Pump the brakes on ImPACT testing Rowdy Keselowski
NASCAR announced this past week that starting in 2014 all drivers must receive baseline ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) neurological testing. And while the tool is already in regular use elsewhere, not everyone in NASCAR is comfortable with bringing it to their sport. Defending champion Brad Keselowski was particularly outspoken about it, saying that, “This (racing) is not a field for doctors. Let them play in their arena and I'll play in mine.” Kyle Busch may have the nickname but no driver ever sounded more like Rowdy Burns than Brad did here.
The purpose of the testing is to provide doctors with a picture of how a driver's brain works. Doctors can then administer the test after an accident to determine if a driver's cognitive ability has been impacted (click HERE for more information on how the test works). When used in concert with a full medical examination, ImPACT testing provides an outstanding tool in determining both the presence and the severity of a concussion. The NFL has used the ImPACT test as a part of its concussion protocol for over a year now. While there have been some complaints about its lack of use (due in no small part to players hiding concussion symptoms), few have complained about the actual program itself.
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While Keselowski's opposition to the testing was the loudest, it's safe to say he's not alone in his feelings. He's a racer, and as many noted after Tony Stewart's August accident, racer's race. It's why Martin Truex Jr. spent the close of his summer with a cast on his arm a la Ricky Bobby. It's why Keselowski himself spent much of his championship run with a wrecked ankle thanks to a wreck while testing at Road Atlanta. Denny Hamlin missed four races earlier this year thanks to a broken back but given his results after returning might have benefited from a longer layoff. Like athletes in any other sport, a race car driver doesn't want to be out of the car any longer than is medically required and concussion testing has the possibility of putting more drivers on the shelf for at least a race.
Missing a race often has consequences that go far beyond merely getting out of the race car. NASCAR's point system penalizes a poor finish far more than it rewards a win and it's hard to finish worse than not starting at all. Making the Chase comes with enormous incentives both in media coverage and in final season payout. It also keeps the sponsor dollars flowing; companies pay big money to see their product a part of the season-ending playoffs.
In addition, sponsors generally don't like to see their investment wasted on a secondary driver. There's a very different value proposition depending on the driver. Bass Pro Shops and Mobil 1 signed on to have Tony Stewart drive their car, not Austin Dillon and Mark Martin. They paid serious dollars to have their products represented by a three time former champion who would win races and contend for a championship. Instead, they got a rookie who's never won and a veteran who hasn't won since 2009. No disrespect to Dillon and Martin but neither is Tony Stewart. NASCAR's teams are having enough trouble attracting and retaining sponsors- pulling drivers from the cockpit will only add to those woes.
Yet the strongest argument for concussion testing is ironically one that Keselowski gave as a reason against it. “An NFL player doesn’t walk on the field and say, ‘Today might be the day where I die.’ He doesn’t make a decision when he gets out on the field that could effect the health of others. That’s a pretty distinct difference.” He's absolutely right. Concussion testing in the NFL generally only affects the person being tested. If they manage to duck the test and get back out on the field, the player is potentially impacting their own quality of life for years to come. That's bad but at least it's contained to the person making the choice. In NASCAR, the results are far more serious.
In simplest terms, a concussion is an injury to the brain itself that is the result of impacts to the skull. Symptoms generally fall under one of two categories. The first, physical, deals with the body's reaction to the injury. It includes headaches, dizziness, lessened motor control and light sensitivity. The second, neurological, deals with the mind's reaction to the injury. It includes disorientation, increased difficulty in focusing attention and potentially inappropriate emotional responses. Moreover, these symptoms manifest themselves irregularly. A concussed person can feel perfectly fine one day only for a trigger to set off symptoms the next day.
Think about that in the context of a race car driver. They are strapped into a 3400 lb stock car traveling at speeds up to 200 miles per hour, sharing the track with 42 other individuals doing likewise. The possibility of a wreck is always there even without a concussion. Yet would Keselowski truly want to share the track with someone who had those symptoms? How safe is it for Brad to go side-by-side with someone who has lessened motor control, disorientation and inappropriate emotional responses? A split-second loss of attention could be the difference between making it through a corner and spinning out on turn exit. Or that moment of disorientation while heading down pit road could lead to a wreck involving horribly vulnerable pit crew members of another team.
Moreover, NASCAR has both a moral and a legal obligation to look out for drivers- even when they have little interest in looking out for themselves. The long-term results of repeated brain trauma are becoming clearer every day and the sports world is littered with the careers of those who never managed to fully put those symptoms behind. While NASCAR drivers don't have the same repeated trauma that boxers and football players have, they make up for the lower number with harder overall impacts. Going head-on into a wall at 150 miles an hour seems likely to do more damage than being hit by an NFL safety while going across the middle after all. The sanctioning body cannot afford to stand on the sideline- they watched the NFL pay close to a billion dollars to settle a concussion lawsuit and have no interest in facing a similar one of their own.
Keselowski's hesitance does highlight one other issue. As noted earlier, a driver who misses races is one with little chance to win a championship. The wild card provides an opportunity to make up ground but what about during the Chase itself? Dale Earnhardt Jr. faced that last year, missing two races due to concussion symptoms and ending his chances to win a title. Other drivers with less in the bank and more on the line might be inclined to avoid tests that would expose them to the possibility of missing a race.
2012 wreck that caused Earnhardt's second concussion
While no change would completely eliminate the concern, perhaps the Chase needs another adjustment. The ability to drop the lowest scoring race from a driver's total would have multiple benefits. It would provide a true mulligan for every competitor and keep more teams in the race longer (and thus keep the fans of those drivers interested as well). It would also protect a driver who had to step out of the car due to a mild concussion- allowing those drivers to protect themselves from a greater concussion in the following week by missing a race. Would they want to step out of the car? Maybe not. But a good concussion protocol would mandate it.
Keselowski and others are looking for a firm guideline on the ImPACT test results, which is understandable. The problem is that no such guideline truly exists. The test is not a stand-alone item that you can pass or fail. It is one tool in the toolbox to determine a driver's overall cognitive function and as such will always be a subjective item. A CAT scan might show you a driver's brain, after all, but it cannot tell you what lies inside a driver's mind and the difference is crucial. It remains to be seen just how NASCAR will apply the protocol in their sport and the details will be critical in the policy's overall success or failure. But having another tool for doctors to use isn't a bad thing, no matter how much Rowdy Keselowski says otherwise.