Lightning Get Struck Twice

Last night the Tampa Bay Lightning took a one game to none lead over the number one seed Washington Capitals.  However in that game two players for the Lightning were removed with head injuries.  The most publicized and dramatic of the injuries was Simon Gagne as seen in the video below;

Gagne has had a concussion history beginning in 2002, but was pretty clear until 2007 when with the Flyers he missed 26 games; only to miss another 44 the following year with more concussion issues.  After Gagne’s head bounced off the ice like a basketball and he was clearly unconscious it would be easy to assume he sustained yet another concussion.

As if losing one of their wingers was not enough, Pavel Kubina was taken to the boards by Jason Chimera in a hit that should be Continue reading

NHL Secret Revealed

Ryan Miller of the Buffalo Sabres said, for public consumption and on the record, what we have known for a long time. The cover up of injuries and even playing though the serious injury of concussion is a major issue in the National Hockey League. On Thursday Miller, goaltender for the Sabres and of the US Hockey team these past Olympics, admitted that the injury that was listed as an “upper body injury” late in the season was in fact a concussion (SOURCE);

Miller told reporters there were four shots in a one-week span in late March that hit him in the head, with blasts by New Jersey’s Brian Rolstonon March 26 and by Toronto’s Dion Phaneuf on March 29 doing the most damage. However, Miller said it was the cumulative effect of the pucks’ impacts that forced him to sit out four games.

This is EXACTLY what is wrong with the NHL and injury reporting and something we have hammered the league about all season long in our concussion reports. That now makes 99
Continue reading

Edit: Matthew Gfeller Center Hosting Symposium

The National Sports Concussion Cooperative (NSCC) that was launched in March is meeting up as the Matthew Gfeller Cetner is hosting a symposium this upcoming weekend.  The NSCC is championed by;

These four entities have come together for the goal of reducing the incidence of sports-related concussions with the formation of a cooperative to bring interdisciplinary collaboration to concussion research and testing.

The National Sports Concussion Cooperative will hold its founding organizational meeting in Chapel Hill, North Carolina on May 2, 2011, to develop an agenda by which it will identify the most pressing concussion objectives in sports and set a course for assessing their significance through research and peer review. After the meeting, additional partners will be engaged to consider joining the collaborative effort and finalize the objectives for each stakeholder group.

The event this weekend, April 29 and 30, titled “Matthew Gfeller Sport-Related Neurotrauma Symposium”, will bring together “experts” within the field of research, clinical and equipment manufacturing to share their thoughts on the concussion issue.  The chair for the symposium is Jason Mihalik, Ph.D., any media requests for him should be directed to Patric Lane, (919) 962-8596,

The full press release is as follows; Continue reading

Canada Research Centre Getting NHL Alumni Help

The Rotman Research Institute at Baycrest in Toronto has worked a deal with the National Hockey League Alumni Association to investigate for a link to long-term brain damage.  The Globe and Mail’s James Mirtle took a quick look at what this could mean;

Did their playing careers cause long-term damage? Are they more at risk of developing symptoms such as dementia because of the blows to the head they suffered on the ice?

Using neurocognitive testing and advanced imaging techniques the hope is to discover a link (if it exists) to repeated head trauma and early dementia and other issues such as CTE;

“There are certainly some of our members that have early onset [of the disease]. Whether that’s just the typical aging process or they’re one of the population that this struck, we really don’t know.”

The alumni association hopes the study can help current and future players as well by letting the league know exactly what the risks involved are.

“If it does come out that it’s concussions [causing health issues] then I think the NHL would definitely act on it,” Napier said. “But we don’t know. Let’s just find out first and then you can take steps later.”

PBW and Tracy Yatsko In Action

This morning in the Morning Call, John L. Micek wrote about the concussion legislation in Pennsylvania and how the push is on to make it final.  While reading through it, at the very end our contributor and Project Brain Wave Advocate, Tracy Yatsko had some very clear and powerful words;

Tracy Yatsko, 23, a former basketball star at Tamaqua Area High School until a head injury ended her playing career in 2005, told a crowd in the Capitol rotunda that “this bill should not be about safety and politics. It should be about our safety and protection. We deserve action.”

Thanks Tracy!

Getting It Across

(Project Brain Wave) In June, the Newfoundland and Labrador Brain Injury Association, of which I am on the Board, is holding a symposium-type event to discuss brain injury, who it affects and how we think we can help people in the province. I have been asked to talk about my experiences, so now, I am writing and gathering ideas – from previous posts on this blog and from my mind – so that I can talk about my brain injury, my recovery and the struggles and opportunities that have come out of my experiences. I have named my talk: (Brain injury) Recovery experiences, challenges and new opportunities. Now it’s just a matter of putting this all together.

Before my brain injury I wasn’t a very confident speaker, but once I got going, my nervousness would disguise itself as confidence and I could ramble and bullshit my way through a lot. I have almost the opposite problem now; Now, my speech belies my confidence (this is unfortunately true in more situations than public speaking) and there’s a lot for me to talk about on this subject.

I am very excited about talking about this and I’ve got to make some decisions to keep the audience interested. Here’s the way I see it:
  1. Most people reading this blog are my friends and you may be interested to hear my thoughts because most of you knew me before I was injured and want to know how I feel now and what’s changed for me personally. I can’t thank you enough for your support during and since. Thanks so much everyone!
  2. You’re the audience for this blog, not for my talk in June. That talk is for people who — Continue reading

Almonte on 7-day DL

The Brewers have announced Erick Almonte has been put on the new 7-day disabled list with a concussion.  Almonte is the first Major League player to be placed on the DL specifically set up for concussions.  The Associated Press article states that he was hit with a thrown ball during batting practice.  Almonte complained of dizziness and had a welt above the eye.  This will be something to keep track of over the next several days.

“The Jet” Has Died

Joe “The Jet” Perry died at 84 in Tempe, Arizona.  Perry was the first black player for the San Fransisco 49ers and was the first football player to rush for back-to-back 1,000 yard seasons and was elected to the Hall of Fame in 1969.

Perry has been dealing with dementia for the past 10 years due to his career in football.  The official cause of death has not been announced, but his wife says he died due to complications from the progressive brain disease.

NHL Post Season Concussion Report #2

Throughout the year we have been chronicling concussions in the National Hockey League and now the sport is in the post season.  We will be noting any concussion we can find; that are both ACTUALLY listed and suspected.

There seemed to be a slow down on concussion is the playoffs over the past week.  That was not without trying from players, as Raffi Torres was just one amongst a lot of players that “laid the wood” this past week.  Now I must say that like Gary Bettman, I love the big hit, but I love the CLEAN big hit.  I am not, nor will I ever be a fan of a hit that deliberately targets the head, or is so vicious/blind sided that it causes a head injury.

A prime example is the picture above (via Puck Daddy at Yahoo! Sports) that Greg Wyshynski wrote about; Continue reading

Major Head Injury In The Minor Leagues

The Triple-A affiliate of the St. Louis Cardinals lost two outfielders on the same play.  Both Andrew Brown and Shane Robinson are recovering from a massive collision in the outfield.  In fact Brown may be released to play as soon as today from his concussion.  As for Robinson he will miss significant time due to facial fractures and hand fractures, along with, you guessed it a concussion.

The minor leagues follow the same guidelines as the MLB in terms of return to play, therefore Brown will have undergone the required steps necessary to return.


Adolescent Injury Research

Appearing in Clinical Pediatrics this past month a study that looked at the injuries sustained in football that were ending up in hospital emergency departments.  During the season a sobering 2,000 adolescents are treated in the ED’s every day, that is every day.  Meaning kids aged 6-17 playing football will end up in the ED at some point during their career.

As they looked at the overall visits; Dr. Lara McKenzie and the research team from Nationwide Children’s Hospital also broke down the injuries with sprains/strains and fractures consisting of 59% of the problems.  Of course they did look at concussions and found that 8,631 reports each year;

“Prevention and treatment of concussions are the focus of many discussions at every level of play – from the junior level all the way up to the National Football League. Our data shows that young athletes are at risk for concussions,” said Dr. McKenzie, also a faculty member at The Ohio State University College of Medicine. “Every day during football season, an average of fifty-seven 6 to 17 year olds are treated in U.S. emergency departments for football-related concussions. The potential long-term consequences of this type of injury make this an unacceptably high number.”

57 is a very eye-opening number to see in the ED’s, and with what we know now how many are going unreported?

NFL’er Explains Why He Cheated NP Tests

Matt Bowen former NFL safety from 2000-2006 contributes to the National Football Post and basically did a follow-up on the Alex Marvez story on athletes cheating the baseline tests to gain an advantage when they were actually concussed.  Bowen explains why he did what he did;

During my rookie season in St. Louis and my first year as a Packer in Green Bay I took the concussion test seriously. However, by my third season I started to see the nature of this business play out in front of me and what happened when you couldn’t dress and produce on Sunday.

Your roster spot became expendable and like most athletes who view themselves as “immortal,” I wasn’t going to let a simple concussion slow me down. So I screwed with my own test results to protect my spot in the lineup and on special teams.

Now Bowen, as a writer, has read of the long-term effects and is even dealing with some of the issues personally, he went on further to give insight to what he is thinking now; Continue reading

Matt Chaney: Concussion Testing

Matt Chaney is a former football player and even self-described “juicer” during his time in the game.  He used his first hand experience to write a book about steroids in football “Spiral of Denial: Muscle Doping in American Football“, and now has taken his focus on the concussion issue.  Chaney is what I like to call a “pseudo contributor” to The Concussion Blog, he has helped with finding many articles and topics on this blog.  Behind the scenes Matt is one of the most profound people to spark conversation, and has very “real” views on this issue; not to mention that Chaney is a very good journalist.  (This post is an excerpt preview for a pending analysis on Chaney’s Blog, ‘Brain Trauma Stalks Football Players, Dictates Impact Game Reform,’ which will include independent experts’ recommendations for constructive steps imperative to the sport’s survival at public schools and colleges.)

In his most recent post on his blog concerning concussions, Chaney takes a run at neruopsychological (NP) testing and the issues that he and others, including myself, have had with them.  As I told Matt and still believe; NP testing serves a vital role in the spectrum of concussions such as assessment, management and even some awareness regarding the injury.  The issue that I personally have is one of reliability and the “standard of practice”, each NP test can be done and analyzed differently.  How these tests are used is the biggest issue and Chaney says it in his style;

Current purveyors of the theory, led by Chris Nowinski and Dr. Robert Cantu of the Sports Legacy Institute, and NFL commissioner Roger Goodell—who funds the Nowinski nonprofit with $1 million—propose action reminiscent of the plug-in electric football game, with plastic players bumping across the vibrating surface, hooking at shoulders in ring dances.

And that’s only the beginning of hocus-pocus remedy for rampant head injury in American football.

While mysteries are daunting for the problem, like positive diagnosis of concussion, mere clinical intuition guides the varied protocols of diagnosis and judgment for when players are fit to compete again. No random clinical trial of legitimacy has been attempted.

“It is scary,” said Dr. Lester Mayers, concussion researcher of Pace University athletics, who joins experts like Dr. Bennet Omalu in sounding alarm over football’s touting concussion testing, which is parroted by media.

These critics warn football conducts dangerous “concussion management” based on incomplete research for assessing symptoms, and many brain-injured players are prematurely returning to contact, all ages, typically within days.

Chaney takes clear aim at ImPACT during the article; Continue reading

Knowing Is Half The (UPDATE)

UPDATE: Thanks to commenter @SpMedConcepts I should write that one test is just a piece to the puzzle.  And a comprehensive testing procedure that includes all of the available “baselines” and assessments should be used.  It becomes more difficult to cloud the picture with deception when using this approach.

Knowing about concussions is one thing, but knowing that players may take advantage of the system is another factor.  Like anything else in this world people will look to exploit weaknesses in systems to gain an advantage.  After all isn’t that the crux of competition and sports?  We have seen Irv Muchnick open up the dialogue on Ritalin as a possible way to “cheat the system” and now Alex Marvez of Fox Sports tells us the other, more obvious way to “cheat the system”;

Dr. Daniel Amen, who has treated current and former players for post-concussion symptoms, said some of his clients have confessed to fudging the initial baseline tests administered by NFL teams. By doing so, Amen said those players are seeking quicker clearance to return from any future head injuries they might suffer.

If the baseline tests are to be used to compare then why try hard and excel at them, only to have that first test hinder their return?  This is the common question that the professional and adolescent athletes are dealing with.  Even though baseline tests, be it neurocognitive computer based or hand written like the SCAT2 or the new NFL test, are objective Continue reading

What To Feed A Concussion

During a concussion not only is the brain experiencing a cascade of events causing the injury, but also a metabolic crisis.  Not only does blood flow become compromised but the influx of calcium and quick “ejection” of potassium makes the blood energy system chaotic.  There has always been the question; can we “feed” the injury to help with this issues occurring?  Previous research has mentioned the use of Omega-3’s, DHA, and EPA to help with inflammation.  We have even had a commenter suggest the use of creatine to help with (see comment section of the previous link), and because I had not really done research, other than his post, I was unsure.  Perhaps we are now becoming less unsure of creatine and the role nutrition plays with management of concussions.

The Globe and Mail (fast becoming a go-to source) and Ann Mehler Paperny published a story about another US Military research project, this time dealing with “feeding a concussion”;

A team of U.S. scientists has found that food can play a vital role in mitigating the damage done by traumatic brain injury – and that a speedy supply of specific nutrients can give hurting brain cells the energy and chemical cues they need to heal while preventing inflammation.

Of all the specific examples that were given in the article; creatine, protein, resveratrol (red grapes) and curcumin (turmeric), research into prophylactic use of them has yet to be studied.  What was known is that use of these nutrients very soon after Continue reading

Helmet Help For Soldiers

The United States Army and the Joint IED Defeat Organization funded a study looking into various military and football helmet pads and their attenuation of concussive forces.  Posted on R&D Magazine online the results were summed up this way;

Researchers at Lawrence Livermore National Laboratory (LLNL) have found that soldiers using military helmets one size larger and with thicker pads could reduce the severity of traumatic brain injury (TBI) from blunt and ballistic impacts.

This would be a low-cost solution/improvement on current technology.  The study did indicate that no material tested outperformed the current padding in the Advanced Combat Helmet (ACH); they looked at old military padding, two types of padding in NFL helmets and “padding used in other protective equipment”.

The researchers Willy Moss and Mike King say that these results can be used in current sports too; Continue reading

IHSA Clarifies Concussion Mechanism

The Illinois High School Association (IHSA) and its Board of Directors approved the new recommendation for return to play for athletes (high school only mind you).  Currently Illinois does not have legislation in place for concussions, but when the current HB200 gets mixed with SB150 the legislation will give the authority for policies to the IHSA.  In lieu of not having legislation the IHSA has taken the NFHS rule a bit further in determining when a “concussed” player can return to practice or activity, period;

The new Policy reads: “In cases when an athlete is not cleared to return to play the same day as he/she is removed from a contest following a possible head injury (i.e., concussion), the athlete shall not return to play or practice until the athlete is evaluated by and receives written clearance from a licensed health care provider to return to play.  

For the purposes of this policy, licensed health care providers consist of physicians licensed to practice medicine in all its branches in Illinois and certified athletic trainers working in conjunction with physicians licensed to practice medicine in all its branches in Illinois.”

A proactive step by the IHSA that should be applauded, and also a step in the right direction in defining who exactly can clear an athlete; MD/DO or ATC ONLY.  There are other “doctors” that would be competent in dealing with concussions (see neuropsychologists) and perhaps in the future the IHSA will expand the licensed health care providers to include them.  This clarifies a lot of questions that many, including myself had in this state.

Comprehensive NHL Concussion Study

A research study was released yesterday from the University of Calgary that took a look at reporting concussions.  This study was also helped along by the NHL, so we must acknowledge that, from The Globe and Mail;

One in five National Hockey League players who sustained a concussion during a shift in the regular season went back on the ice that same game, a study by the league and players association has found.

It also showed a significant number of those players who returned to the ice ended up missing more than 10 days of play afterwards because of concussion symptoms, which include headache, dizziness, nausea, blurred vision and sensitivity to light.

The results of the study were very obvious and dramatic and really highlighted the under-reporting that plagues all sports.  With this information we will now Continue reading

Congrats Alan Schwarz

Alan Schwarz of the New York Times is a Pulitzer Finalist for Public Service in Journalism.  We here at The Concussion Blog thank him for his work; his writing has been top-notch and ahead of the “game”.  Congrats Alan!!!

The New York TimesFor the work of Alan Schwarz in illuminating the peril of concussions in football and other sports, spurring a national discussion and a re-examination of helmets and of medical and coaching practices.

Raffi Torres

The Vancouver Canuck just finished his four-game suspension for this hit;

And upon his return to hockey in Game 3 of the opening round how does he go about his business?  Does he play the game with respect?  Does he respect other players?  Does he finally adhere to Rule 48?  Why don’t you take a look;

Some have said that Torres will get at least five games for his most recent hit, others have been baffled by how the NHL has been choosing to apply the rule.  It will be interesting to see how the league handles Torres, as now he is a repeat offender.

NHL Post Season Concussion Report #1

Throughout the year we have been chronicling concussions in the National Basketball Association and National Hockey League and now both sports are in the post season.  Obviously there have been more concussions in the NHL than the NBA but this time of year will lend itself to more “exposure” to the injuries sustained on the court or ice.  We will be noting those injuries that are both ACTUALLY listed and suspected.

The NHL on the other hand had 98 incidences of concussions or “concussion like symptoms”, so the chances of seeing these in the playoffs are pretty good.  In fact, based on the league stats we can expect to see one every game night (between all those playing).  However with the M.O. of the NHL finding all the concussions will be difficult; case-in-point Shaone Morrisonn of the Buffalo Sabres, I give you Exhibit 1;

The Sabres called up Persson from Portland on an emergency basis because Shaone Morrisonn has an upper-body injury. The Sabres are saying he is day to day but the injury is believed to be concussion-related after Morrisonn was crunched by Braydon Coburn during the third period of Game One.

Morrisonn was listed back in December with a concussion, this would be his second. Continue reading

NBA Post Season Concussion Report Week 1

Throughout the year we have been chronicling concussions in the National Basketball Association and National Hockey League and now both sports are in the post season.  Obviously there have been more concussions in the NHL than the NBA but this time of year will lend itself to more “exposure” to the injuries sustained on the court or ice.  We will be noting those injuries that are both ACTUALLY listed and suspected.

We only found/heard of 12 concussions in the NBA this past season so the rate of them in the playoffs should be extremely low.  I have my suspicions as we see the second season progress.  Case-in-point Indiana Pacer Tyler Hansbrough, I give you Exhibit A;

There has yet to be an official listing of “head/concussion” for Hansbrough as of late last night.  With that being said, it would be good to review the basic definition of a concussion; a disruption of normal brain function to include symptoms and signs, both overt and subtle.  Hansbrough appeared to be “out” on the floor, and was very “wobbly” on his feet in the tunnel; both obvious signs of head trauma to this observer.  Granted his symptoms could have resolved in that short period of time before he came back into the game, the portrayal in the media was that he was a “warrior” and able to play through the pain.  The exact cause of the stigma we are trying to change.  Tyler Hansbrough is our only NBA listing at this time.

ADD Drugs and Neurocognitive Testing

Irvin Muchnick written about a topic that is starting to become more evident in the “underground” of neurocognitive testing, the use of Ritalin and similar drugs in its class;

Here’s a story you may be hearing a lot more about in six months or six years: National Football Leaguers – followed by college, high school, and youth league football players – soon will be gaming corrupt Pittsburgh Steelers/World Wrestling Entertainment doctor Joseph Maroon’s “ImPACT” concussion management software system by taking the amphetamine-family drug Ritalin before being retested to assess their recovery from head injuries.

It is quite evident from my perspective that any drug that can help with focus and attention will help with attenuating symptoms of concussions, therefore helping a person on the neurocognitive testing.  If you have taken these tests you will know that mental sharpness is needed for an extended period of time; as the tests look for deficits over time, Ritalin and the likes would certainly help.

Muchnick, like myself and his source have the same “love-hate” relationship with neurocognitive testing (although he focuses on ImPACT); Continue reading

A Calling For Ease: Drew Fernandez’s Story

(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

Prince William County School District Setting Policy

After working with the Trenum’s since late last year I have taken a special interest in how Michelle and Gil have been doing.  Although they will never be the same, what they have been doing in their area has been nothing short of remarkable.  It feels good to me that parents like the Trenum’s have taken the initiative to help out, and are doing it in a manner that is professional and proactive.  After we ran that story Michelle got back with me with some thoughts and more specific information/wording in the school districts policy.

Thank you so much for all your help on this.  You really helped give Gil the information he needed to get the policy through.  The administration will now be working on the regulations and details.  Gil will stay on top of them to make sure all aspects are covered.  It was interesting in all the information the board received, the athletic trainers were credited the most as being the go to on this subject.  They were given ultimate authority over return to play which is good.  Although none of what passed would have made a difference in Austin’s case, once the final medical pathology study is released, we feel that it will keep the momentum on this issue to make changes.

Michelle and Gil not only sought information from people like me, but much smarter individuals; MD’s, PhD’s and the ilk.  With all that information she was willing to share the specific language the board is set to pass; Continue reading