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

18 Aug

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

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

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

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

Upon completion of the drill – rather near Continue reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

Continue reading

Sensor Overload

12 Aug

With all that is new to the concussion realm, nothing is really new.  This includes: how the injury occurs (traumatic variable force vectors – often unanticipated – jarring the brain case), its recovery (unique and undefinable), its identification (mainly subjective but overtly obvious when objective), overall education and general understanding from day-zero to day-undetermined.

The current “hot topic” for concussions is sensors.  These sensors are nothing new, they have been around for years.  As with most technology the devices are getting smaller and more accurate; natural evolution, if you will, for sensors.  I have had the fortune of testing some products, getting deep information on others, and curiously viewing some brought to my attention.  The constant thought I have is: no product has provided a clear-cut reason for inclusion – at this moment in time.

Are sensors a good idea?

Sure, if and when they become accurate enough for trained individuals to use them without impeding current standards of care.  Further, I also believe that down the road we will be looking for a product that can accurately and systematically determine the gross effects of every blow the brain case takes.  The key being EVERY BLOW.  Not just hits to the head, or at full speed, or only in practice, or in helmeted sports.

The overwhelming information we have on concussions and their occurrence is that we just don’t know a threshold; for mine, yours, your son’s, your daughter’s or anyone.  We have a general Continue reading

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

31 Jul

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

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

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

Hamilton, Ontario — July 30, 2104

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


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

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

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

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

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

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

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

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

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

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

Educational Video: Subject Matters, Featuring Dr. Brady

30 Jul

Blog follower and prolific commentator here, Don Brady, PhD, PsyD, NCSP is featured on ION TV’s “The Subject Matters” from May of 2014.  The video is in two 15 minute chunks:

Dr. Brady is a very good resource and wealth of information.  I suggest you take some time to check out his time on ION TV.

Training Camps in NFL Open Up

28 Jul

With the summer pilgrimage to training camps begun it is time to remind everyone that The Concussion Blog will be tracking the concussion injuries in the NFL for the fifth consecutive season.  It is our intention and has been our operating procedure to gather all the best data possible.

This is not a “witch hunt” or some “watch dog” type action, rather a way to inform, publicly, what is happening at the highest and most prolific level, for the most popular sport in the United States.

When we began back in 2010, the information was difficult to come by, we only noted and found eight preseason concussions and as of today there are four reported for this season.  Obviously there has been better knowledge about concussion from players, teams and reporters that has translated in easier tracking for the preseason activities.

I would like to take the time to mention @nflconcussions for their work in data mining the injuries.  Their Twitter account is probably the most productive when it comes to finding concussions.  They too have “reset” their counter for this season, if you follow them (and you should if you are interested) you will notice their numbers will be different from our reports once the regular season begins.

We data crunch only for the regular season due to reporting procedures from the NFL, making those injuries a bit more easy to find.  We also have other avenues to find concussions that may not make the press and are gathered by other places.  Finally there are some instances where a “possible” concussion turns out to be not a concussion.  We are not, in any way, discrediting any other concussion gathering group, we are just pointing out we do it differently.  Regardless, it would be a heck of a lot easier if the NFL was transparent with all injuries including concussions.

So enjoy what is left of your summer, and look forward to our first report coming out near the start of the season.

 

#C4CT Concussion Awareness Summit Reconvenes Next Week

25 Jul

Brewer Sports International and Amarantus Bio Science is continuing their efforts to collaborate and discuss the issue of traumatic brain injury, in particular concussion.  In this version the focus will be on Alzheimer’s;

The #C4CT Concussion Awareness Summit is being convened on July 31, 2014 to explore the potential link between TBI and Alzheimer’s disease.  A diverse working group of clinicians, medical researchers, policy makers, international diplomats, athletes, celebrities, and philanthropic organizations will be assembled to raise awareness, advance clinical research, and develop public policy in order to address this major unmet medical need and public health issue.

The #C4CT Summits have a stated goal to collaborate information and ideas to try and further both understanding and proper response to this issue at hand.  I described it as – using a Japanese proverb – “none of us is as smart as all of us.”  Which is definitely the case for just about anything in life.  However, with so many egos and generally smart people there seems to be a ton of hand-wringing and chest thumping without a lot of resolution.  Jack Brewer and Gerald Commissiong are trying to find a way to get everyone on the same page.  Evidence of this was asking me to be a panelist during the last UN visit in January.  You can see the recap below;

There is still time for you to attend this wonderful event, littered with some great minds and speakers.  If you cannot attend you should follow their twitter feed next Thursday (unfortunately I will be away on vacation so I will not be live blogging the event this time around).

DYK Helmets Do Not Stop Concussions: An article that must get traction

25 Jul

I can tell you there is more coming on this issue – from here and other platforms – but this Regressing (part of Deadspin) article really needs to be highlighted here for those seeking accurate concussion information.  I would be remiss if I didn’t – virtually – give Kyle Wagner a “good game” for writing a beauty!

‘Hockey’s About To Get The Bullshit “Anti-Concussion Helmet” Treatment’ appeared 7/23/14, here are some great excerpts.

Lets begin with the opening salvo;

Virginia Tech thinks hockey helmets are bullshit, which is more or less true. In turn, it wants to look at the differences between hockey’s helmets and football’s recently evolved versions, and bring the concussion-stopping advances to hockey. This is pretty much bullshit.

Then the all-important – simplistic – overview of the concussion process (emphasis mine);

The brain floats suspended by fluids in the skull, and when it suffers concussion, it both smacks into the inside of your skull and incurs rotational force, irreparably damaging the brain stem.

Why we wear helmets;

Helmets, meanwhile, are there to protect your skull from fracturing in the impact of a collision. They provide this protection, and the best helmets have interior mechanisms that can offer some small aid in decelerating a collision.

A wonderful note in the article, that may be glossed over by most readers, but it very peculiar to many of ‘us’ in the know and actually understand/grasp both the concussion injury and the statistics that are thrown out about them;

If the above numbers seem low to you—a combined 64 concussions for eight college football teams over six seasons, or just about 1.3 per team per season—then you’ve likely read enough to have seen players talking about getting their “bell rung” often enough that those Virginia Tech numbers wouldn’t just represent a decrease in risk by half, but exponentially. If the available data say anything, it’s that they are hugely incomplete.

Further on the above excerpt, 1.3 concussions for AN ENTIRE TEAM for AN ENTIRE SEASON is just asinine, Continue reading

#tbt: Eye Opener from 2012: Was it overlooked?

24 Jul

Originally titled “Bombshell Found in Sports Illustrated Vault” this post appeared on July 4, 2012…  To this day, it may be one of the most poignant articles I have written about the road we have been down.  I believe that this post still rings true, two years later, in regards to all the information we knew that we didn’t know…  

Considering where – 2014 – and what has transpired – League of Denial – this article may have been glossed over and was WAY AHEAD OF ITS TIME from SI.  I often find myself wondering why we are not learning from the past to make proactive measures going forward…

Enjoy the read from the past (excellent RT @protectthebrain);

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Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, [...] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. [...] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading

Arkansas Looks Into Hit Limits

18 Jun

Over two years ago I sent an open letter and proposals to the Illinois High School Association (IHSA) regarding hit limits in football.  Some took this as a “candy ass” approach and one that was not needed.  I disagreed with that assessment, in fact, I felt that what I wrote at the time was proactive and could be a way for this state to be a leader in the area of protection in concussions;

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.[...]

Recent evidence suggests that even the subconcussive hits – those that effectively “rattle” the brain but do not produce signs or symptoms – become problematic as the season wears on, let alone a career.  As the researchers in this field gain focus and more specific diagnostic tools, I feel we will see damning evidence that will put collision sports in jeopardy as they are currently constructed – the key being “as they are currently”.  There can be a change, both positive and proactive, that will signal to everyone that the IHSA is taking this matter seriously and can set a nationwide standard.

Needless to say it was brushed aside and was ignored, except for a kind email saying things were happening behind the scenes.  Now, two years and one month later there could be a 12th – TWELVE – states that have contact limits in place for high school football; as Arkansas looks into the matter;

According to reports, the Arkansas Activities Association has passed a recommendation to ask school superintendents to cut full contact practice time to just three times during game weeks. With one of those being the game itself, it leaves just two days of tackling if the proposal passes.

Jason Cates is the lead trainer for Cabot High School, and the former President of the Arkansas Athletic Trainers’ Association, he says, “Something has to be done.”

“The more studies that are showing that hit counts do count and add up.”

The Arkansas proposal limits the full contact days to three, opposed to the two I proposed, but it seems to me that others have seen the light.  That light is both the end of the tunnel and the oncoming freight train.  Kids need Continue reading

Hit Count Symposium

16 Jun

If you have a son or daughter in Little League Baseball you probably have heard of a pitch count.  Basically it is a set number of pitches a pitcher can throw in a certain time period.  The reasoning seems simple and sound, in my opinion; to protect the overuse of the arm/elbow.  Sure, there are many coaches out there in the baseball world that know what they are doing and will only throw players when they are fully rested.  On the other hand there a plenty of coaches out there that either don’t know or knowingly put players at risk when it comes to overuse of the pitching arm.

This has a relation to the concussion world; well, Sports Legacy Institute hopes so.  In an effort to be PROACTIVE about issues surrounding concussions and especially the youth players of collision sports SLI has created an initiative to limit, log and research “hits” absorbed.  I have blogged about it here when the initiative began.

Like many things that are new and different, people often dismiss or fail to grasp what is being attempted or cannot see what may be accomplished by doing them.  In regards to the Hit Count, it to is simple; limit the number of hits one sustains while playing sports – collision sports to begin with.

I may not be the worlds biggest advocate for sensor technology as we currently know it, however this approach is different and unique.  It is something that should be paid attention to, if not for the currently proposed reasons, at the very least the research capability.  How can we know if we don’t know.  In other words; how can we measure if we are making a difference with any of our so-called “advances in concussion issues” if there is not something to measure it against.  For a small niche in the medical community that is all about “baselines” and return to “normal” our peers seem to get all squirmy when people want to find this baseline.

The Hit Count most likely will not be the panacea which our culture so desperately wants but this is at least a step in the right direction.  Below you can see the full press release on the Symposium.  I cannot attend on July 15th, but I have been afforded two (2) transferable registrations.  Please contact me if you will be in the area and are looking to attend.  Without further ado:

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For Immediate Release —Thursday, June 12, 2014

Media Contact: Chelsea McLeod (781) 262-3324 or cmcleod@sportslegacy.org

Sports Legacy Institute Announces 2014 Hit Count® Symposium to be Held on Tuesday, July 15, at the Boston University School of Medicine to Advance Discussion on Use of Head Impact Sensors in Sports to Prevent Concussions

Co-Chaired by Dr. Robert Cantu and Dr. Gerry Gioia, event will gather researchers, athletic trainers, coaches, parents, athletes, medical professionals, and administrators to explore how Hit Count® Certified sensors can be used to improve brain safety  Continue reading

World Cup Time

13 Jun
I took this pic at FIFA HQ

I took this pic at FIFA HQ

For all the blame football gets for concussions and concussion problems; futbol – or the worlds’ game – has its share of concussion issues (so do just about all contact sports).  The unique thing to soccer is that it is not a “collision” sport, by definition.  Yes, it is a contact sport, however it is not designed for full contact or collisions all the time like other sports like: rugby, Aussie Rules, Football, hockey and rodeo (you could even include lacrosse because of the sticks).

The nature of sport, competitiveness, lends itself to injury risk and risky behavior – this is always the case of concussion and their issues.  In the game of futbol/soccer the basic rules have set up a game where concussions can and do occur at frequency for a “non-contact” game.  Of course calling soccer “non-contact” is a complete misnomer if you watch or understand the game at all.  Players are constantly using their bodies to gain an advantage on opponents, from shoulder charging to grabbing or using hips to knock another player about.  The issue as it relates to concussions is how the head is used in this sport.

It is used as a much-needed tool to clear, pass and score the ball.  It is currently unclear as to how heading a ball in general relates to concussions and long-term issues although a general causation link can be observed and some studies have shown higher incidence of deficit of “brain measures” with increased heading.  Most often concussions occur due to collisions on the pitch.

It could be as simple (and scary) as a boot to the head or as subtle as an aerial challenge that resulted in a violent and unanticipated shaking of the head.  Often, concussions occur when the player falls to the ground and the head uncontrollably smacks the ground.  The point being there is ample opportunity for a soccer player to sustain a concussion and at the least subconcussive brain injury.

I thought I would look in to the research done about concussions in soccer and came across a very peculiar paper: “Chronic traumatic brain injury in professional soccer players”.  It is not the title that caught my eye, with all the information we are currently gathering on concussion it seems natural to see that kind of title.  Heck, very recently we saw something that was originally thought of as non-existent, CTE in a soccer player.  No, what made me stop and note this study was the year the paper was published………. 1998.

Yes, 16 years ago.  Let me repeat that, SIXTEEN years ago this information was made available by these pretty dang good researchers: Chronic Traumatic Brain Injury in Professional Soccer Players.  Below are the results and conclusions:  Continue reading

LINK: Rebroadcast of Pres. Obama Sports and Concussions

30 May

You can follow the link below for the rebroadcast of the “summit” on concussions in sport held at the White House yesterday.

http://www.c-span.org/video/?319639-1/president-obama-sports-concussions

There were some interesting thoughts passed along and it was great to hear the POTUS discuss athletic trainers and the need for them.  The next step in that “finger” of concussion care is to find funding and placement of athletic trainers.

I did enjoy Taylor Twellman’s honesty and direct nature during his time.

General Dentistry Publishes a Bombshell About Mouth Guards (ADDENDUM)

5 May

Is it a bombshell or is it just a plain dud?  I say bombshell, but not in a good way for anyone involved with this “research”.

Last week I was inundated with emails regarding this “new” research about mouth guards and concussions.  There were roughly 16 emails in a one hour time span; some wanting comment, some telling me I have been wrong all along, some promoting the research.  This was a “huge” development in my area and my little corner in the blogosphere.  To fully understand perhaps some history is needed (“mouth gear” search on this blog) when it comes to my feelings on mouth gear and concussions.  Here are some selected comments attributed to me;

The basic fundamentals we should be cognizant of here are: concussion is a BRAIN injury, the BRAIN floats inside skull, Physics dictates that the BRAIN will move depending on the forces applied to the skull/head (not always from a blow to that area), mouth gear cannot stop the BRAIN from moving, mouth gear cannot attenuate any forces to the skull/head that are not in the oral region, mouth gear does nothing for the skull/head when forces are placed on it in rotational, angular, acceleration or deceleration fashion.

Now that we have that all out-of-the-way this is the General Dentistry article I was asked to comment on.  On face value and from a “peer-reviewed” angle it Continue reading

Please Let This Be The Beginning: A Public Invitation

28 Apr

The blog began simply enough, making notice of information about concussion in a time when there was so much misunderstanding.  It turned into a cathartic exercise on how I have dealt with concussions as an athletic trainer – the good and the bad.  It has slowly morphed into a platform for change; not only concussions but the healthcare profession of athletic training, in particular at the secondary school level (high school).

Adolescent concussion is not only staggering in terms of exposure but in terms of mismanagement, the true problem in this concussion crisis, in my humble opinion.  I feel – biased – that athletic trainers not only can help with the management but with the overall “acceptance” of this brain injury as it relates to sports.  Because of those thoughts I have been openly and behind the scenes, clamoring for a way to get more AT’s in the high school.  Not just game-day ATC’s either, full-time and daily coverage for our most vulnerable.  The analogy still remains: would you send you kid to a public swimming pool without a life guard on duty?  Why would you send your kid to collision sports without an athletic trainer on duty?

Yes, this is being spurred on by the concussion issue at hand, but in reality an athletic trainer is SO MUCH MORE!  We deal with the mundane (common cold) to the emergent (cardiac arrest) when it comes to athletic or high school (dealing with situations during a school day) injuries.

I came across a tweet today from Rick Burkholder (@proatc), Head Athletic Trainer of the Kansas City Chiefs that is putting this into action.

The NFL is starting a grant process to place certified athletic trainers (ATC’s) into more high schools.  The monies are limited from what I can tell, but this is the start that I have been dreaming of for the past few years.

You can read the entire NFLF ATC Grant by clicking on the link to see all the details but here are the highlights: Continue reading

Refreshing Words From an Athlete

24 Apr

It’s my “off-season” of sorts here on the blog.  Add into that a growing, young family and time just seems to be hard to come by (not to mention my real “day job” of taking care of hundreds of athletes at a high school).  However, I am always listening and reading.

Today I stumbled across an Australian Rules (Footy) article about a knee injury but what I found in the article was a quote, from a professional athlete, that made me smile.  It seems that self-awareness and concussions is starting to take root (emphasis mine);

“I went to lunge to tackle Dangerfield and I remember Jimmy coming the other way and he sort of clipped my head and at the time, I didn’t think too much about my knee, I was more worried about my head,” Armitage told AFL.com.au after he was released from hospital on Wednesday.

If you read about the knee injury and the subsequent teammates horror over that you would wonder why he was thinking about his head.  David Armitage, without realizing it, has shown people, athletes are cognizant of concussion and in this instance placing that injury above a knee injury (albeit a laceration – significant enough to warrant a nine-day hospital stay).

This is where we need to get to, acceptance of the injury.  Understand that this will and can happen and then move on from there.

Its not the injury of concussion that is the real issue, rather it is the mismanagement of the concussion that is the real problem.

Sylvia Mackey – Video

27 Mar

In a follow-up, and what I believe to be the same presentation that Elanor Profetto’s video is from a very strong and wonderful woman, Sylvia Mackey, “Mrs. 88″ gives a talk about brain injury.  She also has intimate and troubling experience with what brain injury/disease can do as she took care of the great John Mackey in is twilight.

Keep on learning and listening!

Eleanor Perfetto, PhD – Video

26 Mar

Been on a video binge lately…  Look for more, but for today please take a listen to Eleanor Perfetto.  There are some points that some may (including me) not agree with entirely, but she has earned the right to be heard!  Not only is she a pharmaceutical epidemiologist, she is the widow of Ralph Wenzel.

Look for more video tomorrow…

A Decent Video

24 Mar

I am finding it hard to find time to post, obviously, but I will get back to this as soon as I can.  For the time being here is a decent video I have had forwarded to me that can be a good example of concussion or mTBI…

I would love to see discussion on this, below!

TCB Commenter Highlighted in Canadian Press

18 Mar

If you visit here enough and take the time to look at the comments at the end of the posts you might notice a person named “Phil”.  He especially took time to comment on the work of Terry Ott and his seven-part series about CTE in the CFL.  Thanks to Terry and this blog we are all able to get the genuine views of a former player in the CFL, Phil Colwell, via The Record from Canada and Terry Ott;

Colwell’s brief CFL career ended in 1981 after a violent on-field collision in a game at Winnipeg Stadium. He was playing for the Toronto Argonauts on that crisp and sunny day in October.

Covering a kickoff, Colwell, a solid six-two, 195-pounder with sprinter speed, was blindsided through the ear hole of his helmet by a Winnipeg player and was knocked out cold. He lay motionless on the field while a trainer ran to his assistance. No penalty was called on the play.

This is the type of story that Ott has sent out to tell from the beginning, placing faces and human behind the issue that has become one of the preeminent problems with football.  Yes, this is not isolated to football but we would be remiss if we didn’t expose and tell the stories of the most oft afflicted in the “head games” we now find ourselves knee-deep in;

Colwell, who graduated from Laurier with a psychology degree, found work with a Scottish government agency but continued to suffer bouts of depression and mood swings. He says accompanying anger issues and self-medicating led to moderate bouts of short-term or primary memory loss. Colwell says he frequently “loses the right words.”

The Scottish doctors he consulted were not familiar with professional football Continue reading

This is Interesting. Share Your Thoughts

6 Mar

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

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

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

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

Nick Mercer: Recovery is in the Eye of the Beholder

26 Feb

For those new to the blog, Nick Mercer is our only “staff” writer here at The Concussion Blog.  He provides a great layman’s perspective; one from a person recovering from a traumatic brain injury.  If you want to know why he does this – for us and himself – you can read THIS POST.  Thanks Nick for your time and content!

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In recent years, my “recovery” (more on why that word is in quotes later) seems to have gained steam and I’ve noticed more improvement, even though the accident that caused my brain injury occurred over ten years ago. I’m sure there are many physiological and neurological reasons why improvements would take this long, then again, maybe I haven’t improved that much neurologically or physiologically, maybe I just feel better in general and in my attitude toward “recovery”.

For the first nine or so years, I was focusing on trying to fix problems – I wasn’t able to do this or that, I was tired, my vision was messed up – problems that no matter how much I tried to fix, I could always improve upon, so I was reaching for a goal that couldn’t be touched. That kept me going, kept me striving. It also put me in a permanent state of dissatisfaction. There were times, of course, when I was depressed, but there were also times when I was happy. Happy, but dissatisfied.

All the while, I was pushing myself physically, in the pool, the gym, walking to and from work. I was also pushing myself mentally, through work, and through reading a lot, especially non-fiction books. My sister had told me for years that I should try Pilates, that she thought it would be good for me. I always had some excuse Continue reading

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.

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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

Where is Tech Going With Concussions

7 Feb

Technology is ever-expanding in all areas of our life; in my short time we have gone from land line phones and massive desktop computers that could play “Lemonade Stand” to handheld personal computers that is also a phone.  The point being that technology is amazing.  In the previous post we discussed how MRI now can actually see damage to the white matter in the brain after concussion.  Until that information was presented the changes in the brain were only theorized about.

Yes, it is true that we are trying to find an objective measure, but people need to understand that this objective measure is not necessarily needed to find the concussion.  An athletic trainer with their years of education and experience are pretty dang good at finding concussions; with or without the help of “tools.”  The need for objective measures is for the TRUE PROBLEM of the “concussion crisis”; the mismanagement of the injury – mainly returning too early.

Conrad Wilson wrote up a good article on technology that is emerging, focusing on balance Continue reading

Research That Should Stop You In Your Tracks

6 Feb

OK, that title may be hyperbole, but the new research out of Canada should make you take a step back and realize what our fine researchers are now able to discover.  Considering the context of hockey it shouldn’t be shocking that this was found in Canada (since posting we have been informed that work was done on both sides of the border), but really for a long while now some of the best work on concussions is coming from the North, for whatever reason (no disrespect to the US scientists).

Now that I effectively pissed off a few readers with the last comment, here is what was found by Dr. Paul Echlin and team:

  • concussions alter the white matter of the brain
  • structural damage can now be seen
  • MRI was used
  • this is both males and females
  • brain vascular changes were noted in males only, but resolved at two months
  • comparison with control counterparts showed that concussed individuals had white mater changes at end of season (upon being fully resolved from injury)

From the CTV News article (video at jump);  Continue reading

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