Training Camps in NFL Open Up

28 Jul

With the summer pilgrimage to training camps begun it is time to remind everyone that The Concussion Blog will be tracking the concussion injuries in the NFL for the fifth consecutive season.  It is our intention and has been our operating procedure to gather all the best data possible.

This is not a “witch hunt” or some “watch dog” type action, rather a way to inform, publicly, what is happening at the highest and most prolific level, for the most popular sport in the United States.

When we began back in 2010, the information was difficult to come by, we only noted and found eight preseason concussions and as of today there are four reported for this season.  Obviously there has been better knowledge about concussion from players, teams and reporters that has translated in easier tracking for the preseason activities.

I would like to take the time to mention @nflconcussions for their work in data mining the injuries.  Their Twitter account is probably the most productive when it comes to finding concussions.  They too have “reset” their counter for this season, if you follow them (and you should if you are interested) you will notice their numbers will be different from our reports once the regular season begins.

We data crunch only for the regular season due to reporting procedures from the NFL, making those injuries a bit more easy to find.  We also have other avenues to find concussions that may not make the press and are gathered by other places.  Finally there are some instances where a “possible” concussion turns out to be not a concussion.  We are not, in any way, discrediting any other concussion gathering group, we are just pointing out we do it differently.  Regardless, it would be a heck of a lot easier if the NFL was transparent with all injuries including concussions.

So enjoy what is left of your summer, and look forward to our first report coming out near the start of the season.

 

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#C4CT Concussion Awareness Summit Reconvenes Next Week

25 Jul

Brewer Sports International and Amarantus Bio Science is continuing their efforts to collaborate and discuss the issue of traumatic brain injury, in particular concussion.  In this version the focus will be on Alzheimer’s;

The #C4CT Concussion Awareness Summit is being convened on July 31, 2014 to explore the potential link between TBI and Alzheimer’s disease.  A diverse working group of clinicians, medical researchers, policy makers, international diplomats, athletes, celebrities, and philanthropic organizations will be assembled to raise awareness, advance clinical research, and develop public policy in order to address this major unmet medical need and public health issue.

The #C4CT Summits have a stated goal to collaborate information and ideas to try and further both understanding and proper response to this issue at hand.  I described it as – using a Japanese proverb – “none of us is as smart as all of us.”  Which is definitely the case for just about anything in life.  However, with so many egos and generally smart people there seems to be a ton of hand-wringing and chest thumping without a lot of resolution.  Jack Brewer and Gerald Commissiong are trying to find a way to get everyone on the same page.  Evidence of this was asking me to be a panelist during the last UN visit in January.  You can see the recap below;

There is still time for you to attend this wonderful event, littered with some great minds and speakers.  If you cannot attend you should follow their twitter feed next Thursday (unfortunately I will be away on vacation so I will not be live blogging the event this time around).

DYK Helmets Do Not Stop Concussions: An article that must get traction

25 Jul

I can tell you there is more coming on this issue – from here and other platforms – but this Regressing (part of Deadspin) article really needs to be highlighted here for those seeking accurate concussion information.  I would be remiss if I didn’t – virtually – give Kyle Wagner a “good game” for writing a beauty!

‘Hockey’s About To Get The Bullshit “Anti-Concussion Helmet” Treatment’ appeared 7/23/14, here are some great excerpts.

Lets begin with the opening salvo;

Virginia Tech thinks hockey helmets are bullshit, which is more or less true. In turn, it wants to look at the differences between hockey’s helmets and football’s recently evolved versions, and bring the concussion-stopping advances to hockey. This is pretty much bullshit.

Then the all-important – simplistic – overview of the concussion process (emphasis mine);

The brain floats suspended by fluids in the skull, and when it suffers concussion, it both smacks into the inside of your skull and incurs rotational force, irreparably damaging the brain stem.

Why we wear helmets;

Helmets, meanwhile, are there to protect your skull from fracturing in the impact of a collision. They provide this protection, and the best helmets have interior mechanisms that can offer some small aid in decelerating a collision.

A wonderful note in the article, that may be glossed over by most readers, but it very peculiar to many of ‘us’ in the know and actually understand/grasp both the concussion injury and the statistics that are thrown out about them;

If the above numbers seem low to you—a combined 64 concussions for eight college football teams over six seasons, or just about 1.3 per team per season—then you’ve likely read enough to have seen players talking about getting their “bell rung” often enough that those Virginia Tech numbers wouldn’t just represent a decrease in risk by half, but exponentially. If the available data say anything, it’s that they are hugely incomplete.

Further on the above excerpt, 1.3 concussions for AN ENTIRE TEAM for AN ENTIRE SEASON is just asinine, Continue reading

#tbt: Eye Opener from 2012: Was it overlooked?

24 Jul

Originally titled “Bombshell Found in Sports Illustrated Vault” this post appeared on July 4, 2012…  To this day, it may be one of the most poignant articles I have written about the road we have been down.  I believe that this post still rings true, two years later, in regards to all the information we knew that we didn’t know…  

Considering where – 2014 – and what has transpired – League of Denial – this article may have been glossed over and was WAY AHEAD OF ITS TIME from SI.  I often find myself wondering why we are not learning from the past to make proactive measures going forward…

Enjoy the read from the past (excellent RT @protectthebrain);

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Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, [...] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. [...] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading

Nick Mercer: Heading the blame away from goal

23 Jul

“Football is a simple game; 22 men chase a ball for 90 minutes and at the end, the Germans always win.” – Gary Lineker

Sunday’s game was scoreless into the 112th minute, but still an exciting one with an attacking, offensive mindset for both teams. That said, I am not writing this post to give an unqualified analysis of the final. I am not even analyzing FIFA’s approach to concussions. Everyone who watched saw Christoph Kramer collapse after colliding with Ezequiel Garay’s shoulder. This was a particularly nasty collision, but by no means the only, or even most, blatant example of brain injury in this World Cup. Not a week before, Argentina midfielder, Javier Mascherano also received a decidedly hard blow to the head after colliding with Dutch midfielder, Georginio Wijnaldum. Then there’s Uruguay’s Alvaro Pereira who was actually knocked out before continuing to play!

Another incident caught my attention in Sunday’s final when Germany’s Thomas Müller banged heads with an Argentine defender as they both attempted to head the ball. The defender (I don’t know who it was) was down for a while after they collided and Müller was reaching for his head. Nevertheless, as is now customary, both continued to play.

Blame seems ridiculous, since it can rationally be shifted around in a never-ending circle. It’s pointless for the same reasons. Yes, teams and doctors could do more. Yes, FIFA could write new rules. Yes, players should be taught the dangers of continuing to play. They should be taught this from a young age. The blame goes to ‘them’ and ‘they’, but what about ‘us’?

Personally, I enjoy watching football (or soccer, as we North Americans say), but I watch very little, especially compared to harder hitting American football – where men in full body armour slam into each other and brain injury seemingly occurs every play. Hockey is the same; full body armour, collisions, brain injury. People seem to forget what protection all of the padding provides. When two athletes collide without padding it hurts a lot more (that’s why padding is used) and it hurts both individuals. It also means that in rugby or Aussie Rules Football, where such padding isn’t used, there is a tendency more toward technique, not trying to lay the opponent out every play, because a hard collision is a hard collision for both athletes. But I digress.

Injury in sports and life will happen. Brain injury in sports and life will happen. It’s not about how brain injury is dealt with in sports, it’s about how it’s dealt with in life. Pressure is placed on governing bodies like FIFA, the NFL, the NHL to do something. As the top bodies of their respective sports, they set standards to strive for. Consequences don’t start and end there. The onus is on the rest of us to be aware and learn.

California First on Football Hitting Legislation

22 Jul

I received this email late last night:

Friends….

Assemblyman Cooley’s office just phoned to say that Gov. Brown has signed Ca. AB 2127, making California the first state to legislate reduced contact on high school practice fields.  As you know, other states have taken similar action via their governing bodies of high school athletics but, after failed attempts in Texas, Illinois and Connecticut, Ca. is the first state to pass legislation and have it signed into law.  Public announcement will be made shortly.  Thanks to Warren Moon, Oliver Luck, Patrick Larimore, Leigh Steinberg, Dr. Chris Giza and others who made it happen.

Reading further on SF Gate:

The law limits full-contact practices to two 90-minute sessions per week during the season and preseason, and prohibits full-contact practices during the offseason. Currently, coaches can hold full-contact practices daily. The law also forces schools to bench players for at least a week if they suffer a concussion. Current rules allow players to return within a day.

The last part of the above paragraph has me very excited about this legislation – AT LEAST one week down time!

Good on CA for taking this to the next step, honestly I don’t think we need more legislation, however if you don’t want to listen this may be the route it has to go…

NOW CALIFORNIA GET YOUR BUTT IN GEAR AND LICENSE THE ATHLETIC TRAINERS IN YOUR STATE!  THEY MUST BE RECOGNIZED FOR WHAT THEY ARE: ALLIED HEALTH CARE PROFESSIONALS.

Terry Ott: Personal Observations in the Wake of Suit

22 Jul

Terry Ott files a follow-up regarding the law suit in Canada and Arland Bruce.  This is his commentary on the coverage of the issue; all information, illustrations, pictures and links are his.

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DOES CANADA’S TSN, THE HOST CFL BROADCASTER, APPEAR TO BE “CIRCLING THE WAGONS” OVER ARLAND BRUCE III CONCUSSION LAWSUIT AND SUBSEQUENT NATIONAL HOOPLA AND HOOTIN’ AND HOLLERING, OR IS IT JUST A CASE OF, AND NOW, FOR SOMETHING (REALLY) COMPLETELY DIFFERENT?

“It is difficult to get a man to understand something when his salary depends on him not understanding it.” — Upton Sinclair, author of The Jungle

The irony of the American-based Concussion Blog breaking one of the biggest stories about the Canadian Football League in recent memory when it exclusively revealed the first concussion lawsuit in CFL history, is certainly very rich.

Prior to D-Day, July 16, 2014, much of the Canadian sports media didn’t know too much about concussions, and, well, seemingly, they didn’t wanna know too much. Or, as they also mused in the movie Casino, “ah,why take a chance?”

And of course there is that lovely old Buddhist proverb of “see no evil, hear no evil, speak no evil.” Maybe that’s what most of the big time scribblers and jolly jock-sniffers were up to up here prior to the Bruce legal revelation but since most would not even talk to me, how would I really know?

However, after Andrew Bucholtz of the Yahoo! Canada 55 Yard Line CFL Blog gave the story of the Bruce lawsuit nation-wide coverage mere hours after it first appeared here, the story became a talking point throughout Canada for days as well as shaking the previously comfortably cocooned CFL , who may have been alerted to the Concussion Blog post by a trusty and observant friendly just shortly after it went live from Chicago at 12:32 EDT, on July 16.  Continue reading

Filed Claim: Arland Bruce III v. CFL Entities

16 Jul

Bruce

The Filed Claim in its entirety can be found HERE.

You will notice the very wide scope and various Defendants.  Certainly it will have to go through the process up in Canada however, it will definitely get some attention:

Like this from The Toronto Sun.

Or this from Twitter:

I would also like to add the follow video of the Commissioner;

Make of this what you will…

Exclusive: First Law Suit Filed in Canada Over Concussions

16 Jul

Terry Ott has filed this BREAKING NEWS in regards to Canadian Football and the Concussion Issue.  We here at The Concussion Blog are pleased to bring this information to you…  You can find the FILED CLAIM HERE.

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FORMER CANADIAN FOOTBALL LEAGUE PLAYER SUES LEAGUE MEMBER TEAMS FOR CONCUSSION RELATED INJURY

Lawsuit on Behalf of Star Arland Bruce III Alleges “Fraudulent Concealment” and “Negligent Misrepresentation” By 9 CFL TeamsLeague Commissioner, CFL Alumni Association and Others

Contrary to (popular) opinion, the sports press likes to fling incense, be part of the show, create stars, and to that end prints and televises a fraction of what it knows.” -Mark Kram, formerly of Sports Illustrated 

July 16, 2014
Hamilton, Ontario

The first lawsuit brought against the CFL member teams and others for concussion injury has been filed in Vancouver, British Columbia in the Supreme Court on behalf of Arland Bruce  III, a veteran of 12 seasons as a speedy wide receiver who last played for the Montreal Alouettes in 2013 and also starred on two different Grey Cup winning teams as well as spending the 2003 season with the San Fransisco 49rs.

Bruce, noted in the claim as an “unemployed football player,” is the holder of the record for most receptions in a CFL game (16) and is a three-time CFL All Star.

The claim, so far for unspecified monetary damages, asks for general damages, special damages, general and special damages “in trust” for the care and services provided by his family, and punitive and aggravated damages.

In the claim filed by the Vancouver law firm of  Slater Vecchio LLP and lawyer Robyn L. Wishart, it is alleged that Bruce suffered a concussion and was knocked unconscious in a game played in Regina, Saskatchewan on September 29, 2012 between the BC Lions — Bruce’s team at the time — and the Saskatchewan Roughriders.

Bruce subsequently returned to play for the Lions in a playoff game on November 18, 2012 and it is alleged that he was still suffering from his previous concussion and it is also alleged he suffered additional concussive and sub-concussive hits during the  Nov. 18 game.

From a copy of the claim, not proven in a court of law, it alleges in part:

  1.  The plaintiff reported concussion signs and symptoms to the BC Lions medical personnel and coaching staff including but not limited to the following:
    1. fogginess;
    2. headaches;
    3. sensitivity to light;
    4. sensitivity to sound;
    5. memory loss;
    6. confusion;
    7. dizziness;
    8. anxiety; and
    9. personality changes.

After the 2012 season, Bruce left the BC Lions and was signed for the 2013 season by the Montreal Alouettes.

Also from the claim: “Further, despite the fact that the plaintiff was displaying the ongoing effects of concussion to medical professionals  and coaching staff, he was permitted to return to play in the 2013 season for Montreal.”

In a 2011 Yahoo! Canada  Sports 55 Yard Line  article by Andrew Bucholtz,  and so noted in the claim, commissioner Mark Cohon said “I am convinced that every concussion is being reported and dealt with. I trust our  doctors. I trust our therapists. I trust our teams to report that.”

And in the 2011 Canadian Football League  concussion “Campaign” directive to the CFL clubs from Cohon advised to “err on the side of extreme caution” when dealing with suspected concussion injury.

Those familiar with my series “3rd Down, CTE To Go,” for the Concussion Blog in 2013 will recall former CFL player Leo Ezerins, now communications director for the Canadian Football League Alumni Association, and Dr. Charles Tator, of the University of Toronto, Krembil Neuroscience Centre, and the Canadian Sports Concussion Project. 

Both Tator and Ezerins believed there were “more questions than answers” between concussion and brain trauma and that “extreme caution” be used in any subsequent diagnosis of CTE.

Accordingly, Ezerins and Tator are named as defendants in the lawsuit and perhaps the most revelatory allegations — again not proven in a court of law — made in the claim are that Bruce continued to play CFL football after suffering concussion  and sub-concussive injuries because:  Continue reading

Back to Basics: Current Concussion Management

9 Jul

What follows below are recommendations that have been on this blog for many years.  I came up with them when it started in 2010 and not much has happened to change what was written.  In fact, more and more these ideas have been accepted, showing that it was ahead of its time in 2010.

AS ALWAYS: PLEASE CONSULT A MEDICAL PROFESSIONAL FOR A CONCUSSION, USING THIS BLOG ALONE FOR TREATMENT OF A BRAIN INJURY IS NOT RECOMMENDED.

We can discuss rehabilitation from a concussion at a later time, but the theory of this being a spontaneous and passive recovery for a vast majority of incidences continues.  It has been my experience that the “less is more approach” is best with concussions, initially.  Being, that after injury the less you do to stimulate the brain and rattle the brain the better and faster the outcomes will be.  When the injury lingers on beyond 10-14 days (usually due to too much activity in the initial phases) that is where rehab and a more dynamic approach to recovery is needed.

Please enjoy and remember that back in 2010 this was not mainstream nor widely accepted.  I hope that four years later this is commonplace.

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Sport-Related Concussion, Don and Flo Brady (NASP Communique)

INITIAL STEPS

After an initial concussion the individual should subscribe to REST, not just physical rest, but COMPLETE and UTTER rest.

  • NO TV
  • NO Texting
  • NO Computers
  • NO Radio
  • NO Bright Lights
  • NO Loud Noises
  • NO Reading

COMPLETE brain rest, in other words, SLEEP!  This should be adhered to for at least 24 hours or when the medical professional that you seek (and you should) tells you otherwise.

SCHOOL AGED INDIVIDUALS

Rest should be continued until all signs and symptoms have resolved.  Rest in this demographic should Continue reading

Nick Mercer: Adjustment/Accomplishment

8 Jul

Nick wrote two quick takes on his experiences with TBI recovery and where he stands, currently.  Here they are presented in one post.  We would like to thank Nick for continuing to post from a unique perspective and appreciate the work he has done for us.

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Adjusting is not quitting.

I finished my Pilates teacher training in Toronto last Sunday – thank you Body Harmonics! I’m feeling great and have confidence that I will be a good and effective teacher. It’s due to the outstanding instruction I’ve gotten from Sarah Stoker at Pony Locale here in St. John’s and the amazing teacher training from Larisa Makuch and Margot McKinnon at Body Harmonics. The excellence of the instruction I’ve received notwithstanding, I’m happy and confident because Pilates suits me. It fits well with my personality and where I am currently; in life, location, and in the time since my brain injury. Pilates wasn’t even in my mind 5 years ago and if you had asked me about taking on Pilates before my brain injury, I wouldn’t have been interested. I am now though. Very interested. And happy and confident too.

I didn’t write this post to talk about Pilates, but about change, about adjustment after, in my case, a very serious brain injury. It’s about having an open mind and knowing that just because adjustment is tough, especially at a challenging point in your life, it doesn’t mean trying something new is a waste of time. Just the opposite actually. While having an unwanted challenge thrown at you can be tough, a challenge you give yourself can be exhilarating! It doesn’t even have to mean a drastic change in your mindset, just a different activity. Before my brain injury, playing water polo and cycling were activities from which I got a lot of enjoyment. I would still love to play a game of water polo like I used to. I would still love to hop on a bike and just ride all day. That doesn’t happen anymore, but, after finally listening to my sister, with encouragement from physios, I decided to try something that keeps me motivated, interested, and looking to improve. Maybe it was something you used to do, but ‘life got in the way’ and you stopped. Maybe it’s something you do every day and would like to know more about. Or maybe it’s something that has never even crossed your mind.

There are aggravating and depressing times while recovering, but those times don’t need to last forever. Instead of refusing yourself of any happiness until you recover all of the abilities you think you have lost, embrace the opportunity to try something different. Whatever that is.

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I’ve received some very nice and intriguing comments about my last post and they led me to write more about the idea of adjusting.

In essence, it’s life. Life is one long adjustment, with a bunch of intermittent adjustments thrown in. I wrote my last post, initially with the idea of talking to brain injury survivors. The more I wrote and gave my views, the more I realized that it applied to everyone who has had to deal with an unintentional life-changing event. Then, after my post (post-post), some comments got me thinking of who else may be able to relate and then thought “everyone”.

Graduation (from high school, college, or university) is an adjustment. A new job is an adjustment. Having kids is an adjustment. Retiring is an adjustment. These are simply easy ones to name, “big” ones. They all get more challenging the less prepared you are for it. For example, graduation is an event you see coming and it’s achieved with intention. It’s viewed as a good thing. An accomplishment. All of those events, when approached with intention and preparation are what we view as accomplishments. Intention and preparation.

Those two important elements are generally lacking when an accident happens and we’re forced to make an adjustment. Although making adjustments are what life’s all about, and although life is viewed as a good thing, ‘adjustment’ has a negative connotation. People are “forced to make adjustments” and even when given a positive spin, it’s with a qualifier – “a good adjustment”, “the correct adjustment”.

Since adjustments are such an essential and ever-present part of life, viewing them negatively goes against the whole notion of life being good. Embracing the idea of adjustment, that adjustment makes life more interesting (whether due to a “good” or “bad” event), gives a new look to challenges.

It’s not about ‘making the best of a bad situation’, it’s simply about adjusting.

SNEER and LOAFING in the CFL: A Sad Trip to Apathy, Amnesia and Animus

19 Jun

Eric “The Flea” Allen

This post is by guest journalist, Terry Ott.  You may remember some of his work posted here previously in the seven-part series looking into concussions and possible long-term issues (you can click on links within the post to read all parts).  With the Canadian Football League avoiding a work stoppage by ratifying a new collective bargaining agreement and play about to begin Ott brings us a follow-up story.

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The Canadian Football League season is set to kick-off on June 26 culminating with the 102st Grey Cup in Vancouver in November. With a new team-the rather unusually named Ottawa RedBlacks-two new stadiums, a recently ratified 5 year collective bargaining agreement between the players and the board of governors that still leaves the owners with a major financial upper hand, and the ever-increasing fan interest in Canada and even south of the border, it would appear the CFL has landed in a cozy albeit modest pro sports sweet spot.

However, there is that not so little matter concerning the past, and especially the future…


Weird Scenes Inside The 110 Yard Gridiron

After my 7 part series on concussions in the CFL appeared at the end of last year, both Concussion Blog founder
Dustin Fink and I both had the same question:Why has the CFL (apparently) not been sued for concussion-related damages? And just where are all the players who played and suffered serious concussions that affected their quality of life after football? How could the CFL possibly be that much different from the NFL?

The CFL has been knocking and sometimes scrambling heads for well over 100 years and yet not a single class action lawsuit for damages due to concussion has yet been filed. It is possible that at some point in the past, singular concussion related lawsuits have been undertaken and settled out of court and bound by confidentiality agreement so they were never reported on but other than that possibility, it would almost appear that the CFL somehow exists in some bizarre twilight zone of brain injury legal non-culpability and/or amnesty. 

Continue reading

Arkansas Looks Into Hit Limits

18 Jun

Over two years ago I sent an open letter and proposals to the Illinois High School Association (IHSA) regarding hit limits in football.  Some took this as a “candy ass” approach and one that was not needed.  I disagreed with that assessment, in fact, I felt that what I wrote at the time was proactive and could be a way for this state to be a leader in the area of protection in concussions;

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.[...]

Recent evidence suggests that even the subconcussive hits – those that effectively “rattle” the brain but do not produce signs or symptoms – become problematic as the season wears on, let alone a career.  As the researchers in this field gain focus and more specific diagnostic tools, I feel we will see damning evidence that will put collision sports in jeopardy as they are currently constructed – the key being “as they are currently”.  There can be a change, both positive and proactive, that will signal to everyone that the IHSA is taking this matter seriously and can set a nationwide standard.

Needless to say it was brushed aside and was ignored, except for a kind email saying things were happening behind the scenes.  Now, two years and one month later there could be a 12th – TWELVE – states that have contact limits in place for high school football; as Arkansas looks into the matter;

According to reports, the Arkansas Activities Association has passed a recommendation to ask school superintendents to cut full contact practice time to just three times during game weeks. With one of those being the game itself, it leaves just two days of tackling if the proposal passes.

Jason Cates is the lead trainer for Cabot High School, and the former President of the Arkansas Athletic Trainers’ Association, he says, “Something has to be done.”

“The more studies that are showing that hit counts do count and add up.”

The Arkansas proposal limits the full contact days to three, opposed to the two I proposed, but it seems to me that others have seen the light.  That light is both the end of the tunnel and the oncoming freight train.  Kids need Continue reading

Hit Count Symposium

16 Jun

If you have a son or daughter in Little League Baseball you probably have heard of a pitch count.  Basically it is a set number of pitches a pitcher can throw in a certain time period.  The reasoning seems simple and sound, in my opinion; to protect the overuse of the arm/elbow.  Sure, there are many coaches out there in the baseball world that know what they are doing and will only throw players when they are fully rested.  On the other hand there a plenty of coaches out there that either don’t know or knowingly put players at risk when it comes to overuse of the pitching arm.

This has a relation to the concussion world; well, Sports Legacy Institute hopes so.  In an effort to be PROACTIVE about issues surrounding concussions and especially the youth players of collision sports SLI has created an initiative to limit, log and research “hits” absorbed.  I have blogged about it here when the initiative began.

Like many things that are new and different, people often dismiss or fail to grasp what is being attempted or cannot see what may be accomplished by doing them.  In regards to the Hit Count, it to is simple; limit the number of hits one sustains while playing sports – collision sports to begin with.

I may not be the worlds biggest advocate for sensor technology as we currently know it, however this approach is different and unique.  It is something that should be paid attention to, if not for the currently proposed reasons, at the very least the research capability.  How can we know if we don’t know.  In other words; how can we measure if we are making a difference with any of our so-called “advances in concussion issues” if there is not something to measure it against.  For a small niche in the medical community that is all about “baselines” and return to “normal” our peers seem to get all squirmy when people want to find this baseline.

The Hit Count most likely will not be the panacea which our culture so desperately wants but this is at least a step in the right direction.  Below you can see the full press release on the Symposium.  I cannot attend on July 15th, but I have been afforded two (2) transferable registrations.  Please contact me if you will be in the area and are looking to attend.  Without further ado:

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For Immediate Release —Thursday, June 12, 2014

Media Contact: Chelsea McLeod (781) 262-3324 or cmcleod@sportslegacy.org

Sports Legacy Institute Announces 2014 Hit Count® Symposium to be Held on Tuesday, July 15, at the Boston University School of Medicine to Advance Discussion on Use of Head Impact Sensors in Sports to Prevent Concussions

Co-Chaired by Dr. Robert Cantu and Dr. Gerry Gioia, event will gather researchers, athletic trainers, coaches, parents, athletes, medical professionals, and administrators to explore how Hit Count® Certified sensors can be used to improve brain safety  Continue reading

World Cup Time

13 Jun
I took this pic at FIFA HQ

I took this pic at FIFA HQ

For all the blame football gets for concussions and concussion problems; futbol – or the worlds’ game – has its share of concussion issues (so do just about all contact sports).  The unique thing to soccer is that it is not a “collision” sport, by definition.  Yes, it is a contact sport, however it is not designed for full contact or collisions all the time like other sports like: rugby, Aussie Rules, Football, hockey and rodeo (you could even include lacrosse because of the sticks).

The nature of sport, competitiveness, lends itself to injury risk and risky behavior – this is always the case of concussion and their issues.  In the game of futbol/soccer the basic rules have set up a game where concussions can and do occur at frequency for a “non-contact” game.  Of course calling soccer “non-contact” is a complete misnomer if you watch or understand the game at all.  Players are constantly using their bodies to gain an advantage on opponents, from shoulder charging to grabbing or using hips to knock another player about.  The issue as it relates to concussions is how the head is used in this sport.

It is used as a much-needed tool to clear, pass and score the ball.  It is currently unclear as to how heading a ball in general relates to concussions and long-term issues although a general causation link can be observed and some studies have shown higher incidence of deficit of “brain measures” with increased heading.  Most often concussions occur due to collisions on the pitch.

It could be as simple (and scary) as a boot to the head or as subtle as an aerial challenge that resulted in a violent and unanticipated shaking of the head.  Often, concussions occur when the player falls to the ground and the head uncontrollably smacks the ground.  The point being there is ample opportunity for a soccer player to sustain a concussion and at the least subconcussive brain injury.

I thought I would look in to the research done about concussions in soccer and came across a very peculiar paper: “Chronic traumatic brain injury in professional soccer players”.  It is not the title that caught my eye, with all the information we are currently gathering on concussion it seems natural to see that kind of title.  Heck, very recently we saw something that was originally thought of as non-existent, CTE in a soccer player.  No, what made me stop and note this study was the year the paper was published………. 1998.

Yes, 16 years ago.  Let me repeat that, SIXTEEN years ago this information was made available by these pretty dang good researchers: Chronic Traumatic Brain Injury in Professional Soccer Players.  Below are the results and conclusions:  Continue reading

It Has Been A Long Time

11 Jun

Hello everyone, my name is Dustin Fink.  I am an athletic trainer and I have created a blog about concussions…  Wait, what?

It has been a long time since I have gotten to this blogging thing, perhaps I needed to reintroduce myself.  As devout readers – that you all are – you have noticed a sharp decline in the publishing prowess of The Concussion Blog.  Thank you for your concern and information over the past few months, it means a lot to me.

I am writing today to simply keep you all in “the loop” when it comes to this space going forward.  The simple answer is that it will remain what it was; a spot for information about the issue of concussion and the issues surrounding concussions.  With a much more active family (three kids getting to the “we go everywhere” age), a welcome increase in responsibility in my main job as an athletic trainer, and simply being more selfish with my time you all can expect decreased frequency of posts from me.  However, there will be spurts of information, commentary and editorials from time to time.

There is plenty to be talked about in this “concussion world” as we currently know it; I plan on doing just that going forward.  Recently I have tried to delve into other parts of this entire Pandora’s Box – attempting to get research published, commenting on research, discussions about being educational partners, lining up speaking engagements, etc.  So, I have not strayed away from this issue, in fact, I feel I have become more aware of things happening in this arena.

If you have followed me on Twitter (@concussionblog) you would have noticed I am not far away.  It seems 140 or less is a bit easier to keep up with.  Thank you for being a follower, supporter and reader.

One thing I have had hammered home to me, very recently, is that people do care what is shared here and appreciate both the candor and experience this space brings.  This ranges from: those affected by concussions, medical professionals, athletic trainers (also a medical professional), press/journalists, students and even the professional sports leagues and players themselves.  It is truly an honor.  Because of this I am going to ramp back up starting this month.

There are exciting things coming to TCB, some exclusive and some in partnerships.  What I am most excited about is being the place that people can comment or even post about things that may cause disagreement or consternation.  Being comfortable allows us to be content and that leads us to my favorite proverb/saying – currently – “If you do what you’ve always done, you will be what you’ve always been.” – Mick Buttz.  If this means rocking the boat and questioning people to create further thought and get away from “group think” then sign me up.

Going forward you can expect some of the following (and much more):

  • NFL Concussion Reporting
  • Educational Opportunities
  • Critical Commentary on Research
  • Guest Blogging/Posting from Critical Thinkers
  • Guest Journalism
  • Partnerships in Communication with vastly different “circles”
  • My continuation of keeping sports – I don’t dislike any sport!
  • My main theme: THE INJURY IS NOT THE MAIN ISSUE, RATHER THE MISMANAGEMENT OF THE INJURY IS
  • My skeptical eye on prevention in the way of equipment
  • My soap box about getting medical professionals to the adolescents – athletic trainers
  • My promotion of new and “outside the box” ways of limiting exposure and management of concussion

We are an outlet for those that would like to get information out not only about concussions but for athletic training.  Feel free to drop a line and bounce ideas off of me.  There is plenty lined up for the next month, but I can always add more!  And buckle up for what is surely going to be a much talked about June-July here on The Concussion Blog!

Thank you again for continuing to visit The Concussion Blog!

LINK: Rebroadcast of Pres. Obama Sports and Concussions

30 May

You can follow the link below for the rebroadcast of the “summit” on concussions in sport held at the White House yesterday.

http://www.c-span.org/video/?319639-1/president-obama-sports-concussions

There were some interesting thoughts passed along and it was great to hear the POTUS discuss athletic trainers and the need for them.  The next step in that “finger” of concussion care is to find funding and placement of athletic trainers.

I did enjoy Taylor Twellman’s honesty and direct nature during his time.

A Preliminary Investigation of Active and Retired NFL Players’ Knowledge of Concussion (2004)

19 May

Below is an excerpt from a dissertation from Don Brady, PhD, PsyD, NCSP wrote ten years ago.  Although the year of publishing might seem aged, there are pertinent and salient points to behold in this.  Without further ado…

TBI and Postconcussion:  Many Years of Controversy

Vague and inconsistent definitions of the constructs used to explain a [concussion] brain injury, coupled with confusion and misunderstanding of brain injury symptoms, create further problems in the study of sports-related concussion research.  Wills and Leathem (2001) amplify: “The quagmire created by the use of inconsistent, overlapping and poorly defined terminology relating to brain injury research is exacerbated in sport-related research” (p. 646).

Common synonyms for concussion include mild traumatic brain injury (mild TBI) and minor closed head injury (minor CHI) (Kelly, 1999). Other terms which have been utilized since last century to describe the concept of a mild brain injury include: spinal concussion, railway spine, railway brain, traumatic neurosis, nervous shock, traumatic hysteria, traumatic hysteroneurasthenia, spinal anemia, vasomotor symptom complex, litigation neurosis, compensation neurosis, accident neurosis, Erichsen’s disease, Friedmann’s disease, traumatic neurasthenia, the posttraumatic concussion state, the posttraumatic psychoneurotic state, traumatic encephalopathy, posttraumatic cerebral syndrome, posttraumatic syndrome, post traumatic nervous instability, postconcussion syndrome, postconcussive syndrome, postconcussional syndrome, posttraumatic stress  syndrome, and a persistent postconcussive syndrome (p. 32).

Gerstenbrand and Stepan (2001) also reported a variety of terms being used to describe minor brain injury: “mild head injury, mild injury, traumatic head syndrome, postbrain injury syndrome, mild concussion syndrome, postconcussional syndrome, traumatic cephalgia, posttraumatic syndrome, Commotio cerebri, light traumatic brain injury damage and mild traumatic brain injury” (p. 95).

Approximately 50% of persons who sustained a TBI experienced postconcussion syndrome (PCS), which manifested itself in various symptoms that were not present in the person prior to sustaining the concussion (Bazarian & Atabaki, 2001). Although controversy exists Continue reading

General Dentistry Publishes a Bombshell About Mouth Guards (ADDENDUM)

5 May

Is it a bombshell or is it just a plain dud?  I say bombshell, but not in a good way for anyone involved with this “research”.

Last week I was inundated with emails regarding this “new” research about mouth guards and concussions.  There were roughly 16 emails in a one hour time span; some wanting comment, some telling me I have been wrong all along, some promoting the research.  This was a “huge” development in my area and my little corner in the blogosphere.  To fully understand perhaps some history is needed (“mouth gear” search on this blog) when it comes to my feelings on mouth gear and concussions.  Here are some selected comments attributed to me;

The basic fundamentals we should be cognizant of here are: concussion is a BRAIN injury, the BRAIN floats inside skull, Physics dictates that the BRAIN will move depending on the forces applied to the skull/head (not always from a blow to that area), mouth gear cannot stop the BRAIN from moving, mouth gear cannot attenuate any forces to the skull/head that are not in the oral region, mouth gear does nothing for the skull/head when forces are placed on it in rotational, angular, acceleration or deceleration fashion.

Now that we have that all out-of-the-way this is the General Dentistry article I was asked to comment on.  On face value and from a “peer-reviewed” angle it Continue reading

Please Let This Be The Beginning: A Public Invitation

28 Apr

The blog began simply enough, making notice of information about concussion in a time when there was so much misunderstanding.  It turned into a cathartic exercise on how I have dealt with concussions as an athletic trainer – the good and the bad.  It has slowly morphed into a platform for change; not only concussions but the healthcare profession of athletic training, in particular at the secondary school level (high school).

Adolescent concussion is not only staggering in terms of exposure but in terms of mismanagement, the true problem in this concussion crisis, in my humble opinion.  I feel – biased – that athletic trainers not only can help with the management but with the overall “acceptance” of this brain injury as it relates to sports.  Because of those thoughts I have been openly and behind the scenes, clamoring for a way to get more AT’s in the high school.  Not just game-day ATC’s either, full-time and daily coverage for our most vulnerable.  The analogy still remains: would you send you kid to a public swimming pool without a life guard on duty?  Why would you send your kid to collision sports without an athletic trainer on duty?

Yes, this is being spurred on by the concussion issue at hand, but in reality an athletic trainer is SO MUCH MORE!  We deal with the mundane (common cold) to the emergent (cardiac arrest) when it comes to athletic or high school (dealing with situations during a school day) injuries.

I came across a tweet today from Rick Burkholder (@proatc), Head Athletic Trainer of the Kansas City Chiefs that is putting this into action.

The NFL is starting a grant process to place certified athletic trainers (ATC’s) into more high schools.  The monies are limited from what I can tell, but this is the start that I have been dreaming of for the past few years.

You can read the entire NFLF ATC Grant by clicking on the link to see all the details but here are the highlights: Continue reading

Refreshing Words From an Athlete

24 Apr

It’s my “off-season” of sorts here on the blog.  Add into that a growing, young family and time just seems to be hard to come by (not to mention my real “day job” of taking care of hundreds of athletes at a high school).  However, I am always listening and reading.

Today I stumbled across an Australian Rules (Footy) article about a knee injury but what I found in the article was a quote, from a professional athlete, that made me smile.  It seems that self-awareness and concussions is starting to take root (emphasis mine);

“I went to lunge to tackle Dangerfield and I remember Jimmy coming the other way and he sort of clipped my head and at the time, I didn’t think too much about my knee, I was more worried about my head,” Armitage told AFL.com.au after he was released from hospital on Wednesday.

If you read about the knee injury and the subsequent teammates horror over that you would wonder why he was thinking about his head.  David Armitage, without realizing it, has shown people, athletes are cognizant of concussion and in this instance placing that injury above a knee injury (albeit a laceration – significant enough to warrant a nine-day hospital stay).

This is where we need to get to, acceptance of the injury.  Understand that this will and can happen and then move on from there.

Its not the injury of concussion that is the real issue, rather it is the mismanagement of the concussion that is the real problem.

Sylvia Mackey – Video

27 Mar

In a follow-up, and what I believe to be the same presentation that Elanor Profetto’s video is from a very strong and wonderful woman, Sylvia Mackey, “Mrs. 88″ gives a talk about brain injury.  She also has intimate and troubling experience with what brain injury/disease can do as she took care of the great John Mackey in is twilight.

Keep on learning and listening!

Eleanor Perfetto, PhD – Video

26 Mar

Been on a video binge lately…  Look for more, but for today please take a listen to Eleanor Perfetto.  There are some points that some may (including me) not agree with entirely, but she has earned the right to be heard!  Not only is she a pharmaceutical epidemiologist, she is the widow of Ralph Wenzel.

Look for more video tomorrow…

A Decent Video

24 Mar

I am finding it hard to find time to post, obviously, but I will get back to this as soon as I can.  For the time being here is a decent video I have had forwarded to me that can be a good example of concussion or mTBI…

I would love to see discussion on this, below!

TCB Commenter Highlighted in Canadian Press

18 Mar

If you visit here enough and take the time to look at the comments at the end of the posts you might notice a person named “Phil”.  He especially took time to comment on the work of Terry Ott and his seven-part series about CTE in the CFL.  Thanks to Terry and this blog we are all able to get the genuine views of a former player in the CFL, Phil Colwell, via The Record from Canada and Terry Ott;

Colwell’s brief CFL career ended in 1981 after a violent on-field collision in a game at Winnipeg Stadium. He was playing for the Toronto Argonauts on that crisp and sunny day in October.

Covering a kickoff, Colwell, a solid six-two, 195-pounder with sprinter speed, was blindsided through the ear hole of his helmet by a Winnipeg player and was knocked out cold. He lay motionless on the field while a trainer ran to his assistance. No penalty was called on the play.

This is the type of story that Ott has sent out to tell from the beginning, placing faces and human behind the issue that has become one of the preeminent problems with football.  Yes, this is not isolated to football but we would be remiss if we didn’t expose and tell the stories of the most oft afflicted in the “head games” we now find ourselves knee-deep in;

Colwell, who graduated from Laurier with a psychology degree, found work with a Scottish government agency but continued to suffer bouts of depression and mood swings. He says accompanying anger issues and self-medicating led to moderate bouts of short-term or primary memory loss. Colwell says he frequently “loses the right words.”

The Scottish doctors he consulted were not familiar with professional football Continue reading

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