Nick Mercer: Recovery is in the Eye of the Beholder

For those new to the blog, Nick Mercer is our only “staff” writer here at The Concussion Blog.  He provides a great layman’s perspective; one from a person recovering from a traumatic brain injury.  If you want to know why he does this – for us and himself – you can read THIS POST.  Thanks Nick for your time and content!

==========

In recent years, my “recovery” (more on why that word is in quotes later) seems to have gained steam and I’ve noticed more improvement, even though the accident that caused my brain injury occurred over ten years ago. I’m sure there are many physiological and neurological reasons why improvements would take this long, then again, maybe I haven’t improved that much neurologically or physiologically, maybe I just feel better in general and in my attitude toward “recovery”.

For the first nine or so years, I was focusing on trying to fix problems – I wasn’t able to do this or that, I was tired, my vision was messed up – problems that no matter how much I tried to fix, I could always improve upon, so I was reaching for a goal that couldn’t be touched. That kept me going, kept me striving. It also put me in a permanent state of dissatisfaction. There were times, of course, when I was depressed, but there were also times when I was happy. Happy, but dissatisfied.

All the while, I was pushing myself physically, in the pool, the gym, walking to and from work. I was also pushing myself mentally, through work, and through reading a lot, especially non-fiction books. My sister had told me for years that I should try Pilates, that she thought it would be good for me. I always had some excuse Continue reading

Advertisements

Helmet Minutia: What you need to know

I was dropped a line from a source back home (OK my dad) about reports recently on the news in Denver.  Here is the LINK to the 9news story that prompted my father to send the info.  I found the report very informative and brought forth many angles on the story of helmets.

Meanwhile I also was given information from other coaches and followers about other press-type people asking for helmet information in Missouri, Georgia and Louisiana to name a few.

Who is behind all of this information gathering, I have not had it confirmed, but from the people I have been in contact with, Virginia Tech keeps getting mentioned.  I don’t know if this is because of the Star Rating System or if there is a PR campaign being driven by VT and the researchers.  Regardless this seems interesting to me on many levels.

What you need to know is simple and is as follows (of course in my opinion):

  • Helmets were never designed to prevent concussions
  • Helmet fit is currently the key to proper protection
  • Physics and anatomy/physiology currently limit helmets from providing concussion protection alone  Continue reading

4th Annual Traumatic Brain Injury Conference

April 16 and 17 in Washington DC – make your plans now!  Visit Site HERE.

Now in its 4th year, Arrowhead’s Annual TRAUMATIC BRAIN INJURY CONFERENCE  brings together researchers and clinicians from industry, academia, the military and government to present ground-breaking research in a variety of areas related to traumatic brain injury, including:

  • Neuroimaging
  • Clinical Trial Design
  • Cognitive Measures of TBI
  • Chronic Outcomes
  • Drug Discovery & Development
  • Pre-clinical Models
  • Biomarkers
  • Neurodegenerative Implications for TBI

This is shaping up to be one of the good conference in regards to traumatic brain injury.  The focus will not be on concussions rather the global injury of the brain.  The information shared here will help with the concussion issue going forward.  If you get the chance and have the resources this is a place that you should go.

REGISTER HERE

Book Review by Dorothy Bedford: “Fourth Down and Inches”

Dorothy Bedford is an avid follower and contributor to The Concussion Blog.  She has offered up a book review – out of the blue and appreciated – for me to post here.  I have not read the book and if I get the chance may offer up my two-cents but until then I think that perhaps some of you may want to know about the book.  With out further ado here it is (Thanks Dorothy);

==========

The history, the stories, and the latest science of football concussions

“Fourth Down and Inches: Concussions and Football’s Make or Break Moment”   by Carla Killough McClafferty (2013)

Every week during the season, a few famous players’ concussions attract attention. They are attended by expert medical teams. Every week during the season, many youth and high school players suffer head injuries in silence because they don’t believe that a “ding” is a real injury, or they don’t want to “let the team down,” or the coach shrugs it off, or the parents don’t realize the medical or academic consequences. This book could change all that.

Carla McClafferty has written an excellent survey in a format accessible to a broad age spectrum of football players, their families, fans and youth football volunteers. With an extensive selection of heavily captioned illustrations and photos, and featuring short, punchy chapters the author presents a balanced view of the epic story of American football’s 1905 head injury crisis and the hidden, functional brain injuries underestimated and misunderstood until modern scientific methods began to reveal the truth in the 21st century. The colorful historical tale fills about one-third of the book, while the unfolding of a new perspective on brain injury and clear explanations of the latest research mix throughout the balance of the 87 page text, (plus wonderful supplemental material in the form of notes, bibliography, and further reading suggestions).

As a concussion safety advocate and fan, I have Continue reading

Repost: Matt Chaney’s Take on Heads Up Football

The following was posted here on TCB 10/24/13, I feel with the traffic it has been garnering that it should be reposted at the top of the cue for the time being.  It is worth comment and questions…

The post below is from Matt Chaney’s Blog, re-posted (in part) here with his permission.  We are posting it here not as an endorsement, rather as an opposing view that is worth the read.  Our commentary on this article by Chaney will be below this post.  We encourage everyone to see the entire post on his blog.  You can view it by clicking on the hotlink, it is titled; ‘Heads Up Football’: Truth, Tales and Legal Consequences.  *Chaney has moved his blog and we are efforting the current link of his original article.  However, he does read the comments from time to time so if you have question leave it here and he may get to it.

==========

By Matt Chaney

Posted Wednesday, October 23, 2013

Peter King posits bogus hitting technique as Safer Football in Sports Illustrated

—geezuz, the further we go in this latest football crisis, the worse many people become, willingly, on behalf of the sexy blood sport… and so Peter King of SI skips along, telling us bona fide prevention is possible for football’s irreversible head-ramming… a new post by the Hall of Fame football scribe portrays Heads Up ‘proper contact’ as legitimate; King purports this theoretical headless hitting can be instilled by coaches, enforced by referees, adopted by players… I’d like to see King demonstrate on a football field, suited-up himself for forward collisions governed by physics and bullet-head helmets; he’d ram, too, or get his ass kicked… look, folks, players cannot govern or stop ramming on a football field; rather, forces of the crazy game dictate human behavior… forget talk and trust your eyesight, especially naïve parents and kids, to understand Heads Up ‘technique’ is invalid, unreliable, a lienothing new: it’s mere rehash of musty old ‘head up’ form hitting, proven invalid since the 1960s… here’s King, introducing his discussion:

What’s been eye-opening to discover is the trickle-down effect from the NFL to youth football. As the pro league emphasizes safety more and more, so do high schools around America. … Coaches are concerned; 41 of 49 polled [by SI] said they have modified training techniques because of increased education about concussions and head trauma.

—sure, trickle-down effect will reform football danger, once again… solution for brain trauma in the collision game is just around the corner… like trickle-down ‘steroid awareness’ for football’s immense problem with anabolic substances…  King continues:

Several high school coaches emphasized the NFL teaching new tackling techniques, such as “Heads Up Football,” which teaches coaches to train kids to tackle with heads up—instead of using the helmet as a battering ram. Said Middlebury Union (Vt.) coach Dennis Smith: “In any drills we’re doing—whether it be fundamental drills at the beginning of practices, especially defensive practices—we’re always stressing head up. You have to be able to see what you’re tackling.” … Said Brandon (Miss.) coach Brad Peterson: “We always start the year, whether spring or fall, with walking through the proper techniques of tackling.” … The coach of E.O. Smith High in Storrs, Conn., Jody Minotti, said he knows he can’t prevent every concussion, but he trains his players to minimize the risks. “We do less contact throughout the week and we teach proper tackling,” said Minotti. “We preach in practice all of the time, ‘Bite the ball. Bite the ball.’ That means keep your head up and don’t ever lead with your helmet. We film tackling, we talk about tackling whenever we’re watching film.”

—huh, these coaches don’t address the facemask dilemma, the prime fault of football rules behind the charade of Continue reading

Dear Time and Readers…

What in the world has happened?  It seems like months ago I was in New York on a huge stage sharing my opinion on athletic training and concussions; in particular secondary schools and adolescents.  Now looking at the blog I have realized it has been some time since posting.

I would be lying if I said I just flat had no time, although it seems to be very scarce now-a-days.  In truth I have not had the motivation to post stories and thoughts – which happens in this blogging thing.  I truly appreciate those that have visited and have interacted on Twitter (I have found it easier to communicate in 140 or less when in this “mood”).

If you throw in the chaotic weather here in the Midwest you have a “perfect storm” that has prohibited me from being on here for some time.  With all the snow and ice I have been relegated to stay-at-home dad and then when school is back in session we have a back log of games that need to be made up.  One aspect that people don’t fully understand/appreciate about high school athletic trainers – if there is a game we MUST be there.  Not because it is our job but because we want to be there for “our” kids and families that rely upon us to take care of them.  This creates many nights that were originally scheduled to be family or personal time to be work time.

If I have learned one thing in this career its to balance your family life and personal time.  Unfortunately many athletic trainers burn out because of such demands and honestly the family dynamics pressure a career change with stable hours.  If you throw in the blog it can be hazardous for your stability; this is why I always go back to the advice from Will Carroll (@injuryexpert) when I started “don’t let the blog run you, you run the blog.”

There are times when my wife – my best friend and rock in my crazy world – deserves all my efforts around the house so doing the honey-do list takes priority over this blog.  There are times when my three kids need my attention and play/free time and take priority over the blog.  There are times when a parent calls and asks Continue reading

Just keep at it

Eleven years ago my balance and mobility were better than good. My health was better than good. Ten years and seven months ago, I was a long way away from feeling anything remotely close to good about my balance and my mobility, or about my health at all. That was a drastic turn, and it sucked, but it happened. I can’t pretend it didn’t. Well, I could pretend, but what good would that do?

Since most people’s introduction and familiarity with rehabilitation is through movies and TV, it’s important to reiterate that it’s a gradual process. It doesn’t just happen one day that everything clicks and all of a sudden life’s back to normal. Hard work is also not the secret. It’s essential for improvement, especially continuous improvement, but it doesn’t guarantee it. It happened for me. I’ve worked hard and I’ve improved, but by no means am I back to normal. It certainly doesn’t mean that someone, whose condition doesn’t improve, didn’t work hard. I know of countless examples. Movies and TV have to fit a story into an allotted time. If a book is too long nobody will read it. So, most of what people know about rehabilitation is a very Continue reading

Where is Tech Going With Concussions

Technology is ever-expanding in all areas of our life; in my short time we have gone from land line phones and massive desktop computers that could play “Lemonade Stand” to handheld personal computers that is also a phone.  The point being that technology is amazing.  In the previous post we discussed how MRI now can actually see damage to the white matter in the brain after concussion.  Until that information was presented the changes in the brain were only theorized about.

Yes, it is true that we are trying to find an objective measure, but people need to understand that this objective measure is not necessarily needed to find the concussion.  An athletic trainer with their years of education and experience are pretty dang good at finding concussions; with or without the help of “tools.”  The need for objective measures is for the TRUE PROBLEM of the “concussion crisis”; the mismanagement of the injury – mainly returning too early.

Conrad Wilson wrote up a good article on technology that is emerging, focusing on balance Continue reading

Have To Keep Educating & Holding People Accountable

The education of concussions is great, the legislation is in the right place but there is absolutely no accountability for instances where athletes are “failed”.  Before I go on, I am not perfect, I have and will continue to miss some things here and there (I missed an ACL in football which bothers me).  In fact, looking at the pressure I put on myself and hoping the world puts on my chosen profession of athletic training it may be a bumpy road.  However, missing obvious problems of health and welfare of athletes when one is an athletic trainer is inexcusable.  I implore anyone out there that feels I have missed something to call my ass to the carpet as well.

This brings me to something that I found in my inbox recently and it made me sick and should be handled.  This particular incident occurred in a state that has similar mechanisms for concussions as here in Illinois.  To create the back story on the “mechanisms” in play you should understand the state legislation and high school association concussion education;

  • Players, parents and coaches all have been given information regarding concussions
  • Officials have been given authority to remove player for concussion signs or suspicion including mechanism of injury (MOI)
  • Once removed they cannot return unless cleared by approved medical professional (IL is ATC, MD, or DO only)

With that information here is the email from a fellow athletic trainer – emphasis added is mine – (obviously stripped of identifying information);

Still have a long road ahead of education.

I was at a basketball game Friday night as a spectator and watched a player bounce [their] head off the floor.  Opponent had set a screen and athlete ran right into [defender], bounced off and landed on floor bouncing head off the floor.  The player then rolled around on the floor grabbing head and could tell [athlete] was in pain.  Time was called by the officials to attend to the player.   MOI would strongly Continue reading

Research That Should Stop You In Your Tracks

OK, that title may be hyperbole, but the new research out of Canada should make you take a step back and realize what our fine researchers are now able to discover.  Considering the context of hockey it shouldn’t be shocking that this was found in Canada (since posting we have been informed that work was done on both sides of the border), but really for a long while now some of the best work on concussions is coming from the North, for whatever reason (no disrespect to the US scientists).

Now that I effectively pissed off a few readers with the last comment, here is what was found by Dr. Paul Echlin and team:

  • concussions alter the white matter of the brain
  • structural damage can now be seen
  • MRI was used
  • this is both males and females
  • brain vascular changes were noted in males only, but resolved at two months
  • comparison with control counterparts showed that concussed individuals had white mater changes at end of season (upon being fully resolved from injury)

From the CTV News article (video at jump);  Continue reading