Tag Archives: Dr. Robert Cantu

ESPN OTL Article Sparking Quite A Debate

8 Apr

On the surface this article may be innocuous to many, but the the minutia of concussion research and information is coming to a head very quickly, especially pertaining to the NFL.  Tomorrow is the first hearings in front of the judge – and the possibility of total dismissal - for the concussion law suits filed by thousands of former NFL players.

ESPN and its Outside the Lines department (in conjunction with Frontline) filed this article taking a look at two of the most prominent people in the concussion research/awareness arena, Dr. Robert Cantu and Chris Nowinski;

Two prominent concussion researchers — including a senior adviser to the NFL — served as paid consultants to law firms suing the league for allegedly concealing the link between football and brain damage, according to interviews and documents obtained by “Outside the Lines” and “Frontline.”

The article written by Steve Fainaru and Mark Fainaru-Wada sheds light on the very issues the research community faces with this problem.  Some of this information can be classified as “not new” to people who participate in the constantly shifting arena of litigation and research, while some information can be deemed as scathing.  There is a very tight and ubiquitous line in this matter;

Researchers often are asked to appear as expert witnesses in legal proceedings related to their fields. The NFL suit, with the potential for billions of dollars in damages, has created a large demand for researchers with expertise in the science of concussions.

But some researchers said they have turned down such requests despite the potentially lucrative payoff out of concern the perceived conflict could compromise their research.

Conflict of interest (COI) is something we all need to pay attention to, although it applies to this current article, the COI in this field is rampant and often unchecked.  This is nothing new, players have talked about COI, other journalists have noted it, and one of our prominent commentators (Dr. Don Brady) on the site has even devoted some of his dissertation to COI.

It would seem this is nothing “new” in the world Continue reading →

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Concussion Round Table

12 Nov

Last week The Aspen Institute hosted a round table discussion on “Playing Safely: The Future of Youth Football” to address growing concern about the epidemic of concussions on our youth.  It should be noted that professional athletes are both more mature (in size and brain development) and are adults who can make informed consent decisions.  The issue this panel discussed was for the youth football.

The speaking list was both wide and deep including: DeMaurice Smith, NFLPA, Dr. Gerry Gioa, Chris Nowinski and Dr. Robert Cantu amongst others in attendance;

At the Aspen Ideas Festival in June, a panel featuring concussion experts and former NFL players considered the health safety risks of playing football. Since then, concerns have sharpened, with many parents of young boys saying that tackle football should not start before age 14. At the same time, football also plays a role in addressing the epidemic of physical inactivity. Our roundtable dives deep into the state of football at the youth/community level with a discussion on reforms — and implications on the game up to the professional level.

With awareness beginning to gain traction and definitive research in the area starting to bear fruit this round table Continue reading →

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Cantu Interview with SportsLetter

8 Oct

Thanks to a heads up serial emailer I was able to not miss this interview of Dr. Robert Cantu, appearing in the SportsLetter – it appears to be written by David Davis.  There were some very good questions and answers, below is a sampling;

SL: When did you first realize that concussions in youth sports were becoming a major problem?

RC: When I was a sideline physician for a high school football team over 30 years ago.  That’s when it occurred to me that we needed some written guidelines for returning our young athletes to the field of play after they suffered a head injury.  That’s what led me to write the first Return to Play Guidelines back in 1986.

I’m a strong supporter of youth sports, but no head trauma is good head trauma.  You cannot condition the brain to taking blows. If you subject the brain to enough head trauma, permanent brain damage may happen.

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SL: In your practice today, what are the most common myths — the most common misconceptions — about concussions among youth athletes?  Is it that there has to be a contact sport involved?

RC: I think the number-one most serious misconception is that you have to be rendered unconscious to have suffered a concussion.  More than 90 percent of athletic concussions occur without any loss of consciousness.  There are 26 symptoms associated with concussions, and loss of consciousness is only one of those.

Another very common myth is that concussions become exponentially worse as you accumulate them, so that your first one will be more mild than your second, and your third will be worse than your second one.  That’s just not reality.  The concussions happen to be whatever they are based on the forces involved.  I’ve seen many individuals whose first concussion was much more severe than subsequent ones.

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SL: How is a concussion involving a youth athlete different than a concussion involving an adult athlete? Continue reading →

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Book Review: Concussions and Our Kids – Dr. Robert Cantu

17 Sep

Due out tomorrow, Tuesday, September 18th, is Dr. Robert Cantu’s most recent writing on brain trauma; more specifically the concussion and how it relates to the ‘kids’.  Dr. Cantu is THE expert when it comes to concussions, heck his CV is so expansive it would take up like 7 pages on here.  The man knows his stuff; collaborating with Mark Hyman I believe he has written a book that is worth the read for everyone interested in this topic.  By writing this book they not only address the concussion issue but the “iceberg below the surface” the youth athletes and their care.  Obviously the millions that partake in sport and recreation are not privy to the top of the line medical staffs that the professional and high college athletes have at their disposal.

With Dr. Cantu’s wealth of knowledge there was a chance this book could have been written above the audience – so to speak – but after reading it twice I have found it to be perfectly succinct and to the point.  There is no beating around the bushes and you definitely get the feeling of where Dr. Cantu stands on this pressing issue.  All of that being said there are some points that I disagree with, but remember my favorite Japanese Proverb: “None of us is as smart as all of us.”

The book begins with the most important topic, in my opinion, “what is a concussion?”, delving into the brain and its physiology.  Don’t be scared, it is a well written chapter and explains to the layman how and what we feel determines a concussion.  Highlighting that section is the explanation of linear and rotational acceleration and why one is way more important than the other.  If you have read here enough you will note that the rotational aspect of the traumatic force to the brain bucket is the most troublesome, Cantu agrees.  In this chapter Cantu also discusses the term “rest”, and what we are all trying to convey, especially to the youth.  Rest is both physical AND cognitive, meaning not using your brain.

The next two chapters deal with collision sports Continue reading →

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Bombshell Found in Sports Illustrated Vault

4 Jul

Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, [...] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. [...] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading →

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Limiting Head Trauma is Logical

31 May

The research is starting to come in; the problem is that results and conclusions bring more questions that should be answered.  Naturally some will look at early evidence and make a 180 degree change on their attitudes about certain things.  We are talking about concussions and the research associated with it.  Unfortunately there is plenty of anecdotal and observational cases that sear into our memory, this perhaps shape our thought process.  Along with that there is gathering evidence that supports some sort of process change in how we handle this particular injury.

The need to make change is upon us, that cannot be debated; what can be debated is how or what the changes should be.  I recently read an article where Micky Collins of UPMC said something to the effect of current concussion concern is like a pendulum that has swung all the way to the other side.  Although the changes in sports and activities has certainly not taken that full swing the other way, the pendulum is on the way.  His feelings, like mine is that there is no evidence to suggest that a full swing to the other side is warranted, rather there needs to be competent and complete understanding of what we are facing.  Rather than making full sweeping changes that would be akin to digging up your backyard to rid your self of a mole; when placing traps and poisons and maybe only having to dig up a small section would fix the problem.

There are definitely things we can do as parents, players, coaches, researchers, doctors and concerned people in general to make a dent in the issue.  If we find that the changes are not working then taking another aggressive step may be necessary.  I guess the reason for the above rant is to reinforce the need for changes, but the right changes.  (As I wrote the last sentence I realized how do we know if the changes are the “right” ones; I guess we don’t but certainly what is happening now needs attention).

One of the small changes that can be made is very obvious to me; Continue reading →

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Head Game Movie Providing Head Scratching Already: UPDATE

14 May

UPDATE BELOW

Irv Muchnick has been using his investigative nature to find out about the new movie “Head Games” based on the Chris Nowinski book and history.  Although the use of alternate media is a wonderful thing and that this movie will at least bring more people to the discussion there are some peculiar things about at least the production and the producers that make one wonder.

Muchnick, who has turned over a new leaf and started to lean away from the ‘nuclear option’ of banning the sport of football period to a more incremental – albeit very conservative incremental (however he does deserve credit for adjusting his train of thought) – approach to limiting tackle football for youth.  However the bulldog that he is, Muchnick has uncovered some interesting tidbits on the new movie, currently he is in Part 5;

The principal funder of the new documentary film Head Games is Steve Devick, a billionaire music and technology entrepreneur, who co-invented and is marketing a sports sideline concussion tool called the King-Devick Test.

On the virtual eve of the first preview screening of the movie in Chicago – originally billed as a “red carpet premiere,” now called a “private sneak peek” – Continue reading →

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Educational Videos

7 May

Thanks to our heads up commenter Concerned Mom I perused two videos that she linked up.  They are produced and posted onto YouTube by the Massachusetts School of Law.  In the two-part series you will learn what we know and are learning; being in Massachusetts there is access to the BSTE (Nowinski, Cantu, Stern and McKee group).

Both videos are an hour in length but are again worth the time to sort out some things you may find questionable.  As with most information regarding concussions it is hard to agree with ABSOLUTELY every part of this information, but it is as one person told me “worth posting”.

In the second one at 17:04 mark is where the now famous statement from Dr. Cantu on collisions sports and those under the age of 14.  It echos what we have come to accept at this point.  The way collision sports are being played currently are not a safe ground for youth and adolescent brains.

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CTE Insight from the Bostonia: but take time to remember the real pioneer

3 May

Shortly before this blog began in September of 2010 there was a brilliant article written in Bostonia regarding the work that Boston University was doing.  This article did not fall into my lap until yesterday during the Junior Seau reporting, it was found tweeted out by none other than Will Carroll, @injuryexpert.

We have come to understand a bit more about chronic traumatic encephalopathy (CTE) though the work of those in Boston.  It would be an absolute shame to not mention the person who first found this brain issue, Dr. Bennet Omalu.  Dr. Omalu found it but then was unceremoniously Continue reading →

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Monday Morning Weekend Review

30 Apr

There has been a lot of press about concussions the past weekend, mainly due to the NFL draft, however much information is out there (thanks to Concerned Mom for highlighting some in the comment section).  Here is a quick rundown with links that I find interesting.

Mike Florio of ProFootballTalk makes some great points about NFL litigation and actual player concern;

Supporting that contention will be the fact that no NFL player has retired due to fear of potential harm from concussions.  Yes, some have retired due to the immediate consequences of multiple concussions.  But no NFL player, current or prospective, has passed on playing football at its highest level due merely to the fear that the player may suffer one or more concussions that may cause problems for him later in life.[...]

That’s not to say that claims regarding the NFL’s failure to take meaningful steps before 2009 to protect players from concussions will lack merit.  But as players who now know all they need to know about the risks associated with playing football continue to flock to the NFL, it will be harder and harder to get a judge or a jury to accept that players would have walked away from the sport if they had known then what all players know now.

Agreed on all fronts with Florio here, its tough to sell an Continue reading →

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MMA and CTE

20 Feb

The hot button topic in the research world with concussions is chronic traumatic encephalopathy (CTE), the degenerative brain disease, twin (fraternal) sibling of dementia pugilistica first found by Dr. Bennett Omalu.  This brain disease is debated and some times discounted (as you will see tomorrow) for its links to repetitive brain trauma, i.e. multiple concussions.  It does however have a place in the discussion with combative sports like MMA.

Recently a former fighter named Gary Goodridge has said he believes to be suffering from its onset.  Steven Marrocco of MMAjunkie.com wrote a piece on Goodridge and the debate of CTE in the sport;

The damage, he noted, was not extensive enough that it had caused irreversible trauma. But had the fighters continued to compete, he believes they would have been candidates for CTE.

“What I’m saying is that mixed martial arts belongs to the high-risk group of CTE,” Omalu said. “I would consider mixed martial arts just like I would boxing.” Continue reading →

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SLI “Hit Count” Initiative

3 Feb

Sports Legacy Institute did in fact release their white paper today; it simply brings to the surface something that they along with others have been saying with more frequency.  Their initiative to create a Hit Count is a bold step and on that is welcomed, especially in light of the very current research from Purdue.

You can find the article on the SLI website (here) or you can read the final white paper .pdf here; there is a very good background for this idea and the simple yet powerful citation of research already performed in this area.  Their idea is mapped out very well, again the devil will be in the details as it all begins to be sorted out;

There are technological and monetary limitations to a pure Hit Count, as Hit Count systems currently are only sold for helmeted sports, and there are costs involved.  A Hit Count is not as simple as a pitch count, where coaches only need a pencil and paper.

However, hits to the head can be accurately estimated, and methods can be developed to approximate the brain trauma exposure during games and during practice based on known variables, like position.  With these estimations, rule changes and practice guidelines can be provided to ensure few, if any, athletes exceed a proposed limit. Continue reading →

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White Paper

3 Feb

Sometime today Sports Legacy Institute (SLI), headed by Dr. Robert Cantu and Chris Nowinski are going to release a “white paper” that will “plan to spread successful NFL policy changes to all youth sports,”  this according to Irvin Muchnick via his blog Concussion Inc.

What is a white paper?  Glad you asked it is important for context (via Wikipedia);

A white paper is an authoritative report or guide that helps solve a problem. White papers are used to educate readers and help people make decisions, and may be a consultation as to the details of new legislation. The publishing of a white paper signifies a clear intention on the part of a government to pass new law. White Papers are a “ … tool of participatory democracy … not [an] unalterable policy commitment.[1] “White Papers have tried to perform the dual role of presenting firm government policies while at the same time inviting opinions upon them.”

It is mentioned that along with SLI, Boston University’s Center for the Study of Chronic Traumatic Encephelopathy (headed by Dr. Ann McKee) will be in the white paper as well.

I will be interested to see what exactly they are Continue reading →

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Sport of Lacrosse: A view from Dr. Cantu

5 Jan

Have I mentioned that I really LOVE you readers?  In case you have missed it, I do love all of you; you make this blog better every day.  In the mailbag today was an article forwarded to me from a family about lacrosse.  The article is from Inside Lacrosse the January issue, written by Terry Foy.  The article is a question and answer with Dr. Robert Cantu and has wonderful-insightful questions and answers.

Because I cannot in good conscience rip off the entire article I will provide the questions by Inside Lacrosse and some quotes, but mostly summations of the answers by Cantu.  Make sure you visit the article for all the information.

  • How familiar are you with men’s and women’s lacrosse?
    • Just like our stance on woman’s lacrosse, Dr. Cantu is very adamant about putting head-gear on players in that subset of the sport.
  • Are helmets one of the primary actors in diminishing the amount of concussions in lacrosse?
    • Depending on the actual cause of the injury helmets can help in decreasing the amount.  Dr. Cantu’s information provides him with data that show most woman’s lacrosse concussions come from stick strikes to the head.  He is correct in estimating that putting helmets on woman would decrease concussions in that case.  He does echo what we have been telling you from day one; helmets do not prevent the primary reason for concussions in collision sports (rotational forces).
  • Because the NFL changed their rules to protect from head injuries, do you think lacrosse, aside from adding helmets on the women’s side, needs to adjust any rules to create the same protection? Continue reading →

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ESPN OTL Takes on Cantu’s Stance

17 Sep

Outside the Lines on ESPN interviewed Dr. Robert Cantu after he made public his stance on the issue of youth sports.  I have embedded the video from ESPN via YouTube.

I would like to highlight not only Dr. Cantu’s take but also a VERY GOOD journalist that has covered concussions, Peter Keeting at the back end of the video.

In the accompanying story by Ian O’Connor of ESPNNewYork, Harry Carson believes that the state of football and its aftermath may be similar to playing Russian Roulette;

Carson played through all of his undiagnosed concussions, if only because that’s what NFL players did in the ’80s. He knew something was wrong when he struggled with his vocabulary during interviews, a problem that inspired him to secretly listen to language tapes on his drives home from practice in the hope, he said, “of retraining my brain.”

Carson was diagnosed with post-concussion syndrome Continue reading →

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No Collision Sports For Kids Under 14

13 Sep

On this blog we have been presenting information that has led to me and others saying that intentional contact to the head of adolescents is not good for long-term health.  What has not happened until recently is a “big name” in the research/medical world suggest that collision sports are inherently dangerous enough to warrant us to re-think our practices.

At the end of August the American Academy of Pediatrics announced that kids should not be boxing for the risk associated with concussions (number one injury in boxing).  That was quickly shunned by the boxing world and even the prominent Dr. Robert Cantu said there could be a social impact that should be realized.  Dr. Cantu stopped short of admonishing the decision as well as supporting the decision (in the related article).  However, the announcement was not unexpected if you have been paying attention, more as more problems are being found with brain injury.

I have clearly stated that I will have no problem with my children playing collision sports, only when they are older and in high school.  I want nothing more than for my sons to play football (if they choose), but at what risk?  Sure “back in the day” kids were getting their “clocks cleaned”, then subsequently grabbing some “smelling salts” and returning to the game, heck I was one of those.  As they and me have aged things have changed, not just in research, Continue reading →

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No Boxing For Kids

30 Aug

The American Academy of Pediatrics and the Canadian counterpart (Canadian Pediatric Society) have urged parents to keep kids out of the ring or sports that focus on head and face contact, like MMA;

“In boxing, children and youth are encouraged and rewarded for hitting the head. We’re saying, don’t put kids in a sport where hitting the head is condoned and encouraged,” said Dr. Claire LeBlanc, co-author of the new position statement and chair of the Canadian Paediatric Society’s Healthy Active Living and Sports Medicine Committee.

The new policy statement is published in the September issue of Pediatrics, and was released online Aug. 29.

The news was not met with fanfare everywhere, Continue reading →

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