Most cases of concussion resolve spontaneously over time, we have had discussions on here that vary from 72 hours to 6 months or longer – however, people/researchers are trying to find a way to help along recovery. Most of this is an inexact science, to say the least, it is almost the ol’ adage of “throw crap on the wall and see if it sticks.”
Lindsay Barton wrote a great summation of current ideas for therapy for lingering effects of concussion, in some cases being classified as PCS, or post concussion syndrome, for Mom’s Team. I do like his list which includes;
- Craniosacral therapy
- Chiropractic Neurology
- Vestibular Rehabilitation
- “Buffalo Protocol”
- Epsom Salts
The first three are very “hands on” Continue reading
Brooke de Lynch of Mom’s Team sent over this article and video about a family and their dealings with post-concussion syndrome and the long recovery after a very “innocent” looking hit. It begins as most complex cases often do, with incorrect initial management;
On the evening of Friday, February 12, 2010, my then 15-year-old daughter Heidi was hit on the head by the stick of a teammate as she was warming up in goal before a hockey game.
It was not a catastrophic brain injury requiring a trip by ambulance to the hospital. But the blow did result in a concussion; one that turned out to be far more severe, complicated and long-lasting than initially thought.
Because multiple mistakes were made in the immediate aftermath of the injury by all parties – including by me, her mother – which exacerbated her symptoms, that cold winter’s night marked the beginning of what would turn out to be a fourteen-month long search for answers to the enigmatic riddle that is post-concussion syndrome.
Another great perspective from a mom, this time about a girls hockey player.
Listen, all cases are not as drawn out like this one, in fact stats tell us that some 75-90% of all cases of mTBI/concussion recover in 7-10 days. Remember that the “recover” portion of that last sentence is from symptoms AT REST. This brings me to my soap box moment of the day… Continue reading
There have been some very valuable resources to this blog, one who continually provides a vast amount of information both for posting and in the comment section is Don Brady, PhD, PsyD, NCSP, LMFT. He along with his wife, Flo, have written to often cited pieces of information on concussions. The first is the Communique on Sport-Related Concussions from the NASP. The second is the common myths associated with concussions. Let us not forget some the excerpts from his dissertation.
Recently Dr. Brady has sent me a couple of articles, neither of which were earth shattering in content, rather they were interesting due to the publication dates on them.
The first is a guest editorial by Allan J. Ryan, MD and appeared in The Physician and Sports Medicine, in 1987, 25 years ago (emphasis mine);
Rimel et all found that such events may be followed for weeks or months by symptoms and disorders of brain function that can be measured objectively. Gronwall and Wrightson found that persons who have sustained concussion show a reduced information-processing rate that may persist beyond 35 days when other post concussion symptoms (such as poor concentration, irritability, and fatigue) are present. Also, 20 young adults had less information-processing ability and took longer to recover following a second concussion that controls who had sustained only one concussion. Thus, a cerebral concussion is a serous event that is indicative of an injury to the brain, and should be taken very seriously.
Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there. As time allows she will be submitting posts for you to read. I truly hope that everyone gets a chance to read about concussions from yet another perspective. Thank you Tracey!
My son, Drew, suffered a severe concussion during a freshman high school football game in September, 2008, and has not played football since. He would have stepped back on the field the next week and would still do so if he was allowed to. It was not his first concussion, but it was clearly the most severe. My earlier posts on here explain the details of what he has gone through. Clearly, he has made tremendous progress, but he still has some cognitive difficulties. He also suffers from migraines, which are typically provoked by intense focusing or from being hit on the head. It does not happen often, but there have been a handful of incidents over the past 2 years. Two weeks ago, he was elbowed in the head very hard during a basketball game, which resulted in a migraine with major fatigue that lasted for 4 days.
Drew saw a leading neuropsychologist out of Loyola who is an expert in concussive injury last week. I chose to not reveal his name Continue reading
The hot button topic in the research world with concussions is chronic traumatic encephalopathy (CTE), the degenerative brain disease, twin (fraternal) sibling of dementia pugilistica first found by Dr. Bennett Omalu. This brain disease is debated and some times discounted (as you will see tomorrow) for its links to repetitive brain trauma, i.e. multiple concussions. It does however have a place in the discussion with combative sports like MMA.
Recently a former fighter named Gary Goodridge has said he believes to be suffering from its onset. Steven Marrocco of MMAjunkie.com wrote a piece on Goodridge and the debate of CTE in the sport;
The damage, he noted, was not extensive enough that it had caused irreversible trauma. But had the fighters continued to compete, he believes they would have been candidates for CTE.
“What I’m saying is that mixed martial arts belongs to the high-risk group of CTE,” Omalu said. “I would consider mixed martial arts just like I would boxing.” Continue reading
I had missed this article but thanks to an email I think everyone should take a look at this op-ed piece from the New York Times by Joe Nocera titled “The Cost of Football Glory“. He begins with discussing his initial thoughts after reading a 36 year-old article by Clark Booth. If you would like to read it as well here is Clark Booth at the Super Bowl: Death & Football.
But no one had ever written an article like that before Clark Booth went to Miami. I remember being thunderstruck reading it. D.D. Lewis of the Dallas Cowboys talked about having nightmares and his fear of breaking his neck. Lee Roy Jordan, a veteran Cowboys linebacker, was asked by Booth why he kept playing with a sciatic nerve condition.
“By the time I’m 55, I feel they’ll have learned enough to medically treat me,” he said. “If they can’t, I can accept that.”
Booth asked sportswriters and ex-players about the worst injury they had ever seen. Continue reading
Yesterday there were two important shows that aired. One on ESPN, the Outside the Lines presentation on helmets and the other was a documentary by CNN and Dr. Sanjay Gupta.
CNN and Dr. Sanjay Gupta presented an hour-long look into the concussion issue, mainly at the high school level. Although the main press is with the professionals, the time spent at the high school was a HUGE KEY to making this documentary a success. Like we have been posting on this blog for the past 18+ months the real issue with concussions begin at or earlier than high school. This is not only because there are obviously more participants at the HS level, but it is also where kids are learning and learning how to learn. In short the high school level is where the brain is functioning the hardest.
The presentation was excellent, it not only provided the current (subjectivity) but exploding (CTE) issues in the concussion discussion, but exposed a real solution to the issue. Continue reading
Kris Dielman would most likely do it all over again. In a piece done by the Associated Press and posted on ESPN, Dielman explains that the drive for the ring would make him do dumb stuff;
“This was definitely a scare,” said Dielman, known for his hard-nosed, blue-collar demeanor. “Waking up in the hospital with my wife standing over me, that was pretty scary. I don’t scare easy, but that was something different.”
Dielman went on to explain that having a family and kids would most likely make the decision harder, if it were to happen again, to return. This is the first opportunity the media has had to talk with Dielman, as players on the IR are not allowed to be interviewed by the press.
Marc Staal makes return to ice in Ranger uniform, outdoors in Philly. Staal had been out since February last year Continue reading
Originally published August 11th, “Student athletes suffer the stings of concussions while lawmakers fail to help” written by Steve Jansen and Gus Garcia-Roberts (not their first) in the Miami New Times News shows examples of how missing concussions and not handling them correctly (from player to coach to parents to athletic trainers) can be very troubling.
Including in this piece are quotes from Dr. David Hovda, one of the leaders in concussion/brain trauma research from UCLA, as well as other lawmakers and parents.
I was previously unaware of the Village Voice Media research and findings; Continue reading
If you have read the blog much you will find a fair amount of information and commentary from Matt Chaney regarding his position on head/brain injury. One thing that Matt does well, from his journalistic background, is document the many cases of catastrophic injury related to football in America.
Chaney is not the only one who does this, he just appears to be more transparent about it than the national foundation for such tracking, the National Center for Catastrophic Sport Injury Research (NCCSI). In his most recent post on his blog, Chaney gives us the list he has compiled for 2011, both by the NCCSI criteria and his extended criteria (which deserves credit).
The rate of catastrophic injuries in American football could be a record in 2011, with more than 70 survivor cases of conditions such as brain hemorrhage and spinal fracture, according to an intensive electronic survey by this reporter.
See the complete annotated list of cases below, with juveniles comprising the large majority of victims.
The findings belie talk of “culture change” by football officials, their popular claim of “safer” football in America, and raise question whether catastrophic injuries of the inherently brutal sport are significantly under-reported in record-keeping of the present and past.
Last year the National Center for Catastrophic Sport Injury Research (NCCSI) logged only 24 survivor cases—barely half the 2010 cases still available online, including players with brain bleeds and spinal paralysis missed in the report.
Now stronger accounting is assured for 2011, standing on results of my daily searching of Google banks that’s garnered a solid 70 survivor cases for verification as catastrophic football injuries, defined by the NCCSI as affecting the brain, skull, spinal cord and/or vertebral column.
My cases include the following: Continue reading
Former Pennsylvania governor Ed Rendell was once quoted in describing what he termed to be the “wussification of America.” If we look at this “wussification” in the spectrum of hockey’s concussion debate within the keystone state (the commonwealth of Pennsylvania), may we draw conclusions on differences between the Philadelphia Flyers and Pittsburgh Penguins? This is, of course, a heated in-state rivalry, and both teams understand the effects that concussions can have on even the brightest of players. In the past, the Flyers have seen the woes of the likes of Eric Lindros and Keith Primeau. The Penguins have seen their young star in Sidney Crosby miss much of last season on top of additional games missed this season.
Yesterday, ESPN published a report stating that one of the Flyers’ best players, Chris Pronger, would be out for the remainder of the season due to post-concussion syndrome. Pronger has not seen the ice since November 19th.
And for quite some time now we have all heard the news of Sidney Crosby’s recurring symptoms. His career now may be in question.
But with regards to this “wussification,” as we may bend its direction toward the hockey organizations in Pennsylvania, there are some clear polarities between both fan bases between the Flyers and Penguins. This is coming from the observations of an outside-observing indifferent viewer of the sport who is from Philadelphia and attends college in Pittsburgh—me. Continue reading
Symptoms with which I am familiar are primarily dizziness and fatigue. The biggest symptoms I deal with are my balance/movement and double vision, but apart from immediate vision problems most people have after a brain injury, I think balance /movement and double vision lasting over 8 years is more specific to serious brain injuries, so I won’t talk about them per se.
The severity of my symptoms has lessened over these 8 years and I have never had to deal with headaches (apart from an intense and especially long one after the doctors replaced my bone flap), but the dizziness and fatigue, however diminished, remain. That’s not to say that I deal with serious episodes of these symptoms every day, but they are there frequent. As I wrote in a previous post, standing up quickly or abruptly turning my head to the side can result in dizziness. Fatigue is another animal altogether. I don’t know when it will be intense.
For people dealing with the immediate symptoms of a brain injury, these are unfamiliar and must be Continue reading
Outside the Lines on ESPN interviewed Dr. Robert Cantu after he made public his stance on the issue of youth sports. I have embedded the video from ESPN via YouTube.
I would like to highlight not only Dr. Cantu’s take but also a VERY GOOD journalist that has covered concussions, Peter Keeting at the back end of the video.
In the accompanying story by Ian O’Connor of ESPNNewYork, Harry Carson believes that the state of football and its aftermath may be similar to playing Russian Roulette;
Carson played through all of his undiagnosed concussions, if only because that’s what NFL players did in the ’80s. He knew something was wrong when he struggled with his vocabulary during interviews, a problem that inspired him to secretly listen to language tapes on his drives home from practice in the hope, he said, “of retraining my brain.”
Carson was diagnosed with post-concussion syndrome Continue reading
Information about concussions seems to have been suddenly placed upon all of us; the information and management has changed multiple times since the mid 2000′s – maybe not. As early as the 1800′s other professions were relaying information to doctors that appear to symptoms of concussions (Caplan, 1995 – Erichson, 1997 – Keller, 1995), the authors focused on the railroad industry. Information about concussion and it’s debatable cousin, Post Concussion Syndrome.
Information about concussions and PCS has been documented very well by R.W. Evans as early as 1987, here is the list of his symptoms;
- Muscle contraction type
- Occipital neuralgia
- Secondary to neck injury Continue reading
Denard Span, center fielder for the Minnesota Twins, returned to the clubhouse earlier this week after spending some limited time at his home in Florida to cope with migraine-like symptoms stemming back to a concussion he received earlier in the baseball season. Span has been hopeful in making several instances of return, only to be touched again by the building-up of symptoms that generated enough discomfort to sideline him again. It has, too, been but a frustrating course of events for Span, much like that of his teammate Justin Morneau’s struggles with post-concussion syndrome during the 2010 regular season and 2011 spring training schedule.
His teammates have seen a difference in his play during his post-injury attempts at return, and his numbers would suggest just that. Before his concussion in June, Span was batting a solid .294 at the lead-off spot with an on-base percentage of .361. During his hopeful confirmation of recovery in August, Span went 2-35 (.057) in nine games played, only to be shutdown by prolonged symptoms as a result. Fox Sports North recently published a compelling article on Span’s time dealing with post-concussion related symptoms, which includes interviews of both Span and his teammates.
Regarding his absence from the team when he was sent to his home in Flordia, Span touched upon one of the most common psychological reactions to the concussion injury, whereas the feelings of hopelessness and frustration would take over one’s mind to the point where their own worth at that point and place in time was self-questioned. Continue reading
Pittsburgh Penguins star Sidney Crosby is planned to speak to the media this afternoon, at 12:30PM ET, of his progress regarding his post-concussive condition which has put a halt to the current moment of his shining career. Today will mark the first time since the previous NHL season where Crosby will publicly describe the extent of his injury, as he has clearly been heavily scrutinized and shamed due to the extensive time he has lost and failed to provide to the growing spectrum of hockey. Whom many may consider the face of professional hockey, Crosby stands hopeful for a promising return but still remains unsure of his medical future.
Specialists in Georgia and Michigan have been monitoring the course of Crosby’s recovery for several months now, and until recently they found him to be at what was considered to be a 90% recovery, though headaches would gradually return only to provide that cloud of doubt around him and his closest friends and family. The complications of the concussion injury are at most difficult and different in every case, and by matter of it happening to the Penguins’ prodigy, the hockey audience now presents itself with a real-time situation that clarifies the implications of mild traumatic brain injury, as well as displaying the vulnerability of the most valued players in the league. Continue reading
I was brain injured in 2003 while cycling in Victoria, BC. Concussions are also known as mild traumatic brain injuries and while what I sustained was a coma-inducing severe traumatic brain injury, from what I hear, and what makes sense to me, there seem to be many overlapping symptoms. I read about how Marc Savard has “post-concussion” symptoms and I’m really wondering why they call them post-concussion symptoms and why I always say ‘I was brain injured’. I guess the major traumatic blow to my head is a thing of the past, so, on a technicality, I can get away with saying “was brain injured”, but plain logic is enough to tell you that you don’t have symptoms from an injury that doesn’t exist. I still have major symptoms and even though you can’t see my injury just by looking at me today, doesn’t mean that my brain has completely healed. Some parts of my brain seem unaffected, but Continue reading
That is not an off-shoot of the cable channel, it is a therapy that can be used for brain injury. Hyperbaric Oxygen Therapy has been in the distance as a treatment for head injury, specifically concussion for a few years. The main reason is the lack of support from the insurance companies as pharmaceuticals seem to be the main concern.
What we do know is there is not a “pill” that can solve the mysteries of concussion/mTBI, but we are now starting to see results from therapeutic modalities that can help: vestibular rehabilitation, balance training, cognitive training, dual-task therapy. However HBOT seems Continue reading
Drew Cumberland of Pensacola, Florida and Pace High School was a fast rising star since being drafted by the San Diego Padres. by the age of 22 he had seen action at the AA level and even appeared in a spring training game for the parent club. However his career is now over, as a player, due to concussions and vestibular issues. Bob Heist of pnj.com wrote a good story on how a promising career was ended.
Cumberland is like any other typical high school “stud” that played many sports, also a true competitor that would play through pain and a little “headache”. His earliest known/documented concussion came in 2003 as a freshman in football but later Continue reading
Matt Chaney has been busy this summer with work, but he found some time to forward a bunch of links regarding concussions. There were a lot dealing with the state laws and the mandates now in place across the sporting landscape, all with very valid opinions. Some dealt with his area of expertise, steroid and PED detection. However there was one that I must share with you; a link to a NASP Communique (National Association of School Psychologists)
The link was very resourceful but the gem was the attached .pdf that dealt with the myths we commonly hear with concussions. Due to the rudeness of ripping off all the information below you will see the myths they took on, and for the actual facts please click on the .pdf link above;
- Professionals agree on the definition of a concussion.
- A more accurate term for concussion is a head injury rather than a brain injury. Continue reading
The memories of Matt Dunigan are both good and bad from his years in the Canadian Football League. Unfortunately, the recent thoughts to his past have made a profound statement about concussions in sports, in particular football;
How far has post-concussion syndrome penetrated the culture of sport? Witness the tear-streaked face of former CFL star Matt Dunigan in his interview with Brian Williams last Friday on TSN. In a shockingly personal segment, Williams led Dunigan though the hell brought on by at least twelve diagnosed concussions in his playing career. The troubled private life of a very public athlete (Dunigan won two Grey Cups) was put in a new perspective as he wept beside his wife.
His wife went on to tell the audience the Dunigan forgot how to laugh and lost his sense of humor, basically becoming a Continue reading
The Athletic Trainers’ Society of New Jersey is hosting its second annual Concussion Summit on July 17th. It is after the “early registration” however the line-up is certainly worth a look. This is the same organization that produced the very well put together tutorials on concussions, SEE HERE.
- Steve Broglio, PhD, ATC – Assessing Balance in Concussion
- Robert Cantu, MD – Long-term Effects of Concussions
- Annegret Detwiler-Danspeckgruber, EdD – Imaging Concussions: DTI and fMRI
- Ruben Echemendina, PhD, PSY – The Role of Neurocognitive Testing
- Jason Mihalik, PhD, CAT(C), ATC – Biomechanics of Concussions Continue reading
Perhaps. University of Buffalo doctors and researchers believe that they may have a tool that can provide definitive answers and take the “chance” out of the impending second injury. John J. Leddy, MD, Karl Kozlowski, PhD and Barry Willer, PhD are authors of a study aimed at just doing that;
University at Buffalo researchers have developed a test to determine when it’s safe for athletes to return to play after a concussion.
Currently no standardized method exists to assess when the time is right. It is usually a judgment call made by team physicians.
“We believe this new approach could change the way professional and amateur sports team physicians make decisions about concussion recovery.”
Barry Willer, PhD
professor of psychiatry and rehabilitation medicine and senior author on the paper
The treadmill test devised by UB concussion specialists in the Department of Orthopedics could change that by providing a systematic approach to evaluate readiness.
“In the past, how a team physician and trainer made this decision was left to chance,” says Barry Willer, PhD, professor of psychiatry and rehabilitation medicine.
Willer is senior author of a paper titled Reliability of a Graded Exercise Test for Assessing Recovery from Concussion, published in the Clinical Journal of Sport Medicine.
Using the Balke standardized treadmill test the subjects were taken to either symptom exacerbation or perceived exhaustion. Starting Continue reading
Welcome to the intended live feed from the 2nd Annual Sports Concussion Summit here in Lexington, Kentucky. We are at Cardinal Hill Rehabilitation Hospital, a beautiful facility. Attendance looks to be very good, about “60 or so” according to Jonathan Lifshitz, host of the event. I will be updating this post as we go along with a time, follow @concussionblog on Twitter for updates.
7:05am CST: Jonathan Lifshitz, PhD opens up the conference, a big “walk-in” group, I still think I may be the only one not from KY here.
7:10am CST: Dr. Lifshitz had a great perspective on announcers and how the terminology of the game regarding head injuries has to slowly begun to change.
7:50am CST: Dan Han, PsyD “Contemporary Perception on CHI: Multidisciplinary Initiatives“
- 1.7M documented TBI; 52,000 deaths per year, 275,000 Hospitalizations (CDC Numbers)
- 75% of TBI (1.3M) are concussions/mTBI/mDAI; 300,000 are DOCUMENTED sports concussions
- 0-4, 15-19 and 65+ y/o’s most likely to sustain a TBI
- Females have significantly higher odds of poor outcomes
- Documented TBI (see above) not the real issue; the undocumented TBI is the proverbial iceberg under the water
- Diffuse Brain Injury
- Secondary to stretching forces on the axons
- Moderate DAI = “Classic Concussion” (unconsciousness, possible basal skull fracture)
Severe DAI = Brainstem Injury (high mortality rate)
And TCB Contributor Tracy Yatsko gets some run on a video!!! Man girl you get around !
- Persistent confusion, retrograde & anterograde amnesia, mood/personality changes
- LOC > 5 min or anterograde amnesia or new onset of seizures within 6 months after CHI
AND attention or memory deficit
Plus 3 or more symptoms present for at least 3 months following CHI
Significant impairment in social or occupational functioning
Academic achievement decline
HUGE Multidisciplinary Concussion Program at University of Kentucky, well on the way to being a leader in concussions
- Just learned a lot about seizures; many go unnoticed
8:50am CST: Greg Wheeler, MD “Treatment of Sports-related concussions and return-to-play clearance” Continue reading