A Rugby Player-Turned-Researcher Tackles the Reality of Concussions

In the US, about 13-19% of all sports-related injuries are concussions. Concussions are a mild form of traumatic brain injury (TBI), where a sudden movement or impact causes the brain to bounce around in the skull. Most people will recover from concussions without long-term effects, but a growing body of research showing the dangers of large accumulations of head impacts and concussions has sparked more scientific interest in understanding the injury.

Still, there are a lot of misconceptions and unknowns about TBIs. Assistant professor of Exercise Science, Katie Hunzinger, PhD, ACSM-CEP, is working to change that, and she’s doing it from a unique position: as a rugby player and referee. She’s experienced concussions herself, and she’s now built a career researching the effects of head injuries. In this Q&A, Dr. Hunzinger talks about how her own experience with concussions prompted her to enter the field to make a change, and she mulls over a big question: whether she, knowing more about TBIs now, would let her future child play a high-contact sport like rugby.

How would you describe your research to the person riding the elevator with you?

 My research focuses on the long-term effects of traumatic brain injury (TBI) and repetitive head impacts (RHIs) from sport. I use large datasets to ask how the long-term effects of RHIs and TBIs relate to health outcomes such as disease, injury and death. I’m personally interested in rugby as it is the only collision sport where men and women play by the same rules, and I’m a former collegiate rugby player and current rugby referee. I hope that by identifying how TBI impacts health, we can create targeted measures to reduce and prevent future injury risk, reduce symptom progression and lessen the healthcare burden of TBI.

What first sparked your interest in rugby and TBIs?

 I suffered multiple sport-related concussions from basketball in college, which led me to playing rugby (go figure). The rugby team found me working out one day and said, “Do you want to play”? My dad played once, and I grew up playing tackle football, so it was a natural progression. During my time in graduate school, I suffered from persistent concussion symptoms related to a car accident; unfortunately, my treatment as a student was handled very differently than how it was when I was a student-athlete.

How did your lackluster concussion treatment motivate your eventual research career?

As a collegiate athlete, I was closely monitored by a multidisciplinary team and had a targeted rehabilitation program. As just a student, I was told to sit in a dark room and avoid school and exercise until I felt better. This “cocoon” therapy has been shown to exacerbate symptoms of concussion and slow healing. It is not recommended. This angered me — there was existing research supporting graded return to sport and return to learning, and data showing that cocoon therapy doesn’t work and shouldn’t be prescribed in the majority of cases. Historically in medicine, it takes about 14 years between the research being published to it reaching standard clinical practice. This delay in knowledge translation means that there may be answers and treatments out there that patients and their providers aren’t aware of.

What’s one question you’re exploring currently?

Currently, I’m looking at the relationship between prior TBI and gait in older adults: how do those with TBI history walk and perform a cognitive task (i.e., do two things at once) compared to those without TBI? This builds off of my previous work in middle-aged adults. It’s an important question because our daily lives often involve doing two things at once, be it walking while carrying our grandchildren, cooking while standing on a foam kitchen mat (i.e., an uneven surface), or walking and talking on the phone. The inability to do two things at once causes walking and balance errors, putting us at risk for falls and future injury.

What’s a unique fact about TBIs? 

If you’ve seen one concussion, you’ve seen one concussion. It is a very heterogeneous injury, and everyone presents differently with different recovery timelines.