Archive | Concussion Blog Original RSS feed for this section

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.

About these ads

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!

==========

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);

==========

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.

==========

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);

###

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:

==========

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!

===========

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

Terry Ott: 3rd Down, CTE to go – Part 6 – UPDATED

22 Jan

CBC 5th EstateThis 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.

==========

UPDATE 21:19 1/22/14 – rectified link to CBC The Fifth Estate “Head Games” (see below)

==========

HELLO, IS THERE ANYBODY IN/OUT THEREJUST NOD IF YOU CAN HEAR ME, IS THERE ANYONE AT HOME?

“Now I remember why I gave up speaking to journalists. They are a species of foul vermin. I wouldn’t hire people like that to guard my sewer. Journalists are morons. They’re idiots. They’re ignorant and stupid.” – The late, great, irascible Lou Reed.

Well, up here in the Great White North, the question of (seriously) addressing the serious problem of concussions in the Canadian Football League would appear to be a deaf, dumb and blind one, boy.

Or, maybe as popular as baked beans on a bus trip.

For whichever way you want to turn this thing loose, up here, it’s locked up, tight.

As I’ve written before in this series, although there has been some pretty good reporting, especially by the CBC where on their website they still carry many reports and videos about concussions, about the only report on concussions and the CFL’s role that I can find is a 2008 CBC Fifth Estate report entitled, “Head Games.”

Below is the web promo, description and link but that link does not work. (The Concussion Blog originally linked to this report several years ago when the link did work.)

CBC The Fifth Estate – “Head Games” broadcast in 2008:

“They have been called the greatest football team in the history of the CFL — the Edmonton Eskimos of the 1970s and ’80s that won five consecutive Grey Cups. But, for some of the star players on that team, the years of triumph ended ingloriously in early deaths, from heart attack, suicide and misadventure. The tragedy of those early deaths was often compounded by alcohol or drug addictions, probably caused by another, less visible, killer. Recent research by neuroscientists now shows the link between on-the-field concussions and brain damage; a permanent injury that can lead to depression, suicide and severe aberrant behaviour. The damage is so profound, the researchers say, that post-mortem examinations of the brain tissue of five former professional football players can be compared only to the tissue found in the brain tissue of advanced Alzheimer’s cases.” CBC The Fifth Estate – Head Games

This 2008 report was actually ahead of its time, and again, the only one that I know of that cornered the CFL and asked some tough, prescient questions. The former commissioner had that old deer/headlamps face a few times and newspapers at the time took a toot but then everyone went back to a snore. Comfortably numb.

But now, there is a proviso on the Fifth Estate website advising thatprior programs from 2003 were inadvertently re-posted in 2013 and therefore, contact customer service, yada, yada, yada, and blah-blah.

Yet interestingly – I said interestingly - the only Fifth Estate link that I could not get to work was…TA DAH: Head Games.

I am alleging nothing-although I may later sort of spatially speculate-but there are some conspiracy theorists out there who are very suspicious.

One of them is Phil Colwell, the former CFL running back who Continue reading

Terry Ott: 3rd Down, CTE to go – Part 5

15 Jan

MIPSThis 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.

IS “MIPS” A FOUR LETTER WORD AND (Every)THING YOU ALWAYS WANTED TO KNOW ABOUT SNAKE-OIL*

*But were unaware to ask

“The cold truth is that football players are in jeopardy.”  – Bill O’Reilly, he of the No Spin (End) Zone, Jan. 8. 2014


The Concussion Blog supremo Dustin Fink once mused to me that football, in its infancy a hundred years ago or there about, was meant to be played by (slower) men about five foot nine and weighing an average 150 pounds or so and at a time when a 200LB plus player was basically a monster, a freak.

You can appreciate the Dustin statement inference by referencing high school physics in that net (G) force equals mass times acceleration and also appreciate that now, with players routinely 50-150 pounds heavier then when the first Roosevelt was in the White House, and many now with world-class speed, the G forces generated on impact by today’s pro and college football players are exponentially greater than in Knute Rockne’s days and the resulting collisions on the field can be life threatening in the short, and long-term.

Life in big-time football today is both Darwinian-only the strong survive, and if lucky thrive, and inherently  Hobbesian-nasty, brutish and short.

But since literally millions of boys and young men seek football playing dreams, what to do?

Well, since just about all aspects of football equipment has undergone a radical revolution-footwear, pads, uniforms, gloves and eye protection-how about an update on the most important piece of football gear-the helmet.

A little history lesson: President and Rough Rider Teddy R was a big football fan, and when 9 players died in 1913 as a result mostly of skull fracture injuries, he, along with Knute Rockne advocated for a shift from three yards Continue reading

The OTL Investigation on ‘Heads Up’ Football

14 Jan

It may have slipped some of your reading or viewing, but ESPN’s Outside the Lines did a piece on the USA Football Heads Up Program.  The article and video were presented last Sunday morning – I cannot find a YouTube version of the OTL show but you can find that part HERE.  The seven minute presentation is great for a quick overview of the issues ESPN has found.

For more in-depth coverage you should read the article by Steve Fainaru and Mark Fainaru-Wada, the same authors that penned League of Denial.  There are some wonderful points brought to light by the Fainaru’s;

The program teaches concussion awareness and proper helmet fitting, but its central tenet is the soon-to-be trademarked Heads Up Tackling program. When executed properly, proponents say, Heads Up Tackling literally takes the head out of the game. Players are taught to keep their heads up and lead with their shoulders when tackling.

[...]

But critics view Heads Up as a cynical marketing ploy — a repackaging of old terminology to reassure parents at a time the sport is confronting a widening health crisis.

There is a reason I have been “relatively” quiet on this topic; it’s because they are doing some very good things in the way of education and helmet fitting.  As you may know I am huge on the topic of awareness when it comes to concussions.  I have stated many times that the injury itself is not the “ice burg we can see above the water” rather it’s the mismanagement of the concussion that is the massive ice chunk we cannot see from the surface.

That being said, with the actual tackling technique being taught I too feel this is a repackaging of an old mantra.  Rules were even put in place as early as the 70′s to accomplish this task of taking the head out of the game.  Face tackling, spearing and butt blocking all have been on the books as penalties to help avoid using the head as a weapon.

The problem being that those are not called very often, when they are called they are inconsistent at best, and what has it done for the game over nearly 40 years?  I am not nearly as critical as others;  Continue reading

Terry Ott: 3rd Down, Absence of CTE to go – Part 4

6 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.

THE CURIOUSLY TITLED AND ENIGMATIC BRAIN STUDY, AND THE SEEMINGLY RHETORICAL QUESTION OF ’14

“We can’t solve problems by using the same kind of thinking we used when we created them.” –Albert Einstein, who knew a thing or two about brains.

Dr. Tator: Not absent

Dr. Ann McKee, professor of neurology and pathology and co-director of the Center For The Study Of Chronic Traumatic Encephalopathy at Boston University once mused in a television interview that she wondered if most if not all professional football players had some degree of CTE.

After all, the brains of former football players examined by the Center so far has found the existence of CTE was near one hundred percent.

Whether one agrees with the now famous Dr. McKee in totality regarding the prevalence of CTE in former players, her and her team are world-class doctors and researchers who have brought the serious issue of football related brain trauma into the collective consciousness of tens of millions of observers.

Most believe that the BU work on CTE was the main catalyst for the National Football League to eventually in 2009 admit that there was a cause and effect between football play and CTE and was also the key preponderance of the evidence that made for a 765 million dollar settlement between the league and former players who claimed neurological damage from playing football.

Here in the Great White North, Dr. Charles Tator, of the University of Toronto, has been referred to as the grandfather of brain research and sort of the Canuck version of BU-like CTE research.

Dr. Tator, a neurosurgeon, originally specialized in spinal cord injuries, but was leader of a study of the brains of 6 former Canadian Football League players that was published in May, 2013.

Despite the fact that Dr. Tator’s study found a fifty percent incidence of CTE among the subjects, the study was entitled “Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatically”

The detailed study places much weight on the small number of brains Continue reading

Thank You! Good Luck Going Forward.

1 Jan

The reason for this post is simple; Thank You!

To the reader, the commentators, the links, the views, the emails, the tweets, the everything.

When this blog started in September of 2010 I had no clue.  No clue on what I was doing.  No clue on how to write.  No clue on the audience.  No clue on if it would impact anyone.  No clue if it would last.

If not for all of you on the other side of this screen, none of this would have happened.  In terms of bandwidth and views this blog is very small compared to the juggernauts of the interwebs, but over time it has had place and a voice.  Not only for me, but for you.

I could sit here and spew the stats, the accolades and such but, why?  There is no need, this blog was never founded on that or is continued for that.  This blog is a space for information and opinions from an athletic trainers perspective about concussions.  Looking back on the “Disclaimer” page I wrote over three years ago I feel I have attained what I wanted to accomplish and WILL CONTINUE TO PURSUE.

So, as you ring in 2014 let us all try to make this the best year yet!

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

31 Dec

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.

LEAGUE OF NON-DENIAL, DENIAL HEARS, SEES NO EVIL or KNOCKED OUT, LOADED

QUESTION: Could the Canadian Football League receive and survive a class action law suit brought on behalf of former players suffering from football concussions and related brain injury?

ANSWER: Later.

This year, when the Canadian Football League’s director of communications, Jamie Dykstra, declined to answer what he termed my “loaded” questions about concussions and how the CFL was going to address them, I told Jamie it was unfortunate and that I would have to note the league’s silence in my story. “I know,” he said.

So, I am, noting it, that is. Because, to reference some other talking heads, this ain’t no disco; this ain’t no foolin’ around.

To reiterate, my questions, posted on the Concussion Blog earlier and condensed here concerned among other things, whether baseline testing info from the teams was shared with the league, whether the CFL was looking at any new helmet technology such as MIPS and would the CFL, like the NFL in 2009 confirm that in some cases, a causal relationship between football concussions and brain injury was a possibility.

Even after I appealed to Dykstra that hitting the mute button on such an important issue seemed, well, just wrong, and that my questions were not exactly League of Denial serious as a statement of claim or heart attack, he replied that “we (the CFL) are well aware of what is going on.”

I certainly hope so, yet being “aware,” and actually having a prescient policy would appear to be two different things.

Before Dykstra stopped talking, he had earlier forwarded me some pretty white-bread CFL concussions protocols and when I picked at its crust, was told the league’s policy was “organic.”

Far out. Nice, sexy, trendy new-age word Jamie, but what does it actually mean in the real, sometimes savage head knockin’ world of Canuck pro football?

Since the CFL won’t tell me, let me introduce to you a number of quite plausible if not certain “organic” scenarios for what in some ways seems a Darwinian policy.

Unlike the NFL, the CFL right now Continue reading

2013 Week 16 NFL Concussion Report

27 Dec

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.

This is the last set of numbers I feel most confident about, as you will recall this coming week has proven to be difficult at best when finding concussions in the NFL.  Rather than boring you in this post with the reasons please click on the link above for that information.

In Week 16 there were only 13 concussions found, I say “only” because it seemed to Twitter, broadcasts and me, there were more players that exhibited something on the field that warranted further investigation.  The skeptic in me is also screaming at me to say that playoff eligible teams – especially those that have not clinched – are “gaming” they injury system.  To be fair, concussions are not the only injury being messed around in the “grey area”.  As I said that is the skeptic in me, the recent weeks have placed some better faith in the reporting system this season.

Something must be done to address – at the least acknowledge what we have found – the massive back-end of the season concussions we continue to see on a yearly basis.  The numbers cannot be easily washed away with the narrative that all teams are playing (versus bye weeks) as we have exposed.  It is very stark, the difference: weeks 1-9 there were 67 concussions in weeks 10-16 there have been 92.  When the NFL talks of expanding the schedule to 18 games I fear we will see an even bigger increase in the back half of the season.  There is a possible solution (more of a band-aid) though: two bye weeks.  It will expand the season further, but I don’t think the NFL really minds, in fact I think that is the overall goal.

Further observations of the numbers show the perpetual story of defensive backs being concussed most often.  As of this report the DB’s make up 26% of all concussions (41), the next closes it tight ends at 14% (22).  In fact, running backs (17), wide receivers (21), offensive lineman (21), linebackers (16) and TE’s are somewhat equal.  Even the defensive lineman are close to that grouping with 13.  Making all positions on the field outside of quarterbacks, DB’s and P/K somewhat equal in terms of the injury.

While we would like to see as few as possible, if concussions were equal across all positions (outside of QB, P/K) it would show that the injury is becoming a random incident.  Which is really the best case possible.  However, its not and the DB’s continue to be the most at risk players on the field, yet they also have some of the most restrictive tackling rules in place.

Now let us look at the Week 16 report (previous weeks numbers): Continue reading

The Abyss of NFL Concussion Reporting: Week 17

27 Dec

As football fans we are either gearing up to root on our favorite teams for a playoff and hopeful Super Bowl run, or the other 20 fan bases time is now spent looking at coaching changes, player acquisitions and the draft.  It has been a fun and exciting season for various reasons.  In terms of concussion data collection it will complete our fourth year and it has been a success once again.

However Week 17 provides for some of the hardest data capturing possible for the NFL.

During the season when teams play the following week they must report injuries and then they are listed on the NFL Official Injury Report prior to the game being played.  This mechanism, even with its overt flaws, is the launching point for our data.  With the regular season ending there are only eight teams that must report injuries the following week, effectively eliminating 3/4′s of the league.

This where you the reader can come in – and I am once again doing my yearly begging – if you note a concussion via a broadcast or twitter or the interwebs, please pass it along to us.  Although @nflconcussions does a tremendous job, he too probably welcomes the help.

So here is your homework for Week 17:

  • Watch games and enjoy games – root on your interests
  • If a concussion is noted send it via Twitter (@concussionblog) or email (theconcussionblog.comcast.net) in this format:
    • Player, Team, link/credit/notes
    • EX: Joe Schmoe, NYG, broadcast 3Q
    • EX: Joe Schmoe, KC, @examplehandlehere *link*
    • EX: @concussionblog RT: @examplehandlehere ……
  • I welcome any questions regarding the concussions during the games, but unless I catch it on RedZone or you have a video link I will be unable to answer to specifically.

Think of this as “OUR” project for the end of the NFL season, crowd sourcing style!

Thanks in advance.

Terry Ott: 3rd Down, Absence of CTE to go – Part 2

27 Dec

This “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.

==========

THE LINEBACKER’S HEAD GAMES

Article 19 of the Universal Declaration of Human Rights, adopted in 1948, states that:

“Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.”[6]

———————————————————————————————-

Former star CFL player Leo Ezerins was a ferocious linebacker through the 80s and won a Grey Cup while playing for the Hamilton Tiger Cats in 1986.

In that game, in which Hamilton was in some sports books a 22 point dog to the vaunted Edmonton Eskimos, Ezerins and company absolutely stomped and annihilated  the Eskimos, a seek and  destroy mission that in the first half forced half a dozen sacks, several forced fumbles and recoveries and a total offense by Edmonton of basically, nadda.

Here, are some highlights:

Ezerins was perhaps the 80s CFL’s answer to former Pittsburgh Steeler wild-man and Hall of Famer Jack Lambert, taking no prisoners and showing no quarter on the gridiron.

And right now, Leo is not too happy with me. I kinda feel bad about that, and here’s how it happened.

You see, Ezerins is currently the executive director of the CFL Alumni Association which boasts around 1000 participants.

The Alumni Association attempts to bring former players together in friendship, events and sometimes even modest philanthropy. Some members have been directly involved in examinations of former player
health and safety issues as well, including concussion research. Obviously, the CFL Alumni does some good work.

And so last October, I sought Ezerins out via e-mail, inquiring as to Continue reading

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

Follow

Get every new post delivered to your Inbox.

Join 7,141 other followers