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This is Interesting. Share Your Thoughts

6 Mar

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

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

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

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

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Repost: Matt Chaney’s Take on Heads Up Football

21 Feb

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

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

==========

By Matt Chaney

Posted Wednesday, October 23, 2013

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

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

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

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

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

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

Have To Keep Educating & Holding People Accountable

6 Feb

The education of concussions is great, the legislation is in the right place but there is absolutely no accountability for instances where athletes are “failed”.  Before I go on, I am not perfect, I have and will continue to miss some things here and there (I missed an ACL in football which bothers me).  In fact, looking at the pressure I put on myself and hoping the world puts on my chosen profession of athletic training it may be a bumpy road.  However, missing obvious problems of health and welfare of athletes when one is an athletic trainer is inexcusable.  I implore anyone out there that feels I have missed something to call my ass to the carpet as well.

This brings me to something that I found in my inbox recently and it made me sick and should be handled.  This particular incident occurred in a state that has similar mechanisms for concussions as here in Illinois.  To create the back story on the “mechanisms” in play you should understand the state legislation and high school association concussion education;

  • Players, parents and coaches all have been given information regarding concussions
  • Officials have been given authority to remove player for concussion signs or suspicion including mechanism of injury (MOI)
  • Once removed they cannot return unless cleared by approved medical professional (IL is ATC, MD, or DO only)

With that information here is the email from a fellow athletic trainer – emphasis added is mine – (obviously stripped of identifying information);

Still have a long road ahead of education.

I was at a basketball game Friday night as a spectator and watched a player bounce [their] head off the floor.  Opponent had set a screen and athlete ran right into [defender], bounced off and landed on floor bouncing head off the floor.  The player then rolled around on the floor grabbing head and could tell [athlete] was in pain.  Time was called by the officials to attend to the player.   MOI would strongly Continue reading

The OTL Investigation on ‘Heads Up’ Football

14 Jan

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

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

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

[...]

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

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

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

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

Terry Ott: CFL Follies

19 Dec

If you recall a few weeks ago I posted a request for some help for a journalist, Terry Ott of Canada.  It was simple, if anyone who reads this is a former Canadian Football (CFL) player or knows a former CFL’er, could they contact Mr. Ott for a story he is doing on concussions in that subset of professional football.  The good news was that people responded, albeit a small number, it was more than he was able to find doing his journalistic thing.  It made me happy that this blog could help out someone looking for information, because that is why it occupies a space.  But…………..

In the post below, that Mr. Ott wrote, you will see that by using this blog it may have stonewalled any help from the CFL, its Players’ Association or the Alumni Association.  Mr. Ott titled this post “CFL Follies” and I cannot think of a better title for what you are about to read.

Without further ado, Mr. Ott;

==========

I’d imagine that most reading this Blog will have heard of League of Denial.

But, I doubt you have heard of League of Non Denial, Denial.

Because after three months of dodge-ball dealing with the CFL about the concussion issue past, present and future, I was, after some initial boiler-plate information given in October, told today that my follow-up questions were “loaded” and would not be addressed by the CFL. (The questions are at the bottom of this post, and you can make up your own mind if they were “loaded,” or not.)

In addition, the CFLPA will no longer respond to my Continue reading

PUMP THE BRAKES, Everyone!

4 Dec

I am a bit on edge this fine, foggy-impending-wintery-weather, day.  No, it’s not the great coffee I am drinking now and the nice jog I had clearly didn’t ease my current frustration.  This forthcoming “strongtake” may get my ass in hot water with some readers, but so be it.

People need to calm down, slow down, take a step back, reflect and realize some important things.  Before I go further understand that I have tried to be as “neutral” as possible – a simple athletic trainer that sees concussions on an intimate level from occurrence to recovery.  I have had 13 myself.  This post is something that apparently has boiled up from all the press clippings I have read and feedback I am getting.  Not one person, entity, sport, or profession is my target here; these are observations and opinions (in my most succinct way possible).

First of all, concussions are not a football problem, they are not a soccer problem, they are not a doctors problem, they are a societal problem.  Rightly so, football in America gets the mass attention, because it happens there more than any other sport out there (don’t waste my time with the skewed numbers of other sports and genders).  With that being said because of the higher incidence in football that does not mean the sport as a whole needs to be banished.  You know very well where I stand on this but I will spell it out for those new here.

Professional football is a different animal from the other forms of the sport, mainly because they are grown adults making informed decisions about their health.  And they get paid to do it, other than providing immediate safety for the concussed players and proper information about the injury, short and long-term, they can and should be able to make their own decisions.  However, this does not indemnify those players or the sanctioning bodies from having some casual responsibility for the emulation of the game at the lower levels.  A clear line must be drawn between amateur and professional medical care; for concussions and all other injuries.  Remember that the professionals have much greater medical care available to them, and if you think that is unfair well too bad, that’s life and where the money is.  Professional football holds a certain responsibility to inform its fans and future players of the risks and rewards of the sport.

As for the lower levels, with proper coaching and medical care/coverage I feel there is a place for this sport as we know it.  Unfortunately as we trickle down in age the participation numbers go way up and at the bottom, youth, is where we have the greatest disconnect from coaching and medical coverage/care.  Because of this and other factors I am of the ilk that kids should wait until the arbitrary age of 14 or freshman in high school to begin full collision football.  Believe it or not this has to do with more than just concussions, in my opinion.  And here is where my first beef is coming from.  Continue reading

Tottenham Hotspurs; More Like Tottenham Hotmess

4 Nov

The center of the club soccer world resides in England (two teams in Wales) with the Barclay’s Premiere League (BPL).  Being the “best” soccer league has allowed the BPL to be televised live here in the States as the sport is showing some growth in participation and in viewership.  I have recently found myself watching more matches and even choosing “a side” – as they call it across the pond (it should be noted that soccer it called football everywhere else but here).  Through research and general information gathering as I get further into the sport the BPL or other European soccer leagues are not much different in its fandom.  Supporters of teams and players are similar to the fanatics that follow football here in America; critical of team play, ownership, players effort and results.  One area where the fans and the sport of soccer is well behind, in terms of knowledge, is concussions.

The readers of this blog know quite well that a concussion is simply an event that alters normal brain function.  Being primarily subjective it may be hard to distinguish a concussion by simply looking at a player or person.  However, the vast majority of sports fans here in America and participants know that there are tell-tale signs of concussion that cannot be disputed.  When one of those objective signs is observed it is and should be understood that said player was concussed and requires immediate removal from the game/practice/activity.  The reason is simple, concussions are a brain injury and bad.  Research has shown that playing through a concussion is very detrimental to short-term and long-term mental health.

Years ago, pre-2004, getting knocked out or displaying signs of a concussion was a mere nuisance and even a “badge of honor” among the top-level sporting participants.  It was known back then that something as obvious as someone losing consciousness was not a good thing for the younger participants, however it wasn’t looked upon as it is now.  When a sports participant absorbs enough force to effectively “reboot” the body’s central nervous system that is NOT A GOOD thing.  As the information about concussion has become more clear through the years if a player is KO’ed that player is removed from play immediately and does not return for the period determined by the medical staff.  In the NFL the soonest anyone has returned to practice or game after being knocked out, since 2010 has been six days.  Even that may not be enough time for the brain to recover.  Heck, in boxing and MMA, fighters that are KO’ed are medically suspended for 90 days.

This leads me to the bloody mess that occurred in Everton, England yesterday.  Continue reading

Matt Chaney’s Take on Heads Up Football

24 Oct

The post below is from Matt Chaney’s Blog, re-posted (in part) here with his permission.  We are posting it here not as an endorsement, rather as an opposing view that is worth the read.  Our commentary on this article by Chaney will be below this post.  We encourage everyone to see the entire post on his blog.  You can view it by clicking on the hotlink, it is titled; ‘Heads Up Football’: Truth, Tales and Legal Consequences.

==========

By Matt Chaney

Posted Wednesday, October 23, 2013

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

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

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

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

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

—huh, these coaches don’t address the facemask dilemma, the prime fault of football rules behind the charade of Heads Up, ‘proper contact,’ ‘head up technique,’ ‘anti-butting’ or whatever term… this toothless policy and language have been a football mandate since 1976, for high schools and the NCAA… the rules specifically ban Continue reading

I Echo the Call From Cantu

17 Oct

Dr. Robert Cantu recently wrote an article for the Health & Science section of Time that discussed some of the obstacles for true understanding of cumulative effects of collision sports.  As he notes some of it is ambivalence but the main reason is that we truly don’t have the hard data, only tiny snapshots.

Cantu begins his article by cementing his thoughts on youth football, it should be flag until age 14.  Although this is an arbitrary age the reasoning seems sound, immature brains do react differently than fully developed brains.  Research does indeed suggest that adolescent brains – especially prepubescent – are more susceptible and take longer to recover.  Granted if they are not playing tackle football there is a good likelihood that some will sustain a concussion riding a bike or jumping on a trampoline; doing general “kid stuff”.  The massive difference between that and organized sports is that concussions that happen in the playground or in a park are accidents.  Some of our sports mandate that you hit or create collisions.  As we should all be keenly aware, it doesn’t take a direct blow to the head to create the concussive injury.

Moreover, once a child had sustained a concussion getting the vital information from them in this subjective injury is difficult.  Children and young adults are not very good at describing or even acquiescing to what is wrong.  This puts them behind the 8-ball, so to speak, as the proper management is often delayed or not even sought.  Mismanagement is the true elephant in the room on this issue.  As seen above many concussions occur, by accident, outside of organized sports.

In no way has he, nor I, even remotely been associated with banning of organized sports; if anything we have championed ways to get MORE children involved through less potentially harmful ways.  If people would Continue reading

“League of Denial” Wrap Up and Reax

9 Oct

I surely hope everyone was able to watch PBS Frontline’s “League of Denial” last night, if you happened to miss it you can view it HERE.  This is also an opportunity to insist that you seek out the book, which is much more detailed and has more “players” in this issue.

During the film I along with others was asked to tweet live about what we were seeing, and as the app updated on my iPad the comments and opinions were very interesting.  I thought it was great that both the Fainaru’s were adding key details of the story while the action was unfolding, a lot of my retweets were from them.

From my feed it was obvious that the league did not look like they did enough in the way of getting information out.  Most poignant to me was the timeline of first admission – 2000 when the NFL Retirement Board awarded Mike Webster disability and admitted football created his problems.  Yet for years after that the league itself denied all research that supported those findings, Dr. Ira Casson even went as far as saying “No” to every question asked about long-term damage in 2007.  SEVEN YEARS AFTER.  Further, the league continued to deny and even down play leaked research (that was sponsored by the league itself) about brain issues after retirement, in 2009 when Alan Schwartz was leaked that information.  Later that same year Greg Aiello – after the thrashing of the league in Congress – admitted to Schwartz that there is a connection.

The film did a tremendous job of showing the plight Continue reading

“League of Denial” (Part 2)

8 Oct

Coming to a bookstore and TV near you today is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

I was reminded quickly, yesterday via Twitter, that I may lack valuable perspective when it comes to concussion information (and that I am not normal – this is not breaking news).  Will Carroll of Bleacher Report let me know that this information will be new to a lot of people out there.  He is exactly right, not only that, this documentary will be easily digestible for the fan of football.  For any person just wading into this, when you tune into PBS tonight to view “League of Denial” you will be absolutely hooked from the start.

The sounds of the crowd, visuals of big hits grab your football part of the brain IMMEDIATELY, over those sounds you will quickly discover the problem NFL players have faced with brain injuries playing their sport.  Harry Carson saying “and then they are gone” when talking about former players.  A bold statement that the level of denial was “just profound.”  An NFL lawyer saying “we strongly deny those allegations that we withheld information or misled the players.”  And more video and sound of punishing hits that used to fill the highlight reel bring the opening curtain of this very important documentary.

This problem is real – it’s not just real for the professionals – and from the get go Frontline makes you understand, vividly and personally, why this is.  After listening to old radio calls of the Steel Curtain it all begins with the story of Mike Webster and the forensic pathologist who studied his brain, Bennet Omalu.

The discovery of a possible reason one of the most respected and lauded players in Pittsburgh sports pantheon fell from grace and eventually found and early demise.  If the football portion of your brain does not connect to what is being presented then I would haphazardly guess that you are not ingrained within the fabric of football.

As Harry Carson explains how the game was played and to some extent how it’s still played you can begin to understand the issue at hand.  This is hammered home when Robert Stern, PhD tells the audience blows to the brain are at forces 20 times greater than the force of gravity (20 G’s); or as he so eloquently put it “driving into a brick wall at 35mph”, 1,000 times or more in a season.

In the first 11 minutes of this 2 hour presentation you are at full attention and want to understand the “whats”, “whys” and “whos”.  If you are not engaged and ready for further explanation I can only say that you don’t care or want to bury your head in the sand.

Contributions in the film include Continue reading

“League of Denial” (Part 1)

7 Oct

Coming to a bookstore and TV near you tomorrow is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

In all honesty, if you have followed any part of this issue nothing revealed in either medium (thus far in the book) is seen as “BREAKING NEWS” rather an illustration of what has been happening with the research arm and policy makers of the National Football League, with regards to concussions.

“League of Denial” the Book:

In what I have been able to read thus far both Steve Fainaru and Mark Fainaru-Wada have done a good job of telling the hidden secret.  The Fainau’s went as deep as they possibly could without the help of the league itself, even as far as getting one of the original researchers to recount some of the possible misgivings in the past.

By utilizing the real stories of players that met an early demise (Mike Webster most notably) the information has an emotional connection with the reader.  While reading this you understand why this information may have been so valuable to the families and friends of those that could have been effected by repeated head trauma.

It doesn’t take a brain surgeon to tell you that repetitive brain trauma is bad for you, but the problem here is Continue reading

The “Other” PBS Film

3 Oct

ICYMI there is another film not named “League of Denial” that PBS is showing that deals with concussions.  This one however is “a proactive look” at concussions in a high school setting.  As Founder, Editor, Journalist, Producer of MomsTEAM; Brooke de Lench put it in a recent post on the release of this film;

We also careful to explain on “The Smartest Team” website that the documentary is no more than an “audio-visual blueprint,” and “an introduction to a set of principles (the Six Pillars) to guide development of a sound concussion risk management program based on the latest research and opinions of experts; to provide a solid foundation on which to build such a program;” that we see it “only as as a jumping off point for what we hope will be the beginning of a multi-year and continuing process involving parents, coaches, players, athletic directors, school boards, booster clubs, and health care professionals, motivated by a desire to preserve all that is good about youth and high school football, to work as a team to implement best practices in concussion risk management.”

The Smartest Team” is a documentary of a high school in Oklahoma that was looking for a better way to combat concussions, and sought out de Lench and MomsTEAM.  During this film you will see the use of Continue reading

Drop the Puck, 2013-14 Style

3 Oct

I am a sports nut, that should go without saying, but one of the most exciting sports has begun its campaign.  Living in Illinois, I am often reminded of who are the current keepers of Lord Stanley’s Cup but I also have a keen eye on my hometown team, the Colorado Avalanche.  With all that being said I do not follow hockey nearly as well as football, or my own high school sports (our soccer team in undefeated).  However, this is a sport that is also classified as a collision sport and is predisposed to disproportionate amounts of head trauma.

This season there should be some interesting findings about concussions as a confluence of a few rule changes as well as an Olympic schedule may in fact reduce the incidence of concussion, here is why;

  • Longer season (not strike shortened) so the players don’t feel the pressure to play so damned hard so quickly
  • Olympic schedule will have players worried about country over NHL when the winter gets in full swing
  • Fighters must keep helmets on for fights (I guess visored players cannot fight) for protection when falling to the ice
  • Rule 48 is in its third year, referees, players and the league have a better grasp on the outlawed hits

OK, logically there should be “more” concussions Continue reading

Rules of the Game

18 Sep

I have waited about five days to collect my thoughts on this and honestly let my emotions calm a bit.  As some know I can be a bit outspoken and harsh at times but I wanted to refrain from letting emotion get in the way of an important message.  Yes, this post will be mainly about football, but don’t view it as an attack on the sport so many of us, including me, love.

This season across all the levels of play in football there has been a larger emphasis placed on player safety, most notably contact to and with the head while playing football.  It is a FACT that the helmet in football was designed and remains a protective device not a weapon or offensive piece of equipment.  Using the helmet in the later fashion is and should always be a penalty for both sides of the ball.  This is nothing new; since the mid 1970′s “spearing”, “face tackling” and “butt-blocking” (scroll to page 32 of that link) have been outlawed in the sport.  However, routinely those events on the football field are rarely called, now in 2013 there is an emphasis on these types of infractions.  Now there is a caveat of this type of action on the field called “targeting” which at the college level can have a player ejected if egregious enough. (BTW, that picture is a placard that was made in 70′s)

Before I go further, I would like to say that officiating at the high school and lower levels is a thankless job.  The pay is not life changing and most do it as a hobby.  Sure, I have seen some officials that the game has passed by or is too fast for them, but I have also seen men and women that do Yeoman’s work with nothing more than a handshake for a job well done.  It’s not easy folks, I have done it, but done correctly and consistently it is a thing of beauty.  At the college and pro levels these people do great work and often have other jobs besides being on TV and getting players, coaches and fans mad at them.  I can assure you they are doing the best they can.  But, I feel the game of football resides in their and coaches hands, for survival.

At the high school level in our state I know that officials have been told to watch out for targeting and the use of the helmet above the shoulders; this has helped at the cost of adjudicating the other, more established rules from the 70′s.  I have seen four flags in five games for “targeting”/”spearing” above the shoulders; I have seen zero flags for “spearing” when it was below the shoulders.  I didn’t write down every occurrence of these types of tackles in each of my games, however, I can vividly recollect at least 10 instances of spearing on both teams.  Side note here, if I see one of our players do it they get quite the ass chewing from me on the sidelines.

People need to realize that tackling with the head-down is not a safety measure for the person getting tackled, it is a safety measure for Continue reading

What Are the Experts Saying About Guardian Caps

13 Sep

This post has no intention of being inflammatory, rather it is a post designed to hold a conversation and create a counter point.  I have been bombarded with information regarding this product; since early 2011 I have not been “on board” with this.  It is important to note that this product and its PR firm have been good at communicating with me and have listened, but I do find some of the press regarding this product and similar ones is a bit off base.  We do need to understand that what reporters and people say – not affiliated with the product – cannot be controlled buy the company.  So that being said I have found and have some opinions on the recent spike of press.  Take it for what you want.  Just know that I am trying to provide information for everyone to make their own decisions.

It began in 2011 rolling into 2012 when Guardian Caps shot me an email about their product.  And from the beginning I was not sold on the promises or the theory.  It’s quite simple in my estimation; you can wrap an egg up in 45 pounds of bubble wrap and if you shake it hard enough the yolk will still move or even break.  Essentially that is a concussion in an “egg-shell”.  Sure, the bubble wrap will stop all linear forces from cracking the shell and even prevent it from moving with those linear forces, but what is it doing to for the acceleration and deceleration of the concussion?  Moreover, even though it may be very light, we are adding mass to the head, thus we are creating a fulcrum change and balance change.  If you read here enough you know what I am talking about.

However, I have seen fellow athletic trainers rave about this and plenty of teams/coaches/schools adopt this product and even consult me on it, so I thought I would do my best to get the most information possible, on my own.  This company was willing to provide me with all the information they thought I needed, so good for them.  It really came to a head recently, while in the midst of the NOCSAE statement on 3rd party add-on’s, I received this email from the company;

Dustin,

I wanted to drop a line about both the Aug 9th article “NOCSAE Press Release Clarifies” and a short picture of our product and company as a whole.  Thanks for all your hard work with The Concussion Blog.  It is a valuable resource and you do a great job presenting an educated, unbiased view.

About NOCSAE certification:

  • If companies want to sell equipment that alters the original tested/certified helmet THEY or the individual must re-certify each helmet model it is placed on – adult and youth separate but not sizes.

What Does the Derek Sheely Case Foreshadow?

3 Sep

Inherent risks, of life and sport, are a constant issue none more controversial than concussions.  The truth of the matter is that concussions will occur in life without sports so playing: hockey, lacrosse, basketball, baseball, water polo or any sport comes with differing amount of risks/chances of concussion.  By playing those sports we should understand those risks and be willing to accept the chances of injury, particularly concussion.

As we have stated close to eleventybillion times now; the actual injury of concussion is not the issue of this crisis, rather it is the mismanagement of the injury that is the problem.  In other words it’s not the sports fault for concussions, it the people’s fault for not taking this brain injury serious.  Even worse, it is people in positions of power that have caused many to be “mishandled” after injury, bringing us to where we are today.

This is where Derek Sheely comes in; this young man died on a football field in Maryland as a result of head trauma and the purported facts in the case are very scary;

  • Four hour contact practice
  • “Preseason practices at Frostburg served more as a gladiatorial thrill for the coaches than learning sessions for the players… Practice involved virtually unlimited, full-contact, helmet-to-helmet collisions.”
  • Named coach in lawsuit explicitly told players to lead with their head and use their hat when tackling
  • Apparent lack of preventative medical care by an athletic trainer
  • And this quote: “Stop your bitching and moaning and quit acting like a pussy and get back out there Sheely!”

We have yet to have full discovery in this case and most likely there will be a settlement Continue reading

NFL Concussion Litigation Settled Out of Court

29 Aug

Twitter and my in box is exploding at this very moment…  The NFL and the players who have filed suit against the league have come to a settlement of $765,000,000, Judge Brody’s statement can be found HERE.  This works out to about $170,000/player or estate if there were only 4,500 plaintiffs (numbers are not clearly known).

This is a good thing for the league, and for some players this is well needed cash flow.  If the promise of establishing a better future with study and plans for players hold true it will be a great day.  But excuse me if I’m a bit reserved on the confetti and marching bands…

The 88 plan was supposed to be the answer, then the new Head Neck & Spine Committee, then the Mackey Council within the league (headed by Sean Morey).  There have been many band aids placed on this gashing wound before, perhaps just throwing money at it will clot it up?

Moreover, the fact that the NFL does not have to go through discovery in the litigation process makes those in Manhattan pop the champagne!

Doesn’t it seem a bit coincidental that this has come on the heels of the release of “The United States of Football” and the upcoming release of the Frontline (formerly co-partnered with ESPN)  “League of Denial“?

Perhaps I am skeptical, fine, but who has really won in this?

It. Has. To. Stop.

20 Aug

There is a lot of belief and trust each and every one of us has in those that are medical professionals.  The further you go up the chain in those professionals our trust is greater and our belief is stronger that they know more.  The sad fact that in some instances those near or at the top of the chain don’t know enough and are putting people, in this case a kid, in danger; not only in the near future but the long-term.

Compared to a physician (MD/DO) I would say my medical skills are pale in comparison, and rightfully so; their schooling and experience far outpace what I have learned in the medical field.  Because of this the athletic trainer (I) am not held as in high regard when it comes to decisions about the care of an athlete; which I am fine with… 97.43% of the time (I just made up that number, ha).  However there are times when a MD/DO – those making the final and binding (in parents and patients minds) decisions – make a mistake.  This is not just some Monday morning quarterbacking either, its FACT.

Just recently I had an athlete take a blow to the body and head in a practice, and they immediately came to me distressed.  How distressed?  Well that is one advantage I have over a MD/DO, especially the ER doc, I know the kids and have the resources of his/her peers as well as coaches who have known the kid for many years.  In this case the Continue reading

Princeton, New Jersey Makes Peculiar Move

7 Aug

In a very unusual move by a school board the Princeton Regional School District – servicing one high school, one middle school and four elementary schools – has made it mandatory to wear head-gear in sports not known for head-gear.  In a proactive move the board has voted to make this a must in their school district;

The requirement, one that is not used teamwide for those sports anywhere else in New Jersey, will be mandatory initially for the sixth grade only, officials said. For children in grades seven to 12, the headgear is optional, although parents or guardians will have to sign a form saying they have declined to have their children wear it.

Still, officials were clear this week that with each year, the headgear would become mandatory one subsequent grade level at a time, so that all athletes in those sports eventually will have to wear it if they want to play.

This move strikes me as both good and forward thinking and as a waste of money as well.  Let us examine, first with the not-so-good ideas/thoughts.

First, the premise for this move was in part due to concussions (although they did also state it is for facial and oral injury protection as well) and the thinking on this is wrong in my humble opinion.  Many researchers, doctors, athletic trainers agree that helmets do not prevent concussions.  Sure there is disagreement on whether they protect – for focal-direct-linear forces they do have validity in this premise (as you will see below) – but the general consensus on concussion attenuation is exposure limitation.

Secondly, the addition of head-gear in soccer Continue reading

Speaking of Helmets, NOCSAE Press Release

23 Jul

I was forwarded this NOCSAE press release from a very prominent AT in the NCAA, and although the sender declined to comment, it was his intention to get mine.  I feel it would be good to comment and publish this press release here.  You can find the press release, dated July 3, 2013 HERE.

The purpose of the information provided by NOCSAE was to clear up some perceived and often misunderstandings about the Virgina Tech Helmet Ratings for football helmets.  Like NOCASE, I encourage the research into helmets, the first line of defense against blunt force trauma to the head in collision sports (rodeo included).  However, there are some things that may need explaining.

Now by no means am I taking sides here, I feel Stefan Duma and his cohorts do a tremendous job, as well as the current helmet makers.  I feel that everyone is doing their part to provide Continue reading

Why Are We Here? Confusion and muddy water

17 Jun

With all the work that has been done up to this point with concussions I truly believe that we should have a better grasp on this injury.  Recently, we have seen some very confusing information come forward, I feel the message has been mixed and may lead to further issues when handling concussions.  Patrick Hruby, in his article on Sports on Earth, takes a very critical look at the Collins research as well as other studies that have pointed to the players being the problem in this concussion issue.

It is not the players fault, it’s not the referees fault, it’s not the coaches fault, it’s not the sports fault.

I do think that football and collision sports do require some sort of “full” practices in a controlled environment.  Although the actual speed of a game is difficult to replicate in a practice, full-go is needed for players to understand the closing speeds, angles and decision-making of the sport.  Without a full grasp on this the player may be at further risk for overall injury in sport.  It would be insane to have a football, hockey Continue reading

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

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: 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

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