The Case Against The NFL – Hruby

Interviewer: Is there any evidence, as far as you’re concerned, that links multiple head injuries among pro football players with depression?

Casson: No.

Interviewer: With dementia?

Casson: No.

Interviewer: With early onset of Alzheimer’s?

Casson: No.

Interviewer: Is there any evidence as of today that links multiple head injuries with any long-term problem like that?

Casson: In NFL players?

Interviewer: Yeah.

Casson: No.

The above is not a made up story, in fact it is on video for everyone to see and make their own judgements.  Patrick Hruby of Yahoo! Sports and “The Post Game.” has written yet ANOTHER very good article about concussions.  This one delves into the hot water the NFL is finding itself in; if not in court then in public opinion – if anyone cares to look at the information. Continue reading

Kobe with a Concussion – Not News Here

As we hinted to on Monday Kobe Bryant has as concussion to go along with the broken nose;

In addition to a broken nose, Los Angeles Lakers guard Kobe Bryant suffered a concussion in the third quarter of the NBA All-Star Game on Sunday when Miami Heat guard Dwyane Wade fouled Bryant across the face.

The 16-year veteran visited Dr. John Rehm, an ear, nose and throat specialist, on Tuesday morning where his nasal fracture was confirmed. Bryant was experiencing other symptoms related to the nose injury and was sent to neurologist Dr. Vern Williams, who diagnosed the concussion.

Courtesy of

We have listed Kobe as the 7th concussion of the season for the NBA…

Message from the CDC

The Centers for Disease Control have reached out to us at The Concussion Blog.  They are interested in publishing information via our blog, which I am both honored and flattered to be considered.  I am getting nothing in return, although I would love to be on their panel of concussion experts that help form plans, what the CDC gets is another avenue to disseminate information (no Irv and Matt I am not selling out).

I am more than happy to help out, but remember that this is information for everyone to take on their own, TCB does not always endorse all material from third-parties.  However giving the reader more information to digest is EXACTLY what we set out to do from the beginning of this blog.

Without further ado here is the recent CDC message; Continue reading

UPMC and Recovery Predictor?

The University of Pittsburgh Medical Center and its concussion program have released what they think is a new model to predict how long each individual may take to recover.  Lead researcher on this topic is Dr. Micky Collins who stated in a press release that this information is a “game changer”.

The study involves the ImPACT neurocognitive testing platform (developed by UPMC) and its results two days after injury.  Although the actual score has not been released publicly; it will appear in the next issue of Neurosurgery.  The benefits of such a specific diagnostic indicator would be tremendous for a lot of interested parties.

At the end of the press release/story Dr. Collins indicated something that is similar to what we posted yesterday; “Eighty percent of concussed people recover inside of three weeks.”

This information is all well and good but I would like to speak to some initial “wait a second” thoughts I have regarding this study; Continue reading

Family Travels Long Road of Recovery – TCB Suggestion

Brooke de Lynch of Mom’s Team sent over this article and video about a family and their dealings with post-concussion syndrome and the long recovery after a very “innocent” looking hit.  It begins as most complex cases often do, with incorrect initial management;

On the evening of Friday, February 12, 2010, my then 15-year-old daughter Heidi was hit on the head by the stick of a teammate as she was warming up in goal before a hockey game.

It was not a catastrophic brain injury requiring a trip by ambulance to the hospital. But the blow did result in a concussion; one that turned out to be far more severe, complicated and long-lasting than initially thought.

Because multiple mistakes were made in the immediate aftermath of the injury by all parties – including by me, her mother – which exacerbated her symptoms, that cold winter’s night marked the beginning of what would turn out to be a fourteen-month long search for answers to the enigmatic riddle that is post-concussion syndrome.

Another great perspective from a mom, this time about a girls hockey player.

Listen, all cases are not as drawn out like this one, in fact stats tell us that some 75-90% of all cases of mTBI/concussion recover in 7-10 days.  Remember that the “recover” portion of that last sentence is from symptoms AT REST.  This brings me to my soap box moment of the day… Continue reading

Scathing Accusations of a Coach

If you have followed the news about concussions you would have certainly notices a case of a coach being investigated about his handling of concussions and general mistreatment of players.  You would also know that the investigation of this Pittsburgh area coach found no wrong-doing, and retained his position.

The exact specifics were not privy to public information, that was until now;

In August, the trainers said, two players suffered concussions. Both returned to the sidelines to watch the team while wearing sunglasses and hats to protect them from sunlight, which can aggravate concussion symptoms.

Mr. Traber, 26, of Bridgeville, said Mr. Piccinini told the players “not to wear sunglasses on his field.”

“He kept saying … that, ‘He doesn’t have a concussion. He needs to get back on the field.’ He kept pressuring us to push up the date of his appointment with UPMC to be ready for the initial scrimmage,” Mr. Traber said.

Matt Bianco, father of one player, said he became concerned when other parents told him their children were not reporting injuries because they were being “belittled” by the coach. Continue reading

NBA Concussion Update #3

Our periodical report for The Association.

These do not occur as often as football and hockey for a couple of reasons, one; fewer players equals less incidence and two; the reporting of injuries is up to beat writers, as I have yet to find an official league injury page.  I will be using the standard and ESPN for compiling this information.  Also to note for 2012 is the shortened season due to the lock-out.

Concussions in the NBA are easily missed; they appear on searches but the normal searches I do the reports are often a sentence regarding the injury.  I believe this to be mainly because of two factors, the first being in the above statement the other is that a concussion has not occurred to a “big time” player, yet.

This could all be changing after an incident in the All-Star Game last night between Kobe Bryant and Dwayne Wade (video below).  According to Lakers Nation and Gary Lee Kobe may be suffering from some well-known symptoms; Continue reading

Some Food For Thought For Weekend

We have tried to bring you information that may not be easily found or looked for about concussions.  Sometimes this includes stories about the destruction of sports as we know it.  Let it be known that I do not believe that all sports, especially professional and high level-well monitored athletics need to be abolished.  As we have constantly stated on here there is a solution for some of the problems, athletic trainers.  Yes it costs money, but consider the day and age we are in, it will take new resources to keep everyone safe as we learn more about problems.

With that preface, here are some articles/snippets/quotes of some less traveled articles that have been forwarded to me.


Hank Pellissier wrote an article called Brain Damage – 83 ways to stupefy intelligence;

Concussions – 300,000 concussions occur annually in the USA in teen football programs. Loss of IQ can occur after a single concussion.

========== Continue reading

NHL Concussion Report 2/24/12 – 98 – Same as 2010 Total

Each week we (TCB & @nhlconcussions)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.

At the NHL All-Star Break we reported that there was a 60% increase in concussions over the previous year.  To which the NHL stated that they only have noted a 10% increase.  Yes, we use Fink’s Rule but that only comprises of four players, hardly a number that would provide a 50% difference in the numbers.  We have found that there are AT LEAST nine players listed as “upper body injury” that have either been found to have a concussion or the video/reporting of the injury holds clear evidence of a head injury.

Speaking of UBI and undisclosed; I know I am beating a dead horse, but why the need to hide the injury?  Why misinform the public Continue reading

NASCAR Takes Center Stage

Today the NASCAR racing series will set their starting grid for the Daytona 500, stock car racing’s most prestigious event.  Over the next few days the sporting world will cast a keen eye on the racing series.  On Tuesday the Associated Press ran a story about how NASCAR has been handling concussions.  It really began in earnest when Dale Earnhardt Sr. died due to massive head trauma in the 2001 Daytona 500.

Traveling in a motor vehicle at nearly 200 mph obviously has a high risk factor for catastrophe; since the series took drastic measures for driver safety, starting in 2001, there has not been one death.  Interventions included updated helmets and neck restraints along with an overhaul of the driver area inside the car and safer walls on the track.

Times have changed in this sport, like others, but concussions remained vastly misunderstood until about 2004, when the series began keeping track; tracking only 29 and 11 in the last five years.  Drivers whose careers have spanned the before and after of Dale Sr.’s death can definitely tell the difference; Continue reading

Research From The Now

Virginia Tech and Wake Forest researchers Ray W. Daniel, Steven Rowson, and Stefan M. Duma have published a new research article on impact telemetry on youth football players.  The abstract is as follows;

The head impact exposure for athletes involved in football at the college and high school levels has been well documented; however, the head impact exposure of the youth population involved with football has yet to be investigated, despite its dramatically larger population. The objective of this study was to investigate the head impact exposure in youth football. Impacts were monitored using a custom 12 accelerometer array equipped inside the helmets of seven players aged 7–8 years old during each game and practice for an entire season. A total of 748 impacts were collected from the 7 participating players during the season, with an average of 107 impacts per player. Linear accelerations ranged from 10 to 100 g, and the rotational accelerations ranged from 52 to 7694 rad/s2. The majority of the high level impacts occurred during practices, with 29 of the 38 impacts above 40 g occurring in practices. Although less frequent, youth football can produce high head accelerations in the range of concussion causing impacts measured in adults. In order to minimize these most severe head impacts, youth football practices should be modified to eliminate high impact drills that do not replicate the game situations.

There are some very interesting findings in the abstract alone that need to be noted: Continue reading

Research From The Past

There have been some very valuable resources to this blog, one who continually provides a vast amount of information both for posting and in the comment section is Don Brady, PhD, PsyD, NCSP, LMFT.  He along with his wife, Flo, have written to often cited pieces of information on concussions.  The first is the Communique on Sport-Related Concussions from the NASP.  The second is the common myths associated with concussions.  Let us not forget some the excerpts from his dissertation.

Recently Dr. Brady has sent me a couple of articles, neither of which were earth shattering in content, rather they were interesting due to the publication dates on them.

The first is a guest editorial by Allan J. Ryan, MD and appeared in The Physician and Sports Medicine, in 1987, 25 years ago (emphasis mine);

Rimel et all found that such events may be followed for weeks or months by symptoms and disorders of brain function that can be measured objectively. Gronwall and Wrightson found that persons who have sustained concussion show a reduced information-processing rate that may persist beyond 35 days when other post concussion symptoms (such as poor concentration, irritability, and fatigue) are present. Also, 20 young adults had less information-processing ability and took longer to recover following a second concussion that controls who had sustained only one concussion.  Thus, a cerebral concussion is a serous event that is indicative of an injury to the brain, and should be taken very seriously.

Continue reading

Mom Seeking Answers and Insight

There are great websites out there to visit to find information about injuries and concussions, I hope this is a good resource for all of you.  We are not the be-all-end-all rather just a piece of the puzzle when it comes to awareness.  There is a great site that is devoted to the Mom’s of the world called “Mom’s Team“, headed by Brooke de Lynch.  A serial emailer sent along a recent letter a concerned mom had about a concussion her son endured while playing tackle football – her son’s age… 8;

The following is a redacted version of a letter one mom of a concussed young football player recently sent to her state legislators in a Midwestern state:

Dear _________________:

As the mother of an eight-year-old who sustained a concussion during bantam football practice, I believe it is essential for the provisions of our state’s youth sports concussion safety law to be applied to all children participating in contact and collision sports held on school grounds. The injuries which occurred on my son’s team of approximately 25 third- and fourth-graders clearly demonstrate that concussion information is necessary for these players, their parents, and their coaches.

The letter is very compelling and articulate, it is worth the jump and read Continue reading

New Doctor, Different Results: Tracey Mayer

Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there.  As time allows she will be submitting posts for you to read.  I truly hope that everyone gets a chance to read about concussions from yet another perspective.  Thank you Tracey!

My son, Drew, suffered a severe concussion during a freshman high school football game in September, 2008, and has not played football since.   He would have stepped back on the field the next week and would still do so if he was allowed to.   It was not his first concussion, but it was clearly the most severe.  My earlier posts on here explain the details of what he has gone through.  Clearly, he has made tremendous progress, but he still has some cognitive difficulties.  He also suffers from migraines, which are typically provoked by intense focusing or from being hit on the head.  It does not happen often, but there have been a handful of incidents over the past 2 years.  Two weeks ago, he was elbowed in the head very hard during a basketball game, which resulted in a migraine with major fatigue that lasted for 4 days.

Drew saw a leading neuropsychologist out of Loyola who is an expert in concussive injury last week.   I chose to not reveal his name Continue reading


The hot button topic in the research world with concussions is chronic traumatic encephalopathy (CTE), the degenerative brain disease, twin (fraternal) sibling of dementia pugilistica first found by Dr. Bennett Omalu.  This brain disease is debated and some times discounted (as you will see tomorrow) for its links to repetitive brain trauma, i.e. multiple concussions.  It does however have a place in the discussion with combative sports like MMA.

Recently a former fighter named Gary Goodridge has said he believes to be suffering from its onset.  Steven Marrocco of wrote a piece on Goodridge and the debate of CTE in the sport;

The damage, he noted, was not extensive enough that it had caused irreversible trauma. But had the fighters continued to compete, he believes they would have been candidates for CTE.

“What I’m saying is that mixed martial arts belongs to the high-risk group of CTE,” Omalu said. “I would consider mixed martial arts just like I would boxing.” Continue reading

Collecting Concussion Data: Massachusetts

As part of the concussion legislation put in place in the state of Massachusetts, the public middle and high schools must report all head injuries/concussions to the state Department of Public Health.  Although plans have not been set for the actual purpose of the data collection, it can provide a snapshot of what high schools are dealing with.  As Lisa Kocian of the Boston Globe wrote;

Football and soccer players from 26 area high schools suffered more than 300 head injuries last fall, the first time athletic departments were required to collect data under the state’s new concussion law, according to a Globe survey.

Football players accounted for 207 of the injuries found in the survey, exceeding the totals on soccer teams at most schools. Girls’ soccer programs reported nearly twice as many head injuries as boys’ soccer teams, 85 compared with 46.

The sample set of data has been put in graphical form, click on the link above to see it.  The average injury reports Continue reading

Video Game Testing and Rehab

Using the video game platform from Nintendo, the Wii, is not novel as much as it may be possibly underused.  One of the first posts on this blog dealt with the usage of the Wii at two different universities, on a trial basis.  What brings me back to this topic; a search earlier this month revealed an article from February of last year and the usage of the Wii at a high school in Pennsylvania;

Testing high school athletes for concussion symptoms is a serious business, but one way the Haverford School athletic training staff is accomplishing this is through a game – Nintendo Wii Fit Plus.

The Wii Fit Plus module contains several games that require balance and coordination – some even require thinking, processing and then quick decisions translated into body movements.

This is what some people are now calling “Wii-hab” from a concussion.

“There are only a few colleges that I know of who are using the Wii as part of a concussion protocol, and I am not aware of any high schools in our area that are using it [for that purpose] yet,” said Haverford School athletic trainer Bill Wardle.

I have always thought that this could be used Continue reading

Concussion Awareness/Testing and US Youth Soccer

On February 7th an agreement between a neurocognitive testing company and US Youth Soccer was made.  Not only was this a partnership for the use of the tool, but it also provides some of the best, in my opinion; concussion education, awareness and management tools out there.

Soccer has been a rather underrepresented sport when it comes to the concussion issue, perhaps because it does not garner the spotlight in today’s sports media, like that of football.  However, soccer has its fair share of brain injuries, one reason is the use of the head in the sport is encouraged.  Because of this it exposes players to more risk, even if heading the ball is controlled, what happens in the air leading to that can be more apropos to creating the sudden traumatic event causing a concussion.

Below is the full press release;

US Youth Soccer and Axon Sports bring Affordable Concussion Management to Leagues, Teams, and Clubs

Web-based tool helps medical providers manage concussions; facilitate the safe return of players to the field

FRISCO, Texas (February 7, 2012) – US Youth Soccer, the nation’s largest youth sports organization, today announces Axon Sports as a long-term strategic partner for computerized baseline testing for concussion management, leading the way in making soccer safer for kids at the grassroots level.  Through the relationship, US Youth Soccer will provide member discounts and educational resources on  It will also provide more than 25,000 US Youth Soccer players free access to the Axon Sports Computerized Cognitive Assessment Tool (CCAT).      Continue reading

More Touchbacks = Less Concussions, NFL Reports

The co-chair of NFL Head, Neck & Spine Committee, Hunt Batjer, reported yesterday in Chicago that concussions dropped 50 percent on kickoffs as compared to previous years.  Speaking at a forum about NFL health and safety Batjer confirmed what we had said with our observational data;

“We just got the data recently, it looks to me like a decreased number of runbacks played a role. It did not affect a lot of the other injuries paradoxically.”

In this article by Brad Biggs there is also a good sub-story about Hunter Hillenmeyer and his dealings Continue reading

Youth Football Going Forward: Hruby

Patrick Hruby is not new to this blog, as he was highlighted with his commentary on brain trauma and football back in 2010.  His newest article has been out about 24 hours and it has provoked quite the response from many different locations, mostly silence.  There are articles that come out that see like a lightning rod for comments, “End Game: Brain Trauma and the Future of Youth Football in America” has provided the opposite: silence.

It could be that the article appearing on Yahoo! Sports blog The Post Game has not been viewed enough to get a response; very unlikely as it was trumpeted around the Twitterverse by many people.  Rather, I believe, it may have caused many people to sit back and think.  Hruby looked at what Drew Rickerson and his mother Jean (founder/developer of went through in 2008;

No one had a clue. Not his coaches. Not his teammates. Not even his mother, looking on from her usual spot in the grandstand. On a foggy November night four years ago, Drew Rickerson found himself wandering around the sidelines of a football field in Sequim, Wash., a city of 6,600 on the state’s Olympic peninsula. He was 15 years old, playing quarterback for the Sequim High varsity football team in the final game of the regular season, a week away from the state playoffs. He also was struggling to speak, dazed and disoriented, hardly able to drink water.

Hruby traces the issue from the beginning of the injury to the trials and tribulation of the family eventually to what has been found since that time about the brain injury of concussion.

It is a very well written piece that shows the obvious dilemma that we currently face with youth football, yet we are very unprepared to talk about or even address; Continue reading

Coexistence of Concussion and Football: Part XII & References

I have been asked to write about concussions from time to time.  I attempted a chapter on concussions for a book at some point, this is the conclusion of my writing as well as the sources, as I wrote it, no matter how horrible it is.  After all I am not an author, but at least you can take a look.  This particular chapter deals with concussions in the sport of football.  We all should know this injury can be sustained in any sport.  Because football is the biggest draw of sporting eyes I felt it was best to present it in this way. (Part I, Part II & III, Part IV, Part V & VI, Part VII & VIII, Part IX-XI)

Going Forward and Conclusion

There has been a lot of banter about what can be done to eliminate the epidemic of concussions, particularly in football.  Let it be known that the injury of concussion is something that can and will continue in sport, no matter the changes.  However there are things that can be addressed in order to bring this issue under control.

The key to all of this is the understanding of the injury, not only from inception but all the way through recovery, simply put, education and informed consent.  Everyone that plays the sport or supports those that play should know what risks they are taking, from the broken toe to a concussion.  This will allow all to make correct and prudent decisions regarding the safety of players.  Along with the knowledge of this injury every person should what it takes to get back to the field safely and ACCEPT that.  Erasing the stigma of the concussion epidemic is difficult due to the deeply ingrained traditions and money involved.  It will not be easy but the number one thing that should be done is to get everyone on the same page.

Rule changes are another angle some are asking for; with the education this process will become much clearer.  Reducing the exposure of contact will lessen the cases of this injury, but the game cannot and should not turn into a game of “backyard touch”.  Decreasing the number of days in practice contact is allowed would significantly reduce the exposure and is a simple step, in terms of saying and implementing.  Everyone should be on board with this as coaches would welcome “fresher” players and players would welcome “less pain” during the week.  If everyone was held to those standards then pushing the envelope, Continue reading

HufPo Sports: Concussions

The fact that I had no idea that the Huffington Post even had a “sports” section should indicate how often I read that particular online ‘rag’.  I have not read it because it rarely falls on my radar for concussion, nor is it what I want to spend my free reading time on, other than that I have heard they do a great job and have a good product.

An article and video on concussions by Cara Santa Maria was posted today;

In medical parlance, a concussion is a traumatic brain injury that causes transient alterations in the function of the brain. It can be mild or severe, and it can cause bleeding or swelling. Symptoms usually go away within weeks following a concussion, with proper care. For those who stay in the game after a concussion, they are at a high risk for second-impact syndrome, which can result in lasting brain damage or death. Continue reading

AOSSM Helmet Fit Findings

As I prepared for a presentation at a football coaches clinic I was just checking my usual sources for new information when I came across a research study that was put out by the American Orthopaedic Society for Sports Medicine regarding concussions and helmet fit.  It was a welcome finding, not only could I use it in my studies but it was a great find to back up the new NFHS helmet rule.

One thing I have learned, the hard way, is that when speaking to coaches simply discussing what the concussion is and how it affects them only goes so far.  They are coaches, they naturally want to know about their opponent (concussions in this case) and how it will affect their team.  I have found that a simple overview of why we are where we are – current research, why it has changed – style of game, what is being done – rules/legislation, and how they can help – awareness/athletic training they seem to be very receptive.  Rarely do I get the chance to explain a new rule and then have research back up the change.

That is what happened on Saturday; NFHS focusing on proper helmet fit and then the AOSSM study; Continue reading