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PHYSICAL SIDE OF FOOTBALL

Paper by the Surgeons Who Had Charge of the Harvard Squad This Fall.

Fractures.--The number of fractures received was considerable although nearly all were of minor severity. In almost every case the fractures were x-rayed. In many cases the men were allowed to play after receiving fractures, at a time when patients ordinarily would be willing to protect themselves, although in every case the players were very carefully guarded by special apparatus. In no case did a man who had been allowed to play a relatively short time after the receipt of a fracture receive a refracture.

Ruptured muscles.--These injuries were common and affected either the quadriceps extensor of the leg or the hamstring muscle. Ruptures of the quadriceps were especially common among the heavy men and in many cases were due apparently entirely to the muscular exertion of quick starting. In some cases and especially in the severer ones, the injury appeared to be due to a violent blow upon the thigh of a man running at speed with the muscles tense. Ruptures of the hamstring muscles, which are also common among sprinters, were in every case due to muscular exertion alone. These cases were treated by heat and massage and moderate exercises, such as walking. In two cases, however, the injury was so severe as to require fixation by splints.

Sprained ankles.--The injuries of this type were not, on the whole, severe, and in no case was a player kept out of the scrimmage for any considerable length of time. The ankles were treated by heat, massage and by strapping, although in one case a special apparatus, somewhat resembling a valgus shoe, was worn by a player throughout the greater portion of the season.

Synovitis of the knee.--These cases, except those due to a loose semilunar cartilage, were not numerous, and were treated by heat, both hot water and baking, by massage and by compression. The results obtained by these measures were surprisingly good and the time out of play was extremely limited.

Broken Noses.--In practically every case there was a fracture, not only of the external but of the internal nose, and all those cases were sent to a nose specialist.

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The opinion of the players was that the injuries received were, on the whole, not severe. The real severity of the injuries, however, may be estimated in a number of ways:

(1) By the length of time during which players were incapacitated from taking part in the game. In answer to the circular letter the players stated the number of days that they had been kept out of the play by their injuries. The aggregate number of days during which players were incapacitated previous to this season was 864. The aggregate number of days during which players were kept out of the play during the season of 1905 was 1,057 days, that is an aggregate practically of three years. In regard to the apparent excessive amount of incapacity during the season of 1905, it must be borne in mind that players who had received injuries were not allowed to play until they had received the permission of the surgeon in charge, and, as has already been stated, great caution was exercised in keeping men out until they were thoroughly fit to play.

(2) Another index of the severity of the injuries is the number of days that players were kept away from scholastic or college duties. From the answers to the circular letter it appears that previous to 1905 players were kept away from school or college a total of 128 days; during the season of 1905 they were kept away from college duties 175 days. These figures are based upon the players' own written statements but have not been varified by the college record and probably do not represent more than the facts.

(3) Another index of the severity of injuries is shown by the amount of surgical supplies which were required during the season to properly dress and take care of injuries. To cost of those supplies for the past season was (including the sterilizer which cost about thirty dollars) two hundred and twenty dollars.

A final index is the answer of the players as to whether their recovery from injuries was complete, at the time the circular letter was sent out, a few days after the close of the season. One hundred and ten answers were received to 150 letters, and of those 110, 35 acknowledged that they had not entirely recovered from their injuries at that time. Besides those 35 who acknowledged that they were still suffering from a certain amount of disability or discomfort, it is known to us that many of the men who said that they were entirely recovered are suffering from injuries of more or less permanence. For instance, one man said that he had entirely recovered "except for a slight loss of vision." Another said that he had completely recovered "except for a slight dullness in the side of his head, with a bloodshot eye." Another reported that a loose semilunar cartilage was "absorbing," but "still in evidence." No one seemed to be in a position to settle with certainty the question as to whether there is any possibility of later effects from concussion. Many of the joint injuries are of such a character as to be likely to be progressively worse and many of the injuries to the shoulder are certain to cause some disability in later years.

The question arises, Is it possible to avoid these injuries as the game is now played? Many of the players claim that many of the injuries are avoidable. This year special precautions were taken to avoid the occurence of injuries. Men who were known to be candidates for the squad were notified early in the summer to begin to get into good physical condition before reporting for football in the middle of September. The scrimmage was not begun as early this year as is usual, in order to harden the men up as much as possible before the violent work began, and special pads and armor were provided in sufficient quantities to protect the players as far as possible. In spite of these special precautions it is claimed that the number of injuries was excessive. It was noticeable that the injuries came

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