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This Is Unacceptable, In My Humble Opinion

24 Oct

Yesterday I wrote about concussions and the difference between professionals and adolescents using Jamaal Charles as an example.  What happened last night on the professional field with millions watching was completely unacceptable, professional athlete not withstanding.

Late in the third quarter of the game, last night, San Diego’s defensive back Jahleel Addae (#37) ran into a pile to finish the tackle on the Denver running back.  He was running at full speed and led with his left shoulder, but as he made contact with the RB his head dropped and he also made (incidental) helmet to helmet contact with the runner.  This type of collision is very frequent and looked innocuous…  Until you saw the after math…

Addae was bounced back, still on his feet, and began “short circuiting” for the national audience to see.  He begins to look around, kind of, and stumble, kind of, and lose full control of his extremities, all of them.  As a medical professional and athletic trainer I would have documented this OBJECTIVE finding as “unsteadiness and disorientation”.  It looked like a boxer/MMA fighter catching a fist/kick in the face late in a boxing match; the type of reaction that any referee in those sports would stop a match for and award a TKO to the other guy.

It happens from time to time in this and other sports, that is not the issue here.  The issue is that Addae returned to the game (oh, it gets worse).  Here is the tweet from last night (h/t to Brady Phelps’ Vine);

https://twitter.com/concussionblog/status/525487638481235968

From what I can piece together this play was the last of the 3rd quarter and reports had him taking the field on the first play of the 4th quarter.  HE DIDN’T MISS A SINGLE SNAP!  Even with the long commercial break between quarters there is a maximum of 4 minutes, but if my DVR time was correct it was between 2 and 3 minutes.  This is not nearly enough time for a full concussion evaluation, by anyone.

“Maybe he was screened, like you said yesterday, Fink.”

There was absolutely no reason for a cursory “screen” in this situation, Addae showed a clear and overt sign of neurological impairment, in concussion recognition jargon: a sign.  When any player shows a sign there is no screen it means Continue reading

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Jamaal Charles; No Different Then Vast Majority of Competitive Athletes

23 Oct

Last week when the Chiefs played the Chargers running back Jamaal Charles scored a touchdown and was blasted in the end zone by Brandon Flowers.  A shot that Charles bounced up from and headed to the sideline while Flowers was slow to get to his feet.  The hit was helmet to face mask and the resulting forces were a classic case of what is typically needed to produce a concussion for one or both of the players.  Whether or not it actually did, we will never “officially know.”

The issue is not with the hit or the fact that Charles apparently cleared the screening done on the sideline after such a hit, the issue is with his comments a few days after on the Dan Le Batard show;

“It definitely hurt,” Charles said. “A couple plays later, I just [saw] this light buzz around my eyes and I was trying to catch ‘em. But I was like, ‘Let’s get the ball and run again.'”

I am 100% confident that Head Athletic Trainer Rick Burkholder did his job on Sunday – screening Charles after the hit – it was evidenced on Tuesday/Wednesday when Burkholder placed Charles in the protocol as a precaution solely due to the comments Charles made.

Why you may ask?  Simple, by the absolute letter of the definition of concussion – disruption of normal brain function following a traumatic event – Charles admitted he was “not normal”.

Whether or not Charles had a concussion is up for debate among many people, not only externally – us blogging/media type – but likely internally – Charles and med staff.  Here in lies the problem with concussions and the issue of concussions.

As we tried to explain in the University of Michigan post, concussion is most often a subjective injury, we as medical professionals rely upon the athlete or injured to tell us what is going on.  If there are no overt or outward signs (loss of consciousness, wobbliness, gaze, vomiting, etc.) then all we can do is screen the athletes.  And by screening I mean simply asking the athlete if they are OK.

GAMING THE SYSTEM

I heard Mark Schlereth on Mike and Mike this morning saying something to the effect of; “there has to be more than just asking the player if they are ‘OK’?”.  The truth of the matter is that there is not really anything other than that; although just asking one question is not due diligence.  In my experience I ask more questions and even try to trick athletes into giving up any ruse they are trying to pull on me.  I have a to questions and line of questioning that has produced many responses that then warranted them to be fully examined with a sideline evaluation, even for the best “liars” (I won’t share them here because it can be used for people to study and then find a way around it).

The more complex yet simple reason we as athletic trainers feel confident with screening, even with limited questions, is that we know the athlete.  Their usual demeanor, behavior and general presentation.  People often ask me how long it takes me to know if someone has a concussion.  When they are my players, the ones I am around on a daily basis, usually it takes me Continue reading

Terry Ott: Concussion Coverage from Canadian Media is Woefully Lacking

22 Oct

The original purpose of The Concussion Blog was – and still is – to inform those that choose to look about concussions.  Part of this goal has been looking deeper into issues and “lip service” given to the brain injury we know as concussions.  In 2010, when the blog began, this was a novel idea and much of what was written here was “breaking news”.  Along with that, opinions that I shared on the issue were meant to be coming from someone with vast and dynamic experience in concussions.  The initial thought was this was to be a “clearinghouse” for concussion information – and it succeeded.  As years have passed and the media here in the United States has slowly caught on and passed along, mostly, the correct messages TCB has been slower.  However, that does not preclude us from posting information/opinion that we feel needs noticed.  Examples of this have been our white paper on NFL Concussions, the mouth gear controversy and general editorials on published research.

In the past year TCB has been lucky enough to have a journalist spend his own time investigating a part of the global concussion story, in Canada.  Terry Ott, as you may have noticed many of his articles here on the blog.  To be clear, this was all his work and I have become his one and only outlet for his sleuthing and writing.  As he can attest to I don’t always agree with his tact or his tone, but his information is important, especially because in Canada there seems to be a void in the information that would be important to most.  We here at TCB are glad to file his reports as long as he and others understand this is a conduit for discussion and discovery.  I have zero intention of “killing a sport” or “getting someone in trouble”, rather shedding light on some of the problems and issues we face when dealing with concussions.

All of that being said I present to you Ott’s latest (hopefully last here because someone in Canada needs to pick him up) on the concussion issue as it relates to the Great White North.

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WHEN IT COMES TO FOOTBALL CONCUSSIONS, CANADIAN MEDIA BADLY OFFSIDE

Recent New York Times Article Throws Flag

Hamilton, Ontario

October 22, 2014

For the past year readers of The Concussion Blog have learned about the nascent football concussion awareness movement going on in the Great White North, mostly pertaining to how the Canadian Football League, and the mainstream media, have handled-for lack of a better word-the issue.

Years behind the National Football League on the matter, the CFL nonetheless saw the first concussion-related lawsuit come its way last July, accompanied by media attention, much of which was a critical and sometimes downright hostile questioning and smack-down of former 2013  CFL’er Bruce’s groundbreaking statement of claim against the nine member teams of the CFL, neurosurgeon Dr. Charles Tator, Tator associate Leo Ezerins, and several other parties.

The lawsuit, among other things, alleges that the CFL member teams, and specifically some of Dr. Tator’s published research on TBI and CTE-partly funded by the CFL-mislead Mr. Bruce into believing he was not vulnerable to serious and long-term consequences from concussions he received while playing for the BC Lions. None of the allegations have been proven in court and Tator has filed a defense-covered here previously-that asks for the suit against him to be dismissed, with costs.

Yet other than one small article on former 80s era CFL player Phil Colwell, whose brief story and concussion-related problems appeared in his hometown KW Record paper in Ontario, last spring, your correspondent has been unable to place a single word in any other publication in Canada.

If it were not for Andrew Bucholtz of the Yahoo! Canada CFL 55 yard Line Blog sometimes linking to my stories here, few outside of the Concussion Blog’s sphere ever would have known about what did, and what continues to go on in Canada regarding football concussions and especially, their aftermath. Besides a small mention in the Vancouver Sun by journalist Mike Beamish when the Bruce story hit, no one in Canada besides Bucholtz saw the story as important enough to follow-up, and he has done fine work on his own regarding the concussion problem. As of now, I don’t believe Andrew is on many CFL General Manager or team PR weasel Christmas card lists.  (TSN, the CFL’s television carrier did do a piece on their website about the lawsuit in September that mentioned The Concussion Blog, but it was subsequently removed from their archive shortly after my last story for this site last month, and for reasons so far presumed, but actually unknown at this time to this writer. And I have not seen another story in the Canadian media on the lawsuit since.)

And a week ago, after reading in the Winnipeg Free Press a flattering tome on Dr. Tator from last July that appeared just before he was named as a defendant in the Bruce lawsuit, your correspondent reached out to the paper inquiring whether they would entertain a slightly different take on Tator’s research and related concussion issues via an Op-Ed.

However, after being ping-ponged back and forth between editors at the paper, I was told by an Op-Ed editor that the concussion issue was not “topical,” despite the Jevon Belcher CTE story breaking that week and despite the fact that Winnipeg is home to a CFL franchise. But rather, I was informed,  “Ebola” was of more import to their readers than what is essentially a real world and serious public health concern right now that surely can not be adequately explained by just one or two opinions, opinions which are even controversial within the medical and research community.

Likewise a kiss-off from my hometown CBC News website, whose editor, after some initial back and forth, just stopped responding to my e-mails and never published a piece I wrote on concussions in July even though it partly concerned the former Hamilton Tiger Cat, Phil Colwell.

TVO, the Canadian version of PBS, runs a show called The Agenda-and hell, the guy that hosts it has Hamilton roots!-that never met a contentious or important issue it did not glom on to and yet after receiving one return e-mail from a producer back in July commenting on my “unique” insights, I never heard another word.

Even the nice gal who runs TVO’s documentary film division, after initially offering to ask around if any of the filmmakers she had association with would be interested in the concussion story, none of my further e-mails were answered.

And, after being shut-out by nearly every institution purporting to be doing valid research into football concussions in Canada, I endured a recent 6 week runaround afforded me by the University of Western Ontario in London, Ont. which is supposed to be “partnering” with the Canadian version of the Sports Legacy Institute, but certainly did not do much for their reputation for cooperation with journalists trying to ask valid questions.
So after over a month of BS and excuses, I got nadda from them. I actually felt bad for the PR lady who drew the short stick to deal with me, and then she just stopped responding altogether.
To say that some of my dealings with the Canadian media and medical academia would be a joke, would only serve to denigrate comedy.

So obviously, the question is, why?

A veteran of the sports medicine community in Canada speaking on condition of anonymity said that many in the medical community were “afraid” of upsetting Dr. Tator, who carries much weight in medical academia and research grants around these parts.

The source said that many in the closed community are “buzzing” about Tator  being named in the Bruce lawsuit but do not want to be featured in any story seeming to critique the doctor the TSN story described as “renown.”

However, the New York Times apparently does not have a problem featuring a different Canadian medical professional who, unlike Dr. Tator, does not believe CTE  from football concussions is still open for (serious) debate.  Continue reading

Constantly Learning and Watching: There is a Time to Act

16 Oct

It has been a truly busy season – in regards to injuries – where I perform my “day job”.  I was going over some records that I keep and this season has been the busiest in my 15 years.  In fact, when discussing with peers they too have had a high volume of injuries in the training room.  I would say it is karma; last season we were as slow as I could remember.

Part of what I do in my job is to evaluate the injuries and determine if there are any that could have been prevented.  Certainly preseason preparation – weights and conditioning – is a huge factor and we did that here, but there is always a place to learn and watch to make adjustments.  In reviewing the injuries (over 50 – not all concussions) I’ve encountered that required medical care beyond the athletic training room the results were “good”.  Only three were incidents that I considered “preventable”, one of which I posted about weeks ago. That is less than 10% of injuries that could have been prevented, which is good, not great, but good.  In years past I have seen numbers as high as 25-30% of injuries that I deemed “preventable”.  I take pride in doing my job and if I can prevent every single incident and only have injuries that occur on a “random” basis I will take it (has yet to happen in my 15 years).

Before we go further, I would like to give a glimpse into how I review injuries.  We will use a tib/fib fracture we had this year; this player was injured in a game and to me that is “un-preventable”.  However, a few years back we had a tib/fib fracture that occurred in practice – a practice with only “uppers” on and players were not supposed to take anyone to the ground – that incident was considered “preventable” to me.  If players and coaches were vigilant to the rules of practice that player would never have been rolled up on during a tackle.  Concussions are similar…

I feel that concussions can be “prevented” in practice with contact limits and proper technique during drills.  The other two incidents, thus far, I deemed preventable occurred in practices and were concussions.  One player was hit by a teammate during a non-contact soccer drill as a “joke” and the other did not use good judgement and ran into a pile and was rocked.

The take home here is that most injuries are part of sports and we must accept this.  Also, athletic trainers have much more to worry about and analyze than most think.

All of the observation and learning also pertains to return to play; whether that be orthopedic rehabilitation or concussion return to play protocol.  We, as athletic trainers, must express our voices when there is something going on that is a player safety issue.  This can be as simple as modifying team warm-ups all the way to the case I had yesterday.

One of the concussed kids was on his final step for RTP (full contact practice), he is Continue reading

Terry Ott: Canadian Concussion Law Suit Begins Its Slow Crawl To Resolution

23 Sep
In July this blog broke the news that Canada was facing its first law suit based on concussions in their professional football league.  Since that time there has been plenty of information, misinformation and general commentary about this issue in Canada.  The fact remains that this is a long way from getting settled, if you remember correctly the concussion issue in America took over a year to get “settled” and even now it is not completely final/finished.  Although there has been coverage in Canada (which has limited this blogs need to post/present about it) Terry Ott continues to beat the trail and get information to  present in his unique way.  With that backdrop I give you Mr. Ott’s latest filing…
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DEE-FENCE!
“Absence Of CTE” Doctor Files Defense in CFL Arland Bruce Concussion Lawsuit, But Claims to be “Outside The Knowledge Of” On Many Relevant Concussion Issues
HAMILTON
September 23, 2014

Just as it was a long way to Tipperary, it is surely a long way to go before the Arland Bruce III concussion lawsuit against the CFL, its member clubs, CFL Alumni director Leo Ezerins and Dr. Charles Tator and Krembil Neurosciences Center (KNC) ever comes close to a courtroom, or even any kind of resolution.

However, the legal equivalent of a punt has begun, and court documents obtained for this story provide for a very interesting if limited insight as to what can be expected in this first of its kind case in Canada.

On Sept. 10, the Vancouver BC firm of Harper Grey LLP, and attorney Nigel Trevethan filed a defense on behalf of Dr. Charles Tator,  denying or described as “outside the knowledge of the defendant” all but three parts of Bruce’s claim, only excepting that:  1. Tator is affiliated with Krimbil, 2. the KNC is based in Toronto,Ont. and 3. that Dr. Tator is the director of the Canadian Sports Concussion Project; these are the only facts that “are admitted” in Bruce’s 47 page statement of claim.

And while much of the above is pro-forma legal to-and-fro tiddlywinks, some of the “denied” and “outside the knowledge of the defendant” defenses as described in the Tator response to the civil claim are, ah, questionable to this reporter. (See attachments provided below.)

For instance, according to the filed document of defense Dr. Tator denies that he knew or should have known that:  Continue reading

2014 NFL Concussion Report: Week 1

13 Sep

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).  You can also view our white paper with original research about concussion reporting in the NFL from 2010-2012 HERE.

It is always interesting to see what the first week will reveal in the way of concussions.  In the past we have had significant numbers (2012 – 12 and 2011 – 9) and we have had strangely low numbers (2013 – 5).  During the first three weeks all teams are playing games – no byes – so, we should expect “larger” numbers because there are more players on the field.  However, it should be noted that it is also very early in the season and the speculated cumulative effect of repetitive brain trauma has yet to take hold.

Over the past four years we have seen a steady incline in reported concussions each week with a spike around weeks 12-14, it will be worth following and noting as we go along.  Our 2013 End of Season Report.

Other than that, I did not notice any other newsworthy incidents – well we did notice that Arizona had a concussion after going entire preseason without one – in fact I would say the conversation on broadcasts and in print were very much proactive, in terms of the injury.  I sensed a lot less “pussyfooting” around with the term concussion and the evaluation of the injury.  We really need this to continue.

Now is the time for the Week 1 recap of concussions (will indicate previous week);  Continue reading

2014 NFL Concussion Report: Week 0

4 Sep

Sq 300 JThe 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).  You can also view our white paper with original research about concussion reporting in the NFL from 2010-2012 HERE.

It is 2014 and The Concussion Blog’s fifth year collecting concussion data from the NFL.  By now – I hope – you have read our original research about what we have done (can be found above by clicking “HERE”).  In that white paper you will see how data is collected and what we have noted to this point in data crunching.  It is obviously our hope that we can get more numbers and refine what we know.

Week 0 represents the end of the preseason; as you have noted we don’t do much than provide a quick glance at what happened on our way to the start of the season.  There are a myriad of reasons we don’t “crunch” the numbers like regular season.  The biggest is that there is not a standard reporting system in place for the teams – to the public – like that of the Official Injury Report of the NFL.  Regardless, with the better awareness and access (looking at @NFLConcussions) we can get better numbers in a preseason.  For example, when we started collecting data in 2010, we could only find FOUR preseason concussion, ONLY 1, 2, 3, FOUR.  This year there has been 68 found; quite the change.

The answer to your next question is, no.  No, concussions have not risen that drastically in five years.

It is our plan to bring to you a concise weekly update of the numbers, using your capture points for you the reader to make of it what you will.  However, going forward you should look for the following trends:

  • Does the Tight End continue to be the most prone to concussions
  • Will reporting numbers increase
  • Will the trend of defensive players being concussed remain constant
  • Will there be another uptick in starters being concussed
  • Will any rule modifications make a change in numbers
  • Will there be “creative titling” for head injuries (see stingers and concussion-like)

Again, it is not our agenda to create a “gotcha” for the NFL or any league, rather we would like to see a true baseline of concussions in the NFL.  So, we can truly see the effectiveness of all the changes being implemented.

Here is the snapshot of the NFL concussions from the preseason:  Continue reading

Concussion Trends 2010-2012; TCB Original Research

26 Aug

The National Football League is nine days away from the kickoff of its regular season.  If social media, fantasy sports, and hype are any indication 2014 is set up to one of the most watched seasons in history.  There are plenty of story lines abound: from each division, to playing time of newly drafted players, to veterans returning from injury, and of course concussions.

The league is doing its best to keep concussions from overriding the game itself, as they should be.  Concussion is but just one of a myriad of injuries sustained in the sport; plus it is not unique to just American Football.  However this issue continues to gain/keep traction because of the relatively late and “slow-footed” response to this topic.  Even though the settlement with the players has been all but signed-sealed-delivered (there are some interesting issues posed by Patrick Hruby that are worth noting), the youth arm of the league is promoting and teaching a “safer” way of tackling, and the talking points about this injury are becoming more evident from players and the league; there still is a shroud of secrecy.  In all the hand-wringing and court battles and public relations scuffles the leader of this glorious sport has yet to “rip the band-aid off” and assess the situation.

How can you assess the situation?  I think it is rather simple: gather data to find out the “true” value of actual concussions sustained in the NFL over a season.  Then and only then can you see if any changes brought forth are actually helping the cause.

Sure the league has its own data and is probably doing just that, but it is so far behind a curtain, tucked in a corner where light has no chance of hitting it.  I have always thought we should be transparent on this issue; or at least have a truly (Pollyannaish) independent data collection group for it.  At the very least an Ombudsman should be hawking this situation, for this is not going to go away over night.  It won’t go away until we can definitively say ‘X’ is the way to play this game with ‘Y’ & ‘Z’ at the professional level; then each subsequent level below the pro ranks need to modify based upon age and development.

The NFL probably doesn’t want this responsibility for it comes with some liability, not only on the medical front but in the public relations department…  SO WHAT!  When I chose to have a child I didn’t have the choice to be a role model and change the way I played life in order to make sure my children grew up safe and learned a better way to live.  The NFL is basically the “father figure” for the other levels of this great sport.  I have heard a great saying, it was applied to business in general: “the tree rots from the top”.  This is exactly the case in a family, in a business and in sport.

When the blog began in 2010 there was no way to find out how many concussions were occurring in the NFL without Continue reading

#tbt Mouth Guard BS Research!

21 Aug

This was originally posted in May, not a long throwback, but since football started I have been hit up with this question a lot.  So here is the “truth” about this research.  I love the effort and attempt to find a reason; however when you have a critical and FUNDAMENTAL flaws then present it in a way that could be considered fraudulent I have a major problem.  I would also like to add that this research has not been pulled by the publisher.  This is exactly how we get in trouble, the Academy of General Dentistry needs to address this, now, as this peer-reviewed “science” is getting run in media…

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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 seems all good.  A significant finding between custom mouth gear (noted as LM MG in article) and over the counter “boil and bite” mouth gear (noted as OTC MG).  However once you take a deeper look there are some peculiar problems, in my humble opinion – that comes later.

First, we should look at the possible limitations of this study that seems well populated and well thought out (honestly these were my first concerns before finding the real issue):

  • Were the injuries controlled for by football position? (we have documented this issue here)
  • Were the injuries controlled for by size of players/school they were playing?
  • Were the injuries controlled for by playing time? (more exposure more risk)
  • Were the injuries controlled for by game vs. practice?
  • Were all the injuries seen and recorded by a single MD or was it the ATC at each school?
  • Did any of the players have a previous history of concussion?
  • Was the study controlled based on practice habits of the teams? (do some hit more than others)
  • How do we know that every player complied with the “no wedging or chewing” rule? (this plays a massive role later)
  • The study says that all 412 subjects wore the same exact helmet, I find that: A) hard to believe and B) was the fit on every player the relatively the same?
  • Who funded this research? (no disclosure)

As you can see there is a litany of reasons I would have dismissed this research, if I were peer reviewing because those limitations are extremely real and realistic to control for in this type of study.  I wrote to the public relations group handling this research and was unable to get a straight answer on those questions I raised.  In the meantime I sent out the article to some better than average “stat nerds” and awaited a response.

While waiting I noticed something really troubling, as in a fatal flaw with the research.  In some places an oversight like this is intolerable, because Continue reading

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

18 Aug

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

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

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

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

Upon completion of the drill – rather near Continue reading

Terry Ott: Former Canadian Football League Star Terry Metcalf To Sue League

14 Aug
Metcalf.Terry3
Terry Ott has filed this report to The Concussion Blog, again this is his journalism, we offer up the space for him to publish.  If you want to post here feel free to contact us.
 
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Will Claim Debilitating Injury From Multiple Concussions and “Neglectful” Treatment
 
 
HAMILTON,ONT.
August 14, 2014
 
Running back Terry Metcalf  was an NFL 3rd round draft pick in 1974 and played 5 seasons for the St. Louis Cardinals before coming north and signing amidst much hoopla with the Toronto Argonauts in 1978.
 
From 1978 to 1980, Metcalf gained nearly 3300 all purpose yards with the Argos, including 1900 yards rushing and was the subject of much media attention, if not winning seasons.
 
Metcalf retired from football in 1981 and is now suffering from what he says are major health deficits as the result of multiple concussions suffered while he was playing for the Argonauts.

Mr. Metcalf, who now resides in Seattle said in an interview that the last concussion he received was in a 1980 Toronto home game and “was a pretty good shot.”

“I don’t remember finishing the game,” said Metcalf, adding that he categorized his concussion treatment at the time as “neglectful, nothing, really.”

Now Metcalf, who teaches kindergarten, complains of chronic ringing in his ears, memory issues, and says he has a “50% loss of feeling in (his) right hand.” Mr. Metcalf said his symptoms had been noted when he had been examined by doctors in 2011 for the NFLPA class action suit against the NFL for concussion related injury.

Mr. Metcalf has retained a Canadian lawyer and is intending through counsel to file suit against the CFL for concussion injury.

Metcalf, 63, also complains about his mood saying that he had been “quite depressed in his life” and that he was lately “grumpier, and you can ask my wife about that.”

Perhaps just as troubling is the fact that of the three CFL players who have come forward in the last year complaining about multiple concussion injury-Phil Colwell, Eric Allen and now Terry Metcalf-all three played for the same Toronto team between 1972 and 1980 and all three former players claim deficient or even non-existent concussion medical care.

And in previous interviews, all three former Argo players in question who claim to have suffered concussions while playing for Toronto had, according to a source, been treated by the same group of medical and training personnel at the time of injury, and afterwards.

Those familiar with a 2013 story on the Concussion Blog on former Argo Phil Colwell who was knocked unconscious in a 1981 game, will recall that he claimed the only medical advice given to him at the time was to not go to sleep the night of the injury, and was in fact allowed to drive himself (70 miles) home after the game.

Colwell, who is also suing the CFL, said that he returned to play one week after his 1981 KO hit and further said that “at the time, if I had gone on the injury list for a concussion, I would have been cut.”

And Colwell, who nearly became homeless earlier this year pulls no punches when it comes to his current situation: “The CFL stole my brain, ” he said, “maybe I’ll get it back (but) I want memories, not money.”

Also in a previous Concussion Blog story, former Argonaut Eric “The Flea” Allen described his treatment after concussion by the Argo medical and training staff in question as “I don’t think (they) looked at me.”

Mr. Allen, 65, who is also in the process of suing the CFL is now no longer able to walk and is for the most part bedridden with severe vertigo.


And while there would seem to be a common thread with the three former Argo players claiming to have had similar experiences with the Argo staff after suffering concussion injury, a source speaking on condition of anonymity said that there are many more former players from different CFL teams who had the same basic after concussion injury treatment and many of them would be coming forward in the future.

Continue reading

Intended Consequences Lead to Unintended Issues: NCAA Settlement

1 Aug

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

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

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

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

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

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

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

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

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

Terry Ott — E”TF”A: Now 1 of 7 and Counting

31 Jul

Eric "the Flea" Allen Toronto Argonaults 1972. Photo Ted GrantThe information being brought to The Concussion Blog has been astounding, newsworthy, controversial (to some) and welcome.  We are not paying anyone for their guest posts, rather providing a platform for the information.  The inbox is always open for such things – with me as executive editor.  Just because something is posted here does not mean that I or we generally agree or endorse unless otherwise stated.  I have reached out to many people on the other side of this current CFL issue to open my pages to them and have yet to get a post from them.  Honestly, I don’t know that much about the CFL and its players – Doug Flutie being the only one I remember that well.  I truly appreciate the feedback on this continuing saga, but remember this is one journalist, Terry Ott’s, work.  It is here because he cannot find anyone to publish his information in Canada.  I feel this information is important to share.  What follows is Terry’s most recent filing.

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1970s ERA CFL STAR ERIC “The Flea” ALLEN WILL REPORTEDLY SUE CFL FOR ALLEGED MANY HEALTH PROBLEMS AS A RESULT OF PLAY

Former Toronto Argonaut Player Dealing With “Serious” And Debilitating Concussion Related Issues

Hamilton, Ontario — July 30, 2104

Eric “The Flea” Allen starred with the Toronto Argonauts between 1973-1975, and as noted previously here in Sneer and Loafing, is suffering the effects of what is alleged to be serious brain damage caused by multiple concussions while he was playing for the Toronto team, which at the time, was the highest profile and richest franchise in the league.


In an interview, Allen’s mother Rebecca Young, 84, said that Eric’s condition had declined precipitously in the last 6 weeks to the point that her son “can hardly walk now,” even with the aid of a walker, and spends most of the day in bed suffering from vertigo and has recently developed bouts of incontinence as well as suffering from worsening memory and mood issues.

Mrs. Young said that she had recently been visited by Canadian lawyer Robyn Wishart who Mrs. Young said will be representing Mr. Allen in a legal action against the Canadian Football League, allegedly for concussion injuries Allen says he suffered while playing in the league for the Toronto Argos for the three seasons in question.

“She said she was going to do her best to get (us) some help,” said Mrs.Young, of lawyer Wishart. “I hope it’s soon…I’m so tired,” added Mrs. Young, who as the principal caregiver for her debilitated son has a multiple hour drive to take Mr. Allen for treatment at the Medical University of South Carolina.

Ms. Wishart was traveling and did not return telephone calls for comment about Allen’s condition.

Two weeks ago, Arland Bruce, also represented by attorney Wishart, was the first 21st century former CFL player to file suit against the CFL member teams and others for concussion injury. Mr. Allen now marks the first from another era to follow a similar path although legal sources expect any lawsuit alleging head injury prior to any officially established CFL concussion protocols to be constructed quite differently than the Bruce pleadings, possibly along the lines of the now settled NFLPA 1 billion dollar suit against the NFL.

Furthermore, according to a source speaking on condition of anonymity, there are now at least a total of 7 former CFL players, some who played over 50 years ago, currently, or intending to, bring suit against the league for concussion injury.

The Arland Bruce III lawsuit story was national news in Canada for several days after it first broke on this Blog July 16, albeit with some of  the coverage taking on a near inquisition tone regarding Mr. Bruce’s motivations and alleged recent actions.

And unfortunately, your correspondent has been hearing about rumblings/grumblings supposedly originating from within The Great White North sports media community that somehow I have embellished, made up, or even peddled “lies” in my episodic and breaking reporting of the emerging concussion crisis in the CFL during the last 9 months.

In case you still don’t get it boys: this is not about me, but rather the wounded former players and common human decency. The players are making nothing up. Mull that scenario over for a while my suspicious, duplicitous friends.

This latest report on Mr. Allen’s troubles and intentions will hopefully give those uninformed and wrong side of history naysayers some pause before they raise questions about Mr. Allen and his family’s motivations and needs, as well as way, way down the line, mine.

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.

 

#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

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