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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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George Visger – A Story to Tell

15 Jan

You have seen him post in the comments and there have been many stories written on him and his plight, but it is nice to get those involved to write about themselves as much as possible.  George Visger a former NFL player has taken the time to send along a couple of notes, it began with this email;

I played for the 81 Super Bowl champion SF 49ers.  During the season I developed hydrocephalus (water on the brain) from concussions, and underwent emergency VP Shunt brain surgery.  Four months after our Super Bowl XVI victory, my shunt failed, I had 2 more brain surgeries 10 hrs apart and was given last rites.  Also given the hospital bills, and forced to sue for Work Comp.  Completed my  Biology degree during brain surgeries 4 thru 7, now on # 9.   The long-term effects of concussive and sub concussive hits can be seen in what it’s done to my family in the following KVIE Channel 6 Sacramento link.

KVIE Channel 6  Sidelined:  Concussions In Sports   121912- http://vids.kvie.org/video/2318744182
After that was sent my way I asked for something he has written and wants to be known, and below is what I received.  Thank you for your time George;
My football and TBI career began in 1970 at age 11, playing for the West Stockton Bear Cubs Pee Wee Pop Warner team in Stockton, CA.  Twenty nine kids on the team, and 3 of us went on to play for the undefeated, nationally ranked, 1975 A.A. Stagg high squad and sign NFL contracts in 1980 (me, Jack Cosgrove, Pat Bowe).  We also had a kid on the squad by the name of Von Hayes, who went onto a multi-year MLB All Star career with the Cincinnati Reds.During my 3rd year of Pop Warner, I knocked myself unconscious in a worthless Bull – In – The – Ring drill and was hospitalized.  This was the only “diagnosed” concussion I sustained, despite playing several games through college and pros where I have no memory of playing. Continue reading →

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Sports discourse in the aftermath of Junior Seau’s suicide

13 Jan

Screen shot 2013-01-13 at 6.32.33 PMI remember the anguish that punctured my thoughts when Junior Seau, a star in his own right on the gridiron, placed a handgun to his chest and took his own life eight months ago at his California home. Sitting in my room, I sunk into my chair and spoke no words for more than an hour while giving all I could to refrain from shedding any tears. His death struck me in an unforgettable way that positioned myself, once again, at a crossroads with football and its place in our culture infatuated with the image of the modern-day gladiator.

On May 3, 2012, the day after Seau’s suicide, I scrambled for answers with the shadows of chronic traumatic encephalopathy (CTE) looking over my back. I ran a number of searches in Google’s archives for newspaper articles from the 1990s to find some sort of explanation for his actions, but rarely was Seau’s name mentioned directly in relation to a head injury. Although my efforts were rather premature and assuming, there had to be some sort of correlation between Seau’s noted altercations behind closed doors with the thousands of hits his brain endured over the course of a 19-year professional career.

There are, of course, many different storylines that people turn to to explain something so tragic immediately after its occurrence, but confirmation of my original hypothesis (shared by many, I’m sure) by the National Institute of Health several days ago left me in an inexplicable state of unsettled anxiety. Though I inferred Seau would be diagnosed postmortem with CTE, my response to the official announcement was still along the lines of, “Unbelievable.” Continue reading →

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Boston Globe Opinion: James Carroll

7 Jan

It certainly is not the first opinion piece that has graced the papers in recent year, nor will it be the last, but James Carroll’s opinion piece does take a reflective look at the sport and issue we now face;

Even as a high school kid, I knew that more honor was to be had in playing through an injury than in the few passes I actually ever caught.

As I learned when my parents later took me to the doctor, I had suffered a concussion. That was nothing to the embarrassment I felt when they made me tell Coach I’d be sitting out practice for a week. His sneer flooded me with shame. That simply, I’d been plunged into the macho heart of football — a gladiator ethos which has lately drawn scrutiny because, indeed, of brain concussions.

This attitude must change when it comes to playing with concussions.  The entire game or mindset does not need to be completely rewritten, rather the view-point of one specific injury needs to be changed up.  Can you imagine what Bo Shemblecher or Woody Hays would have thought about spreading 5 wide receivers out and only have the QB in the backfield in shotgun?  Certainly they would have thought the game was coming to an end.

Naturally since the sport of football is so popular any type of tinkering or changing the game many people, especially those established in the sport, feel they are personally taking something away.

Listen, concussions are not good, in the short-term or long-term, and its and injury that will be part of football and of other sports too.  Some changes are necessary to protect the player – Continue reading →

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2012 NFL Concussion Report Post Week 16

28 Dec

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

REMINDER: I am asking for your help this week; as you probably have noticed by my tweets and facebook posts.  The NFL teams that do not make the playoffs and don’t play in the Wild Card round (24 of them) do not have to report concussions after this week.  I am looking for you the reader to tweet/email us any concussion found.  It has to be within these parameters:

  1. Reported by team/media
  2. Have a source

As always you can tweet/send me info about a particular instance of questionable action taken after a huge hit.  I thank you in advance as we are pumped to possibly have the first ever “official” Week 17 concussion report.

Week 16 brought us the “usual” numbers but an unusual occurrence of a player fessing up to a concussion four days later, as Greg McElroy divulged his injury to the team late in the week.  Along with the “usual” numbers we have surpassed last years total concussion count in the regular season (by four and counting).

I really don’t have an opinion this week to share with all of you so let us get onto the numbers for the past week in the NFL… Continue reading →

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2012 NFL Concussion Report Post Week 15

21 Dec

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

After last week and the NFL reporting only six concussions this week picked right back up to previous levels.  We have unearthed 14 concussion for Week 15; showing that last week was definitely an outlier.  Since Week 11 the number of concussions per week were as follows: 16, 19, 15, 6, and 14.  As my two-year old’s favorite TV show says “one of these things are not like the others”.

Our data collection, the most comprehensive since 2010, has shown that more than 50% of ALL concussions in the NFL occur after week number 9, or the back half of the season.  As of this week we have surpassed the Week 1-9 total of 80; there have been 82 since Week 10.  Of course the pundits will tell you that all the byes have taken place, so more teams means more concussions; true.  However, as the season wears on and the accumulation of hits to the head compile, the theory of cumulative subconcussive blows eventually creates concussive episodes may also be a culprit of our bigger numbers in the second half.

Going forward into the last two weeks – wait one week (I will get that in a second) it will be interesting to see if the trend continues or if there will be another “outlier”.  About that “one” week thing I just mentioned; sure there is two games left but because 67.5% of the league is done after Week 17 concussion reporting is horrible.  As was explained last week, teams will not – do not – report concussions if they are not playing a game in the 1st round of the playoffs.  It takes work from the media and other information gathering Continue reading →

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2012 NFL Concussion Report Post Week 14

14 Dec

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

It seems that concussion tracking has hit a “major market” finally with the launch of the PBSFrontline/ESPN Concussion Watch, which is another good source for information.  Their Concussion Watch includes all players that were listed on the NFL Official Injury reports, with either “concussion” or “head” injuries.  This gathers a vast majority of the concussions but they will miss some.

I had the opportunity to pseudo-collaborate with the entities that are compiling this information (via phone and email contact), and we discussed how their numbers would be different from ours here or a place like @NFLConcussions on Twitter.  Our discrepancies go to further the hot mess that is the NFL concussion issue summarized by the Fainaru brothers today.

I not only utilize the Official Injury Report but other methods; data mining and sources.  I had to go that route after Will Carroll explained to me that teams only have to list players that are/may be in a position to play that week or will be out.  In other words, if for some reason a player was concussed and was told he was concussed – even reported as concussed – but miraculously had no issues come Wednesday deadline for the OIR then they would not be listed.  Likewise if a player Continue reading →

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Matthew Gfeller Neurotrauma Symposium

12 Dec

Loudermilk_picsIn Zurich I had the chance to speak to many people; I enjoyed my brief time speaking with Jason Mihalik – fellow athletic trainer.  He reminded me of the previous Symposium in North Carolina and the upcoming second version.  I asked him to send along an email and I would put it up on the blog.  Here it is, and he is right, make sure you register NOW, it fills fast.

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It is with great excitement that my colleagues and I will be hosting the Second Matthew Gfeller Neurotrauma Symposium at the University of North Carolina at Chapel Hill on March 8-9, 2013. We have lined up another great list of local, regional, and national speakers. For additional information regarding a schedule of topics, invited faculty, and links to negotiated hotel rates, please visit us at http://tbicenter.unc.edu, and click on “TBI Symposium” in the header. A direct link to register for the symposium is as follows: http://tinyurl.com/c576kdu.

Our first symposium sold out 2 months prior to the scheduled event, so register early! Current Early Bird rates in effect until January 8, 2013 are as follows:   Continue reading →

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Nick Mercer: Understanding Runs Both Ways

12 Dec

First off, Movember 2012 is over and the moustache is gone. Thank you to everyone who donated, whether it was to me or not, the money goes to the same very worthwhile cause.

Now, onto the post…

Yesterday, I tweeted  a story from the New York Times, “Report Urges ‘Cultural Shift’ as Hockey Coaches Defy Concussion Specialists”. In the study, in the Journal of Neurosurgery, Dr. Paul Echlin writes, “Concussion is a significant public health issue that requires a generational shift. As with smoking or seat belts, it doesn’t just happen overnight — it takes a massive effort and collective movement.” I couldn’t agree more! Which leads me to this post.

I’ve previously written about this idea and I’m happy to see that I’m not alone. For this ‘generational shift’ and ‘massive effort and collective movement” to occur, we need to stop dividing ourselves. Right now, there seem to be two camps. Those who’ve had a brain injury or have a close relationship with someone who has, and those who play contact sports and relish the ‘contact’ aspect. The latter is the group that we’re trying to educate about concussions and the former is the group that knows about it all too well.

There has been a blatant ‘make them understand’ movement and, not surprisingly, it hasn’t worked overnight, or it’s been begrudgingly accepted. At times, the higher levels of an organization like the NHL or NFL  have fully endorsed changes to contact rules and have subsequently, unilaterally imposed them on the players and officials. In the case of the NFL,Commissioner Roger Goodell, counter-productively and idiotically, pushed for a longer season, so players could collide more and have more opportunity to be concussed. But I digress…

It feels like there is a discernible “you’re either with us or against us” attitude. Not to get too political here, but Continue reading →

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2012 NFL Concussion Report Post Week 13 – LATE

11 Dec

Guess the holiday season has many people behind on tasks, including yours truly.  Anyhow, here is the report from after 13 weeks in the NFL.  The report for week 14 should make it to this space by the end of the week (cross your fingers, ha).

During Week 13 we found 15 concussions, seems the weekly average is going up.  We now have 142 regular season concussions – 190 since camp opened.  NOTES: The offense continues to hold roughly a 10% advantage in concussions, which is weird it should be a 50/50 split…  Including preseason DB’s have more concussions (48) then the rest of the defense (38) – 36/28 split in regular season…  Interestingly RB, TE, OL, DL and LB all have similar occurrence; WR and DB’s are higher and QB’s way low…  I think we are going to see a new season “high water” mark, credit to Will Carroll for calling this before the season…  ()’s represent last week’s numbers…;

  • 142 Concussions/head injuries (127)
  • 10.92 Concussions/week (10.60)
  • 185 Projected Concussions (180)
  • 0.73 Concussions/game (0.70)
  • 12.90% InR (12.49)
  • 10.95% EInR (10.61)
  • 70 Offensive (78) – 57 Defense (64)
  • Positionally Speaking
    • QB – 7 (7), RB – 14 (16), TE – 13 (14), WR – 24 (27), OL – 12 (14), DL – 10 (13), LB – 15 (15), DB – 32 (36)
  • Team Breakdown
    • OAK – 12
    • DET, JAX – 8
    • CLE, IND, KC, WAS – 7
    • NE, NYJ, PIT – 5
    • CAR, CHI, DAL, MIN, NYG, SEA, SF STL, TB, TEN – 4
    • ARI, BUF, CIN, DEN, GB, MIA, NO, PHI – 3
    • BAL, HOU, SD – 2
    • ATL – 1
    • NONE – 0

Our definition of Incidence Rate (InR) is projected concussions/45 players taking the field per team per game, our definition of Epidemiological Incidence Rate (EInR) is projected concussions/53 man roster per team.

Comparing to past seasons the following has been found after Week 13: # (2011, 2010):

  • Regular Season Concussions – 127 (122, 119)

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How To Choose A Sport

11 Dec

Choosing a sport/activity for your child can be difficult – it shouldn’t be initially – as they progress in age and skill level.  Some believe there are factors that come into play when beginning to “specialize”, including injury risk; this is true.  However, our current culture is making the sporting issue way more difficult than it needs to be.

I may not be the best parent, certainly I’m not the first to accomplish this feat, but I do try to be A PARENT and not a friend.  When it comes to sports I let my children choose what they want to play.  My son is now 7, getting ready to get neck-deep in sport and the culture of sports.  He has shown some above average skills in a few sports, and loves one sport; however I will not force him to be exclusive, nor will I be crushed if he chooses not to play.  I will encourage him and my other kids to play MULTIPLE sports and do multiple things, for their entire life.

Alas, there are some families that are weighing the issue of choosing, say football over soccer, or vice versa; tennis or hoop, etc.  Injury risk can be a massive component in this decision so getting all the information is best before choosing, just like making informed decisions.  When discussing concussions and catastrophic injuries the sports we play do matter.

Mom’s Team has a video from Dr. Lyle Micheli, Director, Division of Sports Medicine at Children’s Hospital Boston, which can be found HERE.  It does bring up some good points but Continue reading →

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Outreach: Jay Fraga

5 Dec

tweet-retweetWe are beginning a new program here at TCB.  This one is 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.

The stipulations are simple: 500-2000 words with specific situations that we all can learn from and benefit from, email them to us at theconcussionblog@comcast.net and consent to possible editing as I see fit.  It would be nice if you included a bio or frame of reference, but if you would like to remain anonymous that is fine to (however, it would be good if you included something like “licensed doctor in _____ (state)” or coach, athletic trainer, mom, dad, etc.

I love people who are as, or more, active about concussion awareness, Jay Fraga has shown he means business.  He sent in his personal story about concussions, now he is elaborating more on the issue of awareness.  I appreciate Jay’s work and urge others to follow in his footsteps.

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Beating your head against a wall while suffering from Post Concussion Syndrome is probably counter-productive, yet I seem to find myself doing it (figuratively) virtually every day. We live in an electronic world, and in my electronic travels, I frequently “run” into the very people who I’m trying to get my concussion message across to.  The results are typically frustrating and lead me to ask myself why I bother trying to warn people about the perils of concussion.

Searching Twitter with the hash tag ‘#concussion” will provide a comprehensive selection of Tweets that feature illuminating articles and studies about concussion. I find that it also directs me straight to a painful paradox: kids with concussions who’ve been kept home from school on Doctors’ orders in order to heal, yet who are blissfully Tweeting their health away, 140 characters at a time, with the rapidity of an automatic rifle. If I had a nickel for every time I saw something like “Ahhhhhhhh! Home from school. Hate #concussions !”, I’d have the market absolutely cornered when it came to nickels.

RED ALERT!!!!! (DOCTORS and PARENTS- This is where you come in.)

Kids with concussions are sent home because they need Continue reading →

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2012 NFL Concussion Report Through 12 Weeks

29 Nov

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).

I will save the “soap box” for another day as I will get right to the meat of it.

Numbers are rising, but naturally there are more games as all byes have taken place.  There are more players on the field and more plays so there will be, by logic alone, more concussions.  Our research over the past few years has shown that 55% of all concussions found happen after Week 9.  Both an indication of more games but also prolonged exposure to micro trauma.

This week we say another first, a new high water mark for a weekly find; 19 players were concussed last week, roughly 15% of all concussions to this point.  I have some reasons for this, the most poignant being that I believe the NFL is starting to get it right.  With so many eyeballs on the game now, especially looking at concussions and how it impacts the game they better start to get it right.  I have had multiple sources tell me – which is hard for me to believe but I have heard it more than once – the “crapstorm” that is the NFL medical in-game coverage is now just catching up to what we know.  One person told me that some (stresses some) athletic trainers are still learning about concussion detection, another told me (which I already knew) the doctors being on retainers for the teams are too conflicted.  My most trusted source tells me that players actually have a protocol of their own to evade detection, which they practice from time to time.

Regardless there was a perfect storm this past week to give us the 19 found.  Now onto the stats, 127 regular season concussions – 175 since camp opened.  Notes: due to my 20 month old son “rearranging” my database I rechecked numbers there may be some differences from last week (the #’s are sound)… DB’s and WR’s are now starting to rack up…  ()’s represent last week’s numbers…; Continue reading →

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Nick Mercer: The Education of Nick

26 Nov

When I try to think of an idea for a post, I look to sports, news, pop culture, and usually find something that gets my mind firing. Sometimes, actually more often than not for my most recent posts, my idea seemingly comes out of nowhere, but once I get a hold of it, off I go. So, while trying to think of the subject for this post, although there were a lot of stories of concussed athletes – not the least of whom is Alex Smith of my favourite team in any sport, the San Frncisco 49ers – I have decided to take another tack and look more at society. I’ve written a bunch in this vein, so you could simply call this tactic ‘going to the well’, but there is just so much fodder here. Plus, it gives me a wider audience than  1000 words on Colin Kaepernick would have (nonetheless, he played an awesome game on Monday!). There have been countless stories over the past 2 years about concussion in pro sports, youth sports, and recreational sports. Every time a new story comes around, a catalog of articles are written, a fury of interviews are given, and an exhaustive supply of statistics are produced. As I’m the only one working alone on this blog, the only resource at my disposal, or at least the only original resource I have, is my experience as someone who’s had a severe traumatic brain injury.

Starting my blog (concussiontalk.com) was one of my best ideas. It gives me a place where I can share my views and vent my frustrations, all under the guise of thoughtful, and dare I say, good, writing. I have, not so subtlety, been able to integrate some pop culture events into my posts. From the start, the point of my blog was to write about brain injury in sports, notably football and hockey, because in July or August of 2010, it seemed a bit different, and as such, it would be interesting to write about. If anything, I’ve deviated from this, Continue reading →

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Educational Debate; what to actually teach?

26 Nov

WARNING some content may be considered “nerdy”, as there are very big words, even words I had to look up (OK you got me I have to look up many words longer than 5 letters).  I may even go on a diatribe that may lose you.  I do feel it is important for athletic trainers to read as well as our educators.

Awareness is the key with concussions – as I see it in this moment in time – understanding what one is and the proper management are probably the biggest issues we can educate on currently.  That does not mean the rest of the information is forgotten or omitted rather, grasping the nature of concussions is of special attention.  Once people start to understand/respect concussions some of the fear will be removed and fewer people will brazenly dismiss this brain injury.  Decisions need to be made about exactly what to educate each audience about; granted it would be nice to explain all of it – every minute detail – to every audience, that is unlikely to get people to understand.  The information about concussions – while remaining consistent – must be tailored to each subset for better understanding.  One can always go out and find more information, but the basics must be the same for everyone.  For example; disseminating the general signs and symptoms of concussion, the appropriate definition of a concussion, and immediate management of a suspected concussion.  This information should be the same for everyone.

And I think we are doing a good job all around on this; from the CDC, to NFHS, to state level, to this blog.

Last night was an opportunity to learn more about concussions and the thought process of teaching about concussions, to at least athletic trainers, on twitter.  During Thanksgiving I mentioned – and was pushing people – to understand what the Fencing Response is (pubmed) as Julian Edelman of the New England Patriots demonstrated this after getting hit in the game (unfortunately I cannot get a film/.gif of this currently) (thanks to a reader here is the LINK to the video).

It was then suggested to me by fellow athletic trainer and current educator Dr.Theresa Miyashita ‏(@DrMiyashita) that I should “be careful-the fencing response Continue reading →

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2012 NFL Concussion Report Through Week 11

22 Nov

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).

Getting hit in the head by a friend – not hard enough to cause concussion symptoms – say 15 times on a weekly basis is probably not something you would enjoy.  Eventually after about 10 or so weeks of that, theory suggests that there has been enough “micro” damage that the threshold for “macro” damage has been reduced.  Further, if your friend hit you with the same force he/she has been doing previously you may get concussion symptoms, thus a concussion.

If the force was at the same “low-level” as the previous hits – that did not cause a concussion – then why now do you have a concussion?

Looking at it from another angle; if you hit concrete with a hammer – not with so much force it actually cracks – say 15 times a week for 10 or so weeks, will the concrete finally crack and break at some point?  I would venture to guess, yes.

This is now some of the focus on the research in concussions, trying to identify the actual causation/pathology for such cases.  Speaking from a logical perspective; getting hit in the head over and over and over and over and…  Well, over seems to cause damage, no?

This is possibly why we are seeing greater numbers of concussions in the later part of the season; sure awareness is better, but players have been exposed to hundreds and thousands of hits late in the season.  There was a good white paper written on how to possibly abate this issue in Youth Sports, composed by The Sports Legacy Institute.  It is not practical in the NFL, nor do I think that professional adults need to have this in place, unless they choose to – in its place the NFLPA negotiated fewer “hitting” days outside of games in the recent CBA.

This again gives me a chance to wonder aloud why high schools will not adopt a reduction in exposure/hit days for football?  I have generated a proposal on this for the Illinois High School Association that has yet to be brought to a vote.

Back to the NFL and the concussions found this past week, SIXTEEN of them, nearly doubling the average up to this point; the numbers have tied a single week high for the past three years.  Perhaps its a reaction to the week 9 issues, especially the heightened attention after three starting quarterbacks were sent out with concussions.

Now on to the stats for the week – 108 regular season & 156 since camp opened.  Notes: DB’s now make up 25% of all the regular season concussions (8 last week)…  Offense continues to outpace the defense…  Current numbers/stats are getting close to being in line with last year…  The least concussed positions are QB and DL…  The ()’s represent last week’s figures; Continue reading →

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Outreach: BMX Athlete – Jay Fraga, His Story, His Words

20 Nov

We are beginning a new program here at TCB.  This one is 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.

The stipulations are simple: 500-2000 words with specific situations that we all can learn from and benefit from, email them to us at theconcussionblog@comcast.net and consent to possible editing as I see fit.  It would be nice if you included a bio or frame of reference, but if you would like to remain anonymous that is fine to (however, it would be good if you included something like “licensed doctor in _____ (state)” or coach, athletic trainer, mom, dad, etc.

————

By Jay Fraga, Former BMX Athlete, Husband, Father, Sports Lover

If you’ve ever had a bad hangover, I think we can all agree that it’s a relief when the day is over, you sleep, and it’s gone when you wake up the next day.

I have had a hangover for as long as I can remember. It’s been there for more than a year and a half. If you can recall the misery and suffering involved in one day with a hangover, maybe you can begin to imagine what it’s like to try to live day-to-day feeling like that.

Then again, maybe you can’t.

My last concussion was approximately 8 months after a previous one that I got crashing in a bike race.  I wasn’t especially symptomatic from the previous one, but all of my doctors virtually agree that I hadn’t yet healed when I was injured again this last time. The scientific community has a number of guidelines for concussion, but the one thing everyone can agree on is that layering a second concussion on top of a previously unhealed concussion is very, very dangerous.

In spite of our knowledge about how dangerous multiple concussions are, we see NFL players being cleared to go out onto the gridiron a week or two after sustaining not one, but two concussions in a three-week span of time, while proclaiming that they feel great, and their coach stands by, nodding approvingly.  Fantastic.

For those of us who struggle to live daily with Post Concussion Syndrome, seeing these stories play out in the news is especially painful.  There is nothing more painful than regret, and many of us watch helplessly as we watch players and coaches, who are in absolute denial, speak nonchalantly and hollowly about a subject that we are intimately acquainted with. We watch knowing full well that there’s a pretty good chance that these players will soon be joining our ranks, where the challenge isn’t a championship at the end of the season, but rather to live like a normal human being and be able to enjoy life. And it feels like there’s nothing that we can do about it.

If we want to change things in sports, we have to understand how athletes operate.  Athletes are wired a little bit differently.  Those who have learned how to overcome -  through the process of competition, loss, reflection, coaching, training, more competition, rising above, winning, and then ultimately understanding how to win, have a different belief set.  They think of themselves as machines that are able to prevail through anything.  Competition becomes a necessary part of their diet, and   Continue reading →

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Tuesday Quick Thoughts

20 Nov

Ed Reed was suspended by the NFL for repeat offenses of the leagues mandate on blows to the head.  Some former players are taking serious umbrage with this decision by Ray Anderson, NFL Executive VP of Football Operations.  Fortunately I had the opportunity to listen to an interview with Anderson on Mike & Mike this morning.

The synopsis, in my opinion, was that the League is now looking at hits to the head and neck as an aggravating offense and will take serious steps to eliminate this type of hit from the game.  More striking was Mr. Anderson’s statement (paraphrased) that; we know now that hits to head are not only a problem we know now that they are life altering, he emphasized that the evidence was now clear to this.

Ray Anderson kept hammering home that “times have changed” and hits like Ronnie Lott made and that were common place years back have no place in today’s game.  He also mentioned that fines are not working as they had hoped, so other measures will need to be taken, including suspensions.

I really feel that the NFL is playing good lip service to this issue, and really are taking baby-steps to change the culture of football.  Now getting on to Continue reading →

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Ding, ding, ding!

16 Nov

I recently read a story in the Globe and Mail, “Stampeders backpedal on concussion talk” about Calgary QB Drew Tate who was hit in a head-to-head collision in the 2nd quarter of play on Sunday, November 11. At halftime, Tate said that he had his “bell rung” and couldn’t remember the first half of play, generating this comment from Eric Francis of the Calgary Sun, “All the questions Monday will and should revolve around the apparent silliness of letting Tate play after his halftime admission to TSN.” (emphasis added) Not to worry though, according to Tate all that really happened is that he was “dinged” and “felt some fuzziness”, besides, as Tate says, “As far as talk about a concussion, I didn’t get what the fuss was because I felt fine and just wanted to play.” The Stampeders administered concussion tests during the game, after the game, and Monday morning. Tate was ruled to be symptom free.

It seems fairly clear that Tate was concussed. However, not according to Dave Dickenson, Calgary’s offensive coordinator and a former QB, whose diagnosis was that  he “can tell when I look into someone’s eyes if they are concussed or not,” and he didn’t see any symptoms. Nevertheless, Chris Nowinski knows a thing or two about concussions, concussion management, and the Continue reading →

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2012 NFL Concussion Report Through Week 10

16 Nov

The Concussion Blog Original, NFL Concussion Report, is a weekly (not so much this year) compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

It seems that one time each season there is a “watershed” moment on concussions in the NFL.  Week 10 was that week for 2012 (so far) as three starting quarterbacks were sidelined with concussion – Alex Smith, Mike Vick, and Jay Cutler.

Perhaps unnoticed in the coverage of the QB’s were the 9 other concussions that occurred, including three players having their second concussion – Cliff Avril, Brandon Meyers and Ryan Clark.  It would be Amari Spievey second as well, if you are counting the preseason concussions.

Certainly noticed by me was an ABSOLUTE first in NFL concussion history, which really should be noted.  Again, with all my research on concussions this is the first time this has occurred in the NFL.  This is the very first time that Continue reading →

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Defining success in rehab: exhaustion

14 Nov

Admittedly, I didn’t understand or even appreciate the importance of my physiotherapy rehab after my brain injury. When the doctors first told me that I’d be going to the Miller Centre (the rehab hospital in St. John’s, NL) I was really excited! At least I’d be out of the hospital! I couldn’t sleep. When I was eventually able to eat food it was terrible. I was bored to say the least. I was newly dealing with my double vision, so I couldn’t read. I figured, when I got to rehab, I’d be able to go to the rehab gym all day, at least it was something to do. They’d never seen me at rehab. I’ll be awesome! “Sure I can’t walk now, but you let me at that place for a few weeks and I’ll be running the stairs and doing burpees in the hall in no time!” “I’ll run home one day and won’t need to go back.” It’ll only be a few weeks, a few months tops.

At first, my motivation to get there was to get out of that GD hospital and get the whole ‘brain injury’ thing over. It sucked and there was a bunch of stuff I’d rather be doing. I had a co-op job in Ottawa for my master’s program that I had to get to. Most of my friends from Queen’s were in Ontario, so I’d see them a lot on weekends, whenever. That was the goal. Bang this rehab out and get back to life. An inconvenience. A pretty big inconvenience, and a good story, but an inconvenience is all it was.

I eventually realized that to get back to my old self, physically, was going to take longer than a few months. My motivation was then much harder Continue reading →

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Parent Advocate: Tracey Mayer

13 Nov

Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there.  As time allows she will be submitting posts for you to read.  I truly hope that everyone gets a chance to read about concussions from yet another perspective.  Thank you Tracey!  I thought I would pass along this note from Tracey Mayer she sent me the other day:

It’s been a bit over four years since Drew’s injury.  Last night I was thinking holy crap; it was me against the world when I refused to let him return to the field.  Honestly, there was no one on my side—not even my husband.

Clearly, concussion awareness was in its infancy stage at that time.  Back then, I rarely recall seeing any media coverage on concussions, and now I read at least 8-10 articles per day.  I was flipping through the mail yesterday and came across a newsletter from Rush with an article about resting the brain after a concussion – how it is necessary to take at least 2 weeks off from school, etc.   I cannot imagine what things would have been like if there had been even a smidge of academic support when Drew was hurt.  Even more, I can only imagine what might have happened to him had I not dug my heels in and held firm about him not returning to football.

Parents, you know your children better than anyone.  If something doesn’t seem right, most likely it isn’t.  Trust your gut – it costs nothing and generally holds value.  Your child has one brain—the vital organ that runs his or her body.  Protect it at any cost.

Tracey is right, we have come a long way in a very short time, alas we are only scratching the surface on the issue.

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Good Reminder About Rest After Concussion

13 Nov

This blog post was made a while back, from time-to-time I will republish them with associated comments that resulted.  This topic is about “rest” after the injury.  Most if not all medical professionals now prescribe this method, but as we found out in Zurich recently, the research behind exactly what “rest” is and for how long is unknown.  What is known allowing the brain to settle down for a period of time is highly beneficial.

———-

Although most point to physical rest as the major component of concussion management the truth of the matter is that all activity that affects brain activity needs to be limited after a concussion.  If we use the “snow globe” analogy; all the flakes in the globe must come to rest before exposing it to further activity.  What excites the “flakes” or brain, honestly, just waking up does this.  That is why I have been hammering on the need for COMPLETE rest after a concussive episode.  It is also why I am a firm believer in getting kids out of school while the brain injury heals.

This information is not new to you that read the blog, but it seems that this management technique is just catching on as a principal protocol, rather than using it if there are setbacks;

“There is so little we really know about concussions,” said Dr. Mary Dombovy, vice president of Unity Neurosciences, which includes physical medicine and rehabilitation, neurology and neurosurgery. “We’re learning more as time goes by. What we’re learning is it’s not just physical exertion that is making the brain work harder. School tasks, studying for tests, trying to write a paper, these things are very stressful for people who’ve had a concussion.”

It is not that it is stressful, per se, it is that the brain is FUNCTIONING to do those tasks and like getting on crutches for a broken leg, the only way to get the brain on “crutches” is to not give it any stimulation.  Along with that comes how long and what to do when symptoms have gone, to me it is obvious that this is where you then begin the Zurich RTP protocol (the current concussion management protocol I use).

What I am having a hard time fathoming is Continue reading →

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Concussion Round Table

12 Nov

Last week The Aspen Institute hosted a round table discussion on “Playing Safely: The Future of Youth Football” to address growing concern about the epidemic of concussions on our youth.  It should be noted that professional athletes are both more mature (in size and brain development) and are adults who can make informed consent decisions.  The issue this panel discussed was for the youth football.

The speaking list was both wide and deep including: DeMaurice Smith, NFLPA, Dr. Gerry Gioa, Chris Nowinski and Dr. Robert Cantu amongst others in attendance;

At the Aspen Ideas Festival in June, a panel featuring concussion experts and former NFL players considered the health safety risks of playing football. Since then, concerns have sharpened, with many parents of young boys saying that tackle football should not start before age 14. At the same time, football also plays a role in addressing the epidemic of physical inactivity. Our roundtable dives deep into the state of football at the youth/community level with a discussion on reforms — and implications on the game up to the professional level.

With awareness beginning to gain traction and definitive research in the area starting to bear fruit this round table Continue reading →

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An Opportunity Presents Itself

12 Nov

Concussions have been on the “front burner” for a few years now, yet not everyone has the clear and consistent message about this injury.  There continues to be gaps in how the injury is covered by the media, accepted by the leagues and understood by the general sport loving public.  Yesterday was arguably the most high-profile week for concussions in American sport as three well-known quarterbacks exited the game with concussion.  Due to the attention that will be given, I am deeming this a “teachable moment” for everyone.

Several opportunities have been presented to get the message correct and out there this year; in week 2 and week 5 there were 12 concussions.  Last year, week 11 produced 14 and week 14 had 16 concussions yet not nearly the “attention”.  Two seasons ago there was the “watershed” moment of NFL concussions not to mention the 15 concussions in week 16.  Yet the message continues to be clouded.

Regardless where you stand on the concussion issue (you should be concerned), particularly in the NFL, it would be a good time to get the basic information out there and link up some further information if you choose to look.  I will try to lay this out in the most helpful manner; to the point with as much fact as possible (I will notify when its opinion).  I will do it bullet point style;

  • FROM CDC: of the roughly 3.6M concussions that go the emergency room in the US, over 50% are due to recreational activities/wheeled sports.  Estimates have been made that 30-50% of all concussions are undisclosed or unreported.
  • Concussions occur in all sports, the exposure and rate is much higher in: American football, rugby, Aussie Rules, men’s lacrosse, ice hockey.
  • Current research/theory suggests Continue reading →
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