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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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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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National Concussion Awareness Tour

18 Dec

It is an idea that can catch on, real quick, it has the basic tenet of education/awareness at its core, with the right promotion and teaching/tools I am in agreement this will do some good.  The plan is to have a national concussion awareness month, September, and along with that have a tour across the United States.  Instead of me trying to explain it, here is a promotional video, geared to finding sponsors for this event;

I do not endorse the Shockwave System, I am only endorsing the idea of an awareness tour….  Heck I don’t even know about baseline and/or neurcognitive testing…  However the idea to inform everyone is sound…

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Matthew Gfeller Neurotrauma Symposium

12 Dec

Loudermilk_picsIn Zurich I had the chance to speak to many people; I enjoyed my brief time speaking with Jason Mihalik – fellow athletic trainer.  He reminded me of the previous Symposium in North Carolina and the upcoming second version.  I asked him to send along an email and I would put it up on the blog.  Here it is, and he is right, make sure you register NOW, it fills fast.

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It is with great excitement that my colleagues and I will be hosting the Second Matthew Gfeller Neurotrauma Symposium at the University of North Carolina at Chapel Hill on March 8-9, 2013. We have lined up another great list of local, regional, and national speakers. For additional information regarding a schedule of topics, invited faculty, and links to negotiated hotel rates, please visit us at http://tbicenter.unc.edu, and click on “TBI Symposium” in the header. A direct link to register for the symposium is as follows: http://tinyurl.com/c576kdu.

Our first symposium sold out 2 months prior to the scheduled event, so register early! Current Early Bird rates in effect until January 8, 2013 are as follows:   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

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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 →

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More Helmet News: Oversized Helmet?

17 Oct

Will Carroll (@injuryexpert) pointed out an article this morning from the Miami Herald regarding Dolphins running back Daniel Thomas;

Thomas said he passed the NFL-mandated cognitive tests Monday, and will now practice and play with an oversized helmet designed to minimize trauma to the brain.

I immediately thought to some of the many emails I receive regarding concussions, it was from ProCap; the soft shield placed on the outside of the helmet to reduce linear forces.  It has been re-branded and changed a bit to conform to the newer helmets (as you can see in the picture above).

This is no different from the CRT Technology that was in the previous Harrison post; it possibly will reduce the linear forces, but again how does it affect the acceleration/deceleration/rotation of the head which in turn effectively “moves/sloshes” the brain around inside the skull.

Without seeing what Thomas will be wearing this is our best guess, we will be interested to see any photos of what he is donning.

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James Harrison A Head Trauma Spokesperson?

17 Oct

James Harrison, the oft criticized football player – rather punisher – of the Pittsburgh Steelers has now found time to make comments regarding safety of players brains.  I will admit that this tact is much more productive than blaming “soft” rules for his repeat offenses of the illegal hitting rules.  I suppose he would be a very good “test subject” for a new product that may provide protection of the head;

After enduring what he estimated as “double digit” bouts with concussion-like symptoms throughout his decade-long career, Harrison began using a special layer of padding inside his helmet last fall and is pleased with the results.

“I haven’t seen any spots or had any blackouts,” Harrison said Tuesday.

Although the article and the statements from Harrison seem more like an advertisement, it is clear and important to remember that the CRT technology does not and will not prevent concussions.  Interior padding is something helmet companies have been working on over the years; it is the place on this piece of equipment where changes can have an impact – rather reducing impact.

Before everyone runs out to get the CRT technology, which in my opinion has real and definite helpful qualities for its other uses, we need to remember that concussions are mainly a result of Continue reading →

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The Risk of Professional Football: Do Not Do This At Home

24 Sep

It is scenes like the ones below that we cringe about while watching our favorite sports.  In football they happen relatively frequent; what once was 2-3 times a year a person getting carted off now has become a weekly occurrence.  In the videos below (certain to be pulled by the NFL so see them while you can), you will notice the rotational forces being the problem for both players.  Also both players exhibited the Fencing Response, if you are not intimate with this, I suggest you learn.

First is Darrius Heyward Bey of the Oakland Raiders.  This hit was not penalized by the way even though principle contact was made by the defender with his helmet to the head.  Bey was carted off and went to the hospital for observation.

In this one Nate Irving of the Denver Broncos was blocked into the returner as he was making a tackle and he too made principal contact with his helmet up high.  This time it was the “hammer” getting K.O.’ed due to rotational forces.  Irving was attended to and later walked off the field under his own power.

One more example of hitting with the helmet, but a case of linear forces going to the head and the drastically different outcome.  Also in Denver, Matt Schaub took a shot to the head from a Denver defender.  This time the forces were mainly (if not all) linear and the QB didn’t lose consciousness, but did lose part of his ear lobe.

I provide these videos as a LEARNING TOOL for the audience:

  • Fencing Response
  • Rotational Forces
  • Linear Forces

And I also would like to note this type of tackling behavior should not ever be part of a youth or high school level program.  Launching and or using the crown of the helmet should be penalized, early and often.  So all you non-professionals do not try this at home.

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Book Review: Concussions and Our Kids – Dr. Robert Cantu

17 Sep

Due out tomorrow, Tuesday, September 18th, is Dr. Robert Cantu’s most recent writing on brain trauma; more specifically the concussion and how it relates to the ‘kids’.  Dr. Cantu is THE expert when it comes to concussions, heck his CV is so expansive it would take up like 7 pages on here.  The man knows his stuff; collaborating with Mark Hyman I believe he has written a book that is worth the read for everyone interested in this topic.  By writing this book they not only address the concussion issue but the “iceberg below the surface” the youth athletes and their care.  Obviously the millions that partake in sport and recreation are not privy to the top of the line medical staffs that the professional and high college athletes have at their disposal.

With Dr. Cantu’s wealth of knowledge there was a chance this book could have been written above the audience – so to speak – but after reading it twice I have found it to be perfectly succinct and to the point.  There is no beating around the bushes and you definitely get the feeling of where Dr. Cantu stands on this pressing issue.  All of that being said there are some points that I disagree with, but remember my favorite Japanese Proverb: “None of us is as smart as all of us.”

The book begins with the most important topic, in my opinion, “what is a concussion?”, delving into the brain and its physiology.  Don’t be scared, it is a well written chapter and explains to the layman how and what we feel determines a concussion.  Highlighting that section is the explanation of linear and rotational acceleration and why one is way more important than the other.  If you have read here enough you will note that the rotational aspect of the traumatic force to the brain bucket is the most troublesome, Cantu agrees.  In this chapter Cantu also discusses the term “rest”, and what we are all trying to convey, especially to the youth.  Rest is both physical AND cognitive, meaning not using your brain.

The next two chapters deal with collision sports 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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Echoing “Concussion Prevention” Concerns

2 Aug

On Paul Anderson’s (@PaulD_Anderson) NFL Concussion Litigation blog a guest post went up the other day taking on the ever-growing concern of concussion “prevention” products.  The article was written by Andrew M. Belcher, MD (@the_jockdoc) and plainly explains it is buyer beware, as concussions are more than protection for the skull;

So then what we really need to prevent concussions are seatbelts and airbags for our brains inside of our skulls.  Here’s one more example to make it clear.  Shaken baby syndrome is caused by shaking a screaming baby back and forth to make them stop crying.  Even though their head never hits anything, the shaking leads to brain damage.  Would wearing a baby helmet have helped?  Of course not.  So how can a helmet possibly eliminate concussions in football.  It can’t.  Any protective device that claims to prevent concussions in a contact sport is false advertising and may be giving athletes a false sense of security.  How can athletes be well informed of the risks they are taking when the advertising by equipment manufacturers minimizes the risks?  The only way to prevent concussions is not to step on the field in the first place.

Very succinct and spot on, concussions are not mainly caused by linear forces to the skull; they are created by acceleration and deceleration of the brain INSIDE the skull.  Products that claim that they prevent concussions are borderline fraudulent, as there is NO study available that any current product can prevent concussions.  Sure, some can attenuate certain (see linear) forces to the head region, but other than a HANS device there is nothing in sport that limits the acceleration/deceleration or rotational properties of brain trauma.  In fact, increasing the weight of the head can increase mass, therefore by the laws of Physic’s, increase the overall force.

There is no guessing where I stand on the claims put forth by Continue reading →

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Changing the Culture: Will Carroll – Special Contributor

25 Jul

I am honored and privileged to post an article from Will Carroll regarding concussions.  I thank Will very much for his time and contribution!

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Changing The Culture

Will Carroll for The Concussion Blog

It’s a quiet, warm Saturday morning in July. Coming up to the Colts Complex on the west side of Indianapolis, it’s normal to see players walking in. It’s not normal for them to be nine years old.

USA Football is rolling out what amounts to a pilot program they are calling the “Protection Tour.” It’s a multi-part seminar for kids, coaches and parents that focus on the concussion issue. Sponsored in part by the NFL, it’s easy to see why they chose this program. USA Football isn’t the typical governing body. They don’t have any form of control over the largest programs, the NFL and NCAA. They don’t even hold any sway over scholastic programs. They’re more a lobbying organization, taking hold of “should bes” like coaching standards and player safety.

The Protection Tour is made of up of three “stations”. In the first and perhaps most important, coaches and players are shown tackling drills that emphasize old fashioned concepts like shoulder contact, athletic position, and wrapping up. These kinds of hits won’t make SportsCenter, but they are safer for everyone. There’s an emphasis Continue reading →

Mr. Rodgers Not Exactly Correct

20 Jun

If you follow me on twitter you know that I made a comment about the recent statement from Aaron Rodgers – concussed Super Bowl MVP – about helmets;

In his remarks he said the helmet he now wears, compared to the one he wore when he started in the league in 2005, has prevented him from “a couple” of concussions, including one against the New York Giants in a playoff game last season.

Rodgers was part of a panel of other quarterbacks that were also Super Bowl MVP’s hosted/moderated by Bob Costas – apparently a charity event.  Regardless if there was an actual quote from Rodgers about prevention of concussions from helmets or it was simply inferred by the context, it is not correct and could provide false hope to others.

Helmets were designed to attempt to eradicate skull fractures and brain bleeds, the most heinous of brain injuries that were felling many players at the turn of the 20th century.  As technology has progressed we have seen fewer and fewer of this often life-threatening injury; unfortunately it does still occur.  The helmet shell along with the interior padding is designed to absorb the massive linear forces that cold fracture a skull or provide enough trauma to rupture vessels in the head.

Concussions are a slight bit different – even though both are brain injuries – a concussion is mainly a neurometabolic and microscopic structural issue.  Concussions are set off in a variety of ways but the biggest culprit is angular acceleration/deceleration and rotation of the skull (most commonly those type of collisions in ALL Continue reading →

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Girls Soccer Story Follow Up – NBC

7 Jun

In response to the overwhelming reaction to their report on concussions among high school girls playing soccer, “Rock Center’s” Kate Snow goes to New Jersey, Florida, Texas and California to dig deeper into the danger, and the psyche of these young girls and their families. Many have responded to the risk by wearing special headgear advertised as protecting against concussions, but Snow discovers that the reality may be very different. It’s a piece of reporting no parent should miss.  (VIDEO PREVIEW LINK IS BELOW )

VIDEO LINK

Rock Center With Brian Williams will air this episode tonight as the new season begins at 10EST/9CST.  It will bring up the physics of concussion, and how the headgear is supposed to work and the potential problems of that logic.  Here is an excerpt from the associated print preview; Continue reading →

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What Impact can WE make?

7 May

I have worked with Battle Sports Science for the past year, mainly as the athletic trainer trying to come up with all the problems one would have by putting any “concussion” device on the field of play.  The things I have gained out of this relationship are: friendship, an opportunity to be the overbearing and opinionated athletic trainer, be on the cutting edge of the concussion awareness movement, tickets to a Nebraska football game, and a few Impact Indicators (oh and an unflattering picture of me on the package).  More importantly what I have learned in the relationship; is that with Chris Circo at the helm there is truly a company out there looking to make a difference – yes they aim to profit as well – however they want to get it right.  It all begins with the words and actions.  One such action that carried heavy weight for me was a conversation about their mouthguards.  I mentioned to Circo that I felt his product claims on the mouthguard was out of line in terms of their concussion claims, and just asked him to remove it.  Guess what, he did!  He had to change packaging and even when there was a distributor that had the old verbage on a website was found he made a call and had that changed too.

I tell you this because Chris has worked on a post for this blog (hopefully others) to use to bring up the question: “How can WE ALL help?”  It explains what they are trying to accomplish as well, using the Impact Indicator as a good first step;

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What Vince Lombardi can teach us about protecting athletes from brain injuries.

Gap-toothed and sporting a trademark crew cut, the face of Vince Lombardi brings to mind one word for most football fans, winning. It’s easy to see why too. The legendary coach led the Green Bay Packers to 3 straight league championships, won 2 consecutive Super Bowls and never had a losing season as a head coach in the NFL. He’s also famous for a quote about winning he never uttered, “Winning isn’t everything, it’s the only thing.” The hard-nosed coach’s actual quote “Winning isn’t everything … but wanting to win is” gives us I believe, cause to stop and think.

The place we find ourselves today in the battle to reduce head injuries in football is Continue reading →

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Innovative Concussion Care Concept

18 Apr

It seems that I often am applauding the efforts north of the border in Canada, it really seems that they have put a concerted COMBINED effort to seek out and implement innovative ideas.  I don’t think it says much about the United States other than we are all trying to do our best in our own little areas.  There is little consortium or conglomeration of effort, rather “‘A’ has found this”, “‘B’ has discovered this”, “‘C’ is saying this”, etc, etc, etc…

It may be the same up north but with the population centers mainly in fewer areas in Canada it seems that the Toronto, Ottawa, Montreal, and Vancouver areas seem to all be on the same page.  This could also be because of the overall influence of the Brain Injury Association of Canada and its influence on such things.

This idea is not from the BIAC, but it has some solid foundations none the less, including our partner in concussion awareness stopconcussions.com with Kerry Goulet and Keith Priemeau at the lead.  They have created a vision and group of like-minded individuals to create what they are calling Sports Concussion Care Clinic.  Here it is in a press-release; Continue reading →

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Athletic Trainer Innovates – Yup that’s what we do

23 Mar

We have seen volleyball players wearing soft sided helmets in games, and we have seen the explosion of “head-gear” for sports like soccer.  It is starting to become a trend; something that long time athletic trainer at Louisville put into practice – figuratively and practically – for the previously concussed on the mens basketball team (looks like Hina or others have softened Pitino’s stance on concussions);

Looking to protect players who’ve had previous concussions, Cardinals trainer Fred Hina came up with the idea of having them wear the padded helmets in practice.[...]

“We’re just trying to proactive and keep our multiples (concussions) down to a minimum, limit our risk,” Hina said Thursday before the Cardinals played Michigan State in the West Regional semifinals. “It may be overkill, but I really think you’re going to see it more and more with the focus being on head injuries.”

REMEMBER THAT HELMETS DO NOT PREVENT CONCUSSIONS, Continue reading →

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Published Article in CJoSM Supports ‘Hit Count’

21 Mar

I was forwarded this information from a very astute and prominent concussion researcher for my take and information.  The Clinical Journal of Sports Medicine published an article regarding the under-reporting of concussions.  The authors are: Greenwald, Richard M. PhD; Chu, Jeffrey J. MS; Beckwith, Jonathan G. MS; Crisco, Joseph J. PhD.

It is important to note that the authors (as it is disclosed) have an interest in the Head Impact Telemetry System created by Simbex and limited currently to Riddell helmets.  With that out-of-the-way the article exposes the bigger problem with concussions with competitive athlete; the subjective nature of the injury and the self-reporting;

We typically cannot “see” a brain injury, and even with increased public and medical awareness about the serious nature of any brain injury, a “warrior mentality” inspires many athletes to continue to play. Contemporary, more stringent guidelines proscribing a same-day return to play may actually fuel underreporting of symptoms by some athletes. It is therefore critical that improved techniques for identifying athletes at increased risk of developing brain injury be implemented at all levels of play.

Prevention of brain injury should be a priority. Athletes in contact sports are exposed to head impacts, Continue reading →

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Kevin Turner Interview

7 Mar

We have written about Kevin Turner before; a former NFL player and Alabama stud who is now dealing with the effects of ALS (Lou Gehrig’s Disease).  Turner has started a foundation in his name where they are raising money and awareness about ALS and the workings of the Sports Legacy Institute (SLI) as it relates to CTE.

Yesterday Rachel Baribeau, on her show Barbo & Scarbo (Kevin Scarbinsky), interviewed Kevin Turner on 97.3 The Zone out of Birmingham.  It is such a profound interview that I encourage everyone to take a listen.  You can CLICK HERE for the podcast.

The perseverance of Kevin Turner is and SHOULD be Continue reading →

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NASCAR Takes Center Stage

23 Feb

Today the NASCAR racing series will set their starting grid for the Daytona 500, stock car racing’s most prestigious event.  Over the next few days the sporting world will cast a keen eye on the racing series.  On Tuesday the Associated Press ran a story about how NASCAR has been handling concussions.  It really began in earnest when Dale Earnhardt Sr. died due to massive head trauma in the 2001 Daytona 500.

Traveling in a motor vehicle at nearly 200 mph obviously has a high risk factor for catastrophe; since the series took drastic measures for driver safety, starting in 2001, there has not been one death.  Interventions included updated helmets and neck restraints along with an overhaul of the driver area inside the car and safer walls on the track.

Times have changed in this sport, like others, but concussions remained vastly misunderstood until about 2004, when the series began keeping track; tracking only 29 and 11 in the last five years.  Drivers whose careers have spanned the before and after of Dale Sr.’s death can definitely tell the difference; Continue reading →

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Research From The Now

22 Feb

Virginia Tech and Wake Forest researchers Ray W. Daniel, Steven Rowson, and Stefan M. Duma have published a new research article on impact telemetry on youth football players.  The abstract is as follows;

The head impact exposure for athletes involved in football at the college and high school levels has been well documented; however, the head impact exposure of the youth population involved with football has yet to be investigated, despite its dramatically larger population. The objective of this study was to investigate the head impact exposure in youth football. Impacts were monitored using a custom 12 accelerometer array equipped inside the helmets of seven players aged 7–8 years old during each game and practice for an entire season. A total of 748 impacts were collected from the 7 participating players during the season, with an average of 107 impacts per player. Linear accelerations ranged from 10 to 100 g, and the rotational accelerations ranged from 52 to 7694 rad/s2. The majority of the high level impacts occurred during practices, with 29 of the 38 impacts above 40 g occurring in practices. Although less frequent, youth football can produce high head accelerations in the range of concussion causing impacts measured in adults. In order to minimize these most severe head impacts, youth football practices should be modified to eliminate high impact drills that do not replicate the game situations.

There are some very interesting findings in the abstract alone that need to be noted: Continue reading →

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Collecting Concussion Data: Massachusetts

20 Feb

As part of the concussion legislation put in place in the state of Massachusetts, the public middle and high schools must report all head injuries/concussions to the state Department of Public Health.  Although plans have not been set for the actual purpose of the data collection, it can provide a snapshot of what high schools are dealing with.  As Lisa Kocian of the Boston Globe wrote;

Football and soccer players from 26 area high schools suffered more than 300 head injuries last fall, the first time athletic departments were required to collect data under the state’s new concussion law, according to a Globe survey.

Football players accounted for 207 of the injuries found in the survey, exceeding the totals on soccer teams at most schools. Girls’ soccer programs reported nearly twice as many head injuries as boys’ soccer teams, 85 compared with 46.

The sample set of data has been put in graphical form, click on the link above to see it.  The average injury reports Continue reading →

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AOSSM Helmet Fit Findings

13 Feb

As I prepared for a presentation at a football coaches clinic I was just checking my usual sources for new information when I came across a research study that was put out by the American Orthopaedic Society for Sports Medicine regarding concussions and helmet fit.  It was a welcome finding, not only could I use it in my studies but it was a great find to back up the new NFHS helmet rule.

One thing I have learned, the hard way, is that when speaking to coaches simply discussing what the concussion is and how it affects them only goes so far.  They are coaches, they naturally want to know about their opponent (concussions in this case) and how it will affect their team.  I have found that a simple overview of why we are where we are – current research, why it has changed – style of game, what is being done – rules/legislation, and how they can help – awareness/athletic training they seem to be very receptive.  Rarely do I get the chance to explain a new rule and then have research back up the change.

That is what happened on Saturday; NFHS focusing on proper helmet fit and then the AOSSM study; Continue reading →

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New High School Helmet Rule

10 Feb

We have all seen it, the rolling helmet on a play that has seemed to have lost its player.  Now if this occurs, not due to a penalty, the player will have to sit out the next play.  This is one of eight rules/changes that the National Federation of State High School Associations announced in a NFHS Football Rules Press Release 2012;

INDIANAPOLIS, IN (February 9, 2012) — High school football players must sit out one play next year if their helmet comes off while the ball is live. In cases where the helmet comes completely off without it being directly attributable to a foul by the opponent, the player will have to leave the game for at least one down.  This addition to Rule 3-5-10 was one of eight rules changes approved by the National Federation of State High School Associations (NFHS) Football Rules Committee at its January 20-22 meeting in Indianapolis. All rules changes were subsequently approved by the NFHS Board of Directors.  “The committee made this rules change after reviewing data from multiple states regarding the frequency of helmets coming off during live-ball play,” said Julian Tackett, chair of the Football Rules Committee and commissioner of the Kentucky High School Athletic Association. “It is the committee’s hope that this serves notice for schools to properly fit players with helmets to reduce the incidence of these situations and remind the players not to take steps that alter the fit.”

Of the other seven rule changes Continue reading →

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White Paper

3 Feb

Sometime today Sports Legacy Institute (SLI), headed by Dr. Robert Cantu and Chris Nowinski are going to release a “white paper” that will “plan to spread successful NFL policy changes to all youth sports,”  this according to Irvin Muchnick via his blog Concussion Inc.

What is a white paper?  Glad you asked it is important for context (via Wikipedia);

A white paper is an authoritative report or guide that helps solve a problem. White papers are used to educate readers and help people make decisions, and may be a consultation as to the details of new legislation. The publishing of a white paper signifies a clear intention on the part of a government to pass new law. White Papers are a “ … tool of participatory democracy … not [an] unalterable policy commitment.[1] “White Papers have tried to perform the dual role of presenting firm government policies while at the same time inviting opinions upon them.”

It is mentioned that along with SLI, Boston University’s Center for the Study of Chronic Traumatic Encephelopathy (headed by Dr. Ann McKee) will be in the white paper as well.

I will be interested to see what exactly they are Continue reading →

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