Concussions: Not Just Male; Not Just Football

Here at The Concussion Blog, we talk all things concussions. Concussions are brain injuries and they are definitely something we must continue to learn more about and continue to educate the youth and the parents. Dustin and I are both Certified Athletic Trainers at the high school level and I really believe that puts us on the “front lines” when it comes to concussions and concussion education. But I think something that gets lost in the whole concussion issue that a concussion is NOT a football problem; it is a SPORTS concern. This article will once again present another sport that brings its own risks of concussion and it needs to be brought forward once again. Cheerleading, girls basketball, and girls soccer are all prime examples of concussion sports that slide underneath many people’s radar. Continue reading

Saint Louis University TBI Research

Researchers at Saint Louis University have teamed up with the Department of Defense as they conduct research on traumatic brain injury. Dr. Richard Bucholz, director of the Saint Louis University Advanced Neurosurgical Innovation Center (SANIC) and his colleagues have received a grant from the DOD to study the brains of service members coming back from the recent wars in Iraq and Afghanistan. Continue reading

Concussion Management: Change is Happening!

I have noticed a major change in how we have been able to manage concussions at my school since this new legislation. When it initially came out the school personnel, athletes, and parents were reluctant and upset with the new requirements. I, on the other hand, was ecstatic because it put the athletic trainers in the forefront and helped bring to light the issue of concussions along with the issue of the lack of athletic trainers in secondary schools.

I am solely responsible for concussion management at the school that I am contracted with. In August, I spoke numerous times at parents’ meetings, with the athletes, and with the coaching staff. I spoke at length with the school nurse. All of them received information from the Illinois High School Association and CDC regarding concussions. The coaches, administrators, and school nurse were also provided with the return to play protocols.

It is important that we as athletic trainers take control of concussion management. Most others are not educated to do so nor Continue reading

Ten Reasons Your School Needs an Athletic Trainer

  1. A certified athletic trainer is the #1 healthcare provider trained and educated to work with athletes.
  2. A certified athletic trainer is trained to handle emergencies whether it’s a broken arm, a neck injury, or cardiopulmonary. All athletic trainers are trained in life-saving skills such as CPR and AED use.
  3. Athletic trainers are one of the best-educated professionals to recognize and manage concussions.
  4. Athletic trainers are proactive and spend a lot of time trying to prevent injury.
  5. Athletic trainers have hundreds of hours of related experience before they ever step foot into a full-time job. Continue reading

Trends in Concussion Incidence in High School Sports

Mike Hopper takes a second to review a current research article, we would love to hear your take on this as well.

Concussions appear to continue to rise. Is it due to an increase in incidence or is it due to an increase in awareness? This study was conducted over an 11 year period in the Fairfax County School District in Falls Church, Virginia. The authors note that the numbers saw significant increases over the course of the study, but they do not attribute that to anything in particular.

The researchers conducted an 11 year study in a large school district with a certified athletic trainer on site for games and practices. Each school had 2 part-time athletic trainers from 1997-2005 and then a minimum of one full-time athletic trainer and one part-time athletic trainer after that.

A common occurrence is that football was the leading sport for concussion incidence. I think this fairly well-known at this point and no surprise. Girls’ soccer was #2 on the list which also should Continue reading

Helmets First

For youth, riding a bike is a favorite form of exercise and fun. But accidents do happen and parents should make sure they provide protection for their kids. For many, wearing a helmet while riding a bike is seen as a weakness, but kids should wear a helmet when riding a bike because you just never know what might happen. Dr. Joseph Cangas, a Columbia, IL pediatrician, is on a mission to get kids to start wearing bike helmets. He founded Helmets First in 2004 and gives away approximately 2,000 helmets each year to kids in the St. Louis area. ‘The Helmet Doctor’ not only gives away helmets, but he also educates the kids through school assemblies, bike rodeos, and other safety events.
Helmets First originated when the pediatrician discovered how few of his patients wore a bike helmet. It has continued to grow as this doctor donates his time and works to educate and equip kids and parents with this important information. Not only does he give away helmets, but also the kids and parents are also instructed on the proper fit of the helmet.
I won’t begin to tell you that wearing a bike helmet is going to definitively prevent a concussion because we all know there is no piece of equipment able to do so. I will, however, tell you that a bike helmet can prevent other head injuries and could potentially save lives. The most recent information I have seen recommends replacing a bike helmet after a single impact which is different from many other helmets.

More information about this non-profit organization can be found at

Almonte on 7-day DL

The Brewers have announced Erick Almonte has been put on the new 7-day disabled list with a concussion.  Almonte is the first Major League player to be placed on the DL specifically set up for concussions.  The Associated Press article states that he was hit with a thrown ball during batting practice.  Almonte complained of dizziness and had a welt above the eye.  This will be something to keep track of over the next several days.

Could Using an AED in Fennvile Helped?

This blog is mainly about concussions however, athletic training is a very strong undercurrent here.  Mike Hopper takes a look at a column surrounding the tragedy in Fennville, MI, and how an athletic trainer could have been utilized.

I’m sure anybody in the athletics world has heard of the unfortunate tragedy that took place last Thursday night.  For those who don’t know, Wes Leonard, a 16 year-old basketball player from Michigan, died after scoring the winning basket that sealed his team’s 20-0 perfect regular season.  Leonard collapsed amid the celebration that ensued after the game and died a couple of hours later.

Chilling reports have come from this small town of Fennville that are sending up red flags across the country.  There are mixed reports as to if any care was given immediately following the collapse, but it appears very little was given until paramedics arrived.

In John Doherty’s column on Monday, the author goes to another problem with this whole incident.  CPR or lack of CPR has been brought up numerous times and rightfully so.  But what has remained hush-hush is the lack of AED and the lack of proper medical services provided onsite that night. Continue reading

Winter Wednesdays– In the Clinic

The football season is officially over, however that does not mean the concussion risk is gone.  Yes, it will be reduced slightly, but awareness is continued and the importance of an athletic trainer is underscored more.  During the winter months we will spend time blogging about the life of an athletic trainer, what I do, and what we can do for schools.

Dustin has written some about his “days in the life” and with National Athletic Training Month upon us, I thought I’d share what my current job is like as well. 

Like Dustin, I am an athletic trainer working in a physical therapy clinic and providing outreach services to local high schools.  I have worked a large amount of hours in the fitness centers, but I also spend a good amount of time working in the physical therapy area as well.  This is in addition to being at the high school one day week plus varsity games.  Now that spring season has begun (yesterday here in Illinois) things will begin to pick up; running between baseball, softball, girls’ soccer, and the occasional track practice.  But I have more recently added additional responsibilities in the physical therapy clinic.

As many surely know, athletic trainers are not “billable” providers in the physical therapy setting, but in our Continue reading

National Athletic Training Month

Welcome to National Athletic Training Month.  Each year during the month of March, our profession takes the time to reinforce our stance and spread the message to promote the athletic training profession.  Many of you here have probably heard of an athletic trainer, and hopefully you know what an athletic trainer can do.  For those who don’t know, hopefully you can learn something over the next month and recognize the importance of the athletic trainer to athletes and to active workers.  The Concussion Blog originated as an idea of Dustin Fink, an athletic trainer in Central Illinois.  The blog has spread to include a few more authors including myself, an athletic trainer in Southern Illinois.  Over the course of the next month, we intend to highlight athletic training in addition to continuing to educate on concussions.

The National Athletic Trainers’ Association selects a theme each year.  For 2011, the theme of National Athletic Training Month is “Not All Athletes Wear Jerseys.”  The most common location that one will find an athletic trainer is working for a sports team whether at the high school, college, or professional level.  This is referred to as the “traditional” setting, but athletic trainers have gone on to thrive in other settings as well.  Athletic trainers have found success in the public safety sector and military setting as well as in other medical offices.  The education and training we receive has led to being able to branch out into these other fields.

Tune in throughout the month as we highlight the athletic training profession.

Every athlete deserves an athletic trainer.

Advocates for Injured Athletes

Beth and Tommy Mallon have a story to tell; it’s a story they hope will help protect youth athletes across the nation.  The mother-son duo has launched Advocates for Injured Athletes based out of San Diego, California.  Their goal: have a certified athletic trainer at every high school in America.

Tommy was a high school lacrosse player going for a ball when he and an opponent collided in a seemingly simple collision that would change lives permanently.  Luckily for Tommy, the certified athletic trainer present at the event would not allow Tommy to get up.  Riki Kirchhoff, ATC quickly and accurately assessed the situation and determined that Tommy had suffered a serious injury to his neck.

Here is a part of a post made on Tommy’s blog the day after the injury:

As many of you know already, Tommy broke his neck (in a lacrosse game yesterday) and is in the ICU where he is in the process being stabilized.  Tommy broke his neck at C-1, the very first vertebrae where the skull and the spine connect. We were very fortunate that Rikki (our trainer) was on hand at the game to prevent what most commonly happens in such injuries, spinal cord damage – our heart felt thanks to Rikki for her professionalism and smarts to do what was best for Tommy.  Continue reading

Cheerleading Enters Forefront of Concussion Issue

When most people think about concussions they only allow one sport to enter their mind: football.  As we have documented numerous times before, football is just one of the many athletic activities that put athletes at risk for sustaining a concussion. Much of the general public thinks that the male athletes are the only ones suffering concussions, though that is not the case whatsoever; females are just as susceptible.  According to Dr. Comstock, of the Ohio State University College of Medicine, girls suffer concussions at a higher rate than males.

One specific activity has been shown to have a significant rate of injury in females (and what most people will be surprised to learn) is cheerleading.

The question as to whether cheerleading qualifies to be recognized as a sport continues to be debated, but from my perspective (and what others should consider) it does not matter. The athletes involved in cheerleading should be provided the same health care that other athletes are provided with; they should be treated the same.  There is no doubt in my mind that these girls (and boys) perform very intricate techniques and are at serious risk of injury.

New Jersey has recently passed a law requiring schools to implement a head injury safety training program which must be completed by the school physician, an athletic trainer, and all of the coaches involved. The issue is that cheerleading is not considered a sport by NJSIAA or the NFHS.  For this reason, cheerleading coaches are not required to complete this training program.  Schools must make sure that these coaches are included, for it is important for them to recognize the dangers and risks of concussions with regards to their individual sport.

Patrick Diegan, an assemblyman who played a role in the legislation, stated… Continue reading

Sex Differences in Concussion Symptoms of High School Athletes

Here is a brief overview of the article out of the newest Journal of Athletic Training. I suggest you take a chance to read the entire article. It’s free to NATA members!

Frommer LJ, Gurka KK, Cross KM, Ingersoll CD, Comstock RD, Saliba SA. Journal of Athletic Training. Sex Differences in Concussion Symptoms of High School Athletes. 2011; 46(1):76-84.

An estimated 1.6-3.8 million sport-related concussions are reported each year with about 21% of those being high school athletes. The occurrence of injury in female athletes has continued to rise with the increase in sports participation and females have a higher incidence rate than males of sport-related concussions.

Research has shown that females may respond to concussions differently than males. Females tended to fare worse than male counterparts leading to longer hospitalizations, longer disability, and higher mortality rates. Females also require greater monitoring and more aggressive treatment due to symptoms not aligning with Glascow Coma Scale.

Hormones are believed to be a factor in the response to head trauma. Females tended to be more cognitively impaired after a sport-related concussion.

Males tended to report amnesia and confusion as a primary symptom more often than females. Females reported drowsiness and sensitivity to noise more often than males.

Males often returned to play 7-9 days post-injury while females had a greater percentage returning 3-6 days after a concussion.

This data is representative of what is actually taking place in the high school setting rather than in a research lab.

The outcomes of this study show there is little difference in severity of concussions between the two sexes, but it appears they present with different types of symptoms. Males reported more cognitive symptoms while females reported more neurobehavioral and somatic symptoms.

Saint Francis Medical Minute

This is a short video highlighting concussions and local athletic trainers.  Dr. Bowen is the team physician for the Southeast Missouri State University Redhawks, and works with the athletic trainers of the various college teams as well as high school athletes.

Dr. Bowen talks about the common phrase of “getting your bell rung,” and why that needs to go away.  People need to understand that concussions are serious.  Also, he mentions the ImPACT tests in use at the area high schools through Saint Francis Medical Center.

The Medical Minute is a series that Saint Francis Medical Center out of Cape Girardeau, MO produces for local television.


Suspecting the Unexpected

Dustin’s post “Nightmare on a Football Field” inspired me to write this next post.

During the summer of 2010, I was an intern at the University of Wisconsin-Whitewater.  As interns, we worked with the certified staff members at the University to provide health care for all of the camps run through the Continuing Education Department at UWW, whether it was a sports camp, a music camp, or an academic camp.  One of the first camps that we had at UWW this summer was a football camp.  It was a “Perimeter Camp” which included quarterbacks, receivers, defensive backs, linebackers, etc., basically anybody but the linemen.  This camp had over 320 campers that were all out on the practice fields wearing helmets and shoulder pads.  I was the health care provider for all of them, by myself.  I had help inside, but on the field it was all me providing first aid.

On the second day of camp, I am doing some normal triage of injuries, blood, and hydration when one of the coaches brings a kid over on the golf cart.  This kid was complaining of an upset stomach and being light headed.  Since I was busy, I suggested he get some water and relax for a few minutes, lunch was only a couple of hours earlier and for the Wisconsin kids it was hot out (about 75 degrees).  When I went to talk to him a few minutes later, he was sitting in the shade, but he was not feeling better, nor did he look right, I had a hunch immediately that he probably was not Continue reading

My Solution: Lack of Athletic Trainers in Secondary Schools

I will not claim to be an unbiased source.  I will not claim to know everything there is to know about insurance.  But one thing I know is very clear:  There is a significant lack of athletic trainers available to student-athletes in secondary schools.

As a certified athletic trainer, I think it’s very important to have the proper health care provider available all the time, and the training and education suggests that be a certified athletic trainer.  No other profession spends their entire education learning sports medicine like we do.  We learn to work with next to nothing in the way of supplies and facilities.  We learn to work within time constraints of the athlete.  They are much different from average patients.

The issue always comes down to money.  Administrators say they do not have the money to pay for an athletic trainer, but they have money to provide a nurse during the school day.  It is time that an athletic trainer be mandated for sports at the secondary school level. In these tough economic times, schools are struggling to provide basic services.  Teachers across the state of Illinois and across the country are facing layoffs and pay freezes or even pay cuts.  Programs are being dropped including sports, music, drama, and even some classes are getting cut.  Coaching positions are being cut as well and schools are relying more on volunteers.  But I am here to suggest that schools be required to hire a certified athletic trainer.  Where are they going to get that money? Continue reading

Why I got into Athletic Training

Time to introduce our newest blogger; Mike HopperI will let him describe a little about himself…

I am currently a certified athletic trainer working in a physical therapy clinic and providing outreach coverage to high schools in the Metro-East St. Louis area.  I graduated this past December with my bachelor’s degree in athletic training.  People ask why I would choose a profession that is relatively low-paying and has the hours that athletic training often does.

For a long time, I would say that it’s just what I love, which is true.  I love being around athletes, I love watching sports, and I have taken an interest into the healthcare of these athletes.  But it goes back to high school for why I have become so passionate about this profession.

I suffered concussions in high school.  Not a single one was ever diagnosed or even evaluated by a health care professional, but knowing what I know now, I am certain I had at least 3 of them, probably more than that.  But even 4-5 years ago, we did not know very much about concussions.  I “got my bell rung” but that was just part of being a football player.  I can remember now two specific incidents where I am certain I had symptoms that went unreported.

The first one was in a football game on a kickoff.  I got hit from behind and my facemask actually got stuck in the ground.  I got up a bit dizzy and headed for the sideline—the opponent’s.  I realized it quickly enough, but I developed a headache later.  Again none of it reported.  Then my senior year I was a catcher on the baseball team and took a foul tip Continue reading