Twellman’s retirement should serve as a warning

In the wake of Taylor Twellman’s premature retirement from professional soccer due to post-concussion symptoms, you can’t help but worry about what kind of future awaits the five-time MLS All-Star.

When Twellman began his professional career back ten years ago, concussions were viewed in the same manner as sprained ankles and torn patellas by the sports public and media. They were just one of many garden-variety sports injuries. And as common wisdom dictated at the time, we thought that most of these injuries could be repaired with rigorous rehabilitation, or in some instances, sufficient time to recuperate.

Taylor Twellman receives treatment on the sidelines for the concussion he received on August 30th, 2008 that would eventually force him to end his playing career. (Photo by Art Donahue/artdonahue.com)

But recently, we’ve come to learn that that thinking was all wrong when it came to head trauma. Tragically wrong, in some cases. Concussions – which are actually bruises to the brain- are not the same as a torn muscle or broken leg. They cannot be repaired with surgery and 6-8 weeks of rehab. Contrary to the proverb, time does not heal all wounds.

Twellman’s forced retirement only proves what we’ve learned: concussions are not only far more difficult to treat than we initially believed, but also much, much harder to overcome, if ever.

So much attention has been paid to the study of concussions that Twellman himself announced last month that he is among 300 athletes who will donate his brain post-mortem to a collaborative study between Boston University Medical School and the Sports Legacy Institute that’s researching the disturbing link between concussions and their potentially deadly after-effects.

A cursory review of any national sports website sheds light on how devastating repeated head trauma proven itself to be to athletes in particular. Recently, three notable football players – Owen Thomas, Andre Waters, and Chris Henry – all met unexpected deaths due to self-inflicted, fatal injuries (Thomas and Waters committed suicide, while Henry was killed after falling out of a traveling pickup truck that he hopped onto in an attempt to talk to the driver) that doctors have linked to a condition similar to amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s Disease) called Chronic Traumatic Encephalopathy (CTE).

According to medical reports, CTE is defined as “a degenerative disease that effects the brain and believed to be caused by repeated head trauma resulting in large accumulations of tau proteins, killing cells in regions responsible for mood, emotions, and executive functioning. The chronic injuries sustained by repeated and untreated concussions has shown to damage the brain over time.” What many researchers fear is that CTE can occur even without a player suffering a concussion.

Some doctors theorize that it is the accumulation of multiple hits to the head that can cause CTE, although there is no magic number or range behind how many blows cause CTE. In an October 12, 2010 ESPN.com article, Dr. Robert Cantu, a clinical professor of neurosurgery and co-founder of the aforementioned Sports Legacy Institute, stated that he “has no idea how much head trauma is necessary to produce [CTE].”

The idea that concussions aren’t necessary to cause CTE makes it all the more scarier considering that Twellman, who suffered seven diagnosed concussions throughout his playing career, likely sustained a greater number of less traumatic, but just as dangerous, hits to the head, which conceivably puts him at higher risk of suffering from CTE.

In the locker room after what proved to be his final match on June 7, 2009, Twellman said that he had suffered memory loss, headaches, and nausea as a result of the symptoms of post-concussion syndrome. It was evident that all was not well with the Revolution’s all-time scoring leader, even months removed from that fateful collision with Galaxy goalkeeper Steve Cronin.

Despite scoring two goals as a substitute that day, Twellman had to shut his season down almost immediately after the match. He was placed on the MLS injured reserve before the end of the month. By then, it was clear: the painfully-debilitating symptoms were just too much to bear, even for a relatively-healthy then-29-year-old professional athlete who should have been in the prime of his playing career. Erring on the side of caution, the timetable for his return was set back to zero.

There was brief hope that with more time to rest and recover, Twellman’s symptoms would subside and that his return to the pitch was imminent. The headaches, nausea, and memory loss couldn’t longer indefinitely – or could they?

That was the question on everyone’s mind. Unfortunately, the brain remains a tricky organ to diagnose when it sustains any kind of bruising or damage. It is, by far, the least-understood organ in the human body. And in Taylor’s case, his brain, which had been bruised multiple times, refused to heal as quickly as he had wished it to.

In early-2010, some nine months after his last game, Twellman resumed his rehab one more time. It was snail-like slow at the beginning, as the striker was limited to brief, carefully-monitored low-impact exercises. Gradually, he began work on a stationary bike and tackled mild cardiovascular exercises. By May, he had worked up to light sprints and jogging. It looked encouraging. But before he could partake in a full training session with the rest of his teammates, it became too much.

Coincidentally, one of the final blows to any hopes for a return to the pitch incidentally occurred at a basketball game. As a spectator at a Celtics-Lakers game last May, he was relaxing courtside with a friend before Twellman suddenly became confused.

“Where are the coaches?” asked the admitted sports nut, who could probably name every head coach of every major professional sports team from memory.

“They’re right in front of you, Taylor,” his friend replied.

It was around that time that the Revolution had no choice but to put the brakes on Twellman’s season, and ultimately, his career. They placed him on season-ending injured reserve on June 23, 2010. There would be no more rehabbing. No more baby steps toward one more match in front of the home crowd. Baby steps were far, far too risky with a player who’s brain had endured at least seven significant instances of trauma. It was time to shut the goalscoring machine down. This time, it was permanent.

Some in the media questioned the decision. They questioned Twellman’s passion to play. They saw him walking around the locker room, talking to teammates, and smiling like someone who didn’t have a care in the world. In their estimation, Twellman looked healthy enough to suit up with his teammates and score some goals.

But anyone who’s ever spoken with him or seen him play knows that Twellman, who’s had his skull punched, kicked and elbowed on countless occasions over the years, would never give more than a millisecond of thought to milking an injury. He’s too competitive. He is the consummate competitor to a fault, even. In short, he was a stubborn, single-minded athlete that clearly placed competition over his or her own health more often than not. Put some tape on it and go.

And it showed. We all witnessed Taylor Twellman play with immense passion and reckless abandon, and that style often paid huge dividends on the pitch for both he and his club.

But off the pitch, it may have cost him something far more dear. It may have cost him his long-term well being.