False/Misleading Advertising Targeted

23 May

If there is one thing in the concussion issue that really draws my ire its the false and sometimes fraudulent advertising of some companies claiming they can prevent concussions with a product.  There has been a good effort to reduce this, however now there may be some serious teeth behind the problem.  A press release;

For Immediate Release
May 22, 2013
Contacts:
Tom Udall Press Office / 202.228.6870 / news@tomudall.senate.gov 
Kevin McAlister (Rockefeller) 202.224.8374 / kevin_mcalister@commerce.senate.gov 
 
 
Udall, Rockefeller Introduce Bill to Help Protect Young Athletes from Sports-Related Traumatic Brain Injuries
 
 
WASHINGTON – To mark National Physical Fitness and Sports Month, U.S. Senators Tom Udall (D-N.M.) and John D. “Jay” Rockefeller IV (D-W.Va.), Chairman of the Senate Committee on Commerce, Science, and Transportation, today introduced legislation that seeks to protect youth athletes from the dangers of sports-related traumatic brain injuries by improving equipment safety standards and curbing false advertising claims.
 
The Youth Sports Concussion Act will help ensure that safety standards for sports equipment are up to date and informed by the latest science. The bill will also increase potential penalties for using false injury prevention claims to sell youth sports equipment.
 
“We want our children to be active and participate in sports, but we must take every precaution to protect them from traumatic head injuries,” said Udall. “There will always be some risk, but athletes, coaches and parents need to be aware of Continue reading →
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Free Webinar (TODAY)

22 May

For those looking to cash in on this concussion issue with innovative ideas and products, you should not miss this opportunity;

GE & the NFL are teaming up to accelerate concussion research, diagnosis and treatment. The Head Health Initiative aims to develop new solutions to help diagnose mild traumatic brain injury. This initiative starts with a two-year open innovation program to invest up to $20 million in research and technology. This includes the first Challenge, the focus of this webinar, which offers a $10 million award to better understand and diagnose traumatic brain injury. A second component of the initiative is a four-year $40 million research and development program to determine the key imaging biomarkers in the brain.

Featured speaker include Mark A. Phillips, Chief Marketing Officer, GE Healthcare, Healthcare Systems and Kevin Guskiewicz, Ph.D., Chair, NFL’s Head, Neck & Spine Committee.

You must go to the link to register, the event is at 3pm EST today.

 

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Nick Mercer: Why we continue to see players play

19 May

Nick submitted this article prior to the Bryce Harper wall escapade but it would certainly fall into this opinion piece.

While I didn’t intend to write a post about brain injury in sport, I was inspired to write it based on some events in the NHL playoffs.  Since it’s not my point to dissect the danger of the two hits, I won’t spend much time on them. In fact, I’ll just share the links to the Gryba hit on Eller and the Abdelkader hit on Lydman. Seriously, whether I think either of those hits was clean or delivered with malicious intent is not, in any way, the basis or inspiration for this post. What is, is the idea that we – the North American contact sports-loving public – have all but abdicated our right to a free conscience. Whether either hitter was deserving of the suspension they have subsequently received, depends not on the hit they delivered, but on which team you cheer for (or against), or whether or not you like seeing big hits in hockey. It has nothing to do with what happened.

Some people don’t like where the NHL or NFL are heading; the frequency with which penalties are called when a player hits anywhere near an opposing player’s head. I don’t think that either of these two leagues, NHL and NFL, understand the concept of risk and reward. Hard hitting contact sports are so popular because they exhibit risk in a raw form. That’s probably why some/many of the athletes who make it to the highest levels get into the types of trouble they do. We watch news about multi-millionaire athletes who crash Porsches or who get arrested, and we may think “why would someone with so much to lose risk so much?” However, the athletes actually made logical (that doesn’t necessarily mean good) decisions. They do what all of us do before making most decisions. They, however briefly, look at their risk/reward histories plus their confidence Continue reading →

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Nick Mercer: Spring’s on the way. Get moving

18 May

A while back I saw that Chris Nowinski tweeted this, study by researchers at the University of Buffalo about the benefits of exercise for people who’ve had a concussion, and I thought I’d post now. I was constantly told that my recovery from a severe brain injury (even though, by no means am I back to the way I was pre-injury) was due to my pre- and post- injury fitness. This is an issue I am passionate about and it seemed obvious to me throughout my immediate rehabilitation and continuing recovery/life after my brain injury that exercise and fitness are extremely important. It hasn’t solved my problems or made them go away, but it’s incredibly beneficial and allows me to deal with the effects/issues confidently.

I should know better than to write those four title words when we’re hardly clear of winter. So, first I will apologize in advance to the people of St. John’s. For all intents and purposes, I’ve just guaranteed another dumping of snow. In fairness to me, the title sounds good and I’m looking at a beautiful sunset out my window, so I couldn’t help but write with a tauntingly cheery attitude. Nevertheless, sorry, my bad.

It’s Sunday and the wind was really kicking up a fuss this morning. I, however, stayed safely inside and, although it was sunny and marginally warmer than it has been in a while, I had no need Continue reading →

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Ohio’s New Concussion Law FAQ’s

17 May

I was forwarded an information sheet on the newly enacted Ohio Return to Play Law.  It appears as a Frequently Asked Questions form, here are some highlights;

  • Guidelines for both interscholastic and youth sports
  • Who can clear the athlete
  • Specific definition of required training for coaches, referees and officials of youth sports
  • Resources for parents and athletes

This “fact sheet/FAQ” is probably the best written resource I have seen regarding the new return to play legislative actions by states.  It is good that each state is doing something, but in my honest opinion these laws are just a start.

Unfortunately it took actions by legislature to make it perfectly clear that those with concussions, show signs of concussion or report concussion symptoms shall not return on the same day and must be evaluated by a health care professional.  This is something we have known for a few years now.  Each state piece is great for raising awareness.

What we need to advance is the true problem of this concussion “crisis”, that is the proper management and overall treatment of the brain injury.  Concussions will occur, it is an inherent part of all sports – essentially something we cannot “control” – however we can certainly control how the after effects of each concussion are handled.

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Series from the Pittsburgh Post Gazette on CTE

16 May

Mark Roth of the Pittsburgh Post-Gaette put together an informational series on chronic traumatic encephalopathy; “a brain disease that afflicts athletes”.

In the first part that came out this past Sunday, Roth took a look at the global perception of CTE through the examples of Chris Henry and the possible case of still living Fred McNeill;

Chris Henry was a fleet wide receiver for the Cincinnati Bengals. During his five seasons with the team, he developed a reputation as a talented athlete on the field but a bad boy off it, even though those who knew him well say he was typically quiet and respectful. [...]

Fred McNeill played 12 seasons for the Minnesota Vikings in the ’70s and ’80s. After retiring, he finished law school and became a successful attorney in Minneapolis, helping to win major class-action lawsuits.

Henry would end up dead after an accident that was predicated with some unusual actions by him, McNeill now has full-time care takers as dementia has stripped him of everything he worked hard for.

Roth begins the second piece with those that can be easily called the experts in this area, Bennet Omalu and Ann McKee; Continue reading →

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HS Class Uses Blog to Educate

10 May

One of the more gratifying things about this blog is the chance to educate anyone about concussions and the athletic training profession.  I truly enjoy going out to speak and even debate this hot topic.  I understand that my thought process is not like everyone else, nor do I expect everyone to see it the way I do; however I do want people to become more educated and understand what we are facing with this problem.

As I was wrapping up my interview for a local TV station about the new IHSA Heat Acclimatization Policy, I received and email from a school here in Illinois that used my blog to become better aware of the concussion issue.  Honestly, nothing makes me smile more than to provide that to teachers and kids.  The email ended with some questions regarding concussions, I will answer them here (not only for everyone to see but to give a little pub to the students and teachers of Cuba High School).

My current events class has been debating and conducting research about concussions. I have had them use your blog for resources and it is very informative. We also just finished watching “Head Games” documentary and had further discussions. Many of my students are athletes and have raised interesting questions specifically towards how our small rural high school can best prevent head injuries. I know you’re a busy guy so we cut our questions to just 3. Any chance of a response would be greatly appreciated. Continue reading →

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Bennet Omalu Recent Talk

8 May

For a long time the “father” of CTE, the first pathologist to find/identify the disease in an American football player, Bennet Omalu has been relatively quiet; going about his normal business and continuing his work with CTE.  Last week he was highlighted on the ESPN Outside the Lines/PBS Frontline story about the Junior Seau death aftermath.

Even more recently Dr. Omalu was invited to speak at the 2013 Football Veterans Conference – a sport specific event put on by Dave Pear and his blog;

Well, we just wrapped up our 2013 Football Vets’ Conference in Las Vegas at the South Point Resort and it was our best yet! In two packed days, we covered everything retired football players need and want to know, from concussion lawsuits to CTE to visual rights and everything in between. Our sessions were packed and no one wanted to miss a single discussion. And thanks to the amazing Jennifer Thibeaux, all of our discussions from Friday are already processed and uploaded so you won’t have to miss a minute of it either!

Thanks to Dave we can bring you the entire talk by Omalu – although over an hour its worth your time.

……….

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IHSA Proposed Heat Acclimatization Policy

7 May

There was big news out of Bloomington, Illinois coming and I was getting fired up because the word on the street was they had been working with the Kory Stinger Institute and Sports Legacy Institute to create a new “football” policy.  With my effort over the past two years to get the Illinois High School Association to look at and make some proactive changes to the way football is practiced, there was hope it had not fallen on deaf ears.

Well, the announcement/proposal is out…  It’s a good first step; one that addresses the heat issues that plague football. Some highlights are;

  • 14 day period that every player must go through to be eligible to play
  • Strict guidelines on actual practice time and rest time during multiple practice days (traditionally 2-a-days)
  • Set rest days
  • Removal of “grey area” of weights/agilities/walk throughs
  • Definition of scrimmages
  • No matter what was done before the start of the season all must do the 14 day period

Moreover this proposal is very specific and makes very good sense in the area of heat acclimatization.  Obviously you can see the hard work of KSI in the proposal, but where is SLI input?  Some of the missing talking points Continue reading →

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Downplaying brain injury is not the way to attack this

6 May

Concussions have gained so much attention that the news is almost inundated with story-after-story of occurrences, recovery, litigation and people trying to mitigate the injury.  There seems to be a shortage of press clipping and stories on how to handle this injury.  More often I have witnessed stories downplaying the injury or the oft cited “Heads Up Football“.

The former, downplaying the injury itself, is not a good thing it is exactly what put us in the spot we are in now.  Patrick Hruby also took note of this while reading an article from Andrew Wagaman in the Missourian;

Still, when it comes to the single most head-scratching public statement I’ve seen regarding brain trauma and football, University of Missouri neuropsychologist Thomas Martin takes the pole position. Hands-down. In a piece about youth football and cognitive risks published this week in the Columbia Missourian, Martin compares brain damage to … knee injuries[...]

This blew my mind. I had to read it twice. And then a half-dozen more times. It still blows my mind as I’m typing this. Here’s why people react differently to brain and knee injuries, and why football is in a world of potential trouble: because the potential harm resulting from a brain injury is nothing like that resulting from a knee injury.

If you read Hruby’s article you will see he makes a strong case for this analogy being utterly false; Continue reading →

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True Hero

4 May

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Here is an accompanying story LINK

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Interesting From ‘Gus’

1 May

Here is a TEDx Talk with Kevin Guskiewicz

There are some good moments and some moments that make one scratch their head.  Take a watch (bout 17 minutes) and comment below…

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Vermont Looking to Make AT’s Mandatory

22 Apr

Given the current state of funds and resources for schools, it would seem this is a horrible idea.  However, it is actually needed and should be done everywhere;

According to Senate Bill No. 4, or S.4, currently sitting in the House Education Committee awaiting word on movement to the full House of Representatives, schools “shall ensure that a health care provider is present at any athletic event in which a high school athletic team participates in a collision sport.”

Granted I am a skewed voice here, but it makes almost no sense not to have an athletic trainer on site; not only for concussion – which is uber-importnant – but for the day-to-day injuries and prevention of injuries.  In the article it was noted only 14 schools in Vermont don’t have an AT, but finding one to cover will become a high priority if it becomes law;

While no one has expressed a disinterest in having such coverage, the cost has been prohibitive — “substantially huge,” according to Merriam — for many Vermont schools.

“To get even a part-timer, it’d be $10,000 minimum, but we’re looking at upwards of double that in all likelihood,” Thornton said. “I’ve researched this extensively, and it’s a challenge in itself to get one to come to our school.”

In all honesty it’s about the money…  How much would you pay to keep your child as safe as possible?  How much should you invest to keep liability down and safety up for all students?

Would you send you kids to a pool without a life guard?  Why would you send you kids to collision sports with out an athletic trainer?

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“Concussions Happen” Video

16 Apr

This is a re-post, sort of, of a video created by Bryson Reynolds a neuroscience graduate student.  His area of study is concussions and mTBI.  He shortened the original video for easier consumption, it still holds the essence of what makes it a good too for us to use; stark and striking objective mechanisms of injuries, across all sports.

It is barely over a minute in time, again this is a great teaching tool for those trying to understand the mechanisms of concussion.  If I counted correct only 4 of the clips show head-to-head contact.  THIS IS EXTREMELY NOTEWORTHY, as concussions occur without direct blows to the head.  Also note the concussions (presumed by the filmmaker due to descriptions of the original videos) that occur due to contact with the ground or ball.  Perhaps the most disturbing videos are the last two, youth sports.

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Who Wants Research Monies?

11 Apr

There are plenty of people out there that think they have the answer to the concussion issue.  From helmets (G. Malcom Brown) to mouth gear (Mark Picot), to assessment, to rehabilitation, to research, the whole lot of it.  Well now is your chance to put forth your best effort and get some money for research on your products or your ideas.  The National Institutes of Health and the NFL have created the Sports and Health Research Program;

The Sports and Health Research Program (SHRP) is an innovative partnership among the National Institutes of Health (NIH), the National Football League (NFL) and the FNIH. Launched in 2012, the program aims to help accelerate the pursuit of research to enhance the health of athletes at all levels, past, present and future, and to extend the impact of that research beyond the playing field to benefit others in the general population, including members of the military.

There is an agenda of sorts; regarding what they are looking at going forward (see article) but they are giving grants for those that meet the criteria; Continue reading →

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A Chuckle and Video

10 Apr

I really don’t have much for this quote found in this article;

“I have a theory on concussions,” he said. “I think the reason there’s so much more of them — obviously the impact and the size of the equipment and the size of the player — but there’s another factor: everyone wears helmets, and under your skull when you have a helmet on, there’s a heat issue.

“Everyone sweats a lot more, the brain swells. The brain is closer to the skull. Think about it. Does it make sense? Common sense?” said Carlyle, who said he’d never talked to a doctor about his premise, which he was introduced to by Jim Pappin, the former Leaf who also played his career helmet free.

“I don’t know if it’s true, but that would be my theory. Heat expands and cold contracts. The brain is like a muscle, it’s pumping, it swells, it’s a lot closer to the outside of the skull.”

Stick to coaching hockey, eh!

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The ESPN article and video (click link or below) regarding the NFL Concussion Litigation; Continue reading →

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ESPN OTL Article Sparking Quite A Debate

8 Apr

On the surface this article may be innocuous to many, but the the minutia of concussion research and information is coming to a head very quickly, especially pertaining to the NFL.  Tomorrow is the first hearings in front of the judge – and the possibility of total dismissal - for the concussion law suits filed by thousands of former NFL players.

ESPN and its Outside the Lines department (in conjunction with Frontline) filed this article taking a look at two of the most prominent people in the concussion research/awareness arena, Dr. Robert Cantu and Chris Nowinski;

Two prominent concussion researchers — including a senior adviser to the NFL — served as paid consultants to law firms suing the league for allegedly concealing the link between football and brain damage, according to interviews and documents obtained by “Outside the Lines” and “Frontline.”

The article written by Steve Fainaru and Mark Fainaru-Wada sheds light on the very issues the research community faces with this problem.  Some of this information can be classified as “not new” to people who participate in the constantly shifting arena of litigation and research, while some information can be deemed as scathing.  There is a very tight and ubiquitous line in this matter;

Researchers often are asked to appear as expert witnesses in legal proceedings related to their fields. The NFL suit, with the potential for billions of dollars in damages, has created a large demand for researchers with expertise in the science of concussions.

But some researchers said they have turned down such requests despite the potentially lucrative payoff out of concern the perceived conflict could compromise their research.

Conflict of interest (COI) is something we all need to pay attention to, although it applies to this current article, the COI in this field is rampant and often unchecked.  This is nothing new, players have talked about COI, other journalists have noted it, and one of our prominent commentators (Dr. Don Brady) on the site has even devoted some of his dissertation to COI.

It would seem this is nothing “new” in the world Continue reading →

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Archaic Thinking/Management of Concussion Not Just a N. American Issue

4 Apr

I have cataloged this problem many times in many sports across the world.  It seems that perhaps the focus and glare is greatest here with North American sports (mainly football and hockey), but this problem extends further.  This issue perhaps came to a head in the UK over the past week with this article by Tom English;

Barry O’Driscoll played rugby for Ireland in the Five Nations championship of 1971.

As a respected doctor (whose son was team doctor for Ireland and the Lions in the recent past) with a background as an international full-back he became an important figure on the International Rugby Board where for 15 years he held positions on the medical, anti-doping and disciplinary committees. Until late last summer, when he resigned.

Dr. O’Driscoll left his post because of the way the International Rugby Board (IRB) was/is handling concussions on the field and in general.  As an aside, the IRB is a founding partner of the Zurich statement as well.

What would make a highly trained and well-respected doc – with rugby in the blood – step away?  Take a look, specifically at what happened to his nephew;

After one collision too many that day Brian O’Driscoll lost his bearings, was clearly unsteady on his feet and had to be helped from the field, like a boxer assisted from the ring. You did not need experience in pathology to know that the great man was out of it for a moment in time. Yet a few minutes later he was back on the pitch, supposedly as bright as a button and fully recovered.

He was back on the field because ?????;

There is an accompanying rule now – still on trial – and it states that if a player with suspected concussion can pass a series of tests lasting five minutes then he can be allowed back into the fray: the Pitch Side Concussion Assessment (PSCA) – or the five-minute rule.

Even worse the “new” rule was not even in place when his nephew sustained his concussion, leading the good doc to question what the sanctioning body and the medical board was doing;

“Rugby is trivialising concussion,” he says. “They are sending these guys back on to the field and into the most brutal arena. It’s ferocious out there. The same player who 18 months ago was given a minimum of seven days recovery time is now given five minutes. There is no test that you can do in five minutes that will show that a player is not concussed. It is accepted the world over. We have all seen players who have appeared fine five minutes after a concussive injury then vomiting later in the night. To have this as acceptable in rugby, what kind of message are we sending out?

“If a boxer cannot defend himself after ten seconds he has to have a brain scan before he comes back. And we’re not talking ten seconds for a rugby player, we’re talking maybe a minute that these guys are not sure what’s going on. They don’t have to have a brain scan, they have to have five minutes where they have to stand up straight without falling over four times, they have a basic memory test – ‘What’s the score? Who are you playing against? Which half did it happen in? And do you have any symptoms?’

“These questions should serve as a landmark for when you examine them six hours later to see if they’re getting worse or if they’re bleeding into their brain. That’s why you ask them, not to see if they can go back on. They are already concussed at that point. You don’t need to ask questions to find that out. If six hours later their responses are worse than they were earlier you say ‘Wait a minute, this shouldn’t be the case, is this guy going to bleed?’ That’s why you ask the questions and so it has always been. But we’re going in the other direction now. We’re going from being stood down for three weeks to one week to five minutes with players who are showing exactly the same symptoms. The five-minute rule came out of the blue. I couldn’t be a part of it so I resigned from the IRB. It saddened me, but I couldn’t have my name attached to that decision.”

As you can clearly see some places are not quite ready to accept the real issue of concussions – not the actual injury – the mismanagement of the injury once it occurs.  If the IRB places the new “five-minute pitch side rule” into place they are going in the absolute wrong direction.

If any player in any sport shows clear signs of concussion they should be removed and not allowed back in, period.  Even Zurich, which the IRB is part of states this.  Dr. O’Driscoll is merely saving his reputation by stepping aside, and in my opinion it is the exact correct move.

 

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The Experts Tell Us Why Athletic Trainers Are Needed

3 Apr

You don’t have to take my word for it here, you can watch this video and let the experts in the field tell you;

Although we are not there yet, there are financial barriers, and some misnomers about the profession; athletic trainers should be a must.

As I have clearly stated: “If you cannot afford an athletic trainer you cannot afford to have collision sports, period.”

Hey here is a bonus, athletic trainers are also some of the best at on the field orthopedic injury assessment and injury prevention in the WORLD.  Doctors even defer to the knowledge of an athletic trainer when it comes to sports injuries.

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Mayo Clinic Looking into Autonomic Response to Concussion

1 Apr

Neurologists at Mayo Clinic in Arizona have taken a promising step toward identifying a test that helps support the diagnosis of concussion. Their research has shown that autonomic reflex testing, which measures involuntary changes in heart rate and blood pressure, consistently appear to demonstrate significant changes in those with concussion.

Appearing on their website, the information researchers are delving into is a new angle on  concussions.  It is widely known that traumatic brain injured (TBI) patients have autonomic system (ANS) deficits/abnormalities.  However the group from Arizona thought an investigation into concussed patients was worth the effort.  Low and behold their findings are a promising first step in possible assessment and management of the concussion.

One interesting note, was this notion on dizziness;

“Contrary to popular belief, the symptoms of ‘dizziness’ that patients feel just after a concussion may, in some cases, be symptoms of autonomic system impairment rather than a vestibular or inner ear disturbance,” says Bert Vargas, M.D., a Mayo neurologist.

No one is telling you to take blood pressures with assessment (ergo baselines), yet, but with this information could come not only objective testing but biomarkers associated with ANS changes;

“This study shows a possible electrophysiological biomarker that indicates that a concussion has occurred — we are hopeful that with more research this will be confirmed and that this may also be a biomarker for recovery,” he says.

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Nick Mercer: Impromptu Expectations

28 Mar

The thing about expectations is that they presume a certain course of events. In July 2003, I assumed that I would start my co-op job in Ottawa in September and I based my expectations for the coming years on that presumption – my previous post, Finding yourself after a brain injury. First step: Recon. Brain injuries themselves are unexpected, so you don’t know what presumptions to make that will allow you to generate expectations. You’re already starting off on the wrong foot. It’s not so much the issue of living up to, not meeting, or exceeding expectations, it’s more about the expectations themselves that I will write about.

After considering a patient’s health/medical history, age, other essential factors and the severity of most injuries, conditions, or diseases, doctors can only base their ultimate prognosis on probabilities. This is where expectations begin to go awry. Not to get into statistics or anything, but if the probability of surviving a coma of a certain length and severity is low, it’s because it hasn’t happened very much, therefore there will be few cases upon which to build expectations. The fewer cases, the fewer reliable prognoses can be made, hence few, if any expectations.

Those are for others to make. The most important expectations are the ones you make for yourself. I had been making those ever since
I can remember. When I was a kid and used to catch insects, I had Continue reading →

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Concussion Conglomeration “Road Marker” (UPDATED FREE ARTICLE LINK)

27 Mar

A paramount review of concussions and their “long-term” effects has been published (or soon will) in Nature Reviews Neurology that I certainly hope does not slip past the masses.  Not only is the information somewhat of a “where we stand”-moment of clarity, it is authored by a very underrated and proficient researcher; Dr. Barry D. Jordan.

Jordan, B. D. Nat. Rev. Neurol. advance online publication 12 March 2013; doi:10.1038/nrneurol.2013.33 (note you need a log in).  Here is the FREE DOWNLOAD LINK

Acute and chronic sports-related traumatic brain injuries (TBIs) are a substantial public health concern. Various types of acute TBI can occur in sport, but detection and management of cerebral concussion is of greatest importance as mismanagement of this syndrome can lead to persistent or chronic postconcussion syndrome (CPCS) or diffuse cerebral swelling. Chronic TBI encompasses a spectrum of disorders that are associated with long-term consequences of brain injury, including chronic traumatic encephalopathy (CTE), dementia pugilistica, post-traumatic parkinsonism, post-traumatic dementia and CPCS.

Dr. Jordan also discussed CTE in further detail including the limitations of possible antemortem detection; including imaging and categorization.

In this Review, the spectrum of acute and chronic sport-related TBI is discussed, highlighting how examination of athletes involved in high-impact sports has advanced our understanding of pathology of brain injury and enabled improvements in detection and diagnosis of sport-related TBI.

The overriding theme I gathered from this review article is one that I have been hammering home for a very long time: the mismanagement of the original sequale may be the largest factor in discussion the multiple faces of “chronic TBI” that result from concussion.  This paper is also very succinct in demonstrating the massive amount of work that still needs to be done.

I urge you to find a copy or pay for a subscription for this article, it should be one that we look back on in 5 years as the “where have we come from” moment in this issue, regarding chronic issues from sports related concussion.

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Head Football Coach ‘X’: How to take a stand on player safety

26 Mar

Working on a cause is difficult, especially if you are trying to swim upriver. When the cause is in direct conflict with the juggernaut that is football it becomes even more difficult – even at the high school level. I received and provided counsel to this individual as he fights a good fight in regards to player safety, most notably concussions. I applaud this individuals effort, attention to detail, player first mentality, and his willingness to sacrifice his job. What we have below is a microcosm of the issues we face with concussions; detailed and beyond sufficient for action – that is not being taken except against this author.

This information was obtained mainly through email strings – all identifiable properties have been painstakingly scrubbed to the best of my knowledge. It has been understood and agreed upon by the author that publication of this information may identify him and place him in further jeopardy. He is willing to take that chance and I am willing to provide him a platform. Unless otherwise noted in the post with breaks all of this is his and his alone. We shall begin;

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A Little Context:

At the start of my advocacy for safer measures to be applied to the competitive arena in high school football, I involved many people who I trusted and cared for in helping find my voice. Those people usually ended conversations with the same question:

“Are you willing to Get Fired for this?”

I laughed at the question considering the fact that I am advocating on behalf of measures that enhance Student Athlete Safety. At no point was my advocacy meant to be an argument, so the extent in which there has been resistance to proactive thinking has been quite a disappointing surprise to me.

The last 3 months of my professional career have been a whirlwind as I have gone from Advocate to Agitator. When the time for action came to blaze a trail for the future, and promote all that can be good on behalf of our student athletes, we collectively passed as a school system, even though a safer future for the thousands of kids who choose to play football within it is still very attainable.

Through my advocacy I have felt empowered by the leading researchers in the field of sports injury supporting these ideas. Support from the actual people who could make these changes has been “Hot & Cold” in a way that led to me presenting to the Athletic Administration of our entire school system and then being handed a letter of reprimand. At the current time I am labeled as a “Demanding” Coach and a person “Searching for a Cause”.

What follows is a chronological story of advocacy on behalf of player safety at the high school level as well as an example of how far away we actually are from a safer future for the student athletes who choose to play the sport of football.

Authors Note:

Some of the Main Points of Resistance in this philosophy have been diffused by simple logic when it comes to providing a safer arena for competition.

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ORIGINAL LETTER TO RAISE CONCERNS & TO START MY ADVOCACY
January 8th 2013
To: (School System) Director of Athletics ————————
CC: (School) Principal —————–, (School) Athletic Director ———————, (School) Assistant Athletic Director ——————

Subject: Public Health Issue regarding (School System) Cross-District Scheduling of Football Competition

I am writing to make you aware of a safety issue that our county has unknowingly placed many of our student athletes in through our recent scheduling for football. (School System) Athletics cross district scheduling policy for teams in the newly formed ——– District, while making sense from a convenience and perhaps even a cost basis, exposes athletes at certain smaller schools to a greater risk of serious injury. I share these concerns with other Head Football Coaches within (School System) as was voiced at the —————- 2012 All-District meeting.

(School System) scheduling policy requires each (Small School) District football team, which is made up of schools that have been classified at the 3A and 4A level in the (State League) to compete with three schools at the 5A classification from the (Big School) District for the 2013-2014 scheduling cycle. The 2013-2014 scheduling cycle determines opponents for each school’s next two (2) seasons. ——————— High School (——) is a 3A school that, based upon the recent scheduling for the 2013/14 seasons, is expected to compete with schools classified at the 5A level on six (6) separate occasions, schools at the 4A level 12 times, and similarly sized 3A classified schools 2 times in our next 20 scheduled games.

A schools classification is predicated upon the (State Association) account for each school’s student enrollment. That enrollment produces the available population to field athletic teams. (State Association) has outlined parameters identifying like-sized enrolled schools to view as competition throughout the state. (School System) scheduling policy has ignored these guidelines in which the (State Association) believes our schools can equitably, and safely, compete in the sport of football.

Current scheduling policy lacks the awareness of a significant and measurable increased risk of injury to the players at (School) and similar sized schools. What is alarming, and requires immediate awareness, are the findings of the most recent and advanced studies related to head injuries. These studies strongly suggest that (School System) scheduling policy as currently constituted, subjects student-athletes of the smaller schools, not only to a greater risk of injury but to a greater risk of serious head trauma Continue reading →

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International Boxing to BAN Headgear…

25 Mar

Discuss…  (LINK)

A major sports federation has mandated banning headgear in amateur boxing competition in an effort to reduce concussions and head trauma, a decision that is thought to be a first in the sports world.[...]

Removing the use of helmets or headgear has been discussed as a counterintuitive way to decrease brain injuries, with the idea being that athletes wouldn’t use their heads as weapons or hit as hard if they didn’t feel as protected. In boxing, there also is the belief that headgear makes it harder to see to the side to avoid blows, and makes the head a bigger target.

There has been limited research to support this change, but fresh data, still unpublished, suggests the removal of headgear in elite, male amateur boxing reduces the incidence of concussion, according to the chairman of the AIBA medical commission, Charles Butler, a retired cardiac surgeon and ringside doctor, who spearheaded the study that served as part of the basis for the recommendation.

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AAN Concussion Guidelines – One Stop Post

19 Mar

Here is the presser for the updated AAN Sports Concussion Guidelines; their guidelines are simple and to the point, via YouTube;

  • No Grading System of concussion
  • 10 day rest period – “key” – Dr. Jeffrey Kutcher
  • Greater risk if you have had a concussion
  • Addressing of youth and recovery
  • Helmets are not the full answer
  • Licensed Health Care Providers should be clearing
  • Repetitive head injuries are bad
  • The discovery and annotation of “Chronic Cognitive Impairment”
  • No single test, CLINICAL assessment
  • “Kids are not little adults.” – Dr. Christopher Giza

Here is the LINK to the Updated Guidelines (can someone give me permission to post it here?)

Here is the LINK to the Sports Concussion Toolkit from AAN

Here is the LINK to the Concussion Quick Check from AAN

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What does this mean in comparison to the Zurich Statement?  That is a great question; both groups used “consensus” however this group is much more centered on American practices.  Both have similar approaches, both advise nearly the same thing; but which one carries more weight.  I have been told the AAN will be much more “powerful”, respected and learned than Zurich.

This is a good debate, regardless, there is ample evidence to sit kids and any concussed individual.  This statement also continues the wave of information that cumulative and repetitive trauma to the brain (still figuring out thresholds) is not good.  Based on this and the Zurich statement the only way that we can collectively abate concussions at this point is exposure limitation.  No where in that last sentence does it state “stop playing sports,” or “get rid of football”.

When dealing with the brain and the injury of the brain less is better, which is ironically simple and a “no brainer”.

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