Los Angeles Lakers center Pau Gasol missed his fifth game in a row Tuesday night with concussion symptoms, according to CBSSports.com. He suffered the concussion while taking an elbow to the head earlier this month.

The NBA’s concussion policy requires him to pass a series of health and cognitive tests to establish that the effects have passed. Sometimes effects linger, so no one should be surprised.

* The plight of Gasol has put the NBA’s concussion program in the spotlight. ESPN’s TrueHoop blog delved into the subject with a longer article that focused on making the game safer.

Even so, the league has been proactive, having contracted with respected University of Michigan neurologist Dr. Jeffrey Kutcher, who has served as a sports concussion expert in testimony before Congress as well as in various roles at the American Academy of Neurology, Michigan NeuroSport and at the NFL. Kutcher is leading the implementation of new head injury protocols to keep players safer — by increasing the likelihood head injuries are detected and treated, and to keep concussed players from taking the floor.

But the challenge is a big one. The more experts learn about blows to the head, the more they learn how hard it is to classify any as without long-term health implications. And basketball, though not a collision-based sport like football or hockey, is a contact sport with more blows to the head than you would think.
NBA players, says Kutcher, “are not taking the repetitive hits like they are in football or in hockey, but they do get hit, quite a bit. They may be mild bumps, those kinds of things, but certain brains are susceptible to trauma more than others and to be able to monitor brain health over the course of the season and a career is something that we have to do regardless of the level of impact.”

That same article used Brooklyn Nets forward Gerald Wallace as an example, a player who has suffered at least a half dozen concussions.

Gerald Wallace earned the nickname Crash for his willingness to throw his body into the fray. It was an honorific, but by 2008, Wallace, then with the Bobcats, had suffered four concussions in four seasons, the latest coming from a Mikki Moore elbow that left Wallace unmoving, lying flat on the hardwood.
This was before the NBA’s concussion program was in place. The Bobcats trainer at the time, Joe Sharpe, had so few tools at his disposal to deal with Wallace’s condition that he sought counsel from the NFL. “I talked to the Panthers medical staff and asked them to maybe help me out in this situation,” said Sharpe in a report from The Associated Press.

“I’m not saying we’re behind the ball, because this is very new to basketball,” said Sharpe at the time, and he was right. Until recently, few people considered concussions to be a basketball issue. From the league’s perspective, that has all changed.

* TrueHoop also profiled former NBA player Paul Grant, who has become an advocate for teaching players about concussions and how to deal with them.

During his playing days, Grant says he didn’t even know what a concussion really was.
“There was no education,” Grant says. “It was like, ‘Well you didn’t get knocked out, so you don’t have a concussion.’ And that was the thinking by me and the general consensus I think in the league: Unless you get knocked out cold, we’re not going to talk about a concussion.” 
But, he says, of course concussions have long been a part of basketball: “There are inevitably times when you get your legs taken out from under you, you get pushed in your back, you fly into the backstop, you hit your back on the floor then your head hits the floor, you dive on the floor and run into another player’s head. This type of stuff happens frequently enough that it needs to be addressed so that when it does happen players and organizations aren’t at risk of losing these guys for an extended period of time.”

As for the Gasol concussion, it has become a locker room issue. Teammate Kobe Bryant told the L.A. Daily News on Tuesday that Gasol isn’t taking care of himself during recovery.

“I was a little angry with him the other day because he’s coming to practice and coming to the games,” Bryant said. “Stay home. Cut all the lights off. Just rest. Let your brain rest. But he wants to be around (the team). That’s the type of teammate he is.”

– Bill Bradley, contributing editor