Sociocultural Examinations of Sports Concussions

Matt Ventresca, Mary McDonald

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429639852
• Edition: 1
• Topic: Medicine
• Subtopic: Sports Medicine

Sport's "concussion crisis" has been characterized by controversial scientific discoveries, athlete suicides, and high-profile lawsuits involving professional sports leagues, while provoking widespread media coverage, changes to game rules, and debate about the future of many popular sports. Sociocultural Examinations of Sports Concussion is the first edited collection to bring together multiple sociocultural perspectives on sports concussion that interrogate the social, economic, political, and historical forces shaping the cultural impacts of these injuries.

Each of the ten chapters moves beyond biomedical or neuroscientific paradigms to critically examine a specific intersection of sociocultural factors influencing public perceptions about concussion or athlete experiences of brain injury. These include analyses of media and advertising, medical treatment and diagnostic protocols, gender and masculinity, developments in equipment and scientific models, economics and labor politics, understandings of trauma and recovery, public health philosophies, and disciplinary differences in framing the ontologies of concussion.

Drawing from a wide range of theoretical and methodological approaches, Sociocultural Examinations of Sports Concussion offers a diverse set of analyses examining brain injuries as cultural and embodied phenomena affecting more than just athletes' brains, but also embedded within and (re)shaping meanings, identities, and social contexts. It is valuable reading for graduate students and researchers interested in the experience and treatment of sports concussion, sports sociology, and sports technology.

Part I
Introduction

1 Forces of Impact

Critically Examining Sport’s “Concussion Crises”

Matt Ventresca and Mary G. McDonald

As concern about traumatic brain injury (TBI) in sports has intensified over the past three decades, it has become strikingly ordinary to encounter declarations about how the contemporary sports world is in the throes of a “concussion crisis.” Estimates for the number of concussions sustained in sports contexts per year vary widely. The most commonly cited statistics from the Center for Disease Control (CDC) specify an extremely wide range, approximating that somewhere between 1.6 and 3.8 million concussions occur annually in the United States (Harmon et al. 2013). Even without more precise injury rates, descriptions of the prevalence of concussion in sports as a “national obsession” (Cantu and Hyman 2012), “the number one contemporary sports issue” (Reed 2017), and a “silent epidemic” (Carroll and Rosner 2012) speak to the perceived urgency and severity of this “crisis.” The apparent magnitude of the problem is further reflected in the sheer variety of developments connected to, and emerging from, sport’s “concussion crises.”

National and international research programs, as well as scholarly organizations dedicated to the scientific study of concussion, have been founded. Professional and amateur sports organizations have approved rule changes to protect athletes from brain trauma. Companies have invested millions into developing technologies related to the diagnosis and prevention of concussion, from protective equipment and digital impact sensors to pharmaceutical treatments and nutritional supplements. Governments have enacted legislation to support more comprehensive sideline medical care for concussed athletes. Multi-million-dollar concussion lawsuits have been brought against high-profile sports organizations such as the National Football League (NFL), the National Hockey League (NHL), and the National Collegiate Athletic Association (NCAA). News stories about concussion have become an everyday part of the sports media landscape. A previously obscure neurodegenerative disease, chronic traumatic encephalopathy (CTE), has become a commonly discussed topic among athletes, sports commentators, and fans. Hollywood mega-star Will Smith even played a neuropathologist in a feature film about the discovery of CTE in the brain of an NFL player.

The “concussion crisis” has notably also infiltrated the realm of American politics. In 2014, then U.S. President Barack Obama hosted the “Healthy Kids and Safe Sports Concussion Summit,” a gathering which brought together over 200 sports officials, scientists, clinicians, coaches, parents, and young athletes in conversation about how to best address brain injuries in youth sports. The summit was a venue for sharing the latest scientific breakthroughs and discussing opportunities for better diagnosis and treatment, but Obama also made comments highlighting the cultural dimensions of concussion. Obama asserted, “We have to change a culture that says, ‘you suck it up and play through a brain injury’. The president continued, “It doesn’t make you weak” to report a concussion, “it means you’re strong” (Diamond 2014).

Just over two years later, at an October campaign rally in Lakeland, Florida, soon-to-be President Donald J. Trump noticed a woman in the audience had fainted due to the extremely hot weather conditions. When the woman returned to the rally after receiving medical attention, Trump praised her resilience, joking, “See we don’t go by these new and very much softer NFL rules… . Concussion? Uh oh, got a little ding on the head, no, no you can’t play for the rest of the season. Our people are tough!” (Guarino 2016). Trump’s comments are representative of widespread backlash to rule changes made in the interest of improving athlete health and safety, particularly in the hyper-masculine collision sport of gridiron football. Yet, importantly, Trump’s remarks drew from a larger, ongoing analogy in which the NFL, its predominately African American playing force, and football culture, more broadly, were continuous targets of derision. Thomas Oates (2017, 169) explains how Trump connected football’s apparent symbolic expressions of “hegemonic masculinity to a national decline, reframing a debate about individual safety as a defense of America’s future.” Contrary to Obama’s call for action to address brain injury in youth sports, Trump’s analogy depicts concerns about concussion as representative of a collective “softening” of American culture and antithetical to his brand of white masculine populism.

Scholars have identified that “the problem” of concussion is almost exclusively conceptualized through a biomedical or neuroscientific lens, where the extent of the injury is defined according to impairments across biological systems (Malcolm 2017; Ventresca 2019). Yet such contrasting comments from two American presidents vividly illustrate how the materiality of sports concussions is intertwined with cultural norms and ideologies. This edited collection, Sociocultural Examinations of Sports Concussions, seeks to critically engage such entanglements of the biological and the cultural. Derived from a research symposium held in March 2018 at the Georgia Institute of Technology, this interdisciplinary anthology brings together critical analyses of the cultural implications of brain injuries in sports investigated through relevant histories, controversies, experiences, and knowledge formations.

The chapters that make up this book move beyond analyses of concussion conducted through biomedical or neuroscientific lenses to interrogate the social, economic, political, and historical forces shaping the cultural impact of these injuries. Each of the following nine chapters critically examines a specific intersection of sociocultural factors influencing public perceptions about concussion or athlete experiences of brain injury, including media and advertising, medical treatment and diagnostic protocols, gender and masculinity, developments in equipment and changing scientific paradigms, economics and labor politics, understandings of trauma and recovery, and public health philosophies. Drawing from a wide range of theoretical and methodological approaches that characterize the social sciences and humanities, Sociocultural Examinations of Sports Concussions offers a diverse set of analyses examining brain injuries as cultural and material phenomena affecting more than just an athlete’s brain, but also embedded within and (re)shaping meanings, identities, and social contexts.

Concussion and the Sociological Imagination

The analytical focus of this anthology is first indebted to the tradition of critical scholarship including C. Wright Mills’ (1959) arguments about the importance of developing a sociological imagination. The sociological imagination involves tracing connections between patterns in individual lives and those in society, noticing how personal biographies are shaped by larger socio-historical contexts. The sociological imagination is, therefore, crucially distinct from medical or psychological perspectives, because it moves beyond the study of individual physiology or behavior and instead examines how events, experiences, and ideas are influenced by societal trends. As such, the sociological imagination encompasses three components: historical, comparative, and critical analyses.

Historical examinations allow for mapping change over time and facilitating better understandings of contemporary events by situating them in historical contexts. Comparative analysis enables assessing phenomena across different societies, (sub)cultures, and social environments, thus cultivating an openness to possibilities and ideas beyond dominant ways of thinking. Critical scrutiny requires recognizing how personal problems and societal issues are linked to power imbalances and social inequalities. Thus, critical analysis encourages the questioning of taken-for-granted assumptions about how the world works, while supporting societal improvements and movements toward social change.

The ethos offered via the sociological imagination has been vigorously taken up by scholars demonstrating how sports are cultural practices influenced by, and influencing, the larger societies in which they take place. Sports Studies scholars have, for decades, illustrated how sports are sites of ongoing social and political struggles over meaning, identities, resources, and power (Coakley 2017). These research directions have cultivated insight into how athletic bodies are enactments of beliefs and values about gender, race, social class, sexuality, (dis)ability, and nationhood (McDonald and Birrell 1999). Such analyses have especially contributed to scholarly work concerning sport-related pain and injury that examines how athletes experience and interpret pain, as well as how athletes construct identities through the management (and often disavowal) of pain and injury (Young 2004; Roderick 1998). This research has additionally raised questions about tensions between the unquestioned status of sports as “healthy” activities and the lived experiences of pain and injury, while also interrogating the governance of sports medicine and the discipline’s often-conflicting goals of improving athlete health and enabling sport performance (Safai 2003; Theberge 2008).

Sociocultural Examinations of Sports Concussions is particularly indebted to these perspectives generated by Sport Studies scholars. The anthology also emerges with a growing body of related scholarship, especially evident from 2012 onwards, which draws from social sciences and humanities theories and methods to analyze concussion in sports contexts. While it would be impossible to fairly or exhaustively characterize this research, this scholarship’s commitments to more deeply explore complex TBI assemblages are also evident in scholars’ various engagements with historical, comparative, and critical sensitivities. A few examples are illustrative of this analytical commitment.

For example, Emily Harrison’s (2014) investigation of “football’s first concussion crisis,” suggests that the recent emphasis on brain injuries is hardly new as extensive medical concern about head and brain injuries among US college football players existed in the late nineteenth and early twentieth centuries. As can be seen today, powerful community leaders sought to intervene to make sure that the sport was considered “safe enough” to ensure its long-term viability. This examination helps to contextualize a much longer process whereby brain and bodily health concerns in sports, particularly collision and contact sports, are often downplayed or brushed aside (see also Bachynski this volume). Stephen Casper (2018a, 2018b) has indeed illuminated how neuroscientific research directions around brain injury have historically shaped, but also been shaped by, cultural debates about the safety of collision sports such as boxing and football.

The last three decades have seen rapid growth in media content about concussion across news articles, sports broadcasts, film, social media posts, and podcasts, helping to raise public awareness; although some coverage has been framed in individualistic or sensationalistic ways, the latter of which, some scholars suggest, helps to overstate risks and perpetuate a culture of fear around the dangers of brain injury (Kuhn et al. 2017; Stewart et al. 2019). And yet, investigative reports, have shed light on unethical and dishonest practices undertaken by several sports organizations in the interests of maintaining athlete productivity and in avoiding legal responsibility for athlete well-being (e.g., Fainaru-Wada and Fainaru 2013). Scholars have investigated the intricacies of these sometimes contradictory media discourses, through which journalists disseminate information about advancements in concussion science while also providing unsettling accounts of athletes’ experiences living in the aftermath of brain injury (Bell et al. 2019; Furness 2016; Ventresca 2019) and describing athletes’ attempts to protect their own health (Anderson and Kian 2012; McGannon et al. 2013; Cassilo and Sanderson 2016). Ventresca’s (2019) comparative analysis illustrates how competing media discourses too often privilege the illusion of scientific conclusiveness over athlete testimony in debates about collision sports’ often violent effects. Researchers have also analyzed how information about TBI gets shared across social media, emphasizing the limitations of these platforms for disseminating accurate and relevant information about complex topics (Hull and Schmittel 2014). These examples demonstrate the contested character of cultural knowledge formations as well as the agenda-setting power of the media to socially construct meanings of concussions, often in reductive ways.

Research empirically examining lived experiences of concussion has largely critiqued the influence of social norms and expectations in shaping how athletes interpret and react to their injuries. Nikolaus Dean’s (2019) autoethnography is a case in point as he describes his tumultuous experience of concussion and struggles with the ruptures between his embodied, injured reality and his desire to recapture his self-concept of a healthy, able-bodied athlete dedicated to broader sports values of self-sacrifice and determination (see also Cassilo and Sanderson 2018; Bridel et al. this volume). The linkage between masculinity and sporting norms helps to partially explain why some athletes celebrate “playing hurt” while taking an irreverent attitude toward concussion that downplays the severity of these injuries (Liston et al. 2018). Boneau et al. (2018) further implicate larger social processes at play by documenting how parents too often venerate family identities and community belonging as reasons for encouraging their children to play middle school football despite the potential risks to their boys’ health and well-being.

Given the financial and legal stakes tied to developments in TBI science and policy, scholars have scrutinized what they view as industry-friendly framings of concussion debates and conflicts of interest in the funding of brain injury research. The NFL is a leader in this regard, using strategies that cast doubt on the existing science, thus obscuring any potential liability regarding player injuries (Goldberg 2012; also see Goldberg this volume). Brayton and colleagues (2019; see also Brayton and Helstein in this volume) also resist depoliticized readings of the collective fallout of concussion in professional sport, connecting medical debates about athletes’ brain health with racialized labor struggles in the NFL and NHL. Malcolm (2017) further outlines the broader privileging of biomedical practitioners and protocols in TBI management and how the dominance of such approaches glosses over that concussion is foundationally a social, rather than a medical, problem (see also Morrison in this volume). Hardes (2017) and Ventresca (2020) similarly critique the primacy of neuroscience as a dominant knowledge paradigm in research and legal proceedings concerning concussion (see also Ventresca in this volume). However, Morrison and Casper (2016) question the relentless public focus on CTE in the NFL and highlight the lack of attention given to brain injuries sustained by victims of intimate partner violence (see also van Ingen in this volume). Morrison and Casper (2016) argue that the inflated concern about CTE among football players at the same time erases the embodied consequences of football experiences including by men who are also implicated in violence against women.

While hardly an exhaustive account, collectively this brief review additionally demonstrates that concussions are not simply physiological injuries but material sites of social meaning and political import. Such critical inquiries into the politics of concussion knowledge, embodiment, representations, and the “social arrangements of medical care” in sport environments (Roderick 2006, 24) are interconnected with broader investigations into the socio- historical processes shaping developments in biomedicine, scientific research, and technological innovations (Foucault 1973; Haraway 1997; Jasanoff 2005). Of particular relevance here are recent critical studies of neuroscience detailing how advancements in neuroimaging have facilitated new forms of human subjectivity and ways of thinking about brain function (Rose and Abi-Rached 2013; Dumit 2004; Pitts-Taylor 2016).

Among legitimate fears of biological determinism and neuroreductionism, which reduce humans to products of neural activity or brain chemistry, “the neurosciences are embracing a fundamentally social concept of the brain” (Pitts-Taylor 2016, 3). Feminists are at the forefront of such theorizing, examining “not merely the influence of culture on neurobiology but also the immanent multiplicity of neural matter itself, its refusal to be fully predictable” (Pitts-Taylor 2016, 10). Applied to sports settings, concussions should thus be conceived as material-semiotic phenomena (Ventresc...

Table of contents

• Cover
• Half Title
• Series
• Title
• Copyright
• Contents
• List of Figure
• List of Contributors
• Acknowledgments
• Part I Introduction
• Part II History, Health, Ethics
• Part III The Politics of Trauma, Experience, and Research
• Index