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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

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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!

How Do We Know If Anything Is Working at NCAA Level?

14 Jan

In the NFL we have publicly disclosed injuries, including concussions, so we can (and have) track the numbers that are reported to see if there is a change in outcomes.  Certainly there are flaws with the reporting system as we have discussed many times but at least we can get a set of consistent numbers (we hope) from year to year.

But what about the NCAA, where there are many more players: 126 FBS teams at about 80 players per team means 10,080 players in FBS alone.  Or, about 8,387 more football players than the NFL – this number does not include FCS, DII, DIII or even the NAIA or Juco football schools.

Timothy Bella of Al Jazeera America (I guess the NSA has my IP address now and yours too if you go to links, ha) has produced a great article on this problem of tracking concussions at the NCAA level;

For this college football season, America Tonight has been tracking all the publicly reported concussions in the 10 FBS conferences and the independent teams. Auburn was one of 42 FBS programs to not publicly report a single concussion this season, accounting for exactly one-third of the 126 FBS programs. The group includes Rose Bowl and Big Ten champion Michigan State and Big 12 champion Baylor.

In fact, in the 10 conferences and the independents, coaching staffs and media outlets only reported 192 concussions at all among more than 10,000 players, according to data compiled from early August 2013 to Dec. 27, 2013, in the America Tonight Concussion Map. That’s an average of fewer than two reported concussions per team.

That number is STRIKINGLY low – due to reasons outlined in article – but 192 concussions is less than the 217 concussions we found in the NFL from preseason through the end of the regular season.

I provided many thoughts to Bella about why this may be occurring, including the teams with higher press presence Continue reading

#C4CT Concussion Summit 2014

7 Jan

In a little over three weeks, Brewer Sports International (BSI) along with #C4CT (Coalition for Concussion Treatment) founding partner Amarantus BioScience will be hosting their 2nd Concussion Summit in New York, at the United Nations.  There have been many press releases on this event, and I have mentioned it a time or two on Twitter (and will continue).

Sure, there are many “summits” around concussions and head trauma – which is great as it keeps the dialog going – but few are populated by people with ideas on going forward.  Often, we find ourselves sitting, listening to bright people talk about what was done and can’t be done; rarely do we find the same bright people addressing the issues going forward.  Whether that be with tactical changes or with management or even the possibility of intervention with traumatic brain injury.

This edition of the #C4CT Summit on January 29, 2014 will hear from some people in many fields – you can see the current line-up HERE – focusing on the burgeoning topics of chronic traumatic encephalopathy (CTE), general neuroscience, pharmacology among other topics.

Interestingly enough, yours truly, was invited to sit on a panel and discuss how all of this information has been translated to the high school level – as an athletic trainer.  I was not only surprised by the invitation but feel it is VERY OPPORTUNISTIC for a “boot on the ground” athletic trainer to provide input.  I feel that not only have athletic trainers seemed to be seen and not heard, the vast majority of us practice in the high school setting, where the adolescents are playing sports.  I can assure you I will do my very best to be a quality representative of not only athletic training (it appears I am on the only AT in a speaking role) but those of us working with the most kids/athletes.

Anyhow the cast of speakers/presenters is indeed “star-studded” and even has some opposing view points on where we should be headed; which should make for some quality discussion.  If I can get my technology working and to NYC I will attempt to live blog/tweet the event for those that cannot make it.

Speaking of that, I know that time is short but I encourage anyone who is going to be in NYC during Super Bowl Week try to attend this event.  If there are scribes out there I am sure the wonderful support staff at BSI can arrange for you to cover and meet the star of the show – me, of course – hahahahaha, I kid.  Seriously, you can register HERE and if you have questions feel free to contact them.

I hope to see you all there!

TCB Mail Bag

26 Dec

I trust everyone has had a wonderful Christmas experience (or Hanukkah or Kwanzaa or going to have a good Boxing Day), with that I would like to wish everyone continued successes in whatever endeavor they choose.  Over the Holiday I have received many an email regarding concussions; apparently the down time has given people opportunity to share frustrations or good news.

Today I am bringing you a specific case in which we all can learn from.  At the least we can read this and prepare for similar situations that may arise – whether as a parent, doctor, coach or athletic trainer.  

As always you can write in and with your permission I will re-post anything you would like (and it may suit the audience).  It can be attributed to you or anonymously.  Keep it between 500-2000 words and omit any personal identifying factors if it involves patient care or sensitive information.

Here is our post today – by Anonymous:

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Obviously today is Christmas Eve and in most regions of the country kids are not in school for at least the next two weeks. Maybe less, maybe more. All in all it is a great time to rest up that brain and recharge your body. As athletic trainers we also know that sports do not stop for the holidays. For the most part at least. If you remember last year I read an op-ed article that you put on your blog titled “Parental Decisions Can Undercut Good Concussion Laws” or something of that nature. Well, it’s happened again (as it has many times between that time and now but this one is a little more ridiculous than the last) and I’m nauseous!

To be as brief as I can on this without boring you this is the case of a female soccer player who sustained a nasal fracture as well as a concussion when fighting for a header in the air with an opposing player almost a month ago. To be clear, she actually suffered a deviated septum. Anyway, after our AT did a beautiful job of getting this athlete “entered” into our concussion protocol (which Mom still couldn’t get over the fact that she indeed had a concussion; whoda’ thunk it, right?) we all sat in our physician’s office (Mom, AT, myself, physician, athlete) and witnessed the concussion as well as the nasal issue being addressed. The athlete was clearly concussed (clinical exam, balance assessment, and symptom reporting were all abnormal but ImPACT scores remained at baseline) and the athlete was sent for an MRI and referred to an ENT for further evaluation of the nasal issue. Pretty simple. These folks were given the “red carpet” treatment as all of our athletes/parents are and everyone left happy. The consensus was to see the ENT and address that issue then to follow back up with our physician for the resumption of the concussion issue. The athlete ended up having surgery about a week later. She was out for about a week after that. The ENT cleared her to resume play and actually said that there was no concussion. Wow! OK!

Fast forward to last week during exams and the athlete did not follow-up with the AT during exams like she was instructed to do. She THEN shows up to a game on Saturday with a face shield and tries to plead her case to enter the game. The AT did her job and did not allow the athlete to play. Mom was irate. Athlete conceded. Coach was with the AT. So athlete did not go through the GRTP process and as of today the mother refuses to follow-up with our physician for final clearance after all of the objective information is noted. She is choosing to Continue reading

#tbt Post: Friday Night Lights

19 Dec

This “throwback Thursday” thing is kinda cool for a guy that has a ton of stuff on this site that new people may have missed.  With that I will attempt to drudge up some “oldies-but-goodies” for you the audience.  I am certain I will re-read some of this and laugh at myself or have changed in the way of thinking but I will leave it as it was originally printed.

This weeks post comes from the very first month of this blog, September, 2010.  Back then, when the concussion information on the world-wide web was hard to find I was blogging my experiences on the field as an athletic trainer.  It is funny reading back on these as you can see my knowledge grow as well as how policies were set.  Enjoy, including the REALLY horrible writing style (wow, it was bad).

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Lets just begin by saying we did not have to travel to an emergency department last friday.  That being said there were some lost opportunities for the team to get an underdog victory.  The kids played hard, in a hard-hitting game, so the Continue reading

PUMP THE BRAKES, Everyone!

4 Dec

I am a bit on edge this fine, foggy-impending-wintery-weather, day.  No, it’s not the great coffee I am drinking now and the nice jog I had clearly didn’t ease my current frustration.  This forthcoming “strongtake” may get my ass in hot water with some readers, but so be it.

People need to calm down, slow down, take a step back, reflect and realize some important things.  Before I go further understand that I have tried to be as “neutral” as possible – a simple athletic trainer that sees concussions on an intimate level from occurrence to recovery.  I have had 13 myself.  This post is something that apparently has boiled up from all the press clippings I have read and feedback I am getting.  Not one person, entity, sport, or profession is my target here; these are observations and opinions (in my most succinct way possible).

First of all, concussions are not a football problem, they are not a soccer problem, they are not a doctors problem, they are a societal problem.  Rightly so, football in America gets the mass attention, because it happens there more than any other sport out there (don’t waste my time with the skewed numbers of other sports and genders).  With that being said because of the higher incidence in football that does not mean the sport as a whole needs to be banished.  You know very well where I stand on this but I will spell it out for those new here.

Professional football is a different animal from the other forms of the sport, mainly because they are grown adults making informed decisions about their health.  And they get paid to do it, other than providing immediate safety for the concussed players and proper information about the injury, short and long-term, they can and should be able to make their own decisions.  However, this does not indemnify those players or the sanctioning bodies from having some casual responsibility for the emulation of the game at the lower levels.  A clear line must be drawn between amateur and professional medical care; for concussions and all other injuries.  Remember that the professionals have much greater medical care available to them, and if you think that is unfair well too bad, that’s life and where the money is.  Professional football holds a certain responsibility to inform its fans and future players of the risks and rewards of the sport.

As for the lower levels, with proper coaching and medical care/coverage I feel there is a place for this sport as we know it.  Unfortunately as we trickle down in age the participation numbers go way up and at the bottom, youth, is where we have the greatest disconnect from coaching and medical coverage/care.  Because of this and other factors I am of the ilk that kids should wait until the arbitrary age of 14 or freshman in high school to begin full collision football.  Believe it or not this has to do with more than just concussions, in my opinion.  And here is where my first beef is coming from.  Continue reading

Patrick Hruby Article That Has Everyone Talking

14 Nov

OK, maybe not everyone but it has struck a chord with many people I know.  Hruby writes a long form piece on making a choice about letting your son/daughter play tackle football at a young age.  Sure he has been critical on football for a few years now, but this article is very informative and somewhat balanced on both sides.

I am writing this post not to steal his work, rather have it here for posterity sake and include one very interesting quote.  This is what I believe to be the most applicable (for the audience) when it comes to concussion management and assessment (emphasis added by me);

“If I said that one in 10 middle schools has an athletic trainer, I’d probably be overestimating,” Guskiewicz says. “Having a trainer isn’t going to prevent every injury or solve every problem. But it’s important. Some people say this is extreme, but I think that at the high school level, if you can’t afford to hire a certified athletic trainer, then you shouldn’t field contact sports at your school.

The root cause of concussions is not sports or football, it is simply life.  They happen everywhere; from cabinet doors, to staircases, perhaps headboards, bicycles, trampolines, etc.  To avoid inherent conflicts of interest there needs to be a sole person or persons that have it as their job to keep kids/athletes safe.  We could always do what has been done before and rely upon the coach, but that seems to not be working out too well (conflict of interest).  As a buddy of mine, dad once said; “if you always do what you always did, you will always be what you have always been.”  There needs to be change.  I cannot think of a better point that having athletic trainers to do the work they are educated and trained to do: keep athletes safe.  Yes, there are way more good coaches than bad, but why not give the man/woman some help with medical advice and injury care?  Don’t they have a job to do of coaching a team/individual?

 

 

C3 Logix: Practical Application and Use (It’s Freaking Awesome)

13 Nov

Last year while in Zürich I was approached by a group of people from the Cleveland Clinic and they had a poster they wanted to show me.  It had numbers, graphs and pictures – your normal poster at a conference – but what caught my eye was an iPad strapped on the back of a patient that was measuring movement.  I asked very basic questions and to be frank I was a bit overwhelmed at the entire company I was keeping in Zürich, so the poster was a blur.

After that chance meeting and getting back to the States I really forgot about the project until the spring when I started to hear more about it in the underground.  This testing platform was starting to get noticed and being from one of, if not currently the most, prestigious concussion care centers only helped matters.  I wanted to learn more; and in August that chance finally presented itself as the company selling the C3 Logix, Just Go Products, was able to connect with me for a webinar.

I was very blown away with what they were presenting to me – which is probably what the development team in Zürich was telling me – so much so that I wrote a glowing post on it.  Since that time I have worked hard to find a way to procure the system for use; if nothing more to test it out and see if my perceptions were reality.  This goal of mine finally became a reality, not only was I able to get the iPad needed and the app, C3 even offered to send out a technician (really that may be underselling David, he is a nerd but a very good nerd) to help me get accustomed to it.

This past Friday I scheduled the winter sports concussion testing for my high school; the freshman and juniors that have not already done so completed a popular version of the computer based neurocognitive testing, while the other freshman and juniors along with seniors were up for the “beta test” on the C3 Logix platform.  With the split we had 30 kids Continue reading

Athletic Training Podcast

7 Oct

You may have seen it on Twitter, I have recently finished a podcast with Chris Lenker over at ATPodcast.net (@ATPodcast).  I had a great time just shooting the breeze about who I am and why I started the blog.  My dog Eli even gets in the action with some random barking in the background.  Chris tells me it was a good podcast, but to be honest I think he just asked a question and let me ramble for no apparent reason, ha.

Please if you get the chance and the time give it a listen, Chris and his podcast does a wonderful job for the profession of athletic training.  Help him out by going to his iTunes link HERE.

I would appreciate all feedback on this, there is a wicked rumor that people may want more of this type of interaction between fellow athletic trainers.  And Chris almost has me convinced that I should be doing some of these on a regular basis.  I don’t know if anyone would even want to hear more than what they have.  Feel free to let us know!

The “Other” PBS Film

3 Oct

ICYMI there is another film not named “League of Denial” that PBS is showing that deals with concussions.  This one however is “a proactive look” at concussions in a high school setting.  As Founder, Editor, Journalist, Producer of MomsTEAM; Brooke de Lench put it in a recent post on the release of this film;

We also careful to explain on “The Smartest Team” website that the documentary is no more than an “audio-visual blueprint,” and “an introduction to a set of principles (the Six Pillars) to guide development of a sound concussion risk management program based on the latest research and opinions of experts; to provide a solid foundation on which to build such a program;” that we see it “only as as a jumping off point for what we hope will be the beginning of a multi-year and continuing process involving parents, coaches, players, athletic directors, school boards, booster clubs, and health care professionals, motivated by a desire to preserve all that is good about youth and high school football, to work as a team to implement best practices in concussion risk management.”

The Smartest Team” is a documentary of a high school in Oklahoma that was looking for a better way to combat concussions, and sought out de Lench and MomsTEAM.  During this film you will see the use of Continue reading

Possibly the Most Comprehensive mTBI Guidelines

26 Sep

The Ontario Neurotrauma Foundation has released their updated Guidelines for Concussion/mTBI & Persistent Symptoms: Second Edition, and it may be the most comprehensive/complete to this point.

The guidelines stretch from diagnosis through return with emphasis on “hang-ups” that can come along with recovery, here are the modules;

  • Diagnosis
  • Management
  • Sports Related
  • General Recommendations for Diagnosis/Assessment of Persistent Symptoms
  • General Recommendations for Management of Persistent Symptoms
  • Post-Traumatic Headache
  • Persistent Sleep/Wake Disturbances
  • Persistent Mental Health Disorders
  • Persistent Cognitive Disorders
  • Persistent Vestibular and Visual Disturbances
  • Persistent Fatigue
  • Return to Activity/Work/School

Of special note and to reference is all of these recommendations are for adults.  That being said some of this can be “creatively adapted” for those in high school.

Here is the .pdf for the Sports Related Concussions/mTBI.  All of it is worthy looking over; not only for athletic trainers but doctors as well.

Live Discussion on Concussion

19 Sep

I will be on HuffPost Live today as they discuss concussions…  You can find the archive link here…

Helmet To Helmet: Changing Football

What Does the Derek Sheely Case Foreshadow?

3 Sep

Inherent risks, of life and sport, are a constant issue none more controversial than concussions.  The truth of the matter is that concussions will occur in life without sports so playing: hockey, lacrosse, basketball, baseball, water polo or any sport comes with differing amount of risks/chances of concussion.  By playing those sports we should understand those risks and be willing to accept the chances of injury, particularly concussion.

As we have stated close to eleventybillion times now; the actual injury of concussion is not the issue of this crisis, rather it is the mismanagement of the injury that is the problem.  In other words it’s not the sports fault for concussions, it the people’s fault for not taking this brain injury serious.  Even worse, it is people in positions of power that have caused many to be “mishandled” after injury, bringing us to where we are today.

This is where Derek Sheely comes in; this young man died on a football field in Maryland as a result of head trauma and the purported facts in the case are very scary;

  • Four hour contact practice
  • “Preseason practices at Frostburg served more as a gladiatorial thrill for the coaches than learning sessions for the players… Practice involved virtually unlimited, full-contact, helmet-to-helmet collisions.”
  • Named coach in lawsuit explicitly told players to lead with their head and use their hat when tackling
  • Apparent lack of preventative medical care by an athletic trainer
  • And this quote: “Stop your bitching and moaning and quit acting like a pussy and get back out there Sheely!”

We have yet to have full discovery in this case and most likely there will be a settlement Continue reading

It. Has. To. Stop.

20 Aug

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

Next Level… In Concussion Care

14 Aug

As an athletic trainer – an opinionated one at that – I struggle with all the “bells-and-whistles” in this conundrum that is the concussion issue.  If you have visited here or heard me speak you undoubtedly know that mismanagement of concussions is the true issue of this complex paradigm.  Yes, we need to know when a concussion occurs to begin the process in the right direction; however, this can be accomplished by simply making sure you have a trained medical professional on hand when the need arises.  Getting an athletic trainer to cover the most at risk sports at the most at risk times is a great start (and in the authors opinion is the only choice if you want to have collision sports).  Short of that, education over-education is necessary for everyone: players, coaches, parents, officials, teacher etc. to properly identify and accept the nature of concussion in sport – it is a risk.

Even having an allied medical professional, like an athletic trainer (AT) at practices and games does not stop the injury from occurring.  In fact, many products that may claim reduction in concussions or “possible concussions” are toying with fraud; at the very least they are practicing deceptive marketing.  The point being, once we identify a concussion how do we and who do we send the injury to, to avoid the rest of the iceberg lurking under the surface of the water?  Moreover, what tools do we have that can help get the right prognosis, treatment and recovery for the injured (and there are many out there)?

I feel there is a new product (I am not a paid endorser, nor have I been given compensation for this article/opinion) now hitting the market that may get us closer to the panacea that we are all hoping for (note I said “closer”).  Although it may have been presented as some big secret; the C3 Logix: Comprehensive Concussion Care system is not a secret rather it is something I feel is a “game changer” for concussion care.  It is Continue reading

HS Class Uses Blog to Educate

10 May

One of the more gratifying things about this blog is the chance to educate anyone about concussions and the athletic training profession.  I truly enjoy going out to speak and even debate this hot topic.  I understand that my thought process is not like everyone else, nor do I expect everyone to see it the way I do; however I do want people to become more educated and understand what we are facing with this problem.

As I was wrapping up my interview for a local TV station about the new IHSA Heat Acclimatization Policy, I received and email from a school here in Illinois that used my blog to become better aware of the concussion issue.  Honestly, nothing makes me smile more than to provide that to teachers and kids.  The email ended with some questions regarding concussions, I will answer them here (not only for everyone to see but to give a little pub to the students and teachers of Cuba High School).

My current events class has been debating and conducting research about concussions. I have had them use your blog for resources and it is very informative. We also just finished watching “Head Games” documentary and had further discussions. Many of my students are athletes and have raised interesting questions specifically towards how our small rural high school can best prevent head injuries. I know you’re a busy guy so we cut our questions to just 3. Any chance of a response would be greatly appreciated. Continue reading

Vermont Looking to Make AT’s Mandatory

22 Apr

Given the current state of funds and resources for schools, it would seem this is a horrible idea.  However, it is actually needed and should be done everywhere;

According to Senate Bill No. 4, or S.4, currently sitting in the House Education Committee awaiting word on movement to the full House of Representatives, schools “shall ensure that a health care provider is present at any athletic event in which a high school athletic team participates in a collision sport.”

Granted I am a skewed voice here, but it makes almost no sense not to have an athletic trainer on site; not only for concussion – which is uber-importnant – but for the day-to-day injuries and prevention of injuries.  In the article it was noted only 14 schools in Vermont don’t have an AT, but finding one to cover will become a high priority if it becomes law;

While no one has expressed a disinterest in having such coverage, the cost has been prohibitive — “substantially huge,” according to Merriam — for many Vermont schools.

“To get even a part-timer, it’d be $10,000 minimum, but we’re looking at upwards of double that in all likelihood,” Thornton said. “I’ve researched this extensively, and it’s a challenge in itself to get one to come to our school.”

In all honesty it’s about the money…  How much would you pay to keep your child as safe as possible?  How much should you invest to keep liability down and safety up for all students?

Would you send you kids to a pool without a life guard?  Why would you send you kids to collision sports with out an athletic trainer?

The Experts Tell Us Why Athletic Trainers Are Needed

3 Apr

You don’t have to take my word for it here, you can watch this video and let the experts in the field tell you;

Although we are not there yet, there are financial barriers, and some misnomers about the profession; athletic trainers should be a must.

As I have clearly stated: “If you cannot afford an athletic trainer you cannot afford to have collision sports, period.”

Hey here is a bonus, athletic trainers are also some of the best at on the field orthopedic injury assessment and injury prevention in the WORLD.  Doctors even defer to the knowledge of an athletic trainer when it comes to sports injuries.

AAN Concussion Guidelines – One Stop Post

19 Mar

Here is the presser for the updated AAN Sports Concussion Guidelines; their guidelines are simple and to the point, via YouTube;

  • No Grading System of concussion
  • 10 day rest period – “key” – Dr. Jeffrey Kutcher
  • Greater risk if you have had a concussion
  • Addressing of youth and recovery
  • Helmets are not the full answer
  • Licensed Health Care Providers should be clearing
  • Repetitive head injuries are bad
  • The discovery and annotation of “Chronic Cognitive Impairment”
  • No single test, CLINICAL assessment
  • “Kids are not little adults.” – Dr. Christopher Giza

Here is the LINK to the Updated Guidelines (can someone give me permission to post it here?)

Here is the LINK to the Sports Concussion Toolkit from AAN

Here is the LINK to the Concussion Quick Check from AAN

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What does this mean in comparison to the Zurich Statement?  That is a great question; both groups used “consensus” however this group is much more centered on American practices.  Both have similar approaches, both advise nearly the same thing; but which one carries more weight.  I have been told the AAN will be much more “powerful”, respected and learned than Zurich.

This is a good debate, regardless, there is ample evidence to sit kids and any concussed individual.  This statement also continues the wave of information that cumulative and repetitive trauma to the brain (still figuring out thresholds) is not good.  Based on this and the Zurich statement the only way that we can collectively abate concussions at this point is exposure limitation.  No where in that last sentence does it state “stop playing sports,” or “get rid of football”.

When dealing with the brain and the injury of the brain less is better, which is ironically simple and a “no brainer”.

Zurich 2012 In Writing

12 Mar

If you all recall I went to Zurich in November to attend the “Concussion Conference”; mainly as an observer, but there was enough time and opportunity to impart my questions/knowledge as a practicing athletic trainer.  Here are the links to DAY 1 and DAY 2 of my live blogging.  By the way, the live blogging was WELL received and continues to provide great insight into what went on.  I hope that I am asked back for the next conference, or any other conference that wouldn’t mind my attendance.

Now the information gathered at the conference has been hashed and rehashed and now appears as the 4th Consensus Statement (tweeted previously).

As part of the initiative the Standardized Concussion Assessment Tool (SCAT) was looked at and changes were made to the 2nd version from 2008.  You can now find the new version by clicking SCAT3.

A new wrinkle was an assessment tool for the younger ages, the group decided on the “Child” version of the new SCAT3, that can also be found by clicking Child SCAT3.

Also included in the addendum of the Consensus Statement was a recognition pocket card, found by clicking Recognition Pocket Card.

All of the above is free and intended to be used as a resource for better concussion assessment and even early management of concussion.  Please read the Statement regarding best practices.  As always this blog is NEVER to be used to diagnose or treat a concussion.  There is a lot to be absorbed and read; one thing is for sure we as athletic trainers and concerned/educated individuals now have the most recent information at our fingertips.  I guess this blog is actually doing some good work :)  A side note; how about this appearing during National Athletic Trainers Month?  It might be a coincidence, but I find it serendipitous.

Athletic Trainer Removed from Post for Standing Ground on Concussions

1 Mar

This is one heck of a way to start out National Athletic Trainer Month…

Paul Welliver, a name that should be remembered and learned about.  Welliver is a certified athletic trainer in Maryland and was until a few weeks ago the athletic trainer at Winters Mill High School.  The only one the school has ever known; being outsourced from Maryland SportsCare & Rehab.  The admin at the High School asked his employer to have him no longer provide service for them.  Welliver (at time of post) has not been fired from Maryland SportsCare & Rehab.

Why, you ask?

Because this athletic trainer stood up for what he believed and knows about concussions.  Unfortunately, this scene is all to familiar with us high school athletic trainers.  The story is from Carroll County Times;

The Carroll County Public Schools Supervisor of Athletics Jim Rodriguez and Winters Mill High School Principal Eric King told Welliver’s boss at Maryland SportsCare & Rehab that they did not want him to continue his position at Winters Mill, according to Welliver. After 10 years as the school’s athletic trainer, his last day was Feb. 12. [...]

Welliver said on four different occasions in the last 18 months, he refused to begin the protocol that is meant to gradually release student-athletes back into sports participation after a concussion. The protocol, also known as Return to Play, is supposed to begin once a student-athlete returns a medical clearance form after their injury has been classified as a concussion.

In this school district they have a pretty solid concussion policy and protocol  highlighted in the story, however when the one person – and last line of defense for the student-athlete – stands up for the protection of the children he is summarily dismissed;

He said the athletic trainer has to sign off on a student-athlete’s return to full contact and competition following a diagnosed concussion.

Welliver’s refusal to start the protocol all four times was because he was concerned about the safety of the student-athletes, he said. He is worried about their short- and long-term health, he said.

“There are times when I do not believe they should return to the sport,” Welliver said. “It is not safe.” [...]

“I treat all those athletes like they are my children,” he said. “Sometimes I spend more time with other people’s children than my own.”

He is exactly correct!  As if he had to really explain it to people who should not be part of the process he did for the article;

“I take into account many factors, including the number and severity of previous injuries and the age and grade of the student,” he wrote on Facebook. “It would be much easier to go along with the pressure of returning the student A.S.A.P., but I have seen way too many poor outcomes after multiple head injuries.” [...]

In addition to his decision to keep student-athletes from playing their sport after a concussion based on age, grade and the severity and number of previous concussions they have experienced, he also takes into consideration the sport or sports the athlete would return to. Their return could take longer if they play high-collision sports.

Shockingly, the school district and those that put the separation is motion had no comment.

Welliver did and does it right based on all accounts, the man – athletic trainer – father Continue reading

NFLPA News

31 Jan

So at 3:15pm EST the NFLPA will hold a news conference to discuss some “goings on”; the biggest nugget in this presser will be the announcement of a 100 million grant for Harvard over 10 years to study them.  All aspects of player health is the word I seem to be getting.  Which is good, because for a long time the former player has been neglected and has led to current and future players taking risks their bodies will not be able to cash in down the road.  I believe you can catch it live on YouTube as well, perhaps someone can provide the link in the comments…

In other NFLPA news, Deadspin and Barry Petchesky wrote about how players are overwhelmingly disenfranchised with the medical care they receive as a big-bad NFL player;

An NFLPA study, the results of which were obtained by the Washington Post, finds that the vast majority of players have serious doubts about the care they’re provided.

The NFLPA asked its players to gauge on a one to five scale how much they trust their team’s medical staff. Seventy-eight percent of respondents said five, meaning they’re not satisfied at all. An additional 15 percent said four, and just three percent responded to the question with a one or a two.

“The most troubling aspect of the survey for me is that lack of belief that the doctors are treating them for their players own health, safety and wellness reasons,” DeMaurice Smith said.

Perhaps this is why the NFL is entrusting the elite Harvard to study such things and happenings to players over a long-term time frame.  Petchesky  also takes part of the article to touch on the conflict of interest (COI) that is VERY rampant on the NFL sidelines concerning medical care.  If you have followed and read here long enough you will know it is something that we have been harping on for over two-year and one of our illustrious commentators, Don Brady, has written a dissertation that includes this problem.

Simple facts are that the team athletic trainers are paid by the team, not the players, and in a majority of NFL clubs the “team doctor” is actually paying for the privilege.  In a business model, it would appear – in my humble opinion – that the teams are making sure their priorities are met when it comes to injuries.  NOW HOLD ON…  There are some very outstanding athletic trainers and doctors that roam the hallowed sidelines of the National Football League, and they are VERY VERY VERY good at what they do, but the appearance – TO THE ACTUAL PLAYERS – is that their medical care may not be in their best interest.

I am not throwing anyone under the bus here, I am merely Continue reading

Hey Student AT’s, looking for a job?

30 Jan

Well here is one open…  Full-time high school athletic trainer at Mount Desert Island High School, in Maine.  Here is the write-up about the position;

An anonymous donation of $20,000 for next year and $10,000 the year after that has helped persuade the Mount Desert Island High School board to approve the hiring of a full-time athletic trainer.

Athletic director Bunky Dow, who recommended the staff addition, said the starting salary would be $32,000.

The high school has been budgeting $12,000 a year to contract with Mount Desert Island Hospital to provide medical coverage for home games in football and several other sports. The high school pays $50 an hour for a physician or registered nurse to be on the sidelines and take care of injured players.

The athletic trainer’s responsibilities will include attending all home games and meets, all football practices and away games and, as the schedule permits, away games in other sports. The trainer will tape up athletes prior to games, provide immediate care for athletes injured during play, administer ImPACT (computerized brain injury assessment) tests to all athletes, follow up with injured athletes and determine when it is safe for them to return to competition.

The trainer also will be responsible for all medical and sports permission forms, for educating students and coaches about injury prevention and other health issues, and for making sure all relevant certifications such as first aid and CPR are up to date.

The school board voted unanimously Jan. 8 vote to approve the athletic trainer’s position.

This looks like a great opportunity for a really motivated athletic trainer to set up a program for a community that is ready and willing to help that person out.  This is exactly a job that I would have taken right out of school, so many possibilities.  In fact I would love to be a full-time AT at a high school one day.

Go and get’em kids!!!

Matt Chaney – Tireless Worker

18 Jan

SpringGame1984Sideline
If you have been around enough you have seen the stylings of Matt Chaney on this blog, he is someone I call a friend.  In some circles that discounts me as a professional, which is both stupid and dumb.  I don’t always agree with Matt, heck him and I have been known to battle via electronic and phone communications.  However, his opinion is a valuable one – often his work is based in so much fact it makes your head spin as to why some of its missed.  Regardless, Matt has published two recent articles on his blog, for all to consume, here are some excerpts.

Part 1, published January 7th;

Historic football excuses thrive in modern debate over brutality

Lawsuits, criticism explode and officials project blame onto individuals

Old talking points of football apology resonate yet as officials tout anti-concussion measures like trainers along sidelines, new rules for safer play, injury reduction and expert consultation—same type of promises heard from gridiron leaders during the Victorian Era

American football gets lambasted in public for maiming and killing, denounced by an influential movement of critics, and game officials pledge safer play based on their new concepts of prevention, including:

*Qualified trainers and doctors will patrol sidelines.

*State-of-art medical response will treat the rare severe casualties.

*Limits will govern length of practices.

*Injury tracking will cut rates already on decline.

*Coaches will properly train players.

*Every player will undergo medical prescreening.

*Experts will lead safety reform in rulemaking and research.

*Referees and coaches will enforce new rules of experts.

*Players will follow new rules of experts.

Sounds familiar, these steps, a practical recitation of talking points for contemporary “safer football” promoted by the NFL and commissioner Roger Goodell, in face of lawsuit frenzy against the league and sport in general, along with festering disgust in the public.

Except the football rhetoric is 119 years old, from 1894, a packaged response during the game’s initial siege against formidable opposition seeking abolishment. Continue reading

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