Football draws as much attention lately for the knocks that players take as it does for their drives down the field. The emergence of research linking head collisions with behavioral and cognitive changes similar to those seen in Alzheimer’s patients puts the pummeling in a new context. Whether ramming opponents head-on or butting helmets, athletes may face the risk of long-term brain injury from hits accumulated over time.
Using the ever popular sport of football as the back drop, we get more information about the problems we have seen. But included in the article and what you can see online, if you are not a subscriber is an image of a football player and the hits he sustained over an entire season (yellow indicates force less than 80 G’s, red above 80 G’s and black is a concussion).
A very good article with more visual evidence. If you have not subscribed go and pick up a copy and read for your self. If you are a subscriber you can read on beyond what is at the link. Guskiewicz has this quote to end the “preview”
Guskiewicz envisions databases that track all the hits athletes take throughout their playing years to help explain neurologic changes later in life. But, he says, “it’ll probably be my grandchildren who are analyzing that data.”
Thank you to @ganglion11 (Jonathan Lifshitz, PhD) for directing us to NG….
The Concussion Blog likes to highlight people, places and things that are helping with the awareness, prevention, identification, management, and rehabilitation of concussions. I recently had a good Twitter conversation with @ganglion11, known as Jonathan Lifshitz, PhD, whose research and group was responsible for our most popular video, Fencing Response. I asked him to give me an idea of what he and his group is doing, he wrote below;
The University of Kentucky’s Spinal Cord and Brain Injury Research Center: A Homegrown, Basic Science and Translational Center Dedicated to Developing Novel Treatments for Traumatic Brain and Spinal Cord Injury
In 1999, the Spinal Cord and Brain Injury Research Center (SCoBIRC; http://www.mc.uky.edu/scobirc/) was established at the University of Kentucky College of Medicine to promote individual and collaborative research on injuries to the spinal cord and brain that result in paralysis or other loss of neurologic function. The long-term goal of SCoBIRC is to find treatments for spinal cord and brain injury that are more effective in achieving functional repair of the injured central nervous system. The combination of brain and spinal cord injury investigation sets SCoBIRC apart from its contemporaries.
The creation of SCoBIRC was a direct result of the 1994 state legislation, which established the Kentucky Spinal Cord and Brain Injury Research Trust (KSCHIRT). KSCHIRT is funded annually by the surcharges on moving violations, violating the mandatory seat belt law and driving under the influence. Competitive research grants from KSCHIRT compensate for the disproportionate allocation of federal research funds towards other less prevalent major diseases. Continue reading →
When Mikaela McGuire’s post-concussion symptoms were at their worst, the normally bubbly 16-year-old would cry herself to sleep.
If the piercing headaches, sensitivity to light, drastic memory loss and uncharacteristic mood swings weren’t bad enough, there were times she would sit and stare blankly at her homework.
Her brain – her memory – betraying the honor student so completely she would crawl into bed, her eyes welled with tears, craving sleep.
“I wouldn’t tell anyone, but that’s how frustrated I’d get with myself,” McGuire said, more than 12 weeks after the Nauset Regional High School sophomore sustained her fourth concussion – this one from taking a close-range shot off her temple during soccer practice.
“It’d just be me, sitting there, trying to finish my homework at night thinking, ‘I can’t do this. What’s wrong with me?’”
A very dramatic and sobering set of facts that people are now just coming to grips with. There are many kids out there dealing with the same set of issues that are either ignoring them or not understanding why this may be occurring. Granted the time in our lives Continue reading →
While all the focus is on football there are other sports that have the ability to create the injury we know as a concussion. In fact all of them can but one sport in particular may be lurking in the shadows, basketball. It arguably has some of the highest participation levels in all of sport, from the multi-million dollar professional, to the high school level, to pre-K participation and even the rec-league pick up game at your local court or church. It is most definitely time to look at the sport of basketball.
Basketball does have its inherent risks associated with head injury; flying elbows, knocking heads and even making contact with the floor. On Thursday Jeremiah Rivers of Indiana University was led into a screen while playing defense and his head made contact with Mike Tisdale of the University of Illinois, causing Rivers to double over and remain stunned for a short time. That would be an obvious situation where your head would be in danger on the hardwood. The not so obvious is the surface they play on, typically a neatly painted (Oregon not withstanding) shiny court made of hard wood. Let us examine a specific example of how the hardwood could cause a problem.
Demitri McCamey is perhaps the best and most talented player on the University of Illinois basketball team, he is averaging the most minutes (33.2) and most points (15.1) per game. Continue reading →
A occassional contributor to The Concussion Blog, Matt Chaney, a journalist, editor, teacher and publisher, also has a blog. However, Chaney has published a book titled Spiral of Denial; Muscle Doping in American Football, so he is not new to finding and presenting good information.
Sideline concussed juveniles for three months, says breakthrough neuropath NP testing, lacks validation and might be harmful, critics charge NFL players rebuke ‘safer’ football through their ‘behavior modification’
By Matt Chaney
Posted Friday, January 28, 2011
So-called concussion awareness is said to be sweeping American football, and Scott Fujita, veteran NFL linebacker, agrees to a point.
Yes, Fujita confirms, even hard dudes like him have sobered in their perspective. Head injuries are no longer considered trivial in football but as serious business, and NFL players get it, especially
Fujita, nearing 32 years old at arguably the game’s most violent position for Cleveland.
In his mind the most menacing guys don’t appear so tough anymore, just more human, fragile—even as he targets one to smash on the field.
“I gotta be honest, I think about that every time I go in now to tackle somebody,” Fujita, 6-foot-5 and 250 pounds, said this week in a phone interview. “I’m concerned for my own safety as well as
theirs. I’m a married guy, I’ve got two young kids, and I see a lot more the big picture than I ever did before.”
But has anything changed about danger in tackle football, the game that kills and maims? Is so-called safer play really taking over?
Fujita, member of the players union executive committee, doesn’t equivocate in answering, typical of his trademark frankness. “Do I feel safer with the emphasis on the rules and all that kind of stuff?
No, that doesn’t make me feel safer,” Fujita said. “Do I think the emphasis makes the game safer? No. Overall, I don’t, know.”
How about never? How about retirement as an option? Anybody thinking in those terms?
Those questions are huge and important questions to be asked of Savard. Hockey is a ruthless sport at times and the head is exposed to a lot of danger. At the very least, perhaps Savard should do what Crosby was thinking of doing, sitting out until the NHL decides to get up to speed with the IIHF, and ban hits to the head, period. The unlucky thing for Savard was that the hit that caused his most recent concussion was clean and within the rules. This is something Taylor Twellman knows a lot about.
“It’s the hardest thing,’’ says Twellman. “It’s really a sickness. I’ve heard people say, ‘Aw, it’s only a concussion. Why is he out there crying?’ He’s crying because of fear. He’s scared out of his mind. He felt bad for so long and the symptoms are back.
“When it comes to feeling better or playing, you are behind the 8-ball. Finally, I said, ‘Screw playing, I just want to feel better.’
“We all hope Savard heals quickly. The longer the symptoms go on, I would tell him, ‘Be smart about it. It definitely impacts your life after sports.’
“We see those NFL players. You’ve got to be smart. You can’t replace the brain.’’
Savard is 33 years old. He has three small children. He stands to make $28 million over seven years (a pact signed in December 2009), and he’s going to get that even if he can’t ever play again. Why take a chance on another concussion?
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.
We have spoke about neurocognitive testing on here, even highlighting some of the tests like Concussion Vital Signs and Axon Sports. But the test/technology really has been thrust forward by the ImPACT program. It is of my opinion that each test provides unique advantages, what is key to remember is that these are “tools” that health care providers (athletic trainers) can use to identify both the severity and lasting effects of the injury. To help explain it a bit further is an article from mysuburbanlife.com.
Bednerek is excited to have the software as another tool. She estimated that Glenbard West has given 300 to 400 baseline tests and five to 10 post-injury tests.
Perhaps, the greatest benefit it she no longer has to rely on the word of an athlete, who often will say anything to get back on the field or court.
“Even now, so many kids lie to you so they can come back and they say ‘I’m fine, I’m fine’ and that they don’t have headaches or anything,” said Bednarek. “But then they take the test and their reaction time is slower and their memory is slower. The test really gives you a more concrete answer to when a kid can return.”
The common theme amongst all the different tests is to find out how the cerebral function of the brain is handling the insult/trauma. These tests can measure core functions like visual and verbal memory but they also go deeper into brain function and assessing reaction time and deeper level memory. As the article states and I want to make perfectly clear, this is not a “golden bullet” in determining severity or return to play status, but it sure is handy to have a good tool to assess where they person is at a given time.
If you are interested in using these tools you should “shop” around and find what product will suit you the best; both in terms of time/usage and cost. We will continue to run stories and highlight the products as the get passed along to us.
This is a GREAT video blog and investigation of the Jay Cutler injury. Roy of sportsfansnetwork does make a good case for Cutler’s toughness, and even gives relevance to the “hypothetical” situation we posted about. Take a look at his footwork after where Roy says the injury occurred.
It is called the “360” and it has seen the field. In the National Championship Game, Oregon Duck running back LaMicheal James donned this for its debut. Brittany Sauser of Technology Review, published by MIT, wrote about the helmet today.
Riddell, the official equipment manufacturer of the NFL, has released a new type of helmet designed to help reduce concussions. The Riddell 360 reduces the force of impact to the front of a player’s head, where 70 percent of hits occur, says Thad Ide, Riddell’s senior vice president of research and development. Ide adds that 70 percent of concussions result from hits to the front of the helmet.
Riddell has gathered statistics on head injuries using its own HIT technology, a system that employs sensor-equipped helmets to measure the location, magnitude, and direction of hits experienced during a game or practice.
A lot has been made of the helmets being worn on the field, and they were tracked here on this blog. As the number one producer of helmets for the sport of football, Riddell is doing its best to bring to market the best possible solution. As we all know and the article states no helmet will prevent concussions from occurring; Continue reading →
The football season is in its waning phases, 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.
Recently I sent out a tweet about wrestling and that I have “issues” with injury time. I love wrestling, no it’s not the WWE version, it is Folk Style, and the pure athleticism that is needed for this is amazing. Not only must you defeat your opponent but you must defeat yourself doubts, a great sport. The issue I have is the limited time you have to assess an injury. If you think something like football is demanding to make a judgement, try this on for size… You get a minute and a half, 90 seconds, to determine what is wrong and if they can continue. Not only that you must apply any bracing/taping in that 90 seconds. For most injuries like a knee, ankle, or elbow that can be done, but with a concussion NOT A CHANCE. In this sport you get 5 minutes of “blood time”, to stop and bandage any blood, but for injuries you get 90 seconds. Oh, I failed to mention, that time is not for each incidence, but rather cumulative for the entire match, and with injuries you can only stop twice the third constitutes a DQ.
I completely understand the nature and spirit of the rule, they do not want wrestlers taking advantage of stoppages in the match as conditioning is a HUGE part of the sport. And as I mentioned with most injuries it’s not an issue, but the concussion is troublesome. The easy answer is to just remove the wrestler if he hits his head hard enough to produce symptoms, dully noted and done on my part. However, what do you do with the individual Continue reading →
Interesting little-known factoid I got from my postgame conversation with Aaron Rodgers: After being twice-concussed this season, he changed helmets to one of the new, safer, high-tech models the league has been urging players to use.
In a related article, Shawn Doherty of the Capital Times in Madison, Wisconsin wrote about the “silence” of the possible head injury to Rodgers on Sunday.
Fink says he would have been “shocked” if Packers staff had hauled Rogers off the field after that smack. And given how tough Rodgers is, he probably was determined to scramble back up to his feet no matter what it took. “If he gets up quickly, even if he does have some symptoms, they can quietly test him for a concussion later,” Fink says. “But they almost always will tell you everything is fine. There’s a lot riding on this game.”
Yup I am a conspiracy theorist at heart. What people didn’t see is that Pepper Burruss was on his way to the aid of Rodgers at the time of the hit and was waved off by Rodgers. I am convinced that what they did was right, and they are very good at what they do.
Crosby played one game after getting knocked silly in the Winter Classic; his injury was then termed a “mild concussion,” and the team announced that he would miss about a week of action. “This is exactly what the NHL did NOT need,” Concussion Blog’s Dustin Fink wrote on Jan. 7, “a superstar pushing through and hiding his injury.” In a post on Monday, Fink extended his point, arguing that Crosby “handled this concussion like most ‘bravado’ men do, as if it was nothing. It is time for Crosby to take some responsibility for his actions.”
I am really happy about the awareness of the issues, and honored that this website is making a difference.
There was no hotter topic across the nation yesterday than Jay Cutler, particularly here in Illinois. A lot was made of a very simple issue, and it didn’t take an MRI to figure it out, it took an athletic trainer.
The simple fact is that football players, by definition, are warriors and would give anything to play the game. We see that with the concussion issue. And even though this injury was not a concussion, it was an injury and the athletic trainer and medical staff did the best they could to allow Cutler to play. Forget for a moment your fandom, remove your emotions, and understand what in all likelihood occurred at Solider Field this past Sunday.
BELOW IS AN EDUCATED GUESS AS TO WHAT HAPPENED, this is to better clarify what we do as professionals… I hope that I am certainly not “assassinating” anyone’s character.
Cutler most likely reported to the athletic trainer that he hurt his knee, at which point an interview was conducted and very little was done at the time. The fact that he was upright and not in obvious distress warranted the staff to look closely at him during play. After they noticed that he was not performing up to par, they most likely went to a sideline evaluation, which occurred just prior to halftime. During that evaluation the athletic trainer tested the stability of the knee ligaments (four major), ACL, MCL, PCL, LCL and if the evaluation was thorough, it would have included a screen for a meniscus issue as well.
After that initial evaluation, it warranted the staff to take Cutler to the locker room early, most likely for a more in-depth evaluation, in a “relaxed” setting, as well as allowing the doctors to do the same tests as the athletic trainer. What was most likely found on the Continue reading →
This is a PRIME example of the hits that must be harshly dealt with in the NFL. Using the crown of the helmet to initiate contact is dangerous to the hitter, but going to the head is very dangerous for the hittee… Amazing that we have not heard about Rodgers today.
Each week we scour the web to find concussions in the National Hockey League. We will keep a running tally on that information as the season progresses. However, it is not easy as the NHL has decided that listing injuries as “upper body” or “undisclosed” is a good indicator of actual injuries occurred. Our list is believed to be as accurate as possible, even including injuries that have vague listings but through reports and video analysis should be classified as concussions.
At the end of the Winter Board Meeting, some things were left undecided, but one area that was bandied about was the “audit” of helmet manufacturers and their testing. Well, NOCSAE has reacted quickly with a press release about that subject:
OVERLAND PARK, KANSAS, January 24, 2011 – The National Operating Committee on Standards for Athletic Equipment (NOCSAE) recently required football helmet manufacturers to submit all certification test data, quality control and sample selection documentation for all football helmets manufactured or sold within the past 10 years. All football helmet manufacturers have complied with the request. NOCSAE is an independent and nonprofit standard-setting body with the sole mission to enhance athletic safety through scientific research and the creation of performance standards for protective equipment.
“NOCSAE made this request as part of our ongoing effort to evaluate all aspects of the football helmet standard and evaluate potential changes to the standards relating to lower level impacts,” said Mike Oliver, NOCSAE executive director. “We are the only organization that brings together key areas of expertise to work together on behalf of athletes. Through our process, physicians, academic researchers, coaches, athletic trainers and manufacturers come together to establish standards that are designed to provide the maximum amount of protection to the athlete. In addition to our request for data, Continue reading →
Ben McGrath of the New Yorker has published a story that is appearing online and in print that takes a long look at the concussion issue at hand, most poignantly in the sport of football. I spent a good amount of time with Ben on the phone and the staff of the New Yorker helping create this piece.
McGrath writes about the sport which he has become fond of, where it began for him, and where this issue with head trauma has been and is going:
The crisis surrounding football’s brutality at the turn of the twentieth century was so great that it eventually inspired Presidential intervention. Greg Aiello, the N.F.L.’s present-day spokesman, told me, “You should research Teddy Roosevelt’s involvement in changing the game in 1905.” Roosevelt, whose son was then a freshman football player at Harvard, summoned college coaches to the White House to discuss reforming the sport before public opinion turned too far against it. Eighteen people had died on the field that year. The idea, or hope, was to preserve the game’s essential character-building physicality (“I’ve got no sympathy whatever with the overwrought sentimentality that would keep a young man in cotton-wool,” Roosevelt wrote) without filling up the morgue.
Sidney Crosby will not play in the NHL All-Star Game in Carolina next weekend due to a concussion he is recovering from. Crosby, the Penguins, and his agent have been dancing around this issue, mainly because he is the biggest draw in the sport. Without him, the hype will not be the same.
Initially, it was thought Crosby would be sitting out as a form of protest over the head shots in the NHL. What is becoming more clear is that his recovery from the injury is going slower than anyone wanted it to. From behind this keyboard, I would venture to guess that the delayed recovery can be directly tied to him continuing to play not only in that game, but the next as well.
Crosby can be mad about the head shots, however he needs to look in the mirror a bit too. He handled this concussion like most “bravado” men do, as if it was nothing. It is time for Crosby to take some responsibility for his actions also.
Bill Cody was a standout linebacker for the Auburn Tigers in the season of 1964, now 66 and after years of service in the National Football League, “Wild” Bill has fond memories and NO memories of times spent on the gridiron;
During a 1964 game in Gainesville, Fla., Cody too a particularly hard hit and headed to the bench.
The only problem was that he went to the Florida sideline.
“I don’t know how I got knocked silly, but I actually went over and sat down on their bench,” said Cody, who had suffered a concussion. “Kenny Howard, the old trainer at Auburn, he came over and got me. I don’t remember this, but they told me that’s what happened.”
His memory lapse does not end with that game, rather it is just beginning to manifest itself in his life now, and he truly and deeply believes that it is due to his multiple concussions in the game;
“My wife over the period of the last 3 or 4 years has said, ‘You don’t ever listen’ or ‘why didn’t you do what I told you,'” Cody said. “All wives say those things, but I don’t remember her telling me that. That’s become more frequent. If she told me something yesterday, I might or might not remember.
“It is just frustrating that you just did something yesterday or the day before and you can’t remember what you did. You know you did something. Two or three days later it might all of a sudden just hit you.”
The al.com article not only highlights the concussion issue but it also drives home the need of former players to get assistance from the league with continual health issues. Dainel Boyette of the Press-Register concluded his article by stating that Cody tells him he does not suffer from other issues related to long-term effects of the multiple head injuries, and in fact remains very active.
As we mentioned going into the Winter Board Meetings of NOCSAE, renowned reporter on head injuries, Alan Schwarz of the New York Times, was in attendance. Yesterday we posted parts of the press release from Arizona, in this article Schwarz dives deeper, and using his incredible knowledge about this issue went much deeper than a presser;
“We ultimately came to the conclusion that yes, it would be desirable to look and study and try to understand if we can come up with a meaningful youth football helmet standard,” said Cantu, a clinical professor of neurosurgery at Boston University. He added that a lower-force standard (which Nocsae requires for lacrosse helmets) and tests for more complex rotational forces would be pursued, but said, “The science that tells us where we should set it is not available today.”
Cantu was followed by David Halstead, Nocsae’s technical director and top expert on helmet physics, who theorized that football concussions derived from forces too numerous and complex for helmets to protect against them any better than they currently do. He said that testing helmets against rotational forces “will not lead to a reduction” in concussions, adding, “We’ve got a lot of information, but we don’t know what to do next.”
Marc Savard of the Boston Bruins who began the season on the NHL injury list due to post-concussion syndrome was released to play after 2 months into the season. However the last two games have been a test to his recovery as he was hit at Buffalo on Thursday and again in Denver yesterday. Neither hit was reported as afoul of the rules, never-the-less Savard is not going to the West Coast rather back to Boston for a re-evaluation.
Instead, Savard will remain in Denver tonight and fly home to Boston tomorrow to be re-evaluated. Claude Julien said Savard was not showing any concussion-related symptoms after he was belted by Matt Hunwick in the second period.”He seemed fine when I talked to him,” Julien said. “So we’re hoping it’s all minor.”
At 3:19 of the second period, after dishing the puck to Michael Ryder, Savard absorbed his second head shot in the last week. Julien said it was a clean check by Hunwick…
With the NOCSAE Winter meeting over the news is that they are awarding $610,000 in grants to study concussions and creating a new advisory board to drive research in this area.
During the winter board meeting, NOCSAE approved a new research grant of nearly $340,000 to study concussion biomechanics and awarded a second year of funding for the following:
Can Anthropometric Measurements Explain Gender Differences in Concussion Rates Among High School Basketball, Soccer and Lacrosse Players? R. Dawn Comstock, PhD, Assistant Professor Center for Injury Research and Policy
The effect of sport-related concussion on cognition, balance, symptoms and health-related quality of life in adolescent athletes. Tamara C. Valovich McLeod, Ph.D., ATC, Associate Professor, Athletic Training
Genetic risk factors for concussion, concussion severity, and neurocognitive recovery from concussion in college football and soccer players. Tom Terrell, M.D.
More information on the 2011 grant recipients can be found on the NOCSAE website in the coming weeks.
As an extension of the Multidisciplinary Concussion Task Force, NOCSAE created the new Scientific Advisory Panel chaired by Dr. Robert Cantu, Continue reading →
It is important to note that this device is a good TOOL for medical staff’s to use. There is no way this can detect if there is an actual concussion, but having the ability to see, in real time, that there was a force great enough to possibly disrupt brain function is an exciting development. This device is also cost-effective compared to current models out there.
We will continue to follow this development. Remember this is a tool!