Team Gleason PSA – Hey NFLPA Please Read

I received this from an anonymous source and was asked to spread this news, hopefully it will reach those it is intended for…  How bout you watch the video first then go to the Team Gleason website;
Subject: PSA release: NFL Players and Coaches stand together to cure ALS
Hi everyone…I hope this email finds you well…
Just wanted to let you know that beginning today, we at Team Gleason are rolling out a new ALS awareness campaign to be introduced this week in New Orleans for the Super Bowl.
Here’s a link to the video, which takes viewers directly to the Team Gleason website:
This is important, please spread if you get the chance…  This is NOT JUST A FOOTBALL PROBLEM, this is a problem for everyone!
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NFLPA News

So at 3:15pm EST the NFLPA will hold a news conference to discuss some “goings on”; the biggest nugget in this presser will be the announcement of a 100 million grant for Harvard over 10 years to study them.  All aspects of player health is the word I seem to be getting.  Which is good, because for a long time the former player has been neglected and has led to current and future players taking risks their bodies will not be able to cash in down the road.  I believe you can catch it live on YouTube as well, perhaps someone can provide the link in the comments…

In other NFLPA news, Deadspin and Barry Petchesky wrote about how players are overwhelmingly disenfranchised with the medical care they receive as a big-bad NFL player;

An NFLPA study, the results of which were obtained by the Washington Post, finds that the vast majority of players have serious doubts about the care they’re provided.

The NFLPA asked its players to gauge on a one to five scale how much they trust their team’s medical staff. Seventy-eight percent of respondents said five, meaning they’re not satisfied at all. An additional 15 percent said four, and just three percent responded to the question with a one or a two.

“The most troubling aspect of the survey for me is that lack of belief that the doctors are treating them for their players own health, safety and wellness reasons,” DeMaurice Smith said.

Perhaps this is why the NFL is entrusting the elite Harvard to study such things and happenings to players over a long-term time frame.  Petchesky  also takes part of the article to touch on the conflict of interest (COI) that is VERY rampant on the NFL sidelines concerning medical care.  If you have followed and read here long enough you will know it is something that we have been harping on for over two-year and one of our illustrious commentators, Don Brady, has written a dissertation that includes this problem.

Simple facts are that the team athletic trainers are paid by the team, not the players, and in a majority of NFL clubs the “team doctor” is actually paying for the privilege.  In a business model, it would appear – in my humble opinion – that the teams are making sure their priorities are met when it comes to injuries.  NOW HOLD ON…  There are some very outstanding athletic trainers and doctors that roam the hallowed sidelines of the National Football League, and they are VERY VERY VERY good at what they do, but the appearance – TO THE ACTUAL PLAYERS – is that their medical care may not be in their best interest.

I am not throwing anyone under the bus here, I am merely Continue reading

CDC, NIOSH and Department of HHS Issue Statement

For many years the “government” has kept its collective mouth shut about happenings in sports.  Occasionally they will make statements regarding the health of players in sports; case in point steroids and PED’s.  The highest football league in the States and world has often had little resistance from “government” while doing business, until now.

The Department of Health and Human Services along with The Center for Disease Control and The National Institute for Occupational Safety and Health have released an NFL Notification about brain and nervous system disorders.  The NFL Notification can be found by clicking on the jump above.  Here are the highlights;

  • In general, brain and nervous system disorders were more than 3 times higher among players; 17 players died with Alzheimer’s, ALS, or Parkinson’s compared to 5 men in the U.S. (see graph).
  • More speed position players died from these disorders compared to the non-speed position players.
  • ALS was 4 times higher among players; 7 players died with ALS compared to fewer than 2 men in the U.S.
  • Alzheimer’s was 4 times higher among players; 7 players died with Alzheimer’s compared to fewer than 2 men in the U.S.
  • Parkinson’s was not increased among players compared to men in the U.S.

This is not “old” news rather, it is confirming what has already been known, but Continue reading

Concussions 201

The Concussion Blog, has for years, presented you with the basics of concussions and other issues surrounding this particular brain injury.  Most of it was factual information/research that I opined about.  Others were original information that was seen here first.  Regardless our aim – and continues to be – is to keep everyone aware and educated about this topic.

I was passed along a great article on concussions, it was beyond the “basics” but not so in-depth that you get lost in the mumbojumbo;

In other words, concussions are not caused by a brain doing back flips within the skull. In fact, miniscule amounts of movement might be to blame.

The article was written in response to the Stevan Ridley “Fencing Response” producing injury this past weekend and Dave Siebert colored this situation perfectly; Continue reading

Matt Chaney – Tireless Worker

SpringGame1984Sideline
If you have been around enough you have seen the stylings of Matt Chaney on this blog, he is someone I call a friend.  In some circles that discounts me as a professional, which is both stupid and dumb.  I don’t always agree with Matt, heck him and I have been known to battle via electronic and phone communications.  However, his opinion is a valuable one – often his work is based in so much fact it makes your head spin as to why some of its missed.  Regardless, Matt has published two recent articles on his blog, for all to consume, here are some excerpts.

Part 1, published January 7th;

Historic football excuses thrive in modern debate over brutality

Lawsuits, criticism explode and officials project blame onto individuals

Old talking points of football apology resonate yet as officials tout anti-concussion measures like trainers along sidelines, new rules for safer play, injury reduction and expert consultation—same type of promises heard from gridiron leaders during the Victorian Era

American football gets lambasted in public for maiming and killing, denounced by an influential movement of critics, and game officials pledge safer play based on their new concepts of prevention, including:

*Qualified trainers and doctors will patrol sidelines.

*State-of-art medical response will treat the rare severe casualties.

*Limits will govern length of practices.

*Injury tracking will cut rates already on decline.

*Coaches will properly train players.

*Every player will undergo medical prescreening.

*Experts will lead safety reform in rulemaking and research.

*Referees and coaches will enforce new rules of experts.

*Players will follow new rules of experts.

Sounds familiar, these steps, a practical recitation of talking points for contemporary “safer football” promoted by the NFL and commissioner Roger Goodell, in face of lawsuit frenzy against the league and sport in general, along with festering disgust in the public.

Except the football rhetoric is 119 years old, from 1894, a packaged response during the game’s initial siege against formidable opposition seeking abolishment. Continue reading

George Visger – A Story to Tell

You have seen him post in the comments and there have been many stories written on him and his plight, but it is nice to get those involved to write about themselves as much as possible.  George Visger a former NFL player has taken the time to send along a couple of notes, it began with this email;

I played for the 81 Super Bowl champion SF 49ers.  During the season I developed hydrocephalus (water on the brain) from concussions, and underwent emergency VP Shunt brain surgery.  Four months after our Super Bowl XVI victory, my shunt failed, I had 2 more brain surgeries 10 hrs apart and was given last rites.  Also given the hospital bills, and forced to sue for Work Comp.  Completed my  Biology degree during brain surgeries 4 thru 7, now on # 9.   The long-term effects of concussive and sub concussive hits can be seen in what it’s done to my family in the following KVIE Channel 6 Sacramento link.

KVIE Channel 6  Sidelined:  Concussions In Sports   121912- http://vids.kvie.org/video/2318744182
After that was sent my way I asked for something he has written and wants to be known, and below is what I received.  Thank you for your time George;
My football and TBI career began in 1970 at age 11, playing for the West Stockton Bear Cubs Pee Wee Pop Warner team in Stockton, CA.  Twenty nine kids on the team, and 3 of us went on to play for the undefeated, nationally ranked, 1975 A.A. Stagg high squad and sign NFL contracts in 1980 (me, Jack Cosgrove, Pat Bowe).  We also had a kid on the squad by the name of Von Hayes, who went onto a multi-year MLB All Star career with the Cincinnati Reds.During my 3rd year of Pop Warner, I knocked myself unconscious in a worthless Bull – In – The – Ring drill and was hospitalized.  This was the only “diagnosed” concussion I sustained, despite playing several games through college and pros where I have no memory of playing. Continue reading

2012 Concussion Report – End of Regular Season

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).

This season was not unlike many NFL seasons before; many story lines (Peyton Manning and Adrian Peterson), surprises (Seattle), the youth of the league (Crazy good Rookies) and of course the injuries.  The freshest being the knee injury of Robert Griffin III and his subsequent surgery.  For the second straight year the concussion was the most talked about injury in the league and rightly so.  As much as a league has said it is changing, currently it is not, could have actually copied and pasted pretty much the entire 2011 season wrap up and it would be suffice for 2012.

I like to look back at the suggestions I made at the end of 2011 and see if any of it was addressed, and I can say; kind of.  I proposed six different ideas for the league to address and two were actually adhered to, while three of them were brushed upon and one was not even addressed.

The two proposals I feel the league addressed was limiting contact in practice and enforcing rules that are already on the books.  Naturally, the later was controversial in almost every game; it seemed at some point there would be a receiver getting hammered and a flag flying for contact to the head.  Of all the penalties I saw this past year only about 15% of them were incorrect (Vernon Davis hit is one that sticks out).  That being said the officials are getting the vast majority correct, and I am here to tell you its not easy trying to adjudicate when athletes are literally flying around you.

The NFL basically played lip service to the proposals dealing with; an official concussion database, promotion of proper management and helmets.  The last subject is more about removing the old style helmets from the league: Riddell VSR4, Schutt AiR Advantage and Adams helmets.  I will say that there were way, way, way less of those on the field this year.  The tricky thing about helmets is that a database on what is being worn does not exist either (odd [/sarcasm]), but from just watching it seemed many players had switched it up a bit to more recent technology.  Probably the most farcical of these proposals touched on was the use of USA Football and NFL players to “promote safety” in commercials.  Although it brought attention to how coaches have safety first in mind it did NOTHING to address concussion management and really how to properly handle this injury.  Listen folks its not that hard and it wouldn’t cause a panic for the “football mom’s”, rather it may make them more secure knowing about proper management; add to that the NFL can plainly and overtly state that because they are professional ADULTS they may treat concussions differently, but the correct way is ‘X’.

The untouched proposal will once again be #1 on our proposal list for this year.  How bout we move to the stats from the regular season, following the regular season numbers are the total numbers.  Getting information in the postseason is worse than getting information from rivals during the Cold War.  I am confident the NFL now has all that monitored, just make it public.

On to the stats through Week 17 (2011, 2010); Continue reading

2012 NFL Concussion Report Post Week 16

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).

REMINDER: I am asking for your help this week; as you probably have noticed by my tweets and facebook posts.  The NFL teams that do not make the playoffs and don’t play in the Wild Card round (24 of them) do not have to report concussions after this week.  I am looking for you the reader to tweet/email us any concussion found.  It has to be within these parameters:

  1. Reported by team/media
  2. Have a source

As always you can tweet/send me info about a particular instance of questionable action taken after a huge hit.  I thank you in advance as we are pumped to possibly have the first ever “official” Week 17 concussion report.

Week 16 brought us the “usual” numbers but an unusual occurrence of a player fessing up to a concussion four days later, as Greg McElroy divulged his injury to the team late in the week.  Along with the “usual” numbers we have surpassed last years total concussion count in the regular season (by four and counting).

I really don’t have an opinion this week to share with all of you so let us get onto the numbers for the past week in the NFL… Continue reading

2012 NFL Concussion Report Post Week 15

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).

After last week and the NFL reporting only six concussions this week picked right back up to previous levels.  We have unearthed 14 concussion for Week 15; showing that last week was definitely an outlier.  Since Week 11 the number of concussions per week were as follows: 16, 19, 15, 6, and 14.  As my two-year old’s favorite TV show says “one of these things are not like the others”.

Our data collection, the most comprehensive since 2010, has shown that more than 50% of ALL concussions in the NFL occur after week number 9, or the back half of the season.  As of this week we have surpassed the Week 1-9 total of 80; there have been 82 since Week 10.  Of course the pundits will tell you that all the byes have taken place, so more teams means more concussions; true.  However, as the season wears on and the accumulation of hits to the head compile, the theory of cumulative subconcussive blows eventually creates concussive episodes may also be a culprit of our bigger numbers in the second half.

Going forward into the last two weeks – wait one week (I will get that in a second) it will be interesting to see if the trend continues or if there will be another “outlier”.  About that “one” week thing I just mentioned; sure there is two games left but because 67.5% of the league is done after Week 17 concussion reporting is horrible.  As was explained last week, teams will not – do not – report concussions if they are not playing a game in the 1st round of the playoffs.  It takes work from the media and other information gathering Continue reading

NFL Concussion Litigation – The Science of Sport

That is the title given to the upcoming webinar/teleconference sponsored by Perrin Conferences.  These events are mainly geared toward attorneys/lawyers and offer continuing education credits (CLE) for attending.  Below is the press release;

==========

Experts in NFL Concussion Suits join together to tackle industry trends, litigation challenges, and the science in sports injuries on Jan. 8.

Berwyn, PA – Perrin Conferences‘ teleconference series presents “NFL Concussion Litigation – The Science of Sport,”  a program bringing together leading attorneys, doctors and other experts to discuss the issues dominating the headlines of the concussion cases against the NFL, NCAA and equipment manufacturers.  The teleconference will be hosted on Jan. 8 at 2:00 p.m.- 4:00 p.m. EST.

The program provides an overview of the current allegations and defenses in NFL concussion litigation, an update on the latest scientific studies, and tackles other issues including:

  • The potential legal and economic impact of concussion litigation for players, sports leagues and uniform equipment manufacturers
  • Chronic Traumatic Encephalopathy – what is it and how does the science fit into the current litigation strategies?
  • The history of the dangers of head injuries and the timeline of NFL-sponsored studies/concussion rules
  • Medical monitoring and other potential damages
  • Duty to defend, trigger, occurrence and other insurance issues

Speakers include Continue reading

2012 NFL Concussion Report Post Week 14

The Concussion Blog Original, NFL Concussion Report, is a weekly compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

It seems that concussion tracking has hit a “major market” finally with the launch of the PBSFrontline/ESPN Concussion Watch, which is another good source for information.  Their Concussion Watch includes all players that were listed on the NFL Official Injury reports, with either “concussion” or “head” injuries.  This gathers a vast majority of the concussions but they will miss some.

I had the opportunity to pseudo-collaborate with the entities that are compiling this information (via phone and email contact), and we discussed how their numbers would be different from ours here or a place like @NFLConcussions on Twitter.  Our discrepancies go to further the hot mess that is the NFL concussion issue summarized by the Fainaru brothers today.

I not only utilize the Official Injury Report but other methods; data mining and sources.  I had to go that route after Will Carroll explained to me that teams only have to list players that are/may be in a position to play that week or will be out.  In other words, if for some reason a player was concussed and was told he was concussed – even reported as concussed – but miraculously had no issues come Wednesday deadline for the OIR then they would not be listed.  Likewise if a player Continue reading

In Case You Missed It, the NFL/NFLPA Agree on Neuro Benefits

nflpaI caught this from Paul D. Anderson, apparently Darren Rovell had it as well; the NFL and the NFLPA finally agreed on neurocognitive benefits for NFL players as part of the 2011 collective bargaining agreement.  Obviously this was long overdue, but it is now a done deal.  You can read the nuts and bolts on Anderson’s blog HERE.

The gist of the agreement is that players who are fully vested and played one season after 1994 can get compensation for documented neurocognitive disabilities, something that has been missing from coverage since the beginning of time.  But, and its a HUGE BUT, there is a caveat (from Anderson’s blog);

In order to receive the benefits, the player must sign a release promising not to sue the NFL. In other words, if a player accepts the benefits he cannot join the NFL concussion lawsuits. Stated differently, if a player is currently a plaintiff in the concussion lawsuits, in order to receive the benefits, he will likely have to dismiss his lawsuit. The release will not waive any future workers’ compensation claim he may have against a team.

The plaintiffs in the concussion lawsuits, that played after 1994, have a decision to make: Continue reading

2012 NFL Concussion Report Post Week 13 – LATE

Guess the holiday season has many people behind on tasks, including yours truly.  Anyhow, here is the report from after 13 weeks in the NFL.  The report for week 14 should make it to this space by the end of the week (cross your fingers, ha).

During Week 13 we found 15 concussions, seems the weekly average is going up.  We now have 142 regular season concussions – 190 since camp opened.  NOTES: The offense continues to hold roughly a 10% advantage in concussions, which is weird it should be a 50/50 split…  Including preseason DB’s have more concussions (48) then the rest of the defense (38) – 36/28 split in regular season…  Interestingly RB, TE, OL, DL and LB all have similar occurrence; WR and DB’s are higher and QB’s way low…  I think we are going to see a new season “high water” mark, credit to Will Carroll for calling this before the season…  ()’s represent last week’s numbers…;

  • 142 Concussions/head injuries (127)
  • 10.92 Concussions/week (10.60)
  • 185 Projected Concussions (180)
  • 0.73 Concussions/game (0.70)
  • 12.90% InR (12.49)
  • 10.95% EInR (10.61)
  • 70 Offensive (78) – 57 Defense (64)
  • Positionally Speaking
    • QB – 7 (7), RB – 14 (16), TE – 13 (14), WR – 24 (27), OL – 12 (14), DL – 10 (13), LB – 15 (15), DB – 32 (36)
  • Team Breakdown
    • OAK – 12
    • DET, JAX – 8
    • CLE, IND, KC, WAS – 7
    • NE, NYJ, PIT – 5
    • CAR, CHI, DAL, MIN, NYG, SEA, SF STL, TB, TEN – 4
    • ARI, BUF, CIN, DEN, GB, MIA, NO, PHI – 3
    • BAL, HOU, SD – 2
    • ATL – 1
    • NONE – 0

Our definition of Incidence Rate (InR) is projected concussions/45 players taking the field per team per game, our definition of Epidemiological Incidence Rate (EInR) is projected concussions/53 man roster per team.

Comparing to past seasons the following has been found after Week 13: # (2011, 2010):

  • Regular Season Concussions – 127 (122, 119)

2012 NFL Concussion Report Through 12 Weeks

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).

I will save the “soap box” for another day as I will get right to the meat of it.

Numbers are rising, but naturally there are more games as all byes have taken place.  There are more players on the field and more plays so there will be, by logic alone, more concussions.  Our research over the past few years has shown that 55% of all concussions found happen after Week 9.  Both an indication of more games but also prolonged exposure to micro trauma.

This week we say another first, a new high water mark for a weekly find; 19 players were concussed last week, roughly 15% of all concussions to this point.  I have some reasons for this, the most poignant being that I believe the NFL is starting to get it right.  With so many eyeballs on the game now, especially looking at concussions and how it impacts the game they better start to get it right.  I have had multiple sources tell me – which is hard for me to believe but I have heard it more than once – the “crapstorm” that is the NFL medical in-game coverage is now just catching up to what we know.  One person told me that some (stresses some) athletic trainers are still learning about concussion detection, another told me (which I already knew) the doctors being on retainers for the teams are too conflicted.  My most trusted source tells me that players actually have a protocol of their own to evade detection, which they practice from time to time.

Regardless there was a perfect storm this past week to give us the 19 found.  Now onto the stats, 127 regular season concussions – 175 since camp opened.  Notes: due to my 20 month old son “rearranging” my database I rechecked numbers there may be some differences from last week (the #’s are sound)… DB’s and WR’s are now starting to rack up…  ()’s represent last week’s numbers…; Continue reading

Nick Mercer: The Education of Nick

When I try to think of an idea for a post, I look to sports, news, pop culture, and usually find something that gets my mind firing. Sometimes, actually more often than not for my most recent posts, my idea seemingly comes out of nowhere, but once I get a hold of it, off I go. So, while trying to think of the subject for this post, although there were a lot of stories of concussed athletes – not the least of whom is Alex Smith of my favourite team in any sport, the San Frncisco 49ers – I have decided to take another tack and look more at society. I’ve written a bunch in this vein, so you could simply call this tactic ‘going to the well’, but there is just so much fodder here. Plus, it gives me a wider audience than  1000 words on Colin Kaepernick would have (nonetheless, he played an awesome game on Monday!). There have been countless stories over the past 2 years about concussion in pro sports, youth sports, and recreational sports. Every time a new story comes around, a catalog of articles are written, a fury of interviews are given, and an exhaustive supply of statistics are produced. As I’m the only one working alone on this blog, the only resource at my disposal, or at least the only original resource I have, is my experience as someone who’s had a severe traumatic brain injury.

Starting my blog (concussiontalk.com) was one of my best ideas. It gives me a place where I can share my views and vent my frustrations, all under the guise of thoughtful, and dare I say, good, writing. I have, not so subtlety, been able to integrate some pop culture events into my posts. From the start, the point of my blog was to write about brain injury in sports, notably football and hockey, because in July or August of 2010, it seemed a bit different, and as such, it would be interesting to write about. If anything, I’ve deviated from this, Continue reading

2012 NFL Concussion Report Through Week 11

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).

Getting hit in the head by a friend – not hard enough to cause concussion symptoms – say 15 times on a weekly basis is probably not something you would enjoy.  Eventually after about 10 or so weeks of that, theory suggests that there has been enough “micro” damage that the threshold for “macro” damage has been reduced.  Further, if your friend hit you with the same force he/she has been doing previously you may get concussion symptoms, thus a concussion.

If the force was at the same “low-level” as the previous hits – that did not cause a concussion – then why now do you have a concussion?

Looking at it from another angle; if you hit concrete with a hammer – not with so much force it actually cracks – say 15 times a week for 10 or so weeks, will the concrete finally crack and break at some point?  I would venture to guess, yes.

This is now some of the focus on the research in concussions, trying to identify the actual causation/pathology for such cases.  Speaking from a logical perspective; getting hit in the head over and over and over and over and…  Well, over seems to cause damage, no?

This is possibly why we are seeing greater numbers of concussions in the later part of the season; sure awareness is better, but players have been exposed to hundreds and thousands of hits late in the season.  There was a good white paper written on how to possibly abate this issue in Youth Sports, composed by The Sports Legacy Institute.  It is not practical in the NFL, nor do I think that professional adults need to have this in place, unless they choose to – in its place the NFLPA negotiated fewer “hitting” days outside of games in the recent CBA.

This again gives me a chance to wonder aloud why high schools will not adopt a reduction in exposure/hit days for football?  I have generated a proposal on this for the Illinois High School Association that has yet to be brought to a vote.

Back to the NFL and the concussions found this past week, SIXTEEN of them, nearly doubling the average up to this point; the numbers have tied a single week high for the past three years.  Perhaps its a reaction to the week 9 issues, especially the heightened attention after three starting quarterbacks were sent out with concussions.

Now on to the stats for the week – 108 regular season & 156 since camp opened.  Notes: DB’s now make up 25% of all the regular season concussions (8 last week)…  Offense continues to outpace the defense…  Current numbers/stats are getting close to being in line with last year…  The least concussed positions are QB and DL…  The ()’s represent last week’s figures; Continue reading

Tuesday Quick Thoughts

Ed Reed was suspended by the NFL for repeat offenses of the leagues mandate on blows to the head.  Some former players are taking serious umbrage with this decision by Ray Anderson, NFL Executive VP of Football Operations.  Fortunately I had the opportunity to listen to an interview with Anderson on Mike & Mike this morning.

The synopsis, in my opinion, was that the League is now looking at hits to the head and neck as an aggravating offense and will take serious steps to eliminate this type of hit from the game.  More striking was Mr. Anderson’s statement (paraphrased) that; we know now that hits to head are not only a problem we know now that they are life altering, he emphasized that the evidence was now clear to this.

Ray Anderson kept hammering home that “times have changed” and hits like Ronnie Lott made and that were common place years back have no place in today’s game.  He also mentioned that fines are not working as they had hoped, so other measures will need to be taken, including suspensions.

I really feel that the NFL is playing good lip service to this issue, and really are taking baby-steps to change the culture of football.  Now getting on to Continue reading

2012 NFL Concussion Report Through Week 10

The Concussion Blog Original, NFL Concussion Report, is a weekly (not so much this year) compiling of the reported head injuries in the National Football League.  Concussions are added to the list each week from multiple sources to give you the reader a picture of what is happening on the field.  Each week we will bring you the information along with relevant statistics.  If we have missed a concussion or put one on here erroneously, let us know (we will also be using Fink’s Rule to classify a concussion/head injury).

It seems that one time each season there is a “watershed” moment on concussions in the NFL.  Week 10 was that week for 2012 (so far) as three starting quarterbacks were sidelined with concussion – Alex Smith, Mike Vick, and Jay Cutler.

Perhaps unnoticed in the coverage of the QB’s were the 9 other concussions that occurred, including three players having their second concussion – Cliff Avril, Brandon Meyers and Ryan Clark.  It would be Amari Spievey second as well, if you are counting the preseason concussions.

Certainly noticed by me was an ABSOLUTE first in NFL concussion history, which really should be noted.  Again, with all my research on concussions this is the first time this has occurred in the NFL.  This is the very first time that Continue reading

NFL Makes Case For No Indpendent Neuro

Finding a true “independent” health care provider for concussions in the NFL is a sticky situation; the NFLPA says they want one and the League is saying no.  Of course there are various reasons as to why the League would not want an independent neuro there; cost being one issue, the other issue is that the players may actually be in greater peril – and I agree.  Dr. Richard Ellenbogen co-chair of the NFL Head, Neck and Spine Committee explained this in an article in USAToday;

“No one knows the players as well as the athletic trainers, period.

“Having said that, some teams already have neurosurgeons on the sidelines. Having a doc show up just for a game takes away from the all-important baseline exam and continuity of care. It would be like getting operated upon by a surgeon who did not see you pre-operatively. Is that safer than having someone who saw you beforehand? The baseline is all important in making an assessment if a player is OK after a hit.”

Concussion are so subjective, most cases do not involve overt signs and it is incumbent upon the player to report what is going on.  Trust is a HUGE factor for players – of all ages – but more so in the NFL where they are making a living by playing football.  Although the tests are there and meant to be as objective as possible it is still a clinical diagnosis overall.  The only health care professional Continue reading

The Debate of When To Pull A Player

This past week there were some prime examples of concussions, including mechanism of injury and how they are currently handled – some say mishandled – in the National Football League.  Now the debate rages on about when exactly a player should be pulled for evaluation.

In many cases this is absolutely obvious, for example Johnathan Baldwin of the Kansas City Chiefs last night in Pittsburgh.  As he laid out for a catch his head bounced off the ground and he immediately showed a fencing response and was “limp” on the field in a semi-prone position.  He “came to” and tried to get to his feet, key word being “tried”, as he was wobbly and needed help from a teammate and the official to stand.  The official then summoned the athletic trainers to aid in getting him off the field; it was obvious that Baldwin needed to be evaluated for a concussion (side note: the Chiefs are calling his injury a “neck”, which he could have hurt on that play but once again its an attempt to muddy the water, IMO).

To the credit of the NFL medical staffs these types of situations are rarely missed anymore, especially with the observer in the press box helping with the identification of potential head injuries.  I would dare say that these type of situations are missed more often at college, high school and youth level football games than the professional level; which is way more disturbing.

However, the debate remains about those players that don’t show overt signs of Continue reading

Concussion Round Table

Last week The Aspen Institute hosted a round table discussion on “Playing Safely: The Future of Youth Football” to address growing concern about the epidemic of concussions on our youth.  It should be noted that professional athletes are both more mature (in size and brain development) and are adults who can make informed consent decisions.  The issue this panel discussed was for the youth football.

The speaking list was both wide and deep including: DeMaurice Smith, NFLPA, Dr. Gerry Gioa, Chris Nowinski and Dr. Robert Cantu amongst others in attendance;

At the Aspen Ideas Festival in June, a panel featuring concussion experts and former NFL players considered the health safety risks of playing football. Since then, concerns have sharpened, with many parents of young boys saying that tackle football should not start before age 14. At the same time, football also plays a role in addressing the epidemic of physical inactivity. Our roundtable dives deep into the state of football at the youth/community level with a discussion on reforms — and implications on the game up to the professional level.

With awareness beginning to gain traction and definitive research in the area starting to bear fruit this round table Continue reading

An Opportunity Presents Itself

Concussions have been on the “front burner” for a few years now, yet not everyone has the clear and consistent message about this injury.  There continues to be gaps in how the injury is covered by the media, accepted by the leagues and understood by the general sport loving public.  Yesterday was arguably the most high-profile week for concussions in American sport as three well-known quarterbacks exited the game with concussion.  Due to the attention that will be given, I am deeming this a “teachable moment” for everyone.

Several opportunities have been presented to get the message correct and out there this year; in week 2 and week 5 there were 12 concussions.  Last year, week 11 produced 14 and week 14 had 16 concussions yet not nearly the “attention”.  Two seasons ago there was the “watershed” moment of NFL concussions not to mention the 15 concussions in week 16.  Yet the message continues to be clouded.

Regardless where you stand on the concussion issue (you should be concerned), particularly in the NFL, it would be a good time to get the basic information out there and link up some further information if you choose to look.  I will try to lay this out in the most helpful manner; to the point with as much fact as possible (I will notify when its opinion).  I will do it bullet point style;

  • FROM CDC: of the roughly 3.6M concussions that go the emergency room in the US, over 50% are due to recreational activities/wheeled sports.  Estimates have been made that 30-50% of all concussions are undisclosed or unreported.
  • Concussions occur in all sports, the exposure and rate is much higher in: American football, rugby, Aussie Rules, men’s lacrosse, ice hockey.
  • Current research/theory suggests Continue reading

2012 NFL Concussion Report Week 9

The Concussion Blog Original, NFL Concussion Report, is a weekly (not so much this year) 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).

The NFL is at the theoretical half way point in the season as most teams have eight games in and a few have nine completed.  Usually this spot is a weekly tracking post; never fear I have been keeping track just haven’t found the time to post about it.

The NFL told me last week in Zürich that the eye-in-the-sky is being used and used often, Dr. York told the audience that in Week 6 there were 192 communications alone under this system.  That breaks down to 13 times per game on average; so the discussion seems to be there, but are the results?  It is far too soon to tell, but I am encouraged by the raw stats – knowing what was being discussed would be much more insightful.

Generally speaking the only “alarming” observation I am noting is the massive increase in offensive lineman concussions.  Suppose the theory of cumulative hits eventually creates a lower threshold for an observed concussion then this example/observation would be example number one;  after week 5 there were three OL concussions and after week 9 there are 10.

Other than Larry Fitzgerald amazingly missing only one play and Calvin Johnson admitting  Continue reading

Please Explain

It is a common thought that crosses my mind when I see questionable actions around a concussion situation.  Unfortunately I don’t have the power to get the answers, so I basically post them on here for others to see.

This is not the case in Australian Rules Football; if you are team and you receive a “please explain” regarding an injury (mainly concussions) you are probably treading on thin ice.

There is a mechanism in AFL that formally puts teams and doctors on notice when things just don’t add up.  Take for example the handling of a concussion by the North Melbourne Roos;

Interim Kangaroos chief executive Cameron Vale emailed AFL operations manager Adrian Anderson on Monday after the Roos were told to respond to a ”please explain” issued by the league last week.

The Kangaroos have been under investigation over the manner in which they handled Hansen after he received a heavy knock against Essendon in round 20, and also for the way they have responded to AFL investigators Brett Clothier and Abraham Haddad in recent weeks.

The AFL has been unimpressed with the club’s handling of the issue, although the Kangaroos have bristled at suggestions football manager Donald McDonald had influenced the testimony of key figures involved.

The letter is not the first step, rather the end step in a process that allows the medical board of the AFL to investigate how the practices of player protection is put in place.  Is it oversight?  You bet and I feel that the AFL does something much-needed in all professional sports.  Really, it is only applicable to the pros because of the resources, however it could translate to large colleges as well.

In Zurich I spoke to Dr. McCrory about what they do in regards to this, here are the basics; Continue reading

Zurich Day 2… And We Are Live

I have figured out the power situation so I will be trying to update the blog ASAP after each session…  For the time being make sure to follow on Twitter…

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1030 CST: Session 7, final session: The Sharp End

First debate between Dr. Cantu (yes) and Dr. Herring (no): is no RTP same day the best management paradigm?  Is keeping a player out one week long enough and is the graduated RTP protocol sufficient…

THERE WILL BE NO RTP on same day in the new statement!!!

Change of direction on Session 7, questions with panel answers, pro-con (if available)

Do 3 concussions end your career?

  • its comedy hour
  • Aubrey – treat each athlete individually
  • Dvorak – it has to be based on timing and complexity of each recovery – case-by-case basis
  • Putukian – if we can’t agree on dx how can we agree on a number
  • Overall theme is it is individualized, not all concussions are the same (Cantu)

Who is best qualified to make the sideline decision?

  • Cantu – multiple members working under a physician can make the call
  • Herring – concerning to him that some information is intrinsic to doctors so need to be careful
  • better question is who best qualified – person with most experience
  • Dvorak – looking at spectrum of games played, doctors are best qualified in most instances, but are they there in all matches?  We should aim all this to the “grass roots” as the professional level there is more than adequate coverage.
    • comedy about football versus american football
  • Ellenbogen – those that know the athletes should be making the decision, maybe a parent in youth sports, or athletic trainers, understanding the patients baseline is important
  • Putukian – balancing act, in a perfect world its a team approach (Athletic Trainer mention), and she says in the US the athletic trainer should be making the decisions on the sidelines…
  • Aubrey – Hockey Canada has a safety person (volunteer) in lieu of an athletic trainer
  • Cantu – brings up possibly training school teachers in concussion
  • Herring – if you are team physician do you need someone else to make the decision if you are on the sideline?  Panel – no

Is there a role for grading concussions?

  • Cantu – not perfect, but informing patient is important about severity and duration of recovery, after the fact
  • McCrory – we have moved from grading, look at the recovery – perhaps look at the SCAT/serial testing
  • Putukian – looking at history is more important than arbitrary “grade”
  • Herring – may help with continual care from one place to another, but again important to understand history

Should we be returning on the same day of concussion?

  • Aubrey – what about the NHL player in the playoffs (rhetorical question)
  • Cantu – no once recognized
  • McCrory – what about the players that clear the SCAT, so no concussion, but you know something is amiss?
  • Putukian – example of hockey player with delayed symptoms
  • McCrory – concussion is often an evolving injury
  • Ellenbogen – it is a traumatic brain injury, is the game worth it?  No.
  • Panel – consensus is NO RTP same day
  • McCrory to Aubrey about playoff example – what about a regular season, and Aubrey is being very honest, and he feels the player push back is greater
  • Ken Dryden from the audience – why are we treating professional athletes different from the youth or non-elite athlete
    • We are starting to move away from that, all athletes should be treated the same

Should there be helmets in woman’s lacrosse and field hockey?

  • Cantu – yes, because of stick and ball causation of concussion
  • Putukian – no, change nature of the game, no reports of intercranial bleeds in women’s lacrosse, weary of unintended consequences (BTW, probably has the most experience with this)
  • Cantu and Putukian discussing this topic
  • Change gears – what about football?
    • Dvorak not in FIFA’s plans to recommend, many reasons including the false security of wearing head gear
  • Audience Q: should we discourage the use of the head bands/head gear
    • Dvorak – your own prerogative but data does not support the use of them as recommendation (Czech goalie wears one)
    • McIntosh – Rules are more important at this time

Should there be age restriction on tackling in American football, heading in soccer and checking in ice hockey?

  • Cantu – his words speak for themselves, youth sports needs to look at how the game is played because of the differences between older
  • McCrory – in Australia you cannot get to the gladiatorial aspect of Aussie Rules until they are “of age” (13 if I heard correctly)
  • Ellenbogen – risk of activity, most concussions via CDC information is from wheeled sports and recreation, does not make sense at this time to him, advise accordingly
  • Cantu – youth sports don’t have the good data, personally he does not believe learning a sport at age 5 will make you elite, it is a genetic disposition in his opinion
  • Putukian – it makes sense to decrease exposure, US Lacrosse has put age 13 on checking, her take on soccer is that there is no data to support this when using proper sized ball and equipment
  • Dvorak – young soccer players learn sport first, and fundamentals of “football” its not “headball”, studies done on heading ball and with study there was no increase in biomarkers they were looking at it.  They don’t force kids to head ball until skills are sufficient.
  • Herring – false warranty?  Arbitrary age is concerning, take head out of the game rather then taking the game away from youth athletes.  The limit to exposure is accurate, but complete removal of the sport may not be necessary.
  • Cantu – sport needs to be safer for younger athletes
  • Aubrey – ice hockey has set limits on age for body checking, research is very important, it will help make decisions

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Dr. Jamie Kissick speaking on “From Consensus to Action”

  • Knowledge is power
  • “There is an app for that”
  • Knowledge Translation (KT) Concepts Continue reading