Archive | Athletic Training RSS feed for this section

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

18 Aug

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

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

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

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

Upon completion of the drill – rather near Continue reading

About these ads

Sensor Overload

12 Aug

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

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

Are sensors a good idea?

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

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

Intended Consequences Lead to Unintended Issues: NCAA Settlement

1 Aug

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

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

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

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

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

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

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

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

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

California First on Football Hitting Legislation

22 Jul

I received this email late last night:

Friends….

Assemblyman Cooley’s office just phoned to say that Gov. Brown has signed Ca. AB 2127, making California the first state to legislate reduced contact on high school practice fields.  As you know, other states have taken similar action via their governing bodies of high school athletics but, after failed attempts in Texas, Illinois and Connecticut, Ca. is the first state to pass legislation and have it signed into law.  Public announcement will be made shortly.  Thanks to Warren Moon, Oliver Luck, Patrick Larimore, Leigh Steinberg, Dr. Chris Giza and others who made it happen.

Reading further on SF Gate:

The law limits full-contact practices to two 90-minute sessions per week during the season and preseason, and prohibits full-contact practices during the offseason. Currently, coaches can hold full-contact practices daily. The law also forces schools to bench players for at least a week if they suffer a concussion. Current rules allow players to return within a day.

The last part of the above paragraph has me very excited about this legislation – AT LEAST one week down time!

Good on CA for taking this to the next step, honestly I don’t think we need more legislation, however if you don’t want to listen this may be the route it has to go…

NOW CALIFORNIA GET YOUR BUTT IN GEAR AND LICENSE THE ATHLETIC TRAINERS IN YOUR STATE!  THEY MUST BE RECOGNIZED FOR WHAT THEY ARE: ALLIED HEALTH CARE PROFESSIONALS.

Arkansas Looks Into Hit Limits

18 Jun

Over two years ago I sent an open letter and proposals to the Illinois High School Association (IHSA) regarding hit limits in football.  Some took this as a “candy ass” approach and one that was not needed.  I disagreed with that assessment, in fact, I felt that what I wrote at the time was proactive and could be a way for this state to be a leader in the area of protection in concussions;

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.[...]

Recent evidence suggests that even the subconcussive hits – those that effectively “rattle” the brain but do not produce signs or symptoms – become problematic as the season wears on, let alone a career.  As the researchers in this field gain focus and more specific diagnostic tools, I feel we will see damning evidence that will put collision sports in jeopardy as they are currently constructed – the key being “as they are currently”.  There can be a change, both positive and proactive, that will signal to everyone that the IHSA is taking this matter seriously and can set a nationwide standard.

Needless to say it was brushed aside and was ignored, except for a kind email saying things were happening behind the scenes.  Now, two years and one month later there could be a 12th – TWELVE – states that have contact limits in place for high school football; as Arkansas looks into the matter;

According to reports, the Arkansas Activities Association has passed a recommendation to ask school superintendents to cut full contact practice time to just three times during game weeks. With one of those being the game itself, it leaves just two days of tackling if the proposal passes.

Jason Cates is the lead trainer for Cabot High School, and the former President of the Arkansas Athletic Trainers’ Association, he says, “Something has to be done.”

“The more studies that are showing that hit counts do count and add up.”

The Arkansas proposal limits the full contact days to three, opposed to the two I proposed, but it seems to me that others have seen the light.  That light is both the end of the tunnel and the oncoming freight train.  Kids need Continue reading

Hit Count Symposium

16 Jun

If you have a son or daughter in Little League Baseball you probably have heard of a pitch count.  Basically it is a set number of pitches a pitcher can throw in a certain time period.  The reasoning seems simple and sound, in my opinion; to protect the overuse of the arm/elbow.  Sure, there are many coaches out there in the baseball world that know what they are doing and will only throw players when they are fully rested.  On the other hand there a plenty of coaches out there that either don’t know or knowingly put players at risk when it comes to overuse of the pitching arm.

This has a relation to the concussion world; well, Sports Legacy Institute hopes so.  In an effort to be PROACTIVE about issues surrounding concussions and especially the youth players of collision sports SLI has created an initiative to limit, log and research “hits” absorbed.  I have blogged about it here when the initiative began.

Like many things that are new and different, people often dismiss or fail to grasp what is being attempted or cannot see what may be accomplished by doing them.  In regards to the Hit Count, it to is simple; limit the number of hits one sustains while playing sports – collision sports to begin with.

I may not be the worlds biggest advocate for sensor technology as we currently know it, however this approach is different and unique.  It is something that should be paid attention to, if not for the currently proposed reasons, at the very least the research capability.  How can we know if we don’t know.  In other words; how can we measure if we are making a difference with any of our so-called “advances in concussion issues” if there is not something to measure it against.  For a small niche in the medical community that is all about “baselines” and return to “normal” our peers seem to get all squirmy when people want to find this baseline.

The Hit Count most likely will not be the panacea which our culture so desperately wants but this is at least a step in the right direction.  Below you can see the full press release on the Symposium.  I cannot attend on July 15th, but I have been afforded two (2) transferable registrations.  Please contact me if you will be in the area and are looking to attend.  Without further ado:

==========

For Immediate Release —Thursday, June 12, 2014

Media Contact: Chelsea McLeod (781) 262-3324 or cmcleod@sportslegacy.org

Sports Legacy Institute Announces 2014 Hit Count® Symposium to be Held on Tuesday, July 15, at the Boston University School of Medicine to Advance Discussion on Use of Head Impact Sensors in Sports to Prevent Concussions

Co-Chaired by Dr. Robert Cantu and Dr. Gerry Gioia, event will gather researchers, athletic trainers, coaches, parents, athletes, medical professionals, and administrators to explore how Hit Count® Certified sensors can be used to improve brain safety  Continue reading

LINK: Rebroadcast of Pres. Obama Sports and Concussions

30 May

You can follow the link below for the rebroadcast of the “summit” on concussions in sport held at the White House yesterday.

http://www.c-span.org/video/?319639-1/president-obama-sports-concussions

There were some interesting thoughts passed along and it was great to hear the POTUS discuss athletic trainers and the need for them.  The next step in that “finger” of concussion care is to find funding and placement of athletic trainers.

I did enjoy Taylor Twellman’s honesty and direct nature during his time.

Please Let This Be The Beginning: A Public Invitation

28 Apr

The blog began simply enough, making notice of information about concussion in a time when there was so much misunderstanding.  It turned into a cathartic exercise on how I have dealt with concussions as an athletic trainer – the good and the bad.  It has slowly morphed into a platform for change; not only concussions but the healthcare profession of athletic training, in particular at the secondary school level (high school).

Adolescent concussion is not only staggering in terms of exposure but in terms of mismanagement, the true problem in this concussion crisis, in my humble opinion.  I feel – biased – that athletic trainers not only can help with the management but with the overall “acceptance” of this brain injury as it relates to sports.  Because of those thoughts I have been openly and behind the scenes, clamoring for a way to get more AT’s in the high school.  Not just game-day ATC’s either, full-time and daily coverage for our most vulnerable.  The analogy still remains: would you send you kid to a public swimming pool without a life guard on duty?  Why would you send your kid to collision sports without an athletic trainer on duty?

Yes, this is being spurred on by the concussion issue at hand, but in reality an athletic trainer is SO MUCH MORE!  We deal with the mundane (common cold) to the emergent (cardiac arrest) when it comes to athletic or high school (dealing with situations during a school day) injuries.

I came across a tweet today from Rick Burkholder (@proatc), Head Athletic Trainer of the Kansas City Chiefs that is putting this into action.

The NFL is starting a grant process to place certified athletic trainers (ATC’s) into more high schools.  The monies are limited from what I can tell, but this is the start that I have been dreaming of for the past few years.

You can read the entire NFLF ATC Grant by clicking on the link to see all the details but here are the highlights: 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

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:

==========

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).

==========

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

Follow

Get every new post delivered to your Inbox.

Join 8,080 other followers