Revisited: Academic Accommodations

Some of the most important posts will be re-published from time to time.  This one was published in October of 2010.

In the most recent Journal of Athletic Training, Neal McGrath was published about the accommodations that may need to be made for concussed students.  This topic is one that is commonly overlooked by those that care for the student-athlete that has a concussion.  The every day tasks of walking in a hallway at a high school can be very difficult.

Below are the accommodations that were suggested, if you jump to the article you will see the rationale for each.

  • Excused Absence
  • Rest Periods During Day
  • Extension of Assignments
  • Postponement or Staggering of Tests
  • Excuse from Specific Tests
  • Extended Testing Time
  • Accommodations to Sensitivity to Noise/Light
  • Excuse from PE/Sports
  • Avoid other Physical Exertion
  • Use of Reader for Tests/Assignments
  • Use of Note Taker/Scribe
  • Use of Smaller/Quieter Testing Room
  • Preferential Classroom Seating
  • Use of Tutor

Rypien Led Lawsuit

With the most recent filing it brings the total number to approximately 960 former players; Mark Rypien might be the biggest known name as a former Super Bowl MVP but there are other players in the suit as well.  Doug Farrar of Yahoo! Sports wrote about the recent suit, noteworthy in the article are the quotes from Tony Mandarich.  Mandarich claims this is not a money grab and has joined the suit because he feels the NFL knew of lasting damage during his playing days and it was never disclosed;

“My main objective is, if they knew about it, they should have been disclosed to us,” Mandarich said. “It would have probably prompted more action like [there is] today in the NFL.”

Mandarich estimated that he suffered six or seven concussions during his six-year career, and as a result, he’s become yet another cautionary tale in the battle to further concussion awareness.

“I don’t want to say recently, but for years I have taken medication for [depression],” Mandarich told Weber. Mandarich also said he also suffers from short-term memory loss and affected speech.

The last comment hits home for me, Continue reading

Canada Takes Initiative

When you can get five separate entities – including the largest hockey organization in the country and one of the most well-funded brain injury awareness groups – to pool resources and information to increase awareness of concussion then I would say that is initiative.  This dive is once again coming from north of the border as Hockey Canada and ThinkFirst Canada are amongst the five organizations making a push.

The noteworthy product of this group is a survey;

“I think that’s outstanding,” said Pat Waslen, executive director of Football B.C. “One of the problems from our perspective here is there needs to be more [concussion protocols] put in place. Years ago there were no rules saying you had to have seatbelts in your car, right? So it’s the same thing with concussions.” Continue reading

Suggestions on Setting Up Youth Sports Program

Mentioned previously, the Chartis Insurance group is promoting awareness though a unique way; posting information from their sources on this blog.  Their endeavor is part of  a promotion for aHead of the Game®.  The Concussion Blog does not endorse this company or product, however their willingness to provide information will garner them some blog space.  Chartis is not paying this blog to post as we feel this information is educational in content.  Other companies are welcome to send along information as well; however not all material makes the blog, it is an owner/author decision.

How to Set Up a Safe Sports Program for Kids:

What You Need to Know

By Sally Johnson and Nathan LaFayette

            Creating a new youth sports or recreation program for a local athletic league, recreation center, parks department, or community center is a wonderful and exciting prospect. This gives young children and teenagers the chance to experience the thrill and camaraderie of team sports, as well as remain physically fit and active.

One of the most important components in setting up a youth sports program is safety. The health, well-being, and safety of our youngest athletes – no matter what the sport – are paramount and must take center stage. Just look at a handful of alarming statistics: Emergency room visits for concussions in kids ages 8-13 doubled from 1997 to 2207,  and concussions have skyrocketed 200 percent among children ages 14 to 19 over the same time frame, according to the American Academy of Pediatrics. High school athletes suffer 2 million injuries a year, with 500,000 doctor visits, according to a December 2011 fact sheet from the National Athletic Trainers’ Association. Sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children, according to the Centers for Disease Control. Additionally, athletes who have ever had a concussion are at an increased risk for another concussion. Although death from a sports injury is rare, the leading cause of death from a sports-related injury is a brain injury.

Given the nature of the injuries that can be sustained in youth sports, setting up safety guidelines for any new sports league must be established from the get-go. Here are some suggestions Continue reading

NFL Concussion Information

Yesterday Rich McKay, chairman of the NFL competition committee, made comments regarding player safety and rules.  Of note was McKay stating that kickoff concussions were down from the previous year, he credits the rule change of moving the ball up five yards on the kickoff;

McKay said Monday that concussions on kickoffs dropped by 40 percent during the 2011 season which likely goes hand in hand with the fact that kickoff returns dropped by 53 percent.

Also in the AP story – linked in various places  – McKay released information about concussions being down, for “in-game” situations, versus the previous year;

For all plays, concussions were down 12.5 percent, from 218 in 321 games in 2010 to 190 in 320 games last season. There was no Hall of Fame game last year because of the lockout.

In the end of the year wrap up posted in January you will note not only did we mention the decline in the kickoff concussions, but our data on the past two seasons;

The 200+ concussions should not come as a surprise, as we told you to expect that back in the preseason, Continue reading

Soldiers Suffering After Concussion

It should not be surprising that there are lingering effects from a battle concussion, what may be surprising is the sheer amount of service men and women that may be affected daily by just headaches.  Recent data published in Headache by Army researchers shows that nearly 20% of soldiers that sustained a concussive episode had been diagnosed with “chronic daily headache”;

Of those, a quarter had the headaches every day. More soldiers with chronic headaches had symptoms of post traumatic stress disorder (PTSD) than those who did not suffer frequent headaches. […]

The chronic headache group was also more likely to score higher Continue reading

NBA Concussion Update #4

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.

Last year the regular season produced 12 concussions, with the season winding down we have identified 10 thus far in this shortened season, with others like LeBron, who is apparently to tough for concussions, not on the list: Continue reading

Athletic Trainer Innovates – Yup that’s what we do

We have seen volleyball players wearing soft sided helmets in games, and we have seen the explosion of “head-gear” for sports like soccer.  It is starting to become a trend; something that long time athletic trainer at Louisville put into practice – figuratively and practically – for the previously concussed on the mens basketball team (looks like Hina or others have softened Pitino’s stance on concussions);

Looking to protect players who’ve had previous concussions, Cardinals trainer Fred Hina came up with the idea of having them wear the padded helmets in practice.[…]

“We’re just trying to proactive and keep our multiples (concussions) down to a minimum, limit our risk,” Hina said Thursday before the Cardinals played Michigan State in the West Regional semifinals. “It may be overkill, but I really think you’re going to see it more and more with the focus being on head injuries.”


Outlet for Concussed High School Student

I would be remiss if I didn’t take the time to mention our loyal followers out there, thank you!  We get a lot of email from all sorts of places and most of it is very informative – with the occasional “will you link this” which turns out to be sports betting or worse.  I received this email a while back and while cleaning out the inbox felt compelled to share;

My name is Jacob Lichtenbaum. I am currently a senior at the Potomac School in McLean, Virginia. This semester, I’ve been writing a column about concussions in sports and also in general and your website has been a fantastic resource for me. I love the spins you guys put on all the issues and your candid, educated opinions on all concussion-related events. I especially appreciate your work because I am someone suffering from post-concussion symptoms myself.

This past summer, I suffered a concussion while participating in my varsity football training camp. You’ll be glad to know I was removed from action immediately, but my post-concussion symptoms unfortunately sidelined me for the entire season. I still experience the symptoms to this day, unfortunately with no end in sight.

I decided to write my semester-long column about concussions because I wanted Continue reading


I just finished Slaughterhouse Five by Kurt Vonnegut. It’s about Billy Pilgrim, an optometrist in Ileum, New York who was a World War II POW in Dresden, Germany when it was fire bombed (Vonnegut, himself, was a POW in World War II in Dresden in Schlachthof Fünf (Slaughterhouse Five). He, like his future character, Billy Pilgrim, was there during the bombing in February 1945). After the war (in human time – more on that further down) he becomes an optometrist, has a wife, daughter and son, and is abducted by aliens to their planet of Tralfamadore and ends up with an ability to haphazardly time travel within his life. It’s funny and makes its anti-war points through satire. This is not a book review, I just figured I would give a general overview of the book before I launched into an exhortation about my brain injury and the Tralfamadorian view of life.

The Tralfamadorian view kind of relates to my point that I wouldn’t change a thing about my being brain injured because it leads me to where I am now. The Tralfamadorian view of life is that no one ever dies, they just jump around to different parts of their life and that things that happen will always happen and have always happened. By no means am I saying that I can travel through time Continue reading

Home State has Concussion Education for Public

In Windsor, Colorado the Park District holds concussion education classes for the public three times a month; it is their part in raising awareness about the process of concussion.  This endeavor is in response to the Jake Sankenburg Act signed into law nearly a year ago in Colorado.  The Tribune serving the Greeley and surrounding area (did I mention that Colorado is the best place, EVER) wrote a story about the classes;

“Kids seem to be actually more susceptible to the problems with concussion than adults, which is kind of surprising because we tend to think of kids as being more plastic, meaning if that if they do incur an injury they tend to bounce back pretty quickly,” Kary said. “Actually, the opposite is true with concussions. I think it’s really imperative that we get the message out to parents to take this seriously because our generation was a bump in the head and kind of get back in the game and rub it off or shake it off.” Continue reading

Week 3 Concussion App Giveaway

It is now week three of our giveaway contest for PAR Inc. concussion apps.  In the first week I had you pick who you thought was going to win the B1G Tourney.  In the second week I asked how many 9-16 seeds would win in the first weekend.  Now we are down to the Sweet 16 and Elite 8; time to take a stab at which team will have the largest winning margin, over the entire weekend.  The fist tiebreaker will be who they played the second tie breaker will be who has the lowest winning margin (example: Kentucky – Baylor – Ohio St.).

This can be a $9.99 value if you choose the CARE App.

Here are your match-ups; Continue reading

Attaboy LeBron

I don’t want to knock LeBron for being a poor role model here, because most media outlets stopped presenting him as any sort of paragon of high character around the time of The Decision. But his comments do help underscore how sports leagues can’t just reverse common conceptions of concussions with a new policy or strict rules against blows to the head. More than anything, it’s a cultural issue, with players being told to play through pain from a young age.

What is Eric Freeman of “Ball Don’t Lie” on Yahoo! getting on LeBron James for?  How about this;

As the questioning about the game winded down, James was asked whether he had ever suffered a concussion in his life. James smiled for the first time in the interview and delivered his reply with an attempt at humor.

“No, I’m too tough for that,” James said.

Tom Haberstroh of “Heat Index” on Continue reading

Published Article in CJoSM Supports ‘Hit Count’

I was forwarded this information from a very astute and prominent concussion researcher for my take and information.  The Clinical Journal of Sports Medicine published an article regarding the under-reporting of concussions.  The authors are: Greenwald, Richard M. PhD; Chu, Jeffrey J. MS; Beckwith, Jonathan G. MS; Crisco, Joseph J. PhD.

It is important to note that the authors (as it is disclosed) have an interest in the Head Impact Telemetry System created by Simbex and limited currently to Riddell helmets.  With that out-of-the-way the article exposes the bigger problem with concussions with competitive athlete; the subjective nature of the injury and the self-reporting;

We typically cannot “see” a brain injury, and even with increased public and medical awareness about the serious nature of any brain injury, a “warrior mentality” inspires many athletes to continue to play. Contemporary, more stringent guidelines proscribing a same-day return to play may actually fuel underreporting of symptoms by some athletes. It is therefore critical that improved techniques for identifying athletes at increased risk of developing brain injury be implemented at all levels of play.

Prevention of brain injury should be a priority. Athletes in contact sports are exposed to head impacts, Continue reading

House Hearing on TBI

The Energy and Commerce Subcommittee on Health spent some time on Monday holding a hearing on traumatic brain injury (TBI).  We all know that the spectrum of this injury can range from the severe to the mildest forms (mTBI) also know as concussions.  The government has been involved with TBI since 1996 funding further research and subsidizing awareness/education programs with the passage of the Traumatic Brain Injury Act of 1996;

What the Traumatic Brain Injury Act of 1996 Mandates

Public Law 104-166 charges CDC with implementing projects to reduce the incidence of traumatic brain injury. Specifically, the legislation mandates that CDC shall:

  • Develop a uniform reporting system for traumatic brain injuries.
  • Conduct research into the identification of effective strategies for preventing traumatic brain injury.
  • Implement public information and education programs for preventing TBI and for broadening public awareness about the public health consequences of TBI.
  • Provide technical assistance, either directly or through grants and contracts, to public or nonprofit entities for planning, developing, and operating projects to reduce the incidence of traumatic brain injury.
  • Present a report to Congress that describes the incidence and prevalence of traumatic brain injury.

Funding for all these activities was authorized at $3 million for each of the fiscal years 1997, 1998, and 1999.

The Act has been amended many times, the last, in 2008.

The House heard from witnesses about Continue reading

Chaney Somewhat Prophetic re:McMahon Post

Matt Chaney, who has been critical of the establishment on various subjects including concussions highlights what Jim McMahon and his group of NFL’ers have been saying in preparations for the law suits aimed at the league.  The following excerpt from a Chaney post on his blog appeared in June of 2011, prior to all the suits (bold my emphasis);

Doctors and medical researchers have long agreed boxing can cause brain damage in athletes and lead to personality disorders and outbursts, through repetitive impacts both concussive and sub-concussive.

A 1973 study on postmortem evidence of 15 ex-pro boxers who suffered “punch-drunk syndrome” documented their “violent behavior and rage reaction” through interviews of relatives. Several of the boxers died in psychiatric wards.

Decades earlier, boxers who became demented and deranged were known as “slug nutty,” according to a 1928 report by Dr. Harrison Martland.

Meanwhile, yet today, the NFL and loyalist experts loathe admitting that tackle football even causes long-term impairment, much less off-field violence by players and chaos for families. Continue reading

Motorcross Star “Barely Passes Concussion Test”

Why would there even be any doubt about passing a concussion test after taking a nasty spill and being out of it?  In the video below it is hard to catch the incident the first time you watch; evident after gaining perspective is that James Stewart, the series Michael Jordan, fell and was struck in the back of the head and then was very “not himself” in the aftermath;

You will be able to see the incident more clearly here; Continue reading

McMahon Speaks Up

“We knew what was going on with pretty much every other part of the body,” McMahon said on ESPN’s Outside the Lines. “We knew there was going to be a chance for injury. But we didn’t know about the head trauma. And they did, and that’s the whole reason for this lawsuit. . . . They knew about it and they didn’t tell us. That’s like looking in your face and lying to you. Flat-out lying.”

As reported from various sources after his appearance on ESPN’s OTL, this one via ProFootballTalk, Jim McMahon has set the stage for what the law suits against the NFL basically involve.  The league denies hiding any information from the players, which to this observer is “technically” correct up until the early 2000’s.  However what the didn’t know was available for them to find out, as papers and research articles about compounding head trauma has been available since early in the 1900’s (see dementia pugilistica).

Regardless, I am not here to fight for or against these law suits, the interview with McMahon was very disturbing to hear and see Continue reading

Now This is a Possible Game Changer

There have been many attempts to create a concussion “game changer”, something that will bring the assessment and/or recovery into better focus and provide more concrete answers for all of us.  One thing many people keep forgetting is that the human brain is not only very complex but it is also very individual.  Creating blanket statements, guidelines, and recommendations are very difficult; unless of course you use a multidisciplinary approach that touches on every part of the concussion sequale.

If you have read long enough and seen the comment section you will know that we have been clamoring for a more comprehensive, evidence-based, set of recommendations that broach all four parts of a concussion: physical, cognitive, sleep, and social/behavioral.  Perhaps the Ontario Neurotrauma Foundation has done just that (.pdf at end of post and in “Current Concussion Management Page” or you can go to the ONF website);

ONF is pleased to publicly release the Guidelines for Mild Traumatic Brain Injury (MTBI) and Persistent Symptoms.  The Guidelines were generated through a consensus process using existing evidence and clinical expertise. 10 to 15% of people who sustain MTBI do not recover well or as expected. The guidelines are therefore aimed at treating and reducing the impact of persistent symptoms following MTBI in adults.  On behalf of the project team that oversaw this work, ONF welcomes feedback on the Guidelines to

There have been other guidelines, one we hold as the standard (note not gold standard) Continue reading

A Program Worth Promotion

We have highlighted Advocates for Injured Athletes on here with the story of Tommy Mallon told through the eyes of his mother Beth.  Not only are they continuing to fight for athletic trainers on the sidelines of every school they have come up with an initiative that makes too much sense – Athletes Saving Athletes.

What is Athletes Saving Athletes™?

Athletes Saving Athletes™ (ASA) is a +unique, peer-to-peer education program designed to empower student athletes with skills to help them recognize signs and symptoms of life-threatening injuries and conditions. The goal of ASA is to reduce the risk and incidence of injury and death for high school athletes using the power of kids talking to kids.

Why is the ASA Program Needed?

Every year, more than 1.4 million high school athletes in the U.S. suffer a traumatic or fatal injury. Most of these accidents are preventable. While some schools staff a certified athletic trainer, these personnel cannot be present at all the practices and competitions of every school sport. The ASA program provides student athletes basic knowledge and skills that could help save a life.

With the cost and really the viability Continue reading

How Can This Be?

A group of researchers including R. Dawn Comstock released data, published earlier this year, regarding concussions what was initially found is not surprising, or shouldn’t be;

Of 14,635 high-school sports injuries reported during the 2008-10 school years, 1,936 (13.2 percent) were concussions, according to an epidemiological study published in January in the American Journal of Sports Medicine. This was nearly twice the rate reported in earlier studies of high-school athletes.

Part of the reason the increase exists is because of the inclusion of boys hockey and lacrosse, however taking that away there would be a significant increase otherwise.  This too can be attributed to the increased awareness and better assessment of concussions.  It is of my opinion that we are just now on the verge of finding the “true” rate of concussions, for many years it has been under-reported due to the lack of understanding/awareness (also an issue with general and serious injury tracking as well, see Matt Chaney)

What makes this research “eye-opening” is what the researches found about recovery; Continue reading

NCAA Chipping In on Concussion Research

According to the AP, the NCAA will be donating $400,000 to help fund a research project;

The National Sport Concussion Outcomes Study Consortium plans to study more than 1,000 male and female college athletes who compete in 11 sports at three schools. Researchers hope to track those athletes after their college careers end and examine the long-term effects of head injuries in hopes of gaining a more comprehensive understanding about brain injuries.

As you can see the actual long-term studies with current technology and assessment tools is JUST NOW getting underway.  I don’t believe we will actually fully understand the impact until the longitudinal studies are completed.  We should get our first glimpse from research Down Under.

Week Two of App Giveaway

Last week the winner of the app guessed Michigan State, the only one of four entries…  Now with the brackets upon us it is time for the Week Two giveaway question;

  • Week Two – Deadline March 15th 10:30 PDT:
  • How many wins will 9-16 seeds get Thurs through Sunday

    • 1st tiebreaker the highest (16 being the highest) seed to win in round 1
    • 2nd TB is highest seed to win in round two
    • example: 16, 11, 4
  • Send in via tweet, email, or in the comment section of the original post HERE

NHL Power Brokers to Meet

As the weather warms that means the General Managers of the NHL go south to Florida for the meeting of the minds.  Last year the Commissioner laid out a plan to help curb the concussion issue in the NHL with ideas that included: the quiet room, expansion of Rule 48 and increased penalties from Shanahan.

Where has that gotten the sport in relation to concussions; if you look by pure number it would be an actual increase, however I do believe those measures have indeed helped.  But there is more they (GM’s) and league can do, if they want to.  Part of fostering a game/sport is to realize that there needs to be changes, often ones that go against tradition and the good ol’ days.  People, including those that run hockey seem to forget that this game was not invented with today’s player in mind, the speed and skill has far outgrown this pastime, change is inevitable.

What can the NHL do to make the concussion issue better – don’t ask the Deputy Commissioner; Continue reading

Return of Footy Concussion Watch

Our primary visitors do not know much about Footy, also known as Australian Rules Football, however due to this author liking the sport combined with the seemingly lack of current awareness Down Under I feel it is worthy of keeping up on here.

Last year I was rather critical of how the AFL and the Footy culture appeared to not to be up-to-speed with the concussion/brain injury definitely inherent to the sport;

It should come as no surprise that concussions have been seemingly low for a sport with a ton of full speed collisions; a lot of them coming “unannounced” and unexpectedly, the most prevalent way of sustaining a concussive blow.  There were 374 games played in the season with only 46 found concussions (some of them were classified concussion via the Fink Rule).

Not surprisingly after people started taking notice in Australia and with others (like this blog) doing their best to track the injury the AFL reported a rise in incidence;

After the AFL yesterday announced in its annual injury survey that the incidence of concussion rose in 2011 – following the introduction of new guidelines designed to better protect players from the condition…

However we must hand it to the researchers Down Under, as they have begun a test-retest Continue reading