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10/17 Quick Hits

17 Oct

HockeyNow question and answer with Charles Tator (one of the best);

HN: What have we learned about concussions that maybe we didn’t know a decade or two or three ago?

CT: There are about 30 things that we didn’t know just 10 years ago. For example, the adolescent brain seems to be most susceptible to concussion and takes the longest to recover. It’s rather unfortunate because that age is when kids are now big enough and fast enough that they are getting concussions—it’s also the risk-taking age.

Also, women appear to concuss more easily than men; and that holds for sports like hockey and basketball. We’re not really sure why that is but that’s what the data is telling us.

Unfortunately, there are still a lot of unanswered questions about concussions. We still don’t know the exact mechanism—although, rotational acceleration is more important in producing concussions than linear acceleration. And also, we don’t know how to detect a concussion on imaging techniques; for example, there is no telltale sign on a CAT Scan. And the MRI (magnetic resonance imaging) is still not showing us the effects of concussion. We are hopeful that some newer sequences of MRI will be more informative.

A concussion is still a clinical diagnosis, meaning that it depends on a knowledgeable examiner, like a physician, as well as a compliant patient. And not all patients are compliant; there are still people who want to hide the symptoms and signs of a concussion.

HN: How important is recognition of a concussion?

CT: All you have to do is look at Sidney Crosby—the fact that he got his first concussion on a Monday and it wasn’t recognized; and then on the Wednesday, he got his second concussion and it took a year to recover. It’s important to sit out until you’ve fully recovered and follow the six-step process of gradually incorporating more physical activity, so that your brain is ready to take another hit. If you run around the block and get a headache and get dizzy, that means your brain is not ready for the next hit and then you’re subject to the serious consequences of another concussion because your brain has not recovered fully from the first one.

Ex-ESPN exec says “Stop denying brain damage“;  Continue reading

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Rugby Being Put Through Wringer in Scotland

6 Aug

Scottish rugby has become somewhat of a surrogate for the problems in rugby when dealing with the current concussion issue.  Scotland certainly is not the only place this has become and issue (even though the IRB would like to tell you so); and this issue of concussions and sport seem similar in nature to what we have seen here in the States with American Football.

The uproar all began when a former player, Roy Lamont, made it known that he thinks/knows that players were both “sandbagging” and deliberately deceiving concussion test in order to remain playing;

Players regularly pass the tests. In many cases that is because they cheat,” revealed Lamont. “Players all talk about it. A test is done at the start of the season as a baseline test, and players who suffer from concussion have to return to that level to be passed fit to play.

“But some players will deliberately do stuff in the baseline test so that their results are low, making it easier to pass after concussion. And I’ve seen players carrying concussion into games. They’d come off a fairly straightforward tackle, but be sitting on the ground, starting into space for a few seconds.”

Interestingly Lamont’s comments were in response to an incident where a player was not sent off for concussion even though he exhibited overt signs;  Continue reading

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.

 

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

Please Explain

6 Nov

It is a common thought that crosses my mind when I see questionable actions around a concussion situation.  Unfortunately I don’t have the power to get the answers, so I basically post them on here for others to see.

This is not the case in Australian Rules Football; if you are team and you receive a “please explain” regarding an injury (mainly concussions) you are probably treading on thin ice.

There is a mechanism in AFL that formally puts teams and doctors on notice when things just don’t add up.  Take for example the handling of a concussion by the North Melbourne Roos;

Interim Kangaroos chief executive Cameron Vale emailed AFL operations manager Adrian Anderson on Monday after the Roos were told to respond to a ”please explain” issued by the league last week.

The Kangaroos have been under investigation over the manner in which they handled Hansen after he received a heavy knock against Essendon in round 20, and also for the way they have responded to AFL investigators Brett Clothier and Abraham Haddad in recent weeks.

The AFL has been unimpressed with the club’s handling of the issue, although the Kangaroos have bristled at suggestions football manager Donald McDonald had influenced the testimony of key figures involved.

The letter is not the first step, rather the end step in a process that allows the medical board of the AFL to investigate how the practices of player protection is put in place.  Is it oversight?  You bet and I feel that the AFL does something much-needed in all professional sports.  Really, it is only applicable to the pros because of the resources, however it could translate to large colleges as well.

In Zurich I spoke to Dr. McCrory about what they do in regards to this, here are the basics; Continue reading

Zurich Day 2… And We Are Live

2 Nov

I have figured out the power situation so I will be trying to update the blog ASAP after each session…  For the time being make sure to follow on Twitter…

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1030 CST: Session 7, final session: The Sharp End

First debate between Dr. Cantu (yes) and Dr. Herring (no): is no RTP same day the best management paradigm?  Is keeping a player out one week long enough and is the graduated RTP protocol sufficient…

THERE WILL BE NO RTP on same day in the new statement!!!

Change of direction on Session 7, questions with panel answers, pro-con (if available)

Do 3 concussions end your career?

  • its comedy hour
  • Aubrey – treat each athlete individually
  • Dvorak – it has to be based on timing and complexity of each recovery – case-by-case basis
  • Putukian – if we can’t agree on dx how can we agree on a number
  • Overall theme is it is individualized, not all concussions are the same (Cantu)

Who is best qualified to make the sideline decision?

  • Cantu – multiple members working under a physician can make the call
  • Herring – concerning to him that some information is intrinsic to doctors so need to be careful
  • better question is who best qualified – person with most experience
  • Dvorak – looking at spectrum of games played, doctors are best qualified in most instances, but are they there in all matches?  We should aim all this to the “grass roots” as the professional level there is more than adequate coverage.
    • comedy about football versus american football
  • Ellenbogen – those that know the athletes should be making the decision, maybe a parent in youth sports, or athletic trainers, understanding the patients baseline is important
  • Putukian – balancing act, in a perfect world its a team approach (Athletic Trainer mention), and she says in the US the athletic trainer should be making the decisions on the sidelines…
  • Aubrey – Hockey Canada has a safety person (volunteer) in lieu of an athletic trainer
  • Cantu – brings up possibly training school teachers in concussion
  • Herring – if you are team physician do you need someone else to make the decision if you are on the sideline?  Panel – no

Is there a role for grading concussions?

  • Cantu – not perfect, but informing patient is important about severity and duration of recovery, after the fact
  • McCrory – we have moved from grading, look at the recovery – perhaps look at the SCAT/serial testing
  • Putukian – looking at history is more important than arbitrary “grade”
  • Herring – may help with continual care from one place to another, but again important to understand history

Should we be returning on the same day of concussion?

  • Aubrey – what about the NHL player in the playoffs (rhetorical question)
  • Cantu – no once recognized
  • McCrory – what about the players that clear the SCAT, so no concussion, but you know something is amiss?
  • Putukian – example of hockey player with delayed symptoms
  • McCrory – concussion is often an evolving injury
  • Ellenbogen – it is a traumatic brain injury, is the game worth it?  No.
  • Panel – consensus is NO RTP same day
  • McCrory to Aubrey about playoff example – what about a regular season, and Aubrey is being very honest, and he feels the player push back is greater
  • Ken Dryden from the audience – why are we treating professional athletes different from the youth or non-elite athlete
    • We are starting to move away from that, all athletes should be treated the same

Should there be helmets in woman’s lacrosse and field hockey?

  • Cantu – yes, because of stick and ball causation of concussion
  • Putukian – no, change nature of the game, no reports of intercranial bleeds in women’s lacrosse, weary of unintended consequences (BTW, probably has the most experience with this)
  • Cantu and Putukian discussing this topic
  • Change gears – what about football?
    • Dvorak not in FIFA’s plans to recommend, many reasons including the false security of wearing head gear
  • Audience Q: should we discourage the use of the head bands/head gear
    • Dvorak – your own prerogative but data does not support the use of them as recommendation (Czech goalie wears one)
    • McIntosh – Rules are more important at this time

Should there be age restriction on tackling in American football, heading in soccer and checking in ice hockey?

  • Cantu – his words speak for themselves, youth sports needs to look at how the game is played because of the differences between older
  • McCrory – in Australia you cannot get to the gladiatorial aspect of Aussie Rules until they are “of age” (13 if I heard correctly)
  • Ellenbogen – risk of activity, most concussions via CDC information is from wheeled sports and recreation, does not make sense at this time to him, advise accordingly
  • Cantu – youth sports don’t have the good data, personally he does not believe learning a sport at age 5 will make you elite, it is a genetic disposition in his opinion
  • Putukian – it makes sense to decrease exposure, US Lacrosse has put age 13 on checking, her take on soccer is that there is no data to support this when using proper sized ball and equipment
  • Dvorak – young soccer players learn sport first, and fundamentals of “football” its not “headball”, studies done on heading ball and with study there was no increase in biomarkers they were looking at it.  They don’t force kids to head ball until skills are sufficient.
  • Herring – false warranty?  Arbitrary age is concerning, take head out of the game rather then taking the game away from youth athletes.  The limit to exposure is accurate, but complete removal of the sport may not be necessary.
  • Cantu – sport needs to be safer for younger athletes
  • Aubrey – ice hockey has set limits on age for body checking, research is very important, it will help make decisions

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Dr. Jamie Kissick speaking on “From Consensus to Action”

  • Knowledge is power
  • “There is an app for that”
  • Knowledge Translation (KT) Concepts Continue reading

Two Excellent Researchers Discussion Concussions

10 Sep

If you get the chance you should take the time to read the research that has been done by David Hovda, PhD and Kevin Guskiewicz, PhD, ATC; not only is it good information but it has been some of the leading information.  These two gentleman do a great job of explaining the issues and making them more tangible for everyone.

On September 6th, both Hovda and Guskiewicz had a real-time chat about concussions on ScienceLive;

ScienceLive, Science magazine’s weekly web discussions with experts in various fields, will examine the issue of sports- and combat-related head injuries during a web chat at 3 p.m. Eastern today. Guests include Kevin Guskiewicz of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at The University of North Carolina at Chapel Hill and David Allen Hovda, the Director of the UCLA Brain Injury Research Center.

You can click the link above to go and read the replay of the chat, a must for those looking for information and would be a good idea if you have kids playing sports now.  Below are selected comments from the chat; Continue reading

Rugby Union to Install New Concussion Rule

21 Aug

As part of the new rules in Premiership Rugby the installation of a “concussion bin” will begin September 1st.  Union and the sport of rugby took some criticism when recently played matches included some players that seemed to be dazed or even incapacitated after a hard knock.  Because of this the new rule was created;

If a team doctor or referee suspects that a player may have suffered concussion during an Aviva Premiership match, that player will be required to leave the field for five minutes to undergo cognitive tests.

If that initial suspicion is confirmed in a pitch-side assessment, the concussed player will not be allowed to return and the temporary substitution will be made a permanent one.

Not only does the team medical official have the ability to have the player removed the referee can be more aggressive in getting a player off the field.  The hope is that this will catch more players that have suffered a concussion and make sure they are removed, but if you remember the NHL tried this at the end of the 10-11 season and it was basically abandoned the following year.

Not only do I think this is a productive idea, but it is one that should be adopted by the sports that have limited substitutions, such as soccer and Aussie Rules.  Five minutes are sufficient to get the job done, but more time would be better.  Alas, this is a step in the right direction.

Noteable Retirement in Rugby

27 Jun

News of a significant retirement in the sport of rugby (Union or League) rarely makes the press in America, however the first I have found attributed to concussions made its way stateside, via Chicago Tribune and Reuters;

Former England back-rower Michael Lipman has quit the Melbourne Rebels after suffering severe headaches and “haziness” following a concussion during the Super Rugby season.

Lipman had informed his team mates this week, Melbourne’s The Age newspaper reported, but the decision had been brewing for some time, a Melbourne Rebels spokesman said on Wednesday.[…]

“The bottom line is that throughout my career I’ve had so many bangs to the head and I’ve had so much concussion … the last couple have been the icing on the cake,” Lipman told The Age.

“I’ve just had too many. Enough’s enough and when you’re body’s talking to you like it is now, you’ve got to listen to it and be sensible Continue reading

Rugby Concussion Discussion

23 May

Part of the email I received about the AFL injuries were some papers written about the concussion issue in the National Rugby League (NRL), Rugby Union and of course Footy.  The first article was written by Fredric Gilbert, PhD and Bradley J. Partridge titled The need to tackle concussion in Australian football codes.  The gist of the article was about the still hidden injury of concussion, relating to reporting and return to play.  The authors wanted to point out that the cumulative effects of concussions are just now surfacing and that “all contact sports should adopt and evaluate the effects of precautionary policies that require concussed players to leave the field.”

What I really appreciated was the section devoted to youth sports;

Reducing the risk of concussive and subconcussive impacts is even more critical at the non-professional level, where there is a large population of vulnerable young players to whom a significant duty of care is owed.6 Most reported cases of second-impact syndrome (when a brain that has not healed from a previous injury suffers an additional trauma) that led to death or severe disability have occurred in young athletes.19 Yet most amateur teams do not have qualified health professionals or other staff who are trained to detect and assess concussion. At this level of sport, many concussions likely go unrecognised and incorrectly managed.20,21 However, if players and sporting organisations at the elite level change their approach to head injury and concussion, it is hoped that those at amateur levels will do likewise.

Although the state of athletic trainers – physios in Australia – is currently unknown to me it seems that the push is again for correct oversight for the youth.  Gilbert and Partridge seem to be addressing the same issue we have been here about youth concussions, which is great to see.  If the top-level of sport addresses the issue head on then it will trickle down.  Just like those players sloughing off the concussions to play – and the young players trying to emulate – management can work the same way.

The article above did prompt an editorial reply from some heavy hitters Continue reading

Rugby Star On Career Precipice

21 May

A former player for possibly the world’s most recognizable rugby team may be on his way out due to concussions.  The All Blacks – the New Zealand national team – is the height of sport in New Zealand and a nation holds the players in amazingly high standards.  To say the All Blacks are a union team would be a serious understatement.  The All Blacks are the current World Cup holder, ranked number one, have one 75% of their matches and hold both Bledisloe Cup and Freedom Cup (significant markers).  They are Rugby Union.  Any player that makes the roster is one of the best, this can be said for Benson Stanley.

Stanley now plays for the Blues in the Super Rugby League – a league that extends two continents and three countries.  This past weekend Stanley may have seen his career ended;

Blues coach Pat Lam says that he is concerned about Benson Stanley’s health and playing future after he suffered concussion playing against the Crusaders.

The former All Black centre’s career is now hanging in the balance after this latest concussion which is his fifth major head knock in less than a year.

Lam said that it is possible that Stanley will have to go Continue reading

Coalition for Concussion Treatment #C4CT

27 Apr

Yesterday I helped launch the #C4CT cause via the blog and twitter and it was nice to see the interest really begin to peak (thanks @SchuttSports, @the_jockdoc  and many others).  As with most movements or introduction of products getting interest is the first thing; now with official press release in hand it is time to explain and get more of us going here.

The hard work of Jack Brewer and Alex Nennig (and probably others) of Brewer Sports International have created this coalition which I believe to be a “best foot forward” approach in not only raising awareness and education of concussions (our number on goal on The Concussion Blog) but has a possibility to stake a claim in treatment of lasting effects of TBI.  I am honored to be asked to be a primary supporter of this cause, although as it catches wild-fire I am hopeful more important people jump aboard – looking at you NFLPA and NFL.

It is also an honor to be along side a very strong and promising law student in Paul Anderson.  I have had many conversations about creating such a cause, but have yet to find the trailblazing counterparts until this came along.  Please take the time to read the below press release and join along this weekend in using the #C4CT, even promoting questions from others about the hash tag is an opportunity to inform!

Press Release========== Continue reading

Good On ‘Ya Mate

8 Feb

We follow collision sports around the world as this issue is not localized to just North American sports.  With heading in soccer to the aerial displays of winter/action sports to the high-speed knocks in rugby, everyone can stand to learn and be prepared for concussions.  As we have kept saying it is just part of the game.  Yes, we would like to minimize every chance of concussion but realistically now is the time for awareness and proper management.

I keep an eye on Australia, especially now as the AFL is getting ready for play, and have criticized the apparent lack of understanding of concussion in Footy.  The other big sport this time of year Down Under is rugby, with the National Rugby League 21 days away from starting.  This sport to has drawn both good and bad from me and the visitors of the blog, but I read something today from the Herald Sun that makes me want to stand up and say “about time!”; Continue reading

Rugby Concussion Education: Tim O’Connor

9 Dec

The Concussion Blog is excited and privileged to have a guest author post about rugby.  Tim O’Connor is a barrister practicing in Ireland with a specialty in rugby and sports law.  He writes on the topic at www.rugbylaw.blogspot.com.  Tim will be posting from time-to-time from across the pond.  Here is is first entry about the IRB and concussion law (rules).

As a child, one of the very first things you learn playing rugby, is how to fall and protect your head.

And there’s a good reason. Rugby’s a fast-moving collision sport, and a relentless one; there are multiple phases, no rolling substitutions, and all sorts of areas where a misplaced boot, knee, elbow, shoulder or head can come sharply into contact with your head. No-one is taught to use their head in the tackle; but when a 160-pound 5’10” outhalf can find himself facing up to a 6’7” 260-pound lock who’s moving at 100m-in-11-seconds pace, accidents can and will happen when all the protection you have is a gumshield, maybe a scrum-cap, and determination.

So, rugby has known for a while that concussions happen. And the leading rugby nation on earth, New Zealand, have been leading the way on concussion management. Since their RugbySmart program was introduced in 2001, Continue reading

Examples Of Horrible and Great Decisions

23 Nov

Two weeks ago I highlighted the clear message from the International Rugby Board about concussions, however what I didn’t know is that this protocol was apparently not used for a French player in the World Championship match.  There were two comments, one that led me to the write up about this situation;

Parra took what appeared to be an accidental blow to the side of his head from the knee of All Blacks’ Captain Richie McCaw in a ruck, and appeared to be visibly concussed, looking shaky on getting up after receiving lengthy on-field medical attention. Continue reading

Rugby Makes CLEAR Statements

8 Nov

The International Rugby Board met last spring to make changes to the concussion protocol for their sport.  I had opined that rugby could have been in trouble with the incidence of concussion in their sport.  However I must say (after finally following up on it) the IRB has at least made it perfectly clear on how concussions will be handled for rugby;

….

Continue reading

Is Rugby Staring Down The Barrel

22 Jul

We have highlighted the “slow” response to the concussion issue that rugby has struggled with in the recent past.  Sure the International Rugby Board (IRB) has given monies for research and looked into their policies, traditionally the sports outside of North America have not been as concerned with the issue.  Heck the first article taking the sport to task was the one linked above.

Just like the previous article the Irish Times has once again brought it to the forefront.  After framing the story with the law suit filed by the former NFL players the IT looks at rugby;

Within the last year professional Irish rugby players Bernard Jackman and John Fogarty have both retired from the game due to ongoing issues with concussion, while the International Rugby Board (IRB) last month issued a new “more robust” set of guidelines regarding the recognition and treatment of concussion in players.

Players are not permitted to wear heavily-padded protection, which was being promoted by Australian back Berrick Barnes, who recently took time out of the game because of repeated concussions, but now hopes to play in this summer’s World Cup. Continue reading

More Education Needed Down Under

25 May

If you have followed our attempts at charting the Australian Rules Football concussions you have noticed my overt tone of frustration.  I have even proposed a “cover up”; that may be way more conspiracy than truth.  I do believe that I have found out a reason as to why we are not seeing more concussions in Australia in all sports, lack of knowledge.

In a Sydney Morning Herald story today about a rugby player there are some very SCARY things the doctors are presenting down under;

Doctors have cleared Berrick Barnes of concussion from last Saturday, instead diagnosing him with a less serious condition called footballer’s migraine, which might also explain some of his previous head injuries that have been put down to concussion.

Waratahs team doctor Sharron Flahive said that Barnes sustained a minor knock to the back of the head while playing against the Lions, suffered a delayed reaction of dizziness, and then had such a heavy loss of memory that he could not remember what year it was, which week of the season he was in, or if he had played for the Waratahs last year.

We are going to take this piece by piece; dizziness and loss of memory are obvious signs of abnormal brain function and should have classified this player with a concussion.  But in Australia they are classifying head injuries as “footballer’s migraine” (by the way FM is a term from research in 1972, 40-year-old information), wait until you see what else the Dr.’s are saying. Continue reading

High Profile Rugby & NHL Announcement Part 2 & Crosby

15 Mar

The International Rugby Board instituted greater safety for concussed players by updating their protocol.  The trouble is, we cannot find a text of exactly what this new protocol is.  Nevertheless the IRB changes are being tested this week by Ireland player Eoin Reddan;

Reddan lasted less than two minutes of the defeat to Wales on Saturday after suffering a concussion just 60 seconds into the game at the Millennium Stadium.

Although he is recovering well he will have to see a neurologist this week as part of the concussion management under the IRB concussion ‘Return to Play’ protocols.

While Reddan has not been ruled out of the England match, Ireland have been boosted by Tomas O’Leary’s return to fitness following a back problem.

We can see that constant monitoring of the injured, along with further clearance from a neurologist is part of this protocol.  Reddan is most high profile athlete to take part in the new IRB ‘rules’ with concussions.  It will be interesting to see how Reddan and rugby deal with this.  The next match, versus England, is scheduled for Sunday.

SOURCE

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The NHL further broke down their stats Continue reading

Rugby Making Changes For Concussions

15 Feb

The International Rugby Board (IRB) is set to make wholesale changes in the way injuries, in particular concussions, are handled at all levels of competition.  The results of the Rugby Football Union, Rugby Players’ Association and Premiership Rugby audit of injuries found that concussion/brain trauma was the fourth most common injury that removed a player from the match (3.9 per 1,000 game hours).

Now the IRB is ready to overhaul the system for inspecting a concussion and handling the injury itself;

“The IRB are at the final-draft stage on a new set of concussion guidelines that I expect would flag up the importance of players with symptoms of suspected concussion being removed from the field of play,” Kemp said. “Our management of players once they have come off is according to best practice.

“There are particular challenges around assessment in a game in which the potential for concussion is so high and players get dings the whole time. There are some challenges around making decisions in a short period of time on a pitch with a player who is often engaged in the next play. It will be the focus of a very robust initiative. I am very confident the position we will get to is entirely adequate.”

This will mark the first time the IRB and associated leagues/unions have specifically addressed this issue, highlighted by a scary incident where England wing Chris Ashton remained on the field after a big hit to the head, and an Irish Times article actually taking the rugby institution to task.

This is good for the sport, however changing how the sport currently deals with the injury, mandatory three-week lay off, will be a good start.  We will be looking forward to the specifics as new an unique views are always needed.

Rugby Starting To Take It Serious?

4 Dec

Courtesy of Rugby-Pioneers

A “man’s” game.  A game of violence with little to no protection.  A game prided on tradition and a bit of European stubbornness.  The game is rugby; with positions like props, hookers, flankers, and locks, who would expect anything but a bunch of strange individuals?

Of course, that is the perspective of the general American public, as rugby is not a popular sport on this side of the pond.  However, there is a common link with “our” favorite sport and rugby – concussions.  Although that is the tie that binds the two and all the fans, the approach about tackling this subject has been polar opposites.

While the NFL has made a bold move (and the correct move in my opinion) to address the issue with as much force as a James Harrison helmet-to-helmet hit, rugby and its international sanctioning body has merely tried to put a band-aid on a hemorrhage.  Maybe window dressing would be a better description.

A quick search of what rugby has done for concussions seems on the surface to be a huge step, and more conservative than other sports, but when you really look at the effects of its suggestions, it makes the situation worse.  The rugby community has said that any player with a concussion must sit out three weeks.  Awesome, right?  No, because players will not report the problem since they will be forced to sit out that long.  Granted, that time would be sufficient for a majority of concussions in the sport, but with no compromise in the amount of time on the sidelines, it’s either you have a major problem, or no problem at all.  The issue with that, is every concussion is a major problem, not only for the individual, but for the sport.

Taking rugby to task about concussions, in the places where it is a major sport, has been limited until now.  The Irish Times has published a story about the growing concern in this sport, albeit a quiet groundswell.

IT HAS been described variously in recent times as a time bomb and the elephant in the room. The issue of concussion Continue reading

Rugby Article

27 Oct

The Associated Press ran an article about rugby and how it compares with football in terms of concussions.

Rugby players are taught to never use their head in making the tackle, and without a helmet to protect them, the logic is pretty clear. Any player leading with the head is almost certain to get hurt as badly as the person he’s trying to hit.

The injury rate in rugby varies, however the most recent study suggests concussions account for 19% of all head injuries reported.

A study done by the B.C. Injury Research in Canada says rugby injuries come at almost three times the rate as those in football and soccer. But another study performed by the Eastern Suburbs Sports Medicine Centre in Sydney and the Australian Rugby Union found that while head injuries were most common in the collection of games they studied — adding up to 25 percent of all injuries — three–quarters of those injuries were lacerations, while only 19 percent were concussions.

Meanwhile, both sports struggle to keep accurate concussion statistics.

Finally, rugby may have more of a problem of players failing to report concussion symptoms.

Last season, the NFL mandated that any player who gets a concussion should not return to action on the same day if he shows certain signs or symptoms. The International Rugby Board has a rule that calls for players to take a three–week break after being diagnosed with a concussion.

That three-week break may make some competitors more reluctant to report head injuries.  Obviously there needs to be a balance, and playing without a helmet may not be the answer either.

AP Article via TMCnet.com (link not working for AP story).

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