Knowing Is Half The (UPDATE)

21 Apr

UPDATE: Thanks to commenter @SpMedConcepts I should write that one test is just a piece to the puzzle.  And a comprehensive testing procedure that includes all of the available “baselines” and assessments should be used.  It becomes more difficult to cloud the picture with deception when using this approach.

Knowing about concussions is one thing, but knowing that players may take advantage of the system is another factor.  Like anything else in this world people will look to exploit weaknesses in systems to gain an advantage.  After all isn’t that the crux of competition and sports?  We have seen Irv Muchnick open up the dialogue on Ritalin as a possible way to “cheat the system” and now Alex Marvez of Fox Sports tells us the other, more obvious way to “cheat the system”;

Dr. Daniel Amen, who has treated current and former players for post-concussion symptoms, said some of his clients have confessed to fudging the initial baseline tests administered by NFL teams. By doing so, Amen said those players are seeking quicker clearance to return from any future head injuries they might suffer.

If the baseline tests are to be used to compare then why try hard and excel at them, only to have that first test hinder their return?  This is the common question that the professional and adolescent athletes are dealing with.  Even though baseline tests, be it neurocognitive computer based or hand written like the SCAT2 or the new NFL test, are objective in results the effort put into the testing is really subjective.  There would be no way of knowing if full effort was given, other than a “hunch” or in some advanced testing a “validity score”.  Neither of those have proven to be anywhere near reliable, in fact some would argue that “gut instinct” may be the best measure.

The only way to ensure that everyone is putting their best foot forward on testing procedures it to EDUCATE them about the perils of not taking it serious.  For NFL players that would seemingly be easy as there are many examples to point to; Mike Webster, Shane Dronett and Dave Duerson.  But what about the adolescent; there are far less publicized cases of players not listening to their brains and taking the concussion serious, but they have been just as tragic; Jake Snakenberg, Matt Gfeller, Owen Thomas, Evan Coubal, Nathan Stiles, Brad Evans, Austin Trenum and the list can go on.  Informing the athlete to take the tests serious with the best effort is the only thing we can do for now; as testing becomes better, and technology catches up we might be able to mitigate this issue.  At the very least we have begun a movement in changing the stigma of concussions;

The NFL’s recent efforts to better address the problem have trickled down to youth sports. Eleven states have instituted mandatory diagnosis and treatment protocols with legislation pending in 21 more states and the District of Columbia.

Barnes said more players are now more willing to admit concussion symptoms. Other players are coming forward as well if they believe a teammate is affected, he said.

This is a far cry from when Barnes first entered the league with the Giants in 1980. Barnes recalled telling then-coach Bill Parcells that quarterback Jeff Hostetler had suffered an in-game concussion during Super Bowl XXV in January 1991.

“I said, ‘He doesn’t know his name,'” Barnes recalled. “[Parcells] said, ‘Well, tell him his name.’ “

“When I began, if the player wasn’t knocked out and he knew his name and could make some recall, we let them go back,” Barnes said. “I don’t think we had the respect for it because the (medical) literature just wasn’t there. We’ve seen a vast movement from that perspective.”

Barnes believes there will be even more movement in the future.

“We do know that we have just scratched the surface (of concussion research),” he said.

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2 Responses to “Knowing Is Half The (UPDATE)”

  1. Mike cendoma April 22, 2011 at 07:38 #

    Lets not get off track. Any one test is only a small part of an overall concussion policy. Much harder to cheat a comprehensive approach!

    • Dustin Fink April 22, 2011 at 11:06 #

      I completely agree, I may not have underscored that in this piece, but I have said that over and over, hence the caution with neruocognitive testing… In fact I may update the piece, thanks for the insight

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