Archive by Author

#TheConcussionChallenge

28 Aug

It’s really simple…  Watch this video, then RT or forward in email or post on Facebook…  It’s not as fun as cold water and you won’t be donating money, but you will be understanding concussion and passing that along…  This was the idea of my good friend Katherine Snedaker-Price…

 

At the time of this post there were 787 views, I would like to see that at 2,000 by next week…  Lets do it!!!

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Concussion Trends 2010-2012; TCB Original Research

26 Aug

The National Football League is nine days away from the kickoff of its regular season.  If social media, fantasy sports, and hype are any indication 2014 is set up to one of the most watched seasons in history.  There are plenty of story lines abound: from each division, to playing time of newly drafted players, to veterans returning from injury, and of course concussions.

The league is doing its best to keep concussions from overriding the game itself, as they should be.  Concussion is but just one of a myriad of injuries sustained in the sport; plus it is not unique to just American Football.  However this issue continues to gain/keep traction because of the relatively late and “slow-footed” response to this topic.  Even though the settlement with the players has been all but signed-sealed-delivered (there are some interesting issues posed by Patrick Hruby that are worth noting), the youth arm of the league is promoting and teaching a “safer” way of tackling, and the talking points about this injury are becoming more evident from players and the league; there still is a shroud of secrecy.  In all the hand-wringing and court battles and public relations scuffles the leader of this glorious sport has yet to “rip the band-aid off” and assess the situation.

How can you assess the situation?  I think it is rather simple: gather data to find out the “true” value of actual concussions sustained in the NFL over a season.  Then and only then can you see if any changes brought forth are actually helping the cause.

Sure the league has its own data and is probably doing just that, but it is so far behind a curtain, tucked in a corner where light has no chance of hitting it.  I have always thought we should be transparent on this issue; or at least have a truly (Pollyannaish) independent data collection group for it.  At the very least an Ombudsman should be hawking this situation, for this is not going to go away over night.  It won’t go away until we can definitively say ‘X’ is the way to play this game with ‘Y’ & ‘Z’ at the professional level; then each subsequent level below the pro ranks need to modify based upon age and development.

The NFL probably doesn’t want this responsibility for it comes with some liability, not only on the medical front but in the public relations department…  SO WHAT!  When I chose to have a child I didn’t have the choice to be a role model and change the way I played life in order to make sure my children grew up safe and learned a better way to live.  The NFL is basically the “father figure” for the other levels of this great sport.  I have heard a great saying, it was applied to business in general: “the tree rots from the top”.  This is exactly the case in a family, in a business and in sport.

When the blog began in 2010 there was no way to find out how many concussions were occurring in the NFL without Continue reading

#tbt Mouth Guard BS Research!

21 Aug

This was originally posted in May, not a long throwback, but since football started I have been hit up with this question a lot.  So here is the “truth” about this research.  I love the effort and attempt to find a reason; however when you have a critical and FUNDAMENTAL flaws then present it in a way that could be considered fraudulent I have a major problem.  I would also like to add that this research has not been pulled by the publisher.  This is exactly how we get in trouble, the Academy of General Dentistry needs to address this, now, as this peer-reviewed “science” is getting run in media…

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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 seems all good.  A significant finding between custom mouth gear (noted as LM MG in article) and over the counter “boil and bite” mouth gear (noted as OTC MG).  However once you take a deeper look there are some peculiar problems, in my humble opinion – that comes later.

First, we should look at the possible limitations of this study that seems well populated and well thought out (honestly these were my first concerns before finding the real issue):

  • Were the injuries controlled for by football position? (we have documented this issue here)
  • Were the injuries controlled for by size of players/school they were playing?
  • Were the injuries controlled for by playing time? (more exposure more risk)
  • Were the injuries controlled for by game vs. practice?
  • Were all the injuries seen and recorded by a single MD or was it the ATC at each school?
  • Did any of the players have a previous history of concussion?
  • Was the study controlled based on practice habits of the teams? (do some hit more than others)
  • How do we know that every player complied with the “no wedging or chewing” rule? (this plays a massive role later)
  • The study says that all 412 subjects wore the same exact helmet, I find that: A) hard to believe and B) was the fit on every player the relatively the same?
  • Who funded this research? (no disclosure)

As you can see there is a litany of reasons I would have dismissed this research, if I were peer reviewing because those limitations are extremely real and realistic to control for in this type of study.  I wrote to the public relations group handling this research and was unable to get a straight answer on those questions I raised.  In the meantime I sent out the article to some better than average “stat nerds” and awaited a response.

While waiting I noticed something really troubling, as in a fatal flaw with the research.  In some places an oversight like this is intolerable, because Continue reading

One Man’s (Athletic Trainer) Critical Eye and Observation From Week 1

18 Aug

It’s the beginning of high school football season across this glorious land.  I honestly love nothing more than getting back on the gridiron with the high school kids.  There are so many intangibles that the beginning of any sport brings; and in our massive consumption of football world this sport seems to bring a lot of people together, quickly.  You will see a lot of this “love for the sport” breeding through my posts and rants – the same love I have for all sports.  Seeing kids overcome hurdles and demons and using sport/activity to express their selves is awesome.  Seeing boys and girls using sports as a conduit to become better men and women by learning virtues such as: integrity, commitment, discipline and expecting to succeed.

Over the years I have obviously developed a keen eye for concussion as it relates to sport.  There is no greater sport for this injury to occur at my high school than football.  I have been blessed with coaches and administrators that listen to my input regarding overall safety, particularly when it comes to concussion.  But this past week I noticed something that perhaps I had seen plenty of times before, but it just finally hit me.

It has to do with the practice collisions and how things that start innocently enough can change and create issues.  I must give my head coach massive credit for being on the same wave length and even finishing my sentences when we were discussing my observations.  It shows, to me, that he has the best interest of the players in mind – and he wants a fully healthy team.  Secondly I happened to read a recent research paper about data collection on forces in football (while writing up my Sensor Overload post).

In a simple “technique” tackling drill two players were approximately five yards apart.  To either side of the players were agility bags spaced at about 4 yards.  The purpose of the drill was for the ball carrier to angle run to either bag, while the defensive player was to use proper technique and wrap up the ball carrier – not taking him to the ground.  The players were outfitted in helmets and shoulder pads only.  The players were directed to begin at “3/4″ speed and the ball carrier was to be willing to let the defender use current “proper technique” to achieve the form and fit for a tackle (face mask up, wrap-lift-drive through the man).  It started all well and good, and the players naturally began to increase their speed/effort as they became comfortable with the drill.  The drill lasted five minutes from setup to finish.

Upon completion of the drill – rather near Continue reading

Terry Ott: Former Canadian Football League Star Terry Metcalf To Sue League

14 Aug
Metcalf.Terry3
Terry Ott has filed this report to The Concussion Blog, again this is his journalism, we offer up the space for him to publish.  If you want to post here feel free to contact us.
 
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Will Claim Debilitating Injury From Multiple Concussions and “Neglectful” Treatment
 
 
HAMILTON,ONT.
August 14, 2014
 
Running back Terry Metcalf  was an NFL 3rd round draft pick in 1974 and played 5 seasons for the St. Louis Cardinals before coming north and signing amidst much hoopla with the Toronto Argonauts in 1978.
 
From 1978 to 1980, Metcalf gained nearly 3300 all purpose yards with the Argos, including 1900 yards rushing and was the subject of much media attention, if not winning seasons.
 
Metcalf retired from football in 1981 and is now suffering from what he says are major health deficits as the result of multiple concussions suffered while he was playing for the Argonauts.

Mr. Metcalf, who now resides in Seattle said in an interview that the last concussion he received was in a 1980 Toronto home game and “was a pretty good shot.”

“I don’t remember finishing the game,” said Metcalf, adding that he categorized his concussion treatment at the time as “neglectful, nothing, really.”

Now Metcalf, who teaches kindergarten, complains of chronic ringing in his ears, memory issues, and says he has a “50% loss of feeling in (his) right hand.” Mr. Metcalf said his symptoms had been noted when he had been examined by doctors in 2011 for the NFLPA class action suit against the NFL for concussion related injury.

Mr. Metcalf has retained a Canadian lawyer and is intending through counsel to file suit against the CFL for concussion injury.

Metcalf, 63, also complains about his mood saying that he had been “quite depressed in his life” and that he was lately “grumpier, and you can ask my wife about that.”

Perhaps just as troubling is the fact that of the three CFL players who have come forward in the last year complaining about multiple concussion injury-Phil Colwell, Eric Allen and now Terry Metcalf-all three played for the same Toronto team between 1972 and 1980 and all three former players claim deficient or even non-existent concussion medical care.

And in previous interviews, all three former Argo players in question who claim to have suffered concussions while playing for Toronto had, according to a source, been treated by the same group of medical and training personnel at the time of injury, and afterwards.

Those familiar with a 2013 story on the Concussion Blog on former Argo Phil Colwell who was knocked unconscious in a 1981 game, will recall that he claimed the only medical advice given to him at the time was to not go to sleep the night of the injury, and was in fact allowed to drive himself (70 miles) home after the game.

Colwell, who is also suing the CFL, said that he returned to play one week after his 1981 KO hit and further said that “at the time, if I had gone on the injury list for a concussion, I would have been cut.”

And Colwell, who nearly became homeless earlier this year pulls no punches when it comes to his current situation: “The CFL stole my brain, ” he said, “maybe I’ll get it back (but) I want memories, not money.”

Also in a previous Concussion Blog story, former Argonaut Eric “The Flea” Allen described his treatment after concussion by the Argo medical and training staff in question as “I don’t think (they) looked at me.”

Mr. Allen, 65, who is also in the process of suing the CFL is now no longer able to walk and is for the most part bedridden with severe vertigo.


And while there would seem to be a common thread with the three former Argo players claiming to have had similar experiences with the Argo staff after suffering concussion injury, a source speaking on condition of anonymity said that there are many more former players from different CFL teams who had the same basic after concussion injury treatment and many of them would be coming forward in the future.

Continue reading

Sensor Overload

12 Aug

With all that is new to the concussion realm, nothing is really new.  This includes: how the injury occurs (traumatic variable force vectors – often unanticipated – jarring the brain case), its recovery (unique and undefinable), its identification (mainly subjective but overtly obvious when objective), overall education and general understanding from day-zero to day-undetermined.

The current “hot topic” for concussions is sensors.  These sensors are nothing new, they have been around for years.  As with most technology the devices are getting smaller and more accurate; natural evolution, if you will, for sensors.  I have had the fortune of testing some products, getting deep information on others, and curiously viewing some brought to my attention.  The constant thought I have is: no product has provided a clear-cut reason for inclusion – at this moment in time.

Are sensors a good idea?

Sure, if and when they become accurate enough for trained individuals to use them without impeding current standards of care.  Further, I also believe that down the road we will be looking for a product that can accurately and systematically determine the gross effects of every blow the brain case takes.  The key being EVERY BLOW.  Not just hits to the head, or at full speed, or only in practice, or in helmeted sports.

The overwhelming information we have on concussions and their occurrence is that we just don’t know a threshold; for mine, yours, your son’s, your daughter’s or anyone.  We have a general Continue reading

Intended Consequences Lead to Unintended Issues: NCAA Settlement

1 Aug

Sure the lede looks backwards, but the overwhelming point, in my opinion, of the NCAA recent settlement on concussions has to deal with my profession of athletic training.  The issue is athletic trainers; the need for more of them and what happens if you cannot find them or afford them?

Don’t get me wrong, the fact that attention is being paid to the need for athletic trainers — although the wording does not explicitly name our profession, rather “medical professional” — is tremendous and often overlooked.  Sure, you can have a doctor on the sidelines, but what is their cost?  Perhaps there are some semantics that would allow other medical professionals to be in attendance, but what would be their experience, education and knowledge about concussions?  And how cost/time effective would it be to have another “medical professional” that didn’t have the ability to assess, treat, manage, and rehab other injuries that occur on a sporting field?

In other words, this is an awesome advertisement and endorsement for athletic training.

But there is an issue, as stated in the Chronicle of Higher Education;

Colleges have their own concerns about the settlement, including a requirement that they have a medical professional on the sidelines for every practice and game in the highest-contact sports: basketball, field hockey, football, ice hockey, lacrosse, soccer, and wrestling.

While many big athletics programs already provide such coverage, lower-level NCAA institutions will be hard-pressed to afford it, several athletics officials said.

The requirement could lead colleges to use graduate assistants or others with little medical training, or to cut sports altogether over fears of liability.

“I’m worried about the financial fallout from this, and how it will impact Division II and Division III, and how it’s enforced,” said Tim Kelly, head athletic trainer at the U.S. Military Academy and a former member of the NCAA’s Football Rules Committee. “I’ve always wondered, Do too many schools provide too many sports at a level that’s not effective?”

If you have spent time in the “lower levels” of NCAA sports or even the NAIA you would note the very understaffed sports medicine team compared to the “big boys”.  This is no fault of the fine institutions, rather an economic issue.  From personal experience I can tell you that Continue reading

Terry Ott — E”TF”A: Now 1 of 7 and Counting

31 Jul

Eric "the Flea" Allen Toronto Argonaults 1972. Photo Ted GrantThe information being brought to The Concussion Blog has been astounding, newsworthy, controversial (to some) and welcome.  We are not paying anyone for their guest posts, rather providing a platform for the information.  The inbox is always open for such things – with me as executive editor.  Just because something is posted here does not mean that I or we generally agree or endorse unless otherwise stated.  I have reached out to many people on the other side of this current CFL issue to open my pages to them and have yet to get a post from them.  Honestly, I don’t know that much about the CFL and its players – Doug Flutie being the only one I remember that well.  I truly appreciate the feedback on this continuing saga, but remember this is one journalist, Terry Ott’s, work.  It is here because he cannot find anyone to publish his information in Canada.  I feel this information is important to share.  What follows is Terry’s most recent filing.

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1970s ERA CFL STAR ERIC “The Flea” ALLEN WILL REPORTEDLY SUE CFL FOR ALLEGED MANY HEALTH PROBLEMS AS A RESULT OF PLAY

Former Toronto Argonaut Player Dealing With “Serious” And Debilitating Concussion Related Issues

Hamilton, Ontario — July 30, 2104

Eric “The Flea” Allen starred with the Toronto Argonauts between 1973-1975, and as noted previously here in Sneer and Loafing, is suffering the effects of what is alleged to be serious brain damage caused by multiple concussions while he was playing for the Toronto team, which at the time, was the highest profile and richest franchise in the league.


In an interview, Allen’s mother Rebecca Young, 84, said that Eric’s condition had declined precipitously in the last 6 weeks to the point that her son “can hardly walk now,” even with the aid of a walker, and spends most of the day in bed suffering from vertigo and has recently developed bouts of incontinence as well as suffering from worsening memory and mood issues.

Mrs. Young said that she had recently been visited by Canadian lawyer Robyn Wishart who Mrs. Young said will be representing Mr. Allen in a legal action against the Canadian Football League, allegedly for concussion injuries Allen says he suffered while playing in the league for the Toronto Argos for the three seasons in question.

“She said she was going to do her best to get (us) some help,” said Mrs.Young, of lawyer Wishart. “I hope it’s soon…I’m so tired,” added Mrs. Young, who as the principal caregiver for her debilitated son has a multiple hour drive to take Mr. Allen for treatment at the Medical University of South Carolina.

Ms. Wishart was traveling and did not return telephone calls for comment about Allen’s condition.

Two weeks ago, Arland Bruce, also represented by attorney Wishart, was the first 21st century former CFL player to file suit against the CFL member teams and others for concussion injury. Mr. Allen now marks the first from another era to follow a similar path although legal sources expect any lawsuit alleging head injury prior to any officially established CFL concussion protocols to be constructed quite differently than the Bruce pleadings, possibly along the lines of the now settled NFLPA 1 billion dollar suit against the NFL.

Furthermore, according to a source speaking on condition of anonymity, there are now at least a total of 7 former CFL players, some who played over 50 years ago, currently, or intending to, bring suit against the league for concussion injury.

The Arland Bruce III lawsuit story was national news in Canada for several days after it first broke on this Blog July 16, albeit with some of  the coverage taking on a near inquisition tone regarding Mr. Bruce’s motivations and alleged recent actions.

And unfortunately, your correspondent has been hearing about rumblings/grumblings supposedly originating from within The Great White North sports media community that somehow I have embellished, made up, or even peddled “lies” in my episodic and breaking reporting of the emerging concussion crisis in the CFL during the last 9 months.

In case you still don’t get it boys: this is not about me, but rather the wounded former players and common human decency. The players are making nothing up. Mull that scenario over for a while my suspicious, duplicitous friends.

This latest report on Mr. Allen’s troubles and intentions will hopefully give those uninformed and wrong side of history naysayers some pause before they raise questions about Mr. Allen and his family’s motivations and needs, as well as way, way down the line, mine.

Educational Video: Subject Matters, Featuring Dr. Brady

30 Jul

Blog follower and prolific commentator here, Don Brady, PhD, PsyD, NCSP is featured on ION TV’s “The Subject Matters” from May of 2014.  The video is in two 15 minute chunks:

Dr. Brady is a very good resource and wealth of information.  I suggest you take some time to check out his time on ION TV.

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.

 

#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

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

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

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