I have finally received a response from the IHSA, Associate Executive Director Kurt Gibson emailed me today.
He was “appreciative for the input” and states that the IHSA is continuing to work on recommendations for such issues. He did acknowledge that things don’t always go as fast as we want them to, undoubtedly letting me know that any changes will not be in place this coming season, which I can understand – sort of.
However the proposals can get on the official legislative agenda! With a catch; I have to find a principal of an IHSA member school willing to put their name on it.
So I ask of you Illinois readers out there to put me in contact with a principal that would like to put their name on these proposals and submit them for the process of possibly being put in place.
The research is starting to come in; the problem is that results and conclusions bring more questions that should be answered. Naturally some will look at early evidence and make a 180 degree change on their attitudes about certain things. We are talking about concussions and the research associated with it. Unfortunately there is plenty of anecdotal and observational cases that sear into our memory, this perhaps shape our thought process. Along with that there is gathering evidence that supports some sort of process change in how we handle this particular injury.
The need to make change is upon us, that cannot be debated; what can be debated is how or what the changes should be. I recently read an article where Micky Collins of UPMC said something to the effect of current concussion concern is like a pendulum that has swung all the way to the other side. Although the changes in sports and activities has certainly not taken that full swing the other way, the pendulum is on the way. His feelings, like mine is that there is no evidence to suggest that a full swing to the other side is warranted, rather there needs to be competent and complete understanding of what we are facing. Rather than making full sweeping changes that would be akin to digging up your backyard to rid your self of a mole; when placing traps and poisons and maybe only having to dig up a small section would fix the problem.
There are definitely things we can do as parents, players, coaches, researchers, doctors and concerned people in general to make a dent in the issue. If we find that the changes are not working then taking another aggressive step may be necessary. I guess the reason for the above rant is to reinforce the need for changes, but the right changes. (As I wrote the last sentence I realized how do we know if the changes are the “right” ones; I guess we don’t but certainly what is happening now needs attention).
One of the small changes that can be made is very obvious to me; Continue reading
Last season there were 15 concussions in MLB according to our findings, making it the most concussed year in MLB history. We surmised that this is mainly due to the actual awareness of the injury rather than an increase in the injury. One aspect of the concussion issue and baseball is that the 7-day DL seems to be making an impact; it seems that teams are more likely to sit a player with a concussion with the intermediate list. The conspiracy theorist in me would tell you that teams are now more likely to actually diagnose a concussion because of the 7-day DL; where as before they would call it something else.
The quarter pole has been passed and the unofficial start to summer has come and gone, here is where we stand with the concussions in MLB; (I am surely missing some, let me know) Continue reading
Randall Gay, formerly of the New Orleans Saints and the New England Patriots has decided that football is no longer his career of choice, due to concussions. Gay is 30 years old and feels he is having effects due to too many head traumas;
“But then it gets to the point where you don’t know enough about head injuries to just say I can deal with it. You might be able to deal with it today, but you don’t know what tomorrow holds. That’s the scary thing about it. That’s the decision you don’t want to make.
“I love the game of football, and I feel like I can deal with the headaches or just being nauseous. Just being a little dizzy, I can deal with it, but you just never know what it’s going to bring later.”
Gay was particularly frightened when he heard about former teammate Junior Seau, Continue reading
Thanks to Twitter we stumbled upon a podcast from Scientific American that was done by Stone Phillips and included Harry Carson and Dr. Bennet Omalu. You can find Part one HERE.
It is one of the few times we have heard Dr. Omalu in the public talk about the past and future of his work. The entire podcast is over a half hour in length, but there are some very interesting exchanges. I am not a very good transcriptionist so I will highlight the sections that I find interesting;
6:30 – Omalu discusses how he came across the Webster autopsy
8:05 – Omalu discusses how he feels the NFL tried to discredit him
9:05 – Omalu; “any doctor who say CTE is not for real is a joke.”
10:22 – Carson; “I also knew at that time they [NFL] said there is absolutely no correlation… until they got pulled in front of congress…”
12:35 – Carson discusses how Mike Webster filed for disability and its course
13:53 – Omalu discusses a potential breakthrough Continue reading
A very poignant and descriptive article about concussions in the NCAA. Sean Keeler of Fox Sports penned this article with the perspective of a collegiate athlete and how the machismo of those that play and support cause the biggest issue;
Lazetich is 34 now. An old 34. He suffered seven concussions playing football in his teens and 20s, including five — by his count — during a two-year stretch at Manhattan. The doozy, he says, came against Temple in the 1999 season opener.
“My first memory of the day was coach Snyder coming to see me in intensive care,” Johnno recalls. “I don’t remember tying my tie. I don’t remember the game at all. And then (three) weeks later, I’m back starting again — it’s a (nationally televised) game with Brent Musburger announcing at Texas Stadium, just because I passed the concussion test at the time.
“We do a lot of stupid things. Looking back on it, it probably wasn’t the smartest thing I did.”
More than a decade later, the scars throb — and linger. Lazetich suffers lapses in concentration. The short-term memory comes and goes. The headaches are killer, although they pop up a lot less frequently than they did five years ago.
“Still, if you ask me to close my eyes and shake my head back and forth as hard as I can, I’d tell you to go (expletive) yourself,” says the native of Continue reading
Governor John Lynch has a bill sitting on his desk that will put New Hampshire in line with the majority of states by enacting concussion legislation;
The bill, which has the support of the New Hampshire Interscholastic Athletic Association and others, would have school districts distribute information on the risk and nature of concussions to coaches, students, athletes and their parents.
Under the bill, a student athlete who shows symptoms of a concussion or who a coach, trainer or other suspects has sustained a concussion must be removed from the game or practice.
The student could return to practice or a game only with the permission of a heath care provider.
At first glance it appears that the bill is similar to that of Illinois, the signature would make New Hampshire the 36th state with legislation.
It has been over a week now since I wrote the high school sanctioning body in Illinois about making a change to limit contact in high school football. This was not done to promote myself, nor was it to hammer a sport many – including me – love. It was an attempt to get out in front of the issue and make proactive changes to protect not only the players but the game of football. It is a genuine good intention on my part.
Since the letter went out via email and on this blog I have had many responses from many different people and places. There have been questions and comments about what was written and in this post I will address as many as possible.
Let us begin with the deafening silence on the issue. As in only one email in response (24 sent out) from the IHSA and its board of directors. That response was as follows; “Thanks, Dustin”. Yup that is it. Not that I was expecting an invitation to HQ to break this down but maybe some questions or comments or stonewalling, nope – nothing.
Cost became a hot topic on this proposal. Yes, I concede that hiring an athletic trainer will cost you some money, but seriously would you send you kid to a swimming pool without a life guard? It is the same thing as sudden death, Continue reading
Part of the email I received about the AFL injuries were some papers written about the concussion issue in the National Rugby League (NRL), Rugby Union and of course Footy. The first article was written by Fredric Gilbert, PhD and Bradley J. Partridge titled The need to tackle concussion in Australian football codes. The gist of the article was about the still hidden injury of concussion, relating to reporting and return to play. The authors wanted to point out that the cumulative effects of concussions are just now surfacing and that “all contact sports should adopt and evaluate the effects of precautionary policies that require concussed players to leave the field.”
What I really appreciated was the section devoted to youth sports;
Reducing the risk of concussive and subconcussive impacts is even more critical at the non-professional level, where there is a large population of vulnerable young players to whom a significant duty of care is owed.6 Most reported cases of second-impact syndrome (when a brain that has not healed from a previous injury suffers an additional trauma) that led to death or severe disability have occurred in young athletes.19 Yet most amateur teams do not have qualified health professionals or other staff who are trained to detect and assess concussion. At this level of sport, many concussions likely go unrecognised and incorrectly managed.20,21 However, if players and sporting organisations at the elite level change their approach to head injury and concussion, it is hoped that those at amateur levels will do likewise.
Although the state of athletic trainers – physios in Australia – is currently unknown to me it seems that the push is again for correct oversight for the youth. Gilbert and Partridge seem to be addressing the same issue we have been here about youth concussions, which is great to see. If the top-level of sport addresses the issue head on then it will trickle down. Just like those players sloughing off the concussions to play – and the young players trying to emulate – management can work the same way.
The article above did prompt an editorial reply from some heavy hitters Continue reading
As The Concussion Blog continues to gain recognition it seems that some of the information is being used around the world. This can be noted in our analytics and seeing plenty of blog views from around the globe. Not surprisingly the US has the most traffic, followed by Canada and Mexico. The next most is the United Kingdom and Australia; presumably for our coverage of soccer and Aussie Rules. Because of this we get vast amounts of email from around the globe, and Australia has been providing tons of information to help with the blog and insight of how things are handled in their part of the world.
Most recently I was sent the 2011 AFL Injury Report for a comparison of our numbers versus theirs. Before we get into the actual concussion numbers it is interesting to note the most troublesome injury in football Down Under is hamstrings. By far this muscular injury affects more players per club per season than any other.
Back to the injury report, an injury is defined as “injury or medical condition which causes a player to miss a match”. It does not take into consideration any ailment that a player plays through or one that resolves in time for the next match. This is not unlike the NFL and their injury listings giving rise to an actual reporting issue – one we have discussed many times. If you look at the report they have historical perspective as well; in terms of concussion 2011 was the highest in incidence (1.1 new concussions/team/season) since 1992 (1.3 new concussions/team/season). There was over double the incidence of concussion from 2010 (heck almost three fold since 2006) to this past year.
The primary question was how does the official numbers jive with our numbers here; the answer is Continue reading
Appearing in the USA Today is an article that brings into the forefront the topic we have been discussing for some time here on The Concussion Blog. Although it is easy to target the sport of football, it is not the enemy. Those that run reckless programs and don’t address the ever-growing concerns of catastrophic injuries and concussions are the enemies.
Sport and activity is a must in our society, anything to keep kids and people active as obesity in our society grows. More and more evidence is beginning to support the delay of starting full contact/collision sports including football. This is mainly due to body development but can also be due to brain development.
When reading the article it was refreshing to see that more prominent people are suggesting the EXACT SAME reduction in contact days/hours;
“We are going to look at reducing the number of contact hours in practice and reducing the risk of head contact in practice. … Pop Warner is going to make rule changes to reduce the number of head contacts,” said Chicago neurosurgeon Julian Bailes, chairman of the board.
At Boston’s Sports Legacy Institute, CEO Chris Nowinski also is campaigning for a “hit count” for youths in football and other contact sports. Like a pitch count in baseball, it would limit how many hits a child can take per season and year.
The other aspect of the article that is relevant is the fact that athletic trainers should be available for those participating in collision sports; Continue reading
Rosemarie Scolaro Moser, PhD has written a new book about concussions and youth titled Ahead of the Game: the parents’ guide to youth sports concussions. Dr. Moser is defined by her MomsTeam profile;
Dr. Moser is the Director of the Sports Concussion Center of New Jersey, Director of Research Programs for the International Brain Research Foundation, and MomsTeam.com’s youth sports concussion neuropsychologist. A licensed psychologist, certified school psychologist, and board certified neuropsychologist and rehabilitation psychologist, Dr. Moser received her PhD from the University of Pennsylvania where she also served on the faculty.
She is a fellow of the National Academy of Neuropsychology and of the American Psychological Association, and a Diplomate of the American Board of Professional Neuropsychology and the American Board of Professional Psychology. Dr. Moser currently serves as an adjunct member of the faculty at Widener University, and as neuropsychological concussion consultant to both the Philadelphia Soul and the Trenton Steel Pro Arena Football teams.
As part of the book launch there is a party prior to the Philadelphia Soul’s game on June 24th. The party will Continue reading
A former player for possibly the world’s most recognizable rugby team may be on his way out due to concussions. The All Blacks – the New Zealand national team – is the height of sport in New Zealand and a nation holds the players in amazingly high standards. To say the All Blacks are a union team would be a serious understatement. The All Blacks are the current World Cup holder, ranked number one, have one 75% of their matches and hold both Bledisloe Cup and Freedom Cup (significant markers). They are Rugby Union. Any player that makes the roster is one of the best, this can be said for Benson Stanley.
Stanley now plays for the Blues in the Super Rugby League – a league that extends two continents and three countries. This past weekend Stanley may have seen his career ended;
Blues coach Pat Lam says that he is concerned about Benson Stanley’s health and playing future after he suffered concussion playing against the Crusaders.
The former All Black centre’s career is now hanging in the balance after this latest concussion which is his fifth major head knock in less than a year.
Lam said that it is possible that Stanley will have to go Continue reading
There are many places that provide modules for concussion education. One of the newest entries in this area is the University of Michigan and Michigan NeuroSport. Watch this video and once again see an example from a high school athlete.
As the blog progresses we will republish posts that garnered a lot of page views, especially those that have to do with research or opinion that are consistent with the theme of concussions as we currently understand them. This post originally appeared November 2010.
Research is beginning to suggest that chronic exposure and delayed recovery from TBI (see concussions) is directly effecting executive functioning of the brain. In August 2010, the Journal of Clinical and Experimental Neuropsychology published an abstract on an experiment from Finland.
Hartikainen, Waljas, et al performed executive reaction time testing, standard neuropsych tests and diffusion tensor imaging on their subjects and found that there were significant differences in scores between those that still had symptoms and those that have fully recovered. The issue and problem that presented itself is that the scores indicated trouble in executive functioning of the “still-injured” brain as opposed to the recovered.
MindDisorders.com defines Executive Function as;
The term executive function describes a set of cognitive abilities that control and regulate other abilities and behaviors. Executive functions are necessary for goal-directed behavior. They include the ability to initiate and stop actions, to monitor and change behavior as needed, and to plan future behavior when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes and adapt to changing situations. The ability to form concepts and think abstractly are often considered components of executive function.
These are high level abilities that influence the most basic things like attention, memory and motor functions. Along with the basics the executive functions of the brain allow each of us to adapt and perform in real life situations. Permanent or temporary deficits to the executive functioning of the brain are associated with; obsessive-compulsive disorder, depression, ADD/ADHD, Tourette’s Syndrome, schizophrenia, and autism.
There has been suspicion about how concussion symptoms specifically affect the brain, this could be our first hard evidence of the executive function angle. As with previous studies, actually quantifying executive function is difficult, more research is needed and welcomed.
The difference between male and females has been known for a little while as the females tend to show more cognitive issues and in research have shown to be slower at recovering. Also known but for some reason discounted is the age aspect; it would be logical to expect a developing brain to struggle more with brain trauma. Reuters wrote up an article about the recent research;
Female and high school athletes may need more time to recover from a concussion than their male or college counterparts, according to a U.S. study that comes amid rising concern about concussions in young athletes.
Researchers, whose report appeared in the American Journal of Sports medicine, found that of 222 young athletes who suffered a concussion, female athletes tended to have more symptoms than males. They also scored lower on tests of “visual memory” – the ability to recall information about something they’d seen.
Meanwhile, high school athletes fared worse on memory tests than college players, and typically took longer to improve.
For parents, coaches and athletes, the key message is to have patience with concussion recovery, said lead researcher Tracey Covassin, an assistant professor at Michigan State University in East Lansing.
Research like this will now begin to be shown to the world, as the research and money has ramped up over the past 3-4 years making longevity and high volume studies available. The simple moral of the story is; take plenty of time to recover before returning. One or two games is better than a semester or year.
For some time the thought was that the mTBI, TBI and concussions suffered on a playing field were different from what was being experienced on the battle field. The mechanisms may be different (collisions versus blast injuries) in nature but the resulting devastation may be similar. Again we can look to the northeast to Boston University’s brain bank and researchers for this new finding;
Scientists who have studied a degenerative brain disease in athletes have found the same condition in combat veterans exposed to roadside bombs in Iraq and Afghanistan, concluding that such explosions injure the brain in ways strikingly similar to tackles and punches. [...]
“Our paper points out in a profound and definitive way that there is an organic, structural problem in the brain associated with blast exposure,” said Dr. Lee E. Goldstein of Boston University’s School of Medicine and a lead author of the paper, which was published online Wednesday by the peer-reviewed journal Science Translational Medicine.
The paper provides the strongest evidence yet that some and perhaps many combat veterans with invisible brain injuries caused by explosions are at risk of developing long-term neurological disease — a finding that, if confirmed, would have profound implications for military policy, veterans programs and future research.
As I have stated before I feel the military has been on the cutting edge Continue reading
Thanks to a friend and follower of the blog I have been looking at some traumatic brain injury (TBI) research. Often you see TBI and concussion near each other; you can think of them as brother and sister. They are cut from the same cloth, meaning it is the same mechanisms that cause both. Concussions are referred to as minor traumatic brain injuries (mTBI) due to the lack of diagnostic (see imaging) findings with altered mental status or signs/symptoms. Regardless traumatizing the brain is not something that is good for you on a consistent basis.
The first article is about the link between TBI and stroke;
If you suffer traumatic brain injury, your risk of having a stroke within three months may increase tenfold, according to a new study reported in Stroke: Journal of the American Heart Association.
“It’s reasonable to assume that cerebrovascular damage in the head caused by a traumatic brain injury can trigger either a hemorrhagic stroke [when a blood vessel bursts inside the brain] or an ischemic stroke [when an artery in the brain is blocked],” said Herng-Ching Lin, Ph.D., senior study author and professor at the School of Health Care Administration, College of Medicine, Taipei Medical University in Taiwan. “However, until now, no research had been done showing a correlation between traumatic brain injury and stroke.”
It is the first study that pinpoints traumatic brain injury as a potential risk factor for subsequent stroke.
The next article is about the link between TBI and Parkinson’s; Continue reading
Aloof, that is one way to characterize Ricky Williams. The one time dominant running back in the sport of football who retired early to pursue “peace” and smoke dope only to come back to earn more money has discounted the link of repeated brain trauma and degenerative brain diseases, written up by Mike Florio of ProFootballTalk;
But as his career ends (even though some think he’ll be back), Williams dismisses the link between concussions and brain damage.
Which perhaps conclusively proves it.[...]
“I’m only speaking from my personal experience, because I haven’t allowed myself to buy it, and I haven’t been affected. Yes, I’m aware that football is a rough sport, but instead of saying, ‘Oh — I’m doomed to brain trauma,” I said, ‘What can I do about it?’ And I just started taking care of my body. I found people, places, and things that really helped me — again, I don’t know what’s going to happen to me in 10 years, but I look at the other things I’ve learned about, and the way I see the world.
Maybe it was his dreadlocks that provided extra protection when he played, or perhaps Continue reading
Sometimes sustaining a concussion can bring back memories of other similar injuries, that at the time did not register as concussions, the most recent case is Josh Thole of the New York Mets, Andy Martino of New York Daily News;
Josh Thole returned to Citi Field Tuesday for the first time since suffering a concussion in Philadelphia last week, bringing news both positive and alarming: The catcher has been symptom-free since Friday, but estimated that he has already suffered three or four concussions in his professional career.
“I don’t know the grading system of a concussion, but I got whacked pretty good in ’07 and ’08,” said Thole, 25. “The one in 2007 I think was more significant, just because I had vomiting and stuff like that. In 2008, it was more whiplash than anything, but I think it was still graded a concussion.”
Thole obviously needs some education Continue reading
In the news recently is an undrafted free agent that was signed by the Cleveland Browns, Andrew Sweat. Not because of his prowess on the gridiron, which was decent enough to get a look, rather his career change. Some are surmising that this can be due to concussions or the risk of them.
Sweat had a concussion in college and prior to the mini-camp he had an accident that made the decision easier to pursue a law career;
Then on the morning he was preparing to report to training camp last Friday, Sweat slipped and hit his head in the shower. Not that hard, he said. But hard enough to cause his concussion symptoms to return. So he took the final slip as a sign and decided to end his career as a football player, realizing that he’d been struggling with his decision to give football another chance all along.
“When I fell, it scared me,” Sweat said. “Football is not worth my health. It’s really important to me that I’m able to have a family and a life after football. Football is a great game, but when you have a concussion like that, it’s not worth it.”
It wasn’t just headaches or dizziness that brought major Continue reading
I have been working on this letter for a little while but was really spurred to action by the parent in Maryland, Tom Hearn who discussed his concerns with the local school board. I have tried and tried to use the “chain-of-command” with these thoughts and ideas, however at every step I got the feeling I would have to go alone on this, so I have. This letter may or may not reflect the opinions of my employer, high school, athletic training sanctioning bodies, or others I am involved with. This letter is from a concerned individual who feels I can spread the message effectively by these means. I have emailed the letter, proposals and the Sports Legacy Institute Hit Count White Paper to all Executive Directors and Board of Directors of the Illinois High School Association.
May 15, 2012
Illinois High School Association
c/o: Marty Hickman, Executive Director
2175 McGraw Drive
Bloomington, IL 61704-6011
(309) 663-7479 – fax
Dear IHSA – Executive Directors, Board of Directors and Sports Med Advisory Board:
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.
As a licensed and practicing Athletic Trainer, researcher, commenter, father, and survivor of too many concussions, I feel that in order to keep the sports we love, proactive steps must be taken. Often being proactive is a painful process and easily dismissed because of the trouble it will cause. I urge all involved to think about what the future of all sports will be if nothing is done.
The Illinois State Legislature with the IHSA took the initiative by creating a mechanism of concussion education and awareness in response to the mounting scientific evidence of potential long-term impairments resulting from mishandling of this injury. However, this only represents a first step in the process; passing out a flyer or having parents and athletes initial that they have read the information is one small element of the issue. Another crucial element of the issue is coaching. We must ensure that those we entrust with the care and leadership of our children understand Continue reading
There may not be any posts about Australian Rules Football concussions to this point but we have been watching. As you have seen in previous days the press in Australia is starting to report more and more the issues with concussions, something that was absent the past few years. As it stands now the AFL has 21 listed concussions, up from 11 this time last year.
Heading into this expansion season I was looking forward to the better reporting of concussions in the AFL. Last year the league and press drew harsh criticism from me for what I believed to be intentionally hiding the injury. Heck the ‘Super Footy’ section of the press stopped reporting ALL injuries for a four-week period as I was posting the injuries, and when it returned it was EXTREMELY rare to find anyone listed as a concussion so we turned to another website called Sportal. As the season progressed we found more concussions and by the end of the season last year we had our first picture of footy concussions over a season. Looking back one of the primary problems discovered and remedied by seasons end was the high number of facial fractures that seemed to be overriding a concussion, hence the need for Fink’s Rule.
It is now 2012, with the heightened awareness there is hope that a “truer” picture of AFL concussions can be taken… Continue reading
The Fifth Estate of CBC aired a documentary on the “Greatest Football Team Ever” in Canada, not as a retrospective homage to the good times, rather as an unfolding mystery. The most peculiar thing about this very good documentary is that it was originally aired, not a year ago, not even two but in 2008. Much has been discovered about repetitive brain trauma since 2008 the video is haunting just to view it with “today’s” eyes.
They have been called the greatest football team in the history of the CFL — the Edmonton Eskimos of the 1970s and ’80s that won five consecutive Grey Cups. But, for some of the star players on that team, the years of triumph ended ingloriously in early deaths, from heart attack, suicide and misadventure. The tragedy of those early deaths was often compounded by alcohol or drug addictions, probably caused by another, less visible, killer. Recent research by neuroscientists now shows the link between on-the-field concussions and brain damage; a permanent injury that can lead to depression, suicide and severe aberrant behaviour. The damage is so profound, the researchers say, that post-mortem examinations of the brain tissue of five former professional football players can be compared only to the tissue found in the brain tissue of advanced Alzheimers cases.
Unfortunately I cannot embed the piece you can CLICK HERE to see it in full. You will get to hear from very important people who are not nearly as high-profile as those hailing from Boston; Dr. Julian Bailes, Garrett Webster, son of Mike Webster and Dr. Bennet Omalu.
If you have read Fifty Shades of Grey you know what a hard limit is (yes I will freely admit I have read the series after my wife brought it home) and there is at lease one respected doc Down Under that has proposed such a limit to footballers. Quick reminder we are talking Australian Football, however this could be extrapolated across all sports. However there is danger is such hard limits, as we will discuss later.
From ABC news in Australia, Jeffery Rosenfeld the director of neurosurgery at Alfred Hospital in Melbourne feels that three concussions over a life-time in football should disqualify you from competitive and full contact forms of the game;
“I personally would say three significant concussions, three strikes and you’re out. I would be a bit wary of that player going back,” he said.
“They can still play sport but perhaps not the rough and tumble and risk associated with the tackling in a contact sport like football.” Continue reading