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Nick Mercer: Why we continue to see players play

19 May

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

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

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

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Ohio’s New Concussion Law FAQ’s

17 May

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

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

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

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

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

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HS Class Uses Blog to Educate

10 May

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

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

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

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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 →

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Interesting From ‘Gus’

1 May

Here is a TEDx Talk with Kevin Guskiewicz

There are some good moments and some moments that make one scratch their head.  Take a watch (bout 17 minutes) and comment below…

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“Concussions Happen” Video

16 Apr

This is a re-post, sort of, of a video created by Bryson Reynolds a neuroscience graduate student.  His area of study is concussions and mTBI.  He shortened the original video for easier consumption, it still holds the essence of what makes it a good too for us to use; stark and striking objective mechanisms of injuries, across all sports.

It is barely over a minute in time, again this is a great teaching tool for those trying to understand the mechanisms of concussion.  If I counted correct only 4 of the clips show head-to-head contact.  THIS IS EXTREMELY NOTEWORTHY, as concussions occur without direct blows to the head.  Also note the concussions (presumed by the filmmaker due to descriptions of the original videos) that occur due to contact with the ground or ball.  Perhaps the most disturbing videos are the last two, youth sports.

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A Chuckle and Video

10 Apr

I really don’t have much for this quote found in this article;

“I have a theory on concussions,” he said. “I think the reason there’s so much more of them — obviously the impact and the size of the equipment and the size of the player — but there’s another factor: everyone wears helmets, and under your skull when you have a helmet on, there’s a heat issue.

“Everyone sweats a lot more, the brain swells. The brain is closer to the skull. Think about it. Does it make sense? Common sense?” said Carlyle, who said he’d never talked to a doctor about his premise, which he was introduced to by Jim Pappin, the former Leaf who also played his career helmet free.

“I don’t know if it’s true, but that would be my theory. Heat expands and cold contracts. The brain is like a muscle, it’s pumping, it swells, it’s a lot closer to the outside of the skull.”

Stick to coaching hockey, eh!

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The ESPN article and video (click link or below) regarding the NFL Concussion Litigation; Continue reading →

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ESPN OTL Article Sparking Quite A Debate

8 Apr

On the surface this article may be innocuous to many, but the the minutia of concussion research and information is coming to a head very quickly, especially pertaining to the NFL.  Tomorrow is the first hearings in front of the judge – and the possibility of total dismissal - for the concussion law suits filed by thousands of former NFL players.

ESPN and its Outside the Lines department (in conjunction with Frontline) filed this article taking a look at two of the most prominent people in the concussion research/awareness arena, Dr. Robert Cantu and Chris Nowinski;

Two prominent concussion researchers — including a senior adviser to the NFL — served as paid consultants to law firms suing the league for allegedly concealing the link between football and brain damage, according to interviews and documents obtained by “Outside the Lines” and “Frontline.”

The article written by Steve Fainaru and Mark Fainaru-Wada sheds light on the very issues the research community faces with this problem.  Some of this information can be classified as “not new” to people who participate in the constantly shifting arena of litigation and research, while some information can be deemed as scathing.  There is a very tight and ubiquitous line in this matter;

Researchers often are asked to appear as expert witnesses in legal proceedings related to their fields. The NFL suit, with the potential for billions of dollars in damages, has created a large demand for researchers with expertise in the science of concussions.

But some researchers said they have turned down such requests despite the potentially lucrative payoff out of concern the perceived conflict could compromise their research.

Conflict of interest (COI) is something we all need to pay attention to, although it applies to this current article, the COI in this field is rampant and often unchecked.  This is nothing new, players have talked about COI, other journalists have noted it, and one of our prominent commentators (Dr. Don Brady) on the site has even devoted some of his dissertation to COI.

It would seem this is nothing “new” in the world Continue reading →

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Archaic Thinking/Management of Concussion Not Just a N. American Issue

4 Apr

I have cataloged this problem many times in many sports across the world.  It seems that perhaps the focus and glare is greatest here with North American sports (mainly football and hockey), but this problem extends further.  This issue perhaps came to a head in the UK over the past week with this article by Tom English;

Barry O’Driscoll played rugby for Ireland in the Five Nations championship of 1971.

As a respected doctor (whose son was team doctor for Ireland and the Lions in the recent past) with a background as an international full-back he became an important figure on the International Rugby Board where for 15 years he held positions on the medical, anti-doping and disciplinary committees. Until late last summer, when he resigned.

Dr. O’Driscoll left his post because of the way the International Rugby Board (IRB) was/is handling concussions on the field and in general.  As an aside, the IRB is a founding partner of the Zurich statement as well.

What would make a highly trained and well-respected doc – with rugby in the blood – step away?  Take a look, specifically at what happened to his nephew;

After one collision too many that day Brian O’Driscoll lost his bearings, was clearly unsteady on his feet and had to be helped from the field, like a boxer assisted from the ring. You did not need experience in pathology to know that the great man was out of it for a moment in time. Yet a few minutes later he was back on the pitch, supposedly as bright as a button and fully recovered.

He was back on the field because ?????;

There is an accompanying rule now – still on trial – and it states that if a player with suspected concussion can pass a series of tests lasting five minutes then he can be allowed back into the fray: the Pitch Side Concussion Assessment (PSCA) – or the five-minute rule.

Even worse the “new” rule was not even in place when his nephew sustained his concussion, leading the good doc to question what the sanctioning body and the medical board was doing;

“Rugby is trivialising concussion,” he says. “They are sending these guys back on to the field and into the most brutal arena. It’s ferocious out there. The same player who 18 months ago was given a minimum of seven days recovery time is now given five minutes. There is no test that you can do in five minutes that will show that a player is not concussed. It is accepted the world over. We have all seen players who have appeared fine five minutes after a concussive injury then vomiting later in the night. To have this as acceptable in rugby, what kind of message are we sending out?

“If a boxer cannot defend himself after ten seconds he has to have a brain scan before he comes back. And we’re not talking ten seconds for a rugby player, we’re talking maybe a minute that these guys are not sure what’s going on. They don’t have to have a brain scan, they have to have five minutes where they have to stand up straight without falling over four times, they have a basic memory test – ‘What’s the score? Who are you playing against? Which half did it happen in? And do you have any symptoms?’

“These questions should serve as a landmark for when you examine them six hours later to see if they’re getting worse or if they’re bleeding into their brain. That’s why you ask them, not to see if they can go back on. They are already concussed at that point. You don’t need to ask questions to find that out. If six hours later their responses are worse than they were earlier you say ‘Wait a minute, this shouldn’t be the case, is this guy going to bleed?’ That’s why you ask the questions and so it has always been. But we’re going in the other direction now. We’re going from being stood down for three weeks to one week to five minutes with players who are showing exactly the same symptoms. The five-minute rule came out of the blue. I couldn’t be a part of it so I resigned from the IRB. It saddened me, but I couldn’t have my name attached to that decision.”

As you can clearly see some places are not quite ready to accept the real issue of concussions – not the actual injury – the mismanagement of the injury once it occurs.  If the IRB places the new “five-minute pitch side rule” into place they are going in the absolute wrong direction.

If any player in any sport shows clear signs of concussion they should be removed and not allowed back in, period.  Even Zurich, which the IRB is part of states this.  Dr. O’Driscoll is merely saving his reputation by stepping aside, and in my opinion it is the exact correct move.

 

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The Experts Tell Us Why Athletic Trainers Are Needed

3 Apr

You don’t have to take my word for it here, you can watch this video and let the experts in the field tell you;

Although we are not there yet, there are financial barriers, and some misnomers about the profession; athletic trainers should be a must.

As I have clearly stated: “If you cannot afford an athletic trainer you cannot afford to have collision sports, period.”

Hey here is a bonus, athletic trainers are also some of the best at on the field orthopedic injury assessment and injury prevention in the WORLD.  Doctors even defer to the knowledge of an athletic trainer when it comes to sports injuries.

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Mayo Clinic Looking into Autonomic Response to Concussion

1 Apr

Neurologists at Mayo Clinic in Arizona have taken a promising step toward identifying a test that helps support the diagnosis of concussion. Their research has shown that autonomic reflex testing, which measures involuntary changes in heart rate and blood pressure, consistently appear to demonstrate significant changes in those with concussion.

Appearing on their website, the information researchers are delving into is a new angle on  concussions.  It is widely known that traumatic brain injured (TBI) patients have autonomic system (ANS) deficits/abnormalities.  However the group from Arizona thought an investigation into concussed patients was worth the effort.  Low and behold their findings are a promising first step in possible assessment and management of the concussion.

One interesting note, was this notion on dizziness;

“Contrary to popular belief, the symptoms of ‘dizziness’ that patients feel just after a concussion may, in some cases, be symptoms of autonomic system impairment rather than a vestibular or inner ear disturbance,” says Bert Vargas, M.D., a Mayo neurologist.

No one is telling you to take blood pressures with assessment (ergo baselines), yet, but with this information could come not only objective testing but biomarkers associated with ANS changes;

“This study shows a possible electrophysiological biomarker that indicates that a concussion has occurred — we are hopeful that with more research this will be confirmed and that this may also be a biomarker for recovery,” he says.

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Nick Mercer: Impromptu Expectations

28 Mar

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

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

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

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Concussion Conglomeration “Road Marker” (UPDATED FREE ARTICLE LINK)

27 Mar

A paramount review of concussions and their “long-term” effects has been published (or soon will) in Nature Reviews Neurology that I certainly hope does not slip past the masses.  Not only is the information somewhat of a “where we stand”-moment of clarity, it is authored by a very underrated and proficient researcher; Dr. Barry D. Jordan.

Jordan, B. D. Nat. Rev. Neurol. advance online publication 12 March 2013; doi:10.1038/nrneurol.2013.33 (note you need a log in).  Here is the FREE DOWNLOAD LINK

Acute and chronic sports-related traumatic brain injuries (TBIs) are a substantial public health concern. Various types of acute TBI can occur in sport, but detection and management of cerebral concussion is of greatest importance as mismanagement of this syndrome can lead to persistent or chronic postconcussion syndrome (CPCS) or diffuse cerebral swelling. Chronic TBI encompasses a spectrum of disorders that are associated with long-term consequences of brain injury, including chronic traumatic encephalopathy (CTE), dementia pugilistica, post-traumatic parkinsonism, post-traumatic dementia and CPCS.

Dr. Jordan also discussed CTE in further detail including the limitations of possible antemortem detection; including imaging and categorization.

In this Review, the spectrum of acute and chronic sport-related TBI is discussed, highlighting how examination of athletes involved in high-impact sports has advanced our understanding of pathology of brain injury and enabled improvements in detection and diagnosis of sport-related TBI.

The overriding theme I gathered from this review article is one that I have been hammering home for a very long time: the mismanagement of the original sequale may be the largest factor in discussion the multiple faces of “chronic TBI” that result from concussion.  This paper is also very succinct in demonstrating the massive amount of work that still needs to be done.

I urge you to find a copy or pay for a subscription for this article, it should be one that we look back on in 5 years as the “where have we come from” moment in this issue, regarding chronic issues from sports related concussion.

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International Boxing to BAN Headgear…

25 Mar

Discuss…  (LINK)

A major sports federation has mandated banning headgear in amateur boxing competition in an effort to reduce concussions and head trauma, a decision that is thought to be a first in the sports world.[...]

Removing the use of helmets or headgear has been discussed as a counterintuitive way to decrease brain injuries, with the idea being that athletes wouldn’t use their heads as weapons or hit as hard if they didn’t feel as protected. In boxing, there also is the belief that headgear makes it harder to see to the side to avoid blows, and makes the head a bigger target.

There has been limited research to support this change, but fresh data, still unpublished, suggests the removal of headgear in elite, male amateur boxing reduces the incidence of concussion, according to the chairman of the AIBA medical commission, Charles Butler, a retired cardiac surgeon and ringside doctor, who spearheaded the study that served as part of the basis for the recommendation.

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AAN Concussion Guidelines – One Stop Post

19 Mar

Here is the presser for the updated AAN Sports Concussion Guidelines; their guidelines are simple and to the point, via YouTube;

  • No Grading System of concussion
  • 10 day rest period – “key” – Dr. Jeffrey Kutcher
  • Greater risk if you have had a concussion
  • Addressing of youth and recovery
  • Helmets are not the full answer
  • Licensed Health Care Providers should be clearing
  • Repetitive head injuries are bad
  • The discovery and annotation of “Chronic Cognitive Impairment”
  • No single test, CLINICAL assessment
  • “Kids are not little adults.” – Dr. Christopher Giza

Here is the LINK to the Updated Guidelines (can someone give me permission to post it here?)

Here is the LINK to the Sports Concussion Toolkit from AAN

Here is the LINK to the Concussion Quick Check from AAN

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What does this mean in comparison to the Zurich Statement?  That is a great question; both groups used “consensus” however this group is much more centered on American practices.  Both have similar approaches, both advise nearly the same thing; but which one carries more weight.  I have been told the AAN will be much more “powerful”, respected and learned than Zurich.

This is a good debate, regardless, there is ample evidence to sit kids and any concussed individual.  This statement also continues the wave of information that cumulative and repetitive trauma to the brain (still figuring out thresholds) is not good.  Based on this and the Zurich statement the only way that we can collectively abate concussions at this point is exposure limitation.  No where in that last sentence does it state “stop playing sports,” or “get rid of football”.

When dealing with the brain and the injury of the brain less is better, which is ironically simple and a “no brainer”.

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2013 Concussion Tracking – Need Help

19 Mar

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

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

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

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

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

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

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

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

Thanks again!

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Capt. Peter Linnerooth – US Army

17 Mar

I was just minding my business reading the news and getting lost in my Sunday mindless exercise, when I came upon a news story that shook me – on many levels.  This story is about Captain Peter Linnerooth; a story worth noting and sharing.  Does it have to do with concussions, I don’t know and I don’t care, it has to do with the well-being of humans – a plight that is part of the concussion story.

Regardless the Sharon Cohen authored story on Capt. Linnerooth is well worth your time;

He had a knack for soothing soldiers who’d just seen their buddies killed by bombs. He knew how to comfort medics sickened by the smell of blood and troops haunted by the screams of horribly burned Iraqi children.

Capt. Peter Linnerooth was an Army psychologist. He counseled soldiers during some of the fiercest fighting in Iraq. Hundreds upon hundreds sought his help. For nightmares and insomnia. For shock and grief. And for reaching that point where they just wanted to end it all.

Linnerooth did such a good job his Army comrades dubbed him The Wizard. His “magic” was deceptively simple: an instant rapport with soldiers, an empathetic manner, a big heart.

The man knew how to handle others and create an atmosphere for helping on a battlefield and beyond;

He was, as one buddy says, the guy who could help everybody – everybody but himself. [...]

“There’s no cavalry to save the day,” McNabb explains. “You ARE the cavalry. There was no relief.” [...]

For about half his tour, Linnerooth’s office was a 12-by-12 trailer. His heavy-metal soundtrack – he banned the Beatles and Pink Floyd, deeming them too sad – provided a sound buffer. A thermal blanket serving as a makeshift room divider also provided a modicum of privacy.

Linnerooth brought hope to those gripped by hopelessness. In a desert, he could always find the glass half full.

He turned tragedies into cathartic moments: When a platoon lost a member, he’d encourage the survivors to deal with their grief by writing letters to the children of the fallen soldier, recounting the great things about their father.

Then the pressures were too much; Continue reading →

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Zurich 2012 In Writing

12 Mar

If you all recall I went to Zurich in November to attend the “Concussion Conference”; mainly as an observer, but there was enough time and opportunity to impart my questions/knowledge as a practicing athletic trainer.  Here are the links to DAY 1 and DAY 2 of my live blogging.  By the way, the live blogging was WELL received and continues to provide great insight into what went on.  I hope that I am asked back for the next conference, or any other conference that wouldn’t mind my attendance.

Now the information gathered at the conference has been hashed and rehashed and now appears as the 4th Consensus Statement (tweeted previously).

As part of the initiative the Standardized Concussion Assessment Tool (SCAT) was looked at and changes were made to the 2nd version from 2008.  You can now find the new version by clicking SCAT3.

A new wrinkle was an assessment tool for the younger ages, the group decided on the “Child” version of the new SCAT3, that can also be found by clicking Child SCAT3.

Also included in the addendum of the Consensus Statement was a recognition pocket card, found by clicking Recognition Pocket Card.

All of the above is free and intended to be used as a resource for better concussion assessment and even early management of concussion.  Please read the Statement regarding best practices.  As always this blog is NEVER to be used to diagnose or treat a concussion.  There is a lot to be absorbed and read; one thing is for sure we as athletic trainers and concerned/educated individuals now have the most recent information at our fingertips.  I guess this blog is actually doing some good work :)  A side note; how about this appearing during National Athletic Trainers Month?  It might be a coincidence, but I find it serendipitous.

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Moorad Sports Law Symposium: Concussion Conundrum

12 Mar

The concussion issue has permeated every facet of life and sport.  Now policies, products, rules and law are starting to address the issue head on (pun intended), and one of the most renowned groups is taking a look at this issue as well;

The 2013 Jeffrey S. Moorad Sports Law Journal Symposium—Concussion Conundrum—explores, debates, and informs on the key issues facing players, teams, leagues, doctors, and lawyers regarding head injuries and brain trauma in sports.

Panels include commentary from well-known retired professional athletes about concussion awareness and prevention amongst players; an examination of both sides of the NFL Concussion Injury Litigation—the concussion injury class action suit brought by former NFL players against the league; an exploration of the science and concussion-related liability facing professional and amateur sports; and a look at where we are and where we are going with media personalities commenting on the state of sports and concussions.

Andrew Brandt, Director of the Jeffrey S. Moorad Center for the Study of Sports Law and NFL Business Analyst, has covered the concussion issue for ESPN and moderates all panels.

The Symposium takes place on Friday, March 15, from 9 a.m. to 12 p.m., in the Arthur M. Goldberg Commons at Villanova University School of Law. This program is approved by the Pennsylvania Continuing Legal Education Board for 2 substantive CLE credits. The event is free for non-CLE attendees.

The panel and the topics are top notch; this event should be on the “to-do” list of  anyone interested in sports law.  Below is the topics and panels (check the website for more deets – also notice our partners at stopconcussions.com (Keith Primeau) and our good friend Paul Anderson);

  • Panel 1: Framing the Issue
    • Keith Primeau
    • Jim Nelson
    • Taylor Twellman
    • Brian Westbrook
  • Panel 2: Building the Case — A Legal and Medical Background of Concussions  Continue reading →

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Anyone Want Money?

12 Mar

Basic RGBWell according to our comment section there are many of you out there looking for solutions; along with the efforts of established companies, like the helmet makers.  Now you can draw up and submit any ideas to the efforts of General Electric and the National Football League;

GE and the National Football League’s Head Health Challenge I aims to develop new solutions to help diagnose mild traumatic brain injury and invites proposals for scanning technologies and biomarkers that can accelerate growth. This four-year, $60 million partnership aims to improve the safety of athletes, members of the military and society overall.

The above is only step one, you have 111 days left to complete step 2;

We are seeking viable technologies for detecting early stage mild traumatic brain injuries at all stages of development for Challenge I. Ideas are welcome from all industries, organizations, and technical fields.

Visit the above linked website for further details and required forms.  I implore those that feel they have a technological solution to make the effort.  I will say this as candidly as possible; you cannot do it alone, you WILL and MUST have the resources and “blessings” of the NFL to get things done in the concussion effort.

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Latest Research on Concussions; Rather No Concussions = Changes

7 Mar

Certainly the research is flying in; mostly the investigations are now looking at either ways to detect the injury or objective ways to determine recovery.  There are a bunch of other designs and angles out there but the most important are the above.  Although it would be great if we had an objective way of determining concussion, it is really not the pressing issue (with solid education and conservative approach to injury – sit them out).

As I have stated over and over, the BIGGEST issue we face with concussions is the mismanagement of concussion from the beginning; therefore the need to identify when it is safe to return is more paramount in my opinion.

The newest research is out from the Cleveland Clinic, it looked at 67 college football players, more specifically it looked at their blood, report from WKYC;

In a study of 67 college football players, researchers found that the more hits to the head a player absorbed, the higher the levels of a particular brain protein that’s known to leak into the bloodstream after a head injury.

Even though none of the football players in the study suffered a concussion during the season, four of them showed signs of an autoimmune response that has been associated with brain disorders.

There we go again, telling and showing people that the hits that don’t elicit a concussive response are also a culprit in the brain injury crisis we are facing.  Coaches, particularly in soccer and football, will tell us that we are wrong and that it is either unproven or not a possibility because of how “safe” they practice or the equipment they have.

Back to the research, the group looked for the S100B protein that should only be in the brain;

Typically, S100B is found only in the brain; finding S100B in the blood indicates damage to the blood-brain barrier. While the exact function of S100B is not known, it is used in many countries to diagnose mild traumatic brain injury when other typical signs or symptoms are absent.

Studies in Janigro’s lab revealed that once in the bloodstream, S100B is seen by the immune system as a foreign invader, triggering an autoimmune response that releases auto-antibodies against S100B. Those antibodies then seep back into the brain through the damaged blood-brain barrier, attacking brain tissue and leading to long-term brain damage.

They also did some PET scans to Continue reading →

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Athletic Trainer Removed from Post for Standing Ground on Concussions

1 Mar

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

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

Why, you ask?

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

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

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

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

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

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

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

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

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

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

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

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

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

Video Thursday

28 Feb

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

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

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

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Beyond the Cheers Interview Today

27 Feb

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

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

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

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

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

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Aussies Study Concussions in Former Collision Sport Athletes

26 Feb

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

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

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

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

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

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