Dr. Stanley Herring has a knack for boiling down complex issues into one-liners and witticisms. On his decision to go into medicine, he says, “Life is better if you leave more than you take, and I was terrible at English and colorblind, so what else was I going to do?”
On sports-related concussions—his primary area of expertise—he says, “If you’ve seen one concussion, you’ve seen one concussion.” Meaning each brain injury is as unique as the person suffering from it and should be treated as such.
When patients ask about his work as a team physician for the Seattle Seahawks, he responds, “People say, ‘I want you to care for me like you care for the Seahawks.’ And I say, ‘You’ve got it backwards; I care for the Seahawks like I care for you.’ ”
But as a member of the NFL’s Head, Neck and Spine Committee, a University of Washington clinical professor in the departments of rehabilitation medicine, orthopaedics and sports medicine and neurological surgery, and a driving force in passing the Zackery Lystedt Law (a game-changing piece of legislation for youth sports), Herring's experience, responsibilities and progress are far from being as simple or comical as his signature quips may lead on.
For example, the path that led Herring toward medicine was much more an alignment of forces rather than a decision brought about simply by his inability to color coordinate. Growing up in Texas, he explains his family members—in particular his mother and father—were strong advocates of community service and helping others with disabilities. That, coupled with a proclivity for math and science and a cousin who served as a role model as a physician, piqued his interest during his undergraduate years at the University of Texas.
“I also had a very powerful experience with a mentor in college who showed me the value in helping people with injury and disability. He showed me how powerful it can be to get them moving,” Herring says. “That was reinforced in medical school when I found out early on I had something to contribute to patient care through physical activity, and it was again reinforced when I came [to Seattle], the exercise capital of the country and a place where embracing people with differences was important. That all resonated with me.”
Unpacking another one of his epigrams, Herring explains that once firmly engaged in the sports rehabilitation field in Seattle in the mid-80s, he began to formulate his own way of assessing and treating injured athletes, especially those suffering from spine and brain injuries. In doing, he developed a philosophy that acknowledges the unique story behind every patient and every injury.
"Very early on I began looking at the psychological part of the injury. Some people can’t get back to swimming because they have a bad back; some people can’t get back to swimming because they have a bad life,” Herring says. “It’s not just the pain, it’s the suffering. My goal is to understand why certain things disable a certain person. If you come to see me and your knee hurts, I’m interested in that, but I’m also interested in what that’s done to you. What have you lost because of that? What are your worries because of that, and what’s important to you?
“Really, most sports injuries are about disability. There is impairment. They’ve lost something, and we say the impairment is, ‘I can’t run.’ But when you ask questions it’s, ‘When I can’t run I don’t get along with my wife and kids very well.’ That is the disability the impairment produces. If you are sensitive to all of the issues, you can tailor better treatment for them,” he says. “In my practice, I work very closely with physical therapists, occupational therapists at times and sports psychologists. It’s not just about taking the pain away; it’s about getting your life back. So really what it’s about is autonomy.”
This highly empathetic and thorough approach to sports medicine has been extremely successful and rewarding for Herring. And that success has translated into a national platform on which he is able to fight for topics he is passionate about—mainly concussions and how they affect everyone from peewee football players to professional soccer players. Herring spends a great deal of time and energy traveling and talking about concussions.
But, what he says about them can be surprising to audiences, especially in regards to his thoughts on young athletes and concussions, a topic that recently has saturated the news. “It’s one of the few times I’ve seen a medical problem get such public interest,” Herring says. “I think it’s because of the power and interest in sports. That’s driving the conversation.”
A few years ago, Herring was instrumental in passing the Zackery Lystedt Law, a piece of legislation which requires schools to have a trained medical professional clear students suspected of concussion before returning to play. It was a movement that started in Washington State, but it is now in effect across all 50 states and the District of Columbia. Many people worked in concert to make that happen, and Herring was happy to be a part of the team. Bottom line: he takes youth sports-related concussions every seriously. But, unexpectedly, what that was never translated into was a crusade against youth organized sports.
“Eighty to 90 percent of concussions in young athletes are better in 10 to 14 days. The great majority of people with concussions, even more than one, go on to be great, successful people, captains of industries, drive fancy cars,” he says. “It’s a big misconception that the great majority of people who have concussions when they are young have problems later in life.”
Taking it even a step further, Herring says being overly fearful of concussions—which he stresses is different from being vigilant in the recognition and treatment of them—could be more harmful to a young population than helpful.
“This is coming from a brain injury guy, and trust me nobody takes brain injury more seriously than I do, but to say my nine-year-old can’t play lacrosse because I’m worried about long-term cognitive problems, there are a lot of steps missing there. Inadvertently denying children physical activity is actually a bigger public health problem,” Herring says, adding that inactivity causes a greater chance of children developing obesity and chronic diseases such as hypertension, diabetes and cardiovascular disease.
“If your son or daughter wants to play sports and they are healthy and the sports program has a good emergency medical action plan and their coaches are trained regarding injury recognition, perhaps the safest thing you can do is have your child involved after school in organized sports,” he says.
When it comes to professional sports, his opinion changes a little, but not much. Herring has worked with the Seattle Seahawks, San Francisco 49ers and the Seattle Mariners to name a few teams. He says playing professional sports does open the door for all kinds of potential injuries—including concussions.
“There are bad things that happen to professional athletes across all the thousands of hours of exposure to practice and play, but the great majority of NFL players and other professional athletes do well in terms of brain health,” he says. The same is true for collegiate athletes. That does not mean, however, that Herring and others are not actively looking for ways to better diagnose and treat concussions in these athletes to improve their short and long-term health and to identify and remove those from play who are at unacceptable risk. “In terms of collegiate and professional sports, most of those athletes are doing fine, but they are adults and made an informed choice to play. With kids, they don’t understand risk, and so we have to protect them.”
And that’s exactly what Herring will continue to do, spread the word that sports aren’t the enemy; recognition, education and proper management are the answers. “We have to make it as unacceptable to play with a concussion as it would be to play without having water breaks.”