Tag Archives: Concussion

Jamaal Charles; No Different Then Vast Majority of Competitive Athletes

23 Oct

Last week when the Chiefs played the Chargers running back Jamaal Charles scored a touchdown and was blasted in the end zone by Brandon Flowers.  A shot that Charles bounced up from and headed to the sideline while Flowers was slow to get to his feet.  The hit was helmet to face mask and the resulting forces were a classic case of what is typically needed to produce a concussion for one or both of the players.  Whether or not it actually did, we will never “officially know.”

The issue is not with the hit or the fact that Charles apparently cleared the screening done on the sideline after such a hit, the issue is with his comments a few days after on the Dan Le Batard show;

“It definitely hurt,” Charles said. “A couple plays later, I just [saw] this light buzz around my eyes and I was trying to catch ‘em. But I was like, ‘Let’s get the ball and run again.'”

I am 100% confident that Head Athletic Trainer Rick Burkholder did his job on Sunday – screening Charles after the hit – it was evidenced on Tuesday/Wednesday when Burkholder placed Charles in the protocol as a precaution solely due to the comments Charles made.

Why you may ask?  Simple, by the absolute letter of the definition of concussion – disruption of normal brain function following a traumatic event – Charles admitted he was “not normal”.

Whether or not Charles had a concussion is up for debate among many people, not only externally – us blogging/media type – but likely internally – Charles and med staff.  Here in lies the problem with concussions and the issue of concussions.

As we tried to explain in the University of Michigan post, concussion is most often a subjective injury, we as medical professionals rely upon the athlete or injured to tell us what is going on.  If there are no overt or outward signs (loss of consciousness, wobbliness, gaze, vomiting, etc.) then all we can do is screen the athletes.  And by screening I mean simply asking the athlete if they are OK.

GAMING THE SYSTEM

I heard Mark Schlereth on Mike and Mike this morning saying something to the effect of; “there has to be more than just asking the player if they are ‘OK’?”.  The truth of the matter is that there is not really anything other than that; although just asking one question is not due diligence.  In my experience I ask more questions and even try to trick athletes into giving up any ruse they are trying to pull on me.  I have a to questions and line of questioning that has produced many responses that then warranted them to be fully examined with a sideline evaluation, even for the best “liars” (I won’t share them here because it can be used for people to study and then find a way around it).

The more complex yet simple reason we as athletic trainers feel confident with screening, even with limited questions, is that we know the athlete.  Their usual demeanor, behavior and general presentation.  People often ask me how long it takes me to know if someone has a concussion.  When they are my players, the ones I am around on a daily basis, usually it takes me Continue reading

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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

California First on Football Hitting Legislation

22 Jul

I received this email late last night:

Friends….

Assemblyman Cooley’s office just phoned to say that Gov. Brown has signed Ca. AB 2127, making California the first state to legislate reduced contact on high school practice fields.  As you know, other states have taken similar action via their governing bodies of high school athletics but, after failed attempts in Texas, Illinois and Connecticut, Ca. is the first state to pass legislation and have it signed into law.  Public announcement will be made shortly.  Thanks to Warren Moon, Oliver Luck, Patrick Larimore, Leigh Steinberg, Dr. Chris Giza and others who made it happen.

Reading further on SF Gate:

The law limits full-contact practices to two 90-minute sessions per week during the season and preseason, and prohibits full-contact practices during the offseason. Currently, coaches can hold full-contact practices daily. The law also forces schools to bench players for at least a week if they suffer a concussion. Current rules allow players to return within a day.

The last part of the above paragraph has me very excited about this legislation – AT LEAST one week down time!

Good on CA for taking this to the next step, honestly I don’t think we need more legislation, however if you don’t want to listen this may be the route it has to go…

NOW CALIFORNIA GET YOUR BUTT IN GEAR AND LICENSE THE ATHLETIC TRAINERS IN YOUR STATE!  THEY MUST BE RECOGNIZED FOR WHAT THEY ARE: ALLIED HEALTH CARE PROFESSIONALS.

A Decent Video

24 Mar

I am finding it hard to find time to post, obviously, but I will get back to this as soon as I can.  For the time being here is a decent video I have had forwarded to me that can be a good example of concussion or mTBI…

I would love to see discussion on this, below!

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

2011 NCAA Football Reported-Concussion Study: Week 11

15 Nov

The Concussion Blog Original, 2011 NCAA Football Reported-Concussion Study, is a weekly compilation of reported head injuries in Division-I college football.  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.  This study recognizes that the NCAA has no mandated requirements in reporting injuries, but hopes to shed light on an issue that hasn’t received the kind of critical recognition to that of the National Football League’s.  We encourage reader involvement in contributing to this comprehensive online study.  We will be using Fink’s rule to classify a concussion/head injury.

As we all very well know, college athletics are a beloved element in our national sports culture- controversy aside.  With understanding this country-wide phenomena in the adoration of college football, specifically, we recognize this love, and sit back in our own respective comfort zones of viewing games with our friends and families cheering on our favorite programs and alma mater institutions.  College football is a significant part of our exposure to sports, but for the sake of specificity as it relates to the regards of our blog, college football has not necessarily been given much attention in consideration of the sports concussion crisis.  The purpose of this study is largely to bring forth such attention, and to generate critical questions of the standards in place as football as a whole, without secluding the focus to only that of the professional levels.  This is a hard task, mainly because of the abundance of programs at the Division-I level, but also due to the fact that the NCAA has no requirements placed on coaching staffs to report injuries sustained by players during play. Continue reading

2011 NCAA Football Reported-Concussion Study: Week 10

10 Nov

The Concussion Blog Original, 2011 NCAA Football Reported-Concussion Study, is a weekly compilation of reported head injuries in Division-I college football.  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.  This study recognizes that the NCAA has no mandated requirements in reporting injuries, but hopes to shed light on an issue that hasn’t received the kind of critical recognition to that of the National Football League’s.  We encourage reader involvement in contributing to this comprehensive online study.  We will be using Fink’s rule to classify a concussion/head injury.

As we all very well know, college athletics are a beloved element in our national sports culture- controversy aside.  With understanding this country-wide phenomena in the adoration of college football, specifically, we recognize this love, and sit back in our own respective comfort zones of viewing games with our friends and families cheering on our favorite programs and alma mater institutions.  College football is a significant part of our exposure to sports, but for the sake of specificity as it relates to the regards of our blog, college football has not necessarily been given much attention in consideration of the sports concussion crisis.  The purpose of this study is largely to bring forth such attention, and to generate critical questions of the standards in place as football as a whole, without secluding the focus to only that of the professional levels.  This is a hard task, mainly because of the abundance of programs at the Division-I level, but also due to the fact that the NCAA has no requirements placed on coaching staffs to report injuries sustained by players during play. Continue reading

Sunday Recap

7 Nov

As Football Sunday played out yesterday there was more attention on the head injury issue; naturally because the NFL set in motion – if only through reinforcement – a system to get players off the field in cases of overt signs.  The concern for head injury actually began two plays in, in New Orleans.

Tracy Porter collided with receiver Mike Williams and was obviously stunned and unsteady.  Porter took a knee for a brief second before he crumpled to the ground where he was attended to; spine board and med evac later Porter was released from an area hospital (BTW they are listing this as a “neck” injury).

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Not long after that, Dustin Keller of the Jets jumped in the air and landed on his back/head.  The officials did a good job of summonsing the med staff to Keller.  Keller was subsequently removed evaluated on the sideline and locker room, where it was determined that he did not suffer a concussion.  In an extremely rare occurrence, the Jets medical staff answered questions Continue reading

NCAA Reported-Concussion Study: Entering Week 6

4 Oct

For quite some time now we have been compiling data regarding reported concussions in Division-I NCAA college football, taking note of rates of reported injury as well as the implications that such injuries have placed upon the players themselves.  As before mentioned in a post covering the absence of requirement in NCAA teams reporting injuries, we understand that this study will not be that of an exact science, but it should and will point to several issues on this subject.  The questions that we may raise from this study include inquiry on the prevalence of concussions in this level of football, how the injury is distributed amongst different age groups, how teams may or may not find purpose in not reporting concussions alongside other common injuries, how repetitive injury may impact one’s playing career, and most importantly- should the NCAA be required to report injuries?

Right now, such questions are left to debate and statistical evaluation.  Reporting concussions is analogous to reporting weakness in this level of play, and much so applies to all aspects of contact sports today.  What we have gathered through numerous resources made available online (and for that matter, it has been quite a challenge to track down concussions in the NCAA via Internet) is more so a statement to be made to the general public, for media fatigue and a lack of specialization to compartmentalize this injury aside from others has yet to be available to us.  This study intends on bringing more focus on concussions in college football, and hopefully may lead to more research-based and awareness-provoking paths.

As we enter Week 6 of the 2011-2012 NCAA college football season, here are the numbers to what we are looking at in relation to the incidents of concussions in Division-I programs… Continue reading

Concussion Management: Change is Happening!

21 Sep

I have noticed a major change in how we have been able to manage concussions at my school since this new legislation. When it initially came out the school personnel, athletes, and parents were reluctant and upset with the new requirements. I, on the other hand, was ecstatic because it put the athletic trainers in the forefront and helped bring to light the issue of concussions along with the issue of the lack of athletic trainers in secondary schools.

I am solely responsible for concussion management at the school that I am contracted with. In August, I spoke numerous times at parents’ meetings, with the athletes, and with the coaching staff. I spoke at length with the school nurse. All of them received information from the Illinois High School Association and CDC regarding concussions. The coaches, administrators, and school nurse were also provided with the return to play protocols.

It is important that we as athletic trainers take control of concussion management. Most others are not educated to do so nor Continue reading

Trends in Concussion Incidence in High School Sports

17 May

Mike Hopper takes a second to review a current research article, we would love to hear your take on this as well.

Concussions appear to continue to rise. Is it due to an increase in incidence or is it due to an increase in awareness? This study was conducted over an 11 year period in the Fairfax County School District in Falls Church, Virginia. The authors note that the numbers saw significant increases over the course of the study, but they do not attribute that to anything in particular.

The researchers conducted an 11 year study in a large school district with a certified athletic trainer on site for games and practices. Each school had 2 part-time athletic trainers from 1997-2005 and then a minimum of one full-time athletic trainer and one part-time athletic trainer after that.

A common occurrence is that football was the leading sport for concussion incidence. I think this fairly well-known at this point and no surprise. Girls’ soccer was #2 on the list which also should Continue reading

A Calling For Ease: Drew Fernandez’s Story

16 Apr

(Project Brain Wave)  High school football is one of the most exciting, defining, and proud markers of American culture, and is a level of play that to many, extends beyond being just a game.  The dreaded months of training camp, the long hours in the weight room and practice field, and the time spent studying playbooks to perfect a team’s system all contribute to the same goal—that being the unforgettable feeling of standing beneath the lights on a Friday night before your home crowd, set to take on the opponent you have prepared for.  This feeling that empowers our student athletes, that makes our parents proud and supportive, that makes our friends anxious to witness game day, is what the coaches and players live for.  High school football is defining, and is home to life lessons to be learned and experiences to cherish.  But for the Fernandez family, the high school football season of 2008 is one they will never forget.

Drew Fernandez, a young up and coming running back for his high school’s football program that was known for state championships in seven of the previous ten years, was productive both on the field, and off the field, executing plays on the field and performing well in his studies in the classroom.  His older brother had also been part of their high school’s championship legacy, and Drew was looking forward to contributing to such successes as well.  His first year in high school was in 2008, and it would be the first time he would have an opportunity to be a part of his hometown’s illustrious football program also.  According to his mother, Tracey, “football was everything to him.”

But such a mentality would soon be combated during one of his freshman football games, as Drew received the ball at running back during play, and then took hits from defenders in both the front and back of his head while he was being tackled.  Drew had sustained a concussion, and would be removed from play.  His mother told me of what events would then follow after her son took a blow to the head, resulting in his diagnosis.

“The trainer of the opposing team (the game was away) called me to tell me Drew suffered a concussion, and asked me if I wanted him to go back to school on the team bus or if he should call the paramedics,” said Tracey.  “I asked him to call the paramedics, and I met them at the ER.  The last thing Drew remembers from the day of his injury was riding on the bus to the game.  He has no recall of the trip to the ER via ambulance or anything thereafter until the next morning when he woke up at home.” Continue reading

Time to Heal: Tracy Yatsko’s Story

22 Mar

Last June, I had the pleasure of speaking at a press conference at Lincoln Financial Field in support of Pennsylvania State Representative Tim Briggs’ proposed concussion management legislation.  I was an eighteen-year old who had been researching concussions in sports for nearly ten months at that point—a task that I engaged in to further educate myself and others on the subject at hand; a project that would essentially close many doors in my past that had been left open for too long.  But as I situated myself beside the podium at this press conference, I had no idea what kind of story the young woman sitting to my left had to say.  Of course, throughout my research, I understood that others have been through worse—much worse—than what I had experienced, but never did I think I would meet someone I could relate to.  It was even more than just relating to, for this individual shared a heartbreaking story to the public.  She was at the press conference for the same reason as myself, and that was to promote the need for concussion legislation in our state, but she did more than that.  Her words were more than the cover to a bill.  Her words were the voice of the sports concussion crisis.

Today, Tracy Yatsko, a twenty-three-year old woman from Tamaqua, Pennsylvania, is still fighting the repercussions of an injury that ended her high school athletic career.  Six years removed from the moment of her last concussion, Yatsko represents the qualities of strength and motivation, for her battle has not been one that has been easy.  Sure, I have heard of stories in which athletes have sustained decisively fatal blows to the head.  But when I talk to this woman, and when I think about her story, the only words that I can describe how I have perceived her story is hell on earth.  Why did this situation in which Yatsko found herself within come to be?

2005 was a year, with regards to concussion awareness, that was still present in the sports’ ‘Era of Good Feelings.’  There was not much to worry about, and though there were stories creeping out of the media regarding concussions in football, there was not much of a worry in other athletic activities.  There really wasn’t much consideration as to what a concussion was.  It was merely an injury that was ignorantly summarized as a headache; a distraction; a joke.  And with such stigma comes tides of the familiar phrase that claims pain to be weakness leaving the body.  Only did we, or rather, do we, come to open our eyes to what a concussion is until the moment of a tragedy personally affects ourselves or those who we consider to be close to us. Continue reading

Brad Scioli On Concussions

15 Feb

For nearly a decade, the media has effectively contributed to the heightened awareness of concussions in football.  Many individuals, who either were or were not involved in the sport itself, became enlightened by the growing results of medical discoveries that connected mild traumatic brain injury to conditions such as post-concussion syndrome, depression, second impact syndrome, chronic traumatic encephalopathy, and amyotrophic lateral sclerosis.  The widely dispersed spectrum of opinion on this subject often provided vague interpretations of concussions in sports, so I engaged in something that would be a bit more effective in opening the public’s eyes, as well as my own, to the personal predicaments between concussions and professional athletes.  To do so, I contacted Brad Scioli—former defensive end for the Indianapolis Colts.

Scioli played for the Colts from 1999 to 2004.  He attended the same high school that I graduated from a year ago, and is forever enshrined in the athletic legacy of Upper Merion Area High School’s halls.  He is known to be one of Upper Merion’s greatest, and most proud, athletes of success who took his talents to the professional level.  Today, he is now a health and physical education teacher at Upper Merion, and is an assistant coach for the school’s football program.  During my high school career, I had the pleasure of working with Scioli in a productive player-coach relationship, where I learned a tremendous amount of skills for the defensive end position through his expertise.

By speaking to Scioli, I wanted to learn about what the voice of a former NFL player had to say about the league’s most recent dealings with all aspects of mild traumatic brain injury.  I wanted to see how we could further illustrate an issue that has been brought to the foreground of neuroscience and professional sports.  After seeing my junior year mark the end of my high school football career, it was interesting to see what Scioli, a former defensive mentor who shares similar homegrown roots, had to say about the issue. Continue reading

Concussion = Brain Injury

12 Feb

For years we in the medical community have been struggling with the terms “concussion” and “traumatic brain injury”; is there a difference?  The simple answer is no.  As you have seen on the blog, we use the term interchangeably, however just like anything in life semantics make a difference.  The perception of a “concussion” is that of sports and “not really that big of a deal”, and that would be horribly wrong.

As Broken Brain — Brilliant Mind posts today this injury is to the brain and confusion about semantics need to be cleared in order to gain a firm grasp on the issue at hand;

I’ve been giving a fair amount of thought to concussions over the past couple of years. In the course of my tbi rehab, my neuropsych has referred to my mild tbi’s as “concussions” and oddly, I never really thought of them that way. I’m not sure why I didn’t make the connection. I guess I thought, like so many others, that concussions are not that big of a deal — just a bump on the head. Getting your bell rung. Getting dinged. Big deal, right? Then, when my neuropsych talked about all the concussions I’ve had, the light went on.

My mild traumatic brain injuries were concussions. Concussion sounds a lot less dramatic than TBI, but essentially, it’s the same thing (I won’t go into the distinctions that SUNY-Buffalo Concussion Clinic people make).

By the way if you have not been going to BB–BM you should, as his/her perspective on dealing with brain injury is a massive resource.  Needless to say, whether you use the term “concussion” or “brain injury” the results Continue reading

Sex Differences in Concussion Symptoms of High School Athletes

28 Jan

Here is a brief overview of the article out of the newest Journal of Athletic Training. I suggest you take a chance to read the entire article. It’s free to NATA members!

Frommer LJ, Gurka KK, Cross KM, Ingersoll CD, Comstock RD, Saliba SA. Journal of Athletic Training. Sex Differences in Concussion Symptoms of High School Athletes. 2011; 46(1):76-84.

An estimated 1.6-3.8 million sport-related concussions are reported each year with about 21% of those being high school athletes. The occurrence of injury in female athletes has continued to rise with the increase in sports participation and females have a higher incidence rate than males of sport-related concussions.

Research has shown that females may respond to concussions differently than males. Females tended to fare worse than male counterparts leading to longer hospitalizations, longer disability, and higher mortality rates. Females also require greater monitoring and more aggressive treatment due to symptoms not aligning with Glascow Coma Scale.

Hormones are believed to be a factor in the response to head trauma. Females tended to be more cognitively impaired after a sport-related concussion.

Males tended to report amnesia and confusion as a primary symptom more often than females. Females reported drowsiness and sensitivity to noise more often than males.

Males often returned to play 7-9 days post-injury while females had a greater percentage returning 3-6 days after a concussion.

This data is representative of what is actually taking place in the high school setting rather than in a research lab.

The outcomes of this study show there is little difference in severity of concussions between the two sexes, but it appears they present with different types of symptoms. Males reported more cognitive symptoms while females reported more neurobehavioral and somatic symptoms.

Why I got into Athletic Training

5 Jan

Time to introduce our newest blogger; Mike HopperI will let him describe a little about himself…

I am currently a certified athletic trainer working in a physical therapy clinic and providing outreach coverage to high schools in the Metro-East St. Louis area.  I graduated this past December with my bachelor’s degree in athletic training.  People ask why I would choose a profession that is relatively low-paying and has the hours that athletic training often does.

For a long time, I would say that it’s just what I love, which is true.  I love being around athletes, I love watching sports, and I have taken an interest into the healthcare of these athletes.  But it goes back to high school for why I have become so passionate about this profession.

I suffered concussions in high school.  Not a single one was ever diagnosed or even evaluated by a health care professional, but knowing what I know now, I am certain I had at least 3 of them, probably more than that.  But even 4-5 years ago, we did not know very much about concussions.  I “got my bell rung” but that was just part of being a football player.  I can remember now two specific incidents where I am certain I had symptoms that went unreported.

The first one was in a football game on a kickoff.  I got hit from behind and my facemask actually got stuck in the ground.  I got up a bit dizzy and headed for the sideline—the opponent’s.  I realized it quickly enough, but I developed a headache later.  Again none of it reported.  Then my senior year I was a catcher on the baseball team and took a foul tip Continue reading

Friday Night Lights Week 9

22 Oct

After a one week hiatus, it’s back – my personal experience and feelings on concussions.

It’s the last week for football at the high school I cover, as our team will not have enough wins to qualify for the playoffs here in Illinois.  Two games remain (varsity tonight, JV Monday) and I am not ready for it to end.  I have had one of the most fun and fulfilling years on the gridiron both personally and from an athletic trainer’s stand point.

Recapping the past few weeks, we have had four concussions since I last wrote, two in football and two volleyball players.  All of them were different presentations and circumstances, one of which had me scared out of my wits.

The first of the four was last Thursday as a player was tackled late in the second and came off the field complaining of wrist and hand pain.  The significance of this player is that he was the best on the field and the best player the coaches had at that game.  He came off and we took a look at his wrist/hand, slapped on some tape and had him return, which he did.  But after halftime, the coaches reported to us that this player was “not like himself” during the break, and seemed like he was not paying attention.  They thought he may have a head injury, which was news to us, as we only knew of his hand/wrist injury.  As we walked over to the player he has the “gaze,” as though he is looking straight through you, and grabbing his head.  My student performed the standard tests, Rhomberg, Neurocognitive challenges, and he is obviously struggling.  After we determine that he does in fact reek of concussion, we quizzed him on how he got hurt, and he has no clue.  We talked about the hit that caused his wrist/hand to hurt, and he said he did not remember his head getting hit.  All of his memory was there, but we could not for the life of anyone on the sideline, including his father, figure out where his head was impacted.  The conclusion we finally decided on was that he did not sustain a “monumental” blow, Continue reading

REAP

17 Oct
  • Reduce
  • Educate
  • Accommodate
  • Pace

R.E.A.P is a concussion program that has been put in place in Colorado.  Written by Dr. Karen McAvoy the protocol is about education, making sure all aspects and people are covered/addressed in the recovery from the concussion.  The information can be found at the Youth Sports Medicine Institute’s Center for Concussion.

Denver Post Story

17 Oct

McAvoy, through the REAP initiative, seeks to make sure athletes fully recover from a concussion before returning to play. If not, the consequences can be devastating.

Jake Snakenberg, unlike Camden, never got a second chance. Snakenberg, a freshman football player at Grandview, died from Second Impact Syndrome after suffering two concussions in a one-week span in September 2004.

Ryan Casey of the Denver Post wrote a story about the impact of concussions beyond sports in today’s edition.

Unable to focus, Courtney was pulled out of school. She started sleeping up to 20 hours a day. She started losing things.

“I would forget where I was,” Camden said. “It was not good.”

Five days after her concussion, the migraines started. Mother’s Day came and went. Other symptoms — the lethargy, the forgetfulness, the inability to concentrate — grew worse.

“She just couldn’t

Sideline concussion tests — like this one given by Chaparral athletic trainer Maggie Yates — are a crucial step in making sure high school athletes don’t return to play before they have fully recovered from a hit. (Andy Cross, The Denver Post)

do what was asked of her, physically or mentally,” Joellen said. “All of a sudden, there was like nothing. I used to say it was like looking into her, and it was hollow. And I’m like, ‘Who is this?’ “Ten days after the concussion diagnosis, the family visited The Children’s Hospital in Littleton, where Courtney was put through a series of cognitive examinations, including a standard test during which she was told three words to remember and asked to recall them after a five- or 10-minute conversation.

“If she got one or two, we were lucky,” Joellen said. “I’m sitting there going, ‘That’s like the capacity of a 6-year-old.’ “

Read the entire story HERE

Vestibular Rehab For Concussions

12 Oct

We all know, or should know, that balance issues are a primary concern with concussions and post-concussion syndrome.  Along with memory problems, balance disturbance is high on the predictor list for duration of symptoms ergo severity.

As an athletic trainer one of our primary tests, and “go-to” is the Rhomberg Test, or sobriety test as most may know it as.  What is tested there is the gross balance and fine motor movements controlled by the brain and vestibular system of our ears.  During a concussive episode the synapses (or messages being sent) between the neurons in the brain get disrupted, each individual will experience different durations.  Using the knowledge that balance is commonly and most immediately affected by a concussion the Rhomberg provides great feedback.

During the Rhomberg the athlete is challenged with single leg balance, tandem walking, spatial awareness and other concentration efforts that would otherwise be very simple.  These menial tasks become very difficult when you are concussed.  Now imagine those small but difficult tasks and dizziness plaguing you on a daily basis days, weeks or even months after you have sustained a concussion.

Alsalaheen, Mucha, et al. provided a research study in which they Continue reading

Military About Face

12 Oct

We have blasted the US Military on this blog for the way they have not prioritized head trauma on the battlefield.  And how making soldiers go back to “war” before their brain was ready may have caused deep and permanent damage upon return to civilian life.

Jon Hamilton of NPR has written a story about how the US Military has “called and audible” of sorts.  Using the information and model from the NFL the military is now taking soldiers out of action until they have recovered.

The blast can produce “a concussive wave, or a blast wave, that actually moves the head and body very violently and that can, in fact, cause a concussion,” Hovda says.

Brain scans show that for days or even weeks after an injury like this, the brain’s metabolism slows down, which leaves some cells starved for energy, he says.

“During the time when this metabolism is altered,” Hovda says, “the brain not only is dysfunctional, but it’s also extremely vulnerable, so that if it’s exposed to another mild injury, which normally you’d be able to tolerate really well, now there can be long-term devastating consequences.”

Follow the link for the full story and some very good multimedia teaching tools.

Shining City TV Concussion Video

5 Oct

Via YouTube.  A side note, for some reason the videos are not embedding like they used to.  If anyone has a clue as to how to fix that, can you let me know?

http://www.youtube.com/v/xt5NnnHGtlE?fs=1&hl=en_US&color1=0x5d1719&color2=0xcd311b

Recommendations

1 Oct

Recently I have had a few more concussions than usual.  Along with that I have had parents really struggling to understand the recommendations I have given them.  The restrictions seem very harsh, they tell me, or they are confused because their doctor did not recommend the same.

Here are some guidelines from St. Vincent Sports Performance of Indianapolis

For someone diagnosed with a concussion, increasing the blood flow to the brain through physical or mental exercise can destroy vulnerable and damaged brain cells, slowing down recovery. The following guidelines help an athlete recover faster from the injury:

» Do not attend school.

» No extended reading.

» No video games.

» No MP3 or iPod use.

» No walking the dog.

» No movies.

» No PSAT or SAT tests.

» No computer use.

» No text messaging.

» No socializing with friends.

» No school functions.

» Use sunglasses in bright environments.

» When the athlete no longer has a headache, he or she can return to school gradually, attending class until symptoms return. After 48 hours pass without any symptoms, a doctor will begin a treatment that allows an athlete to return to the field.

An Overlooked Concussion

26 Sep

And its results.  In the video below you will see tennis professional Victoria Azarenka collapse on the court at the US Open in New York.

http://www.youtube.com/v/pBOy8KZzgVA?fs=1&hl=en_US

Although the conditions were hot, and she had been complaining of abdominal pain earlier in the week, it was later found out that Azarenka sustained a concussion just prior to the match.  While warming up for the match she fell and hit her head.  The doctors and official report blame the fainting on the concussion.

I had missed this story until today, with the thought it was heat related, but after further investigation, it was yet another example of a poorly handled concussion.

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