Archive by Author

Refreshing Words From an Athlete

24 Apr

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

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

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

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

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

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

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Sylvia Mackey – Video

27 Mar

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

Keep on learning and listening!

Eleanor Perfetto, PhD – Video

26 Mar

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

Look for more video tomorrow…

A Decent Video

24 Mar

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

I would love to see discussion on this, below!

TCB Commenter Highlighted in Canadian Press

18 Mar

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

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

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

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

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

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

Arizona Concussion Conference – NEXT WEEK

14 Mar

AZ Concussion Conf.

I realize this is, kind of, short notice, but space remains for this good-looking concussion conference in Arizona, next week.  However;

The CACTIS Foundation and Banner Concussion Center present recognized thought leaders at the Third Annual Current Topics in Sports Medicine and Concussions 2014: The Essentials Saturday March 22nd in Scottsdale, AZ, at The Scottsdale Plaza Hotel.  The conference will increase awareness of the health risks to athletes, cover the importance of baseline evaluation in athletes, review assessment tools, and discuss best practices for managing patients with concussions.

You can REGISTER HERE.

The list of speakers is very diverse and has a “west coast” vibe to them, here are some of the presenters:

  • Christopher C. Giza, MD – UCLA
  • Stephen M. Erickson, MD – MLB Umpire Medical Services
  • Shelly Massingale, PT – Banner Concussion Center
  • Bridgett Wallace, DPT – Concussion Health
  • Charlie Shearer, OD – Consultant, Colorado Rockies

Continuing Education credits are provided through this learning opportunity, you can see the AGENDA HERE.

#tbt Post: Mild Concussions

13 Mar

Originally Posted January, 2011…

Hogwash!  There is NOTHING mild about a concussion, period.  However media, teams, players and even medical staffs continue to use this nomenclature with this injury.  It is simply counterproductive to label this injury with a “mild” tag, and hampers the effort of everyone trying to increase awareness.

Granted, those that have extensive training in the area of injuries, and particularly head injuries, understand the term “mild” when it is in concert with concussion.  This subset of the population is not the one that needs the education, rather it is the general public, which includes players, coaches and parents.  A common problem amongst people who are educated in a particular field is that they forget about both who they are servicing and the education level of people other than their peers.  It’s a fine balance to educate without talking down to others, but understanding the stigmas of the topics help with that effort.

One serious stigma is the “mild” tag that is placed on concussions.  Those that watch and participate in sports are so used to using that clarification when assessing and addressing injuries as a whole, that perhaps it carries over to the traumatic brain injury just sustained by the athlete.  We as athletic trainers and doctors need to reassess how we describe this particular injury.

During my public speaking I often relate being “mildly” concussed to being “mildly” pregnant…  You are either concussed or not, just like you are pregnant or not.

Some may say that “the symptoms are mild”, or that the  Continue reading

This is Interesting. Share Your Thoughts

6 Mar

I just saw this on Twitter from @NSAFitness, Time to Re-think the Zürich Guidelines? appearing as an editorial in the Clinical Journal of Sports Medicine March, 2014 issue.

I can think of many reasons to re-think Zurich; the two biggest is no inclusion of return-to-learn/work and the obvious lack of coalition in concussions.  It may be a “consensus” but really its a compromise, AT BEST.  Here are some excerpts;

The problems with the guidelines include a lack of diagnostic specificity, management strategies that are not evidence based, and rehabilitation goals that are not attainable. Given these problems, the Zürich Guidelines cannot be endorsed.

Don’t know why we have to be more specific, rather more global would make sense: ANY DISRUPTION OF NORMAL BRAIN FUNCTION AFTER AN UNNATURAL TRAUMATIC FORCE IS APPLIED TO THE PATIENT, would fit just fine.  I will defend the non-evidence based management strategies; how can they be evidence based if we are just now getting to this part of the puzzle (SPOILER ALERT: the concussion problem is due to the Continue reading

Helmet Minutia: What you need to know

25 Feb

I was dropped a line from a source back home (OK my dad) about reports recently on the news in Denver.  Here is the LINK to the 9news story that prompted my father to send the info.  I found the report very informative and brought forth many angles on the story of helmets.

Meanwhile I also was given information from other coaches and followers about other press-type people asking for helmet information in Missouri, Georgia and Louisiana to name a few.

Who is behind all of this information gathering, I have not had it confirmed, but from the people I have been in contact with, Virginia Tech keeps getting mentioned.  I don’t know if this is because of the Star Rating System or if there is a PR campaign being driven by VT and the researchers.  Regardless this seems interesting to me on many levels.

What you need to know is simple and is as follows (of course in my opinion):

  • Helmets were never designed to prevent concussions
  • Helmet fit is currently the key to proper protection
  • Physics and anatomy/physiology currently limit helmets from providing concussion protection alone  Continue reading

4th Annual Traumatic Brain Injury Conference

25 Feb

April 16 and 17 in Washington DC – make your plans now!  Visit Site HERE.

Now in its 4th year, Arrowhead’s Annual TRAUMATIC BRAIN INJURY CONFERENCE  brings together researchers and clinicians from industry, academia, the military and government to present ground-breaking research in a variety of areas related to traumatic brain injury, including:

  • Neuroimaging
  • Clinical Trial Design
  • Cognitive Measures of TBI
  • Chronic Outcomes
  • Drug Discovery & Development
  • Pre-clinical Models
  • Biomarkers
  • Neurodegenerative Implications for TBI

This is shaping up to be one of the good conference in regards to traumatic brain injury.  The focus will not be on concussions rather the global injury of the brain.  The information shared here will help with the concussion issue going forward.  If you get the chance and have the resources this is a place that you should go.

REGISTER HERE

Book Review by Dorothy Bedford: “Fourth Down and Inches”

24 Feb

Dorothy Bedford is an avid follower and contributor to The Concussion Blog.  She has offered up a book review – out of the blue and appreciated – for me to post here.  I have not read the book and if I get the chance may offer up my two-cents but until then I think that perhaps some of you may want to know about the book.  With out further ado here it is (Thanks Dorothy);

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The history, the stories, and the latest science of football concussions

“Fourth Down and Inches: Concussions and Football’s Make or Break Moment”   by Carla Killough McClafferty (2013)

Every week during the season, a few famous players’ concussions attract attention. They are attended by expert medical teams. Every week during the season, many youth and high school players suffer head injuries in silence because they don’t believe that a “ding” is a real injury, or they don’t want to “let the team down,” or the coach shrugs it off, or the parents don’t realize the medical or academic consequences. This book could change all that.

Carla McClafferty has written an excellent survey in a format accessible to a broad age spectrum of football players, their families, fans and youth football volunteers. With an extensive selection of heavily captioned illustrations and photos, and featuring short, punchy chapters the author presents a balanced view of the epic story of American football’s 1905 head injury crisis and the hidden, functional brain injuries underestimated and misunderstood until modern scientific methods began to reveal the truth in the 21st century. The colorful historical tale fills about one-third of the book, while the unfolding of a new perspective on brain injury and clear explanations of the latest research mix throughout the balance of the 87 page text, (plus wonderful supplemental material in the form of notes, bibliography, and further reading suggestions).

As a concussion safety advocate and fan, I have Continue reading

Repost: Matt Chaney’s Take on Heads Up Football

21 Feb

The following was posted here on TCB 10/24/13, I feel with the traffic it has been garnering that it should be reposted at the top of the cue for the time being.  It is worth comment and questions…

The post below is from Matt Chaney’s Blog, re-posted (in part) here with his permission.  We are posting it here not as an endorsement, rather as an opposing view that is worth the read.  Our commentary on this article by Chaney will be below this post.  We encourage everyone to see the entire post on his blog.  You can view it by clicking on the hotlink, it is titled; ‘Heads Up Football’: Truth, Tales and Legal Consequences.  *Chaney has moved his blog and we are efforting the current link of his original article.  However, he does read the comments from time to time so if you have question leave it here and he may get to it.

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By Matt Chaney

Posted Wednesday, October 23, 2013

Peter King posits bogus hitting technique as Safer Football in Sports Illustrated

—geezuz, the further we go in this latest football crisis, the worse many people become, willingly, on behalf of the sexy blood sport… and so Peter King of SI skips along, telling us bona fide prevention is possible for football’s irreversible head-ramming… a new post by the Hall of Fame football scribe portrays Heads Up ‘proper contact’ as legitimate; King purports this theoretical headless hitting can be instilled by coaches, enforced by referees, adopted by players… I’d like to see King demonstrate on a football field, suited-up himself for forward collisions governed by physics and bullet-head helmets; he’d ram, too, or get his ass kicked… look, folks, players cannot govern or stop ramming on a football field; rather, forces of the crazy game dictate human behavior… forget talk and trust your eyesight, especially naïve parents and kids, to understand Heads Up ‘technique’ is invalid, unreliable, a lienothing new: it’s mere rehash of musty old ‘head up’ form hitting, proven invalid since the 1960s… here’s King, introducing his discussion:

What’s been eye-opening to discover is the trickle-down effect from the NFL to youth football. As the pro league emphasizes safety more and more, so do high schools around America. … Coaches are concerned; 41 of 49 polled [by SI] said they have modified training techniques because of increased education about concussions and head trauma.

—sure, trickle-down effect will reform football danger, once again… solution for brain trauma in the collision game is just around the corner… like trickle-down ‘steroid awareness’ for football’s immense problem with anabolic substances…  King continues:

Several high school coaches emphasized the NFL teaching new tackling techniques, such as “Heads Up Football,” which teaches coaches to train kids to tackle with heads up—instead of using the helmet as a battering ram. Said Middlebury Union (Vt.) coach Dennis Smith: “In any drills we’re doing—whether it be fundamental drills at the beginning of practices, especially defensive practices—we’re always stressing head up. You have to be able to see what you’re tackling.” … Said Brandon (Miss.) coach Brad Peterson: “We always start the year, whether spring or fall, with walking through the proper techniques of tackling.” … The coach of E.O. Smith High in Storrs, Conn., Jody Minotti, said he knows he can’t prevent every concussion, but he trains his players to minimize the risks. “We do less contact throughout the week and we teach proper tackling,” said Minotti. “We preach in practice all of the time, ‘Bite the ball. Bite the ball.’ That means keep your head up and don’t ever lead with your helmet. We film tackling, we talk about tackling whenever we’re watching film.”

—huh, these coaches don’t address the facemask dilemma, the prime fault of football rules behind the charade of Continue reading

Dear Time and Readers…

21 Feb

What in the world has happened?  It seems like months ago I was in New York on a huge stage sharing my opinion on athletic training and concussions; in particular secondary schools and adolescents.  Now looking at the blog I have realized it has been some time since posting.

I would be lying if I said I just flat had no time, although it seems to be very scarce now-a-days.  In truth I have not had the motivation to post stories and thoughts – which happens in this blogging thing.  I truly appreciate those that have visited and have interacted on Twitter (I have found it easier to communicate in 140 or less when in this “mood”).

If you throw in the chaotic weather here in the Midwest you have a “perfect storm” that has prohibited me from being on here for some time.  With all the snow and ice I have been relegated to stay-at-home dad and then when school is back in session we have a back log of games that need to be made up.  One aspect that people don’t fully understand/appreciate about high school athletic trainers – if there is a game we MUST be there.  Not because it is our job but because we want to be there for “our” kids and families that rely upon us to take care of them.  This creates many nights that were originally scheduled to be family or personal time to be work time.

If I have learned one thing in this career its to balance your family life and personal time.  Unfortunately many athletic trainers burn out because of such demands and honestly the family dynamics pressure a career change with stable hours.  If you throw in the blog it can be hazardous for your stability; this is why I always go back to the advice from Will Carroll (@injuryexpert) when I started “don’t let the blog run you, you run the blog.”

There are times when my wife – my best friend and rock in my crazy world – deserves all my efforts around the house so doing the honey-do list takes priority over this blog.  There are times when my three kids need my attention and play/free time and take priority over the blog.  There are times when a parent calls and asks Continue reading

Where is Tech Going With Concussions

7 Feb

Technology is ever-expanding in all areas of our life; in my short time we have gone from land line phones and massive desktop computers that could play “Lemonade Stand” to handheld personal computers that is also a phone.  The point being that technology is amazing.  In the previous post we discussed how MRI now can actually see damage to the white matter in the brain after concussion.  Until that information was presented the changes in the brain were only theorized about.

Yes, it is true that we are trying to find an objective measure, but people need to understand that this objective measure is not necessarily needed to find the concussion.  An athletic trainer with their years of education and experience are pretty dang good at finding concussions; with or without the help of “tools.”  The need for objective measures is for the TRUE PROBLEM of the “concussion crisis”; the mismanagement of the injury – mainly returning too early.

Conrad Wilson wrote up a good article on technology that is emerging, focusing on balance Continue reading

Have To Keep Educating & Holding People Accountable

6 Feb

The education of concussions is great, the legislation is in the right place but there is absolutely no accountability for instances where athletes are “failed”.  Before I go on, I am not perfect, I have and will continue to miss some things here and there (I missed an ACL in football which bothers me).  In fact, looking at the pressure I put on myself and hoping the world puts on my chosen profession of athletic training it may be a bumpy road.  However, missing obvious problems of health and welfare of athletes when one is an athletic trainer is inexcusable.  I implore anyone out there that feels I have missed something to call my ass to the carpet as well.

This brings me to something that I found in my inbox recently and it made me sick and should be handled.  This particular incident occurred in a state that has similar mechanisms for concussions as here in Illinois.  To create the back story on the “mechanisms” in play you should understand the state legislation and high school association concussion education;

  • Players, parents and coaches all have been given information regarding concussions
  • Officials have been given authority to remove player for concussion signs or suspicion including mechanism of injury (MOI)
  • Once removed they cannot return unless cleared by approved medical professional (IL is ATC, MD, or DO only)

With that information here is the email from a fellow athletic trainer – emphasis added is mine – (obviously stripped of identifying information);

Still have a long road ahead of education.

I was at a basketball game Friday night as a spectator and watched a player bounce [their] head off the floor.  Opponent had set a screen and athlete ran right into [defender], bounced off and landed on floor bouncing head off the floor.  The player then rolled around on the floor grabbing head and could tell [athlete] was in pain.  Time was called by the officials to attend to the player.   MOI would strongly Continue reading

Research That Should Stop You In Your Tracks

6 Feb

OK, that title may be hyperbole, but the new research out of Canada should make you take a step back and realize what our fine researchers are now able to discover.  Considering the context of hockey it shouldn’t be shocking that this was found in Canada (since posting we have been informed that work was done on both sides of the border), but really for a long while now some of the best work on concussions is coming from the North, for whatever reason (no disrespect to the US scientists).

Now that I effectively pissed off a few readers with the last comment, here is what was found by Dr. Paul Echlin and team:

  • concussions alter the white matter of the brain
  • structural damage can now be seen
  • MRI was used
  • this is both males and females
  • brain vascular changes were noted in males only, but resolved at two months
  • comparison with control counterparts showed that concussed individuals had white mater changes at end of season (upon being fully resolved from injury)

From the CTV News article (video at jump);  Continue reading

2013 End of Season NFL Concussion Report

31 Jan

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).  It also should be noted that due to the league not disclosing actual injuries until Friday night there may be some added to next weeks numbers.

It has been weeks since you have seen us post about the concussion numbers in the NFL.  A quick explanation; at the end of the year with trouble finding Week 17 numbers we search for a few days, then we sit on numbers and cross check with sources which takes time.  Finally going through and I.D.ing other factors like helmets and new parameters takes some time.  It also helps that the past few years the NFL waits until Super Bowl Week to release their numbers.

Let us first opine about the released NFL numbers via NY Times;

In the preseason and the regular season, players sustained 228 concussions, down from 261 in 2012, when concussions rose 4 percent compared with the previous year. Helmet-to-helmet contact caused almost half the concussions this season, down from 53 percent in 2012. But more concussions occurred when players hit their heads against an opposing player’s knee or the ground.

The whole number for the season is only nine off from what we collected here.  Which tells me that what we are doing is as accurate as you can find anywhere outside of the NFL (actual players notwithstanding).  But where were the missed nine?  I happen to think its a combination of preseason and Week 17.  So, we are happy with our collection system.

The 13% drop is both accurate and inaccurate in our estimation.  Hows that you ask?  In the regular season Continue reading

#C4CT Concussion Summit: 2014 Edition – Live Blog

29 Jan

And so it begins from the United Nations here in New York City.  Check-in has begun, and everyone is arriving; the Brewer Sports staff is feverishly working to make things go as smooth as possible (looking at you Kristi, Lindsay and PJ).  As evidenced by this being posted you can see that the wi-fi is working (at least here in the reception area) and I am ready to blog away.

Throughout the day this post will be updated by me with a time stamp and pertinent information.  The most recent information will be at the bottom of the post.  So, click on the “Continue Reading” and scroll down, enjoy! Continue reading

My Personal Thoughts and Opinions of #C4CT

29 Jan

IMG_1656I am toying with posting some “behind the scenes” stuff, I will start here and see what kind of response I get…  So, here we go and enjoy!

  •  Jack Brewer, Gerald Commissiong and General Peter Chiarelli have a vision of “shared information and working together” to solve this issue.  This means not only research but interventions and management.  I really can grasp onto this. Continue reading

Field Report From TCB Commentator

28 Jan

New York City – January 28, 2014 – Yesterday, TCB posted the announcement by the non-profit Sports Legacy Institute (SLI) regarding the launch of the Hit Count® certification program after two years of development.  Occasional guest poster Dorothy Bedford attended the press conference and filed this report from the Super Bowl Media Center at the New York Sheraton.

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The announcement was attended by several dozen members of the print and broadcast press corps, and other interested parties. In addition to the featured speakers, representatives of several Hit Count sensor device companies were on hand, including g-Force Tracker of Toronto; ImpaKt Protective (Shockbox) of Ottawa; and MC 10 (Checklight by Reebok). Commentary from Dr. Gerald Gioia, Dr. Blaine Hoshizaki, Chris Nowinski and former NFLers Mikes Haynes and Ted Johnson was supplemented by observations from Riverdale Country School (NYC) Athletic Director John Pizzi (RCS was a beta test site for one sensor) about the sensors’ real-time on-the-field utility, from parent Andrea Lustig, mother of a concussion victim, and from Paul Walker, a co-founder of g-Force Tracker.  Presented in the context of football’s marquee event, the new sensors will nevertheless also provide equally good information for other contact sports including boys and girls soccer, boys and girls lacrosse, boys and girls ice hockey, and others (involving headgear or not), as revealed in the Q&A. The Q&A was extensive, so the session unexpectedly ran 90 minutes.

Although rising injury statistics underscore increased awareness, Nowinski pointed out that most concussions are actually still not diagnosed for youth and high school football players. By using Hit Count ® as a teaching tool, efforts to educate coaches and modify players’ behavior can be focused where they can do the most good. “The sensoring technology is critical,” said Nowinski, “finally, the hits can be accurately counted and forces measured. We can achieve apples-to-apples comparison.” Nowinski also thanked the six founding Hit Count ® sponsors for stepping up to the technical challenges presented by the concept of sensoring hits.

Dr. Blaine Hoshizaki, director of the Neurotrauma Lab at the University of Ottawa, explained some of the technical details behind the certification criteria, which include nine different types of impacts. The criteria were set to include as many linear accelerations of the head that may cause brain injury as possible. He also noted that the threshold criteria for rotational impact are not yet part of the Hit Count ® certification, but are still being studied. [Only a few of the new sensors can measure and record rotational forces, whose shearing action on brain tissue has been discussed in the scientific literature.]

Dr Gerald Gioia of Children’s National Medical Center and George Washington University School of Medicine elaborated further. For instance, why was 20 g’s (linear force) set as the threshold for a subconcussive blows?  Gioia demonstrated some of the many lesser forces, such as a thump on the back (4g’s), which are very unlikely to cause damage.  While most sensors will Continue reading

Hit Count® Has Come To Fruition

27 Jan

Prevention of concussion is a bit of an oxymoron; nothing we know about concussions can stop them from occurring while in action.  HOWEVER, there is one way to prevent concussions – limiting exposure to the collisions that create a concussion.  Moreover, research suggests – as well as observations – that being exposed to subconcussive hits can have detrimental effects on brain function.  The subconcussive hits may even predispose someone to getting a concussion later on; this is obvious if you look at the data we have collected on NFL concussion over the past four years, (305 concussions in weeks 1-9 vs. 377 concussions in weeks 10-17) greater than a 20% increase as the season wears on.

Sports Legacy Institute has announced a certification program to further the Hit Count® initiative during a press release during Super Bowl week in New York City, today (along with the SLI Hit Count White Paper – see link below press release);

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Sports Legacy Institute Launches Hit Count® Certification Program in Collaboration with Leading Concussion Experts and Head Sensor Device Companies to Make Contact Sports Safer

Using Hit Count® Certified Products to Monitor and Minimize Brain Trauma Could Eliminate 500 Million Head Impacts in Football a Year, with the Goal of Reducing Risk of Concussion and Long-Term Brain Damage

New York City – January 27, 2014 – The non-profit Sports Legacy Institute (SLI) announced a major advance in the effort to prevent concussions and brain damage in contact sports today with the launch of the Hit Count® certification program after two years of development, which was unveiled at a press conference at the 2014 Super Bowl Media Center in New York City.

Hit Count® builds on the progress that head sensor device companies have made in developing devices that can measure acceleration of the head. Current products used on the field are focused on  alerting coaches, medical professionals, and parents when a potential concussive impact occurs.

Inspired by Pitch Counts baseball, which set limits to the number of times a player throws from the  mound to prevent arm injury, Hit Count® Certified Devices will have a second function that measures and “Counts” impacts that exceed the Hit Count® Threshold, set by a committee of  leading scientists, with the goal of minimizing brain injury.

“Research using sensor devices has revealed that each year in the United States, there are over 1.5 billion impacts to the heads of youth and high school football players,” said Chris Nowinski, Founding Executive Director of SLI who launched the Hit Count® initiative in 2012 with SLI Medical Director Dr. Robert Cantu. “Most hits are unnecessary and occur in practice. By utilizing  Hit Count® certified products as a teaching tool for coaches and a behavior modification tool for athletes, we can eliminate over 500 million head impacts next season.”

Committee member Gerry Gioia, PhD, of Children’s National Medical Center and Continue reading

Getting A Bit Fidgety On A “Snow Day”

27 Jan

It’s not actually snowing, but no school today because of -20′s windchill.  With my kids out and some time to relax, I have found myself looking back and getting a bit nervous for the upcoming week.

It was a heckuva weekend as an athletic trainer and this week is shaping up to be a big week in terms of concussion education for me.  As you may have already noticed I am heading to New York tomorrow to be part of the #C4CT Concussion Summit, both as a live blog feed and a panelist.  I hope many can make the event, and many more learn from what I can get down on the interwebs.

Let us first reexamine the life of an athletic trainer this past weekend…

It started Friday night as the boy’s team was on the road and I caught wind (we seem to have a ton of sources as AT’s) of a collision between two players in the game.  One of them had to go to the ER for some sewing work the other was ruled out by the AT with a concussion.  So began my communication and information gathering well into the late night – and I wasn’t even there.

Saturday came with anticipation of seeing the injured players, fully assessing and beginning a recovery plan – while attending to a high school wrestling dual tournament.  I don’t think many non-AT’s appreciate the juggling act necessary to even take a leak during these type of events let alone get some food, but now throw in two separate concussion evaluations and meetings with parents it becomes a minor miracle.  However, I would be remiss if I didn’t have an outstanding volunteer first responder and student AT.

After testing and making the decision to let one player travel but not play and the other to not travel at all, it was time to focus on the wrestling.  It was a very good set of matches with an unlikely victor as a team.  However, in the aftermath there was a bit of false bravado by an athlete as a fist and arm went through a double-paned glass window – the ones with wires in them – and then extracted said arm.

Having an athlete present with possibly the “ugliest” injury you have ever seen can be a bit discomforting, which it was as blood was not only leaking out it was pulsing out of the large gash.  Some how, some way when controlling the bleeding there was not one drop on my clothes, an absolute miracle.  The stories being related after the fact have been from preposterous to accurate, the net-net was that we had a life-threatening injury and it was taken care of quickly and professionally.  On top of that the athlete was all taken care of and went home that night, a very lucky kid in the face of doing something very dumb.

Sunday was not a rest day as 11 hours in the gym was on the docket again, for the little kids wrestling individual tournament.  I actually learned a ton from being there (only had 5 bloody noses and one “injury).  I learned that if kids/parents want kids to be in a “collision-type” sport that demands physical and mental discipline that wrestling may be the answer, over football for as young as 5.

Although school is out today my job is still in full swing.  Beyond the paperwork from the weekend I had to figure out a way to meet with the injuries at school and talk with parents.  Set up doctors appointments.  Track an injured athlete trough surgery.  Call coaches and admin to remind them of my absence.  And get the training room cleaned, set-up and directions for the sub AT coming in for me.

Oh, there is this blog too, which will have breaking news today.

As I am writing this I only wanted to share what an athletic trainer does.  Sure, because I post here makes me not the “normal” AT but there are many athletic trainers out there that do this and much more than me on a daily basis.  It is very important to me to share my experiences so you can see how valuable AT’s are.

Parting, I would like to now extend an invitation to Commissioner Rodger Goodell to meet with me while I’m in New York.  I am actually staying a block or so away from NFL HQ.  So, Mr. Goodell (or representatives) just give me a shout in my in box! hahahaha.  Can’t say I didn’t try!

Video Interlude

27 Jan

I occasionally look for videos for education purposes.  Today, I found a really good one, except for the “minor concussion” note early on…

More to come today…

SLI Press Release Primer

27 Jan

Coming up at 3:30 EST in New York City as part of the Super Bowl week the Sports Legacy Institute will being having an announcement about an initiative that could help with concussion issues.  It is no secret this will deal with the Hit Count ideas floated two years ago.  Below is the re-post of the February 3, 2012 announcement:

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Sports Legacy Institute did in fact release their white paper today; it simply brings to the surface something that they along with others have been saying with more frequency.  Their initiative to create a Hit Count is a bold step and on that is welcomed, especially in light of the very current research from Purdue.

You can find the article on the SLI website (here) or you can read the final white paper .pdf here; there is a very good background for this idea and the simple yet powerful citation of research already performed in this area.  Their idea is mapped out very well, again the devil will be in the details as it all begins to be sorted out;

There are technological and monetary limitations to a pure Hit Count, as Hit Count systems currently are only sold for helmeted sports, and there are costs involved.  A Hit Count is not as simple as a pitch count, where coaches only need a pencil and paper.

However, hits to the head can be accurately estimated, and methods can be developed to approximate the brain trauma exposure during games and during practice based on known variables, like position.  With these estimations, rule changes and practice guidelines can be provided to ensure few, if any, athletes exceed a proposed limit.

Little League pitch counts are limits on the number of “pitches thrown per day” and mandate up to three days of rest after exposure to elbow trauma to allow the ulnar collateral ligament to recover.

A Hit Count should explore the following guidelines:

  1. Minimum threshold to be considered a “Hit”
  2. Maximum Hits per day (all counts stratified by age)
  3. Maximum Hits per week
  4. Maximum Hits per season
  5. Maximum Hits per year
  6. When the technology is available, should there be a “Total Force” threshold derived from number of hits times mean force per hit
  7. Minimum required days of rest after a minimum brain trauma exposure

In football, a Hit Count might lead to fewer practices that involve helmets and pads or the limits on the use of high impact drills. In soccer practice, it may mean tracking headers in practice and games. This policy is probably most critical to the youngest athletes, who may be at the greatest risk, and should receive less brain trauma than older athletes.

As noted the implementation of this may be difficult to get an accurate hit count for each individual, it is not like a pitcher where they are the only one on the field performing the specific task.  However, that being said and the limitations discussed in the white paper, simply reducing the number of full contact days will reduce the overall number of hits.

Until research can identify a more specific number we must Continue reading

NOCSAE Advancing Testing?

27 Jan

Perhaps, pending a vote in June, new standards could be set to get a helmet NOCSAE certified.  The news comes as the research arm has come up with plans for a testing scenario for something beyond linear drops;

The National Operating Committee on Standards for Athletic Equipment (NOCSAE) board of directors has approved the development of a revised football helmet standard that will require helmets to limit certain concussion causing forces.

You can see the full NOCSAE Jan 24 Release by clicking on the link.

It has been a long while since the standards have changed, but the calls for including more “realistic” type of scenarios in place have been loud for some time.  Including your’s truly, who believe that the rotational and angular forces were woefully under represented in any sort of testing.  I have been told by one representative with vested interest in this that for years the issue has been that these type of tests were “not repeatable.”

If everyone can be on the same footing with this and these new ideas actually translate to the “real world” then I am all for it, no matter the cost.  However, if this is something that is pure window dressing and will not actually impact a change – if that is even possible – then we are wasting time and money.

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