Month: January 2014

2013 End of Season NFL Concussion Report

Dustin Fink5 Comments

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).  It also should be noted that due to the league not disclosing actual injuries until Friday night there may be some added to next weeks numbers.

It has been weeks since you have seen us post about the concussion numbers in the NFL.  A quick explanation; at the end of the year with trouble finding Week 17 numbers we search for a few days, then we sit on numbers and cross check with sources which takes time.  Finally going through and I.D.ing other factors like helmets and new parameters takes some time.  It also helps that the past few years the NFL waits until Super Bowl Week to release their numbers.

Let us first opine about the released NFL numbers via NY Times;

In the preseason and the regular season, players sustained 228 concussions, down from 261 in 2012, when concussions rose 4 percent compared with the previous year. Helmet-to-helmet contact caused almost half the concussions this season, down from 53 percent in 2012. But more concussions occurred when players hit their heads against an opposing player’s knee or the ground.

The whole number for the season is only nine off from what we collected here.  Which tells me that what we are doing is as accurate as you can find anywhere outside of the NFL (actual players notwithstanding).  But where were the missed nine?  I happen to think its a combination of preseason and Week 17.  So, we are happy with our collection system.

The 13% drop is both accurate and inaccurate in our estimation.  Hows that you ask?  In the regular season Continue reading →

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#C4CT Concussion Summit: 2014 Edition – Live Blog

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And so it begins from the United Nations here in New York City.  Check-in has begun, and everyone is arriving; the Brewer Sports staff is feverishly working to make things go as smooth as possible (looking at you Kristi, Lindsay and PJ).  As evidenced by this being posted you can see that the wi-fi is working (at least here in the reception area) and I am ready to blog away.

Throughout the day this post will be updated by me with a time stamp and pertinent information.  The most recent information will be at the bottom of the post.  So, click on the “Continue Reading” and scroll down, enjoy! Continue reading →

My Personal Thoughts and Opinions of #C4CT

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IMG_1656I am toying with posting some “behind the scenes” stuff, I will start here and see what kind of response I get…  So, here we go and enjoy!

  •  Jack Brewer, Gerald Commissiong and General Peter Chiarelli have a vision of “shared information and working together” to solve this issue.  This means not only research but interventions and management.  I really can grasp onto this. Continue reading →

Field Report From TCB Commentator

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New York City – January 28, 2014 – Yesterday, TCB posted the announcement by the non-profit Sports Legacy Institute (SLI) regarding the launch of the Hit Count® certification program after two years of development.  Occasional guest poster Dorothy Bedford attended the press conference and filed this report from the Super Bowl Media Center at the New York Sheraton.

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The announcement was attended by several dozen members of the print and broadcast press corps, and other interested parties. In addition to the featured speakers, representatives of several Hit Count sensor device companies were on hand, including g-Force Tracker of Toronto; ImpaKt Protective (Shockbox) of Ottawa; and MC 10 (Checklight by Reebok). Commentary from Dr. Gerald Gioia, Dr. Blaine Hoshizaki, Chris Nowinski and former NFLers Mikes Haynes and Ted Johnson was supplemented by observations from Riverdale Country School (NYC) Athletic Director John Pizzi (RCS was a beta test site for one sensor) about the sensors’ real-time on-the-field utility, from parent Andrea Lustig, mother of a concussion victim, and from Paul Walker, a co-founder of g-Force Tracker.  Presented in the context of football’s marquee event, the new sensors will nevertheless also provide equally good information for other contact sports including boys and girls soccer, boys and girls lacrosse, boys and girls ice hockey, and others (involving headgear or not), as revealed in the Q&A. The Q&A was extensive, so the session unexpectedly ran 90 minutes.

Although rising injury statistics underscore increased awareness, Nowinski pointed out that most concussions are actually still not diagnosed for youth and high school football players. By using Hit Count ® as a teaching tool, efforts to educate coaches and modify players’ behavior can be focused where they can do the most good. “The sensoring technology is critical,” said Nowinski, “finally, the hits can be accurately counted and forces measured. We can achieve apples-to-apples comparison.” Nowinski also thanked the six founding Hit Count ® sponsors for stepping up to the technical challenges presented by the concept of sensoring hits.

Dr. Blaine Hoshizaki, director of the Neurotrauma Lab at the University of Ottawa, explained some of the technical details behind the certification criteria, which include nine different types of impacts. The criteria were set to include as many linear accelerations of the head that may cause brain injury as possible. He also noted that the threshold criteria for rotational impact are not yet part of the Hit Count ® certification, but are still being studied. [Only a few of the new sensors can measure and record rotational forces, whose shearing action on brain tissue has been discussed in the scientific literature.]

Dr Gerald Gioia of Children’s National Medical Center and George Washington University School of Medicine elaborated further. For instance, why was 20 g’s (linear force) set as the threshold for a subconcussive blows?  Gioia demonstrated some of the many lesser forces, such as a thump on the back (4g’s), which are very unlikely to cause damage.  While most sensors will Continue reading →

Hit Count® Has Come To Fruition

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Prevention of concussion is a bit of an oxymoron; nothing we know about concussions can stop them from occurring while in action.  HOWEVER, there is one way to prevent concussions – limiting exposure to the collisions that create a concussion.  Moreover, research suggests – as well as observations – that being exposed to subconcussive hits can have detrimental effects on brain function.  The subconcussive hits may even predispose someone to getting a concussion later on; this is obvious if you look at the data we have collected on NFL concussion over the past four years, (305 concussions in weeks 1-9 vs. 377 concussions in weeks 10-17) greater than a 20% increase as the season wears on.

Sports Legacy Institute has announced a certification program to further the Hit Count® initiative during a press release during Super Bowl week in New York City, today (along with the SLI Hit Count White Paper – see link below press release);

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Sports Legacy Institute Launches Hit Count® Certification Program in Collaboration with Leading Concussion Experts and Head Sensor Device Companies to Make Contact Sports Safer

Using Hit Count® Certified Products to Monitor and Minimize Brain Trauma Could Eliminate 500 Million Head Impacts in Football a Year, with the Goal of Reducing Risk of Concussion and Long-Term Brain Damage

New York City – January 27, 2014 – The non-profit Sports Legacy Institute (SLI) announced a major advance in the effort to prevent concussions and brain damage in contact sports today with the launch of the Hit Count® certification program after two years of development, which was unveiled at a press conference at the 2014 Super Bowl Media Center in New York City.

Hit Count® builds on the progress that head sensor device companies have made in developing devices that can measure acceleration of the head. Current products used on the field are focused on  alerting coaches, medical professionals, and parents when a potential concussive impact occurs.

Inspired by Pitch Counts baseball, which set limits to the number of times a player throws from the  mound to prevent arm injury, Hit Count® Certified Devices will have a second function that measures and “Counts” impacts that exceed the Hit Count® Threshold, set by a committee of  leading scientists, with the goal of minimizing brain injury.

“Research using sensor devices has revealed that each year in the United States, there are over 1.5 billion impacts to the heads of youth and high school football players,” said Chris Nowinski, Founding Executive Director of SLI who launched the Hit Count® initiative in 2012 with SLI Medical Director Dr. Robert Cantu. “Most hits are unnecessary and occur in practice. By utilizing  Hit Count® certified products as a teaching tool for coaches and a behavior modification tool for athletes, we can eliminate over 500 million head impacts next season.”

Committee member Gerry Gioia, PhD, of Children’s National Medical Center and Continue reading →

Getting A Bit Fidgety On A “Snow Day”

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It’s not actually snowing, but no school today because of -20’s windchill.  With my kids out and some time to relax, I have found myself looking back and getting a bit nervous for the upcoming week.

It was a heckuva weekend as an athletic trainer and this week is shaping up to be a big week in terms of concussion education for me.  As you may have already noticed I am heading to New York tomorrow to be part of the #C4CT Concussion Summit, both as a live blog feed and a panelist.  I hope many can make the event, and many more learn from what I can get down on the interwebs.

Let us first reexamine the life of an athletic trainer this past weekend…

It started Friday night as the boy’s team was on the road and I caught wind (we seem to have a ton of sources as AT’s) of a collision between two players in the game.  One of them had to go to the ER for some sewing work the other was ruled out by the AT with a concussion.  So began my communication and information gathering well into the late night – and I wasn’t even there.

Saturday came with anticipation of seeing the injured players, fully assessing and beginning a recovery plan – while attending to a high school wrestling dual tournament.  I don’t think many non-AT’s appreciate the juggling act necessary to even take a leak during these type of events let alone get some food, but now throw in two separate concussion evaluations and meetings with parents it becomes a minor miracle.  However, I would be remiss if I didn’t have an outstanding volunteer first responder and student AT.

After testing and making the decision to let one player travel but not play and the other to not travel at all, it was time to focus on the wrestling.  It was a very good set of matches with an unlikely victor as a team.  However, in the aftermath there was a bit of false bravado by an athlete as a fist and arm went through a double-paned glass window – the ones with wires in them – and then extracted said arm.

Having an athlete present with possibly the “ugliest” injury you have ever seen can be a bit discomforting, which it was as blood was not only leaking out it was pulsing out of the large gash.  Some how, some way when controlling the bleeding there was not one drop on my clothes, an absolute miracle.  The stories being related after the fact have been from preposterous to accurate, the net-net was that we had a life-threatening injury and it was taken care of quickly and professionally.  On top of that the athlete was all taken care of and went home that night, a very lucky kid in the face of doing something very dumb.

Sunday was not a rest day as 11 hours in the gym was on the docket again, for the little kids wrestling individual tournament.  I actually learned a ton from being there (only had 5 bloody noses and one “injury).  I learned that if kids/parents want kids to be in a “collision-type” sport that demands physical and mental discipline that wrestling may be the answer, over football for as young as 5.

Although school is out today my job is still in full swing.  Beyond the paperwork from the weekend I had to figure out a way to meet with the injuries at school and talk with parents.  Set up doctors appointments.  Track an injured athlete trough surgery.  Call coaches and admin to remind them of my absence.  And get the training room cleaned, set-up and directions for the sub AT coming in for me.

Oh, there is this blog too, which will have breaking news today.

As I am writing this I only wanted to share what an athletic trainer does.  Sure, because I post here makes me not the “normal” AT but there are many athletic trainers out there that do this and much more than me on a daily basis.  It is very important to me to share my experiences so you can see how valuable AT’s are.

Parting, I would like to now extend an invitation to Commissioner Rodger Goodell to meet with me while I’m in New York.  I am actually staying a block or so away from NFL HQ.  So, Mr. Goodell (or representatives) just give me a shout in my in box! hahahaha.  Can’t say I didn’t try!

SLI Press Release Primer

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Coming up at 3:30 EST in New York City as part of the Super Bowl week the Sports Legacy Institute will being having an announcement about an initiative that could help with concussion issues.  It is no secret this will deal with the Hit Count ideas floated two years ago.  Below is the re-post of the February 3, 2012 announcement:

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Sports Legacy Institute did in fact release their white paper today; it simply brings to the surface something that they along with others have been saying with more frequency.  Their initiative to create a Hit Count is a bold step and on that is welcomed, especially in light of the very current research from Purdue.

You can find the article on the SLI website (here) or you can read the final white paper .pdf here; there is a very good background for this idea and the simple yet powerful citation of research already performed in this area.  Their idea is mapped out very well, again the devil will be in the details as it all begins to be sorted out;

There are technological and monetary limitations to a pure Hit Count, as Hit Count systems currently are only sold for helmeted sports, and there are costs involved.  A Hit Count is not as simple as a pitch count, where coaches only need a pencil and paper.

However, hits to the head can be accurately estimated, and methods can be developed to approximate the brain trauma exposure during games and during practice based on known variables, like position.  With these estimations, rule changes and practice guidelines can be provided to ensure few, if any, athletes exceed a proposed limit.

Little League pitch counts are limits on the number of “pitches thrown per day” and mandate up to three days of rest after exposure to elbow trauma to allow the ulnar collateral ligament to recover.

A Hit Count should explore the following guidelines:

  1. Minimum threshold to be considered a “Hit”
  2. Maximum Hits per day (all counts stratified by age)
  3. Maximum Hits per week
  4. Maximum Hits per season
  5. Maximum Hits per year
  6. When the technology is available, should there be a “Total Force” threshold derived from number of hits times mean force per hit
  7. Minimum required days of rest after a minimum brain trauma exposure

In football, a Hit Count might lead to fewer practices that involve helmets and pads or the limits on the use of high impact drills. In soccer practice, it may mean tracking headers in practice and games. This policy is probably most critical to the youngest athletes, who may be at the greatest risk, and should receive less brain trauma than older athletes.

As noted the implementation of this may be difficult to get an accurate hit count for each individual, it is not like a pitcher where they are the only one on the field performing the specific task.  However, that being said and the limitations discussed in the white paper, simply reducing the number of full contact days will reduce the overall number of hits.

Until research can identify a more specific number we must Continue reading →

NOCSAE Advancing Testing?

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Perhaps, pending a vote in June, new standards could be set to get a helmet NOCSAE certified.  The news comes as the research arm has come up with plans for a testing scenario for something beyond linear drops;

The National Operating Committee on Standards for Athletic Equipment (NOCSAE) board of directors has approved the development of a revised football helmet standard that will require helmets to limit certain concussion causing forces.

You can see the full NOCSAE Jan 24 Release by clicking on the link.

It has been a long while since the standards have changed, but the calls for including more “realistic” type of scenarios in place have been loud for some time.  Including your’s truly, who believe that the rotational and angular forces were woefully under represented in any sort of testing.  I have been told by one representative with vested interest in this that for years the issue has been that these type of tests were “not repeatable.”

If everyone can be on the same footing with this and these new ideas actually translate to the “real world” then I am all for it, no matter the cost.  However, if this is something that is pure window dressing and will not actually impact a change – if that is even possible – then we are wasting time and money.

Terry Ott: 3rd Down, CTE to go – FINAL Part

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This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE and PART 6 HERE.

It has been my pleasure to post the stylings of Mr. Ott over the past few weeks.  The guy has worked hard on this basically “paying it forward” so perhaps one person will run with the information.  I admire his spirit and “sticktoitivness”, thank you, Terry!

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AND IN THE END…THE CULTURE MUST CHANGE AND/OR THE FALL OF THE FOOTBALL EMPIRE

“In this sort of feminized atmosphere we exist today guys who are masculine and muscular…kind of old-fashioned guys run some risks.” -Brit Hume, Jan. 13, 2014

You know, I don’t really care much for the brand of “news” that FOX espouses and yet this is the second, and last time I will quote from it.

Because what Brit Hume recently said deserves to be discussed. Even though his comments may be a mile wide and only an inch deep and were not referring to the “manly” sport of football, they may in fact strike to the heart of the civil war now going on in pigskin circles regarding concussions and brain injury.

On one side of the debate are what the League of Denial authors rightly called the deniers, and the other side would seem to be the whistle-blowers. The deniers see the whistle-blowers as silly sissy Marry la-la’s trying to wreck football and the whistle-blowers see the deniers as Neanderthal numbskulls, old-fashioned guys well past their sell date.

Perhaps these are the risks that can befall the old guard, the deniers. That of being accused of being out of touch, thick, ignorant of the facts, or worse.

But does that make the whistle-blowers, those alleged soft, girly man, nanny-state purveyors “feminized”?

Well, if it means caring about football and employing common sense in a brutal arena, then sign me up for NOW, now, man.

Because pro football as we now know it is in danger-yes, real danger.

Danger of being law-suited and legislated out of acceptable existence.

And, as I have previously pointed out, shutting up about it is just plain dumb and ensures football will be KIA.

The lawyers smell money – that’s real money – and the government will most assuredly act, and maybe even in a Draconian fashion, if pro football does not get its brain injury prevention and after care act together very soon.

The NFL and their broadcast partners are joined at the hip. For the most part, this ain’t good because neither hand wants Continue reading →

#C4CT Concussion Summit Agenda Set

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Brewer Sports International has set their agenda for the 2014 Concussion Summit in New York at the United Nations on January 29th.  You can view the full .pdf HERE.

Time is running short for your attendance but I can tell you that this meeting will be well worth the time and investment.  You can also catch some of the Super Bowl festivities during your time in The City (this guy will be).

I am excited to be on a speaking panel, but I am also excited to be typing away a live blog during the event.  I hope that my keystrokes don’t bother those in attendance too much!  Although I will be updating it live, I promise that I will not get every little nugget interesting to you, but I will capture the best I can.

You can register HERE.

As you might imagine there have been plenty of meetings presented to me while I will be there, but I am trying to figure out a spot where we can possibly have a meet up and discuss – stuff.

However, there is one meeting that I have yet to be invited to, but would gladly accept; a meeting with Mr. Goodell and the NFL.  This may be pleading here, but if anyone can make it happen I am open in the afternoon of the 28th!  Hahaha!

Terry Ott: 3rd Down, CTE to go – Part 6 – UPDATED

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CBC 5th EstateThis continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE.

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UPDATE 21:19 1/22/14 – rectified link to CBC The Fifth Estate “Head Games” (see below)

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HELLO, IS THERE ANYBODY IN/OUT THERE, JUST NOD IF YOU CAN HEAR ME, IS THERE ANYONE AT HOME?

“Now I remember why I gave up speaking to journalists. They are a species of foul vermin. I wouldn’t hire people like that to guard my sewer. Journalists are morons. They’re idiots. They’re ignorant and stupid.” – The late, great, irascible Lou Reed.

Well, up here in the Great White North, the question of (seriously) addressing the serious problem of concussions in the Canadian Football League would appear to be a deaf, dumb and blind one, boy.

Or, maybe as popular as baked beans on a bus trip.

For whichever way you want to turn this thing loose, up here, it’s locked up, tight.

As I’ve written before in this series, although there has been some pretty good reporting, especially by the CBC where on their website they still carry many reports and videos about concussions, about the only report on concussions and the CFL’s role that I can find is a 2008 CBC Fifth Estate report entitled, “Head Games.”

Below is the web promo, description and link but that link does not work. (The Concussion Blog originally linked to this report several years ago when the link did work.)

CBC The Fifth Estate – “Head Games” broadcast in 2008:

“They have been called the greatest football team in the history of the CFL — the Edmonton Eskimos of the 1970s and ’80s that won five consecutive Grey Cups. But, for some of the star players on that team, the years of triumph ended ingloriously in early deaths, from heart attack, suicide and misadventure. The tragedy of those early deaths was often compounded by alcohol or drug addictions, probably caused by another, less visible, killer. Recent research by neuroscientists now shows the link between on-the-field concussions and brain damage; a permanent injury that can lead to depression, suicide and severe aberrant behaviour. The damage is so profound, the researchers say, that post-mortem examinations of the brain tissue of five former professional football players can be compared only to the tissue found in the brain tissue of advanced Alzheimer’s cases.” CBC The Fifth Estate – Head Games

This 2008 report was actually ahead of its time, and again, the only one that I know of that cornered the CFL and asked some tough, prescient questions. The former commissioner had that old deer/headlamps face a few times and newspapers at the time took a toot but then everyone went back to a snore. Comfortably numb.

But now, there is a proviso on the Fifth Estate website advising thatprior programs from 2003 were inadvertently re-posted in 2013 and therefore, contact customer service, yada, yada, yada, and blah-blah.

Yet interestingly – I said interestingly – the only Fifth Estate link that I could not get to work was…TA DAH: Head Games.

I am alleging nothing-although I may later sort of spatially speculate-but there are some conspiracy theorists out there who are very suspicious.

One of them is Phil Colwell, the former CFL running back who Continue reading →

University of Oregon Novel Study

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I found a very interesting email about research being done at the University of Oregon.  It was so well written I thought I would just place it on the blog…

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In what may be the first study of its kind, the University of Oregon’s Motion Analysis Laboratory released a fascinating and chilling new video that illustrates the dramatic effect a concussion can have on high school athletes’ ability to control balance while walking.

Using computer generated images from reflective markers worn by the subjects, the video shows the gaits of two high school students – one a healthy subject and the other a victim of a concussion from a helmet-to-helmet collision in football practice two days prior – to emphasize the poor control and balance of the concussed athlete.

The full study included 40 high school athletes – 20 who were diagnosed with a concussion from sports including football, soccer, volleyball and wrestling, and 20 similar healthy athletes – who were tested over a two-month period. The results showed that the concussed athletes had trouble maintaining balance and walking speed while also responding to auditory cues as long as two months following the concussion.

Research on concussion recovery time, like what is being done at the University of Oregon, may help improve safety and better pinpoint when it is safe for to return to field or court.

Interesting .pdf Making Rounds Now – Addendum

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AFCA pdfI was tipped off by a fellow athletic trainer in a state where this .pdf (click first link below) is being circulated around.  I find it interesting in the wake of the American Football Coaches Association meeting that this is being titled the way it is.

Concussions in Football is how it is titled on the info packet, but the subject line that my source received was “Our Game is Under Attack”.

ARE YOU SERIOUS?

First, let me say I have read it – three times – and find nothing wrong about what is being presented.  Even with the opening HUGE FONT reason/opinion Dr. Sandra Bond Chapman has for continuing playing youth football.  I respect that opinion and cases can be made for such a strong statement, in fact it is lore at this time.

But to claim the sport itself is under attack because some may be looking beyond the lore of benefits is a bit much, in my opinion.  I have explained many a time here on the blog that what I see it as – and my reason for presenting information – is to keep the game around.  The game is not under attack because of concussions, if the game was under attack it is because of the way it handles injuries – namely concussions – and the possible ramifications.  The document is correct in stating not all brain injury is permanent, yet we don’t have any long-term data (solid longitudinal) on the effects of this sport or others that are collision based outside of boxing.

I honestly believe that if every sport coach, parent or kid looked at this document and Continue reading →

Return To Learn Conference

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TINY FINALTime is running short for this conference as well, but I thought I would provide another opportunity for people to gain valuable information in the dynamic concussion issue.  A friend of the blog, Katherine Snedaker, is putting on a novel conference; based around the return to learn aspect of concussions.

NORWALK, JAN. 12, 2013 – Katherine Snedaker, MSW and Founder of Pink Concussions, an international social media organization focused on research and resources for female concussions from sports, accidents or military service, and SportsCAPP, a Concussion Education, Advocacy and Policy Group, has announced the dates for The Concussion Conference: Connecticut: Return to School THEN Return to Learn.

The Conference will take place on Thursday January 30th, 2014 at Chelsea Piers Connecticut in Stamford, and then repeat with the same format on Friday, January 31, 2014, at Quinnipiac  University School of Medicine in North Haven, CT.

To register, see http://www.TheConcussionConference.com and to follow on Twitter use #CTBrain.

The Concussion Conference will provide training sessions for school nurses, school staff, pediatricians, athletic trainers, and parents on how best to help children return to school and continue  to heal after concussions.

The Conference daytime training sessions will feature multiple national speakers including Brenda Eagan Brown who is co-author the new 2013 CDC Resource: Helping Students Recover from a Concussion: Classroom Tips for Teachers. Also presenting is Dr. Mike Lee, co-author of the newly issued American Academy of Pediatrics’ report, Returning to Learning Following a Concussion.

You can find the remainder of the Full Press Release HERE.

This event will be on the heels of the Brewer Sports International #C4CT Concussion Summit in NYC.  I wanted to be there as a presenter and as a friend, alas my duty as an athletic trainer will not allow me to do so.  I encourage people and press who have the time to make the Connecticut events as this is a new angle that Katherine is attempting.

In addition to Brenda Eagan Brown, attendees can listen to addresses from Alan Goldberger and TJ Quinn among others, you can find the speaker list HERE.

You can register for the conference HERE.

 

Terry Ott: 3rd Down, CTE to go – Part 5

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MIPSThis continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE.

IS “MIPS” A FOUR LETTER WORD AND (Every)THING YOU ALWAYS WANTED TO KNOW ABOUT SNAKE-OIL*

*But were unaware to ask

“The cold truth is that football players are in jeopardy.”  — Bill O’Reilly, he of the No Spin (End) Zone, Jan. 8. 2014


The Concussion Blog supremo Dustin Fink once mused to me that football, in its infancy a hundred years ago or there about, was meant to be played by (slower) men about five foot nine and weighing an average 150 pounds or so and at a time when a 200LB plus player was basically a monster, a freak.

You can appreciate the Dustin statement inference by referencing high school physics in that net (G) force equals mass times acceleration and also appreciate that now, with players routinely 50-150 pounds heavier then when the first Roosevelt was in the White House, and many now with world-class speed, the G forces generated on impact by today’s pro and college football players are exponentially greater than in Knute Rockne’s days and the resulting collisions on the field can be life threatening in the short, and long-term.

Life in big-time football today is both Darwinian-only the strong survive, and if lucky thrive, and inherently  Hobbesian-nasty, brutish and short.

But since literally millions of boys and young men seek football playing dreams, what to do?

Well, since just about all aspects of football equipment has undergone a radical revolution-footwear, pads, uniforms, gloves and eye protection-how about an update on the most important piece of football gear-the helmet.

A little history lesson: President and Rough Rider Teddy R was a big football fan, and when 9 players died in 1913 as a result mostly of skull fracture injuries, he, along with Knute Rockne advocated for a shift from three yards Continue reading →

How Do We Know If Anything Is Working at NCAA Level?

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In the NFL we have publicly disclosed injuries, including concussions, so we can (and have) track the numbers that are reported to see if there is a change in outcomes.  Certainly there are flaws with the reporting system as we have discussed many times but at least we can get a set of consistent numbers (we hope) from year to year.

But what about the NCAA, where there are many more players: 126 FBS teams at about 80 players per team means 10,080 players in FBS alone.  Or, about 8,387 more football players than the NFL – this number does not include FCS, DII, DIII or even the NAIA or Juco football schools.

Timothy Bella of Al Jazeera America (I guess the NSA has my IP address now and yours too if you go to links, ha) has produced a great article on this problem of tracking concussions at the NCAA level;

For this college football season, America Tonight has been tracking all the publicly reported concussions in the 10 FBS conferences and the independent teams. Auburn was one of 42 FBS programs to not publicly report a single concussion this season, accounting for exactly one-third of the 126 FBS programs. The group includes Rose Bowl and Big Ten champion Michigan State and Big 12 champion Baylor.

In fact, in the 10 conferences and the independents, coaching staffs and media outlets only reported 192 concussions at all among more than 10,000 players, according to data compiled from early August 2013 to Dec. 27, 2013, in the America Tonight Concussion Map. That’s an average of fewer than two reported concussions per team.

That number is STRIKINGLY low – due to reasons outlined in article – but 192 concussions is less than the 217 concussions we found in the NFL from preseason through the end of the regular season.

I provided many thoughts to Bella about why this may be occurring, including the teams with higher press presence Continue reading →

The OTL Investigation on ‘Heads Up’ Football

Dustin Fink9 Comments

It may have slipped some of your reading or viewing, but ESPN’s Outside the Lines did a piece on the USA Football Heads Up Program.  The article and video were presented last Sunday morning – I cannot find a YouTube version of the OTL show but you can find that part HERE.  The seven minute presentation is great for a quick overview of the issues ESPN has found.

For more in-depth coverage you should read the article by Steve Fainaru and Mark Fainaru-Wada, the same authors that penned League of Denial.  There are some wonderful points brought to light by the Fainaru’s;

The program teaches concussion awareness and proper helmet fitting, but its central tenet is the soon-to-be trademarked Heads Up Tackling program. When executed properly, proponents say, Heads Up Tackling literally takes the head out of the game. Players are taught to keep their heads up and lead with their shoulders when tackling.

[…]

But critics view Heads Up as a cynical marketing ploy — a repackaging of old terminology to reassure parents at a time the sport is confronting a widening health crisis.

There is a reason I have been “relatively” quiet on this topic; it’s because they are doing some very good things in the way of education and helmet fitting.  As you may know I am huge on the topic of awareness when it comes to concussions.  I have stated many times that the injury itself is not the “ice burg we can see above the water” rather it’s the mismanagement of the concussion that is the massive ice chunk we cannot see from the surface.

That being said, with the actual tackling technique being taught I too feel this is a repackaging of an old mantra.  Rules were even put in place as early as the 70’s to accomplish this task of taking the head out of the game.  Face tackling, spearing and butt blocking all have been on the books as penalties to help avoid using the head as a weapon.

The problem being that those are not called very often, when they are called they are inconsistent at best, and what has it done for the game over nearly 40 years?  I am not nearly as critical as others;  Continue reading →

#C4CT Concussion Summit 2014

Dustin Fink2 Comments

In a little over three weeks, Brewer Sports International (BSI) along with #C4CT (Coalition for Concussion Treatment) founding partner Amarantus BioScience will be hosting their 2nd Concussion Summit in New York, at the United Nations.  There have been many press releases on this event, and I have mentioned it a time or two on Twitter (and will continue).

Sure, there are many “summits” around concussions and head trauma – which is great as it keeps the dialog going – but few are populated by people with ideas on going forward.  Often, we find ourselves sitting, listening to bright people talk about what was done and can’t be done; rarely do we find the same bright people addressing the issues going forward.  Whether that be with tactical changes or with management or even the possibility of intervention with traumatic brain injury.

This edition of the #C4CT Summit on January 29, 2014 will hear from some people in many fields – you can see the current line-up HERE – focusing on the burgeoning topics of chronic traumatic encephalopathy (CTE), general neuroscience, pharmacology among other topics.

Interestingly enough, yours truly, was invited to sit on a panel and discuss how all of this information has been translated to the high school level – as an athletic trainer.  I was not only surprised by the invitation but feel it is VERY OPPORTUNISTIC for a “boot on the ground” athletic trainer to provide input.  I feel that not only have athletic trainers seemed to be seen and not heard, the vast majority of us practice in the high school setting, where the adolescents are playing sports.  I can assure you I will do my very best to be a quality representative of not only athletic training (it appears I am on the only AT in a speaking role) but those of us working with the most kids/athletes.

Anyhow the cast of speakers/presenters is indeed “star-studded” and even has some opposing view points on where we should be headed; which should make for some quality discussion.  If I can get my technology working and to NYC I will attempt to live blog/tweet the event for those that cannot make it.

Speaking of that, I know that time is short but I encourage anyone who is going to be in NYC during Super Bowl Week try to attend this event.  If there are scribes out there I am sure the wonderful support staff at BSI can arrange for you to cover and meet the star of the show – me, of course – hahahahaha, I kid.  Seriously, you can register HERE and if you have questions feel free to contact them.

I hope to see you all there!

Terry Ott: 3rd Down, Absence of CTE to go – Part 4

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This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE.

THE CURIOUSLY TITLED AND ENIGMATIC BRAIN STUDY, AND THE SEEMINGLY RHETORICAL QUESTION OF ’14

“We can’t solve problems by using the same kind of thinking we used when we created them.” –Albert Einstein, who knew a thing or two about brains.

Dr. Tator: Not absent

Dr. Ann McKee, professor of neurology and pathology and co-director of the Center For The Study Of Chronic Traumatic Encephalopathy at Boston University once mused in a television interview that she wondered if most if not all professional football players had some degree of CTE.

After all, the brains of former football players examined by the Center so far has found the existence of CTE was near one hundred percent.

Whether one agrees with the now famous Dr. McKee in totality regarding the prevalence of CTE in former players, her and her team are world-class doctors and researchers who have brought the serious issue of football related brain trauma into the collective consciousness of tens of millions of observers.

Most believe that the BU work on CTE was the main catalyst for the National Football League to eventually in 2009 admit that there was a cause and effect between football play and CTE and was also the key preponderance of the evidence that made for a 765 million dollar settlement between the league and former players who claimed neurological damage from playing football.

Here in the Great White North, Dr. Charles Tator, of the University of Toronto, has been referred to as the grandfather of brain research and sort of the Canuck version of BU-like CTE research.

Dr. Tator, a neurosurgeon, originally specialized in spinal cord injuries, but was leader of a study of the brains of 6 former Canadian Football League players that was published in May, 2013.

Despite the fact that Dr. Tator’s study found a fifty percent incidence of CTE among the subjects, the study was entitled “Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatically”

The detailed study places much weight on the small number of brains Continue reading →

Thank You! Good Luck Going Forward.

Dustin Fink4 Comments

The reason for this post is simple; Thank You!

To the reader, the commentators, the links, the views, the emails, the tweets, the everything.

When this blog started in September of 2010 I had no clue.  No clue on what I was doing.  No clue on how to write.  No clue on the audience.  No clue on if it would impact anyone.  No clue if it would last.

If not for all of you on the other side of this screen, none of this would have happened.  In terms of bandwidth and views this blog is very small compared to the juggernauts of the interwebs, but over time it has had place and a voice.  Not only for me, but for you.

I could sit here and spew the stats, the accolades and such but, why?  There is no need, this blog was never founded on that or is continued for that.  This blog is a space for information and opinions from an athletic trainers perspective about concussions.  Looking back on the “Disclaimer” page I wrote over three years ago I feel I have attained what I wanted to accomplish and WILL CONTINUE TO PURSUE.

So, as you ring in 2014 let us all try to make this the best year yet!