University of Iowa doctor sees progress on concussions

Mark Emmert

IOWA CITY, Ia. — Dr. Andrew Peterson has seen greater awareness of concussions among athletes at the University of Iowa, he said Thursday after giving a presentation on the topic to the Presidential Committee on Athletics.

Peterson, who is on the sideline for every Hawkeye football game, said players are more likely to report concussion symptoms and less likely to try to resist efforts to withhold them from competition.

“We just have a culture of respect here. Our athletes respect their coaches. They respect their medical staff. I don’t get any pushback,” said Peterson, who founded the university’s concussion clinic when he arrived six years ago.

Kansas City Chiefs quarterback Alex Smith left the field last Sunday after sustaining a concussion in a high-profile episode. Dr. Andrew Peterson, who works on the sideline during Iowa football games, admitted: "There's probably some that slip through our fingers."

“If we need to remove someone from play, we remove them from play and if I take a little bit of heat from the media or someone anonymous on a blog, I don’t care at all.”

Peterson estimated that there is “less than one” concussion evaluation he needs to perform in the average football game.

Peterson shared with PCA members data that showed Iowa had 11 diagnosed concussions among its athletes in the most recent year. He said only two or three of those occurred on the football team, while acknowledging that that extremely low number was “a statistical aberration.” Iowa had a rate of 1.02 concussions for every 1,000 “athlete exposures” — which includes practices and games — that was among the lowest in the Big Ten and Ivy League Conference schools surveyed.

Other highlights from Peterson’s discussion:

  • He said his job has been helped the past two years after the NCAA mandated that an athletic trainer be stationed in the press box at every football game to act as a “spotter.” That person can alert doctors on the sideline when they suspect a player may have suffered a concussion, and can also provide additional information to doctors about where and how players got hit after watching replay reviews. Peterson doesn’t have access to replay on the sideline.

“It’s good to have people who are kind of medically literate up there and have been around athletics, and can describe to us down on the field” what happened to a player, Peterson said.

  • In addition, Iowa has three athletic trainers at every football practice. Peterson said that athletic trainers are better equipped than doctors to spot concussions.

“Athletic trainers are around athletes. They see infinitely more hits and bad things than we physicians ever see,” he said. “I do as much sports medicine as anyone else in the country and our lowest-trained athletic trainer has seen more hard collisions on a football field than I have.”

  • Coaches are not involved in decisions to remove football players from a game. Peterson said he’s always been supported whenever he’s had to make that call.

“It’s way better than it used to be. We don’t get a lot of pushback from people about, ‘Hey, tough it out’ or ‘Play through your symptoms,’” Peterson said. “People are starting to identify that when you have a concussion, you just don’t play very well. Coaches and other players are interested in getting that concussed player off the field because he’s not a very good teammate when he’s concussed.”

  • One innovation Peterson would like to see is a diagnostic test that would indicate when a concussion has occurred. Currently, doctors use a clinical diagnosis, a 10-minute process. He suspects that a diagnostic test — a blood test or an eye scan — will be available within 10 years. “That would be a game-changer,” he said.

“We don’t have any magic test,” Peterson said. “Are there some (concussed athletes) that slip through our fingers? Yeah, there’s probably some that slip through our fingers. We try to be extra cautious. If we’re not comfortable that someone is definitely normal and hasn’t had an injury, we don’t return them to play. There’s a saying, ‘When in doubt, sit them out,’ and we try to follow that mantra.”

  • Peterson is frequently asked by parents if football is safe for their child. His answer: “It’s safer than a lot of other things we do. It’s safer than driving your car. It’s probably safer than sitting at home on your couch eating chips. … That’s part of the reason we enjoy the sport. If it was completely risk-free, we wouldn’t be interested in the sport quite as much. That danger element is part of what draws kids to the sport and is what draws the television viewership as well.”