Male vs. Female

On Tuesday the National Athletic Trainers’ Association held the Youth Sports Safety Summit in Washington, DC and an important research project was released examining the differences in symptoms being reported by male and female athletes.

The paper will be published in the January edition of Journal of Athletic Training but here are the highlights and take home message.  (By the way the author was R. Dawn Comstock of Ohio State University).

  • 2 year study
  • 800+ subjects
  • 9 different sports
  • Most frequent symptoms of headache/nausea in both male/female
  • Males more often reported fogginess, slowed down, amnesia and disorientation
  • Females more often reported sleep disturbances, balance issues, drowsiness and sensitivity (lights and sounds)

It is important to make sure the symptoms that females show more often are not overlooked or associated to other issues.  Gender-based differences is an issue that has not been researched fully, but this is a good beginning.  The more we can understand how the brains are reacting to the concussion, the better we can be at identifying it.

Seeing what conclusion Comstock has with this information will be interesting.

Leading By Example

Kevin Guskiewicz, department chair of the University of North Carolina’s Exercise and Sports Science program, is leading the nation in concussion research.  We have highlighted some of his work and quotes here on the blog, but the Daily Tarheel did a piece on him and his beginnings today.

“We’re a sport-crazy society, and I think that’s a good thing,” he said. “Just as exercise and sport scientists, we bear the responsibility to help improve the safety of sport.”

Guskiewicz has pioneered research with accelerometers in helmets as well as simple balance assessments to use as tools for diagnosing concussions.  What makes Guskiewicz a huge impact is his athletic training roots; his approach to keeping the balance between safety and the beauty of sports.  His experience with a former NFL player sparked his interest and keeps him going.

“After having a concussion in a game, he was driving and couldn’t find his way home, couldn’t have a conversation with his kids or his wife,” Guskiewicz said. “There was living proof in Merril Hoge that this was a problem.”

As the concussion problem gains attention you will certainly hear his name more and more, and his previous and ongoing research in the area warrants the publicity.

Thanks to Stephanie Willen Brown for the “heads up” on the story.

Philadelphia Story

Courtesy of Flickr, Labeled for Reuse

Philadelphia’s Daily.com posted a story about concussions and how they effect even the grade-school aged individuals.  The story begins with a tale from a father, who is a doctor, making a tough decision on pulling his son from football at a young age.

“Brian loved football, and I was really depressed to take this away from him,” said McDonough, KYW Radio’s medical editor. “I remember telling him, ‘When you’re 25, I’d rather have you say, ‘Dad I can’t stand you for not letting me play football,’ rather than having to feed you your breakfast from a straw.’ ”

The article also mentions legislation for concussions.  As we posted earlier today, there are only 10 states with them on the books.

High schools across the country take concussions very seriously. Washington, Connecticut, Massachusetts, New Mexico, Oklahoma, Oregon, Rhode Island, Texas and Virginia passed laws governing the handling of concussions among student-athletes. Legislation proposed in Pennsylvania is designed to enhance concussion management in youth sports and increase awareness among coaches, parents and players of what the sponsor, Rep. Tim Briggs, D-Montgomery, termed “the devastating, lifelong effects [concussions] can cause when not handled properly.”

An interesting point that Dr. Robert Cantu makes is that ImPACT and other neurocognitive tests should not be used as the be-all, end-all in determining if the individual is ready to return.  And he is EXACTLY correct.

“There is still a lot of ignorance out there when it comes to concussions, and the ImPACT test is not the answer,” Cantu said. “It doesn’t test vision and balance, and it doesn’t test agility. It’s very useful for a good assessment of cognitive awareness. But the ImPACT doesn’t eliminate the need for neurological assessment. Too many school systems that have it aren’t using it appropriately like a red-light, green-light option . . . It’s one tool in the tool box; it’s not the whole tool box.

The important take-home message from this article is simple in my estimation; have an athletic trainer, a plan and a tool box from which you can make informed and correct, albeit, tough decisions.  Changing a culture is not easy, but more and more people are starting to get the feeling something has to change.

Focus on Athletic Trainers

The first line of defense for concussions is athletic trainers, however not everyone knows or understands why that might be.  Chuck Finder does a great job explaining why in is Head in the Game series of articles for the Post-Gazette in Pittsburgh.

“The old story is, ‘We can’t afford to have one,’ ” said Mike Cordas, parroting some school districts’ explanations. He is a Harrisburg-area physician and chairman of the sports-medicine advisory committee to the Pennsylvania Interscholastic Athletic Association. “You can’t afford not to have one. That is your first line of defense.”

“There are 7.6 million kids playing high school sports in this country, and now less than 50 percent of those high schools have a certified athletic trainer on staff,” said Dawn Comstock, the principal investigator at the Center for Injury Research and Policy in Columbus, Ohio. Another survey last summer by the Scripps-Howard News Service placed the figure at nearly two of every three school districts nationally without such full-time help. Dr. Comstock added, “I think we’re letting those kids down.”

Dr. Cordas has this exactly right without an athletic trainer, especially if they would be available in your area, the risk and liability of not having one is greater than the cost of retaining one.

“The athletic trainer is the most important [medical professional] on that field,” continued Dr. Cordas, who also worked with Penn State football in years past. “He or she knows that athlete better than any physician; he or she sees them every day. The athletes confide in him or her; they trust them. The athletic trainer is the most indispensable part of the outfit.”

Read the entire story HERE.

Mailbag

In my effort to spread the word I frequent message boards and places I can help.  One such place is the Illinois High School Sports website.  After a discussion came up on concussions/head injury in basketball I gave advice and this website for resource, I unexpectedly got this in return;
 
Thanks for the information you have made available through IHSS. My teenage daughter fell and hit the back of her head last night and exhibits many of the signs of concussion. We took her to the ER and they did a head CT, no bleed on the brain. I would have had her back doing things much quicker had I not read the information on your site and the links in it. After reading the information, I called home and put her on a mental break, as any teenager she was ready to get back to normal, but still has a loss of memory and a strangeness to her.
She went from me probably letting her go back to cheerleading on Monday, to sitting until symptoms clear.

Thanks for spreading your knowledge.

Chris Gordon

 
 

NHL Concussion Report 12/6

This is the list of current players on the injured list for concussions or suspected head injuries (^=new);

  • Shaone Morrisonn, BUF^
  • Raitis Ivanans, CAL
  • Peter Mueller, COL
  • Kyle Cumiskey, COL
  • Matthew Lombardi, NAS
  • Bryce Salvador, NJ
  • Ian Laperriere, PHI
  • Kurt Sauer, PHX
  • David Perron, STL

The list of injured is clearing up a bit, that is GREAT news, however….I am starting to get a bit upset at the NHL and their so-called reporting of head injuries.  Take for example injuries like a broken cheek bone.  Don’t you think that a force great enough to break a facial bone would be sufficient to cause a concussion?  All the “undisclosed” and “upper-body” listings make this nearly impossible.

Commissioner Bettman, you must implore your teams and organization to take concussions seriously.  A good first step would be the full disclosure of the injuries and not hiding behind the sublime.  The rest of the hockey world will not take this pressing issue seriously until your league does so.

We have one confirmed new case, bringing the total to 36.  According to a group out of Canada the number is 33, however if we were to include the injuries that may also bring concussion, (i.e. broken jaws, broken facial bones, neck injuries and such), the number may be into the 40’s.

Rugby Starting To Take It Serious?

Courtesy of Rugby-Pioneers

A “man’s” game.  A game of violence with little to no protection.  A game prided on tradition and a bit of European stubbornness.  The game is rugby; with positions like props, hookers, flankers, and locks, who would expect anything but a bunch of strange individuals?

Of course, that is the perspective of the general American public, as rugby is not a popular sport on this side of the pond.  However, there is a common link with “our” favorite sport and rugby – concussions.  Although that is the tie that binds the two and all the fans, the approach about tackling this subject has been polar opposites.

While the NFL has made a bold move (and the correct move in my opinion) to address the issue with as much force as a James Harrison helmet-to-helmet hit, rugby and its international sanctioning body has merely tried to put a band-aid on a hemorrhage.  Maybe window dressing would be a better description.

A quick search of what rugby has done for concussions seems on the surface to be a huge step, and more conservative than other sports, but when you really look at the effects of its suggestions, it makes the situation worse.  The rugby community has said that any player with a concussion must sit out three weeks.  Awesome, right?  No, because players will not report the problem since they will be forced to sit out that long.  Granted, that time would be sufficient for a majority of concussions in the sport, but with no compromise in the amount of time on the sidelines, it’s either you have a major problem, or no problem at all.  The issue with that, is every concussion is a major problem, not only for the individual, but for the sport.

Taking rugby to task about concussions, in the places where it is a major sport, has been limited until now.  The Irish Times has published a story about the growing concern in this sport, albeit a quiet groundswell.

IT HAS been described variously in recent times as a time bomb and the elephant in the room. The issue of concussion Continue reading

Eastern Illinois Article

Alex McNamee of the Daily Eastern News, the campus newspaper for Eastern Illinois University in Charleston, Illinois ran a story today about “Hank”.

Hank said he has no recollection of 12 hours before the concussion or the 12 hours after the hit during summer preseason training in August.

“You say weird things, act weird, then go to sleep,” Hank said.

But sleeping is difficult, as he lies in bed trying to count sheep but cannot get past the heartbeat in his head.

Hank is not his real name but the story chronicles his REAL story, a collegiate football player that had to end his playing career due to a concussion, or multiple concussions.

Hank said this semester of school has been by far the most difficult; however, he said a lot of the struggles might be because he has been recovering from two concussions most of the time.

“The hardest (semester) I’ve ever done and I’m taking some of the easiest classes. That’s pretty frustrating,” Hank said.

During his recovery, Hank said it was hard to concentrate on school as he was having splitting headaches all the time and not getting a lot of sleep. Continue reading

NFL Concussion Report Week 13

The Concussion Blog Original, NFL Concussion Report is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the list of players along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know.

Since training camp has opened there have been 115 total reported concussions. There were eight concussions reported prior to the regular season.  The regular season total is now 107, as Week 12 produced one of the lowest amounts of concussions this season.  New this week is the team breakdown, interestingly enough there are four teams that have yet to report a concussion.  I wonder if they are doing something different, in terms of equipment or preventative measures?  The following are regular season stats.

  • Incidence Rate = 14.35% (14.63% W12)
  • Epidemiological Incidence = 8.94% (9.11% W12)
  • Concussions per week = 8.9 (9.0 W12)
  • Concussions per game = .50 (.60 W12)
  • Projected Concussions = 152 (154 W12)

The following stats are for all 115 concussion;

  • Offensive Concussions = 56
  • Defensive Concussions = 59
  • QB = 8, RB = 10, TE = 12, WR = 18, OL = 8
  • DL = 12, LB = 14, DB = 33
  • By Team;
    • 8 – CAR & STL
    • 7 – PHI & OAK
    • 6 – PIT & CLE
    • 5 – BAL, DET, NO, SEA & WAS
    • 4 – ARI, JAX, KC & NYG
    • 3 – CHI, CIN, DAL, DEN, GB, IND & MIN
    • 2 – ATL, NE, NYJ, SF & TEN
    • 1 – HOU
    • 0 – BUF, MIA, SD & TB

Click on the rest of the story for the entire list… Continue reading

New Study Released

Children’s Hospital Boston and their Concussion Clinic just published a study about concussions.  They found that there were 136,000 sports related concussions in high school athletes during the 2008-2009 school year.  It appeared in the December issue of the Journal of Sports Medicine.  Here are some quick stats:

  • 76% came from contact with another player
    • 53% of those were head-to-head
  • Most common symptoms
    • Headache 94%
    • Dizziness 75%
    • Concentration 57%
    • Confusion 46%
  • 25% of concussed had amnesia
  • 5% reported loss of consciousness
  • 83% recovered in one week
    • 27% within 24 hours
  • 26% of the concussed were assessed with neuropsychological tests

LINK to story

A good start, but it needs to be known this is an extremely limited study.  Sure, a subject pool of 136,000 is good, but that is only those reported.  It has been our estimation that upwards of 70% of concussions are not reported or hidden by the athlete.  Remember, this injury is mainly a subjective injury.  We as professionals are RELYING upon teens to give us the truth, ha!

I think it is important to note the massive difference (statistically speaking) between amnesia and loss of consciousness.  The stigma was that you had to be KO’ed to be concussed, as we have said and now see with this study that is not the truth.

Colorado Public Radio

Eric Whitney of Colorado Public Radio did a quick spot about youth concussions.  It is very good and he spends a good amount of time talking to Karen McAvoy, a psychologist from Denver that has developed REAP.

Click HERE for the web link of the radio interview, and you can click on listen just above the football player picture.

I would like to thank the Brain Injury Association of Colorado for bringing this to our attention.

Exciting Beginnings and Unsafe Return

The football season is over in high school and will be completed soon in college and pro’s, however that does not mean the concussion risk is gone.  Yes, it will be reduced slightly, but awareness is continued and the importance of an athletic trainer is underscored more.  During the winter months we will spend time blogging about the life of an athletic trainer, what I do, and what we can do for schools.

New Center

As you may or may not know, I am employed by a hospital as an athletic trainer, and part of my duties include being outsourced to the high school I mention frequently.  The other part of my job is to serve the hospital in whatever fashion they think I can be of help.  Continue reading

Virtual Biopsy

Scientists have coined the title ‘Virtual Biopsy’ for a new and emerging MR technique for the brain.  At the annual Radiological Society of America meeting, evidence is being presented about detection of chemicals in the brain that may be precursors for CTE or general brain damage.

Five former players were scanned and had these chemicals show up on the MR scan, as opposed to the five not previously injured subjects that did not have the chemicals present in the same scan.

This is a promising beginning to more helpful techniques for assessing and showing a concussion.  Currently this is an invisible injury that comes along with a stigma because we cannot quantify it.

Read the AP story on the AOLHealth website.