The quote in the title is a Japanese proverb, I have read it most recently in a very good book call “The Red Circle” by Brandon Webb; a biography of a Navy SEAL (you can learn a lot from these heroes). As with most proverbs you can take the meaning and apply it to whatever you want. In this case we are talking about concussions: awareness, education, assessment, recovery, treatment, etc.
One thing that I hope comes through is that I do not feel that I am a “be-all-end-all” expert, rather I am a devoted husband and father that is an athletic trainer that chooses to spend time paying it forward – so to speak. I have been asked many times why this blog is here and there are many answers to said question but the underlying reason is simple: raise awareness and bring together all who care to create more understanding and better protection from this brain injury.
The simple fact is that we have only just begun to really understand the concussion injury, each episode (aptly coined by Xenith) is unique; not only from age-group to age-group but from person to person. We know that males and females react differently, we know that youth and adolescent brains are much more susceptible to lingering effects than an adult brain, we know OR SHOULD KNOW there is no magic pill or course of action to prevent concussions other than living in a bubble, we know that there are very smart people out there with good ideas, we know that information can be controlled by many sources for many reasons, and we really should understand and know that the actual injury is not the elephant in the room, it is how it is handled from the beginning of the process.
Concussions are a process not an event; as soon as the injury occurs what happens next is what shapes the individual brain for eternity, yes eternity.
Where am I going with this? Simple, The Concussion Blog has become a fast growing outpost for people to opine on all things concussion; whether it’s through posts or more importantly in the comment sections. I would like to highlight why I think The Concussion Blog fits into the “none of us is as smart as all of us” mantra. Below are selected comments from across the board, included with them will be the link to the posts they appear in.
From the “Forest for the trees” post (by Nick Mercer):
Birgit Diederich April 12, 2012 at 18:40
I know you’re in Canada, but this post really resonated with me since my brother plays hockey and has suffered from 2 concussions. I recently read a blog about how Pennsylvania made a law for young athletes so that they are unable to play if they show signs of a brain injury until they are cleared by a doctor. It also said that there is an effort to educate athletes, coaches, trainers and parents about brain injuries after research showed that 40% of athletes return to play too soon after their injury. I think efforts like this need to be made early on, and hopefully this effort can carry on through adulthood.
A Concerned Mom April 13, 2012 at 07:57
Accidents happen, and there are no guarantees in life. Even if someone is proven negligent, the injured party often can’t be made whole. That’s just life. Sometimes you just have to be thankful the accident wasn’t worse.
However, I’m not sure if “accidents” are our primary problem when it comes to concussions in youth sports. Kids try to play like the professionals, and when you go all out like that, injuries are more likely (it’s a part of the sports saga that’s been kept quiet – no one paid attention to the price professional athletes were paying with respect to brain trauma). When you start looking, you can find concussion stories everywhere, but many parents, coaches, students, and schools are still in the dark (greater awareness may come from the NFL lawsuits).
Don Brady, PhD, PsyD, NCSP, Licensed Psychologist April 13, 2012 at 10:52
The terms ACCIDENT and FLUKE are misnomers when it describes a sport-related concussion.
Please read the below definition of an accident:
Definition of ACCIDENT- Merriam Webster (obtained online)
a : an unforeseen and unplanned event or circumstance
Sadly, ignorance manifests itself when the adjectives ‘accidental’ or ‘fluke’ are used to describe a presenting concussion/brain injury.
‘ACCIDENTAL’ or ‘FLUKE football injuries and deaths’….. ARE FORESEEN, PREDICTABLE and EXPECTED every year…and clearly are neither improbable nor unforeseen.
Though a so-called ‘small statistical percentage of children’ may die each year…each death is both clinically and humanly significant!!!!
Our children are being placed ‘in harms way’ when they walk onto on the football fields, and for some youngsters their fields become their ‘sports graveyard”…for what logical reasons????
It is becoming more apparent that we are playing Russian Roulette with children’s brains, emotions and other parts of their bodies.
Perhaps parents should read this following mantra to their child:
There are 40 comments in that post alone and are not only informative but help create dialogue, no matter the side you fall on now it is worth the time to read – moving to the next sample.
Educator Mom April 18, 2012 at 11:55
Until tracking and reporting is established and required, there will be no change. Our kids will continue to be sacrificed on the altar of sports with little regard to their long-term health and well-being. Every day I run into a parent, teacher, coach, or youth sports organizer who has no idea what the long-term risks are to these kids who experience traumatic brain injuries. I certainly wish someone had educated me, my son, and his coach before my son’s injury. Not only will tracking and reporting establish an environment of education but an environment of accountability. Then maybe…just maybe, we will see change.
More ideas, more thinking, make that critical thinking from other people outside of the experts.
Jake Benford April 25, 2012 at 10:41
The concerns you raise are spot on. This is why so many of us are pushing to have full contact football be eliminated until 1) the athlete is older and 2) the program has enough money to have medical personnel on site, ie: hight school.
Unfortunately, in my experience, the reaction from parents so far is push back, wanting to get their kids back before they are ready. I often have to ask them if I told them their child had a heart injury, would they still be questioning the medical staff.
joe bloggs April 27, 2012 at 09:27
First , I must agree with several commenters that certified ATCs are a requirement for a school to offer any collision sport. If you can’t afford an ATC then you can’t have collision sports. ATC need to report to be hired and report to school administration not athletic directors or coaches.
Coaches in all sports need serious training. Just because one played the sport 10 or 20 years ago, things do change, does not qualify one to coach a sport or lead children. Further, I see no evidence children under 14 should be playing helmet and pads football. There is no evidence it increases their skills. Forget the rational offered by many parents that my child will get a scholarship or go pro. Genetics have much more to do with someones ability to make the cut than anything else. The physical and psychological profile of a scholarship athlete and a professional athlete is extremely distinct. Tom Brady, 2 time SuperBowl winning QB for the NE Pats, did not play until he was 14 and Jason Pierre Paul, NY Giant rookie standout, until his junior year in high school. The variance in these athletes characteristics is extremely small. If your child does not fit this profile he is little more than a tackling dummy. Spend your money buying lottery tickets to pay for college or better yet put the money in a 529. Coaching is also a significant factor and very few schools have high level coaches.
I have also heard the missive that, “I had multiple concussions, and I am fine.” You are fine now but who knows in a couple of decades. You might have been President instead of being in a municipal job. Harry Carson, HOF NY Giant, has stated clearly that regrets playing and refuses to let his grandson play. Similar thoughts have been expressed by HOF DB Lem Barney and numerous other distinguished players.
I do believe in NP testing as one element along with balance, psycho screens etc. of a protocol to assess and treat athletes. Complex cases should be referred out to a board certified neuropsych but they are few and far between, expensive and may not take sports referrals. It is tough, but we are dealing with a child’s brain. The old maxim when in doubt keep them out. Any coach worth his salt knows when he has great player with pro-potential and knows it is best to keep him off the field in his long-term interest. The world is not going to end because some kid can’t take the field. Coaches and parents need to get real and take it down a notch.
Chaney is correct that youth football is at risk because it is poorly funded, managed and fails to account for its true costs. Insurance companies will not only abandon schools but also equipment makers (it is happening already). Football should be left to programs that are professional at all levels and depending on the outcome of current research certainly left to young adults, if not adults.
Sports are great and most children should play, but it is a game. It is not the NFL, NBA, etc. Have fun, stay fit and stay healthy.
A Concerned Mom April 26, 2012 at 11:15
The stigma of concussions is one reason I focus so intently on the youth level. It’s in the best long-term interest of youth athletes to avoid sustaining concussions at a young age (both for health reasons and for future playing prospects). Unfortunately, many in the current group of coaches for that level are stuck in the dark ages.
“Finding when one is ‘fully recovered’” is what scares me the most.
If it is true that: “a fully recovered concussion has not shown to be a factor for future concussions.” What does that say about the study(ies) finding a significant re-injury rate in youths visiting the emergency room for concussion? I seem to recall something about re-injury occurring within 6 to 12 months of a visit to an emergency room.
joe bloggs April 26, 2012 at 12:35
Forget fully recovered and think functionally recovered.
As far as the NFL, they are making an economic choice. A player who has a history of concussion is more susceptible to future concussion and the more concussion one has suffered, especially with no or poor treatment, would imply poor long-term outcomes.
These comments scratch the surface, it is very satisfying to see the constant communication about this issue. There really are many out there willing to help and give ideas/feedback. In order to progress and grow we MUST have the discussions and even disagreement, so please feel free to jump in; either by comment or email.