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Series from the Pittsburgh Post Gazette on CTE

16 May

Mark Roth of the Pittsburgh Post-Gaette put together an informational series on chronic traumatic encephalopathy; “a brain disease that afflicts athletes”.

In the first part that came out this past Sunday, Roth took a look at the global perception of CTE through the examples of Chris Henry and the possible case of still living Fred McNeill;

Chris Henry was a fleet wide receiver for the Cincinnati Bengals. During his five seasons with the team, he developed a reputation as a talented athlete on the field but a bad boy off it, even though those who knew him well say he was typically quiet and respectful. [...]

Fred McNeill played 12 seasons for the Minnesota Vikings in the ’70s and ’80s. After retiring, he finished law school and became a successful attorney in Minneapolis, helping to win major class-action lawsuits.

Henry would end up dead after an accident that was predicated with some unusual actions by him, McNeill now has full-time care takers as dementia has stripped him of everything he worked hard for.

Roth begins the second piece with those that can be easily called the experts in this area, Bennet Omalu and Ann McKee; Continue reading →

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Bennet Omalu Recent Talk

8 May

For a long time the “father” of CTE, the first pathologist to find/identify the disease in an American football player, Bennet Omalu has been relatively quiet; going about his normal business and continuing his work with CTE.  Last week he was highlighted on the ESPN Outside the Lines/PBS Frontline story about the Junior Seau death aftermath.

Even more recently Dr. Omalu was invited to speak at the 2013 Football Veterans Conference – a sport specific event put on by Dave Pear and his blog;

Well, we just wrapped up our 2013 Football Vets’ Conference in Las Vegas at the South Point Resort and it was our best yet! In two packed days, we covered everything retired football players need and want to know, from concussion lawsuits to CTE to visual rights and everything in between. Our sessions were packed and no one wanted to miss a single discussion. And thanks to the amazing Jennifer Thibeaux, all of our discussions from Friday are already processed and uploaded so you won’t have to miss a minute of it either!

Thanks to Dave we can bring you the entire talk by Omalu – although over an hour its worth your time.

……….

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Who Wants Research Monies?

11 Apr

There are plenty of people out there that think they have the answer to the concussion issue.  From helmets (G. Malcom Brown) to mouth gear (Mark Picot), to assessment, to rehabilitation, to research, the whole lot of it.  Well now is your chance to put forth your best effort and get some money for research on your products or your ideas.  The National Institutes of Health and the NFL have created the Sports and Health Research Program;

The Sports and Health Research Program (SHRP) is an innovative partnership among the National Institutes of Health (NIH), the National Football League (NFL) and the FNIH. Launched in 2012, the program aims to help accelerate the pursuit of research to enhance the health of athletes at all levels, past, present and future, and to extend the impact of that research beyond the playing field to benefit others in the general population, including members of the military.

There is an agenda of sorts; regarding what they are looking at going forward (see article) but they are giving grants for those that meet the criteria; 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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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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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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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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Team Gleason PSA – Hey NFLPA Please Read

31 Jan
I received this from an anonymous source and was asked to spread this news, hopefully it will reach those it is intended for…  How bout you watch the video first then go to the Team Gleason website;
Subject: PSA release: NFL Players and Coaches stand together to cure ALS
Hi everyone…I hope this email finds you well…
Just wanted to let you know that beginning today, we at Team Gleason are rolling out a new ALS awareness campaign to be introduced this week in New Orleans for the Super Bowl.
Here’s a link to the video, which takes viewers directly to the Team Gleason website:
This is important, please spread if you get the chance…  This is NOT JUST A FOOTBALL PROBLEM, this is a problem for everyone!

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Watch This: Enough Said

31 Jan

This is Ry Koopman, a 7th grader from Georgia…

The kids are now talking about it, the feeder system of all sports.  If the kids are talking the parents are talking.  Awareness is setting in!

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UCLA Tau PET Study

23 Jan

If you paid attention yesterday you saw that a very preliminary study was unveiled about identification of tau proteins in the brain.  This is significant on two fronts

  1. up until now this has been non-existent with current imaging technology
  2. tau is the #1 culprit in chronic traumatic encephalopathy

If, in fact, this PET scan can find and map out the tau in living brains this would be a “watershed” moment in the treatment of CTE.  This would be because we have not been able to treat CTE, the only way to find CTE is via a posthumous examination.

I believe this is very exciting, but remember like all things in life, caution is needed – the study was only five former NFL’ers and to fully confirm the information gathered the researchers could be waiting a long time, hopefully.

A quick side note here, Dr. Bennett Omalu is a co-author on this study, which isn’t ironic as some have suggested, rather a product of his good work in this area.  For those in the “know” surrounding research in concussions and CTE finds this part of the story – Omalu – “interesting”.

What a great start, and I am willing to be scanned if anyone wants to pass that along!  I would even write a blog about my experiences with it.

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Matt Chaney – Tireless Worker

18 Jan

SpringGame1984Sideline
If you have been around enough you have seen the stylings of Matt Chaney on this blog, he is someone I call a friend.  In some circles that discounts me as a professional, which is both stupid and dumb.  I don’t always agree with Matt, heck him and I have been known to battle via electronic and phone communications.  However, his opinion is a valuable one – often his work is based in so much fact it makes your head spin as to why some of its missed.  Regardless, Matt has published two recent articles on his blog, for all to consume, here are some excerpts.

Part 1, published January 7th;

Historic football excuses thrive in modern debate over brutality

Lawsuits, criticism explode and officials project blame onto individuals

Old talking points of football apology resonate yet as officials tout anti-concussion measures like trainers along sidelines, new rules for safer play, injury reduction and expert consultation—same type of promises heard from gridiron leaders during the Victorian Era

American football gets lambasted in public for maiming and killing, denounced by an influential movement of critics, and game officials pledge safer play based on their new concepts of prevention, including:

*Qualified trainers and doctors will patrol sidelines.

*State-of-art medical response will treat the rare severe casualties.

*Limits will govern length of practices.

*Injury tracking will cut rates already on decline.

*Coaches will properly train players.

*Every player will undergo medical prescreening.

*Experts will lead safety reform in rulemaking and research.

*Referees and coaches will enforce new rules of experts.

*Players will follow new rules of experts.

Sounds familiar, these steps, a practical recitation of talking points for contemporary “safer football” promoted by the NFL and commissioner Roger Goodell, in face of lawsuit frenzy against the league and sport in general, along with festering disgust in the public.

Except the football rhetoric is 119 years old, from 1894, a packaged response during the game’s initial siege against formidable opposition seeking abolishment. Continue reading →

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Another Upcoming Concussion Symposium – January 25th

16 Jan

Time is short on this, I understand, but I just was dropped a note about this symposium being held in Chicago.  Once again yours truly has “commitments”, this time it is a wrestling dual tournament – where my services are needed more.  Regardless, when I looked at the faculty list and the speaking topics my interest was piqued.  BIG NOTE here it is only $25 for athletic trainers to attend ($60 for physicians).

The lecture is going to be directed by Julian Bailes, MD and David Firm, MD, PhD, both unheralded leaders in the field of brain injury.  What is more interesting than that is the fact that two relative “quiet” doctors will be presenting their information.  Both of these men are “controversial”; one is seen as an extreme outsider by the NFL and the powers that be in their corner – Dr. Bennett Omalu the other has had his share of issues, mainly in the press (see Irv Muchnick), for previous perceived mishandling of concussions in the NFL and WWE – Dr. Joseph Maroon.

Unlike the symposium I posted about yesterday, there are no athletic trainers on the speaking panel, to me that is a shame as the athletic trainer is the front lines on concussions in sports (mainly HS up).  Here are the topics, Continue reading →

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Sports discourse in the aftermath of Junior Seau’s suicide

13 Jan

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

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

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

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NFL Concussion Litigation – The Science of Sport

18 Dec

That is the title given to the upcoming webinar/teleconference sponsored by Perrin Conferences.  These events are mainly geared toward attorneys/lawyers and offer continuing education credits (CLE) for attending.  Below is the press release;

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Experts in NFL Concussion Suits join together to tackle industry trends, litigation challenges, and the science in sports injuries on Jan. 8.

Berwyn, PA – Perrin Conferences‘ teleconference series presents “NFL Concussion Litigation – The Science of Sport,”  a program bringing together leading attorneys, doctors and other experts to discuss the issues dominating the headlines of the concussion cases against the NFL, NCAA and equipment manufacturers.  The teleconference will be hosted on Jan. 8 at 2:00 p.m.- 4:00 p.m. EST.

The program provides an overview of the current allegations and defenses in NFL concussion litigation, an update on the latest scientific studies, and tackles other issues including:

  • The potential legal and economic impact of concussion litigation for players, sports leagues and uniform equipment manufacturers
  • Chronic Traumatic Encephalopathy – what is it and how does the science fit into the current litigation strategies?
  • The history of the dangers of head injuries and the timeline of NFL-sponsored studies/concussion rules
  • Medical monitoring and other potential damages
  • Duty to defend, trigger, occurrence and other insurance issues

Speakers include Continue reading →

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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

—–

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

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

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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 →

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New Study; Posting for Reference

7 Sep

This information was not only new, but really took up time on the airwaves with its information.  For some this may be a head scratching, but for most in the know it was really confirmation of what the popular line of thinking has been.  Really, if you think about this in a vacuum, brain trauma is bad, and increased exposure over long periods of time is real bad.

Here is a recap from CTVNews in Canada;

Former NFL players appear to be at an unusually high risk of dying from Alzheimer’s, Parkinson’s or Lou Gehrig’s disease, suggests a new study that once again highlights the dangers of the game of football.

The study, which appears in the journal Neurology, found that the death rate from those three diseases among a group of former NFL players was about three times what one would expect from the general population.

The study looked at 3,439 former players who had at least five playing seasons from 1959-1988 with the NFL. The average age of the study participants was 57 and only 334 players – about 10 per cent of them – have now died.

Researchers compared the players’ deaths to a comparable group of American men and found that in 10 of the former NFL players, either Alzheimer’s, Parkinson’s or Lou Gehrig’s disease (also called ALS) was listed as the cause of death.

That’s about three times the general rate for American men, the researchers reported.

I would also like to take this time to make sure we are not vilifying the NFL or football for that matter.  Sure the sport has plenty of brain injury, but concussions and repetitive blows to the head are not unique to the gridiron.  Soccer for one is a sport that is both understudied and had potential for chronic cases.  In the sport of baseball the catcher position is an area of concern.  Hockey, rugby, rodeo, Aussie Rules all have a place in this discussion.

Mostly, remember that kids are now exposed to sports at a much younger age then this study group, and the group also was playing before the 90′s – before everyone got bigger, faster and stronger.

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Comments About Wagner/Deadspin Article

29 Jun

The comments on this blog have been on point but I was able to find some other very informed comments regarding the information provided in the Deadspin article via Football Outsiders;

by MJK :: Thu, 06/21/2012 – 6:46pm

Interesting article, but there’s some things in it that are decidedly wrong, and others that are completely ridiculous. The idea that increasing intracranial pressure through trapped blood accumulation could somehow “cushion” the brain and reduce the impact force of the brain as it “sloshes” in side the skull was obviously dreamed up by someone that has no grounding in biomechanics whatsoever. First, many head “mild” injuries (the ones that don’t involve skull fracture or haematoma) occur because of rotation of the head, not linear impacts, and suppressing brain motion relative to the skull won’t do a thing to help that. Secondly, CSF is essentially water from a physical response standpoint–and if you have an object floating in water, increasing the pressure in the water doesn’t do a single thing cushion the object floating in it.

The other major issue that I can see is, based on the doctors and biologists I’ve talked to, the accumulation of tau protein associated with CTE can take a minimum of many months, and more generally several years, to occur after the head traumas that triggered it. Also, apparently once you hit a critical threshold level of tau buildup, it becomes self propagating, even if you don’t have any additional head trauma. So monitoring the increase in tau protein wouldn’t be a good way to decide when to hang up the cleats…you could quit when you were still at a “healthy” level, it could take a couple of years to accumulate more, hit the threshold, and you could still end up with early onset of dementia or other lasting brain injury.

The article also touches briefly on, but glosses over, an alternative diagnosis technique that does show promise…diffusion tensor imagine MRI. Although poorly understood, there’s some really promising research about using it to track the biomechanical insults that could lead to long term tau protein buildup.

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by akn :: Thu, 06/21/2012 – 7:25pm

This entire article sounds like the author took the researchers’ grant proposal and Continue reading →

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In Case You Missed It…

26 Jun

Last week I tweeted about a story on Deadspin.  It was a very well written article, one that should make us hopeful and fearful at the same time; at the very least it is thought-provoking.  Even after reading it several times I still feel that Kyle Wagner absolutely did everyone a service by publishing this piece;

The question, after a decade of brain-slicing autopsies, is when any of this will help players before they’re dead. Doctors can’t just crack open living patients’ skulls and lop off slices of their brains to stick under a microscope.

But new research at UCLA is using a cutting-edge biomarker that can attach itself to tau protein tangles so that they show up on PET scans of living subjects. Dr. Gary Small is currently running a pilot study on retired NFL players, imaging their brains in place. If he is successful, his work would reorient the science of head injuries around saving lives instead of merely contextualizing deaths.

“I’ve always sort of thought of tau imaging as the holy grail on the issue of chronic brain damage, especially CTE,” said Dr. Julian Bailes, one of the founders of the Brain Injury Research Institute (BIRI).[...]

PET imaging tech is half a century old, and though FDDNP is relatively new, it’s still been around for years. So it’s strange to think about the marker being on the cutting edge of a fairly recently discovered brain disease. If the marker can find and pinpoint CTE, why hadn’t anyone tried it before now? And for that matter, why isn’t it already in use?[...] Continue reading →

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Ricky Being Ricky

16 May

Aloof, that is one way to characterize Ricky Williams.  The one time dominant running back in the sport of football who retired early to pursue “peace” and smoke dope only to come back to earn more money has discounted the link of repeated brain trauma and degenerative brain diseases, written up by Mike Florio of ProFootballTalk;

But as his career ends (even though some think he’ll be back), Williams dismisses the link between concussions and brain damage.

Which perhaps conclusively proves it.[...]

“I’m only speaking from my personal experience, because I haven’t allowed myself to buy it, and I haven’t been affected.  Yes, I’m aware that football is a rough sport, but instead of saying, ‘Oh — I’m doomed to brain trauma,” I said, ‘What can I do about it?’  And I just started taking care of my body.  I found people, places, and things that really helped me — again, I don’t know what’s going to happen to me in 10 years, but I look at the other things I’ve learned about, and the way I see the world.

Maybe it was his dreadlocks that provided extra protection when he played, or perhaps Continue reading →

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Parent Urges School Board to Take a Look

14 May

In Maryland, Montgomery County to be specific, the school board is taking – at the minimum – a look at what they can possibly do to help with the safety of the kids they are in charge of.  Lisa Gartner of The Examiner wrote a brief column on it;

Montgomery County school officials are weighing efforts to screen high school athletes for concussions and similar head injuries linked to Alzheimer’s-like disease and suicide.

Superintendent Joshua Starr said Tuesday that his staff is drafting a memo on concussions, while school board member Patricia O’Neill asked for a report on the cost and implementation of baseline screening, which would allow doctors to compare athletes’ brain activity before and after injuries.

“I know our budget doesn’t have an inch to spare,” O’Neill said, “but our students’ health obviously has to be paramount.”

As the board mentioned there is not much money there, so why are they entertaining the thought of using baseline tests?  It is just a tool that is often highly criticized for its results.  I feel that if baselines are needed then deals should be made with local doctors that use the tool and are trained to use the tool.  By deals I mean the baselines be given away or at a significantly high discount, then the doctors are in control.  Perhaps if the schools have outsourced athletic trainers the place of employment of the AT’s can defer or absorb the cost.

The point is that a Walt Whitman HS parent by the name of Continue reading →

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Concussion Article Links – MUST READ

9 May

Since the tragic and untimely death of Junior Seau the concussion issue has begun to fester like a three-day old pimple on a 13 year-old’s greasy face.  It is ready to pop and keeping up with all of the pertinent articles and “specials” has been very trying.  In this post I will attempt to link up and highlight as many as I can (surely I will miss many, however Concerned Mom in the comment section will have more).

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Lets begin with ESPN and the Outside the Lines week-long look at concussions.  I have found this to be must see, my DVR is a testament to this; using previous stories and bringing in commentators on the subject have provided information and even fireworks.  Yesterday Merril Hoge and Matt Chaney did just that – provide information and create fireworks.  You can find the podcast here (panelists begin about 7:30 mark).

Hoge drew my ire earlier this week with his admonishing of Kurt Warner’s statement of being a father, however yesterday he did have a very valid point about the management of concussions.  I have said is ad nausea here: the elephant in the room is the management of concussions, however Hoge sounded a bit “underconcerned” about the actual injury.  Which is where Chaney had very valid points about the exposure of concussions to the youth.  They are both right in my estimation; the management is the larger issue but we are seeing too many too young people being effected by concussions.  There needs to be work in both areas and remember this is not just a football issue.

We have the duty to protect our kids and if that means flag football for 5-13 year-olds then I am cool with that.  If we find after making such a drastic change that has not been enough then we can take it further if needed.  I feel that a change like this will allow a few things: 1) more time to let the brain develop and thus allowing research to catch up to what we know.  2) employ more medical providers in a position to find, assess and manage concussions (see athletic trainers). And 3) begin a culture shift about the seriousness of concussions, after all this is a brain injury.

As Chaney later told me; Continue reading →

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Lesser known but just as powerful

7 May

Thirteen days before Junior Seau was found dead in California with an apparent gun shot wound to the chest there was another former NFL player who ended his own life.  His name was obviously not as “powerful” as Seau’s however, Ray Easterling left in his wake just as much trouble and turmoil over the issue of head injuries.

In an article written by Mike Tierney of the New York Times it is tough to shrug off all that we have come to know over the past few years, just read about how Mary Ann Easterling, Ray’s widow, is handling and plans to go forward with her life and her husbands legacy;

For Mary Ann Easterling, the prudent and less painful options, it might seem, are to move away and move on.

Relocate from the home where she found the body of her husband, Ray, a handgun nearby, and the neighborhood where Ray, a former N.F.L. safety, would become disoriented on long-distance jogs, sometimes prompting one-woman search parties at 2 a.m.
Withdraw his name from the class-action lawsuit that accuses the league of improperly caring for retired players with head injuries, a consequence that she contends turned Ray’s last two decades into a living, foggy hell.
Instead, Mary Ann, 59, plans to go nowhere. She won’t leave the brick ranch house on Continue reading →

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Educational Videos

7 May

Thanks to our heads up commenter Concerned Mom I perused two videos that she linked up.  They are produced and posted onto YouTube by the Massachusetts School of Law.  In the two-part series you will learn what we know and are learning; being in Massachusetts there is access to the BSTE (Nowinski, Cantu, Stern and McKee group).

Both videos are an hour in length but are again worth the time to sort out some things you may find questionable.  As with most information regarding concussions it is hard to agree with ABSOLUTELY every part of this information, but it is as one person told me “worth posting”.

In the second one at 17:04 mark is where the now famous statement from Dr. Cantu on collisions sports and those under the age of 14.  It echos what we have come to accept at this point.  The way collision sports are being played currently are not a safe ground for youth and adolescent brains.

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Thoughts on Warner, Toomer and Concussions

4 May

Even with the recent events of the Junior Seau passing the issue of concussions, CTE, safety, and longevity of the sport have been very much a hot topic.  What hasn’t happened, until recently, is the overt and valuable opinions of those that played in the public forum.  Yesterday while traveling to the high school I was listening to the radio and hearing what Kurt Warner had to say about his thoughts as a father watching his sons play football.  Basically he stated that AS A FATHER he had concerns and was worried for his children, mainly because of safety and the long-term effects of playing.  He himself stated he is “worried” about his health going forward as well.

All genuine and pertinent information from a former player that carries a lot of weight, and I didn’t have one problem with it.  Even though he stated he didn’t want his kids to play (as a father) he is not the first, Harry Carson made the same statements about his grandchildren.  What caught me completely off-guard was the reaction from former player, teammate of Warner and NY Giant (same team as Carson), Amani Toomer;

“What this reminds me of is the guy at the basketball court, who once he gets done playing takes the ball and ruins the game for everybody else,” Toomer said  Thursday on NBC SportsTalk. “I think Kurt Warner needs to keep his opinions to himself when it comes to this. Everything that he’s gotten in his life has come from playing football. He works at the NFL Network right now. For him to try and trash the game, it seems to me that it’s just a little disingenuous to me.”

Disingenuous?  He is a father concerned about the safety of his children, how in the world is that disingenuous?  Yes the sport Continue reading →

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