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Nick Mercer: Why we continue to see players play

19 May

Nick submitted this article prior to the Bryce Harper wall escapade but it would certainly fall into this opinion piece.

While I didn’t intend to write a post about brain injury in sport, I was inspired to write it based on some events in the NHL playoffs.  Since it’s not my point to dissect the danger of the two hits, I won’t spend much time on them. In fact, I’ll just share the links to the Gryba hit on Eller and the Abdelkader hit on Lydman. Seriously, whether I think either of those hits was clean or delivered with malicious intent is not, in any way, the basis or inspiration for this post. What is, is the idea that we – the North American contact sports-loving public – have all but abdicated our right to a free conscience. Whether either hitter was deserving of the suspension they have subsequently received, depends not on the hit they delivered, but on which team you cheer for (or against), or whether or not you like seeing big hits in hockey. It has nothing to do with what happened.

Some people don’t like where the NHL or NFL are heading; the frequency with which penalties are called when a player hits anywhere near an opposing player’s head. I don’t think that either of these two leagues, NHL and NFL, understand the concept of risk and reward. Hard hitting contact sports are so popular because they exhibit risk in a raw form. That’s probably why some/many of the athletes who make it to the highest levels get into the types of trouble they do. We watch news about multi-millionaire athletes who crash Porsches or who get arrested, and we may think “why would someone with so much to lose risk so much?” However, the athletes actually made logical (that doesn’t necessarily mean good) decisions. They do what all of us do before making most decisions. They, however briefly, look at their risk/reward histories plus their confidence Continue reading 

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Nick Mercer: Spring’s on the way. Get moving

18 May

A while back I saw that Chris Nowinski tweeted this, study by researchers at the University of Buffalo about the benefits of exercise for people who’ve had a concussion, and I thought I’d post now. I was constantly told that my recovery from a severe brain injury (even though, by no means am I back to the way I was pre-injury) was due to my pre- and post- injury fitness. This is an issue I am passionate about and it seemed obvious to me throughout my immediate rehabilitation and continuing recovery/life after my brain injury that exercise and fitness are extremely important. It hasn’t solved my problems or made them go away, but it’s incredibly beneficial and allows me to deal with the effects/issues confidently.

I should know better than to write those four title words when we’re hardly clear of winter. So, first I will apologize in advance to the people of St. John’s. For all intents and purposes, I’ve just guaranteed another dumping of snow. In fairness to me, the title sounds good and I’m looking at a beautiful sunset out my window, so I couldn’t help but write with a tauntingly cheery attitude. Nevertheless, sorry, my bad.

It’s Sunday and the wind was really kicking up a fuss this morning. I, however, stayed safely inside and, although it was sunny and marginally warmer than it has been in a while, I had no need Continue reading 

Ohio’s New Concussion Law FAQ’s

17 May

I was forwarded an information sheet on the newly enacted Ohio Return to Play Law.  It appears as a Frequently Asked Questions form, here are some highlights;

  • Guidelines for both interscholastic and youth sports
  • Who can clear the athlete
  • Specific definition of required training for coaches, referees and officials of youth sports
  • Resources for parents and athletes

This “fact sheet/FAQ” is probably the best written resource I have seen regarding the new return to play legislative actions by states.  It is good that each state is doing something, but in my honest opinion these laws are just a start.

Unfortunately it took actions by legislature to make it perfectly clear that those with concussions, show signs of concussion or report concussion symptoms shall not return on the same day and must be evaluated by a health care professional.  This is something we have known for a few years now.  Each state piece is great for raising awareness.

What we need to advance is the true problem of this concussion “crisis”, that is the proper management and overall treatment of the brain injury.  Concussions will occur, it is an inherent part of all sports – essentially something we cannot “control” – however we can certainly control how the after effects of each concussion are handled.

HS Class Uses Blog to Educate

10 May

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

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

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

IHSA Proposed Heat Acclimatization Policy

7 May

There was big news out of Bloomington, Illinois coming and I was getting fired up because the word on the street was they had been working with the Kory Stinger Institute and Sports Legacy Institute to create a new “football” policy.  With my effort over the past two years to get the Illinois High School Association to look at and make some proactive changes to the way football is practiced, there was hope it had not fallen on deaf ears.

Well, the announcement/proposal is out…  It’s a good first step; one that addresses the heat issues that plague football. Some highlights are;

  • 14 day period that every player must go through to be eligible to play
  • Strict guidelines on actual practice time and rest time during multiple practice days (traditionally 2-a-days)
  • Set rest days
  • Removal of “grey area” of weights/agilities/walk throughs
  • Definition of scrimmages
  • No matter what was done before the start of the season all must do the 14 day period

Moreover this proposal is very specific and makes very good sense in the area of heat acclimatization.  Obviously you can see the hard work of KSI in the proposal, but where is SLI input?  Some of the missing talking points Continue reading 

Downplaying brain injury is not the way to attack this

6 May

Concussions have gained so much attention that the news is almost inundated with story-after-story of occurrences, recovery, litigation and people trying to mitigate the injury.  There seems to be a shortage of press clipping and stories on how to handle this injury.  More often I have witnessed stories downplaying the injury or the oft cited “Heads Up Football“.

The former, downplaying the injury itself, is not a good thing it is exactly what put us in the spot we are in now.  Patrick Hruby also took note of this while reading an article from Andrew Wagaman in the Missourian;

Still, when it comes to the single most head-scratching public statement I’ve seen regarding brain trauma and football, University of Missouri neuropsychologist Thomas Martin takes the pole position. Hands-down. In a piece about youth football and cognitive risks published this week in the Columbia Missourian, Martin compares brain damage to … knee injuries[...]

This blew my mind. I had to read it twice. And then a half-dozen more times. It still blows my mind as I’m typing this. Here’s why people react differently to brain and knee injuries, and why football is in a world of potential trouble: because the potential harm resulting from a brain injury is nothing like that resulting from a knee injury.

If you read Hruby’s article you will see he makes a strong case for this analogy being utterly false; Continue reading 

Nick Mercer: Impromptu Expectations

28 Mar

The thing about expectations is that they presume a certain course of events. In July 2003, I assumed that I would start my co-op job in Ottawa in September and I based my expectations for the coming years on that presumption – my previous post, Finding yourself after a brain injury. First step: Recon. Brain injuries themselves are unexpected, so you don’t know what presumptions to make that will allow you to generate expectations. You’re already starting off on the wrong foot. It’s not so much the issue of living up to, not meeting, or exceeding expectations, it’s more about the expectations themselves that I will write about.

After considering a patient’s health/medical history, age, other essential factors and the severity of most injuries, conditions, or diseases, doctors can only base their ultimate prognosis on probabilities. This is where expectations begin to go awry. Not to get into statistics or anything, but if the probability of surviving a coma of a certain length and severity is low, it’s because it hasn’t happened very much, therefore there will be few cases upon which to build expectations. The fewer cases, the fewer reliable prognoses can be made, hence few, if any expectations.

Those are for others to make. The most important expectations are the ones you make for yourself. I had been making those ever since
I can remember. When I was a kid and used to catch insects, I had Continue reading 

Head Football Coach ‘X’: How to take a stand on player safety

26 Mar

Working on a cause is difficult, especially if you are trying to swim upriver. When the cause is in direct conflict with the juggernaut that is football it becomes even more difficult – even at the high school level. I received and provided counsel to this individual as he fights a good fight in regards to player safety, most notably concussions. I applaud this individuals effort, attention to detail, player first mentality, and his willingness to sacrifice his job. What we have below is a microcosm of the issues we face with concussions; detailed and beyond sufficient for action – that is not being taken except against this author.

This information was obtained mainly through email strings – all identifiable properties have been painstakingly scrubbed to the best of my knowledge. It has been understood and agreed upon by the author that publication of this information may identify him and place him in further jeopardy. He is willing to take that chance and I am willing to provide him a platform. Unless otherwise noted in the post with breaks all of this is his and his alone. We shall begin;

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A Little Context:

At the start of my advocacy for safer measures to be applied to the competitive arena in high school football, I involved many people who I trusted and cared for in helping find my voice. Those people usually ended conversations with the same question:

“Are you willing to Get Fired for this?”

I laughed at the question considering the fact that I am advocating on behalf of measures that enhance Student Athlete Safety. At no point was my advocacy meant to be an argument, so the extent in which there has been resistance to proactive thinking has been quite a disappointing surprise to me.

The last 3 months of my professional career have been a whirlwind as I have gone from Advocate to Agitator. When the time for action came to blaze a trail for the future, and promote all that can be good on behalf of our student athletes, we collectively passed as a school system, even though a safer future for the thousands of kids who choose to play football within it is still very attainable.

Through my advocacy I have felt empowered by the leading researchers in the field of sports injury supporting these ideas. Support from the actual people who could make these changes has been “Hot & Cold” in a way that led to me presenting to the Athletic Administration of our entire school system and then being handed a letter of reprimand. At the current time I am labeled as a “Demanding” Coach and a person “Searching for a Cause”.

What follows is a chronological story of advocacy on behalf of player safety at the high school level as well as an example of how far away we actually are from a safer future for the student athletes who choose to play the sport of football.

Authors Note:

Some of the Main Points of Resistance in this philosophy have been diffused by simple logic when it comes to providing a safer arena for competition.

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ORIGINAL LETTER TO RAISE CONCERNS & TO START MY ADVOCACY
January 8th 2013
To: (School System) Director of Athletics ————————
CC: (School) Principal —————–, (School) Athletic Director ———————, (School) Assistant Athletic Director ——————

Subject: Public Health Issue regarding (School System) Cross-District Scheduling of Football Competition

I am writing to make you aware of a safety issue that our county has unknowingly placed many of our student athletes in through our recent scheduling for football. (School System) Athletics cross district scheduling policy for teams in the newly formed ——– District, while making sense from a convenience and perhaps even a cost basis, exposes athletes at certain smaller schools to a greater risk of serious injury. I share these concerns with other Head Football Coaches within (School System) as was voiced at the —————- 2012 All-District meeting.

(School System) scheduling policy requires each (Small School) District football team, which is made up of schools that have been classified at the 3A and 4A level in the (State League) to compete with three schools at the 5A classification from the (Big School) District for the 2013-2014 scheduling cycle. The 2013-2014 scheduling cycle determines opponents for each school’s next two (2) seasons. ——————— High School (——) is a 3A school that, based upon the recent scheduling for the 2013/14 seasons, is expected to compete with schools classified at the 5A level on six (6) separate occasions, schools at the 4A level 12 times, and similarly sized 3A classified schools 2 times in our next 20 scheduled games.

A schools classification is predicated upon the (State Association) account for each school’s student enrollment. That enrollment produces the available population to field athletic teams. (State Association) has outlined parameters identifying like-sized enrolled schools to view as competition throughout the state. (School System) scheduling policy has ignored these guidelines in which the (State Association) believes our schools can equitably, and safely, compete in the sport of football.

Current scheduling policy lacks the awareness of a significant and measurable increased risk of injury to the players at (School) and similar sized schools. What is alarming, and requires immediate awareness, are the findings of the most recent and advanced studies related to head injuries. These studies strongly suggest that (School System) scheduling policy as currently constituted, subjects student-athletes of the smaller schools, not only to a greater risk of injury but to a greater risk of serious head trauma Continue reading 

2013 Concussion Tracking – Need Help

19 Mar

Looking for some help out there…  Due to a myriad of factors I have let time slip away from me and have gotten behind the seasons for concussion data collection.

I am looking to keep current the NBA, NHL, MLB and AFL concussion lists; as of right now I have the AFL taken care of, the rest, not so much.

I have virtually missed the hockey season, I am hoping you all can fill me in with that.

I have a list of NBA concussions, but it seems that there has not be a single concussion in nearly a month;

Brea JJ MIN
Davis Anthony NO
Zeller Tyler CLE
Kidd-Gilchrist Michael CHA
Kaman Chris DAL
Gasol Pau LAL
Williams Marvin UTA
Melo Fab BOS
Shengalia Tornike BRO
Sanders Larry MIL

And the MLB season is in spring training and have caught only Steven Drew’s concussion to this point.

I am asking for all of your help.  If you wouldn’t mind posting a comment to catch me up (NHL send me an email), or tweeting concussions I would be very appreciative.

If anyone is going to have the time to be the “keeper” of the stats you may also email me your information and we can discuss how best to achieve the most complete lists.

Thanks again!

Nick Mercer: Finding yourself after a brain injury, first step – Recon

18 Mar

As has been said countless times in countless articles about brain injury, “every brain injury is different”. I don’t know and don’t care to know how many times I’ve heard or read it. That phrase is used primarily for the benefit the general public to explain or define a lasting injury about which little is known. Although geared towards people who have – seemingly – little or no experience with brain injury, the statement should still be understood as fully as possible by those of use who have such experience.

In 2003, until making a hard and fast right turn on my bike on a hill in Victoria, BC, I had every intention of completing my upcoming 8 month MPA work term with the Auditor General in Ottawa, and while there, continuing to ride my bike and join a local water polo club. When I finished my MPA I would work somewhere for a few years, then, hopefully, pursue a PhD.  The next morning, all that changed. Two weeks later, when I woke from my coma, I was a different person. Not completely different – I was lucky – but different enough that I had to change my plans for my future.

My focus wouldn’t be on finding an apartment in Ottawa or impressing my Continue reading 

Opinion on Zurich Statement

13 Mar

I think I have had enough time to digest the information in the 4th Consensus Statement; it is enough time for me to give an opinion.  WARNING: My opinion may differ than yours and you may even take umbrage with what I say.  However I am going to give my honest opinion.  To keep it as succinct as possible I will go in bullet form along with the statement itself.

In general I feel that we as the community in the “know” are muddying the waters more when it comes to concussions.  I think there are reasons for this; litigation and emotion mainly.  I still strongly feel that concussion identification and immediate assessment by trained personnel is non-complex; its simple.  Sure others may think it is hard; I think changing the oil in the car is hard and complicated – a mechanic would find that a mundane task.

Secondly, the now undeniable MASSIVE issue with concussions is not the injury itself, rather, the mismanagement of concussion; which includes but not limited to assessment, rest, rehabilitation, return to learn and return to play.  The newest consensus statement address some of this for the first time.  Now, the paper…

SECTION 1: SPORT CONCUSSION AND MANAGEMENT

  • The definition of concussion is more clear for the practitioner.
  • Starting to address the psychological aspects of concussions – about time.
  • Clearly states if no trained health care provider present that if any signs/symptoms present players must sit out.
  • Clearly states that if concussion present, no RTP same day for ANYONE!
  • Not really a fan of all the sideline assessments out there.  No where does it say its mandatory for any of these; rather they are tools at our disposal to help identify concussions.
    • Here is a novel approach people: use your training and ability to be in-tune with the athletes to make a solid clinical judgement.  Oh, wait, not every sport team has an athletic trainer available?  <–THIS IS THE PROBLEM WITH IDENTIFICATION AND ASSESSMENT.
    • The Statement also clearly makes it a point that clinical judgement is the standard of care when it comes to all of this.
  • Although currently there is not an objective measure of the injury on the brain they have opened the idea it may be coming.
  • Neuropsych testing was a good section, the take-home point here is that baselines are not part of best practices and that they should not be used as a clearance device, except in the case of a trained neuropsych using the information.
  • Loved the discussion on “rest”, really thought about it a lot since it came up in Zürich.  The term “rest” is so Continue reading 

Athletic Trainer Removed from Post for Standing Ground on Concussions

1 Mar

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

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

Why, you ask?

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

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

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

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

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

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

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

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

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

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

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

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

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

Video Thursday

28 Feb

Here are a couple of videos to tide you over until some time next week!

In the first one we can hear how the military began their concussion management protocol.  Although not enough it was way ahead of the curve on concussion management.

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Here is one that shows a compilation of big hits found on YouTube.  Watch all the football ones and the vast majority are “clean” hits.  Then take into account all the other sports and think back to my mantra here: “The injury of concussion is not the elephant in the room, rather, it is the mismanagement of the concussion that is problem.”  Then tell me you didn’t throw up in your mouth at the last clip…

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Beyond the Cheers Interview Today

27 Feb

I love radio hits, any chance I get to explain my angle as well as spread the necessary information is a blessing.  I have provided some doozy sound bites and probably some head scratching comments; one thing you get – I really hope – is little BS when it come to this information.  The only problem with local radio and most syndicated sports talk is that I get – at the most – ten minutes to get the necessary information out.

Today I will have an opportunity to spend some quality time on the subject.  Dave Furgeson, host of Blog Talk Radio and Beyond the Cheers has invited me to the show today.  Starting at 7pm EST we will be talking concussions for a solid hour – and I’m pumped!

You can listen live by going to Blog Talk Radio or Beyond the Cheers websites and clicking the play button on the “Live Stream” button on the right hand side of the page.  You can get a feel for what the show will be regarding by clicking HERE (live stream also located there).

I believe that Dave will be taking advance questions and live call in/chat questions during the show.  If you have a question for me feel free to send it in and perhaps I will get a chance to answer it.  Dial-in TOLL FREE 1-877-357-2448 in Canada and United States to ask a question or e-mail Dave (dferguson@beyondthecheers.com) in advance.

Also, I would appreciate honest feedback – good or bad – after the show.  An honest discussion on this issue is really the only hope of getting things in a place that is comfortable for everyone.

Aussies Study Concussions in Former Collision Sport Athletes

26 Feb

From Sunday Night down in Australia a story of how research on the brains of former footballers may shake up the sport;

Greg Williams is an AFL legend, and one of the hardest men ever to play the game. In his glittering 14-year career, ‘Diesel’ won a premiership, two Brownlow Medals and was named in the AFL’s Team of the Century. .

Shaun Valentine is another tough bloke: like Williams, he copped countless on field wallopings in his career in rugby league. Williams retired at 34, Valentine at just 26. Both men are now struggling with everyday life as they battle the long-term effects of so many blows to the head during their respective careers. Both men are married with children – and both are facing the biggest challenge of their lives.

In what’s been a world first study here in Australia, the results of tests on retired professional players are revealed, and they will send shockwaves through all the codes.

The video (The price of playing the game) tells the story of Williams and Valentine and gives the results of what they know to this point.  Make sure you click the link above to find it.  You will notice that there is no mention of CTE in the Aussie players – yet when they go to the US for the story CTE is the first thing talked about.  It is understood, that currently most researchers in Australia are not ready to accept CTE as a diagnosis or even its existence in former footballers.  The focus is more on dementia Continue reading 

Nick Mercer: Bubble Times – Is it going to pop?

21 Feb

Continuing with my analogy from my last post, “Brain injuries and pro contact sports: Bubble times” , in which I compared the concussion issue in pro sports with the financial crisis, I thought I’d try to complete the comparison without, hopefully, forecasting the end of contact sports, notably the NFL and football in general.

In my previous post I said that fans, teams, and leagues play the same role in the concussion issue as the banks/financial institutions did in the recent financial crisis; interested only in their short-term benefit, making them unintentionally complicit in the looming collapse. Players are like the borrowers; they want to play the sport they love and make lots of money doing it. Consequences be damned. Just like people wanted to buy houses and a bunch of other stuff, not thinking, wishing away the potentially negative long-term consequences. It’s about the looming collapse that I will write.

Since my last post, I have listened to Malcolm Gladwell talk about the undesirable, yet inevitable decline of football. Then I read an article on the Oxford University Press blog Why football cannot last’ discussing Chronic Traumatic Encephalopathy (CTE) – a neurological disorder resulting from repetitive blows to the head. It got me thinking about the optimism shown at the end of my last post – had I not considered the situation fully? Was it simply wishful thinking?

Gladwell makes a convincing case Continue reading 

Spots Still Open….

20 Feb

Here is a follow-up on the Gfeller Neurotrauma Symposium that we posted about in December…

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We are very excited to announce our non-academic Keynote Address on Saturday will be presented by Merril Hoge. Merril was drafted by the Pittsburgh Steelers, where he played until 1993. He led the team in rushing and receiving in four of his first five years, setting a record in his third year for receptions by a running back. He was the Steelers Iron Man of the Year two years in a row (1989 and 1990) and was named to the All-Madden team in 1989. In 1993, Merril went to the Chicago Bears, where he played for one year until he was forced to retire early due to post-concussion syndrome. At the time of his retirement, Merril had the longest consecutive playing streak in the NFL.

The Second Matthew Gfeller Neurotrauma Symposium at the University of North Carolina at Chapel Hill on March 8-9, 2013 is right around the corner. There are a few spots left. We have informed you earlier of some great speakers we have lined up including, but not limited to, Dr. Christopher Giza, Dr. Robert Cantu, Dr. Michael Collins, Dr. Gerry Gioia, and some of our other local, regional, and national colleagues. A final schedule of topics is available on our website. Additional information regarding the event, including a link to register, is available at http://tbicenter.unc.edu (click on “TBI Symposium” in the header). A direct link to register for the meeting is as follows: http://tinyurl.com/c576kdu.

Healthcare Providers & Researchers (PhD, MD, ATC, CAT(C), RN, etc): $175  Continue reading 

Daniels Dash: Why it MUST be run

19 Feb

ddtOur last “Outreach” writer, Ashlee Quintero, eloquently wrote about her experiences with concussion issues.  As the Concussion Program Coordinator at UHealth Sports Medicine she is involved in many things, one of which is very dear to her.  It is a 5k run in the honor of Daniel Brett, a South Florida kid that sustained concussions and was not properly treated for a long period of time.  Below is his story and information on Daniel’s Dash (2013 Flyer).  The following was written by his mother, Diana Pilar Brett;

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Daniel’s Story 

dd1On August 24th, 2009, our son Daniel made starting linebacker for Cypress Bay High School’s JV football team.  It was a victory for him and his first major step in actualizing his desire to play in college. It was also his last day ever playing football.

At 5’9”, 160 lbs. he wasn’t big, but he was tough and fearless, and he thought it was the way to be, to one day play for his dream team, the University of Miami Hurricanes.  No pain, no gain.

Daniel began playing football at 11, and never looked back. Tough and versatile, he played offense, defense, and special teams, rarely getting off the field. He loved it, and he was good.  Determined, he did all that was needed: kept in shape, practiced hard, kept up his grades, and never complained. No, he never complained and never told anyone when he was hurt up until August 24th, 2009.  Continue reading 

Outreach: Ashlee Quintero

19 Feb

This is the continuation of a new program here at TCB.  Called “Outreach”; the purpose is to publicize the good (we hope the vast majority) and sometimes the not so good of concussion management and experiences across this vast planet.  One thing I realized real quick in Zürich is that the stories of the bad are relatively the same, usually highlighted in the media.  Meanwhile the stories of good are different and helpful and not heard at all.  I am asking our readers to send in stories of your cases (please be mindful identifying specifics) so we can share.  There are vast stories in the comment section but I would like to bring forward as many as possible. 

Ashlee Quintero was a soccer player at the University of Miami in 2009 when she sustained a concussion.  Through this process she decided to become more involved in awareness and education of this injury.  Below is her contribution to The Concussion Blog.

Dog, Cat, and Fish.

The more I am exposed to the public’s reaction to sports concussion (and that’s a lot, I am a youth soccer coach and the Concussion Program Coordinator at UHealth Sports Medicine), the more I realize how far we still have to go with concussion education. Despite the warnings, educational seminars, and the accessibility of concussion information on this little thing called the internet, coaches, youth coaches especially, are more often than not severely misinformed on how to screen who’s taken a hit. My most recent educational presentation really illustrated this need.

I am a youth soccer coach and volunteered to present concussion information to my fellow soccer coaches at our league’s pre-season coaches meeting. While I was speaking on Florida’s new concussion legislation and discussing the ever-difficult sideline evaluation and decision to sit a kid out, I got the inevitable questions, “Well, how do you know if it is a concussion? What’s the tell-tale sign I am looking for?” Before I could vocalize my response to those questions, Continue reading 

Concussions: It’s not the injury

6 Feb

I don’t know how to make this much more clear.

And, believe me about 5 minutes after this goes up my twitter and inbox will be jammed full of criticism.

The injury of concussion: abnormal function of the brain after a traumatic event to the body/head (see all signs and symptoms), is not the “problem” we are facing.

The massive issue and “problems” we are facing in this crisis stem from the improper (see poor or none) and mismanagement of concussion and/or mild traumatic brain injury (mTBI).

Removing concussions from sports is nearly impossible, heck any physical activity has the risk of concussion (see my two concussions standing up and hitting my head on an open cabinet).  If everyone would take the focus away from “stopping” concussions and work on a safe, effective, and universal injury management technique (see ACL rehab protocols) for concussions this “problem” would cease to be a problem.

OK, fire away…

Let’s Clear Something Up Here

5 Feb

On Twitter yesterday I commented on the words Jim Nantz spoke on “Face the Nation” regarding concussions (emphasis mine);

“[r]esearch shows that at the college level, a women’s soccer player is two and half times more likely to suffer a concussion than a college football player. I don’t hear anyone saying right now, ‘should we put our daughter in these soccer programs?’”

Huge props to Jason Lisk of bigleadsports, for doing the work of digging to find the information that Nantz used in the interview.  The long and short of Lisk’s adventure was that he could not find a specific connotation of such claims.  The 2007 article he cited in his wirte-up can be found here, Concussions Among United States High School and Collegiate Athletesvia nih.gov.  You can look and see what Lisk and myself see, football concussions occur more than female soccer concussions – except for an anomaly (very small one less 4%) – in college football and female college soccer.  Lisk also notes this was a 2007 study, although ancient in the realm of concussions, it is very solid and worth citing.

A repeat of the above study could not be found and probably should be done, however there are plenty of “concussion incidence” research in the high school sports.  Those can be found by simply going to ‘Google Scholar’ and defining your terms.  Here is a very good one regarding concussions alone, Marar et Al_ Epidemiology of Concussions, where the football vs. girls soccer numbers are; 6.4/3.4 (that is per 10,000 athlete exposures).  This is a 47% increase as compared between the two sports, almost two-time as likely.  More important is that this information was published a year ago, some of the freshest information out there.

Specifically Nantz was using collegiate soccer as his “trump card” in the case for football.  Not only is collegiate soccer a rare occurrence for those playing soccer, it is not nearly as populated as high school and youth soccer, where the concussion problem is WAY lower than football.

Not only was Nantz – and Limbaugh – spewing information that is both hard to find (no source) and outrageous to this author, it is completely irresponsible to even suggest that female soccer is more “dangerous” than football, in terms of concussions.

Here is my diatribe from twitter last night; Continue reading 

Brain injuries and pro contact sports: Bubble times

31 Jan

As much as I can, I read about and watch professional contact sports. I also read, and have read, a lot about the financial crisis; more specifically, what led to it. Naturally, since I was brain injured in 2003, I have become very interested in brain injury. Hence this blog.  I have also taken a bigger picture view of almost everything and, influenced by many books I’ve read, notably Collapse by Jared Diamond, I’ve been noticing similarities between different situations and events in society. Not connections or links. Similarities in our perception. They make sense to me – that’s why I thought of them. They’re not perfect or identical, they’re similar, the theme is the same. I see the same prevailing theme in the lead up to the financial crisis as we have seen in the current concussion/brain injury issue in professional contact sports.

For the purposes of this post, I’ve picked two themes that I think run through both situations; “arrogance” and “wishful thinking”. It was arrogance on the part of banks who thought they could make the market do what they want, creating financial instruments (and fitting mortgages into these securitized instruments)  that would generate big short-term profits, ignoring the long-term consequences. The bankers had to sell/lend these instruments/mortgages to someone. Whether the buyers/borrowers were deceived or not is not what this post is about. The buyers/borrowers of these financial instruments ended up losing a lot.

The banks are like the teams, Continue reading 

NFLPA News

31 Jan

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

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

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

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

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

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

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

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

UCLA Tau PET Study

23 Jan

If you paid attention yesterday you saw that a very preliminary study was unveiled about identification of tau proteins in the brain.  This is significant on two fronts

  1. up until now this has been non-existent with current imaging technology
  2. tau is the #1 culprit in chronic traumatic encephalopathy

If, in fact, this PET scan can find and map out the tau in living brains this would be a “watershed” moment in the treatment of CTE.  This would be because we have not been able to treat CTE, the only way to find CTE is via a posthumous examination.

I believe this is very exciting, but remember like all things in life, caution is needed – the study was only five former NFL’ers and to fully confirm the information gathered the researchers could be waiting a long time, hopefully.

A quick side note here, Dr. Bennett Omalu is a co-author on this study, which isn’t ironic as some have suggested, rather a product of his good work in this area.  For those in the “know” surrounding research in concussions and CTE finds this part of the story – Omalu – “interesting”.

What a great start, and I am willing to be scanned if anyone wants to pass that along!  I would even write a blog about my experiences with it.

An Act of Digression/Maybe I’ll write about this stuff

16 Jan

I’ve been on long hiatuses from writing before, but coming back from this one feels a bit strange. Lots of stuff happened, but I couldn’t decide how, or if I wanted to write about any of it. My decision not to write was probably based more on lethargy than I want to admit, but it was also based on my desire to take a break. A real break. A do-nothing break. I apologize in advance for the sequencing and general disorder of this post because I still haven’t figured out what I’m going to say. Right now, I’d place bets on ‘nothing’, but there’s a chance, however small, that I’ll pen (or type as the case may be) the most eloquent and poignant piece of literature in the English language. That would actually be a better bet, because the odds of that happening are astronomical, so betting even a penney would net you more money than you could spend in 5 lifetimes. But I digress…

Actually digressing seems to be the way this post is going to go. This country, or more to the point, TSN, is losing its mind about the return of the NHL. In September, the main story in Canadian sports was Continue reading 

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