Month: May 2011

NHL Post Season Concussion Report #5

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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.

And then there were four; San Jose, Vancouver, Boston and Tampa Bay.  And then there were 13; post-season concussions that is.

During Game 7 of the SJ/DET series two RedWings sustained a concussion; Danny Cleary and Todd Bertuzzi.  Our most recent listings bringing into question did any other eliminated team have concussions that were not listed?

We should give credit to the RedWings medical staff for holding out very important players in a Game 7, something that I feel confident would not have happened a few years back.  Following concussions from this point forward should be a lot easier with the attention put on the game, however we can always use help.

The overall total concussion number for the 2010-2011 year stands at 111.

McKee: Unpopular Changes Needed In Football

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Dr. Ann McKee of Boston University was at a one day symposium about brain injuries discussing the effects of repetitive injuries to the head.  Dr. McKee has been on the forefront of the chronic traumatic encephalopathy (CTE) research has information that has changed her perception of the sport of football in particular (via Chicago Sun Times and Tim Cronin).

“It’s scary because we know so many people it’s affecting,” said McKee, a doctor of pathology at Boston University and the keynote speaker at Advocate Christ Medical Center’s one-day symposium on brain injuries. “You see so many individuals in the prime of life, both in the military and former athletes, people who are our heroes, struggling with life.”

Over a ten-year career she surmises that a linebacker may sustain 15,000 sub-concussive hits; those hits that do affect the brain but do not produce instant symptoms consistent with a concussion.  That is fifteen THOUSAND hits, hits that are similar to a low-speed vehicle accident.  The forces being produced are doing some damage in the brain, and the collective damage is causing problems that linger later into life; such as CTE and ALS (Lou Gehrig’s Disease).  To completely discount a “professor/doctor” because they don’t know sports would be wrong in Dr. McKee’s case; Continue reading →

No Such Thing As A “Mild” Concussion

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Hogwash!  There is NOTHING mild about a concussion, period.  However media, teams, players and even medical staffs continue to use this nomenclature with this injury.  It is simply counterproductive to label this injury with a “mild” tag, and hampers the effort of everyone trying to increase awareness.

Granted, those that have extensive training in the area of injuries, and particularly head injuries, understand the term “mild” when it is in concert with concussion.  This subset of the population is not the one that needs the education, rather it is the general public, which includes players, coaches and parents.  A common problem amongst people who are educated in a particular field is that they forget about both who they are servicing and the education level of people other than their peers.  It’s a fine balance to educate without talking down to others, but understanding the stigmas of the topics help with that effort.

One serious stigma is the “mild” tag that is placed on concussions.  Those that watch and participate in sports are so used to using that clarification when assessing and addressing injuries as a whole, that perhaps it carries over to the traumatic brain injury just sustained by the athlete.  We as athletic trainers and doctors need to reassess how we describe this particular injury.

During my public speaking I often relate being “mildly” concussed to being “mildly” pregnant…  You are either concussed or not, just like you are pregnant or not.

Some may say that “the symptoms are mild”, or that the Continue reading →

Footy Concussion Report Round 8

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The Concussion Blog is now tracking the concussions of another collision sport, one with very good media coverage, albeit not in North America.  Aussie Rules Football and its professional league AFL have had an issue with concussion in the past and as we have seen on videos here, they can be scary.  With the help of Sportal we will be compiling the concussions on a weekly basis.

It has been about 5 weeks since we updated this list; reason being one could not find any information on concussions in the AFL.  Personally speaking, while watching the games there have been multiple incidences of players being taken off the field, or staggering around after a hit; yet no concussion report.

In fact, after I sent out multiple emails down under for some help in finding this information; the “Superfooty” coverage of injuries changed.  Continue reading →

Mailbag: Response/Comment

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I know we have talked about Michelle Trenum before, in fact she has been a very good sounding board for us here at TCB.  When we posted the Mailbag yesterday she had a thoughtful response and very intuitive words for everyone to see.  She even said it was OK to share with everyone.  So here is the email in full;

I really think what you are doing is so important…I only wish more people knew the information before they needed it instead of reading about it afterwards.

In today’s posting there was a mention of seeing yellow.   Austin and my other son would come home from football practice each day and tell me their “war stories” of particularly difficult or funny things that had happened at that day’s practices.  I enjoyed hearing about the practical jokes; about who was got put in their place by the coach that day; and who made everyone laugh.  They would also update me on particularly hard hits or injuries.  One day Austin told me about being hit so hard by our 300 lb lineman that he passed out for a moment then woke up and everything looked yellow.  He described it like he was looking through a jar of pee.  The mom in me freaked out when he said he’d passed out and he said “it is no big deal, I’m fine, I probably just got the breath knocked out of me because REDACTED is so big and he was on top of me, I don’t think I was really passed out….mom, stop freaking out, I’m fine”.  The possibility of a concussion was never on my radar.  I did mention the story after Continue reading →

Dr. Gioa Talking Concussions

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Dr. Gerard Gioia (Ph.D in Pediatric Neuropsychologist Chief, Division of Pediatric Neuropsychology and Safe Concussion Outcome, SCORE Program at Children’s National Medical Center) discusses the risks and preventative measures for sport related concussion for youth.  He interviews Steve Young, a well-known professional football player that had multiple concussions and even ended his career.  This is part of the SafeKidsUSA Network.

TCB’s Research Backs Up Va Tech Information

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Virginia Tech just released information about a “low rated” helmet on the field in the NFL, the Riddell VSR4;

Riddell’s VSR-4 helmet received just one star in a study of football helmets led by Virginia Tech professor of biomedical engineering Stefan Duma and released Tuesday. Another Riddell model — the Revolution Speed — was the only helmet that earned five stars, the top rating.

Five models — two made by Riddell, two by Schutt and one by Xenith — received four stars.

According to Riddell’s stats 40% of the players wore this helmet in 2010.  In our exclusive research we found on a random sample that 32.41% of players were wearing the helmet.  And that 71% of all helmets on the field were Riddell’s (75% reported by NFL and 77% reported by Riddell).

Our stats found that of all the counted concussions last year (with a helmet ID) 64% of all concussions were in Riddell helmets, 34% in Schutt and 2% in Xenith.  We further broke down the concussion based on actual models of the helmets and found a staggering number, Continue reading →

CFL and Football Canada Team Up

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The Canadian Football League has been very progressive with concussion awareness, in fact it would be factual to say the CFL has been the most progressive in North America in the sport of football.  The eight-team league instituted a standardized sideline test for concussions last year, the SCAT2; and this year they will use tracking software for concussions.  Not unlike the CDC in the States, the CFL and its partners will be distributing educational information via flyers and handouts.  Thanks to SportMed BC we were given the story;

The goal is to educate players and coaches at all levels and dispel any remnants of the old-school gridiron habits where players made premature returns to the field.

“I think that culture has shifted,” CFL commissioner Mark Cohon said Tuesday. “I think that concept has shifted and these guys want to live long and healthy lives. And part of that is managing concussions.”

Other partners include; Continue reading →

TCB Mailbag: The Weekend Warrior

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It is a good thing to get questions in the inbox; more people wanting to find out more information about concussions.  That being said, as I state in the replies, a medical doctor should be the one to go to with problems with head injuries.  Use that as a base to all the “information and advice” that follows.  We will run the mailbag as a main theme presents itself; this edition will be about “The Weekend Warrior” or non-sanctioned athlete.  If you have questions and want them addressed in my professional, and sometimes comedic, opinion send it TO US.

We will begin with “T-Money”:

So I am playing some beer league softball and roving the outfield like Jim Edmonds in the early 00’s.  A ball is hit to the gap and I take off like a bullet and as the ball approaches the ground I dive and make the grab, well I guess I did.  I do not actually recall making the grab only opening my eyes and seeing the ball in the glove and everything was yellow.  Not a sunny yellow but the yellow of a softball.  I thought it was just because I was looking at the ball, but it was a night game and after I threw the ball to a teammate from my bum I tried to stand up.  And couldn’t, not that I was dizzy, but just didn’t have the power and the yellowness of my vision was very perplexing.  I figure I just got dinged a bit, what are your thoughts, and I did catch the ball!  By the way the yellowness went away after about five minutes.

Nice catch man, hope it was worth it!  This “ding” you are describing is a concussion; altered brain function.  You have described vision impairment (was the yellow like those cool Oakley’s?), memory impairment with a lapse in time, and unable to get up immediately, some motor impairment.  It sounds like you got home OK, but you best bet would be to lay low for a couple of days and let the symptoms die down.  If you are already taking fish oil, bump up your dosage for about a week and monitor your symptoms.  Seek a doctor that has experience in concussions with worsening symptoms, and head to the ER if symptoms become very worrisome.

==========

Greg: Continue reading →

NHL Post Season Concussion Report #4 UPDATE

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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.

UPDATE: Thanks to @ewheeler1976 Patrice Bergeron was a concussion actually listed, well it wasn’t until today that it changed from a “upper body injury” to “mild concussion”.  Have I mentioned what I think about “mild” concussions?  This brings the post season total to 11 known and a couple that are questionable.

There have been no “concussions” in the past week, not really surprising.  While searching for injury information and finding videos of players during the game while they were hurt I noticed something.  Any lower body injury and upper body injury not including the head was easy to find; even on NHL.com.  However, when looking for head injuries or suspected head injuries they were very difficult to find; usually need someone independent putting it on YouTube.  I just thought I would throw that out there…

This week there have been two suspicious listings first is Adam McQuaid with a “sprained neck”, Continue reading →

Welcome To The Profession

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About a month ago many candidates sat for the Board of Certification (BOC) exam to become an athletic trainer.  This national exam tested their knowledge about the five domains of the profession in a grueling format.  Four years of education and hundreds of hours of observation and internships led to this day for the candidates.

The test itself has changed over the years but one common theme has remained; difficulty.  Official statistics of the new format have not been published but observationally; athletic trainers have a pass rate on the first exam of about 40% another 40% remediate and take the exam again and eventually pass, while the remaining 20% are left with re-thinking their idea of a profession.

Currently the candidates sit for a four-hour test consisting of 175 questions that include multiple-choice options.  Once the testing window has closed for a period the exam is scored and those taking the test are notified “pass/fail” in about two weeks, with exact score being mailed in another two weeks.

The testing window has closed and the initial “pass/fail” has gone out for the 2011 candidates; for all of you who passed… Continue reading →

Generation Alzheimer’s

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In The Concussion Mailbag we received this from Diane Wright;

As you may have heard, there have been some amazing breakthroughs this past month in linking certain genes to Alzheimer’s, but there is still a lot of work to be done. This year, the first of the Boomer Generation turns 65. To bring urgently-needed attention to the risk facing the Boomers, Alzheimer’s Association released a groundbreaking study, Generation Alzheimer’s: The Defining Disease of the Baby Boomers.    

I thought that you would be interested in sharing this important information with the readers of The Concussion Blog, so I’ve put together a microsite, with all sorts of information to help spread the word:

http://alz-news.org

I think it is very interesting micro-site and anyone who may be suffering from AD should take a look.

St. Michael’s Information

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The Vancouver Sun has this information regarding the previous press release.  A lot of the information is not “ground breaking” per se, rather just a confirmation of what most have been saying for a very long time;

Although symptoms of a concussion may not be immediate, researchers at St. Michael’s Hospital in Toronto have been able to show in rats that the affected portions of the brain continue to worsen as time passes during a “vulnerability phase.”

“We can see the actual neurons deteriorating for days and days afterwards,” Dr. Andrew Baker, the study’s head researcher said Wednesday. “It’s an ongoing problem and opens up the possibility that doctors can jump in there to stop it. This first step is to show we can show that it takes several days for the effects of a concussion to be visible.”

The “vulnerability phase” may just be the period during which the concussion has not recovered; if you remember back to our example of a concussion via a snow globe, the brain would be vulnerable during the time the flakes were excited.  As the brain has the “cascade” of events including the decrease in blood flow to the brain then the neurons would deteriorate due to lack of nutrients.  The physical effects of a concussion through imaging is very important, however if it takes “several days” to do this then what can we do in the meantime?

In a finding that may be more important to the military than sports was this; Continue reading →

St. Michael’s Press Release

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St. Michael’s Hospital in Toronto, Canada issued the following press release (we will be following the information that will be reported by various media outlets);

Researchers at St. Michael's Hospital will release new research on
Thursday about how traumatic brain injuries such as concussions cause
physical changes to the brain.

    The groundbreaking work will be presented as part of the celebration of
the hospital's new Keenan Research Centre. Federal Industry Minister Tony
Clement will speak at an event for donors later in the morning.

    The centre, and an adjacent education centre, are among the first in the
world and the only ones in Toronto especially built to bring researchers,
physicians and educators together to share insights and ultimately speed
the delivery of best practices to the bedside.

    The number of concussions being diagnosed in Canada is rising, in part
because doctors are better able to recognize the symptoms. The public and
the media are also more aware of the issue after several high-profile
athletes have been sidelines by concussions or had their sports careers
ended.

    The research will be presented by Dr. Andrew Baker, the hospital's chief
of critical care. Also attending the news conference will be:

Continue reading →

IIHF World Championship Concussions

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I was fully prepared to take a look at the good things that International Ice Hockey Federation (IIHF) was doing in terms of penalizing hits to the head, especially those that result in concussions.  Before I lash out at the IIHF let me highlight the good thing, watch this hit;

Radeck Martinek of the Czech team and New York Islander (red) was drilled into the boards by Artus Kulda of Latvia with a lot of the force going to the head.  It is difficult to see weather it was Kulda’s shoulder or actual head that made contact with Martinek, regardless upon trying to skate off Martinek fell to the ice.  He was later diagnosed to have a concussion.  The IIHF wasted no time in suspending Kulda for three games for this action.  Which in my opinion is a very good and swift reaction, especially due to the fact that IIHF hockey bans all contact to the head.

That is where the “pats on the back” end as in the same day this occurred; Continue reading →

NHL Post Season Concussion Report #3

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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.

The only additions this week are what we highlighted on Saturday, the two TB Lightning head injuries.  With the action moving to the Conference semi-finals it would be worthy to note that we should see fewer concussions as we progress.  Along with that as teams lose out injuries are not reported, like the NFL.  That being said there may be a couple of actual concussions that may slip through the cracks.

With Gagne and Kubina the total now sits at 10 in the post season.  There have been a total of 54 games and 9 “game nights” (7 games in quarterfinals and 2 in semi’s); there are some interesting stats: Continue reading →