NHL Concussion Report 11/9/11

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.  We will also be using “Fink’s Rule” to include concussions in the listing.

The NHL was very proactive with protection of its players; tightening down Rule 48 and installing Brendan Shanahan as “Hit Czar” before the season began.  All of this was done in an attempt to keep players safe and avoid a repeat of the Sidney Crosby affair.  With noble intentions put forth by the league, the only way to measure its effectiveness is to compare head injuries from years past.  Unfortunately as we have described in the weekly introduction; many teams used alternate terms (“undisclosed/upper body) to hide/minimize head injuries, for what its worth they still do however it seems less to this observer.

The Concussion Blog attempted to track concussion/head injuries last year, and we believe that we were the only source for this information for the 2010-2011 season.  Although imperfect it gave a “baseline” for us to measure the rule changes installed this year.

After roughly 15 games for each team we can now make a solid observation; Continue reading

Advertisements

Symptoms & Perspective: Nick Mercer

Symptoms with which I am familiar are primarily dizziness and fatigue. The biggest symptoms I deal with are my balance/movement and double vision, but apart from immediate vision problems most people have after a brain injury, I think balance /movement and double vision lasting over 8 years is more specific to serious brain injuries, so I won’t talk about them per se.

The severity of my symptoms has lessened over these 8 years and I have never had to deal with headaches (apart from an intense and especially long one after the doctors replaced my bone flap), but the dizziness and fatigue, however diminished, remain. That’s not to say that I deal with serious episodes of these symptoms every day, but they are there frequent. As I wrote in a previous post, standing up quickly or abruptly turning my head to the side can result in dizziness. Fatigue is another animal altogether. I don’t know when it will be intense.

For people dealing with the immediate symptoms of a brain injury, these are unfamiliar and must be Continue reading

Gaining Momentum

As I began the blog there were plenty of people who told us that what we were doing was “nice” but it will have little effect on the concussion issue.  The easiest and actual response was “so what?”  I honestly did not care if people didn’t take the information we wanted to present seriously; I KNEW that someone would.

The original concept was to gather stories and information from as many sources I could find on the limited time I have to devote to the blog.  Fortunately we were able to add contributors that have helped in this endeavor (looking at you Noodle), as well as Parent Advocates and the occasional “anonymous poster”.

We believe the information is valid and “blog-worthy” in order to make people aware of the ever-changing issue of concussions.  As viewers and commentors have increased over time we believe that we are on the right path.

A lot of the emails and comments I receive in confidence take umbrage with the “attacks” on the NFL and major sports.  I can see that angle and appreciate the candor, however it is those entities that we will gain the most profound guidance Continue reading

Rugby Makes CLEAR Statements

The International Rugby Board met last spring to make changes to the concussion protocol for their sport.  I had opined that rugby could have been in trouble with the incidence of concussion in their sport.  However I must say (after finally following up on it) the IRB has at least made it perfectly clear on how concussions will be handled for rugby;

….

Continue reading

Zurich 2008 & NFL

Yesterday during the games I tweeted a couple of times eluding to the Zurich 2008 Statement on Sports Concussions.  I use this as the current benchmark, because it is exactly that, CURRENT.  Granted some people have expanded on Zurich, now a three-year old consensus statement – for example our protocol now adds a step between current 1 and 2 for return to play.

However, the Zurich Statement is the best we have.  Arising from a group of international scientists it provides the best start in this ever-changing arena.  In 2006 from Prague the group took out grading and the term “mild” from the concussion arena.  In 2008 the group provided what most wanted to know a return to play guideline.

How does this all relate to the NFL?  If you look at the statement closely you will find that there is an actual section that deals with entities like the NFL and return to play on the same day.  It does not use the NFL specifically but looking at the section it is pretty logical to think that is what is meant (bolded is my emphasis); Continue reading

Sunday Recap

As Football Sunday played out yesterday there was more attention on the head injury issue; naturally because the NFL set in motion – if only through reinforcement – a system to get players off the field in cases of overt signs.  The concern for head injury actually began two plays in, in New Orleans.

Tracy Porter collided with receiver Mike Williams and was obviously stunned and unsteady.  Porter took a knee for a brief second before he crumpled to the ground where he was attended to; spine board and med evac later Porter was released from an area hospital (BTW they are listing this as a “neck” injury).

==========

Not long after that, Dustin Keller of the Jets jumped in the air and landed on his back/head.  The officials did a good job of summonsing the med staff to Keller.  Keller was subsequently removed evaluated on the sideline and locker room, where it was determined that he did not suffer a concussion.  In an extremely rare occurrence, the Jets medical staff answered questions Continue reading

Information and Reserach about HBOT

If you recall we have posted about hyperbaric oxygen therapy for TBI and concussions; mainly about how there seems to be promise shown but little research that is accepted/supported for that.  Now the Navy League of the United States is giving a presentation on HBOT for treating Veterans.

The event is November 9th in Arlington, Virginia; granted a lot of you reading will not be able to go, but perhaps you know someone (that knows someone) that would be interested in the DC area.  Here is the press release I challenge people to find someone to attend (I called my uncle);

IEDs cause over 70% of U. S. Casualties in Afghanistan. TBI and PTSD have become the “Signature Injuries” of that conflict.  There are between 200,000 and 600,000 combatants who have been diagnosed with TBI/PTSD.

Untreated TBI/PTSD can bring with it disabling symptoms, including loss of short-term memory and executive functioning , migraines, sleep disruption, loss of impulse control, depression, rapid mood changes, photophobia and hyper-vigilance.  Left untreated, the disabled individual Continue reading

2011 NFL Concussion Report Week 8

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 information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

Through Week 8 we have seen a very slight increase of reported concussions, 6.25%, as compared to last season.  Interestingly 2011 Week 8 provided us with only two reported concussions, yes only 2!  Granted there were six teams on bye, but there has been six teams on bye the last three weeks, so that would not be a factor.  The only teams that were on bye that have been producing the best (most likely accurate) reports were Atlanta and Oakland (14.7% of reported concussions).  Certainly that could be a small factor.

Looking back to last season, Week 8 2010 also produced the lowest number of concussions reported, four.  Maybe it is just the time of the year?  No matter how you look at it, it seems very strange that we recorded 11 concussions in three consecutive week and then it suddenly drops to 2.

There has been one factor brought up to me that may hold some weight; Kris Dielman.  One week after the bungled concussion management of the Charger offensive lineman there is an abnormally low number of concussions.  Before we get into conspiracy theories maybe it could be that there were only two incidents, because there were only two incidents.

Here are the updated stats for the regular season (104 total since training camp); Continue reading

Will Carroll’s Med Check

If you don’t follow Will you really should.  He runs a weekly Med Check on injuries in the NFL, he often utilizes this blog for information regarding concussions.  Will has been all over the concussion issue, not just recently, rather for as long as I have known him.  I appreciate his dedication to sports medicine, athletic trainers (even though his publications say “trainer” he knows and represents the differences), and injuries in general.

In his most recent Med Check he opened up with some very poignant information and editorial;

Mike Florio of NBC has offered both reasonable coverage and interesting suggestions, but inside the game, there’s been quite a bit of pushback. Instead of using their bully pulpit to rally for change to how we treat injuries, ex-players like Merrill Hoge and Mike Golic are against any changes. They go to “back in my day” stories, calling players that come out of games “quitters.” That Hoge, a player who had his career ended early due to concussions, takes this position is amazing. Hoge was cleared to play just five days after a severe concussion and when he suffered another, he ended up being resuscitated Continue reading

Xenith Teams With App Maker

Xentih, the most recent helmet company is teaming up with PAR Inc. the producers of the CRR app as part of the concussion education platform.  Below is the press release;

Xenith offers CRR Application as part of Xenith Academy, an educational curriculum designed to reduce risk in football at all levels of play.

LOWELL, Mass., Nov. 2, 2011 /PRNewswire/ — Xenith LLC has today announced a partnership with PAR Inc., and its newly developed Concussion Recognition and Response (CRR) Mobile Application.  As a result of this partnership, Xenith and PAR Inc. will work together to educate coaches, administrators, parents, and athletic trainers nationwide on signs, symptoms and recognition of concussions.  The application, developed by Gerard A. Gioia, PhD, and Jason Mihalik, PhD, is designed to assist in recognizing the signs and symptoms of a suspected concussion, allowing for a quick and appropriate response. The application takes less than 5 minutes to administer and is iOS (iPhone, iPad, iPod touch) and Android compatible. “We are extremely excited to partner with Xenith to enhance safety for athlete populations,” said CRR co-author Dr. Gerry Gioia. “We continue to be impressed with both Xenith’s innovative technology and their company-wide mission to improve education and awareness. We look forward to working collectively to improve safety measures nationwide.” Continue reading

School Getting Smart

From the Globe and Mail (Canada), St. Micheal’s College School has developed a return to school program from concussions.  As we know return to the classroom and the school environment can be just as harmful as rushing back to sports.

“There’s a lot of focus on the return to play but not on the return to the classroom, where the kids can have a number of difficulties due to their brain injury,” said Corinne Kagan, a program director at the Ontario Neurotrauma Foundation.

The classroom demands that students listen, learn and think, all of which involve brainwork. Some of the symptoms of a concussion, such as headaches, dizziness and trouble concentrating, can make this even more difficult.

What St. Michael’s has developed, Ms. Kagan said, is “a very good thing.”

I have been promoting this from the beginning here on the blog.  In fact the school I work with adopted a policy that deals with this exact thing.  I believe it to be the first of its kind in Illinois.  Simply we educate the athlete and parents about the injury and proper management; with that the school is suggesting and allowing students to be excused for up to three days before seeing a doctor.  Upon return the student will work with the guidance counselor, teachers and myself for a simple graded return to classroom activity.  Since each person is different in recovery there is nothing set in stone for academics.  We do have an understanding that if the student misses quizzes/tests they will not make up more than one a day until full recovery.  Homework is often allowed to be turned in on a “graded return”, and classroom performance is monitored by the teacher.

This is not required of the student or parents, rather a recommendation and not every kid that gets a concussion follows our guidelines.  However my limited sample size shows some serious results (based on concussions from January 2010 to present): Continue reading

NFL Follows NFHS

In light of the Kris Dielman incident – playing with obvious signs of concussion – the NFL met to further the awareness and safety of the players.  If not for the game then for themselves.

The immediate action taken by the NFL is going to have the officials be more aware and implore them to whistle on medical staffs when someone is exhibiting overt signs of concussion;

“We are taking the step on officials to make them alert to obvious concussion symptoms,” Greg Aiello, the NFL’s vice president of public relations, said. “We’re not trying to train the officials to be doctors, but we’re asking them to treat it like other injuries that may make it necessary to stop the game and get them medical attention, either on the field or by getting them off the field.”

Some initially think that the officials are now being put in a position to make medical decisions, they are not.  It was a push back at the high school level Continue reading

Broken Brain Brilliant Writing

This profound article comes from a blogger (really a very good writer), his site is Broken Brain — Brilliant Mind; Using the infinite mind to overcome the limits of the brain…  Including Traumatic Brain Injury (TBI) Survival Strategy and Tactics.  If you have taken the time to follow his stylings you will find out that this self-taught individual has the proper perspective on all things related to head injuries.

It has been far too long that BB has not appeared on this site; for the life of me I don’t know why.  I was cruising the site yesterday and found a wonderful authored article about what is happening to your brain when you get a concussion.  I would love to re-print the entire article here but that would be dirty pool.  In lieu of that I will post some very good sections and implore you to click on THIS LINK to read the entire post.

Because everything is “off” just a tiny bit, and it can create a huge amount of insecurity and anxiety and stress in your life, trying to figure out why the hell everything is working wrong, all of a sudden. On top of your own confusion and frustrations, you’re suddenly surrounded by a whole truckload of people who also wonder why the hell you’re “off” … and whose patience is getting shorter by the day (sometimes by the hour).

What – did you suddenly become an idiot? Did you suddenly get stupid? What’s wrong with you? Continue reading

Exclusive Story from Irv Muchnick

Irvin Muchnick is a writer and investigative journalist who previously mainly focused on the WWE.  Muchnick has changed gears a bit and started Concussion Inc, a website focusing on the brain injury issue.

Yesterday on his website Irv posted an article about the neurocognitive test ImPACT; specifically about the statements from the company that baseline tests are unnecessary;

In a finding that exposes just how aggressively, misleadingly, and perniciously ImPACT concussion management software is being marketed, Concussion Inc. has uncovered ImPACT and University of Pittsburgh Medical Center documents advising potential purchasers that not even baseline neurocognitive tests are needed in order to safely use their expensive, for-profit product.

I will freely admit that early on I truly believed that the need for a baseline was secondary due to the wealth (or lack there of) of information regarding normative data.  Normative data can be useful for a myriad of issues but I have since corrected my thinking and fully understand that a baseline test is needed for proper clinical evaluation of a concussion.  It could be a baseline for balance or the SAC or the combination of the two; the SCAT2.  If you don’t have information about the injured brain prior to injury how would one truly know where he/she stands?  In the case of not getting baseline information on an athlete (which can be as subjective as knowing the individual) there is nothing to refer to for return to activity other than the patients subjective responses. Continue reading

Mike & Mike and My Thoughts Going Forward

There are some of us that had hoped that the “World Wide Leader” in sports would have used its platform last night to further the discussion on the concussion issue.  Yes, as the commenters pointed out in the other post, they did broach the subject of Kris Dielman at half time.  Mainly to emphasize that the league was looking into this and the policy going forward.

On Mike & Mike this morning the hosts were joined by Chris Carter and really talked about it.  Not only the problems with the injury, but how the game is being changed.  You can LISTEN HERE.

No matter the side of the fence you fall on – player safety is number one – for professional players, college players and especially the adolescents.  There is no hard and fast answer to this, but it is worth discussing as they did this morning.  Times have changed, we have learned so much more about brain injuries and perhaps the injury of concussion is getting more severe as time goes on (size, speed, etc.).

I have been accused by coaches and parents that concussions are being sensationalized, not only by the media but by me.  They really feel this way and there is not an issue with that; Continue reading