Gaining Momentum

As I began the blog there were plenty of people who told us that what we were doing was “nice” but it will have little effect on the concussion issue.  The easiest and actual response was “so what?”  I honestly did not care if people didn’t take the information we wanted to present seriously; I KNEW that someone would.

The original concept was to gather stories and information from as many sources I could find on the limited time I have to devote to the blog.  Fortunately we were able to add contributors that have helped in this endeavor (looking at you Noodle), as well as Parent Advocates and the occasional “anonymous poster”.

We believe the information is valid and “blog-worthy” in order to make people aware of the ever-changing issue of concussions.  As viewers and commentors have increased over time we believe that we are on the right path.

A lot of the emails and comments I receive in confidence take umbrage with the “attacks” on the NFL and major sports.  I can see that angle and appreciate the candor, however it is those entities that we will gain the most profound guidance Continue reading

Mike & Mike and My Thoughts Going Forward

There are some of us that had hoped that the “World Wide Leader” in sports would have used its platform last night to further the discussion on the concussion issue.  Yes, as the commenters pointed out in the other post, they did broach the subject of Kris Dielman at half time.  Mainly to emphasize that the league was looking into this and the policy going forward.

On Mike & Mike this morning the hosts were joined by Chris Carter and really talked about it.  Not only the problems with the injury, but how the game is being changed.  You can LISTEN HERE.

No matter the side of the fence you fall on – player safety is number one – for professional players, college players and especially the adolescents.  There is no hard and fast answer to this, but it is worth discussing as they did this morning.  Times have changed, we have learned so much more about brain injuries and perhaps the injury of concussion is getting more severe as time goes on (size, speed, etc.).

I have been accused by coaches and parents that concussions are being sensationalized, not only by the media but by me.  They really feel this way and there is not an issue with that; Continue reading

Kris Dielman Incident

Mike Florio has been hot on the concussion subject from the beginning of the season, pointing out potential flaws and “double-standards” that have presented themselves.  As we mentioned in the Week 7 Report, Kris Dielman of the Chargers sustained a blow that showed OVERT signs of a brain injury and he continued to play.  Not only that on the plane flight home he encountered a grand mal seizure, another very serious sign of brain injury.

Apparently the league looks into all injuries, but this one will garner a much different set of eyes; the circumstances surrounding the concussion (diagnosed AFTER the game) will be scrutinized;

Far more troubling than the fact that Dielman suffered a seizure on the flight home from New York after a loss to the Jets is the fact that Dielman exhibited enough signs of wooziness and disorientation to mandate an immediate evaluation.

For those of you who have the game stored on a DVR or access to NFL.com’s Game Rewind service, fast forward to 12:30 of the fourth quarter.  On that play, Dielman pulls from his left guard position toward the right side of the line, dropping his head to block Jets linebacker Calvin Pace.  Dielman then reels away from the block, takes several steps, and lands on the ground.  He stumbles to his feet, and Jim Nantz of CBS points out that Dielman is “a little shaky and wobbly.”

You know the rest of the story from here.  The typical coach speak after the event by Norv Turner not only made me cringe, but Florio also seems to think the same thing; Continue reading

Tuesday Quick Hits

College football is not immune from the incidence of concussions, although as John has shown the reported numbers seem lower.  There are reasons for this, but I will let him explain them to you more in-depth.  Regardless, the injury occurs as in the case of some “higher” profile athletes.

Justin Blackmon, possibly the best wide receiver in the country of Oklahoma State sustained a possible concussion this past Saturday and was held from practice.  This is not unusual but the term used by OSU to describe Blackmon’s injury is horrible;

Justin Blackmon was held out of Oklahoma State’s practice Sunday night after getting “dinged” in the head during the first half of Saturday’s win against Missouri.

Dinged, really?  C’mon man!!!

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Soap Box Second:

Referring to concussions as a “head injury” diminishes the actual effects the injury is having.  The more prudent and descriptive term would be brain injury.  Unfortunately while listing injuries Continue reading

U.S. Senate Committee on Commerce

Yesterday we posted the press release regarding the hearing on concussions and the marketing of sports equipment.  Soon after that post I received many communications about what was said and my feelings on the subject.  Before we get into how exactly I feel regarding this one short hearing I think you should take the time to see it for your self.  It is a long hearing with five witnesses, so you will have to have a lot of time, HOWEVER IF YOU ONLY HAVE 10 MINUTES IT CAN BE SUMMED UP FROM THE 30:20 MARK TO THE 40:45 MARK.

Click HERE to jump to hearing, via US Senate Committee on Commerce, Science and Transportation website.

In those ten minutes you hear exactly what is wrong with current the current concussion situation, not from doctors, senators, or the “high-ranking” researchers, rather from former student-athletes that lost their playing careers due to this brain injury.  Alexis Ball and Steven Threet paint a picture of the athlete, Continue reading

Political Football: Irv Muchnick

Irvin Muchnick is a writer and investigative journalist who previously mainly focused on the WWE.  Muchnick has changed gears a bit and started Concussion Inc, a website focusing on the head injury issue.

On Friday, on Beyond Chron, Irv Muchnick wrote about the appearance of a conflict of interest between the Centers for Disease Control and the National Football League, in regards to the upcoming panel and recommendations.  In the article Irv was right to point out that the federally funded CDC is taking outside monies for the first time;

A CDC spokeswoman admitted to me that the NFL’s $150,000 grant for “Heads Up” marked “the first time the CDC Foundation has received external funding to help support” this initiative, which has a decade-long history encompassing various outreach to health care professionals and patients, school professionals, sports coaches, parents, and kids and teens. (CDC’s own funding for this program has averaged around $200,000 a year.)

Which brings into question who will be in control of the recommendations?  Will the people shaping the foundation of concussion management, aimed at athletic trainers and doctors, actually have representatives in place?  I am not talking about the usual suspects that may hold a MD or ATC tag – the ones who do Yoeman’s work in the research field – rather some of the “boots on the ground” if you will.  Yes there are some Continue reading

Mouth Gear Comments

If you have not been following the comment section you have missed a debate on mouth gear and concussions (Please feel free to enter into the conversation).  I believe that the information about how there is no current evidence that any oral device can attenuate concussions or help with symptoms related to the injury of concussions.  Here is a statement from the National Federation of State High School Associations (NFHS) Sports Medicine Handbook – 4th Edition;

“The effectiveness of mouthguards for preventing or reducing the risk of sustaining a concussion remains controversial. Research continues to be done on the different mouthguards and their properties to answer this question, but there is currently no reproducible evidence supporting the use of any mouthguard to protect against concussion in any sport.”

For a health care professional dealing with sports injuries this should be a telling statement.  However there are those out there trying to push a product and make money on the misinformation about concussions.  Below you will see some of the exchange and the prime example of why there continues to be a problem. Continue reading

Vick RTP Debate

Clearly the decision to let Mike Vick play this week has come under some scrutiny from many sources.  I have been asked many times my thoughts on this issue as well; it is much more difficult to take a stance on something that really none of us know first hand.  That being said there is no reason anyone cannot give an opinion on the matter.

Barbara Barker of Newsday sought out two opinions; one from a former player and another from an authority in concussions;

“I’m going to be watching him to see how he responds after he gets hit,” said former Giants linebacker and Hall of Famer Harry Carson, who suffered multiple concussions in the course of his career and has been diagnosed with post-concussion syndrome. “I’m sure he’ll go out there and do well, but if he doesn’t and gets hit the right way, there’s no telling what might happen.”

“Frankly, even from a fan’s perspective and even with someone as good as Michael Vick, I would have been happier to see them err on the side of caution,” Nowinski said. “Another concussion right now is the worst-case scenario. Michael Vick could be the Sidney Crosby of the NFL.”

I believe that there are more than Carson, Nowinski, and myself Continue reading

Lingering Effects Of A Concussion: Girls Soccer Case

If you have read the blog enough you know that concussions not only have an immediate and short-term consequences, but lasting effects.  With any injury this is the case, however the sequelae of each injury is far less known.  What is becoming more apparent is that bashing your brain around can cause not only physical issues (balance, dizziness, etc.) and cognitive impairments, but emotional/social changes that are much more difficult to define.

As we all remember growing up, and if you have kids of certain age, adolescents seem to go through personality changes as the hormones begin to set in and the transition to adulthood begins.  It would be fairly easy to dismiss subtle changes in a person and chalk it up as “teenagers”.  However, there are cases that can be attributed to the mismanagement of concussions; not allowing for the proper recovery of the injury. Continue reading

Hockey Gets Underway Friday

The National Hockey League began its preseason media blitz yesterday with a heightened awareness on the head injury in the sport of hockey.  Last season the NHL adopted Rule 48, banning blind side contact to the head, it was later expanded at the Winter General Manager Meetings to include lateral contact.

At the same time other leagues were continuing with their rules of no head contact; International Ice Hockey Federation (international sanctioning body of the sport), the NCAA, and possibly the biggest contributor of NHL talent the Ontario Hockey League.  The NHL with the ingrained “tough guy” mentality of the general managers and the deep seeded tradition of the game seem to be missing the point.

The league’s best players, Continue reading

Sunday Night Debacle

Sunday Night Football (TM by NBC and NFL) was going to be a good watch with Mike Vick returning to his original place of employment.  Not only was that an underlying tone, the Atlanta Falcons faced an early season “must win”, the first half it did not disappoint as both teams scored and forced mistakes from the other team.  As the second half began it looked as though the visiting Eagles were going to take full control of  the game, and to be honest my interest started to wane a bit, then Dunta Robinson happened again.  It was his hit in Week 6 last year that started the avalanche of eyes on concussions in the NFL.  Tonight he basically did the same thing – the hit seen below (will be removed by NFL) and should be met with both a fine and suspension – and brought attention to the broadcast for what became a massive debacle in my opinion.

Later in the drive, not only did Jeremy Maclin return to the game after the hit from Robinson (and being “down”), he caught a pass from Vick, but behind the play Vick was injured.  As you can see Continue reading

Hypothermia For Concussions + A Possible Delivery Device

The old adage of the profession of athletic training is “ice er’ down”.  This comment is both simple and can seem to the patients/parents/coaches that you are not doing enough.  However I am here to tell you that hypothermic treatment (ice) is EXTREMELY beneficial for just about every* injury we see for the basic principle of; slowing the metabolic response to injury.

When there is an insult to the body the immediate response is a metabolic reaction – in other terms the body uses chemical and mechanical pathways to repair/fix itself.  Although the reason for the metabolic response is thought to be for “repair” the body response is usually not limited to what is needed – the more is better philosophy.  I can bore you and make you click away real fast by giving you all the physiology of a metabolic response, so I won’t, but if you would like to read about it T.S. Walsh wrote a chapter in a book called “Principals of Surgical Care”.

Subsequent medical research has shown that attenuating the metabolic response has; decreased pain, shunted swelling, and improved outcomes, especially in a very narrow window after injury.  The least invasive and easiest way to accomplish this is via hypothermia (see heat related illness).  Cooling the body, even locally, can Continue reading

Study Quantifies Hits By Position

Using the Head Impact Telemetry System (HITS) made by Simbex exclusive to the Riddell helmet researchers were able to quantify how often and who was sustaining the most force to the head throughout three seasons.  The study was performed at Brown University, Dartmouth College and Virginia Tech University; compiling information on 286,000+ hits on 314 players (910+ hits/player).  The aim of the study was to identify exposure rates and begin to find ways to limit such exposures if possible.

The lead author on the study was Joseph J. Crisco of Brown University, amongst other faculty positions.  This study is set to appear in The Journal of Biomechanics.

Here are some quotes from the Brown University public release; Continue reading

Hockey World Awaiting Words From Crosby

In roughly two and a half hours from now Sidney Crosby will be going on record with “something” regarding him and his career.  Speculation has been rampant with what he is going to say; from “hi” to “I am retiring”.  First of all, Crosby is 24 years old and has a bright future ahead of him, IN HOCKEY.  Secondly, he stands to make $16 million over the next two years, money makes the world go round.

Before we give our educated (and probably wrong) guesses as to what Sid The Kid will have to say let us review what happened and how this is not only a sport issue but a player issue, even Crosby can make mistakes; Continue reading

Correct Information Is Key

I was forwarded this article from Michelle Trenum as she continues to help The Concussion Blog in getting the proper message out.  As she noted there were many concerning things written in the way of awareness.  We will break down the article appearing in the Amarillo Globe-News by Ricky Treon;

Sargent had the longest hospital stay. He was released from NWTH at about 6 p.m. Saturday with a severe concussion but no permanent damage after an MRI found no swelling or bruising near his brain, said his father, Jason Sargent.

“He’s got a severe headache and his neck is very sore,” Jason Sargent said.

Zach Sargent was taken off the field in a helicopter during McLean’s home game against Motley County.

The first issue we see is that “no permanent damage” Continue reading

Hockey Enforcer – Dangerous Profession

With the death (at his own hands) of Wade Belak that makes three total “hockey tough guys” that have ended their own lives this past summer.  At least one former NHL’er is saying its not a coincidence;

In the wake of Wade Belak’s suicide, retired heavyweight Georges Laraque doesn’t think it’s happenstance that three NHL players who made their living as fighters have shockingly died over the summer.

“A coincidence? No,” said the former Edmonton Oilers’ tough guy, who now is host of a sportstalk show in Montreal modelled after TSN’s Off The Record.

Laraque has been bowled over by the deaths of Derek Boogaard, Rick Rypien and now Wade Belak in the last few months.

It is almost impossible to connect any head Continue reading

Progressively still

Frontline recently re-broadcast a documentary about concussions that it had done in April. The story revolved around a football team from a private high school in Arkansas. The Shiloh Christian program was used primarily as a backdrop for the central theme: the intensity, pressure and the resulting disregard of health issues – notably concussions – in high school football in the US.

It was interesting – and kind of disturbing – to see how easy it is for coaches, parents, players, to convince themselves that the ubiquitousness of the basic football mantra of ‘hit hard, hit often’ somehow destined them to a football player assembly line to produce the same product as everyone else. Like there was nothing they could do but keep hitting as forcefully and as frequently as they could.

Football players in the US, the really good ones anyway, Continue reading

Hockey Camps Almost Open; What Have We Learned

North America concussions are mainly focused on two sports: football and hockey.  Rightfully so as the youth level of these sports are ever growing so the impetus is on all of us to be aware of the injury and it’s proper management.  Sean Meister of Fox Sports ran a story about the work that has yet to be done in the NHL;

It’s worrisome when a player of Crosby’s importance continues to encounter symptoms eight months after the injury. Yes, Crosby is the face of the NHL in many respects. His injury is harmful to the league and is causing some headaches for the NHL brass. Fortunately for those in the NHL offices, they don’t have to suffer the same headaches as Crosby.

The reality is that Crosby is a 24-year-old with a serious injury to his brain. Nothing should take away from that scary reality.

Although Rule 48 was put in place, some modifications still need to be made in the NHL.  How about this change/update; Continue reading

Can Small Schools (Districts) Handle The Concussion Issue?

With all the measures now being put into place a very interesting question is: can all high schools handle this?  The simple answer to this is: NO!

Required education for the coaches, parents and kids can only go so far; I have even touted this as the most important factor.  However, once there is “live fire” will it all sink in?  I believe it will, but not for all.  From personal experience, the high school I am at we have been hard at the awareness part for the above mentioned “players” in the concussion game and there has not been a 100% retention on the information or actions.  I would say that roughly 75-85% of those involved have grasped the information and action points.  I feel that our school is in a rather unique position as well; one of vigilant follow-up and re-education, almost to the point of annoyance.  How many schools have this going on?  Continue reading

Interesting Side Effect Of Concussions In NFL

With the continued focus on the concussion issue throughout the sporting world the major focus is without a doubt on the National Football League.  What should merely be an injury issue all of its own may now be harboring a  troubling side, “damaged goods”.  Eric Ball of Bleacher Report has opined about such a case in the League, Clinton Portis;

Sure Portis isn’t half the back he once was when he rushed for 1,591 yards and 14 TDs in 2003, but there is still gas left in the tank. He has been dealing with concussion issues for the better part of the past two seasons at the worst possible time. Nobody ever really cared about concussions before the New York Times began to do some investigative reporting into the matter. Now it’s one of the top priorities of the league. Portis would have missed half the time he did in 2010 if the concussion controversy hadn’t erupted.

Perhaps in the past teams either didn’t know of previous head injuries or looked the other way; there were surely players in the past that have dealt with repeated issues as they relate to concussions and were signed (Troy Aikman and Steve Young come to mind).  The concussion issue is just an injury and should be treated no different from Continue reading

Pioneer Moving On

There is one person in the media that can be classified as the pioneer of “concussion coverage”, his name is Alan Schwarz.  Since roughly the mid-2000’s Schwarz has been on the beat of national stories involving concussions.  He was recently nominated for a Pulitzer for his work in the area and now he has moved on.  According to Irv Muchnick, Schwarz’s title has changed to “national education reporter.”

I echo the sentiments of Muchnick; Schwarz opened up the national dialogue on concussions, he is one of the main reasons people have begun to pay attention.  Just think without him and the New York Times we may have never heard about Chris Nowinski, Bennet Omalu, the Boston University Brain Bank, etc.  No matter where anyone stands on the current protocols/research/assessment for concussions, A LOT of this discussion should be attributed to Alan Schwarz.

To be honest it was a huge “bucket list” goal that I was quoted in a Schwarz article Continue reading

NHL Taking It Slow: Commentary

As the general managers meet in Florida for the last day, what has come from the meeting the past two has been “tightening of the ship.”  Rather than take sweeping changes and possibly modifying the game to ends that make the owners and their proxy, general managers, uneasy the standards/statements made thus far have at least let us know they are fully aware.  And it has shown that money or fear of losing money drives the ship.

On Monday the league announced that the protocol for a player showing concussion signs will be removed from the bench for a thorough evaluation by a doctor.  I opined that this was a good first step, what I didn’t mention was that I didn’t like how the connotation from the media and even the league that the athletic trainer may be at fault.  Taking the player from the bench is a “no-brainer”; the instinct to hop the boards when your shift is called far outweighs the honest answers a player may be inclined to give to the athletic trainer behind the bench.  Also, removing the player from outside influences, say peers and coaches, makes this move both warranted and good “window dressing.”  This particular move does nothing for the player that will give dishonest answers in an effort to return to the game, the hopes are that using the SCAT2 model, to the ‘T’, will identify more concussions.  Is it a move in the right direction?  Yes!  Just remember before others go on a rampage saying the athletic trainer would not be qualified to do this; the SCAT2 was developed by and for athletic trainers to use, on a hockey bench there is neither the time or space to do such an evaluation.  Part of the umbrage I take as well is the influences of the coaches, peers and players themselves when the injured is still on the bench.  The athletic trainer has never been viewed as an overriding authority on the bench/sidelines in professional sports, which is a shame because that is their profession and that is what they are trained to do.

On Tuesday, there was no move by the league to ban hits to the head, like the IIHF and OHL have done.  Rather the league will enforce Continue reading

Editorial: Nick Mercer

Nick Mercer has concussiontalk.com and is from north of the border, so even though he does not play hockey, he is engrossed in the Canadian National Pastime.  Here is an editorial from him regarding the hit on Max Pacioretty in Montreal last week.

Don’t miss the point!

So let me get this straight: No cursing on TV, no nudity, no drug or alcohol use, because kids may see it and ‘get the wrong idea’.  However, it’s ok to show a man nearly get killed.  On the news, there’s often a warning that the upcoming story may contain scenes that are “not suitable for children”.  These are mostly scenes with blood or graphic violence.

Max Pacioretty of the Montreal Canadiens, without exaggeration, was nearly killed on Tuesday night during the Bruins-Canadiens game. In case you missed it – and if you live in Canada or have access to CBC or TSN – you are fortunate enough to be able to see it ad nauseam at any time of day from every possible angle.  I am a Montreal Canadiens fan and I was watching the game when it happened.  When I saw the replay, I honestly thought his head collapsed.  I thought he was comatose.

There is plenty of blame to go around and I think that blaming Zdeno Chara (the Bruins player who hit Pacioretty) is an incredible waste of time Continue reading