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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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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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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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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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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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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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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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Head Football Coach ‘X’: How to take a stand on player safety

26 Mar

Working on a cause is difficult, especially if you are trying to swim upriver. When the cause is in direct conflict with the juggernaut that is football it becomes even more difficult – even at the high school level. I received and provided counsel to this individual as he fights a good fight in regards to player safety, most notably concussions. I applaud this individuals effort, attention to detail, player first mentality, and his willingness to sacrifice his job. What we have below is a microcosm of the issues we face with concussions; detailed and beyond sufficient for action – that is not being taken except against this author.

This information was obtained mainly through email strings – all identifiable properties have been painstakingly scrubbed to the best of my knowledge. It has been understood and agreed upon by the author that publication of this information may identify him and place him in further jeopardy. He is willing to take that chance and I am willing to provide him a platform. Unless otherwise noted in the post with breaks all of this is his and his alone. We shall begin;

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A Little Context:

At the start of my advocacy for safer measures to be applied to the competitive arena in high school football, I involved many people who I trusted and cared for in helping find my voice. Those people usually ended conversations with the same question:

“Are you willing to Get Fired for this?”

I laughed at the question considering the fact that I am advocating on behalf of measures that enhance Student Athlete Safety. At no point was my advocacy meant to be an argument, so the extent in which there has been resistance to proactive thinking has been quite a disappointing surprise to me.

The last 3 months of my professional career have been a whirlwind as I have gone from Advocate to Agitator. When the time for action came to blaze a trail for the future, and promote all that can be good on behalf of our student athletes, we collectively passed as a school system, even though a safer future for the thousands of kids who choose to play football within it is still very attainable.

Through my advocacy I have felt empowered by the leading researchers in the field of sports injury supporting these ideas. Support from the actual people who could make these changes has been “Hot & Cold” in a way that led to me presenting to the Athletic Administration of our entire school system and then being handed a letter of reprimand. At the current time I am labeled as a “Demanding” Coach and a person “Searching for a Cause”.

What follows is a chronological story of advocacy on behalf of player safety at the high school level as well as an example of how far away we actually are from a safer future for the student athletes who choose to play the sport of football.

Authors Note:

Some of the Main Points of Resistance in this philosophy have been diffused by simple logic when it comes to providing a safer arena for competition.

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ORIGINAL LETTER TO RAISE CONCERNS & TO START MY ADVOCACY
January 8th 2013
To: (School System) Director of Athletics ————————
CC: (School) Principal —————–, (School) Athletic Director ———————, (School) Assistant Athletic Director ——————

Subject: Public Health Issue regarding (School System) Cross-District Scheduling of Football Competition

I am writing to make you aware of a safety issue that our county has unknowingly placed many of our student athletes in through our recent scheduling for football. (School System) Athletics cross district scheduling policy for teams in the newly formed ——– District, while making sense from a convenience and perhaps even a cost basis, exposes athletes at certain smaller schools to a greater risk of serious injury. I share these concerns with other Head Football Coaches within (School System) as was voiced at the —————- 2012 All-District meeting.

(School System) scheduling policy requires each (Small School) District football team, which is made up of schools that have been classified at the 3A and 4A level in the (State League) to compete with three schools at the 5A classification from the (Big School) District for the 2013-2014 scheduling cycle. The 2013-2014 scheduling cycle determines opponents for each school’s next two (2) seasons. ——————— High School (——) is a 3A school that, based upon the recent scheduling for the 2013/14 seasons, is expected to compete with schools classified at the 5A level on six (6) separate occasions, schools at the 4A level 12 times, and similarly sized 3A classified schools 2 times in our next 20 scheduled games.

A schools classification is predicated upon the (State Association) account for each school’s student enrollment. That enrollment produces the available population to field athletic teams. (State Association) has outlined parameters identifying like-sized enrolled schools to view as competition throughout the state. (School System) scheduling policy has ignored these guidelines in which the (State Association) believes our schools can equitably, and safely, compete in the sport of football.

Current scheduling policy lacks the awareness of a significant and measurable increased risk of injury to the players at (School) and similar sized schools. What is alarming, and requires immediate awareness, are the findings of the most recent and advanced studies related to head injuries. These studies strongly suggest that (School System) scheduling policy as currently constituted, subjects student-athletes of the smaller schools, not only to a greater risk of injury but to a greater risk of serious head trauma Continue reading →

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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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Opinion on Zurich Statement

13 Mar

I think I have had enough time to digest the information in the 4th Consensus Statement; it is enough time for me to give an opinion.  WARNING: My opinion may differ than yours and you may even take umbrage with what I say.  However I am going to give my honest opinion.  To keep it as succinct as possible I will go in bullet form along with the statement itself.

In general I feel that we as the community in the “know” are muddying the waters more when it comes to concussions.  I think there are reasons for this; litigation and emotion mainly.  I still strongly feel that concussion identification and immediate assessment by trained personnel is non-complex; its simple.  Sure others may think it is hard; I think changing the oil in the car is hard and complicated – a mechanic would find that a mundane task.

Secondly, the now undeniable MASSIVE issue with concussions is not the injury itself, rather, the mismanagement of concussion; which includes but not limited to assessment, rest, rehabilitation, return to learn and return to play.  The newest consensus statement address some of this for the first time.  Now, the paper…

SECTION 1: SPORT CONCUSSION AND MANAGEMENT

  • The definition of concussion is more clear for the practitioner.
  • Starting to address the psychological aspects of concussions – about time.
  • Clearly states if no trained health care provider present that if any signs/symptoms present players must sit out.
  • Clearly states that if concussion present, no RTP same day for ANYONE!
  • Not really a fan of all the sideline assessments out there.  No where does it say its mandatory for any of these; rather they are tools at our disposal to help identify concussions.
    • Here is a novel approach people: use your training and ability to be in-tune with the athletes to make a solid clinical judgement.  Oh, wait, not every sport team has an athletic trainer available?  <–THIS IS THE PROBLEM WITH IDENTIFICATION AND ASSESSMENT.
    • The Statement also clearly makes it a point that clinical judgement is the standard of care when it comes to all of this.
  • Although currently there is not an objective measure of the injury on the brain they have opened the idea it may be coming.
  • Neuropsych testing was a good section, the take-home point here is that baselines are not part of best practices and that they should not be used as a clearance device, except in the case of a trained neuropsych using the information.
  • Loved the discussion on “rest”, really thought about it a lot since it came up in Zürich.  The term “rest” is so 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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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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Spots Still Open….

20 Feb

Here is a follow-up on the Gfeller Neurotrauma Symposium that we posted about in December…

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We are very excited to announce our non-academic Keynote Address on Saturday will be presented by Merril Hoge. Merril was drafted by the Pittsburgh Steelers, where he played until 1993. He led the team in rushing and receiving in four of his first five years, setting a record in his third year for receptions by a running back. He was the Steelers Iron Man of the Year two years in a row (1989 and 1990) and was named to the All-Madden team in 1989. In 1993, Merril went to the Chicago Bears, where he played for one year until he was forced to retire early due to post-concussion syndrome. At the time of his retirement, Merril had the longest consecutive playing streak in the NFL.

The Second Matthew Gfeller Neurotrauma Symposium at the University of North Carolina at Chapel Hill on March 8-9, 2013 is right around the corner. There are a few spots left. We have informed you earlier of some great speakers we have lined up including, but not limited to, Dr. Christopher Giza, Dr. Robert Cantu, Dr. Michael Collins, Dr. Gerry Gioia, and some of our other local, regional, and national colleagues. A final schedule of topics is available on our website. Additional information regarding the event, including a link to register, is available at http://tbicenter.unc.edu (click on “TBI Symposium” in the header). A direct link to register for the meeting is as follows: http://tinyurl.com/c576kdu.

Healthcare Providers & Researchers (PhD, MD, ATC, CAT(C), RN, etc): $175  Continue reading →

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Let’s Clear Something Up Here

5 Feb

On Twitter yesterday I commented on the words Jim Nantz spoke on “Face the Nation” regarding concussions (emphasis mine);

“[r]esearch shows that at the college level, a women’s soccer player is two and half times more likely to suffer a concussion than a college football player. I don’t hear anyone saying right now, ‘should we put our daughter in these soccer programs?’”

Huge props to Jason Lisk of bigleadsports, for doing the work of digging to find the information that Nantz used in the interview.  The long and short of Lisk’s adventure was that he could not find a specific connotation of such claims.  The 2007 article he cited in his wirte-up can be found here, Concussions Among United States High School and Collegiate Athletes, via nih.gov.  You can look and see what Lisk and myself see, football concussions occur more than female soccer concussions – except for an anomaly (very small one less 4%) – in college football and female college soccer.  Lisk also notes this was a 2007 study, although ancient in the realm of concussions, it is very solid and worth citing.

A repeat of the above study could not be found and probably should be done, however there are plenty of “concussion incidence” research in the high school sports.  Those can be found by simply going to ‘Google Scholar’ and defining your terms.  Here is a very good one regarding concussions alone, Marar et Al_ Epidemiology of Concussions, where the football vs. girls soccer numbers are; 6.4/3.4 (that is per 10,000 athlete exposures).  This is a 47% increase as compared between the two sports, almost two-time as likely.  More important is that this information was published a year ago, some of the freshest information out there.

Specifically Nantz was using collegiate soccer as his “trump card” in the case for football.  Not only is collegiate soccer a rare occurrence for those playing soccer, it is not nearly as populated as high school and youth soccer, where the concussion problem is WAY lower than football.

Not only was Nantz – and Limbaugh – spewing information that is both hard to find (no source) and outrageous to this author, it is completely irresponsible to even suggest that female soccer is more “dangerous” than football, in terms of concussions.

Here is my diatribe from twitter last night; 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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Quick Hits on a Cold Thursday

31 Jan

American Medical Society of  Sports Medicine Position Statement…

I had seen this but caught it again in a below article, the AMSSM released its position statement on concussions recently.  Most of those involved in writing this were in Zurich last November and this comes out about two months before the consensus statement is released in the British Journal of Medicine.  (pssssst – it is also going to have a release in Australia, in conjunction with the AFL Concussion Conference and first round of games and I am still looking for a sponsor)

I found one piece of this position statement very encouraging and made me smile for all the hard work others have done;

Return to Class

* Students will require cognitive rest and may require academic accommodations such as reduced workload and extended time for tests while recovering from concussion.

The rest of the statement is not really “Earth shattering” but there are interesting points in there;

* In sports with similar playing rules, the reported incidence of concussion is higher in females than males.

* Certain sports, positions, and individual playing styles have a greater risk of concussion.

* Youth athletes may have a more prolonged recovery and are more susceptible to a concussion accompanied by a catastrophic injury.

* Balance disturbance is a specific indicator of concussion but is not very sensitive. Balance testing on the sideline may be substantially different than baseline tests because of differences in shoe/cleat type or surface, use of ankle tape or braces, or the presence of other lower extremity injury.

* Most concussions can be managed appropriately without the use of neuropsychological testing.

* There is increasing concern that head impact exposure and recurrent concussions contribute to long-term neurological sequelae.

* Some studies have suggested an association between prior concussions and chronic cognitive dysfunction. Large-scale, epidemiological studies are needed to more clearly define risk factors and causation of any long-term neurological impairment.

* Primary prevention of some injuries may be possible with modification and enforcement of the rules and fair play.

* Helmets, both hard (football, lacrosse, and hockey), and soft (soccer, rugby), are best suited to prevent impact injuries (fracture, bleeding, laceration, etc) but have not been shown to reduce the incidence and severity of concussions.

* There is no current evidence that mouth guards can reduce the severity of or prevent concussions.

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X-Games, D on coverage…

Anyone catch the X-Games this past weekend?  Action sports are on the rise and the X-Games Continue reading →

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CDC, NIOSH and Department of HHS Issue Statement

27 Jan

For many years the “government” has kept its collective mouth shut about happenings in sports.  Occasionally they will make statements regarding the health of players in sports; case in point steroids and PED’s.  The highest football league in the States and world has often had little resistance from “government” while doing business, until now.

The Department of Health and Human Services along with The Center for Disease Control and The National Institute for Occupational Safety and Health have released an NFL Notification about brain and nervous system disorders.  The NFL Notification can be found by clicking on the jump above.  Here are the highlights;

  • In general, brain and nervous system disorders were more than 3 times higher among players; 17 players died with Alzheimer’s, ALS, or Parkinson’s compared to 5 men in the U.S. (see graph).
  • More speed position players died from these disorders compared to the non-speed position players.
  • ALS was 4 times higher among players; 7 players died with ALS compared to fewer than 2 men in the U.S.
  • Alzheimer’s was 4 times higher among players; 7 players died with Alzheimer’s compared to fewer than 2 men in the U.S.
  • Parkinson’s was not increased among players compared to men in the U.S.

This is not “old” news rather, it is confirming what has already been known, but Continue reading →

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Concussions 201

23 Jan

The Concussion Blog, has for years, presented you with the basics of concussions and other issues surrounding this particular brain injury.  Most of it was factual information/research that I opined about.  Others were original information that was seen here first.  Regardless our aim – and continues to be – is to keep everyone aware and educated about this topic.

I was passed along a great article on concussions, it was beyond the “basics” but not so in-depth that you get lost in the mumbojumbo;

In other words, concussions are not caused by a brain doing back flips within the skull. In fact, miniscule amounts of movement might be to blame.

The article was written in response to the Stevan Ridley “Fencing Response” producing injury this past weekend and Dave Siebert colored this situation perfectly; Continue reading →

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