Nick Mercer: Finding yourself after a brain injury, first step – Recon

18 Mar

As has been said countless times in countless articles about brain injury, “every brain injury is different”. I don’t know and don’t care to know how many times I’ve heard or read it. That phrase is used primarily for the benefit the general public to explain or define a lasting injury about which little is known. Although geared towards people who have – seemingly – little or no experience with brain injury, the statement should still be understood as fully as possible by those of use who have such experience.

In 2003, until making a hard and fast right turn on my bike on a hill in Victoria, BC, I had every intention of completing my upcoming 8 month MPA work term with the Auditor General in Ottawa, and while there, continuing to ride my bike and join a local water polo club. When I finished my MPA I would work somewhere for a few years, then, hopefully, pursue a PhD.  The next morning, all that changed. Two weeks later, when I woke from my coma, I was a different person. Not completely different – I was lucky – but different enough that I had to change my plans for my future.

My focus wouldn’t be on finding an apartment in Ottawa or impressing my Continue reading →

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Capt. Peter Linnerooth – US Army

17 Mar

I was just minding my business reading the news and getting lost in my Sunday mindless exercise, when I came upon a news story that shook me – on many levels.  This story is about Captain Peter Linnerooth; a story worth noting and sharing.  Does it have to do with concussions, I don’t know and I don’t care, it has to do with the well-being of humans – a plight that is part of the concussion story.

Regardless the Sharon Cohen authored story on Capt. Linnerooth is well worth your time;

He had a knack for soothing soldiers who’d just seen their buddies killed by bombs. He knew how to comfort medics sickened by the smell of blood and troops haunted by the screams of horribly burned Iraqi children.

Capt. Peter Linnerooth was an Army psychologist. He counseled soldiers during some of the fiercest fighting in Iraq. Hundreds upon hundreds sought his help. For nightmares and insomnia. For shock and grief. And for reaching that point where they just wanted to end it all.

Linnerooth did such a good job his Army comrades dubbed him The Wizard. His “magic” was deceptively simple: an instant rapport with soldiers, an empathetic manner, a big heart.

The man knew how to handle others and create an atmosphere for helping on a battlefield and beyond;

He was, as one buddy says, the guy who could help everybody – everybody but himself. [...]

“There’s no cavalry to save the day,” McNabb explains. “You ARE the cavalry. There was no relief.” [...]

For about half his tour, Linnerooth’s office was a 12-by-12 trailer. His heavy-metal soundtrack – he banned the Beatles and Pink Floyd, deeming them too sad – provided a sound buffer. A thermal blanket serving as a makeshift room divider also provided a modicum of privacy.

Linnerooth brought hope to those gripped by hopelessness. In a desert, he could always find the glass half full.

He turned tragedies into cathartic moments: When a platoon lost a member, he’d encourage the survivors to deal with their grief by writing letters to the children of the fallen soldier, recounting the great things about their father.

Then the pressures were too much; Continue reading →

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Opinion on Zurich Statement

13 Mar

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

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

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

SECTION 1: SPORT CONCUSSION AND MANAGEMENT

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

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Zurich 2012 In Writing

12 Mar

If you all recall I went to Zurich in November to attend the “Concussion Conference”; mainly as an observer, but there was enough time and opportunity to impart my questions/knowledge as a practicing athletic trainer.  Here are the links to DAY 1 and DAY 2 of my live blogging.  By the way, the live blogging was WELL received and continues to provide great insight into what went on.  I hope that I am asked back for the next conference, or any other conference that wouldn’t mind my attendance.

Now the information gathered at the conference has been hashed and rehashed and now appears as the 4th Consensus Statement (tweeted previously).

As part of the initiative the Standardized Concussion Assessment Tool (SCAT) was looked at and changes were made to the 2nd version from 2008.  You can now find the new version by clicking SCAT3.

A new wrinkle was an assessment tool for the younger ages, the group decided on the “Child” version of the new SCAT3, that can also be found by clicking Child SCAT3.

Also included in the addendum of the Consensus Statement was a recognition pocket card, found by clicking Recognition Pocket Card.

All of the above is free and intended to be used as a resource for better concussion assessment and even early management of concussion.  Please read the Statement regarding best practices.  As always this blog is NEVER to be used to diagnose or treat a concussion.  There is a lot to be absorbed and read; one thing is for sure we as athletic trainers and concerned/educated individuals now have the most recent information at our fingertips.  I guess this blog is actually doing some good work :)  A side note; how about this appearing during National Athletic Trainers Month?  It might be a coincidence, but I find it serendipitous.

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Moorad Sports Law Symposium: Concussion Conundrum

12 Mar

The concussion issue has permeated every facet of life and sport.  Now policies, products, rules and law are starting to address the issue head on (pun intended), and one of the most renowned groups is taking a look at this issue as well;

The 2013 Jeffrey S. Moorad Sports Law Journal Symposium—Concussion Conundrum—explores, debates, and informs on the key issues facing players, teams, leagues, doctors, and lawyers regarding head injuries and brain trauma in sports.

Panels include commentary from well-known retired professional athletes about concussion awareness and prevention amongst players; an examination of both sides of the NFL Concussion Injury Litigation—the concussion injury class action suit brought by former NFL players against the league; an exploration of the science and concussion-related liability facing professional and amateur sports; and a look at where we are and where we are going with media personalities commenting on the state of sports and concussions.

Andrew Brandt, Director of the Jeffrey S. Moorad Center for the Study of Sports Law and NFL Business Analyst, has covered the concussion issue for ESPN and moderates all panels.

The Symposium takes place on Friday, March 15, from 9 a.m. to 12 p.m., in the Arthur M. Goldberg Commons at Villanova University School of Law. This program is approved by the Pennsylvania Continuing Legal Education Board for 2 substantive CLE credits. The event is free for non-CLE attendees.

The panel and the topics are top notch; this event should be on the “to-do” list of  anyone interested in sports law.  Below is the topics and panels (check the website for more deets – also notice our partners at stopconcussions.com (Keith Primeau) and our good friend Paul Anderson);

  • Panel 1: Framing the Issue
    • Keith Primeau
    • Jim Nelson
    • Taylor Twellman
    • Brian Westbrook
  • Panel 2: Building the Case — A Legal and Medical Background of Concussions  Continue reading →

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Anyone Want Money?

12 Mar

Basic RGBWell according to our comment section there are many of you out there looking for solutions; along with the efforts of established companies, like the helmet makers.  Now you can draw up and submit any ideas to the efforts of General Electric and the National Football League;

GE and the National Football League’s Head Health Challenge I aims to develop new solutions to help diagnose mild traumatic brain injury and invites proposals for scanning technologies and biomarkers that can accelerate growth. This four-year, $60 million partnership aims to improve the safety of athletes, members of the military and society overall.

The above is only step one, you have 111 days left to complete step 2;

We are seeking viable technologies for detecting early stage mild traumatic brain injuries at all stages of development for Challenge I. Ideas are welcome from all industries, organizations, and technical fields.

Visit the above linked website for further details and required forms.  I implore those that feel they have a technological solution to make the effort.  I will say this as candidly as possible; you cannot do it alone, you WILL and MUST have the resources and “blessings” of the NFL to get things done in the concussion effort.

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Latest Research on Concussions; Rather No Concussions = Changes

7 Mar

Certainly the research is flying in; mostly the investigations are now looking at either ways to detect the injury or objective ways to determine recovery.  There are a bunch of other designs and angles out there but the most important are the above.  Although it would be great if we had an objective way of determining concussion, it is really not the pressing issue (with solid education and conservative approach to injury – sit them out).

As I have stated over and over, the BIGGEST issue we face with concussions is the mismanagement of concussion from the beginning; therefore the need to identify when it is safe to return is more paramount in my opinion.

The newest research is out from the Cleveland Clinic, it looked at 67 college football players, more specifically it looked at their blood, report from WKYC;

In a study of 67 college football players, researchers found that the more hits to the head a player absorbed, the higher the levels of a particular brain protein that’s known to leak into the bloodstream after a head injury.

Even though none of the football players in the study suffered a concussion during the season, four of them showed signs of an autoimmune response that has been associated with brain disorders.

There we go again, telling and showing people that the hits that don’t elicit a concussive response are also a culprit in the brain injury crisis we are facing.  Coaches, particularly in soccer and football, will tell us that we are wrong and that it is either unproven or not a possibility because of how “safe” they practice or the equipment they have.

Back to the research, the group looked for the S100B protein that should only be in the brain;

Typically, S100B is found only in the brain; finding S100B in the blood indicates damage to the blood-brain barrier. While the exact function of S100B is not known, it is used in many countries to diagnose mild traumatic brain injury when other typical signs or symptoms are absent.

Studies in Janigro’s lab revealed that once in the bloodstream, S100B is seen by the immune system as a foreign invader, triggering an autoimmune response that releases auto-antibodies against S100B. Those antibodies then seep back into the brain through the damaged blood-brain barrier, attacking brain tissue and leading to long-term brain damage.

They also did some PET scans to Continue reading →

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It’s National Athletic Trainer Month #NATM2013: Great picture essay!

4 Mar

Feel free to send in a note, picture, video about your favorite Athletic Trainer or the profession itself.  This was on twitter today I don’t know where the credit goes but DANG ITS AWESOME!!! (click to enlarge)

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Athletic Trainer Removed from Post for Standing Ground on Concussions

1 Mar

This is one heck of a way to start out National Athletic Trainer Month…

Paul Welliver, a name that should be remembered and learned about.  Welliver is a certified athletic trainer in Maryland and was until a few weeks ago the athletic trainer at Winters Mill High School.  The only one the school has ever known; being outsourced from Maryland SportsCare & Rehab.  The admin at the High School asked his employer to have him no longer provide service for them.  Welliver (at time of post) has not been fired from Maryland SportsCare & Rehab.

Why, you ask?

Because this athletic trainer stood up for what he believed and knows about concussions.  Unfortunately, this scene is all to familiar with us high school athletic trainers.  The story is from Carroll County Times;

The Carroll County Public Schools Supervisor of Athletics Jim Rodriguez and Winters Mill High School Principal Eric King told Welliver’s boss at Maryland SportsCare & Rehab that they did not want him to continue his position at Winters Mill, according to Welliver. After 10 years as the school’s athletic trainer, his last day was Feb. 12. [...]

Welliver said on four different occasions in the last 18 months, he refused to begin the protocol that is meant to gradually release student-athletes back into sports participation after a concussion. The protocol, also known as Return to Play, is supposed to begin once a student-athlete returns a medical clearance form after their injury has been classified as a concussion.

In this school district they have a pretty solid concussion policy and protocol  highlighted in the story, however when the one person – and last line of defense for the student-athlete – stands up for the protection of the children he is summarily dismissed;

He said the athletic trainer has to sign off on a student-athlete’s return to full contact and competition following a diagnosed concussion.

Welliver’s refusal to start the protocol all four times was because he was concerned about the safety of the student-athletes, he said. He is worried about their short- and long-term health, he said.

“There are times when I do not believe they should return to the sport,” Welliver said. “It is not safe.” [...]

“I treat all those athletes like they are my children,” he said. “Sometimes I spend more time with other people’s children than my own.”

He is exactly correct!  As if he had to really explain it to people who should not be part of the process he did for the article;

“I take into account many factors, including the number and severity of previous injuries and the age and grade of the student,” he wrote on Facebook. “It would be much easier to go along with the pressure of returning the student A.S.A.P., but I have seen way too many poor outcomes after multiple head injuries.” [...]

In addition to his decision to keep student-athletes from playing their sport after a concussion based on age, grade and the severity and number of previous concussions they have experienced, he also takes into consideration the sport or sports the athlete would return to. Their return could take longer if they play high-collision sports.

Shockingly, the school district and those that put the separation is motion had no comment.

Welliver did and does it right based on all accounts, the man – athletic trainer – father Continue reading →

Video Thursday

28 Feb

Here are a couple of videos to tide you over until some time next week!

In the first one we can hear how the military began their concussion management protocol.  Although not enough it was way ahead of the curve on concussion management.

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Here is one that shows a compilation of big hits found on YouTube.  Watch all the football ones and the vast majority are “clean” hits.  Then take into account all the other sports and think back to my mantra here: “The injury of concussion is not the elephant in the room, rather, it is the mismanagement of the concussion that is problem.”  Then tell me you didn’t throw up in your mouth at the last clip…

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Beyond the Cheers Interview Today

27 Feb

I love radio hits, any chance I get to explain my angle as well as spread the necessary information is a blessing.  I have provided some doozy sound bites and probably some head scratching comments; one thing you get – I really hope – is little BS when it come to this information.  The only problem with local radio and most syndicated sports talk is that I get – at the most – ten minutes to get the necessary information out.

Today I will have an opportunity to spend some quality time on the subject.  Dave Furgeson, host of Blog Talk Radio and Beyond the Cheers has invited me to the show today.  Starting at 7pm EST we will be talking concussions for a solid hour – and I’m pumped!

You can listen live by going to Blog Talk Radio or Beyond the Cheers websites and clicking the play button on the “Live Stream” button on the right hand side of the page.  You can get a feel for what the show will be regarding by clicking HERE (live stream also located there).

I believe that Dave will be taking advance questions and live call in/chat questions during the show.  If you have a question for me feel free to send it in and perhaps I will get a chance to answer it.  Dial-in TOLL FREE 1-877-357-2448 in Canada and United States to ask a question or e-mail Dave (dferguson@beyondthecheers.com) in advance.

Also, I would appreciate honest feedback – good or bad – after the show.  An honest discussion on this issue is really the only hope of getting things in a place that is comfortable for everyone.

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Aussies Study Concussions in Former Collision Sport Athletes

26 Feb

From Sunday Night down in Australia a story of how research on the brains of former footballers may shake up the sport;

Greg Williams is an AFL legend, and one of the hardest men ever to play the game. In his glittering 14-year career, ‘Diesel’ won a premiership, two Brownlow Medals and was named in the AFL’s Team of the Century. .

Shaun Valentine is another tough bloke: like Williams, he copped countless on field wallopings in his career in rugby league. Williams retired at 34, Valentine at just 26. Both men are now struggling with everyday life as they battle the long-term effects of so many blows to the head during their respective careers. Both men are married with children – and both are facing the biggest challenge of their lives.

In what’s been a world first study here in Australia, the results of tests on retired professional players are revealed, and they will send shockwaves through all the codes.

The video (The price of playing the game) tells the story of Williams and Valentine and gives the results of what they know to this point.  Make sure you click the link above to find it.  You will notice that there is no mention of CTE in the Aussie players – yet when they go to the US for the story CTE is the first thing talked about.  It is understood, that currently most researchers in Australia are not ready to accept CTE as a diagnosis or even its existence in former footballers.  The focus is more on dementia Continue reading →

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Worth Your Time – Malcolm Gladwell

21 Feb

If you are anywhere near me you might find some time on your hands waiting out the winter weather.  If you are not near me, you should find some time to sit and watch Malcom Gladwell talk about football.  Below is his speech from the University of Pennsylvania on Valentines Day.

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Nick Mercer: Bubble Times – Is it going to pop?

21 Feb

Continuing with my analogy from my last post, “Brain injuries and pro contact sports: Bubble times” , in which I compared the concussion issue in pro sports with the financial crisis, I thought I’d try to complete the comparison without, hopefully, forecasting the end of contact sports, notably the NFL and football in general.

In my previous post I said that fans, teams, and leagues play the same role in the concussion issue as the banks/financial institutions did in the recent financial crisis; interested only in their short-term benefit, making them unintentionally complicit in the looming collapse. Players are like the borrowers; they want to play the sport they love and make lots of money doing it. Consequences be damned. Just like people wanted to buy houses and a bunch of other stuff, not thinking, wishing away the potentially negative long-term consequences. It’s about the looming collapse that I will write.

Since my last post, I have listened to Malcolm Gladwell talk about the undesirable, yet inevitable decline of football. Then I read an article on the Oxford University Press blog ‘Why football cannot last’ discussing Chronic Traumatic Encephalopathy (CTE) – a neurological disorder resulting from repetitive blows to the head. It got me thinking about the optimism shown at the end of my last post – had I not considered the situation fully? Was it simply wishful thinking?

Gladwell makes a convincing case Continue reading →

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Spots Still Open….

20 Feb

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

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

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

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

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Daniels Dash: Why it MUST be run

19 Feb

ddtOur last “Outreach” writer, Ashlee Quintero, eloquently wrote about her experiences with concussion issues.  As the Concussion Program Coordinator at UHealth Sports Medicine she is involved in many things, one of which is very dear to her.  It is a 5k run in the honor of Daniel Brett, a South Florida kid that sustained concussions and was not properly treated for a long period of time.  Below is his story and information on Daniel’s Dash (2013 Flyer).  The following was written by his mother, Diana Pilar Brett;

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Daniel’s Story 

dd1On August 24th, 2009, our son Daniel made starting linebacker for Cypress Bay High School’s JV football team.  It was a victory for him and his first major step in actualizing his desire to play in college. It was also his last day ever playing football.

At 5’9”, 160 lbs. he wasn’t big, but he was tough and fearless, and he thought it was the way to be, to one day play for his dream team, the University of Miami Hurricanes.  No pain, no gain.

Daniel began playing football at 11, and never looked back. Tough and versatile, he played offense, defense, and special teams, rarely getting off the field. He loved it, and he was good.  Determined, he did all that was needed: kept in shape, practiced hard, kept up his grades, and never complained. No, he never complained and never told anyone when he was hurt up until August 24th, 2009.  Continue reading →

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Outreach: Ashlee Quintero

19 Feb

This is the continuation of a new program here at TCB.  Called “Outreach”; the purpose is to publicize the good (we hope the vast majority) and sometimes the not so good of concussion management and experiences across this vast planet.  One thing I realized real quick in Zürich is that the stories of the bad are relatively the same, usually highlighted in the media.  Meanwhile the stories of good are different and helpful and not heard at all.  I am asking our readers to send in stories of your cases (please be mindful identifying specifics) so we can share.  There are vast stories in the comment section but I would like to bring forward as many as possible. 

Ashlee Quintero was a soccer player at the University of Miami in 2009 when she sustained a concussion.  Through this process she decided to become more involved in awareness and education of this injury.  Below is her contribution to The Concussion Blog.

Dog, Cat, and Fish.

The more I am exposed to the public’s reaction to sports concussion (and that’s a lot, I am a youth soccer coach and the Concussion Program Coordinator at UHealth Sports Medicine), the more I realize how far we still have to go with concussion education. Despite the warnings, educational seminars, and the accessibility of concussion information on this little thing called the internet, coaches, youth coaches especially, are more often than not severely misinformed on how to screen who’s taken a hit. My most recent educational presentation really illustrated this need.

I am a youth soccer coach and volunteered to present concussion information to my fellow soccer coaches at our league’s pre-season coaches meeting. While I was speaking on Florida’s new concussion legislation and discussing the ever-difficult sideline evaluation and decision to sit a kid out, I got the inevitable questions, “Well, how do you know if it is a concussion? What’s the tell-tale sign I am looking for?” Before I could vocalize my response to those questions, Continue reading →

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How Many Concussions Are NBA Players Hiding?

13 Feb

I will make this quick, would love to get some more discussion on this…  If we think awareness and management are getting better, then I give you this wonderfully cited article of shots to the head in the NBA.  Some have resulted in concussions but others are very interesting, especially if you read how the player reacted to the contact.  From Henry Abbot of ESPN.com;

For a “noncontact” sport that allegedly doesn’t have a concussion problem, basketball sure does feature a lot of blows to the head.

A partial list just from this season:

  • October 30, 2012: Dwight Howard gets a flagrant for swinging an elbow at the face of Elton Brand.
  • November 2, 2012: Anthony Davis receives a concussion.
  • November 5, 2012: Tyler Zeller takes a hard elbow from DeAndre Jordan causing a fractured cheek bone and concussion.
  • November 7, 2012: Thomas Robinson is ejected for elbowing Jonas Jerebko in the head.
  • November 28, 2012: Marvin Williams falls hard to the floor, is diagnosed with concussion.
  • December 5, 2012: Thomas Robinson takes an incredibly hard blow to the head from Ed Davis.
  • December 12, 2012: After a flagrant foul from David Lee, LeBron James crashes to floor, hits head.
  • December 17, 2012: Tyson Chandler flagrantly fouls Jeremy Lin in the head.
  • December 17, 2012: Tim Duncan misses plays, dazed by an elbow from Kendrick Perkins.
  • December 17, 2012: Russell Westbrook hits his head on the floor in a scary fall.
  • December 18, 2012: Anthony Davis hits his head again.
  • December 18, 2012: Bradley Beal takes a very scary fall to the court.
  • December 25, 2012: Metta World Peace elbows Steve Novak in the head, Novak undergoes concussion testing.
  • December 26, 2012: Dwight Howard clocks Kenneth Faried in the face.
  • December 31, 2012: Fab Melo is diagnosed with concussion.
  • January 1, 2013: Charlie Villanueva is ejected for an elbow to the head of Isaiah Thomas.
  • January 2, 2013: Festus Ezeli sends Blake Griffin hard to the floor with a flagrant foul.
  • January 4, 2013: Jeremy Lin and Larry Sanders bang heads in bloody fashion.
  • January 4, 2013 Kevin Garnett hits Tyler Hansbrough hard in the face, and is ejected.
  • January 6, 2013: Pau Gasol takes a bloody shot to the nose that is diagnosed as a concussion and causes him to miss five games.
  • January 9, 2013: Carlos Delfino, who had a serious concussion two years ago, takes a hard blow to the head and appears shaken up.
  • January 26, 2013: Shannon Brown clobbers Manu Ginobili and was ejected.
  • January 28, 2013: Nets rookie Tornike Shengalia is recalled from the D-League to be treated for concussion.
  • January 29, 2013: Chris Kaman is out indefinitely with a concussion suffered in practice.
  • February 2, 2013: Michael Kidd-Gilchrist is hospitalized with a concussion resulting from colliding with a teammate.
  • February 3, 2013: Metta World Peace is suspended for punching Brandon Knight in the face.
  • February 5, 2013: Larry Sanders collides with a dunking Kenneth Faried in mid-air, hits the back of his head hard on the floor and leaves the game.

Now you might say, this is a physical sport. Who could be alarmed if that physicality involves the head once in a while?

The answer: Medical science.

For the record here is our list of NBA concussions: Continue reading →

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Concussions: It’s not the injury

6 Feb

I don’t know how to make this much more clear.

And, believe me about 5 minutes after this goes up my twitter and inbox will be jammed full of criticism.

The injury of concussion: abnormal function of the brain after a traumatic event to the body/head (see all signs and symptoms), is not the “problem” we are facing.

The massive issue and “problems” we are facing in this crisis stem from the improper (see poor or none) and mismanagement of concussion and/or mild traumatic brain injury (mTBI).

Removing concussions from sports is nearly impossible, heck any physical activity has the risk of concussion (see my two concussions standing up and hitting my head on an open cabinet).  If everyone would take the focus away from “stopping” concussions and work on a safe, effective, and universal injury management technique (see ACL rehab protocols) for concussions this “problem” would cease to be a problem.

OK, fire away…

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Let’s Clear Something Up Here

5 Feb

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

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

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

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

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

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

Here is my diatribe from twitter last night; Continue reading →

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Team Gleason PSA – Hey NFLPA Please Read

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

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Brain injuries and pro contact sports: Bubble times

31 Jan

As much as I can, I read about and watch professional contact sports. I also read, and have read, a lot about the financial crisis; more specifically, what led to it. Naturally, since I was brain injured in 2003, I have become very interested in brain injury. Hence this blog.  I have also taken a bigger picture view of almost everything and, influenced by many books I’ve read, notably Collapse by Jared Diamond, I’ve been noticing similarities between different situations and events in society. Not connections or links. Similarities in our perception. They make sense to me – that’s why I thought of them. They’re not perfect or identical, they’re similar, the theme is the same. I see the same prevailing theme in the lead up to the financial crisis as we have seen in the current concussion/brain injury issue in professional contact sports.

For the purposes of this post, I’ve picked two themes that I think run through both situations; “arrogance” and “wishful thinking”. It was arrogance on the part of banks who thought they could make the market do what they want, creating financial instruments (and fitting mortgages into these securitized instruments)  that would generate big short-term profits, ignoring the long-term consequences. The bankers had to sell/lend these instruments/mortgages to someone. Whether the buyers/borrowers were deceived or not is not what this post is about. The buyers/borrowers of these financial instruments ended up losing a lot.

The banks are like the teams, Continue reading →

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NFLPA News

31 Jan

So at 3:15pm EST the NFLPA will hold a news conference to discuss some “goings on”; the biggest nugget in this presser will be the announcement of a 100 million grant for Harvard over 10 years to study them.  All aspects of player health is the word I seem to be getting.  Which is good, because for a long time the former player has been neglected and has led to current and future players taking risks their bodies will not be able to cash in down the road.  I believe you can catch it live on YouTube as well, perhaps someone can provide the link in the comments…

In other NFLPA news, Deadspin and Barry Petchesky wrote about how players are overwhelmingly disenfranchised with the medical care they receive as a big-bad NFL player;

An NFLPA study, the results of which were obtained by the Washington Post, finds that the vast majority of players have serious doubts about the care they’re provided.

The NFLPA asked its players to gauge on a one to five scale how much they trust their team’s medical staff. Seventy-eight percent of respondents said five, meaning they’re not satisfied at all. An additional 15 percent said four, and just three percent responded to the question with a one or a two.

“The most troubling aspect of the survey for me is that lack of belief that the doctors are treating them for their players own health, safety and wellness reasons,” DeMaurice Smith said.

Perhaps this is why the NFL is entrusting the elite Harvard to study such things and happenings to players over a long-term time frame.  Petchesky  also takes part of the article to touch on the conflict of interest (COI) that is VERY rampant on the NFL sidelines concerning medical care.  If you have followed and read here long enough you will know it is something that we have been harping on for over two-year and one of our illustrious commentators, Don Brady, has written a dissertation that includes this problem.

Simple facts are that the team athletic trainers are paid by the team, not the players, and in a majority of NFL clubs the “team doctor” is actually paying for the privilege.  In a business model, it would appear – in my humble opinion – that the teams are making sure their priorities are met when it comes to injuries.  NOW HOLD ON…  There are some very outstanding athletic trainers and doctors that roam the hallowed sidelines of the National Football League, and they are VERY VERY VERY good at what they do, but the appearance – TO THE ACTUAL PLAYERS – is that their medical care may not be in their best interest.

I am not throwing anyone under the bus here, I am merely Continue reading →

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Watch This: Enough Said

31 Jan

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

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

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Quick Hits on a Cold Thursday

31 Jan

American Medical Society of  Sports Medicine Position Statement…

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

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

Return to Class

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

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

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

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

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

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

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

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

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

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

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

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

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X-Games, D on coverage…

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

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