Archive by Author

Minutes From First Illinois Advisory Council on Player Safety

16 Jun

PSPHlogo“Welcome to a historic event.” Is how Associate Executive Director, Kurt Gibson opened the first meeting of its kind in Illinois and for the Illinois High School Association (IHSA). With the vast majority of the Council present it did not take long for all of us to get to “work”.

The Council (which we shortened to PSAC – Player Safety Advisory Council) dove right into the meat of the issues surrounding sports and player safety. Rather than giving a play-by-play I will let you read the minutes from the meeting (LINK HERE);

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MINUTES OF THE PLAY SMART. PLAY HARD PLAYER SAFETY ADVISORY COUNCIL MEETING June 9, 2015

The Play Smart. Play Hard Player Safety Advisory Council met at the IHSA office in Bloomington, Illinois on Tuesday, June 9, 2015, beginning at 10:00 a.m. Committee members present were Dustin Fink, Sara Flanigan, Tory Lindley, Dennis Piron, and Cole Steward. Also in attendance were Associate Executive Director Kurt Gibson; Assistant Executive Director Matt Troha; and guest, Sports Medicine Advisory Committee member Greg Gaa. Not present were members Tregg Duerson, Senator Napoleon Harris, and Allison Hieb.

ITEMS OF GENERAL DISCUSSION:

1. IHSA administrators Kurt Gibson and Matt Troha welcomed the council to the first meeting of the Play Smart. Play Hard Player Safety Advisory Council.

2. The council reviewed its purpose of monitoring current IHSA programs and initiatives, identifying new areas to advance player safety, and helping communicate the Play Smart. Play Hard vision.

3. The council reviewed the following materials from the IHSA’s Sports Medicine Advisory Committee (SMAC): ● minutes of the committee’s April 2015 meeting ● recommendations made by IHSA’s Football and SMAC regarding football contact ● Managing Heat/Humidity Policy recommendation The council’s feedback on the football contact and Heat Policy recommendations are listed below under items.

4. The council discussed Senate Bill 07, which is currently awaiting signature from Governor Rauner. Among other things, SB 07 creates a Concussion Oversight Team in schools to monitor Return to Play and Return to Learn for student-athletes who have sustained a concussion, requires education on concussions and symptoms for coaches and athletic officials, and requires schools to develop school-specific Emergency Action Plans (EAP’s) to address serious injuries that may occur on campus.

5. The council heard reports from Allison Hieb and Cole Steward, the two student members of the council, on concussion from the perspective of student-athletes. Both students shared the perspective of how their schools have addressed concussion with their student-athletes on both the individual and team level. As a part of that discussion, the council suggested that the IHSA consider developing some kind of post-video assessment be created for students to complete. Additionally, the council thought it may be worthwhile for the IHSA to register and track student-athletes from a sports medicine perspective. IHSA staff indicated they would begin the process by working on some kind of checklist that all member schools can utilize.

6. In reviewing the football recommendations made by the IHSA Football and Sports Medicine Advisory Committees, the council expressed their desire to see the IHSA be bolder with its recommendations concerning the amounts of full contact Continue reading

Triumph Over Trauma

5 Jun

In the beginning it was hard to find a lot of people to share real world examples of what I was trying to describe here on the blog. It is one thing to have the knowledge and experience but entirely another to parse that down to something people can grasp and understand.

Luckily I happened across a great person and advocate that was able and willing to share some stories that made this blog a little more personable. Her name is Tracy Yatsko and she is definitely not just a face in the crowd.

Recently she has joined the blog space with her very own called “Triumph over Trauma” and as she describes in her tag line;

Triumph Over Trauma is a website/blog devoted to concussion victims, survivors, and their families to hopefully lead them into the right direction of recovery, give them hope through stories of others who have struggled yet triumphed, and give them the one thing the concussion community lacks or can’t find: Support.

As mentioned she has been featured here at The Concussion Blog with a wonderfully written story about her from one time contributor John Gonoude and one of her first PSA’s about concussions.

If you have the time you should head over to her blog and see if you can help in any way!

May Mailbag

4 Jun

As the sports season winds down at the high school I am finally getting to the various emails I have received. I do truly enjoy the many stories and questions I get here, often times they are very learned for me; which translates to more information for you the reader.

I picked out one such email and gained permission to reprint it here. The sole purpose of this email is to get feedback about the return to learn aspect of concussions. Tom would like you to give it a read and make comments below.

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Return To Learn in the High School

I am an athletic trainer in a high school in the north suburbs of Chicago. We have a concussion program in place and see about 80 concussion a year in our athletics. I am fortunate to have some control over the return to learn side of concussions in my school. I have found that this is essential in order to properly manage a concussion. I find when physicians only see an athlete once and set accommodations for a determined amount of time, it does a disservice. The same is true if the time between physician evaluations is too long, especially when kids are kept out of school for long periods of time. I find many concussion students don’t need to be out of school, and those that do usually have their symptoms decrease significantly within 1-3 days.  Many times concussions progress rapidly and Continue reading

An Understudied Area of TBI

2 Jun

Although this blog primarily focuses on mild traumatic brain injury (mTBI) – concussion – and the ramifications on adolescents there are many segments of society that deal with brain injury. The most severe of this is traumatic brain injury (TBI); the difference at its basics is that there is actual physical findings of damage to the brain itself – a bleed, skull fracture, hematoma, etc. I am sure there may be a better way to put it but for the sake of being simple that is the difference.

The morbidity rate of TBI is extremely high and thusly we should be very cognizant of this.

A silent portion of the TBI problem comes from domestic abuse, silent because many of the suffers of the brain injury often don’t speak up. There are no actual numbers on this due to the many reasons one would not report incidents. Take car accident TBI’s for example, we have a very definitive number on them because most if not all are seen in emergency rooms but the silence in the domestic abuse realm makes us guess, at best.

This looks to change with a new study on this, below is the press release of a first-of-its-kind;

Sojourner Center Launches First-of-its-Kind Effort to Study Link Between Domestic Violence and Traumatic Brain Injury

Sojourner BRAIN Program to develop innovative screening, deliver treatment and share best practices

 

PHOENIX – Sojourner Center, one of the largest and longest running domestic violence shelters in the United States, announced plans to develop the first world-class program dedicated to the analysis and treatment of traumatic brain injury (TBI) in women and children living with domestic violence, a largely unrecognized public health issue.

With its Phoenix-based Continue reading

When and How ‘Not a Concussion’ Becomes a Concussion: Klay Thompson Injury

28 May

The Western Conference Finals not only provided an opportunity for the Golden State Warriors a chance at winning an NBA title it has provided a wonderful opportunity for people to learn more about concussions. The knee-jerk reaction to incidents like we have seen in Games 4 and 5 are often a mix of truth, hyperbole and eye-rolling; however what is clear they are cases that we can use to forge further understanding and education.

Last night in the would be close-out game of the WCF, Klay Thompson shot faked and the defender rose as he [Thompson] ducked and the defender’s knee blasted the side of Thompson’s head right in his right ear.

Unlike his teammate from the game before, Steph Curry, Thompson did not show overt signs, to my trained eyes, of a concussion. His face was “scruntched” in pain and he immediately grabbed for his ear, plus after the incident he immediately rose to his feet and walked straight to the locker room without assistance. As noted in Tuesday’s post signs are paramount when making critical in-game decisions about return to play; if they are there, there should be no doubt about removal.

The next report we received on TV or Twitter was about Thompson having an ear laceration and that they didn’t need to do a concussion evaluation. Which is entirely possible but unlikely, because I do believe they did a concussion “screen” at the time. The Warriors med staff probably didn’t do the full-blown evaluation because five minutes would not have been sufficient for that, but that was enough time to go over any symptoms and quick balance assessment (think roadside sobriety test). It is also important to know that because concussion are mainly subjective that a massive portion of any concussion evaluation is the interview: talking, questions and mental challenges about venue/score/date/etc.  Continue reading

“Contussiongate”*: The Steph Curry Incident

26 May

*I will admit that I could not come up with a catchy title for this post so I ripped this from Mike Freeman’s twitter feed (@mikefreemanNFL) last night:

But not only is this funny but it is about as accurate as it could have been when summing up the Steph Curry incident last night in Game 4 of the Western Conference series. So, thank you Mr. Freeman for your insightfulness and wonderful wordplay.

Those that were watching the game last night and happened to be on Twitter should know the entire process this sequelae; because of that I will be as brief as possible while injecting the overriding issues and thoughts on this.

It all began in about halfway thought the second quarter as the Warriors were getting throttled by the Rockets;

There is not speculation when looking at that vine, Curry hit his head on the court after taking an uncontrolled fall. What is not seen in the vine is Curry laying prone on the floor for a few minutes as the medical staff took a look at him (even noted checking his c-spine). When the world was brought back to the game from commercial we saw Steph getting assistance off the floor to the locker room, where further evaluation was to be done, obviously.

The first point to note in this event is that Curry not only immediately grabbed his head where it contacted the floor but he also was “down” for some time, that is obviously not normal. He hit his head and very hard so of course he would be slow to get up, but it was the amount of time that would and did have me concerned.

Before we go further we should define concussion for all of you out there, if you want the drawn out and dictionary definitions you can find it HERE, but for the simplest and most poignant way: a concussion is a disruption of normal brain function after a traumatic event. Notice there is nothing about getting hit Continue reading

More Concussions in Practices or Games?

22 May

There was a recent study released that has turned some heads in regards to where all the concussions come from in sports. In this JAMA Pediatrics study appearing at the beginning of the month the investigators have concluded that American football practices were “a major source of concussions” for all three levels of participation studied (youth, high school and collegiate).

Often when we see this type of information released there can be confusion due to the limitation of each individual study. The above data reflects a single sport, football, as compared to other data often cited that deals with all sports. Case in point this National Institute of Health study; which reports “athletes tend to have a higher risk of concussion in competition as compared to practice.”

The discussion topic of where concussion occurs more is not only often debated but it is an important set of data because we can control for one side of this equation, practice.

Reading the JAMA article one might be confused about the conclusions if you were to look only at the data and not have complete context of both the sport and participation. The rate of concussion was extremely higher in competition versus practice yet the majority of overall concussions came from practice. This can be explained by noting that there are far fewer games – thus exposure – and fewer participants in games – thus exposure. The sample set for the data (JAMA) was fairly robust: 118 youth football teams, 96 secondary school football programs and 24 collegiate programs. Ages of athletes exposed were 5 to 23, presenting a very good cross-section of the sport at all levels it is being played at. This information was collected in 2012 and 2013, and the researchers collected over 1,100 concussions over that time frame.

The NIH study breaks down the information for 13 different sports in high school and college only. Their findings Continue reading

The “Mild” Concussion

13 May

Mild

This post was written originally in 2011, but has been re-posted numerous times, it will continue to be posted until we all get the message…

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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.

When public speaking I often times compare a mild concussion to being mildly pregnant. It is rather simple you are concussed or you are not, just like being pregnant.

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 Continue reading

Play Smart. Play Hard.

12 May

PSPHlogo

Today the Illinois High School Association (IHSA) launched a national initiative for overall student-athlete safety and participation in sport. It is called Play Smart. Play Hard. 

The campaign will focus on education and equipping athletes, parents, coaches and schools on ways to better safeguard the heath and welfare of student-athletes, including minimizing the risk of head injuries.

The main function of this campaign is to have readily available information and tools for player safety; taking on the current issues/risks as well as being forward-thinking and discussing and formulating plans for other issues that are of concern in sports. At the center of Play Smart. Play Hard. are the resources including a Player Safety Toolkit which is directed at concussions at this time. When going to the Play Smart. Play Hard. page (www.playsmartplayhard.org) in the resource tab you can find all the current Illinois and IHSA concussion information as well as the National Federation of State High School Association (NFHS) and Centers for Disease Control (CDC) concussion info.

Play Smart. Play Hard. may have been trumpeted by the IHSA and Illinois but there are many other state high school association supporters of this innovative approach, 27 to be exact, check the site to see if your state is part of it.

As mentioned on the blog yesterday Continue reading

Illinois Advisory Council on Player Safety

11 May

It was last month and I was routinely checking the inbox when I noticed a correspondence from the Illinois High School Association (IHSA) with the subject line “IHSA Request”. Of course this piqued my interest because it is not often I get information from the state high school organization and the ‘request’ portion may have been dealing with athletic training. As I opened the message I simply thought this was a blasted email with necessary information from the IHSA…  I was wrong, on so many levels.

This is how the email opened;

Good morning, Dustin.  I hope things are going well.

I wanted to write you today to invite you to be a member of the Illinois High School Association’s (IHSA) newly established Illinois Advisory Council on Player Safety, which aims to influence, shape and strengthen the IHSA’s commitment to protecting the welfare of all those involved in interscholastic competition in Illinois.

Needless to say I was kind of taken aback, but after that fleeting moment I was honored and excited and quickly read the entire correspondence and even more quickly responded to the IHSA with a definite yes (I didn’t want them to second guess my invitation, hahaha).

The Illinois Advisory Council on Player Safety aims to be a well-rounded plenary body – with much and varying expertise – that can guide discussion on ways the Illinois high school athletic community can improve, advance, set initiatives and create higher standards for player safety. This body cannot create policy but it can influence decisions and create internal debate. Initially the main focus will be on head injuries, however, it is thought that the Council will eventually take time to look at all player safety issues going forward (heat illness, sudden cardiac death, and many more). The Illinois Advisory Council on Player Safety is a part of a greater campaign that the IHSA is unveiling tomorrow (more on that then).

The Council is going to be made up of eight members from across the state; student-athletes, coach, official, athletic trainers, alumni and state legislators.  Below are the quick bios of the Council at this time: Continue reading

It. Has. To. Stop. (revisited)

10 May

This is one of my more outspoken and shared opinion pieces about concussions, it originally was penned in August of 2013.

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There is a lot of belief and trust each and every one of us has in those that are medical professionals.  The further you go up the chain in those professionals our trust is greater and our belief is stronger that they know more.  The sad fact that in some instances those near or at the top of the chain don’t know enough and are putting people, in this case a kid, in danger; not only in the near future but the long-term.

Compared to a physician (MD/DO) I would say my medical skills are pale in comparison, and rightfully so; their schooling and experience far outpace what I have learned in the medical field.  Because of this the athletic trainer (I) am not held as in high regard when it comes to decisions about the care of an athlete; which I am fine with… 97.43% of the time (I just made up that number, ha).  However there are times when a MD/DO – those making the final and binding (in parents and patients minds) decisions – make a mistake.  This is not just some Monday morning quarterbacking either, its FACT.

Just recently I had an athlete take a blow to the body and head in a practice, and they immediately came to me distressed.  How distressed?  Well that is one advantage I have over a MD/DO, especially the ER doc, I know the kids and have the resources of his/her peers as well as coaches who have known the kid for many years.  In this case the Continue reading

Concussion = Brain Injury (revisited)

10 May

This post originally appeared in February of 2012, it is a good summation of the minutiae surrounding concussion.

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For years we in the medical community have been struggling with the terms “concussion” and “traumatic brain injury”; is there a difference?  The simple answer is no.  As you have seen on the blog, we use the term interchangeably, however just like anything in life semantics make a difference.  The perception of a “concussion” is that of sports and “not really that big of a deal”, and that would be horribly wrong.

As Broken Brain — Brilliant Mind posts today this injury is to the brain and confusion about semantics need to be cleared in order to gain a firm grasp on the issue at hand;

I’ve been giving a fair amount of thought to concussions over the past couple of years. In the course of my tbi rehab, my neuropsych has referred to my mild tbi’s as “concussions” and oddly, I never really thought of them that way. I’m not sure why I didn’t make the connection. I guess I thought, like so many others, that concussions are not that big of a deal — just a bump on the head. Getting your bell rung. Getting dinged. Big deal, right? Then, when my neuropsych talked about all the concussions I’ve had, the light went on.

My mild traumatic brain injuries were concussions. Concussion sounds a lot less dramatic than TBI, but essentially, it’s the same thing (I won’t go into the distinctions that SUNY-Buffalo Concussion Clinic people make).

By the way if you have not been going to BB–BM you should, as his/her perspective on dealing with brain injury is a massive resource.  Needless to say, whether you use the term “concussion” or “brain injury” the results Continue reading

Fish Oil Revisited

9 May

This post originally appeared on the blog in 2011, not much has changed in this area, it is still not definitively known if this is good, bad or indifferent (probably the latter).  However, this is a supplement that is good for all athletes for a myriad of reasons. I have chosen to post this again because it is one of the most popular and commented on post in the blog history.

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After posting about the “7 Ways To Help With Concussion Management” I realized that I had not posted about the possible benefits of Omega-3 fatty acids/DHA supplements for concussion management.

In a July publication of The Journal of Neurosurgery, Dr. Julian Bailes (BIRI) and Dr. Barry Sears (leading authority on anti-inflammatory nutrition, creator of Zone-Diet) found that supplementing rats with O3/DHA after head injuries reduced the observed issues with a concussion; (SOURCE via weightlosingideas.com)

“Animals receiving the daily fish oil supplement for 30 days post concussion had a greater than 98 percent reduction in brain damage compared with the animals that did not receive the supplement,” Dr. Sears said. “It is hypothesized that the omega-3 fatty acids in the fish oil reduced the neural inflammation induced by the concussion injury.”

O3/DHA has been documented to help with the inflammatory response of the body, many people use this SAFE and AVAILABLE supplement when training to temper swelling.  It is also has shown great promise for the cardiovascular system, mainly heart health.  Further investigation is underway Continue reading

The Fencing Response

9 May

Originally posted January 7, 2011 this was one of the first places to examine and educate people about the Fencing Response, since that time this post has been viewed nearly 50,000 times. This is a great resource.

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The fencing response is an unnatural position of the arms following a concussion. Immediately after moderate forces have been applied to the brainstem, the forearms are held flexed or extended (typically into the air) for a period lasting up to several seconds after the impact. The Fencing Response is often observed during athletic competition involving contact, such as football, hockey, rugby, boxing and martial arts. It is used as an overt indicator of injury force magnitude and midbrain localization to aid in injury identification and classification for events including, but not limited to, on-field and/or bystander observations of sports-related head injuries.

Source: Hosseini, A. H., and J. Lifshitz. Brain Injury Forces of Moderate Magnitude Elicit the Fencing Response. Med. Sci. Sports Exerc., Vol. 41, No. 9, pp. 1687–1697, 2009.

Concussion by Sport (revisited five years later)

8 May

This was another very early post of this blog back in 2010, September to be exact. As you can tell I was very green to the whole linking of articles and writing. However, this is an important article regarding concussion statistics by sport from five years ago. I would be interesting to do a follow-up to this with what we know now. Looking back at my observations have not changed much in the five years, I may move wrestling above cheerleading but that is about all.

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Concussions are not exclusive to American football, although it is the most covered sport as it relates to concussions.  This is a good time to note that in the United States the next most concussive sport, is soccer, the number one sport in the world.

A reasearch project by University of North Carolina reported concussion rates by 100,000 athlete-exposures Continue reading

The Need for Sleep

8 May

This post appeared in the infancy of this blog back in October of 2010, I have made some editorial changes since that time.

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It used to be that doctors would tell you to keep people awake with head injuries.  That has changed, quite a bit.  Keeping someone awake might be indicated for a possible brain bleed, but concussions need the sleep and recovery time.

Sleeping is first. If you’re not sleeping, forget it,” said Cara Camiolo Reddy, the co-director of the UPMC Rehabilitation Institute brain program and the medical adviser to the Sports Medicine concussion program. Sleep is vital in the recovery process because the injured brain needs rest to begin to heal itself. The concussion program and Camiolo prescribe medications, however, only to post-concussion syndrome sufferers who are three weeks or longer into their injury.

This quote was from and article by Chuck Finder of Scrips Howard News Services and appeared on NewsChief.com today.

In the article you will find that this prescription is not widely accepted by the community that deals with concussion management.  However in my experience it is vital to let the brain rest.  When I am debriefing with the athlete and their parents, the most often question I get is “can you sleep too much?”.  My answer is no. Parents often time are apprehensive if they subscribe to the old method of waking every hour, but I try to educate using the snow globe example. If the must wake their child I encourage it at infrequent and few times as possible.

With my experiences at the schools I’ve been an AT at, the kids and parents that abided by the recommendations of sleep and complete brain rest have recovered at a much quicker rate.  The kids and parents that did not listen often times have delayed recovery.

I know that is not a research study in its most proper form, but the observational evidence tells us, and those in the above article that sleep is indeed needed.

The Future is Good. Things are Changing.

7 May

Sq 300 JHello, once again, let me reintroduce myself. I am Dustin Fink, an athletic trainer in Illinois that has made it a special interest and hobby of mine to learn and talk about concussions [/sarcasm].

It has been some time since I have delved back into the blogosphere and I don’t feel I owe an explanation (to be honest many of you wouldn’t care, it’s rather boring), however things are about to change.  I cannot promise that this space will be as prolific as it once was with concussion news and commentary however I think it will be more active that it has been the past year or so.

The exact details about how and why this change is occurring I cannot say quite yet, all I can tell you is that nearly five years of work has been realized and this now gives me the reason to get back to this part of my life. To say I am excited is a vast understatement at this point.

While I have been away I have seen my growing family get more active and my resources as an athletic trainer get more useful and respected within my workplace/school. It has been quite the adjustment going from covering a small school to a medium school with all the events and time constraints. And back to the kids, my kids, they are crazy busy with baseball, volleyball, basketball, softball, flag football, etc. it will be entertaining trying to watch this family juggle three kids in all of that (will take unsolicited advice from parents any time).

Concussions have not and will not go away from the sports scene no matter how much snake oil we throw at it. Simply, concussion is a risk associated with activity – any activity – not just sports. It seems that the general media (those beyond the taboo “blogs”) have become a bit more familiar with it and there are plenty of organizations and people stepping in dog doodoo when handling the actual injury or the public relations portion of it, so coverage has been decent. We have continued to field interviews and speak to classes and groups about concussion as well as advise those that ask, in reality The Concussion Blog has not gone anywhere (still Tweeting up a storm).

There are many opportunities coming down the pipe in terms of concussion legislation, concussion rehabilitation, concussion identification, and a myriad of other things related to this brain injury (including the shams and rhetoric about the danger). This provides a chance for us to discuss those many things; highlight the positives and critically examine the questionable topics.

I am looking forward to letting you all in on the news, next week, but for the time being you will be seeing many old posts come back to the top of this blog as a reminder of where we stand and where we are.

I appreciate all of you that have stuck with this blog for so long and continue to click on it even though the content is not as fresh as it once was. I don’t know how long this adventure will last but lets take advantage of the time while we have it!

Athletic Training: Why I Love My Job

27 Mar

Dustin Fink:

A great read! And excellent write up!

Originally posted on I Train Therefore I Eat.:

I’m an Athletic Trainer.

Oh, so you’re a gym teacher? NO. 

Oh, so you’re a personal trainer? NO

Oh, so you’re a strength coach? NO

Wait, so what do you do?

Believe it or not, this type of exchange actually happens a lot.  It’s funny, because athletic trainers (ATs) are everywhere. Most high schools, colleges, semi-pro teams, Olympic teams, professional teams, and basically any organized athletic association has them. Athletic Trainers work for corporations, for the military, as physician extenders, and in the performing arts (Yes, Cirque du Soleil employs athletic trainers for the performers).

Athletic Trainers are on TV all the time. Although they’re usually being called “trainers” by the talent at ESPN or your local news organization, so I don’t blame you if you don’t know who we are.

athletictrainer

I work at a small Division III college in Boston, and along with my colleagues, am responsible for the…

View original 1,301 more words

Photo Essay #NATM2015

24 Mar

Feel free to send in a note, picture, video about your favorite Athletic Trainer or the profession itself.  I don’t know where the credit goes but DANG ITS AWESOME!!! (click to enlarge)

AT make

Mouth Guards (5/5/14) — How is this study not retracted?

19 Mar

It has been nearly a year since I wrote this up, but it has been making the rounds again.  I honestly want to know why this “peer-reviewed” article has not been retracted.  This is one of the most blatant oversights I have witnessed in publications, and that is not hyperbole.  Read the following for yourself:

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Is it a bombshell or is it just a plain dud?  I say bombshell, but not in a good way for anyone involved with this “research”.

Last week I was inundated with emails regarding this “new” research about mouth guards and concussions.  There were roughly 16 emails in a one hour time span; some wanting comment, some telling me I have been wrong all along, some promoting the research.  This was a “huge” development in my area and my little corner in the blogosphere.  To fully understand perhaps some history is needed (“mouth gear” search on this blog) when it comes to my feelings on mouth gear and concussions.  Here are some selected comments attributed to me;

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 itseems 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 Continue reading

Borland, Now What?

18 Mar

If you are interested in sports or the brain trauma/concussion debate you probably did not miss the news about Chris Borland’s abrupt retirement from the NFL and the San Francisco 49ers.  In case you missed it, he broke this news to Outside the Lines on ESPN.

Since he made his decision there has been quite the discussion regarding why and what this means in the long-term; not only for football but for the awareness angle of this injury he has cited for his reason for hanging them up.

But what does it really mean, beyond the #hottakes from all over the internet?

When Borland decided it was his time walk away he knew there would be great interest, well had to know.  It has not been the norm to see a 24-year-old to retire due to concerns over long-term effects of repetitive brain trauma.  Most people in his position, now and going forward, are probably more concerned about making a living playing a game they love and a good one at that.  But think about the ripple effect of this news.

First, remember when Jake Locker decided to retire?  Hardly now, I bet.  Or Patrick Willis, from the same 49er team?  A bit more memorable because of his stature, I bet.

But both of those decisions were pale in comparison to the news from Borland, who until he retired I and many hardly knew him outside of very devout followers of the league and team.  The reaction was a combination of mass hysteria and shock with everyone waiting to chime in their opinion.  We saw nothing like that from the other two more “high-profile” players before Borland.  Why was this… Continue reading

#NATM2015 YouTube Video – OATS

11 Mar

From my home state of Illinois, I give you Oswego High School…  Make sure you see the interviews at the end of the video!!!!!!!!!!!

Well Done!

NATM 2011 Letter (3/22/11)

6 Mar

This post is from March 22, 2011 and is great to bring back for all to read.  I am unaware of any changes in Paul’s professional life, but this remains relevant!

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During the month of March we will continually highlight the work of an athletic trainer.  This series will incorporate open letters about the men and women of the profession from other professionals, the aim is to have at least one a week.  If there are others out there; parents, coaches, teachers, doctors, lawyers, athletes or anyone that would like to form a letter please do so and send it to theconcussionblog@comcast.net.

I have saved this letter for publishing toward the end of the month, because we should be thinking about what an athletic trainer does every month, and every day if you are lucky enough to have one around.  Paul LaDuke Jr. is a full-time athletic trainer for a public high school in Pennsylvania and has “uber” years devoted to athletic training.  Not only does he provide daily coverage, he has recently created a blog entitled “Promote The Profession” devoted to Athletic Training.  Paul has been a wonderful resource and “reality check” for me during my process.  It is an honor that he took time to write this letter;

What is it like to be an Athletic Trainer? Continue reading

Taylor Twellman Story (9/21/2010)

2 Mar

Originally posted on The Concussion Blog in September of 2010.  I would be interested to see Taylor talk about this in a reflecting manner and see if anything has changed with him and his thoughts on concussions in the sport he loves.

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Just ask Taylor Twellman, a soccer player from the New England Revolution how unpredictable they are.  In 2008 near the top of his game and the American leagues he ran full speed into the goal keeper, creating a whiplash effect on his body, most namely the skull.

To this day Twellman has not had a single day without some post-concussive effects.  He was only just recently, June, released to begin light activities.  Granted this is a professional athlete that has a career to think about, his health remains his number one priority.

Monique Walker of Boston.com ran a story about him and his not so quick recovery from concussion.

For our adolescent population this can be even more devastating, a delay in recovery could mean a decline in grades, an emotional disconnect from teammates, and a social decline in school.  All while the brain and personality are still developing.

If you get your “bell-rung” make sure you communicate that with someone who can help.

We Prepare – You Perform

2 Mar

It is that time of the year again to point the spotlight on the countless, often faceless, professionals that do much more that many know in protecting your physically active peers.  This year the message is “We Prepare You Perform” and has many different meanings to many different people.  I want to take this time and space today to tell you what this means to me.

It still happens, I get the occasional “what do you exactly do” comment/question from people.  Certainly most of that comes from those that are not in a sporting type setting, be it at the HS level or connected to professional sports in an interest type of way.  However, it is a great question that I love to answer even though it can get tiresome realizing that our profession is not universally understood.

What “I” do is not that different from what other athletic trainer does.  Bringing it to a more practical analogy, it is not much different that what one does a parent; as I have learned being a father of three.  What we do is make the lives of those in an active lifestyle or profession safer and when warranted BETTER.  The core foundation of this comes from preparation, period.

WE PREPARE.  You imagine it, there is a good chance we have prepared for it in the active arena.  This goes for sports, where the vast majority of athletic trainers are employed, to the industrial setting where the hard-working, blue-collar workers need to be at their best as well.

The easy cop-out would be to say this comes from our education, at least four but increasingly more like six years of study.  Sure that is some of it, but the reality is that no matter what you learn in a classroom setting has little to do with what we do on the “ground” in our profession.  The more complex and reality of the preparation we do comes from experience and adapting.  Constantly thinking of what could happen — and we don’t want to happen — and how to react in those situations.  The first time Continue reading

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