Being From IL, People Want To Know What I Think of Law Suit Against IHSA

Dustin Fink6 Comments

Sq 300 JI have been asked by many people what my thoughts are on the first law suit filed against a state high school association in regards to concussion.  With this coming in my “home” state of Illinois, people figured I would have a strong statement or unique perspective.  I have struggled with coming up with exactly what I wanted to say and could not figure out why.  This is in my wheelhouse, commentary on recent and public events; one would think it would have been natural.

Then, I figured out why I couldn’t come up with something…  BECAUSE I ALREADY DID, 29 MONTHS AGO!!!

Almost like I could see into the future.  Below is what I wrote here and sent off to the Illinois High School Association in May of 2012.  Looking back on it I still feel strongly in the proposals and the rationale.  Take a quick look for yourself:

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I have been working on this letter for a little while but was really spurred to action by the parent in Maryland, Tom Hearn who discussed his concerns with the local school board.  I have tried and tried to use the “chain-of-command” with these thoughts and ideas, however at every step I got the feeling I would have to go alone on this, so I have.  This letter may or may not reflect the opinions of my employer, high school, athletic training sanctioning bodies, or others I am involved with.  This letter is from a concerned individual who feels I can spread the message effectively by these means.  I have emailed the letter, proposals and the Sports Legacy Institute Hit Count White Paper to all Executive Directors and Board of Directors of the Illinois High School Association.

OPEN LETTER

May 15, 2012

Illinois High School Association
c/o: Marty Hickman, Executive Director
2175 McGraw Drive
Bloomington, IL 61704-6011
(309) 663-7479 – fax

Dear IHSA – Executive Directors, Board of Directors and Sports Med Advisory Board:

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.

As a licensed and practicing Athletic Trainer, researcher, commenter, father, and survivor of too many concussions, I feel that in order to keep the sports we love, proactive steps must be taken.  Often being proactive is a painful process and easily dismissed because of the trouble it will cause.  I urge all involved to think about what the future of all sports will be if nothing is done.

The Illinois State Legislature with the IHSA took the initiative by creating a mechanism of concussion education and awareness in response to the mounting scientific evidence of potential long-term impairments resulting from mishandling of this injury.  However, this only represents a first step in the process; passing out a flyer or having parents and athletes initial that they have read the information is one small element of the issue.  Another crucial element of the issue is coaching. We must ensure that those we entrust with the care and leadership of our children understand Continue reading →

Why Can’t We All Just Get Along?

Dustin Fink1 Comment

In a time when I truly feel strongly that we should collaborate rather than look down noses’ at other peoples work and words within the concussion realm there seems to be none of that with a recent report from TSN, Canada.  Although I did get a chance to read, I really didn’t have the perspective that, say, a Canadian would.  Insert Terry Ott, who has penned some very interesting articles here, in regards to concussion coverage and information — particularly in Canadian Football — from north of the border.

I believe Mr. Ott presented a very fair summation of the information provided — mainly the Tator quote — via TSN.  It has been very interesting to see how different places handle the concussion issue, from North America to Europe to Australia.  For the most part it mainly has to do with the “biggest #&^!” in the room.  Which is not always the best way to accomplish the same overall goal: tackling the concussion issue — head on!  (see what I did there?)

Remember, “None of us is as smart as all of us.” -Japanese Proverb

Now for Terry

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TSN CANADA REPORT DEMONSTRATES DIFFERENT NORTH/SOUTH CONCUSSION PERSPECTIVES

HAMILTON

Dec. 6. 2014

TERRY OTT

In Canada, The Concussion Blog has come an awfully long way in the past 18 months.

Prior to its ongoing addressing of the concussion crisis in the Canadian Football League the site was definitely for seekers of specificity of brain injury and prevention, but certainly not pertaining to the CFL. Canuck readers were limited.

All of that changed last July when The Concussion Blog broke the story of the first concussion related lawsuit filed in Canada by former CFL player Arland Bruce. The Concussion Blog is now required reading for many interested parties of Canadian football and the northern medical community researching brain injury.

And now, Canadian-based The Sports Network (TSN) which previously had cast a rather jaded TV and radio eye on the Arland Bruce concussion lawsuit now seems to be seriously pursuing the story with a Dec. 3 piece by Continue reading →

2014 NFL Concussion Report: Week 12

Dustin Fink1 Comment

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League (posted when time allows).  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).  You can also view our white paper with original research about concussion reporting in the NFL from 2010-2012 HERE.

Where has this post been?

It has been 11 weeks since this report last was published, a long time.  For those that looked forward to this weekly post, I am sorry, time has not allowed me to be on the ball for weekly information.  However, that does not mean we have not been cataloging the concussions within the NFL.

Lets be honest, the constant concussion information has been almost to a point of overload for many, this includes me.  The weekly contribution on NFL concussions has been “lacking” due to where I have been, so please amuse me while I explain.  When the blog started it was for the dissemination of obscure, yet pertinent, information on concussions.  This included the founding of the NFL Concussion Report (first of its kind) which was, is and will be used for public research.  At times other media outlets have used this report for reference and in a naive manner I think that those that really care and can affect change look in on this from time to time.

With greater coverage from media, social media and the policy changers a lot of my “niche” has been filtered away from me.  I have been in the process of finding another angle/branch of this massive issue to keep people informed.  My biggest contribution going forward will be providing commentary about research and developments in the concussion realm.  I will be continuing to champion original research and testing products that come to the market for further opinion.

In reality I have gone no where, but I have published less.  So that is where this post and I have been.  Thanks for listening, now to the meat of this post.

82

Eighty-two is the number of concussions found in the NFL through 12 weeks of regular season football.  This number is significant.  Not significantly high, rather it continues the trend from last season of having overall lower numbers.  Depending on what color glasses you look through this can be a good thing or a strange thing.

Certainly we would all like to see lower numbers, it would mean some of the changes within the sport at the highest level have been working.  It would be tough to discern which exact method was doing this but less concussions would be a good thing.

However, if you were paying attention you would have noticed that it took 11 weeks (71) for the NFL to surpass the number of concussions found in the five weeks of the preseason (68).  It would be even more peculiar that through 10 weeks of regular season football there were five teams that had not reported a single concussion.

Following that tweet, I noticed something else;

So, two teams had reported a concussion following that first tweet.  And one week later, in week 12, Tampa Bay and New York Jets reported a concussion.  That only leaves Atlanta as the only team without a regular season concussion.

It’s because of these little nuggets of information and coincidence that one could possibly be jaded about the concussion reporting numbers.  There are other anecdotal tales of players being removed for concussion protocol and then returning to the field that also fuel this fire.  However, the later is not something that “bothers” me, in fact, it is a good thing, in my humble opinion.

The number “82” represents the lowest concussion total the past five years to this point in the season, by 20 or slightly over 25%.

Trends

Even with lower numbers there are trends that continue to hold, as seen in the past four years.  The most Continue reading →

NFHS Develops Concussion Guidelines for Football

Dustin Fink7 Comments

In what has been a long time coming the National Federation of State High School Associations (NFHS) has released the long-awaited guidelines from their concussion summit in July.  The NFHS is basically the governing body that most, if not all, states look to when implementing rule changes in sports, policies for participation and for sports medicine advice/guidelines.  Many states do not act, even with good information, with out the NFHS “seal of approval”.

This has been evidenced in the past when it comes to concussion “mitigation”, in terms of undue risk – contact limitations.  There have been many states that have not waited for the NFHS (California, Arizona, Wisconsin come to mind) while there are others that sat on their hands regarding this topic.  Regardless of where your state is/was it now has some guidelines to follow when it comes to the controversial topic of impact exposure.

Before I post the full press release from the NFHS, I would like to highlight the recommendations from the 2014 NFHS Recommendations and Guidelines for Minimizing Head Impact;

  • “Live” and “Thud” are considered full-contact
    • I really like that there is a clear definition
  • Full-contact should be allowed in no more than 2-3 practices a week; 30 min a day and between 60-90 minutes a week.  Only glossed over was the fact that theNFHS strongly suggests that there should not be consecutive days of full-contact.
    • A great place to start, although there are a vast majority of programs, around here, that do not do more than 2-3 times a week.
    • The time limits are great.
    • Unaddressed is the specific back-to-back days of games to practice.  For example a Monday game and Tuesday full-contact practice.  Sure common sense should prevail, but there will be plenty of loophole finding on this issue.
  • Recognition of preseason practices needing more contact time to develop skills.
    • Obviously a sign that these guidelines are taking everything into consideration.
  • During 2-a-days only one session should be contact.
    • THANK YOU!
  • Review of total quarters played for each player
    • This has been one of my biggest points of contention with any concussion policy.  The risk for injury during a game is much higher and kids that play multiple levels have an exponentially higher risk.
    • Although nothing more was stated than above, this should get people talking and moving.  The issue, of course, will be monitoring this.  Regardless, the fact that this important point is included is a massive thumbs up!
  • Considerations for contact limits outside of traditional fall football season
    • Acknowledging the ever-growing practice of off-season practices.
  • Implementing a coach education program
    • Ideal for understanding all of this and the issues we face.
  • Education of current state laws and school policies (if schools don’t have one they should)
    • Putting pressure on the institutions to take some onus.
  • Emergency Action Plans (EAP) and Athletic Trainers should be utilized
    • AT’s should be at both games and practices.
    • EAP’s should be in place and the best person for taking care of an EAP is an AT.
    • The first “governing” body that has firmly suggested the use of athletic trainers for football at all levels in practice and games.  This is truly noteworthy, and appreciated.

Auspiciously omitted from this document was USA Football’s “Heads Up” tackling program.  They referenced the USA Football definitions of level of contact and coaching courses; but never mention the embattled “Heads Up” program.  I must say, my confidence in the NFHS has skyrocketed after reading this, and a lot has to do with the people on the task force.  I am looking squarely at: Mark Lahr, Tory Lindley, Steve McInerney and John Parsons.  Those gentleman are of the highest quality and character when it comes to athlete safety.

Here is the full press release…  Continue reading →

This Is Unacceptable, In My Humble Opinion

Dustin Fink20 Comments

Yesterday I wrote about concussions and the difference between professionals and adolescents using Jamaal Charles as an example.  What happened last night on the professional field with millions watching was completely unacceptable, professional athlete not withstanding.

Late in the third quarter of the game, last night, San Diego’s defensive back Jahleel Addae (#37) ran into a pile to finish the tackle on the Denver running back.  He was running at full speed and led with his left shoulder, but as he made contact with the RB his head dropped and he also made (incidental) helmet to helmet contact with the runner.  This type of collision is very frequent and looked innocuous…  Until you saw the after math…

Addae was bounced back, still on his feet, and began “short circuiting” for the national audience to see.  He begins to look around, kind of, and stumble, kind of, and lose full control of his extremities, all of them.  As a medical professional and athletic trainer I would have documented this OBJECTIVE finding as “unsteadiness and disorientation”.  It looked like a boxer/MMA fighter catching a fist/kick in the face late in a boxing match; the type of reaction that any referee in those sports would stop a match for and award a TKO to the other guy.

It happens from time to time in this and other sports, that is not the issue here.  The issue is that Addae returned to the game (oh, it gets worse).  Here is the tweet from last night (h/t to Brady Phelps’ Vine);

From what I can piece together this play was the last of the 3rd quarter and reports had him taking the field on the first play of the 4th quarter.  HE DIDN’T MISS A SINGLE SNAP!  Even with the long commercial break between quarters there is a maximum of 4 minutes, but if my DVR time was correct it was between 2 and 3 minutes.  This is not nearly enough time for a full concussion evaluation, by anyone.

“Maybe he was screened, like you said yesterday, Fink.”

There was absolutely no reason for a cursory “screen” in this situation, Addae showed a clear and overt sign of neurological impairment, in concussion recognition jargon: a sign.  When any player shows a sign there is no screen it means Continue reading →

Jamaal Charles; No Different Then Vast Majority of Competitive Athletes

Dustin Fink8 Comments

Last week when the Chiefs played the Chargers running back Jamaal Charles scored a touchdown and was blasted in the end zone by Brandon Flowers.  A shot that Charles bounced up from and headed to the sideline while Flowers was slow to get to his feet.  The hit was helmet to face mask and the resulting forces were a classic case of what is typically needed to produce a concussion for one or both of the players.  Whether or not it actually did, we will never “officially know.”

The issue is not with the hit or the fact that Charles apparently cleared the screening done on the sideline after such a hit, the issue is with his comments a few days after on the Dan Le Batard show;

“It definitely hurt,” Charles said. “A couple plays later, I just [saw] this light buzz around my eyes and I was trying to catch ’em. But I was like, ‘Let’s get the ball and run again.'”

I am 100% confident that Head Athletic Trainer Rick Burkholder did his job on Sunday – screening Charles after the hit – it was evidenced on Tuesday/Wednesday when Burkholder placed Charles in the protocol as a precaution solely due to the comments Charles made.

Why you may ask?  Simple, by the absolute letter of the definition of concussion – disruption of normal brain function following a traumatic event – Charles admitted he was “not normal”.

Whether or not Charles had a concussion is up for debate among many people, not only externally – us blogging/media type – but likely internally – Charles and med staff.  Here in lies the problem with concussions and the issue of concussions.

As we tried to explain in the University of Michigan post, concussion is most often a subjective injury, we as medical professionals rely upon the athlete or injured to tell us what is going on.  If there are no overt or outward signs (loss of consciousness, wobbliness, gaze, vomiting, etc.) then all we can do is screen the athletes.  And by screening I mean simply asking the athlete if they are OK.

GAMING THE SYSTEM

I heard Mark Schlereth on Mike and Mike this morning saying something to the effect of; “there has to be more than just asking the player if they are ‘OK’?”.  The truth of the matter is that there is not really anything other than that; although just asking one question is not due diligence.  In my experience I ask more questions and even try to trick athletes into giving up any ruse they are trying to pull on me.  I have a to questions and line of questioning that has produced many responses that then warranted them to be fully examined with a sideline evaluation, even for the best “liars” (I won’t share them here because it can be used for people to study and then find a way around it).

The more complex yet simple reason we as athletic trainers feel confident with screening, even with limited questions, is that we know the athlete.  Their usual demeanor, behavior and general presentation.  People often ask me how long it takes me to know if someone has a concussion.  When they are my players, the ones I am around on a daily basis, usually it takes me Continue reading →

Terry Ott: Concussion Coverage from Canadian Media is Woefully Lacking

Dustin Fink1 Comment

The original purpose of The Concussion Blog was – and still is – to inform those that choose to look about concussions.  Part of this goal has been looking deeper into issues and “lip service” given to the brain injury we know as concussions.  In 2010, when the blog began, this was a novel idea and much of what was written here was “breaking news”.  Along with that, opinions that I shared on the issue were meant to be coming from someone with vast and dynamic experience in concussions.  The initial thought was this was to be a “clearinghouse” for concussion information – and it succeeded.  As years have passed and the media here in the United States has slowly caught on and passed along, mostly, the correct messages TCB has been slower.  However, that does not preclude us from posting information/opinion that we feel needs noticed.  Examples of this have been our white paper on NFL Concussions, the mouth gear controversy and general editorials on published research.

In the past year TCB has been lucky enough to have a journalist spend his own time investigating a part of the global concussion story, in Canada.  Terry Ott, as you may have noticed many of his articles here on the blog.  To be clear, this was all his work and I have become his one and only outlet for his sleuthing and writing.  As he can attest to I don’t always agree with his tact or his tone, but his information is important, especially because in Canada there seems to be a void in the information that would be important to most.  We here at TCB are glad to file his reports as long as he and others understand this is a conduit for discussion and discovery.  I have zero intention of “killing a sport” or “getting someone in trouble”, rather shedding light on some of the problems and issues we face when dealing with concussions.

All of that being said I present to you Ott’s latest (hopefully last here because someone in Canada needs to pick him up) on the concussion issue as it relates to the Great White North.

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WHEN IT COMES TO FOOTBALL CONCUSSIONS, CANADIAN MEDIA BADLY OFFSIDE

Recent New York Times Article Throws Flag

Hamilton, Ontario

October 22, 2014

For the past year readers of The Concussion Blog have learned about the nascent football concussion awareness movement going on in the Great White North, mostly pertaining to how the Canadian Football League, and the mainstream media, have handled-for lack of a better word-the issue.

Years behind the National Football League on the matter, the CFL nonetheless saw the first concussion-related lawsuit come its way last July, accompanied by media attention, much of which was a critical and sometimes downright hostile questioning and smack-down of former 2013  CFL’er Bruce’s groundbreaking statement of claim against the nine member teams of the CFL, neurosurgeon Dr. Charles Tator, Tator associate Leo Ezerins, and several other parties.

The lawsuit, among other things, alleges that the CFL member teams, and specifically some of Dr. Tator’s published research on TBI and CTE-partly funded by the CFL-mislead Mr. Bruce into believing he was not vulnerable to serious and long-term consequences from concussions he received while playing for the BC Lions. None of the allegations have been proven in court and Tator has filed a defense-covered here previously-that asks for the suit against him to be dismissed, with costs.

Yet other than one small article on former 80s era CFL player Phil Colwell, whose brief story and concussion-related problems appeared in his hometown KW Record paper in Ontario, last spring, your correspondent has been unable to place a single word in any other publication in Canada.

If it were not for Andrew Bucholtz of the Yahoo! Canada CFL 55 yard Line Blog sometimes linking to my stories here, few outside of the Concussion Blog’s sphere ever would have known about what did, and what continues to go on in Canada regarding football concussions and especially, their aftermath. Besides a small mention in the Vancouver Sun by journalist Mike Beamish when the Bruce story hit, no one in Canada besides Bucholtz saw the story as important enough to follow-up, and he has done fine work on his own regarding the concussion problem. As of now, I don’t believe Andrew is on many CFL General Manager or team PR weasel Christmas card lists.  (TSN, the CFL’s television carrier did do a piece on their website about the lawsuit in September that mentioned The Concussion Blog, but it was subsequently removed from their archive shortly after my last story for this site last month, and for reasons so far presumed, but actually unknown at this time to this writer. And I have not seen another story in the Canadian media on the lawsuit since.)

And a week ago, after reading in the Winnipeg Free Press a flattering tome on Dr. Tator from last July that appeared just before he was named as a defendant in the Bruce lawsuit, your correspondent reached out to the paper inquiring whether they would entertain a slightly different take on Tator’s research and related concussion issues via an Op-Ed.

However, after being ping-ponged back and forth between editors at the paper, I was told by an Op-Ed editor that the concussion issue was not “topical,” despite the Jevon Belcher CTE story breaking that week and despite the fact that Winnipeg is home to a CFL franchise. But rather, I was informed,  “Ebola” was of more import to their readers than what is essentially a real world and serious public health concern right now that surely can not be adequately explained by just one or two opinions, opinions which are even controversial within the medical and research community.

Likewise a kiss-off from my hometown CBC News website, whose editor, after some initial back and forth, just stopped responding to my e-mails and never published a piece I wrote on concussions in July even though it partly concerned the former Hamilton Tiger Cat, Phil Colwell.

TVO, the Canadian version of PBS, runs a show called The Agenda-and hell, the guy that hosts it has Hamilton roots!-that never met a contentious or important issue it did not glom on to and yet after receiving one return e-mail from a producer back in July commenting on my “unique” insights, I never heard another word.

Even the nice gal who runs TVO’s documentary film division, after initially offering to ask around if any of the filmmakers she had association with would be interested in the concussion story, none of my further e-mails were answered.

And, after being shut-out by nearly every institution purporting to be doing valid research into football concussions in Canada, I endured a recent 6 week runaround afforded me by the University of Western Ontario in London, Ont. which is supposed to be “partnering” with the Canadian version of the Sports Legacy Institute, but certainly did not do much for their reputation for cooperation with journalists trying to ask valid questions.
So after over a month of BS and excuses, I got nadda from them. I actually felt bad for the PR lady who drew the short stick to deal with me, and then she just stopped responding altogether.
To say that some of my dealings with the Canadian media and medical academia would be a joke, would only serve to denigrate comedy.

So obviously, the question is, why?

A veteran of the sports medicine community in Canada speaking on condition of anonymity said that many in the medical community were “afraid” of upsetting Dr. Tator, who carries much weight in medical academia and research grants around these parts.

The source said that many in the closed community are “buzzing” about Tator  being named in the Bruce lawsuit but do not want to be featured in any story seeming to critique the doctor the TSN story described as “renown.”

However, the New York Times apparently does not have a problem featuring a different Canadian medical professional who, unlike Dr. Tator, does not believe CTE  from football concussions is still open for (serious) debate.  Continue reading →

Constantly Learning and Watching: There is a Time to Act

Dustin FinkLeave a comment

It has been a truly busy season – in regards to injuries – where I perform my “day job”.  I was going over some records that I keep and this season has been the busiest in my 15 years.  In fact, when discussing with peers they too have had a high volume of injuries in the training room.  I would say it is karma; last season we were as slow as I could remember.

Part of what I do in my job is to evaluate the injuries and determine if there are any that could have been prevented.  Certainly preseason preparation – weights and conditioning – is a huge factor and we did that here, but there is always a place to learn and watch to make adjustments.  In reviewing the injuries (over 50 – not all concussions) I’ve encountered that required medical care beyond the athletic training room the results were “good”.  Only three were incidents that I considered “preventable”, one of which I posted about weeks ago. That is less than 10% of injuries that could have been prevented, which is good, not great, but good.  In years past I have seen numbers as high as 25-30% of injuries that I deemed “preventable”.  I take pride in doing my job and if I can prevent every single incident and only have injuries that occur on a “random” basis I will take it (has yet to happen in my 15 years).

Before we go further, I would like to give a glimpse into how I review injuries.  We will use a tib/fib fracture we had this year; this player was injured in a game and to me that is “un-preventable”.  However, a few years back we had a tib/fib fracture that occurred in practice – a practice with only “uppers” on and players were not supposed to take anyone to the ground – that incident was considered “preventable” to me.  If players and coaches were vigilant to the rules of practice that player would never have been rolled up on during a tackle.  Concussions are similar…

I feel that concussions can be “prevented” in practice with contact limits and proper technique during drills.  The other two incidents, thus far, I deemed preventable occurred in practices and were concussions.  One player was hit by a teammate during a non-contact soccer drill as a “joke” and the other did not use good judgement and ran into a pile and was rocked.

The take home here is that most injuries are part of sports and we must accept this.  Also, athletic trainers have much more to worry about and analyze than most think.

All of the observation and learning also pertains to return to play; whether that be orthopedic rehabilitation or concussion return to play protocol.  We, as athletic trainers, must express our voices when there is something going on that is a player safety issue.  This can be as simple as modifying team warm-ups all the way to the case I had yesterday.

One of the concussed kids was on his final step for RTP (full contact practice), he is Continue reading →

Weighing in on Michigan Situation

Dustin Fink62 Comments

If you follow college football or listen to sports radio there is a good chance that you have been exposed to the story of Michigan quarterback, Shane Morris, and the apparent failure to keep him from the field after sustaining a head injury.  The official story from the University is that it was a communication error.

Believe it or not, that could be exactly correct.  Now, were there some possible missteps along the way by ALL involved, yes.  Is there one single person or policy in place that is to blame, no.  I offer some perspective before everyone eviscerates their choice of target in this case, lets take a look at how this could have went sideways.

The Player

Morris was roughed up a bit as the game progressed; he is a sophomore QB that was just elevated to the starting position on a premiere football program.  Certainly he displayed some orthopedic distress as he was limping heavily after a play – how many times have we seen players play through ankle/knee/leg/foot injuries and some times even celebrated for doing so.  Morris was playing through pain trying to help his team, but what happened next need not happen; however the player himself has a lot to do with how it will and did go down.

After Morris was hit in the head he attempted to get up and was obviously unsteady on his feet, he even waved off the medical team.  I have been told by a good source that he even told the sidelines it was his ankle that was the issue, not his head.  Which is entirely plausible, but due to the mechanism of the previous play would be unlikely the main reason for his wobbliness.

Athletic trainers as medical professionals are not omnipotent but we sure are close (ha) when it comes to injuries on the field/court of play.  We do rely upon input from other human beings to make quick and decisive decisions.  Doing so, in some instances, can end up creating a delay in proper treatment as it did in this case.  Morris’ insistence that he was ‘OK’ immediately after the hit was taken for face value in that very short period of time.  Considering the confluence of all the other factors for player safety – his ankle, his immediate response to the sideline, his demeanor – he was not ripped from the field.  To be honest here, I have never seen a coach, teammate, athletic trainer or other – in the college or professional ranks – step on a field to remove a player that got up and “shook it off”; usually it takes the player going down and staying down for that to happen, if he/she does not leave the field under their own volition.  Because of this, it is on the player to make sure they are seeking the proper care for their own well-being.

After the next play, Morris was removed for evaluation of his injuries.  Part of that evaluation included his head and the team Continue reading →

The Journal of Law, Medicine and Ethics Issue Worth Bookmarking

Dustin Fink1 Comment

Twitter is such a wonderful thing!  You can get so much information is such a short time; sure there is a ton of unsolicited information that one may have to weed through, but the benefits outweigh the bad – at least for us here at The Concussion Blog.

Such an instance was getting a tweet at me about a journal and a particular issue.  The Journal of Law, Medicine and Ethics, Volume 42:3 to be exact.  In this volume all of the pages are filled with concussion related issues, after all it was titled: Concussion and Sports.

I cannot speak to the “prestige” or “reach” of this particular journal, however I can post the link here (above) for you to bookmark for some reading on where the tone of med-legal is going in relations to concussion and sport.

Topics include:

  • Youth Concussion Laws
  • Requiring receipt of concussion related materials (a study)
  • Coach Support
  • Informed Consent

At the link you can download, free, the journal and its articles.  It might be worth some time to investigate and look into what we may be facing.

Players Against Concussions (PAC) Foundation Begins

Dustin Fink3 Comments

PAC Image

I received an email and press release about a new foundation for awareness on concussions.  PAC was conceived by Jim McMahon (NFL) and Jeremy Roenick (NHL). PAC’s mission is to become a global leader in concussive education, research and treatment. They have many athletes on board to support this mission as you can see from the invite (bottom). The athletes are the voice in telling their personal stories.  I thought I would pass it along.

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Jim McMahon and Jeremy Roenick Launch Players Against Concussions (PAC) Foundation To Support Concussion Awareness and Prevention

Foundation Kicks Off With Star-Studded PAC Golf Event in Westchester, NY October 6th

Greenwich, Conn. (September 22, 2014)—The numbers are staggering: In 2012, nearly four million athletes suffered concussions, double the number from 2004. Every year, 20% of high school athletes suffer a concussion during any given sports season, and concussion rates are even on the rise among middle schoolers. Concussions often go undiagnosed and multiple concussions can lead to higher risk for permanent neurologic disability. On the flip side of these troubling statistics, sports brings joy to millions and is, without question, a cherished part of our society and culture. Players Against Concussions (PAC) is a new nonprofit organization founded on the uniting principles that we all love sports—but we all want to make them safer. Conceived by Super Bowl-winning quarterback Jim McMahon and NHL All-Star Jeremy Roenick, PAC’s mission is to unite the full spectrum of the sports world—athletes, leaders in research and medicine, coaches, parents, athletic brands and equipment manufacturers—to create a forum and platform where innovation and ideas can be shared to advance the end goal of preserving the sports we love—while making them safer for all who play them.

The PAC mission begins on Monday, October 6th, when celebrities and professional athletes from across the country converge on the Pelham Country Club in Westchester, New York to participate in the First Annual Players Against Concussions Golf Outing. Sponsored by Guidepost Solutions, the daylong kick off event will begin with a morning brunch and press conference from 10am – Noon, followed by an afternoon round of golf, and will conclude with a cocktail hour and dinner beginning at 5pm. Athletes scheduled to attend include Jeremy Roenick, Jim McMahon, Mario Lemieux, Michael Strahan, Darius Rucker, David Cone, David Wells, Ken Daneyko, Rick Rhoden, Bode Miller, Tony Siragusa, Nat Moore, Richard Dent, Otis Wilson, Kevin Millar, Stephane Matteau, Roy Green, Jackie Flynn, Victor Green, Kevin Butler, Joe DeLamielleure, Claudio Reyna, Debbie Dunning, and Jeremy Lincoln (with more athletes and celebrities to be confirmed).

“This is a deeply personal issue for me as both a player and a parent,” said McMahon. “I loved every minute of the football I played as a kid and during my professional career, but Continue reading →

Terry Ott: Canadian Concussion Law Suit Begins Its Slow Crawl To Resolution

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In July this blog broke the news that Canada was facing its first law suit based on concussions in their professional football league.  Since that time there has been plenty of information, misinformation and general commentary about this issue in Canada.  The fact remains that this is a long way from getting settled, if you remember correctly the concussion issue in America took over a year to get “settled” and even now it is not completely final/finished.  Although there has been coverage in Canada (which has limited this blogs need to post/present about it) Terry Ott continues to beat the trail and get information to  present in his unique way.  With that backdrop I give you Mr. Ott’s latest filing…
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DEE-FENCE!
“Absence Of CTE” Doctor Files Defense in CFL Arland Bruce Concussion Lawsuit, But Claims to be “Outside The Knowledge Of” On Many Relevant Concussion Issues
HAMILTON
September 23, 2014

Just as it was a long way to Tipperary, it is surely a long way to go before the Arland Bruce III concussion lawsuit against the CFL, its member clubs, CFL Alumni director Leo Ezerins and Dr. Charles Tator and Krembil Neurosciences Center (KNC) ever comes close to a courtroom, or even any kind of resolution.

However, the legal equivalent of a punt has begun, and court documents obtained for this story provide for a very interesting if limited insight as to what can be expected in this first of its kind case in Canada.

On Sept. 10, the Vancouver BC firm of Harper Grey LLP, and attorney Nigel Trevethan filed a defense on behalf of Dr. Charles Tator,  denying or described as “outside the knowledge of the defendant” all but three parts of Bruce’s claim, only excepting that:  1. Tator is affiliated with Krimbil, 2. the KNC is based in Toronto,Ont. and 3. that Dr. Tator is the director of the Canadian Sports Concussion Project; these are the only facts that “are admitted” in Bruce’s 47 page statement of claim.

And while much of the above is pro-forma legal to-and-fro tiddlywinks, some of the “denied” and “outside the knowledge of the defendant” defenses as described in the Tator response to the civil claim are, ah, questionable to this reporter. (See attachments provided below.)

For instance, according to the filed document of defense Dr. Tator denies that he knew or should have known that:  Continue reading →

2014 NFL Concussion Report: Week 1

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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).  You can also view our white paper with original research about concussion reporting in the NFL from 2010-2012 HERE.

It is always interesting to see what the first week will reveal in the way of concussions.  In the past we have had significant numbers (2012 – 12 and 2011 – 9) and we have had strangely low numbers (2013 – 5).  During the first three weeks all teams are playing games – no byes – so, we should expect “larger” numbers because there are more players on the field.  However, it should be noted that it is also very early in the season and the speculated cumulative effect of repetitive brain trauma has yet to take hold.

Over the past four years we have seen a steady incline in reported concussions each week with a spike around weeks 12-14, it will be worth following and noting as we go along.  Our 2013 End of Season Report.

Other than that, I did not notice any other newsworthy incidents – well we did notice that Arizona had a concussion after going entire preseason without one – in fact I would say the conversation on broadcasts and in print were very much proactive, in terms of the injury.  I sensed a lot less “pussyfooting” around with the term concussion and the evaluation of the injury.  We really need this to continue.

Now is the time for the Week 1 recap of concussions (will indicate previous week);  Continue reading →

What Is The Cost For Care?

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The fine people over at InjureFree have a wonderful blog post about the cost for care as it relates to athletic trainers.  This is an ABSOLUTE MUST READ for those interested in athletic training at the high school level.  Rather than re-post the entire article I will present you with their infographic and give some quick thoughts.

This is for a high school with an athletic trainer, who as the blog post notes, can identify and asses acute injuries as part of their health care provider education.  Not only can the ID the injuries but also place the injured athlete in the proper place within the continuum of care depending on the injury itself.  Meaning, if the AT feels the injury will warrant possible surgery or is in need of immediate care they will be directed by the AT to “skip” the primary care physician and go directly to a specialist.  This not only saves some money for a doctor visit, but it also will save time, which can be of the essence in some cases.

Secondly, if you did not have an AT on staff, and an injury that would have warranted further investigation by a doctor and it went “unchecked” the injury could have morphed into greater damage and further costs.

The athletic trainer is not limited to the above examples, not shown in this infographic is rehabilitation costs.  Many times – depending on state regulations – the AT can perform rehabilitation services right at school at no or little cost.  Moreover, the very minor injuries that require taping or simple stretching/monitored practice are at no cost to the injured player and their insurance.  Again saving money.

Yes, this is a commercial for athletic trainers.  We really need people to understand that our profession will not only save time and money when someone is injured, but we also save lives and stress of those dealing with the injuries.

#AT4ALL

2014 NFL Concussion Report: Week 0

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Sq 300 JThe 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).  You can also view our white paper with original research about concussion reporting in the NFL from 2010-2012 HERE.

It is 2014 and The Concussion Blog’s fifth year collecting concussion data from the NFL.  By now – I hope – you have read our original research about what we have done (can be found above by clicking “HERE”).  In that white paper you will see how data is collected and what we have noted to this point in data crunching.  It is obviously our hope that we can get more numbers and refine what we know.

Week 0 represents the end of the preseason; as you have noted we don’t do much than provide a quick glance at what happened on our way to the start of the season.  There are a myriad of reasons we don’t “crunch” the numbers like regular season.  The biggest is that there is not a standard reporting system in place for the teams – to the public – like that of the Official Injury Report of the NFL.  Regardless, with the better awareness and access (looking at @NFLConcussions) we can get better numbers in a preseason.  For example, when we started collecting data in 2010, we could only find FOUR preseason concussion, ONLY 1, 2, 3, FOUR.  This year there has been 68 found; quite the change.

The answer to your next question is, no.  No, concussions have not risen that drastically in five years.

It is our plan to bring to you a concise weekly update of the numbers, using your capture points for you the reader to make of it what you will.  However, going forward you should look for the following trends:

  • Does the Tight End continue to be the most prone to concussions
  • Will reporting numbers increase
  • Will the trend of defensive players being concussed remain constant
  • Will there be another uptick in starters being concussed
  • Will any rule modifications make a change in numbers
  • Will there be “creative titling” for head injuries (see stingers and concussion-like)

Again, it is not our agenda to create a “gotcha” for the NFL or any league, rather we would like to see a true baseline of concussions in the NFL.  So, we can truly see the effectiveness of all the changes being implemented.

Here is the snapshot of the NFL concussions from the preseason:  Continue reading →

#TheFIFA5 A Recap by Snedaker

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Although the news of a concussion lawsuit is not really “new” anymore the fact that it was brought against FIFA was “earth-shattering” in terms of news.  Sure, the football leagues and even the NCAA have been targets, but for soccer to get the proverbial target painted on its back has really shook up the sporting world.  It was big enough news that it was in national sports casts and even was termed “breaking news” in corners of the world.

Perhaps the beginning of football season here in America has swept away most of its “front burner” power; it is mindful to take a look at what this law suit is all about.  Mind you, it is not your normal litigation.  Below is a wonderful recap of #TheFIFA5 suit being brought forth, submitted by Katherine Snedaker-Price (it appears on her blog pinkconcussions.com):

This summary is based on information posted on the Hagens Berman S Shapiro LLP website and is my unofficial review of the lawsuit I have hash tagged as #TheFIFA5. NOTE: I am not a lawyer, and am merely outlining the suit as I read it. I welcome comments and thoughts.

On August 27, 2014, a Class-Action Lawsuit Filed Against FIFA, U.S. Youth Soccer Over Concussions made headlines. This lawsuit pits three mothers and two female college students vs FIFA, soccer’s worldwide governing body—the Fèdèration Internationale de Football Association (FIFA)—and affiliated soccer organizations in the United States

  • US Soccer Federation
  • U.S. Youth Soccer + American Youth Soccer (over 3 US million child and adolescent soccer players)

Note: In 2013, FIFA reported $1.386 billion in revenue.  The 2014 World Cup brought FIFA $1.2 billion from U.S. broadcasters. This lawsuit states FIFA has failed to enact the policies and rules needed to protect soccer players. FIFA and the others mentioned…

  1. Failed to adopt effective policies to evaluate and manage concussions, at all levels of the game
  2. Lacked of effective policies poses a greater danger to women and children players, who may more vulnerable to traumatic and long-lasting brain injury
  3. Ignored medical community called for changes over a decade ago
  4. Ignored simple, best-practice guidelines, which have been updated three times since the initial international conference on concussions (FIFA even hosted)

FIFA has made progress…  Continue reading →

MomsTEAM Presents Youth Safety Summit

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It is approaching quickly, but if you are in the northeast a week from Monday you really should check into SmartTeams Play Safe™: Protecting the Health & Safety of the Whole Child In Youth Sports By Implementing Best Practices.  There is a myriad of topics to be included:

  • Sport-related concussion best practices
  • The evolving landscape of youth sports safety
  • Injury prevention strategies in youth sports
  • Reducing injury risk in youth football
  • Cognitive rest and return to learn
  • Gender influences on sport-related concussions and outcomes
  • Preventing sudden death in young athletes
  • Cost-effective youth sports injury prevention
  • Overuse injuries, early specialization, and burnout
  • Bullying, emotional and psychological injury prevention
  • InSideOut Coaching: transforming the lives of young athletes
  • Preventing sexual abuse of youth athletes
  • Role of game officials in injury prevention
  • The power of the permit in youth sports safety

The speaker list is studded with some very bright individuals including: Brian Hainline of the NCAA and Doug Casa of the Korey Stringer Institute at the University of Connecticut and many more.

The cost is $45.00 and looks to be well worth your time and money.  Click the above link for further information and registration.  Tell them The Concussion Blog sent ya!

The day-long event will take a holistic approach to youth sports safety which addresses not just a child’s physical safety, but emotional, psychological and sexual safety as well, and will show how, by following best practices, youth sports programs can stem the rising tide of injuries that have become an all-too-common and unfortunate by-product of today’s hyper-competitive, overspecialized, and over-commercialized youth sports environment.

Thanks Brooke for the press release…  The following is the media contact information:

Media Contact:

Sheila M. Green

Office: (617) 337-9514

Cell: (339) 224-3914

Email: sgreen@thecastlegrp.com

#TheConcussionChallenge

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It’s really simple…  Watch this video, then RT or forward in email or post on Facebook…  It’s not as fun as cold water and you won’t be donating money, but you will be understanding concussion and passing that along…  This was the idea of my good friend Katherine Snedaker-Price…

 

At the time of this post there were 787 views, I would like to see that at 2,000 by next week…  Lets do it!!!

Concussion Trends 2010-2012; TCB Original Research

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The National Football League is nine days away from the kickoff of its regular season.  If social media, fantasy sports, and hype are any indication 2014 is set up to one of the most watched seasons in history.  There are plenty of story lines abound: from each division, to playing time of newly drafted players, to veterans returning from injury, and of course concussions.

The league is doing its best to keep concussions from overriding the game itself, as they should be.  Concussion is but just one of a myriad of injuries sustained in the sport; plus it is not unique to just American Football.  However this issue continues to gain/keep traction because of the relatively late and “slow-footed” response to this topic.  Even though the settlement with the players has been all but signed-sealed-delivered (there are some interesting issues posed by Patrick Hruby that are worth noting), the youth arm of the league is promoting and teaching a “safer” way of tackling, and the talking points about this injury are becoming more evident from players and the league; there still is a shroud of secrecy.  In all the hand-wringing and court battles and public relations scuffles the leader of this glorious sport has yet to “rip the band-aid off” and assess the situation.

How can you assess the situation?  I think it is rather simple: gather data to find out the “true” value of actual concussions sustained in the NFL over a season.  Then and only then can you see if any changes brought forth are actually helping the cause.

Sure the league has its own data and is probably doing just that, but it is so far behind a curtain, tucked in a corner where light has no chance of hitting it.  I have always thought we should be transparent on this issue; or at least have a truly (Pollyannaish) independent data collection group for it.  At the very least an Ombudsman should be hawking this situation, for this is not going to go away over night.  It won’t go away until we can definitively say ‘X’ is the way to play this game with ‘Y’ & ‘Z’ at the professional level; then each subsequent level below the pro ranks need to modify based upon age and development.

The NFL probably doesn’t want this responsibility for it comes with some liability, not only on the medical front but in the public relations department…  SO WHAT!  When I chose to have a child I didn’t have the choice to be a role model and change the way I played life in order to make sure my children grew up safe and learned a better way to live.  The NFL is basically the “father figure” for the other levels of this great sport.  I have heard a great saying, it was applied to business in general: “the tree rots from the top”.  This is exactly the case in a family, in a business and in sport.

When the blog began in 2010 there was no way to find out how many concussions were occurring in the NFL without Continue reading →

#tbt Mouth Guard BS Research!

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This was originally posted in May, not a long throwback, but since football started I have been hit up with this question a lot.  So here is the “truth” about this research.  I love the effort and attempt to find a reason; however when you have a critical and FUNDAMENTAL flaws then present it in a way that could be considered fraudulent I have a major problem.  I would also like to add that this research has not been pulled by the publisher.  This is exactly how we get in trouble, the Academy of General Dentistry needs to address this, now, as this peer-reviewed “science” is getting run in media…

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The basic fundamentals we should be cognizant of here are: concussion is a BRAIN injury, the BRAIN floats inside skull, Physics dictates that the BRAIN will move depending on the forces applied to the skull/head (not always from a blow to that area), mouth gear cannot stop the BRAIN from moving, mouth gear cannot attenuate any forces to the skull/head that are not in the oral region, mouth gear does nothing for the skull/head when forces are placed on it in rotational, angular, acceleration or deceleration fashion.

Now that we have that all out-of-the-way this is the General Dentistry article I was asked to comment on.  On face value and from a “peer-reviewed” angle it seems all good.  A significant finding between custom mouth gear (noted as LM MG in article) and over the counter “boil and bite” mouth gear (noted as OTC MG).  However once you take a deeper look there are some peculiar problems, in my humble opinion – that comes later.

First, we should look at the possible limitations of this study that seems well populated and well thought out (honestly these were my first concerns before finding the real issue):

  • Were the injuries controlled for by football position? (we have documented this issue here)
  • Were the injuries controlled for by size of players/school they were playing?
  • Were the injuries controlled for by playing time? (more exposure more risk)
  • Were the injuries controlled for by game vs. practice?
  • Were all the injuries seen and recorded by a single MD or was it the ATC at each school?
  • Did any of the players have a previous history of concussion?
  • Was the study controlled based on practice habits of the teams? (do some hit more than others)
  • How do we know that every player complied with the “no wedging or chewing” rule? (this plays a massive role later)
  • The study says that all 412 subjects wore the same exact helmet, I find that: A) hard to believe and B) was the fit on every player the relatively the same?
  • Who funded this research? (no disclosure)

As you can see there is a litany of reasons I would have dismissed this research, if I were peer reviewing because those limitations are extremely real and realistic to control for in this type of study.  I wrote to the public relations group handling this research and was unable to get a straight answer on those questions I raised.  In the meantime I sent out the article to some better than average “stat nerds” and awaited a response.

While waiting I noticed something really troubling, as in a fatal flaw with the research.  In some places an oversight like this is intolerable, because Continue reading →

One Man’s (Athletic Trainer) Critical Eye and Observation From Week 1

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It’s the beginning of high school football season across this glorious land.  I honestly love nothing more than getting back on the gridiron with the high school kids.  There are so many intangibles that the beginning of any sport brings; and in our massive consumption of football world this sport seems to bring a lot of people together, quickly.  You will see a lot of this “love for the sport” breeding through my posts and rants – the same love I have for all sports.  Seeing kids overcome hurdles and demons and using sport/activity to express their selves is awesome.  Seeing boys and girls using sports as a conduit to become better men and women by learning virtues such as: integrity, commitment, discipline and expecting to succeed.

Over the years I have obviously developed a keen eye for concussion as it relates to sport.  There is no greater sport for this injury to occur at my high school than football.  I have been blessed with coaches and administrators that listen to my input regarding overall safety, particularly when it comes to concussion.  But this past week I noticed something that perhaps I had seen plenty of times before, but it just finally hit me.

It has to do with the practice collisions and how things that start innocently enough can change and create issues.  I must give my head coach massive credit for being on the same wave length and even finishing my sentences when we were discussing my observations.  It shows, to me, that he has the best interest of the players in mind – and he wants a fully healthy team.  Secondly I happened to read a recent research paper about data collection on forces in football (while writing up my Sensor Overload post).

In a simple “technique” tackling drill two players were approximately five yards apart.  To either side of the players were agility bags spaced at about 4 yards.  The purpose of the drill was for the ball carrier to angle run to either bag, while the defensive player was to use proper technique and wrap up the ball carrier – not taking him to the ground.  The players were outfitted in helmets and shoulder pads only.  The players were directed to begin at “3/4” speed and the ball carrier was to be willing to let the defender use current “proper technique” to achieve the form and fit for a tackle (face mask up, wrap-lift-drive through the man).  It started all well and good, and the players naturally began to increase their speed/effort as they became comfortable with the drill.  The drill lasted five minutes from setup to finish.

Upon completion of the drill – rather near Continue reading →

Terry Ott: Former Canadian Football League Star Terry Metcalf To Sue League

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Metcalf.Terry3
Terry Ott has filed this report to The Concussion Blog, again this is his journalism, we offer up the space for him to publish.  If you want to post here feel free to contact us.
 
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Will Claim Debilitating Injury From Multiple Concussions and “Neglectful” Treatment
 
 
HAMILTON,ONT.
August 14, 2014
 
Running back Terry Metcalf  was an NFL 3rd round draft pick in 1974 and played 5 seasons for the St. Louis Cardinals before coming north and signing amidst much hoopla with the Toronto Argonauts in 1978.
 
From 1978 to 1980, Metcalf gained nearly 3300 all purpose yards with the Argos, including 1900 yards rushing and was the subject of much media attention, if not winning seasons.
 
Metcalf retired from football in 1981 and is now suffering from what he says are major health deficits as the result of multiple concussions suffered while he was playing for the Argonauts.

Mr. Metcalf, who now resides in Seattle said in an interview that the last concussion he received was in a 1980 Toronto home game and “was a pretty good shot.”

“I don’t remember finishing the game,” said Metcalf, adding that he categorized his concussion treatment at the time as “neglectful, nothing, really.”

Now Metcalf, who teaches kindergarten, complains of chronic ringing in his ears, memory issues, and says he has a “50% loss of feeling in (his) right hand.” Mr. Metcalf said his symptoms had been noted when he had been examined by doctors in 2011 for the NFLPA class action suit against the NFL for concussion related injury.

Mr. Metcalf has retained a Canadian lawyer and is intending through counsel to file suit against the CFL for concussion injury.

Metcalf, 63, also complains about his mood saying that he had been “quite depressed in his life” and that he was lately “grumpier, and you can ask my wife about that.”

Perhaps just as troubling is the fact that of the three CFL players who have come forward in the last year complaining about multiple concussion injury-Phil Colwell, Eric Allen and now Terry Metcalf-all three played for the same Toronto team between 1972 and 1980 and all three former players claim deficient or even non-existent concussion medical care.

And in previous interviews, all three former Argo players in question who claim to have suffered concussions while playing for Toronto had, according to a source, been treated by the same group of medical and training personnel at the time of injury, and afterwards.

Those familiar with a 2013 story on the Concussion Blog on former Argo Phil Colwell who was knocked unconscious in a 1981 game, will recall that he claimed the only medical advice given to him at the time was to not go to sleep the night of the injury, and was in fact allowed to drive himself (70 miles) home after the game.

Colwell, who is also suing the CFL, said that he returned to play one week after his 1981 KO hit and further said that “at the time, if I had gone on the injury list for a concussion, I would have been cut.”

And Colwell, who nearly became homeless earlier this year pulls no punches when it comes to his current situation: “The CFL stole my brain, ” he said, “maybe I’ll get it back (but) I want memories, not money.”


Also in a previous Concussion Blog story, former Argonaut Eric “The Flea” Allen described his treatment after concussion by the Argo medical and training staff in question as “I don’t think (they) looked at me.”

Mr. Allen, 65, who is also in the process of suing the CFL is now no longer able to walk and is for the most part bedridden with severe vertigo.


And while there would seem to be a common thread with the three former Argo players claiming to have had similar experiences with the Argo staff after suffering concussion injury, a source speaking on condition of anonymity said that there are many more former players from different CFL teams who had the same basic after concussion injury treatment and many of them would be coming forward in the future.

Continue reading →

Sensor Overload

Dustin Fink5 Comments

With all that is new to the concussion realm, nothing is really new.  This includes: how the injury occurs (traumatic variable force vectors – often unanticipated – jarring the brain case), its recovery (unique and undefinable), its identification (mainly subjective but overtly obvious when objective), overall education and general understanding from day-zero to day-undetermined.

The current “hot topic” for concussions is sensors.  These sensors are nothing new, they have been around for years.  As with most technology the devices are getting smaller and more accurate; natural evolution, if you will, for sensors.  I have had the fortune of testing some products, getting deep information on others, and curiously viewing some brought to my attention.  The constant thought I have is: no product has provided a clear-cut reason for inclusion – at this moment in time.

Are sensors a good idea?

Sure, if and when they become accurate enough for trained individuals to use them without impeding current standards of care.  Further, I also believe that down the road we will be looking for a product that can accurately and systematically determine the gross effects of every blow the brain case takes.  The key being EVERY BLOW.  Not just hits to the head, or at full speed, or only in practice, or in helmeted sports.

The overwhelming information we have on concussions and their occurrence is that we just don’t know a threshold; for mine, yours, your son’s, your daughter’s or anyone.  We have a general Continue reading →

Intended Consequences Lead to Unintended Issues: NCAA Settlement

Dustin Fink4 Comments

Sure the lede looks backwards, but the overwhelming point, in my opinion, of the NCAA recent settlement on concussions has to deal with my profession of athletic training.  The issue is athletic trainers; the need for more of them and what happens if you cannot find them or afford them?

Don’t get me wrong, the fact that attention is being paid to the need for athletic trainers — although the wording does not explicitly name our profession, rather “medical professional” — is tremendous and often overlooked.  Sure, you can have a doctor on the sidelines, but what is their cost?  Perhaps there are some semantics that would allow other medical professionals to be in attendance, but what would be their experience, education and knowledge about concussions?  And how cost/time effective would it be to have another “medical professional” that didn’t have the ability to assess, treat, manage, and rehab other injuries that occur on a sporting field?

In other words, this is an awesome advertisement and endorsement for athletic training.

But there is an issue, as stated in the Chronicle of Higher Education;

Colleges have their own concerns about the settlement, including a requirement that they have a medical professional on the sidelines for every practice and game in the highest-contact sports: basketball, field hockey, football, ice hockey, lacrosse, soccer, and wrestling.

While many big athletics programs already provide such coverage, lower-level NCAA institutions will be hard-pressed to afford it, several athletics officials said.

The requirement could lead colleges to use graduate assistants or others with little medical training, or to cut sports altogether over fears of liability.

“I’m worried about the financial fallout from this, and how it will impact Division II and Division III, and how it’s enforced,” said Tim Kelly, head athletic trainer at the U.S. Military Academy and a former member of the NCAA’s Football Rules Committee. “I’ve always wondered, Do too many schools provide too many sports at a level that’s not effective?”

If you have spent time in the “lower levels” of NCAA sports or even the NAIA you would note the very understaffed sports medicine team compared to the “big boys”.  This is no fault of the fine institutions, rather an economic issue.  From personal experience I can tell you that Continue reading →