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Training Camps in NFL Open Up

28 Jul

With the summer pilgrimage to training camps begun it is time to remind everyone that The Concussion Blog will be tracking the concussion injuries in the NFL for the fifth consecutive season.  It is our intention and has been our operating procedure to gather all the best data possible.

This is not a “witch hunt” or some “watch dog” type action, rather a way to inform, publicly, what is happening at the highest and most prolific level, for the most popular sport in the United States.

When we began back in 2010, the information was difficult to come by, we only noted and found eight preseason concussions and as of today there are four reported for this season.  Obviously there has been better knowledge about concussion from players, teams and reporters that has translated in easier tracking for the preseason activities.

I would like to take the time to mention @nflconcussions for their work in data mining the injuries.  Their Twitter account is probably the most productive when it comes to finding concussions.  They too have “reset” their counter for this season, if you follow them (and you should if you are interested) you will notice their numbers will be different from our reports once the regular season begins.

We data crunch only for the regular season due to reporting procedures from the NFL, making those injuries a bit more easy to find.  We also have other avenues to find concussions that may not make the press and are gathered by other places.  Finally there are some instances where a “possible” concussion turns out to be not a concussion.  We are not, in any way, discrediting any other concussion gathering group, we are just pointing out we do it differently.  Regardless, it would be a heck of a lot easier if the NFL was transparent with all injuries including concussions.

So enjoy what is left of your summer, and look forward to our first report coming out near the start of the season.

 

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#tbt: Eye Opener from 2012: Was it overlooked?

24 Jul

Originally titled “Bombshell Found in Sports Illustrated Vault” this post appeared on July 4, 2012…  To this day, it may be one of the most poignant articles I have written about the road we have been down.  I believe that this post still rings true, two years later, in regards to all the information we knew that we didn’t know…  

Considering where – 2014 – and what has transpired – League of Denial – this article may have been glossed over and was WAY AHEAD OF ITS TIME from SI.  I often find myself wondering why we are not learning from the past to make proactive measures going forward…

Enjoy the read from the past (excellent RT @protectthebrain);

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Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, [...] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. [...] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading

Nick Mercer: Heading the blame away from goal

23 Jul

“Football is a simple game; 22 men chase a ball for 90 minutes and at the end, the Germans always win.” – Gary Lineker

Sunday’s game was scoreless into the 112th minute, but still an exciting one with an attacking, offensive mindset for both teams. That said, I am not writing this post to give an unqualified analysis of the final. I am not even analyzing FIFA’s approach to concussions. Everyone who watched saw Christoph Kramer collapse after colliding with Ezequiel Garay’s shoulder. This was a particularly nasty collision, but by no means the only, or even most, blatant example of brain injury in this World Cup. Not a week before, Argentina midfielder, Javier Mascherano also received a decidedly hard blow to the head after colliding with Dutch midfielder, Georginio Wijnaldum. Then there’s Uruguay’s Alvaro Pereira who was actually knocked out before continuing to play!

Another incident caught my attention in Sunday’s final when Germany’s Thomas Müller banged heads with an Argentine defender as they both attempted to head the ball. The defender (I don’t know who it was) was down for a while after they collided and Müller was reaching for his head. Nevertheless, as is now customary, both continued to play.

Blame seems ridiculous, since it can rationally be shifted around in a never-ending circle. It’s pointless for the same reasons. Yes, teams and doctors could do more. Yes, FIFA could write new rules. Yes, players should be taught the dangers of continuing to play. They should be taught this from a young age. The blame goes to ‘them’ and ‘they’, but what about ‘us’?

Personally, I enjoy watching football (or soccer, as we North Americans say), but I watch very little, especially compared to harder hitting American football – where men in full body armour slam into each other and brain injury seemingly occurs every play. Hockey is the same; full body armour, collisions, brain injury. People seem to forget what protection all of the padding provides. When two athletes collide without padding it hurts a lot more (that’s why padding is used) and it hurts both individuals. It also means that in rugby or Aussie Rules Football, where such padding isn’t used, there is a tendency more toward technique, not trying to lay the opponent out every play, because a hard collision is a hard collision for both athletes. But I digress.

Injury in sports and life will happen. Brain injury in sports and life will happen. It’s not about how brain injury is dealt with in sports, it’s about how it’s dealt with in life. Pressure is placed on governing bodies like FIFA, the NFL, the NHL to do something. As the top bodies of their respective sports, they set standards to strive for. Consequences don’t start and end there. The onus is on the rest of us to be aware and learn.

Terry Ott: Personal Observations in the Wake of Suit

22 Jul

Terry Ott files a follow-up regarding the law suit in Canada and Arland Bruce.  This is his commentary on the coverage of the issue; all information, illustrations, pictures and links are his.

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DOES CANADA’S TSN, THE HOST CFL BROADCASTER, APPEAR TO BE “CIRCLING THE WAGONS” OVER ARLAND BRUCE III CONCUSSION LAWSUIT AND SUBSEQUENT NATIONAL HOOPLA AND HOOTIN’ AND HOLLERING, OR IS IT JUST A CASE OF, AND NOW, FOR SOMETHING (REALLY) COMPLETELY DIFFERENT?

“It is difficult to get a man to understand something when his salary depends on him not understanding it.” — Upton Sinclair, author of The Jungle

The irony of the American-based Concussion Blog breaking one of the biggest stories about the Canadian Football League in recent memory when it exclusively revealed the first concussion lawsuit in CFL history, is certainly very rich.

Prior to D-Day, July 16, 2014, much of the Canadian sports media didn’t know too much about concussions, and, well, seemingly, they didn’t wanna know too much. Or, as they also mused in the movie Casino, “ah,why take a chance?”

And of course there is that lovely old Buddhist proverb of “see no evil, hear no evil, speak no evil.” Maybe that’s what most of the big time scribblers and jolly jock-sniffers were up to up here prior to the Bruce legal revelation but since most would not even talk to me, how would I really know?

However, after Andrew Bucholtz of the Yahoo! Canada 55 Yard Line CFL Blog gave the story of the Bruce lawsuit nation-wide coverage mere hours after it first appeared here, the story became a talking point throughout Canada for days as well as shaking the previously comfortably cocooned CFL , who may have been alerted to the Concussion Blog post by a trusty and observant friendly just shortly after it went live from Chicago at 12:32 EDT, on July 16.  Continue reading

Filed Claim: Arland Bruce III v. CFL Entities

16 Jul

Bruce

The Filed Claim in its entirety can be found HERE.

You will notice the very wide scope and various Defendants.  Certainly it will have to go through the process up in Canada however, it will definitely get some attention:

Like this from The Toronto Sun.

Or this from Twitter:

I would also like to add the follow video of the Commissioner;

Make of this what you will…

Exclusive: First Law Suit Filed in Canada Over Concussions

16 Jul

Terry Ott has filed this BREAKING NEWS in regards to Canadian Football and the Concussion Issue.  We here at The Concussion Blog are pleased to bring this information to you…  You can find the FILED CLAIM HERE.

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FORMER CANADIAN FOOTBALL LEAGUE PLAYER SUES LEAGUE MEMBER TEAMS FOR CONCUSSION RELATED INJURY

Lawsuit on Behalf of Star Arland Bruce III Alleges “Fraudulent Concealment” and “Negligent Misrepresentation” By 9 CFL TeamsLeague Commissioner, CFL Alumni Association and Others

Contrary to (popular) opinion, the sports press likes to fling incense, be part of the show, create stars, and to that end prints and televises a fraction of what it knows.” -Mark Kram, formerly of Sports Illustrated 

July 16, 2014
Hamilton, Ontario

The first lawsuit brought against the CFL member teams and others for concussion injury has been filed in Vancouver, British Columbia in the Supreme Court on behalf of Arland Bruce  III, a veteran of 12 seasons as a speedy wide receiver who last played for the Montreal Alouettes in 2013 and also starred on two different Grey Cup winning teams as well as spending the 2003 season with the San Fransisco 49rs.

Bruce, noted in the claim as an “unemployed football player,” is the holder of the record for most receptions in a CFL game (16) and is a three-time CFL All Star.

The claim, so far for unspecified monetary damages, asks for general damages, special damages, general and special damages “in trust” for the care and services provided by his family, and punitive and aggravated damages.

In the claim filed by the Vancouver law firm of  Slater Vecchio LLP and lawyer Robyn L. Wishart, it is alleged that Bruce suffered a concussion and was knocked unconscious in a game played in Regina, Saskatchewan on September 29, 2012 between the BC Lions — Bruce’s team at the time — and the Saskatchewan Roughriders.

Bruce subsequently returned to play for the Lions in a playoff game on November 18, 2012 and it is alleged that he was still suffering from his previous concussion and it is also alleged he suffered additional concussive and sub-concussive hits during the  Nov. 18 game.

From a copy of the claim, not proven in a court of law, it alleges in part:

  1.  The plaintiff reported concussion signs and symptoms to the BC Lions medical personnel and coaching staff including but not limited to the following:
    1. fogginess;
    2. headaches;
    3. sensitivity to light;
    4. sensitivity to sound;
    5. memory loss;
    6. confusion;
    7. dizziness;
    8. anxiety; and
    9. personality changes.

After the 2012 season, Bruce left the BC Lions and was signed for the 2013 season by the Montreal Alouettes.

Also from the claim: “Further, despite the fact that the plaintiff was displaying the ongoing effects of concussion to medical professionals  and coaching staff, he was permitted to return to play in the 2013 season for Montreal.”

In a 2011 Yahoo! Canada  Sports 55 Yard Line  article by Andrew Bucholtz,  and so noted in the claim, commissioner Mark Cohon said “I am convinced that every concussion is being reported and dealt with. I trust our  doctors. I trust our therapists. I trust our teams to report that.”

And in the 2011 Canadian Football League  concussion “Campaign” directive to the CFL clubs from Cohon advised to “err on the side of extreme caution” when dealing with suspected concussion injury.

Those familiar with my series “3rd Down, CTE To Go,” for the Concussion Blog in 2013 will recall former CFL player Leo Ezerins, now communications director for the Canadian Football League Alumni Association, and Dr. Charles Tator, of the University of Toronto, Krembil Neuroscience Centre, and the Canadian Sports Concussion Project. 

Both Tator and Ezerins believed there were “more questions than answers” between concussion and brain trauma and that “extreme caution” be used in any subsequent diagnosis of CTE.

Accordingly, Ezerins and Tator are named as defendants in the lawsuit and perhaps the most revelatory allegations — again not proven in a court of law — made in the claim are that Bruce continued to play CFL football after suffering concussion  and sub-concussive injuries because:  Continue reading

Back to Basics: Current Concussion Management

9 Jul

What follows below are recommendations that have been on this blog for many years.  I came up with them when it started in 2010 and not much has happened to change what was written.  In fact, more and more these ideas have been accepted, showing that it was ahead of its time in 2010.

AS ALWAYS: PLEASE CONSULT A MEDICAL PROFESSIONAL FOR A CONCUSSION, USING THIS BLOG ALONE FOR TREATMENT OF A BRAIN INJURY IS NOT RECOMMENDED.

We can discuss rehabilitation from a concussion at a later time, but the theory of this being a spontaneous and passive recovery for a vast majority of incidences continues.  It has been my experience that the “less is more approach” is best with concussions, initially.  Being, that after injury the less you do to stimulate the brain and rattle the brain the better and faster the outcomes will be.  When the injury lingers on beyond 10-14 days (usually due to too much activity in the initial phases) that is where rehab and a more dynamic approach to recovery is needed.

Please enjoy and remember that back in 2010 this was not mainstream nor widely accepted.  I hope that four years later this is commonplace.

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Sport-Related Concussion, Don and Flo Brady (NASP Communique)

INITIAL STEPS

After an initial concussion the individual should subscribe to REST, not just physical rest, but COMPLETE and UTTER rest.

  • NO TV
  • NO Texting
  • NO Computers
  • NO Radio
  • NO Bright Lights
  • NO Loud Noises
  • NO Reading

COMPLETE brain rest, in other words, SLEEP!  This should be adhered to for at least 24 hours or when the medical professional that you seek (and you should) tells you otherwise.

SCHOOL AGED INDIVIDUALS

Rest should be continued until all signs and symptoms have resolved.  Rest in this demographic should Continue reading

SNEER and LOAFING in the CFL: A Sad Trip to Apathy, Amnesia and Animus

19 Jun

Eric “The Flea” Allen

This post is by guest journalist, Terry Ott.  You may remember some of his work posted here previously in the seven-part series looking into concussions and possible long-term issues (you can click on links within the post to read all parts).  With the Canadian Football League avoiding a work stoppage by ratifying a new collective bargaining agreement and play about to begin Ott brings us a follow-up story.

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The Canadian Football League season is set to kick-off on June 26 culminating with the 102st Grey Cup in Vancouver in November. With a new team-the rather unusually named Ottawa RedBlacks-two new stadiums, a recently ratified 5 year collective bargaining agreement between the players and the board of governors that still leaves the owners with a major financial upper hand, and the ever-increasing fan interest in Canada and even south of the border, it would appear the CFL has landed in a cozy albeit modest pro sports sweet spot.

However, there is that not so little matter concerning the past, and especially the future…


Weird Scenes Inside The 110 Yard Gridiron

After my 7 part series on concussions in the CFL appeared at the end of last year, both Concussion Blog founder
Dustin Fink and I both had the same question:Why has the CFL (apparently) not been sued for concussion-related damages? And just where are all the players who played and suffered serious concussions that affected their quality of life after football? How could the CFL possibly be that much different from the NFL?

The CFL has been knocking and sometimes scrambling heads for well over 100 years and yet not a single class action lawsuit for damages due to concussion has yet been filed. It is possible that at some point in the past, singular concussion related lawsuits have been undertaken and settled out of court and bound by confidentiality agreement so they were never reported on but other than that possibility, it would almost appear that the CFL somehow exists in some bizarre twilight zone of brain injury legal non-culpability and/or amnesty. 

Continue reading

It Has Been A Long Time

11 Jun

Hello everyone, my name is Dustin Fink.  I am an athletic trainer and I have created a blog about concussions…  Wait, what?

It has been a long time since I have gotten to this blogging thing, perhaps I needed to reintroduce myself.  As devout readers – that you all are – you have noticed a sharp decline in the publishing prowess of The Concussion Blog.  Thank you for your concern and information over the past few months, it means a lot to me.

I am writing today to simply keep you all in “the loop” when it comes to this space going forward.  The simple answer is that it will remain what it was; a spot for information about the issue of concussion and the issues surrounding concussions.  With a much more active family (three kids getting to the “we go everywhere” age), a welcome increase in responsibility in my main job as an athletic trainer, and simply being more selfish with my time you all can expect decreased frequency of posts from me.  However, there will be spurts of information, commentary and editorials from time to time.

There is plenty to be talked about in this “concussion world” as we currently know it; I plan on doing just that going forward.  Recently I have tried to delve into other parts of this entire Pandora’s Box – attempting to get research published, commenting on research, discussions about being educational partners, lining up speaking engagements, etc.  So, I have not strayed away from this issue, in fact, I feel I have become more aware of things happening in this arena.

If you have followed me on Twitter (@concussionblog) you would have noticed I am not far away.  It seems 140 or less is a bit easier to keep up with.  Thank you for being a follower, supporter and reader.

One thing I have had hammered home to me, very recently, is that people do care what is shared here and appreciate both the candor and experience this space brings.  This ranges from: those affected by concussions, medical professionals, athletic trainers (also a medical professional), press/journalists, students and even the professional sports leagues and players themselves.  It is truly an honor.  Because of this I am going to ramp back up starting this month.

There are exciting things coming to TCB, some exclusive and some in partnerships.  What I am most excited about is being the place that people can comment or even post about things that may cause disagreement or consternation.  Being comfortable allows us to be content and that leads us to my favorite proverb/saying – currently – “If you do what you’ve always done, you will be what you’ve always been.” – Mick Buttz.  If this means rocking the boat and questioning people to create further thought and get away from “group think” then sign me up.

Going forward you can expect some of the following (and much more):

  • NFL Concussion Reporting
  • Educational Opportunities
  • Critical Commentary on Research
  • Guest Blogging/Posting from Critical Thinkers
  • Guest Journalism
  • Partnerships in Communication with vastly different “circles”
  • My continuation of keeping sports – I don’t dislike any sport!
  • My main theme: THE INJURY IS NOT THE MAIN ISSUE, RATHER THE MISMANAGEMENT OF THE INJURY IS
  • My skeptical eye on prevention in the way of equipment
  • My soap box about getting medical professionals to the adolescents – athletic trainers
  • My promotion of new and “outside the box” ways of limiting exposure and management of concussion

We are an outlet for those that would like to get information out not only about concussions but for athletic training.  Feel free to drop a line and bounce ideas off of me.  There is plenty lined up for the next month, but I can always add more!  And buckle up for what is surely going to be a much talked about June-July here on The Concussion Blog!

Thank you again for continuing to visit The Concussion Blog!

General Dentistry Publishes a Bombshell About Mouth Guards (ADDENDUM)

5 May

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

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

The basic fundamentals we should be cognizant of here are: concussion is a BRAIN injury, the BRAIN floats inside skull, Physics dictates that the BRAIN will move depending on the forces applied to the skull/head (not always from a blow to that area), mouth gear cannot stop the BRAIN from moving, mouth gear cannot attenuate any forces to the skull/head that are not in the oral region, mouth gear does nothing for the skull/head when forces are placed on it in rotational, angular, acceleration or deceleration fashion.

Now that we have that all out-of-the-way this is the General Dentistry article I was asked to comment on.  On face value and from a “peer-reviewed” angle it Continue reading

Arizona Concussion Conference – NEXT WEEK

14 Mar

AZ Concussion Conf.

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

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

You can REGISTER HERE.

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

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

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

This is Interesting. Share Your Thoughts

6 Mar

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

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

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

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

Nick Mercer: Recovery is in the Eye of the Beholder

26 Feb

For those new to the blog, Nick Mercer is our only “staff” writer here at The Concussion Blog.  He provides a great layman’s perspective; one from a person recovering from a traumatic brain injury.  If you want to know why he does this – for us and himself – you can read THIS POST.  Thanks Nick for your time and content!

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In recent years, my “recovery” (more on why that word is in quotes later) seems to have gained steam and I’ve noticed more improvement, even though the accident that caused my brain injury occurred over ten years ago. I’m sure there are many physiological and neurological reasons why improvements would take this long, then again, maybe I haven’t improved that much neurologically or physiologically, maybe I just feel better in general and in my attitude toward “recovery”.

For the first nine or so years, I was focusing on trying to fix problems – I wasn’t able to do this or that, I was tired, my vision was messed up – problems that no matter how much I tried to fix, I could always improve upon, so I was reaching for a goal that couldn’t be touched. That kept me going, kept me striving. It also put me in a permanent state of dissatisfaction. There were times, of course, when I was depressed, but there were also times when I was happy. Happy, but dissatisfied.

All the while, I was pushing myself physically, in the pool, the gym, walking to and from work. I was also pushing myself mentally, through work, and through reading a lot, especially non-fiction books. My sister had told me for years that I should try Pilates, that she thought it would be good for me. I always had some excuse Continue reading

Helmet Minutia: What you need to know

25 Feb

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

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

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

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

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

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

24 Feb

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

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

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

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

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

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

Repost: Matt Chaney’s Take on Heads Up Football

21 Feb

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

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

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By Matt Chaney

Posted Wednesday, October 23, 2013

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

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

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

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

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

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

Dear Time and Readers…

21 Feb

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

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

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

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

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

Just keep at it

8 Feb

Eleven years ago my balance and mobility were better than good. My health was better than good. Ten years and seven months ago, I was a long way away from feeling anything remotely close to good about my balance and my mobility, or about my health at all. That was a drastic turn, and it sucked, but it happened. I can’t pretend it didn’t. Well, I could pretend, but what good would that do?

Since most people’s introduction and familiarity with rehabilitation is through movies and TV, it’s important to reiterate that it’s a gradual process. It doesn’t just happen one day that everything clicks and all of a sudden life’s back to normal. Hard work is also not the secret. It’s essential for improvement, especially continuous improvement, but it doesn’t guarantee it. It happened for me. I’ve worked hard and I’ve improved, but by no means am I back to normal. It certainly doesn’t mean that someone, whose condition doesn’t improve, didn’t work hard. I know of countless examples. Movies and TV have to fit a story into an allotted time. If a book is too long nobody will read it. So, most of what people know about rehabilitation is a very 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

2013 End of Season NFL Concussion Report

31 Jan

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

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

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

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

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

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

#C4CT Concussion Summit: 2014 Edition – Live Blog

29 Jan

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

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

Hit Count® Has Come To Fruition

27 Jan

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

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

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

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

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

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

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

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

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

Getting A Bit Fidgety On A “Snow Day”

27 Jan

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

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

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

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

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

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

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

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

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

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

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

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

SLI Press Release Primer

27 Jan

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

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

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

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

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

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

A Hit Count should explore the following guidelines:

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

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

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

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

Terry Ott: 3rd Down, CTE to go – FINAL Part

25 Jan

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE and PART 6 HERE.

It has been my pleasure to post the stylings of Mr. Ott over the past few weeks.  The guy has worked hard on this basically “paying it forward” so perhaps one person will run with the information.  I admire his spirit and “sticktoitivness”, thank you, Terry!

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AND IN THE END…THE CULTURE MUST CHANGE AND/OR THE FALL OF THE FOOTBALL EMPIRE

“In this sort of feminized atmosphere we exist today guys who are masculine and muscular…kind of old-fashioned guys run some risks.” -Brit Hume, Jan. 13, 2014

You know, I don’t really care much for the brand of “news” that FOX espouses and yet this is the second, and last time I will quote from it.

Because what Brit Hume recently said deserves to be discussed. Even though his comments may be a mile wide and only an inch deep and were not referring to the “manly” sport of football, they may in fact strike to the heart of the civil war now going on in pigskin circles regarding concussions and brain injury.

On one side of the debate are what the League of Denial authors rightly called the deniers, and the other side would seem to be the whistle-blowers. The deniers see the whistle-blowers as silly sissy Marry la-la’s trying to wreck football and the whistle-blowers see the deniers as Neanderthal numbskulls, old-fashioned guys well past their sell date.

Perhaps these are the risks that can befall the old guard, the deniers. That of being accused of being out of touch, thick, ignorant of the facts, or worse.

But does that make the whistle-blowers, those alleged soft, girly man, nanny-state purveyors “feminized”?

Well, if it means caring about football and employing common sense in a brutal arena, then sign me up for NOW, now, man.

Because pro football as we now know it is in danger-yes, real danger.

Danger of being law-suited and legislated out of acceptable existence.

And, as I have previously pointed out, shutting up about it is just plain dumb and ensures football will be KIA.

The lawyers smell money – that’s real money – and the government will most assuredly act, and maybe even in a Draconian fashion, if pro football does not get its brain injury prevention and after care act together very soon.

The NFL and their broadcast partners are joined at the hip. For the most part, this ain’t good because neither hand wants Continue reading

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