James Harden And The Language Of Brain Trauma

We’ve all spent the last few days raising our voices and cutting people off, citing numbers, facts, past instances and personal biases to gain leverage in our debates over Metta World Peace and his elbow to James Harden’s head. We all have an opinion, and we all know where we stand on the punishment announced yesterday. It’s easy to debate about the perpetrator and the motives behind the act. It’s a lot harder to talk about the victim, which is at least partially due to the language we’re given.

James Harden surely has a concussion. That much seems evident. Taking a sharp elbow to the temple at point blank range from one of the league’s most tank-like athletes will inevitably cause some sort of cerebral damage. But what kind of damage are we talking about, exactly?

Oklahoman columnist Barry Thamel’s opening graf of his postgame/suspension reaction article states that World Peace’s elbow gave Harden a brain bruise. This is important. A brain bruise (or a cerebral contusion) is not the same as a concussion. Could it have been an innocuous turn of phrase? Absolutely. Columnists are allowed that sort of creative license. But also judging from the apparent impact of the elbow, a cerebral contusion definitely seems likely.

What’s the difference between a contusion and a concussion? After an hour of scouring different medical sources, contusions occur when a blow to the head forces the brain to collide with ridges in the inner skull, causing small blood leakage into the brain. The affected area is limited; either the area right where the impact occurred is damaged, or the polar opposite of the area (meaning the brain had slammed against the opposite side of the skull). A severe contusion can cause intracranial pressure to rise, and brain tissue to swell with fluid build-up, requiring surgery to clear. Thankfully, Harden’s injury—whatever it is—isn’t nearly that severe, as evidenced by the training staff clearing a second half appearance against the Lakers, and his teammates noting his good condition after the Tuesday win against the Kings.

Thamel’s article later states that Harden has a concussion. However, a brain bruise and a concussion are not synonymous; a person with a contusion can also be concussed. So what is a concussion? It’s tough to say. There is no standardized definition, and the language gets even vaguer in the realm of sports. Generally, it refers to mild traumatic brain injury that briefly impairs brain functions. Unlike contusions, concussions don’t occur in one specific area nor is there discernible bleeding in brain tissues.  So while all cerebral contusions will technically feel the effects of concussion, not all concussions can be considered contusions.

The NBA unveiled a concussion policy this season, and it is vital for the wellbeing of the players involved in this league. It explains the tests that the league runs on players with potential concussions to both diagnose and check for clearance. What specifically constitutes as a concussion is still unclear, but then again, so are the complexities of the human brain. Slapping a concrete definition on concussions belies the singularity of each individual case. We’re still learning about how the brain works and recuperates. As basketball fans, we’re lucky—concussions don’t happen often. But a basic education of the implications and a sensible policy can play a significant role in keeping concussions as far away from the game as possible.

Seth Carstens