NOCSAE Advancing Testing?

27 Jan

Perhaps, pending a vote in June, new standards could be set to get a helmet NOCSAE certified.  The news comes as the research arm has come up with plans for a testing scenario for something beyond linear drops;

The National Operating Committee on Standards for Athletic Equipment (NOCSAE) board of directors has approved the development of a revised football helmet standard that will require helmets to limit certain concussion causing forces.

You can see the full NOCSAE Jan 24 Release by clicking on the link.

It has been a long while since the standards have changed, but the calls for including more “realistic” type of scenarios in place have been loud for some time.  Including your’s truly, who believe that the rotational and angular forces were woefully under represented in any sort of testing.  I have been told by one representative with vested interest in this that for years the issue has been that these type of tests were “not repeatable.”

If everyone can be on the same footing with this and these new ideas actually translate to the “real world” then I am all for it, no matter the cost.  However, if this is something that is pure window dressing and will not actually impact a change – if that is even possible – then we are wasting time and money.

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Terry Ott: 3rd Down, CTE to go – FINAL Part

25 Jan

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE and PART 6 HERE.

It has been my pleasure to post the stylings of Mr. Ott over the past few weeks.  The guy has worked hard on this basically “paying it forward” so perhaps one person will run with the information.  I admire his spirit and “sticktoitivness”, thank you, Terry!

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AND IN THE END…THE CULTURE MUST CHANGE AND/OR THE FALL OF THE FOOTBALL EMPIRE

“In this sort of feminized atmosphere we exist today guys who are masculine and muscular…kind of old-fashioned guys run some risks.” -Brit Hume, Jan. 13, 2014

You know, I don’t really care much for the brand of “news” that FOX espouses and yet this is the second, and last time I will quote from it.

Because what Brit Hume recently said deserves to be discussed. Even though his comments may be a mile wide and only an inch deep and were not referring to the “manly” sport of football, they may in fact strike to the heart of the civil war now going on in pigskin circles regarding concussions and brain injury.

On one side of the debate are what the League of Denial authors rightly called the deniers, and the other side would seem to be the whistle-blowers. The deniers see the whistle-blowers as silly sissy Marry la-la’s trying to wreck football and the whistle-blowers see the deniers as Neanderthal numbskulls, old-fashioned guys well past their sell date.

Perhaps these are the risks that can befall the old guard, the deniers. That of being accused of being out of touch, thick, ignorant of the facts, or worse.

But does that make the whistle-blowers, those alleged soft, girly man, nanny-state purveyors “feminized”?

Well, if it means caring about football and employing common sense in a brutal arena, then sign me up for NOW, now, man.

Because pro football as we now know it is in danger-yes, real danger.

Danger of being law-suited and legislated out of acceptable existence.

And, as I have previously pointed out, shutting up about it is just plain dumb and ensures football will be KIA.

The lawyers smell money – that’s real money – and the government will most assuredly act, and maybe even in a Draconian fashion, if pro football does not get its brain injury prevention and after care act together very soon.

The NFL and their broadcast partners are joined at the hip. For the most part, this ain’t good because neither hand wants Continue reading

#C4CT Concussion Summit Agenda Set

22 Jan

Brewer Sports International has set their agenda for the 2014 Concussion Summit in New York at the United Nations on January 29th.  You can view the full .pdf HERE.

Time is running short for your attendance but I can tell you that this meeting will be well worth the time and investment.  You can also catch some of the Super Bowl festivities during your time in The City (this guy will be).

I am excited to be on a speaking panel, but I am also excited to be typing away a live blog during the event.  I hope that my keystrokes don’t bother those in attendance too much!  Although I will be updating it live, I promise that I will not get every little nugget interesting to you, but I will capture the best I can.

You can register HERE.

As you might imagine there have been plenty of meetings presented to me while I will be there, but I am trying to figure out a spot where we can possibly have a meet up and discuss – stuff.

However, there is one meeting that I have yet to be invited to, but would gladly accept; a meeting with Mr. Goodell and the NFL.  This may be pleading here, but if anyone can make it happen I am open in the afternoon of the 28th!  Hahaha!

Terry Ott: 3rd Down, CTE to go – Part 6 – UPDATED

22 Jan

CBC 5th EstateThis continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE.

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UPDATE 21:19 1/22/14 – rectified link to CBC The Fifth Estate “Head Games” (see below)

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HELLO, IS THERE ANYBODY IN/OUT THEREJUST NOD IF YOU CAN HEAR ME, IS THERE ANYONE AT HOME?

“Now I remember why I gave up speaking to journalists. They are a species of foul vermin. I wouldn’t hire people like that to guard my sewer. Journalists are morons. They’re idiots. They’re ignorant and stupid.” – The late, great, irascible Lou Reed.

Well, up here in the Great White North, the question of (seriously) addressing the serious problem of concussions in the Canadian Football League would appear to be a deaf, dumb and blind one, boy.

Or, maybe as popular as baked beans on a bus trip.

For whichever way you want to turn this thing loose, up here, it’s locked up, tight.

As I’ve written before in this series, although there has been some pretty good reporting, especially by the CBC where on their website they still carry many reports and videos about concussions, about the only report on concussions and the CFL’s role that I can find is a 2008 CBC Fifth Estate report entitled, “Head Games.”

Below is the web promo, description and link but that link does not work. (The Concussion Blog originally linked to this report several years ago when the link did work.)

CBC The Fifth Estate – “Head Games” broadcast in 2008:

“They have been called the greatest football team in the history of the CFL — the Edmonton Eskimos of the 1970s and ’80s that won five consecutive Grey Cups. But, for some of the star players on that team, the years of triumph ended ingloriously in early deaths, from heart attack, suicide and misadventure. The tragedy of those early deaths was often compounded by alcohol or drug addictions, probably caused by another, less visible, killer. Recent research by neuroscientists now shows the link between on-the-field concussions and brain damage; a permanent injury that can lead to depression, suicide and severe aberrant behaviour. The damage is so profound, the researchers say, that post-mortem examinations of the brain tissue of five former professional football players can be compared only to the tissue found in the brain tissue of advanced Alzheimer’s cases.” CBC The Fifth Estate – Head Games

This 2008 report was actually ahead of its time, and again, the only one that I know of that cornered the CFL and asked some tough, prescient questions. The former commissioner had that old deer/headlamps face a few times and newspapers at the time took a toot but then everyone went back to a snore. Comfortably numb.

But now, there is a proviso on the Fifth Estate website advising thatprior programs from 2003 were inadvertently re-posted in 2013 and therefore, contact customer service, yada, yada, yada, and blah-blah.

Yet interestingly – I said interestingly - the only Fifth Estate link that I could not get to work was…TA DAH: Head Games.

I am alleging nothing-although I may later sort of spatially speculate-but there are some conspiracy theorists out there who are very suspicious.

One of them is Phil Colwell, the former CFL running back who Continue reading

University of Oregon Novel Study

22 Jan

I found a very interesting email about research being done at the University of Oregon.  It was so well written I thought I would just place it on the blog…

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In what may be the first study of its kind, the University of Oregon’s Motion Analysis Laboratory released a fascinating and chilling new video that illustrates the dramatic effect a concussion can have on high school athletes’ ability to control balance while walking.

Using computer generated images from reflective markers worn by the subjects, the video shows the gaits of two high school students – one a healthy subject and the other a victim of a concussion from a helmet-to-helmet collision in football practice two days prior – to emphasize the poor control and balance of the concussed athlete.

The full study included 40 high school athletes – 20 who were diagnosed with a concussion from sports including football, soccer, volleyball and wrestling, and 20 similar healthy athletes – who were tested over a two-month period. The results showed that the concussed athletes had trouble maintaining balance and walking speed while also responding to auditory cues as long as two months following the concussion.

Research on concussion recovery time, like what is being done at the University of Oregon, may help improve safety and better pinpoint when it is safe for to return to field or court.

Interesting .pdf Making Rounds Now – Addendum

16 Jan

AFCA pdfI was tipped off by a fellow athletic trainer in a state where this .pdf (click first link below) is being circulated around.  I find it interesting in the wake of the American Football Coaches Association meeting that this is being titled the way it is.

Concussions in Football is how it is titled on the info packet, but the subject line that my source received was “Our Game is Under Attack”.

ARE YOU SERIOUS?

First, let me say I have read it – three times – and find nothing wrong about what is being presented.  Even with the opening HUGE FONT reason/opinion Dr. Sandra Bond Chapman has for continuing playing youth football.  I respect that opinion and cases can be made for such a strong statement, in fact it is lore at this time.

But to claim the sport itself is under attack because some may be looking beyond the lore of benefits is a bit much, in my opinion.  I have explained many a time here on the blog that what I see it as – and my reason for presenting information – is to keep the game around.  The game is not under attack because of concussions, if the game was under attack it is because of the way it handles injuries – namely concussions – and the possible ramifications.  The document is correct in stating not all brain injury is permanent, yet we don’t have any long-term data (solid longitudinal) on the effects of this sport or others that are collision based outside of boxing.

I honestly believe that if every sport coach, parent or kid looked at this document and Continue reading

Return To Learn Conference

16 Jan

TINY FINALTime is running short for this conference as well, but I thought I would provide another opportunity for people to gain valuable information in the dynamic concussion issue.  A friend of the blog, Katherine Snedaker, is putting on a novel conference; based around the return to learn aspect of concussions.

NORWALK, JAN. 12, 2013 – Katherine Snedaker, MSW and Founder of Pink Concussions, an international social media organization focused on research and resources for female concussions from sports, accidents or military service, and SportsCAPP, a Concussion Education, Advocacy and Policy Group, has announced the dates for The Concussion Conference: Connecticut: Return to School THEN Return to Learn.

The Conference will take place on Thursday January 30th, 2014 at Chelsea Piers Connecticut in Stamford, and then repeat with the same format on Friday, January 31, 2014, at Quinnipiac  University School of Medicine in North Haven, CT.

To register, see http://www.TheConcussionConference.com and to follow on Twitter use #CTBrain.

The Concussion Conference will provide training sessions for school nurses, school staff, pediatricians, athletic trainers, and parents on how best to help children return to school and continue  to heal after concussions.

The Conference daytime training sessions will feature multiple national speakers including Brenda Eagan Brown who is co-author the new 2013 CDC Resource: Helping Students Recover from a Concussion: Classroom Tips for Teachers. Also presenting is Dr. Mike Lee, co-author of the newly issued American Academy of Pediatrics’ report, Returning to Learning Following a Concussion.

You can find the remainder of the Full Press Release HERE.

This event will be on the heels of the Brewer Sports International #C4CT Concussion Summit in NYC.  I wanted to be there as a presenter and as a friend, alas my duty as an athletic trainer will not allow me to do so.  I encourage people and press who have the time to make the Connecticut events as this is a new angle that Katherine is attempting.

In addition to Brenda Eagan Brown, attendees can listen to addresses from Alan Goldberger and TJ Quinn among others, you can find the speaker list HERE.

You can register for the conference HERE.

 

Terry Ott: 3rd Down, CTE to go – Part 5

15 Jan

MIPSThis continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE.

IS “MIPS” A FOUR LETTER WORD AND (Every)THING YOU ALWAYS WANTED TO KNOW ABOUT SNAKE-OIL*

*But were unaware to ask

“The cold truth is that football players are in jeopardy.”  – Bill O’Reilly, he of the No Spin (End) Zone, Jan. 8. 2014


The Concussion Blog supremo Dustin Fink once mused to me that football, in its infancy a hundred years ago or there about, was meant to be played by (slower) men about five foot nine and weighing an average 150 pounds or so and at a time when a 200LB plus player was basically a monster, a freak.

You can appreciate the Dustin statement inference by referencing high school physics in that net (G) force equals mass times acceleration and also appreciate that now, with players routinely 50-150 pounds heavier then when the first Roosevelt was in the White House, and many now with world-class speed, the G forces generated on impact by today’s pro and college football players are exponentially greater than in Knute Rockne’s days and the resulting collisions on the field can be life threatening in the short, and long-term.

Life in big-time football today is both Darwinian-only the strong survive, and if lucky thrive, and inherently  Hobbesian-nasty, brutish and short.

But since literally millions of boys and young men seek football playing dreams, what to do?

Well, since just about all aspects of football equipment has undergone a radical revolution-footwear, pads, uniforms, gloves and eye protection-how about an update on the most important piece of football gear-the helmet.

A little history lesson: President and Rough Rider Teddy R was a big football fan, and when 9 players died in 1913 as a result mostly of skull fracture injuries, he, along with Knute Rockne advocated for a shift from three yards Continue reading

How Do We Know If Anything Is Working at NCAA Level?

14 Jan

In the NFL we have publicly disclosed injuries, including concussions, so we can (and have) track the numbers that are reported to see if there is a change in outcomes.  Certainly there are flaws with the reporting system as we have discussed many times but at least we can get a set of consistent numbers (we hope) from year to year.

But what about the NCAA, where there are many more players: 126 FBS teams at about 80 players per team means 10,080 players in FBS alone.  Or, about 8,387 more football players than the NFL – this number does not include FCS, DII, DIII or even the NAIA or Juco football schools.

Timothy Bella of Al Jazeera America (I guess the NSA has my IP address now and yours too if you go to links, ha) has produced a great article on this problem of tracking concussions at the NCAA level;

For this college football season, America Tonight has been tracking all the publicly reported concussions in the 10 FBS conferences and the independent teams. Auburn was one of 42 FBS programs to not publicly report a single concussion this season, accounting for exactly one-third of the 126 FBS programs. The group includes Rose Bowl and Big Ten champion Michigan State and Big 12 champion Baylor.

In fact, in the 10 conferences and the independents, coaching staffs and media outlets only reported 192 concussions at all among more than 10,000 players, according to data compiled from early August 2013 to Dec. 27, 2013, in the America Tonight Concussion Map. That’s an average of fewer than two reported concussions per team.

That number is STRIKINGLY low – due to reasons outlined in article – but 192 concussions is less than the 217 concussions we found in the NFL from preseason through the end of the regular season.

I provided many thoughts to Bella about why this may be occurring, including the teams with higher press presence Continue reading

The OTL Investigation on ‘Heads Up’ Football

14 Jan

It may have slipped some of your reading or viewing, but ESPN’s Outside the Lines did a piece on the USA Football Heads Up Program.  The article and video were presented last Sunday morning – I cannot find a YouTube version of the OTL show but you can find that part HERE.  The seven minute presentation is great for a quick overview of the issues ESPN has found.

For more in-depth coverage you should read the article by Steve Fainaru and Mark Fainaru-Wada, the same authors that penned League of Denial.  There are some wonderful points brought to light by the Fainaru’s;

The program teaches concussion awareness and proper helmet fitting, but its central tenet is the soon-to-be trademarked Heads Up Tackling program. When executed properly, proponents say, Heads Up Tackling literally takes the head out of the game. Players are taught to keep their heads up and lead with their shoulders when tackling.

[...]

But critics view Heads Up as a cynical marketing ploy — a repackaging of old terminology to reassure parents at a time the sport is confronting a widening health crisis.

There is a reason I have been “relatively” quiet on this topic; it’s because they are doing some very good things in the way of education and helmet fitting.  As you may know I am huge on the topic of awareness when it comes to concussions.  I have stated many times that the injury itself is not the “ice burg we can see above the water” rather it’s the mismanagement of the concussion that is the massive ice chunk we cannot see from the surface.

That being said, with the actual tackling technique being taught I too feel this is a repackaging of an old mantra.  Rules were even put in place as early as the 70′s to accomplish this task of taking the head out of the game.  Face tackling, spearing and butt blocking all have been on the books as penalties to help avoid using the head as a weapon.

The problem being that those are not called very often, when they are called they are inconsistent at best, and what has it done for the game over nearly 40 years?  I am not nearly as critical as others;  Continue reading

#C4CT Concussion Summit 2014

7 Jan

In a little over three weeks, Brewer Sports International (BSI) along with #C4CT (Coalition for Concussion Treatment) founding partner Amarantus BioScience will be hosting their 2nd Concussion Summit in New York, at the United Nations.  There have been many press releases on this event, and I have mentioned it a time or two on Twitter (and will continue).

Sure, there are many “summits” around concussions and head trauma – which is great as it keeps the dialog going – but few are populated by people with ideas on going forward.  Often, we find ourselves sitting, listening to bright people talk about what was done and can’t be done; rarely do we find the same bright people addressing the issues going forward.  Whether that be with tactical changes or with management or even the possibility of intervention with traumatic brain injury.

This edition of the #C4CT Summit on January 29, 2014 will hear from some people in many fields – you can see the current line-up HERE – focusing on the burgeoning topics of chronic traumatic encephalopathy (CTE), general neuroscience, pharmacology among other topics.

Interestingly enough, yours truly, was invited to sit on a panel and discuss how all of this information has been translated to the high school level – as an athletic trainer.  I was not only surprised by the invitation but feel it is VERY OPPORTUNISTIC for a “boot on the ground” athletic trainer to provide input.  I feel that not only have athletic trainers seemed to be seen and not heard, the vast majority of us practice in the high school setting, where the adolescents are playing sports.  I can assure you I will do my very best to be a quality representative of not only athletic training (it appears I am on the only AT in a speaking role) but those of us working with the most kids/athletes.

Anyhow the cast of speakers/presenters is indeed “star-studded” and even has some opposing view points on where we should be headed; which should make for some quality discussion.  If I can get my technology working and to NYC I will attempt to live blog/tweet the event for those that cannot make it.

Speaking of that, I know that time is short but I encourage anyone who is going to be in NYC during Super Bowl Week try to attend this event.  If there are scribes out there I am sure the wonderful support staff at BSI can arrange for you to cover and meet the star of the show – me, of course – hahahahaha, I kid.  Seriously, you can register HERE and if you have questions feel free to contact them.

I hope to see you all there!

Terry Ott: 3rd Down, Absence of CTE to go – Part 4

6 Jan

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE.

THE CURIOUSLY TITLED AND ENIGMATIC BRAIN STUDY, AND THE SEEMINGLY RHETORICAL QUESTION OF ’14

“We can’t solve problems by using the same kind of thinking we used when we created them.” –Albert Einstein, who knew a thing or two about brains.

Dr. Tator: Not absent

Dr. Ann McKee, professor of neurology and pathology and co-director of the Center For The Study Of Chronic Traumatic Encephalopathy at Boston University once mused in a television interview that she wondered if most if not all professional football players had some degree of CTE.

After all, the brains of former football players examined by the Center so far has found the existence of CTE was near one hundred percent.

Whether one agrees with the now famous Dr. McKee in totality regarding the prevalence of CTE in former players, her and her team are world-class doctors and researchers who have brought the serious issue of football related brain trauma into the collective consciousness of tens of millions of observers.

Most believe that the BU work on CTE was the main catalyst for the National Football League to eventually in 2009 admit that there was a cause and effect between football play and CTE and was also the key preponderance of the evidence that made for a 765 million dollar settlement between the league and former players who claimed neurological damage from playing football.

Here in the Great White North, Dr. Charles Tator, of the University of Toronto, has been referred to as the grandfather of brain research and sort of the Canuck version of BU-like CTE research.

Dr. Tator, a neurosurgeon, originally specialized in spinal cord injuries, but was leader of a study of the brains of 6 former Canadian Football League players that was published in May, 2013.

Despite the fact that Dr. Tator’s study found a fifty percent incidence of CTE among the subjects, the study was entitled “Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatically”

The detailed study places much weight on the small number of brains Continue reading

Thank You! Good Luck Going Forward.

1 Jan

The reason for this post is simple; Thank You!

To the reader, the commentators, the links, the views, the emails, the tweets, the everything.

When this blog started in September of 2010 I had no clue.  No clue on what I was doing.  No clue on how to write.  No clue on the audience.  No clue on if it would impact anyone.  No clue if it would last.

If not for all of you on the other side of this screen, none of this would have happened.  In terms of bandwidth and views this blog is very small compared to the juggernauts of the interwebs, but over time it has had place and a voice.  Not only for me, but for you.

I could sit here and spew the stats, the accolades and such but, why?  There is no need, this blog was never founded on that or is continued for that.  This blog is a space for information and opinions from an athletic trainers perspective about concussions.  Looking back on the “Disclaimer” page I wrote over three years ago I feel I have attained what I wanted to accomplish and WILL CONTINUE TO PURSUE.

So, as you ring in 2014 let us all try to make this the best year yet!

Terry Ott: 3rd Down, Absence of CTE to go – Part 3

31 Dec

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE.

LEAGUE OF NON-DENIAL, DENIAL HEARS, SEES NO EVIL or KNOCKED OUT, LOADED

QUESTION: Could the Canadian Football League receive and survive a class action law suit brought on behalf of former players suffering from football concussions and related brain injury?

ANSWER: Later.

This year, when the Canadian Football League’s director of communications, Jamie Dykstra, declined to answer what he termed my “loaded” questions about concussions and how the CFL was going to address them, I told Jamie it was unfortunate and that I would have to note the league’s silence in my story. “I know,” he said.

So, I am, noting it, that is. Because, to reference some other talking heads, this ain’t no disco; this ain’t no foolin’ around.

To reiterate, my questions, posted on the Concussion Blog earlier and condensed here concerned among other things, whether baseline testing info from the teams was shared with the league, whether the CFL was looking at any new helmet technology such as MIPS and would the CFL, like the NFL in 2009 confirm that in some cases, a causal relationship between football concussions and brain injury was a possibility.

Even after I appealed to Dykstra that hitting the mute button on such an important issue seemed, well, just wrong, and that my questions were not exactly League of Denial serious as a statement of claim or heart attack, he replied that “we (the CFL) are well aware of what is going on.”

I certainly hope so, yet being “aware,” and actually having a prescient policy would appear to be two different things.

Before Dykstra stopped talking, he had earlier forwarded me some pretty white-bread CFL concussions protocols and when I picked at its crust, was told the league’s policy was “organic.”

Far out. Nice, sexy, trendy new-age word Jamie, but what does it actually mean in the real, sometimes savage head knockin’ world of Canuck pro football?

Since the CFL won’t tell me, let me introduce to you a number of quite plausible if not certain “organic” scenarios for what in some ways seems a Darwinian policy.

Unlike the NFL, the CFL right now Continue reading

2013 Week 16 NFL Concussion Report

27 Dec

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).  It also should be noted that due to the league not disclosing actual injuries until Friday night there may be some added to next weeks numbers.

This is the last set of numbers I feel most confident about, as you will recall this coming week has proven to be difficult at best when finding concussions in the NFL.  Rather than boring you in this post with the reasons please click on the link above for that information.

In Week 16 there were only 13 concussions found, I say “only” because it seemed to Twitter, broadcasts and me, there were more players that exhibited something on the field that warranted further investigation.  The skeptic in me is also screaming at me to say that playoff eligible teams – especially those that have not clinched – are “gaming” they injury system.  To be fair, concussions are not the only injury being messed around in the “grey area”.  As I said that is the skeptic in me, the recent weeks have placed some better faith in the reporting system this season.

Something must be done to address – at the least acknowledge what we have found – the massive back-end of the season concussions we continue to see on a yearly basis.  The numbers cannot be easily washed away with the narrative that all teams are playing (versus bye weeks) as we have exposed.  It is very stark, the difference: weeks 1-9 there were 67 concussions in weeks 10-16 there have been 92.  When the NFL talks of expanding the schedule to 18 games I fear we will see an even bigger increase in the back half of the season.  There is a possible solution (more of a band-aid) though: two bye weeks.  It will expand the season further, but I don’t think the NFL really minds, in fact I think that is the overall goal.

Further observations of the numbers show the perpetual story of defensive backs being concussed most often.  As of this report the DB’s make up 26% of all concussions (41), the next closes it tight ends at 14% (22).  In fact, running backs (17), wide receivers (21), offensive lineman (21), linebackers (16) and TE’s are somewhat equal.  Even the defensive lineman are close to that grouping with 13.  Making all positions on the field outside of quarterbacks, DB’s and P/K somewhat equal in terms of the injury.

While we would like to see as few as possible, if concussions were equal across all positions (outside of QB, P/K) it would show that the injury is becoming a random incident.  Which is really the best case possible.  However, its not and the DB’s continue to be the most at risk players on the field, yet they also have some of the most restrictive tackling rules in place.

Now let us look at the Week 16 report (previous weeks numbers): Continue reading

The Abyss of NFL Concussion Reporting: Week 17

27 Dec

As football fans we are either gearing up to root on our favorite teams for a playoff and hopeful Super Bowl run, or the other 20 fan bases time is now spent looking at coaching changes, player acquisitions and the draft.  It has been a fun and exciting season for various reasons.  In terms of concussion data collection it will complete our fourth year and it has been a success once again.

However Week 17 provides for some of the hardest data capturing possible for the NFL.

During the season when teams play the following week they must report injuries and then they are listed on the NFL Official Injury Report prior to the game being played.  This mechanism, even with its overt flaws, is the launching point for our data.  With the regular season ending there are only eight teams that must report injuries the following week, effectively eliminating 3/4′s of the league.

This where you the reader can come in – and I am once again doing my yearly begging – if you note a concussion via a broadcast or twitter or the interwebs, please pass it along to us.  Although @nflconcussions does a tremendous job, he too probably welcomes the help.

So here is your homework for Week 17:

  • Watch games and enjoy games – root on your interests
  • If a concussion is noted send it via Twitter (@concussionblog) or email (theconcussionblog.comcast.net) in this format:
    • Player, Team, link/credit/notes
    • EX: Joe Schmoe, NYG, broadcast 3Q
    • EX: Joe Schmoe, KC, @examplehandlehere *link*
    • EX: @concussionblog RT: @examplehandlehere ……
  • I welcome any questions regarding the concussions during the games, but unless I catch it on RedZone or you have a video link I will be unable to answer to specifically.

Think of this as “OUR” project for the end of the NFL season, crowd sourcing style!

Thanks in advance.

Terry Ott: 3rd Down, Absence of CTE to go – Part 2

27 Dec

This “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE.

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THE LINEBACKER’S HEAD GAMES

Article 19 of the Universal Declaration of Human Rights, adopted in 1948, states that:

“Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.”[6]

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Former star CFL player Leo Ezerins was a ferocious linebacker through the 80s and won a Grey Cup while playing for the Hamilton Tiger Cats in 1986.

In that game, in which Hamilton was in some sports books a 22 point dog to the vaunted Edmonton Eskimos, Ezerins and company absolutely stomped and annihilated  the Eskimos, a seek and  destroy mission that in the first half forced half a dozen sacks, several forced fumbles and recoveries and a total offense by Edmonton of basically, nadda.

Here, are some highlights:

Ezerins was perhaps the 80s CFL’s answer to former Pittsburgh Steeler wild-man and Hall of Famer Jack Lambert, taking no prisoners and showing no quarter on the gridiron.

And right now, Leo is not too happy with me. I kinda feel bad about that, and here’s how it happened.

You see, Ezerins is currently the executive director of the CFL Alumni Association which boasts around 1000 participants.

The Alumni Association attempts to bring former players together in friendship, events and sometimes even modest philanthropy. Some members have been directly involved in examinations of former player
health and safety issues as well, including concussion research. Obviously, the CFL Alumni does some good work.

And so last October, I sought Ezerins out via e-mail, inquiring as to Continue reading

Interesting Take On Tackling

26 Dec

I have been fortunate to be in some great email “groups” with information that surrounds the playing of sports.  Of course I have been attracted to concussion and those ancillary problems surrounding the brain injury.  It not only furthers, the some time outrageous, fodder but it also provides some critical thinking.

Matt Chaney has been doing a great job of circulating information – mainly about football – and from time to time I get some links that I feel would be best shared for “group thought process”.  A quick aside: Chaney’s blog has been removed from cyberspace due to some confounding issues on the user end, but he will dredge up his information in the coming weeks and re-launch his blog.  Back to the post…

Here is how Chaney describes this forthcoming link:

–super piece by a very interesting writer, an outstanding athlete-scribe, Doug Brown in Canada, former CFL D-lineman… he nails NFL rule-making as lousy lipstick on the pig… great points on the folly of ‘proper form’ or Heads Up or ‘safe tackling’ especially in the head-on avenues of football contact, or the ‘allies’ on-field, as Brown refers…. the tunnel effect of forward contact… though I don’t see any wall-in by other players as necessary for a head-on collision; it’s all about angles of intersecting opponents, and all you need are two principals incoming, ballcarrier and tackler, each with his mission…. boom!…. Doug Brown

I share his sentiments on the article, it brings to light some of the things we CANNOT get rid of in current football.  But does that make the game “unsafe”?  That is the penultimate question; further if it is a problem how can it even be solved?

Here is an excerpt from Doug Brown’s article that appeared in the Winnipeg Free Press;

When an offensive and defensive player meet in an alley, the options for tackling from an angle, or putting your head to the side of the ball carrier are absent. Instinct and self preservation in football tells a ball carrier to lower his head and shoulder pads when he anticipates a collision. Hitting a ball carrier above Continue reading

TCB Mail Bag

26 Dec

I trust everyone has had a wonderful Christmas experience (or Hanukkah or Kwanzaa or going to have a good Boxing Day), with that I would like to wish everyone continued successes in whatever endeavor they choose.  Over the Holiday I have received many an email regarding concussions; apparently the down time has given people opportunity to share frustrations or good news.

Today I am bringing you a specific case in which we all can learn from.  At the least we can read this and prepare for similar situations that may arise – whether as a parent, doctor, coach or athletic trainer.  

As always you can write in and with your permission I will re-post anything you would like (and it may suit the audience).  It can be attributed to you or anonymously.  Keep it between 500-2000 words and omit any personal identifying factors if it involves patient care or sensitive information.

Here is our post today – by Anonymous:

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Obviously today is Christmas Eve and in most regions of the country kids are not in school for at least the next two weeks. Maybe less, maybe more. All in all it is a great time to rest up that brain and recharge your body. As athletic trainers we also know that sports do not stop for the holidays. For the most part at least. If you remember last year I read an op-ed article that you put on your blog titled “Parental Decisions Can Undercut Good Concussion Laws” or something of that nature. Well, it’s happened again (as it has many times between that time and now but this one is a little more ridiculous than the last) and I’m nauseous!

To be as brief as I can on this without boring you this is the case of a female soccer player who sustained a nasal fracture as well as a concussion when fighting for a header in the air with an opposing player almost a month ago. To be clear, she actually suffered a deviated septum. Anyway, after our AT did a beautiful job of getting this athlete “entered” into our concussion protocol (which Mom still couldn’t get over the fact that she indeed had a concussion; whoda’ thunk it, right?) we all sat in our physician’s office (Mom, AT, myself, physician, athlete) and witnessed the concussion as well as the nasal issue being addressed. The athlete was clearly concussed (clinical exam, balance assessment, and symptom reporting were all abnormal but ImPACT scores remained at baseline) and the athlete was sent for an MRI and referred to an ENT for further evaluation of the nasal issue. Pretty simple. These folks were given the “red carpet” treatment as all of our athletes/parents are and everyone left happy. The consensus was to see the ENT and address that issue then to follow back up with our physician for the resumption of the concussion issue. The athlete ended up having surgery about a week later. She was out for about a week after that. The ENT cleared her to resume play and actually said that there was no concussion. Wow! OK!

Fast forward to last week during exams and the athlete did not follow-up with the AT during exams like she was instructed to do. She THEN shows up to a game on Saturday with a face shield and tries to plead her case to enter the game. The AT did her job and did not allow the athlete to play. Mom was irate. Athlete conceded. Coach was with the AT. So athlete did not go through the GRTP process and as of today the mother refuses to follow-up with our physician for final clearance after all of the objective information is noted. She is choosing to Continue reading

ABC’s ‘This Week’: Football’s Concussion Crisis

24 Dec

First I want to lead this off by saying it is not a “crisis” just for the NFL, or football, this is an issue for everyone.  Once again this provides me the opportunity to say; the injury of concussion is not the problem/elephant in the room, rather it is the mismanagement of those injuries that have created this problems we are facing.

This video is from YouTube and I was tipped off by Dave Pear to its existence.

It is 11 minutes in length but there are some good sound bites in it.  If you can wade your way through the minutia you will see that the repeating issue is what I have stated above.  Basically doing nothing to fix the real problem.

Guest Series by, Terry Ott – Part 1: 3rd Down, “Absence of CTE” to go.

23 Dec

This “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of “League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause.

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THIRD DOWN, “ABSENCE OF CTE” TO GO

The Canadian Football League claims to be the oldest professional football circuit in existence, dating back to the late 1800s.

Last year, the 100th Grey Cup league championship was played in Toronto before 50,000 fans and millions more on TV.

The league, which used to advertise that their “balls were bigger,” has recently signed a new, lucrative-for Canada-television deal, and a 18 game regular season is currently seen in the United States on three cable sports networks

In 2014, the CFL returns to one of their previous core markets in the nation’s capital, and there is talk and hope of further expansion to eventually reach at least 10 teams, bad, nation-wide, is a real possibility.

Three new stadiums have recently been built and another is on the way.

The level of play has never been better and the brand and ownership-albeit with one individual owning two teams-unlike some prior years, is strong.

The future for the CFL would seem to be bright, but…

KNOCKED OUT

Former CFL player Phil Colwell doesn’t watch the Canadian Football League.

He doesn’t live in Canada anymore, and has pretty much lost touch with all of the players he knew and played with between 1980 and 1983.

When he left the game early due to a series of injuries and questionable coaching decisions, he intended to leave it completely behind. But while he may have left the game, the game as the old saying goes, has never left him.

“Philthy” Colwell, the strapping, bearded, homegrown and swift running back then in his mid 20s, was knocked out in a game in 1981 while playing for the Toronto Argonauts, suffering a devastating concussion that to this day he says he has very little recollection of and that was most likely the participator of his premature departure from football.

Colwell had played high school football, starred for three years for his Canadian college team, and played a form of semi-pro “junior” football and even drew some interest from the New England Patriots after playing in the short lived Can Am Bowl series, before making it to the CFL’s Hamilton Tiger Cats in 1980 and appearing in the Grey Cup as a rookie.

He later shared a field with former Houston Oilers star Billy “White Shoes” Johnston and former LA Ram quarterback Vince Feragamo when they briefly came north with the Montreal Alouettes. Colwell’s quarterback when he was in Toronto was former University of Tennessee super star Conredge Holloway.

Notwithstanding the galaxy of football talent he kept company with, Colwell says that at every level of football he participated in, he knows took many concussive hits in what then was considered to be “just part of the game.”

You got “dinged,” you got “your bell rung,” and then you went right back to same game including a particularly nasty incident while playing junior football in Sarnia, Ontario, when he Continue reading

2013 Week 15 NFL Concussion Report

20 Dec

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).  It also should be noted that due to the league not disclosing actual injuries until Friday night there may be some added to next weeks numbers.

There were three “firsts” this past week in the NFL Concussion Report, one of them had never occurred before in our data collection.  In the incident where Cincinnati punter Kevin Huber was demolished by Terence Garvin (fined $25k) our very first P/K was logged as a concussion.  I know, you wont see Huber’s name with “concussion” or “head” on the Official Injury Report from the NFL but this case is a classic instance of Fink’s Rule being put into effect (second “first”);

when there is a diagnosed fracture of the face and jaw (excluding the nasal bone) the forces absorbed during the injury will be beyond a threshold to elicit a concussive episode.  This would indicate to the clinician that the person should ALSO be evaluated for a concussion.

Alternate definition: when the terms “jaw injury”, “head contusion” , or “concussion-like symptoms” are present in an injury report one should be aware that forces were elicited to the head, and an assessment for a concussion should be indicated.

If you recall Huber spent the hours after the game getting his jaw wired shut and discovering he had a neck fracture.  Although there is no confirmation of a concussion from the league, team or player at this point, we will include in our data set, like we have done in previous seasons for other players.  It’s very difficult to imagine, while watching that train wreck, that Huber did not experience any brain trauma.

The third “first” of the week came just yesterday as we received news that Andrew Whitworth – another CIN Bengal – was concussed in practice.  Looking back on records for this year, this is the first concussion that occurred in practice this season.  It is important to note this, as previous seasons have had more concussions in practice.  It would make sense that the CBA rules of decreased contact days have really helped (2 – 2012, 5 – 2011).

Another notable number is: 200.  That is the total number of concussions we have logged since the opening of training camp.  In 2010 there was 172 concussions found from training camp through the playoffs, in 2011 there was 225 and in 2012 we found 237.  As you can see the overall number seems to be trending back to what we have seen the past few years.  Regular season numbers appear to be down by a factor of one week, again a very good reason to catalog the data and see the overall picture.

In hopes of not burying the lede here; for those interested in the comparison of weeks 1-3 and 13-15 – weeks in which every team was playing – and the effect of late season “wear and tear” on the brain here you go: 21 vs. 44.  Further, in the first nine weeks there was 67 concussions in the next six we have seen 79 concussions.  It seems pretty obvious to me that there is a cumulative effect here.

Quick reminder, Continue reading

#tbt Post: Friday Night Lights

19 Dec

This “throwback Thursday” thing is kinda cool for a guy that has a ton of stuff on this site that new people may have missed.  With that I will attempt to drudge up some “oldies-but-goodies” for you the audience.  I am certain I will re-read some of this and laugh at myself or have changed in the way of thinking but I will leave it as it was originally printed.

This weeks post comes from the very first month of this blog, September, 2010.  Back then, when the concussion information on the world-wide web was hard to find I was blogging my experiences on the field as an athletic trainer.  It is funny reading back on these as you can see my knowledge grow as well as how policies were set.  Enjoy, including the REALLY horrible writing style (wow, it was bad).

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Lets just begin by saying we did not have to travel to an emergency department last friday.  That being said there were some lost opportunities for the team to get an underdog victory.  The kids played hard, in a hard-hitting game, so the Continue reading

Terry Ott: CFL Follies

19 Dec

If you recall a few weeks ago I posted a request for some help for a journalist, Terry Ott of Canada.  It was simple, if anyone who reads this is a former Canadian Football (CFL) player or knows a former CFL’er, could they contact Mr. Ott for a story he is doing on concussions in that subset of professional football.  The good news was that people responded, albeit a small number, it was more than he was able to find doing his journalistic thing.  It made me happy that this blog could help out someone looking for information, because that is why it occupies a space.  But…………..

In the post below, that Mr. Ott wrote, you will see that by using this blog it may have stonewalled any help from the CFL, its Players’ Association or the Alumni Association.  Mr. Ott titled this post “CFL Follies” and I cannot think of a better title for what you are about to read.

Without further ado, Mr. Ott;

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I’d imagine that most reading this Blog will have heard of League of Denial.

But, I doubt you have heard of League of Non Denial, Denial.

Because after three months of dodge-ball dealing with the CFL about the concussion issue past, present and future, I was, after some initial boiler-plate information given in October, told today that my follow-up questions were “loaded” and would not be addressed by the CFL. (The questions are at the bottom of this post, and you can make up your own mind if they were “loaded,” or not.)

In addition, the CFLPA will no longer respond to my Continue reading

2013 Week 14 NFL Concussion Report – UPDATED

13 Dec

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).  It also should be noted that due to the league not disclosing actual injuries until Friday night there may be some added to next weeks numbers.

UPDATED 16:57 CST – Nate Solder, OL, NE added

67 versus 65 66.

Once I explain those numbers some of you will be dumbfounded and even shocked.  If you have been here long enough, that comparison will make a lot of sense to you.

In the regular season weeks 1-9 there were a total of 67 concussions found.  Over a nine week span there was an average of 7.44 concussions found per week.  In weeks 10-14 – FIVE WEEKS – there have been 65 66 concussions found and average of 13.o 13.2 concussions found per week.  Almost a double of the numbers.

Before you go blaming the bye weeks on this discrepancy, make sure you note that there were three weeks in the beginning of the season when no teams had byes, and in the most recent five-week sample there has been only two.  Breaking down to just the week in which every team was playing the numbers are even more stark;

Weeks 1-3:  21 for an average of 7.0/week

Weeks 13-15 (WE ARE NOW IN WEEK 15, still awaiting those numbers): 30 31 for an average of 15.0 15.5/week an absolute doubling of concussions in the later part of the season.

Before everyone goes off and screams to the hills about a problem, there isn’t a problem.  This is normal for the NFL and normal according to published studies.  This is also a theory of the Sports Legacy Institute that seems to be playing out.  The idea of a ‘hit count’ for the brain.  A theoretical threshold the brain has before the ‘subconcussive hits’ become concussive episodes.  In simple terms the hits that were not producing a concussion for a player in weeks 1-3 are now producing the injury in weeks 13 and beyond.  The theory goes that the brain protection system (whatever that is) has weakened due to the repetitive nature of their profession and the brain is therein more vulnerable.

For further discussion I will now produce the Weeks 1-3 vs. Weeks 13-15 from 2010 to today (Key = total/per week vs. total/per week):

  • 2010: 21/7.0 vs. 30/10.0
  • 2011: 26/8.67 vs. 34/11.33
  • 2012: 30/10.0 vs. 35/11.67
  • 2013: 21/7.0 vs. 30+/???

By statistics alone one can see that concussions increase as the season wares on, this is not reason to panic, rather a point where we can try to figure something out.  This is the primary reason for this Continue reading

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