’s not the obvious thing that you see on the screen, but, uh, unfortunately I think, you know, they’ll continue to be increasing numbers in college just like there are in the pros.
HORNER: Yeah, and I was getting into a discussion with some friends of mine about that subject over the holidays and I said, “Well, it could be a factor that the guys in the NFL are bigger, stronger, faster and, you know, you’re looking at lightning speed, huge 250-pound athletes.” Maybe that’s where it comes ’cause not all the college guys are that big, strong and fast. I don’t know.
DR. CONGENI: Well, I think that’s part of it. Going up a level there’s no doubt that the force of the blows, the g-forces that we look at, those kinds of things definitely go up at the professional level for sure.
But we know that even at the high school level, and we’ve come to understand that even at the youth level, there are some really, you know, forceful hits and blows, and our job is to try and prevent and minimize a