Tag Archives: Athletic Trainers

Sensor Overload

12 Aug

With all that is new to the concussion realm, nothing is really new.  This includes: how the injury occurs (traumatic variable force vectors – often unanticipated – jarring the brain case), its recovery (unique and undefinable), its identification (mainly subjective but overtly obvious when objective), overall education and general understanding from day-zero to day-undetermined.

The current “hot topic” for concussions is sensors.  These sensors are nothing new, they have been around for years.  As with most technology the devices are getting smaller and more accurate; natural evolution, if you will, for sensors.  I have had the fortune of testing some products, getting deep information on others, and curiously viewing some brought to my attention.  The constant thought I have is: no product has provided a clear-cut reason for inclusion – at this moment in time.

Are sensors a good idea?

Sure, if and when they become accurate enough for trained individuals to use them without impeding current standards of care.  Further, I also believe that down the road we will be looking for a product that can accurately and systematically determine the gross effects of every blow the brain case takes.  The key being EVERY BLOW.  Not just hits to the head, or at full speed, or only in practice, or in helmeted sports.

The overwhelming information we have on concussions and their occurrence is that we just don’t know a threshold; for mine, yours, your son’s, your daughter’s or anyone.  We have a general Continue reading

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Intended Consequences Lead to Unintended Issues: NCAA Settlement

1 Aug

Sure the lede looks backwards, but the overwhelming point, in my opinion, of the NCAA recent settlement on concussions has to deal with my profession of athletic training.  The issue is athletic trainers; the need for more of them and what happens if you cannot find them or afford them?

Don’t get me wrong, the fact that attention is being paid to the need for athletic trainers — although the wording does not explicitly name our profession, rather “medical professional” — is tremendous and often overlooked.  Sure, you can have a doctor on the sidelines, but what is their cost?  Perhaps there are some semantics that would allow other medical professionals to be in attendance, but what would be their experience, education and knowledge about concussions?  And how cost/time effective would it be to have another “medical professional” that didn’t have the ability to assess, treat, manage, and rehab other injuries that occur on a sporting field?

In other words, this is an awesome advertisement and endorsement for athletic training.

But there is an issue, as stated in the Chronicle of Higher Education;

Colleges have their own concerns about the settlement, including a requirement that they have a medical professional on the sidelines for every practice and game in the highest-contact sports: basketball, field hockey, football, ice hockey, lacrosse, soccer, and wrestling.

While many big athletics programs already provide such coverage, lower-level NCAA institutions will be hard-pressed to afford it, several athletics officials said.

The requirement could lead colleges to use graduate assistants or others with little medical training, or to cut sports altogether over fears of liability.

“I’m worried about the financial fallout from this, and how it will impact Division II and Division III, and how it’s enforced,” said Tim Kelly, head athletic trainer at the U.S. Military Academy and a former member of the NCAA’s Football Rules Committee. “I’ve always wondered, Do too many schools provide too many sports at a level that’s not effective?”

If you have spent time in the “lower levels” of NCAA sports or even the NAIA you would note the very understaffed sports medicine team compared to the “big boys”.  This is no fault of the fine institutions, rather an economic issue.  From personal experience I can tell you that Continue reading

Please Let This Be The Beginning: A Public Invitation

28 Apr

The blog began simply enough, making notice of information about concussion in a time when there was so much misunderstanding.  It turned into a cathartic exercise on how I have dealt with concussions as an athletic trainer – the good and the bad.  It has slowly morphed into a platform for change; not only concussions but the healthcare profession of athletic training, in particular at the secondary school level (high school).

Adolescent concussion is not only staggering in terms of exposure but in terms of mismanagement, the true problem in this concussion crisis, in my humble opinion.  I feel – biased – that athletic trainers not only can help with the management but with the overall “acceptance” of this brain injury as it relates to sports.  Because of those thoughts I have been openly and behind the scenes, clamoring for a way to get more AT’s in the high school.  Not just game-day ATC’s either, full-time and daily coverage for our most vulnerable.  The analogy still remains: would you send you kid to a public swimming pool without a life guard on duty?  Why would you send your kid to collision sports without an athletic trainer on duty?

Yes, this is being spurred on by the concussion issue at hand, but in reality an athletic trainer is SO MUCH MORE!  We deal with the mundane (common cold) to the emergent (cardiac arrest) when it comes to athletic or high school (dealing with situations during a school day) injuries.

I came across a tweet today from Rick Burkholder (@proatc), Head Athletic Trainer of the Kansas City Chiefs that is putting this into action.

The NFL is starting a grant process to place certified athletic trainers (ATC’s) into more high schools.  The monies are limited from what I can tell, but this is the start that I have been dreaming of for the past few years.

You can read the entire NFLF ATC Grant by clicking on the link to see all the details but here are the highlights: Continue reading

Getting A Bit Fidgety On A “Snow Day”

27 Jan

It’s not actually snowing, but no school today because of -20’s windchill.  With my kids out and some time to relax, I have found myself looking back and getting a bit nervous for the upcoming week.

It was a heckuva weekend as an athletic trainer and this week is shaping up to be a big week in terms of concussion education for me.  As you may have already noticed I am heading to New York tomorrow to be part of the #C4CT Concussion Summit, both as a live blog feed and a panelist.  I hope many can make the event, and many more learn from what I can get down on the interwebs.

Let us first reexamine the life of an athletic trainer this past weekend…

It started Friday night as the boy’s team was on the road and I caught wind (we seem to have a ton of sources as AT’s) of a collision between two players in the game.  One of them had to go to the ER for some sewing work the other was ruled out by the AT with a concussion.  So began my communication and information gathering well into the late night – and I wasn’t even there.

Saturday came with anticipation of seeing the injured players, fully assessing and beginning a recovery plan – while attending to a high school wrestling dual tournament.  I don’t think many non-AT’s appreciate the juggling act necessary to even take a leak during these type of events let alone get some food, but now throw in two separate concussion evaluations and meetings with parents it becomes a minor miracle.  However, I would be remiss if I didn’t have an outstanding volunteer first responder and student AT.

After testing and making the decision to let one player travel but not play and the other to not travel at all, it was time to focus on the wrestling.  It was a very good set of matches with an unlikely victor as a team.  However, in the aftermath there was a bit of false bravado by an athlete as a fist and arm went through a double-paned glass window – the ones with wires in them – and then extracted said arm.

Having an athlete present with possibly the “ugliest” injury you have ever seen can be a bit discomforting, which it was as blood was not only leaking out it was pulsing out of the large gash.  Some how, some way when controlling the bleeding there was not one drop on my clothes, an absolute miracle.  The stories being related after the fact have been from preposterous to accurate, the net-net was that we had a life-threatening injury and it was taken care of quickly and professionally.  On top of that the athlete was all taken care of and went home that night, a very lucky kid in the face of doing something very dumb.

Sunday was not a rest day as 11 hours in the gym was on the docket again, for the little kids wrestling individual tournament.  I actually learned a ton from being there (only had 5 bloody noses and one “injury).  I learned that if kids/parents want kids to be in a “collision-type” sport that demands physical and mental discipline that wrestling may be the answer, over football for as young as 5.

Although school is out today my job is still in full swing.  Beyond the paperwork from the weekend I had to figure out a way to meet with the injuries at school and talk with parents.  Set up doctors appointments.  Track an injured athlete trough surgery.  Call coaches and admin to remind them of my absence.  And get the training room cleaned, set-up and directions for the sub AT coming in for me.

Oh, there is this blog too, which will have breaking news today.

As I am writing this I only wanted to share what an athletic trainer does.  Sure, because I post here makes me not the “normal” AT but there are many athletic trainers out there that do this and much more than me on a daily basis.  It is very important to me to share my experiences so you can see how valuable AT’s are.

Parting, I would like to now extend an invitation to Commissioner Rodger Goodell to meet with me while I’m in New York.  I am actually staying a block or so away from NFL HQ.  So, Mr. Goodell (or representatives) just give me a shout in my in box! hahahaha.  Can’t say I didn’t try!

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.

Hammering Home The Need For Athletic Trainers

6 Nov

I published this 10/22…  Since there has been higher volume as of late, I feel it is a good time to repost.  There is also another article by John Doherty that supplements this, HERE.

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In findings released today in New Orleans it is becoming more clear that athletic trainers play a vital role in secondary level athletics.  Using reports from 2006-2009 in various injury reporting systems there has been significant findings about injuries and concussions;

Overall injury rates were 1.73 times higher among soccer players and 1.22 times higher among basketball players in schools without athletic trainers. Recurrent injury rates were 5.7 times higher in soccer and 2.97 times higher in basketball in schools without athletic trainers. In contrast, concussion injury rates were 8.05 times higher in soccer and 4.5 times higher in basketball in schools with athletic trainers.

Not having an athletic trainer predisposes the athletes to greater risks, not from the usual sporting activity, but playing with injuries that can develop into greater problems.  Athletic Trainers also have the educational background and grasp of prevention of injury; either through (but not limited to) nutrition/hydration or conditioning of the body.

Athletic Trainers are also on the forefront for concussion awareness, education and assessment, often the first allied health care professional to see the problem and identify it.  As much as I hammer home Continue reading

Concussions: Not Just Male; Not Just Football

19 Jun

Here at The Concussion Blog, we talk all things concussions. Concussions are brain injuries and they are definitely something we must continue to learn more about and continue to educate the youth and the parents. Dustin and I are both Certified Athletic Trainers at the high school level and I really believe that puts us on the “front lines” when it comes to concussions and concussion education. But I think something that gets lost in the whole concussion issue that a concussion is NOT a football problem; it is a SPORTS concern. This article will once again present another sport that brings its own risks of concussion and it needs to be brought forward once again. Cheerleading, girls basketball, and girls soccer are all prime examples of concussion sports that slide underneath many people’s radar. Continue reading

Concussion Article Links – MUST READ

9 May

Since the tragic and untimely death of Junior Seau the concussion issue has begun to fester like a three-day old pimple on a 13 year-old’s greasy face.  It is ready to pop and keeping up with all of the pertinent articles and “specials” has been very trying.  In this post I will attempt to link up and highlight as many as I can (surely I will miss many, however Concerned Mom in the comment section will have more).

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Lets begin with ESPN and the Outside the Lines week-long look at concussions.  I have found this to be must see, my DVR is a testament to this; using previous stories and bringing in commentators on the subject have provided information and even fireworks.  Yesterday Merril Hoge and Matt Chaney did just that – provide information and create fireworks.  You can find the podcast here (panelists begin about 7:30 mark).

Hoge drew my ire earlier this week with his admonishing of Kurt Warner’s statement of being a father, however yesterday he did have a very valid point about the management of concussions.  I have said is ad nausea here: the elephant in the room is the management of concussions, however Hoge sounded a bit “underconcerned” about the actual injury.  Which is where Chaney had very valid points about the exposure of concussions to the youth.  They are both right in my estimation; the management is the larger issue but we are seeing too many too young people being effected by concussions.  There needs to be work in both areas and remember this is not just a football issue.

We have the duty to protect our kids and if that means flag football for 5-13 year-olds then I am cool with that.  If we find after making such a drastic change that has not been enough then we can take it further if needed.  I feel that a change like this will allow a few things: 1) more time to let the brain develop and thus allowing research to catch up to what we know.  2) employ more medical providers in a position to find, assess and manage concussions (see athletic trainers). And 3) begin a culture shift about the seriousness of concussions, after all this is a brain injury.

As Chaney later told me; Continue reading

Research From The Now

22 Feb

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

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

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

NFL Concussion Crew

22 Dec

The change for the NFL in searching for and making sure all players with concussion symptoms get checked out will make its debut this weekend.  The addition of non-team paid (NFL) athletic trainers will help with game observation.  The wide angle and TV in the booth should alleviate some of the issues of being preoccupied or blocked from the action.

The concussion observing athletic trainer will not have the authority to actually pull the players nor make any recommendations regarding evaluation.  Rather they will be in communication with both teams to insure that Player X has been checked out.  This process would be similar to the Head Impact Telemetry System (HITS) being employed on college and high school fields.  Instead of using a pager to notify the athletic trainer of an exceedingly high impact, the “independent” athletic trainer will call down to the sidelines.

Yesterday on the Baribeau & Scarbo Show I discussed how it may in fact go down.  I was and still Continue reading

US H.R. 469

11 Jul

We have logged 21 different states putting forth legislation for head injuries in sports.  The first one was in Washington with the passage of the Zachary Leystedt Law in 2009.  Now the United States House of Representatives has put forth an effort to create a “minimum” standard for each state to follow.  H.R. 469 was introduced in January of this year and has not garnered a lot of press, here are the highlights;

  • School Sponsored Athletic Activity (all schools)
  • Healthcare Professional includes athletic trainers
  • A very well constructed definition of concussion
  • Informed consent to parents, athletes, coaches, etc.
  • Required assistance for students to return to academics
  • Required posting of information regarding concussions in the schools
  • Out a minimum of 24 hours and cannot RTP without written clearance from healthcare provider
  • A report out to the Secretary of Education at end of year

We have reached out for comment from various sources and here is what some have to say. Continue reading

AAN: “A New Game Plan for Concussion”

6 Apr

The American Academy of Neurology has defined a more comprehensive stance when dealing with concussions.  The AAN released a position statement regarding the initial management of concussions, last November;

1. Any athlete who is suspected to have suffered a concussion should be removed from participation until he or she is evaluated by a physician with training in the evaluation and management of sports concussions.

2. No athlete should be allowed to participate in sports if he or she is still experiencing concussion symptoms.

3. Following a concussion, a neurologist or physician with proper training should be consulted prior to clearing the athlete for return to participation.

4. A certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk for concussion.

5. Education efforts should be maximized to improve the understanding of concussion by all athletes, parents, and coaches.

Neurology Now a publication for “healthy living for parents and their families” has published an article by Kate Gamble that takes a closer look at why the statement was made.  With the back drop of new and expanding research along with stories like Tommy Mallon Gamble interviews the likes of Dr. Julian Bailes and Dr. Jeffery Kutcher to explain why we need to readjust the stigma of concussions; Continue reading

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