Soccer Concussions

Concussion by Sport (revisited five years later)

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This was another very early post of this blog back in 2010, September to be exact. As you can tell I was very green to the whole linking of articles and writing. However, this is an important article regarding concussion statistics by sport from five years ago. I would be interesting to do a follow-up to this with what we know now. Looking back at my observations have not changed much in the five years, I may move wrestling above cheerleading but that is about all.

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Concussions are not exclusive to American football, although it is the most covered sport as it relates to concussions.  This is a good time to note that in the United States the next most concussive sport, is soccer, the number one sport in the world.

A reasearch project by University of North Carolina reported concussion rates by 100,000 athlete-exposures Continue reading →

Taylor Twellman Story (9/21/2010)

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Originally posted on The Concussion Blog in September of 2010.  I would be interested to see Taylor talk about this in a reflecting manner and see if anything has changed with him and his thoughts on concussions in the sport he loves.

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Just ask Taylor Twellman, a soccer player from the New England Revolution how unpredictable they are.  In 2008 near the top of his game and the American leagues he ran full speed into the goal keeper, creating a whiplash effect on his body, most namely the skull.

To this day Twellman has not had a single day without some post-concussive effects.  He was only just recently, June, released to begin light activities.  Granted this is a professional athlete that has a career to think about, his health remains his number one priority.

Monique Walker of Boston.com ran a story about him and his not so quick recovery from concussion.

For our adolescent population this can be even more devastating, a delay in recovery could mean a decline in grades, an emotional disconnect from teammates, and a social decline in school.  All while the brain and personality are still developing.

If you get your “bell-rung” make sure you communicate that with someone who can help.

#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 →

World Cup Time

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I took this pic at FIFA HQ
I took this pic at FIFA HQ

For all the blame football gets for concussions and concussion problems; futbol – or the worlds’ game – has its share of concussion issues (so do just about all contact sports).  The unique thing to soccer is that it is not a “collision” sport, by definition.  Yes, it is a contact sport, however it is not designed for full contact or collisions all the time like other sports like: rugby, Aussie Rules, Football, hockey and rodeo (you could even include lacrosse because of the sticks).

The nature of sport, competitiveness, lends itself to injury risk and risky behavior – this is always the case of concussion and their issues.  In the game of futbol/soccer the basic rules have set up a game where concussions can and do occur at frequency for a “non-contact” game.  Of course calling soccer “non-contact” is a complete misnomer if you watch or understand the game at all.  Players are constantly using their bodies to gain an advantage on opponents, from shoulder charging to grabbing or using hips to knock another player about.  The issue as it relates to concussions is how the head is used in this sport.

It is used as a much-needed tool to clear, pass and score the ball.  It is currently unclear as to how heading a ball in general relates to concussions and long-term issues although a general causation link can be observed and some studies have shown higher incidence of deficit of “brain measures” with increased heading.  Most often concussions occur due to collisions on the pitch.

It could be as simple (and scary) as a boot to the head or as subtle as an aerial challenge that resulted in a violent and unanticipated shaking of the head.  Often, concussions occur when the player falls to the ground and the head uncontrollably smacks the ground.  The point being there is ample opportunity for a soccer player to sustain a concussion and at the least subconcussive brain injury.

I thought I would look in to the research done about concussions in soccer and came across a very peculiar paper: “Chronic traumatic brain injury in professional soccer players”.  It is not the title that caught my eye, with all the information we are currently gathering on concussion it seems natural to see that kind of title.  Heck, very recently we saw something that was originally thought of as non-existent, CTE in a soccer player.  No, what made me stop and note this study was the year the paper was published………. 1998.

Yes, 16 years ago.  Let me repeat that, SIXTEEN years ago this information was made available by these pretty dang good researchers: Chronic Traumatic Brain Injury in Professional Soccer Players.  Below are the results and conclusions:  Continue reading →

TCB Mail Bag

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I trust everyone has had a wonderful Christmas experience (or Hanukkah or Kwanzaa or going to have a good Boxing Day), with that I would like to wish everyone continued successes in whatever endeavor they choose.  Over the Holiday I have received many an email regarding concussions; apparently the down time has given people opportunity to share frustrations or good news.

Today I am bringing you a specific case in which we all can learn from.  At the least we can read this and prepare for similar situations that may arise – whether as a parent, doctor, coach or athletic trainer.  

As always you can write in and with your permission I will re-post anything you would like (and it may suit the audience).  It can be attributed to you or anonymously.  Keep it between 500-2000 words and omit any personal identifying factors if it involves patient care or sensitive information.

Here is our post today – by Anonymous:

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Obviously today is Christmas Eve and in most regions of the country kids are not in school for at least the next two weeks. Maybe less, maybe more. All in all it is a great time to rest up that brain and recharge your body. As athletic trainers we also know that sports do not stop for the holidays. For the most part at least. If you remember last year I read an op-ed article that you put on your blog titled “Parental Decisions Can Undercut Good Concussion Laws” or something of that nature. Well, it’s happened again (as it has many times between that time and now but this one is a little more ridiculous than the last) and I’m nauseous!

To be as brief as I can on this without boring you this is the case of a female soccer player who sustained a nasal fracture as well as a concussion when fighting for a header in the air with an opposing player almost a month ago. To be clear, she actually suffered a deviated septum. Anyway, after our AT did a beautiful job of getting this athlete “entered” into our concussion protocol (which Mom still couldn’t get over the fact that she indeed had a concussion; whoda’ thunk it, right?) we all sat in our physician’s office (Mom, AT, myself, physician, athlete) and witnessed the concussion as well as the nasal issue being addressed. The athlete was clearly concussed (clinical exam, balance assessment, and symptom reporting were all abnormal but ImPACT scores remained at baseline) and the athlete was sent for an MRI and referred to an ENT for further evaluation of the nasal issue. Pretty simple. These folks were given the “red carpet” treatment as all of our athletes/parents are and everyone left happy. The consensus was to see the ENT and address that issue then to follow back up with our physician for the resumption of the concussion issue. The athlete ended up having surgery about a week later. She was out for about a week after that. The ENT cleared her to resume play and actually said that there was no concussion. Wow! OK!

Fast forward to last week during exams and the athlete did not follow-up with the AT during exams like she was instructed to do. She THEN shows up to a game on Saturday with a face shield and tries to plead her case to enter the game. The AT did her job and did not allow the athlete to play. Mom was irate. Athlete conceded. Coach was with the AT. So athlete did not go through the GRTP process and as of today the mother refuses to follow-up with our physician for final clearance after all of the objective information is noted. She is choosing to Continue reading →

Soccer (Football) Suggested Changes

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In the wake of the Hugo Lloris incident there has been plenty of discussion on how to possibly avert such a situation from happening again.  In this particular case it is simple; if a player is knocked unconscious they are removed, no questions asked.  The problem really is the minutia of the game, more explicitly the traditions of the game.  Why not remove emotion and tradition and figure out a way to be better.

Because of this I am going to propose some changes for the international game of soccer.  Being mindful that some places and medical staffs do it correctly – I do not intend to “pick” on any particular league (although my lack of soccer knowledge may be off-putting to some).  There is no rooted soccer tradition in my family, nor do I even pretend to know all the history and because of that I feel that some of these ideas are void of fanaticism.

In order of importance;

  • Allow for a medical substitution for head injuries (this can be both a temporary and/or permanent replacement for the fixture)
    • After play is stopped for a head injury the team should immediately sub for that player; this gives the player less of an ability to fight to stay on the pitch.  It will also allow the medical team to properly evaluate the player in an environment more fitting (locker room).
    • If player cannot continue due to head injury then the sub stays permanent for the fixture.  If the player is deemed fit, then a re-entry is given to the initially injured.
    • This substitute would not count against the maximum of three subs/match, in either case above.
    • In the event of multiple incidents of head injury then another medical substitution would be allowed.
    • The referee would be in control of the above medical substitutions.
    • All medical subs would be subject to FA review; as to prevent gamesmanship of the rule.
    • This medical substitution would be for head injuries only.
  • If a player shows signs of a concussion, i.e.: loss of consciousness, Continue reading →

Tottenham Hotspurs; More Like Tottenham Hotmess

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The center of the club soccer world resides in England (two teams in Wales) with the Barclay’s Premiere League (BPL).  Being the “best” soccer league has allowed the BPL to be televised live here in the States as the sport is showing some growth in participation and in viewership.  I have recently found myself watching more matches and even choosing “a side” – as they call it across the pond (it should be noted that soccer it called football everywhere else but here).  Through research and general information gathering as I get further into the sport the BPL or other European soccer leagues are not much different in its fandom.  Supporters of teams and players are similar to the fanatics that follow football here in America; critical of team play, ownership, players effort and results.  One area where the fans and the sport of soccer is well behind, in terms of knowledge, is concussions.

The readers of this blog know quite well that a concussion is simply an event that alters normal brain function.  Being primarily subjective it may be hard to distinguish a concussion by simply looking at a player or person.  However, the vast majority of sports fans here in America and participants know that there are tell-tale signs of concussion that cannot be disputed.  When one of those objective signs is observed it is and should be understood that said player was concussed and requires immediate removal from the game/practice/activity.  The reason is simple, concussions are a brain injury and bad.  Research has shown that playing through a concussion is very detrimental to short-term and long-term mental health.

Years ago, pre-2004, getting knocked out or displaying signs of a concussion was a mere nuisance and even a “badge of honor” among the top-level sporting participants.  It was known back then that something as obvious as someone losing consciousness was not a good thing for the younger participants, however it wasn’t looked upon as it is now.  When a sports participant absorbs enough force to effectively “reboot” the body’s central nervous system that is NOT A GOOD thing.  As the information about concussion has become more clear through the years if a player is KO’ed that player is removed from play immediately and does not return for the period determined by the medical staff.  In the NFL the soonest anyone has returned to practice or game after being knocked out, since 2010 has been six days.  Even that may not be enough time for the brain to recover.  Heck, in boxing and MMA, fighters that are KO’ed are medically suspended for 90 days.

This leads me to the bloody mess that occurred in Everton, England yesterday.  Continue reading →

Please Explain

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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

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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 →

Two Excellent Researchers Discussion Concussions

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If you get the chance you should take the time to read the research that has been done by David Hovda, PhD and Kevin Guskiewicz, PhD, ATC; not only is it good information but it has been some of the leading information.  These two gentleman do a great job of explaining the issues and making them more tangible for everyone.

On September 6th, both Hovda and Guskiewicz had a real-time chat about concussions on ScienceLive;

ScienceLive, Science magazine’s weekly web discussions with experts in various fields, will examine the issue of sports- and combat-related head injuries during a web chat at 3 p.m. Eastern today. Guests include Kevin Guskiewicz of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at The University of North Carolina at Chapel Hill and David Allen Hovda, the Director of the UCLA Brain Injury Research Center.

You can click the link above to go and read the replay of the chat, a must for those looking for information and would be a good idea if you have kids playing sports now.  Below are selected comments from the chat; Continue reading →

Reflection on the Weekend

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While away on a family vacation I don’t get to the researching/data mining I usually do, inevitability there are events and happenings that occur that get push back in coverage.  The nice thing is that the media and other sources are doing a wonderful job of highlighting the issues that come about.  There are a few instances of concussion related news that I would like to now opine on.

First and most concerning was the Olympic woman’s soccer match between the United States and New Zealand and this;

Not only can you clearly see the keeper get hit in the head and having a violent deceleration, then her head smashes the turf, not only that she was CLEARLY unconscious after this hit, yet she was allowed to continue.  If the governing bodies of sports want to get a handle on the concussion issue then cases like this must be handled with supreme independence and a player should be removed.  Take a look at this picture and tell me she should have continued…

I will be as obnoxious and abrasive as possible with this next statement:

IF ANY PLAYER IS KNOCKED OUT FOR WHAT EVER REASON THEY SHOULD BE REMOVED FROM ACTIVITY, PERIOD.  SCORE AND CIRCUMSTANCES SHOULD NOT HAVE A BEARING ON THIS DECISION.  SAID PLAYER SHOULD NOT RETURN TO ACTIVITY UNTIL CLEARED BY A PHYSICIAN AFTER AT LEAST 24 HOURS.

We are talking about a disruption of the brains activities so “gross” Continue reading →

Concussions: Not Just Male; Not Just Football

Michael Hopper18 Comments

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

Neck Strengthening Should Be Addressed

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Looking at the human body, in particular the head, it’s a wonder we exist at all.  Our operations center is basically held in place by small bones and strong neck muscles.  The human brain weighs between 3.5-5.5kg or 8-12lbs which does not seem like much until you find a 10lb medicine ball and try to balance it on a pole.  Once balanced then strike the ball and then you will be amazed at how our body handles extreme forces.  Even more convincing would be hitting the pole or lower and look what happens to the ball, our body is simply amazing.

In order to control your skull – in effect your brain – the neck muscles must be good at detecting even the slightest movements and be able to activate in an instant to compensate for sudden trauma to the head or body.  It would stand to reason that increasing the strength of your neck would also help with lowering transitional forces to the head.

There is one little caveat with this example, the brain itself.  On average the brain weighs 1.5kg or 3.5-4lbs, which makes up the majority of the weight in our head an it is not attached to anything.  That is the crux of the problem; a free-floating organ – our most important – that is susceptible to forces anywhere on the body.  This is why helmets cannot claim, nor do they, prevent concussions and it is why even with the strongest neck an unanticipated hit (when neck muscles are not tensed or engaged) can and will result in acceleration of the head.  Translated that means high potential for concussion.

Rock Center once again takes a look into the concussion realm Continue reading →

Girls Soccer Story Follow Up – NBC

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In response to the overwhelming reaction to their report on concussions among high school girls playing soccer, “Rock Center’s” Kate Snow goes to New Jersey, Florida, Texas and California to dig deeper into the danger, and the psyche of these young girls and their families. Many have responded to the risk by wearing special headgear advertised as protecting against concussions, but Snow discovers that the reality may be very different. It’s a piece of reporting no parent should miss.  (VIDEO PREVIEW LINK IS BELOW )

VIDEO LINK

Rock Center With Brian Williams will air this episode tonight as the new season begins at 10EST/9CST.  It will bring up the physics of concussion, and how the headgear is supposed to work and the potential problems of that logic.  Here is an excerpt from the associated print preview; Continue reading →

Concussion Article Links – MUST READ

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Since the tragic and untimely death of Junior Seau the concussion issue has begun to fester like a three-day old pimple on a 13 year-old’s greasy face.  It is ready to pop and keeping up with all of the pertinent articles and “specials” has been very trying.  In this post I will attempt to link up and highlight as many as I can (surely I will miss many, however Concerned Mom in the comment section will have more).

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Lets begin with ESPN and the Outside the Lines week-long look at concussions.  I have found this to be must see, my DVR is a testament to this; using previous stories and bringing in commentators on the subject have provided information and even fireworks.  Yesterday Merril Hoge and Matt Chaney did just that – provide information and create fireworks.  You can find the podcast here (panelists begin about 7:30 mark).

Hoge drew my ire earlier this week with his admonishing of Kurt Warner’s statement of being a father, however yesterday he did have a very valid point about the management of concussions.  I have said is ad nausea here: the elephant in the room is the management of concussions, however Hoge sounded a bit “underconcerned” about the actual injury.  Which is where Chaney had very valid points about the exposure of concussions to the youth.  They are both right in my estimation; the management is the larger issue but we are seeing too many too young people being effected by concussions.  There needs to be work in both areas and remember this is not just a football issue.

We have the duty to protect our kids and if that means flag football for 5-13 year-olds then I am cool with that.  If we find after making such a drastic change that has not been enough then we can take it further if needed.  I feel that a change like this will allow a few things: 1) more time to let the brain develop and thus allowing research to catch up to what we know.  2) employ more medical providers in a position to find, assess and manage concussions (see athletic trainers). And 3) begin a culture shift about the seriousness of concussions, after all this is a brain injury.

As Chaney later told me; Continue reading →

Coalition for Concussion Treatment #C4CT

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Yesterday I helped launch the #C4CT cause via the blog and twitter and it was nice to see the interest really begin to peak (thanks @SchuttSports, @the_jockdoc  and many others).  As with most movements or introduction of products getting interest is the first thing; now with official press release in hand it is time to explain and get more of us going here.

The hard work of Jack Brewer and Alex Nennig (and probably others) of Brewer Sports International have created this coalition which I believe to be a “best foot forward” approach in not only raising awareness and education of concussions (our number on goal on The Concussion Blog) but has a possibility to stake a claim in treatment of lasting effects of TBI.  I am honored to be asked to be a primary supporter of this cause, although as it catches wild-fire I am hopeful more important people jump aboard – looking at you NFLPA and NFL.

It is also an honor to be along side a very strong and promising law student in Paul Anderson.  I have had many conversations about creating such a cause, but have yet to find the trailblazing counterparts until this came along.  Please take the time to read the below press release and join along this weekend in using the #C4CT, even promoting questions from others about the hash tag is an opportunity to inform!

Press Release========== Continue reading →

Barca Gets It: so it seems

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In a tough match against Chelsea, Barcelona defender Gerard Pique took a shot to the head from the keeper that resulted in immediate Fencing Response. (Video below, sorry for the music all I could find)

Not only was he removed from the game the club has taken a stance that I feel all professional clubs should take with ANY concussion, not only the ones resulting in obvious signs like the Fencing Response; Continue reading →

Soccer Concussion from Russia

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One of Europe’s top goal keepers was injured in a Russian Premier League game after taking a knee to the face (video below at 0:50 mark).  Andriy Dykan was attended to but continued to play, until things were bad enough he asked for a sub;

Spartak said Dykan had “broken multiple bones and suffered concussion” after being struck in the face by Zenit striker Alexander Kerzhakov’s knee.

The 34-year-old decided to play on following the collision early in the second half but 10 minutes later he asked to be substituted.

Concussion Awareness/Testing and US Youth Soccer

Dustin Fink3 Comments

On February 7th an agreement between a neurocognitive testing company and US Youth Soccer was made.  Not only was this a partnership for the use of the tool, but it also provides some of the best, in my opinion; concussion education, awareness and management tools out there.

Soccer has been a rather underrepresented sport when it comes to the concussion issue, perhaps because it does not garner the spotlight in today’s sports media, like that of football.  However, soccer has its fair share of brain injuries, one reason is the use of the head in the sport is encouraged.  Because of this it exposes players to more risk, even if heading the ball is controlled, what happens in the air leading to that can be more apropos to creating the sudden traumatic event causing a concussion.

Below is the full press release;

US Youth Soccer and Axon Sports bring Affordable Concussion Management to Leagues, Teams, and Clubs

Web-based tool helps medical providers manage concussions; facilitate the safe return of players to the field

FRISCO, Texas (February 7, 2012) – US Youth Soccer, the nation’s largest youth sports organization, today announces Axon Sports as a long-term strategic partner for computerized baseline testing for concussion management, leading the way in making soccer safer for kids at the grassroots level.  Through the relationship, US Youth Soccer will provide member discounts and educational resources on USYouthSoccer.org.  It will also provide more than 25,000 US Youth Soccer players free access to the Axon Sports Computerized Cognitive Assessment Tool (CCAT).      Continue reading →

Tuesday Quick Hits (UPDATED)

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Bending the rules for a star is not uncommon, heck we see it almost every week in the NFL as players are initially reported to have “dirt in the eye”, or “back spasms”, etc.  However it is rare that you see an overt “relaxing” of rules to possibly allow them to play.  It has happened in the UK in Premiere League Soccer, the team is Arsenal Manchester United and the player is Rio Ferdinand (bold my emphasis);

Ferdinand claimed on Twitter that he ‘could not remember’ what happened during United’s 3-0 victory over Bolton at Old Trafford on Saturday.

He also admitted  he had suffered concussion, which under previous FA rules meant he would automatically miss the next 10 days.

But the FA have relaxed the guidelines and Ferdinand, 33, will now be put through a thorough medical examination.

Thanks to twitter both @SportsDocSkye and @SportsDoc_Chris find that the article as I have presented it and was reported in the link is inaccurate.  I appreciate them following and correcting this issue (also my stupidity when it comes to European Futbol).  The issue that needs correcting is that the current FA concussion guidelines follow the Zurich statement and a player will follow graduated return to play, meaning the 10 day issue is moot…

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I was reading an editorial in the Star Tribune about how the concussion laws could be a detriment to coaches and teams, when I came across some good Continue reading →

Wonderful Retrospective Article

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Originally published August 11th, “Student athletes suffer the stings of concussions while lawmakers fail to help” written by Steve Jansen and Gus Garcia-Roberts (not their first) in the Miami New Times News shows examples of how missing concussions and not handling them correctly (from player to coach to parents to athletic trainers) can be very troubling.

Including in this piece are quotes from Dr. David Hovda, one of the leaders in concussion/brain trauma research from UCLA, as well as other lawmakers and parents.

I was previously unaware of the Village Voice Media research and findings; Continue reading →

Playing With Concussion In Soccer: Not A Good Idea

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Since you have been following the blog you certainly know that soccer or (futbol or football) is very high on the scale of concussion risk.  This is not only due to collisions but to heading the ball; remember that the unanticipated traumatic events in all sports lead to a disproportionate amount of brain injury.  This occurs often in soccer, a sport without helmets or any head protection for that matter.  You also know that playing with concussion symptoms can lead to further damage and even serious consequences – particularly in adolescents.

Let us take the example of Leeds United’s Darren O’Dea.  On Wednesday, October 26th Leeds played a game in which they won 1-0, however O’Dea complained of dizziness after the match and taking a blow to the head.  The player (O’Dea) then proclaimed himself “fit” for yesterday’s match against Cardiff City.

Early on in Sunday’s match Leeds scored with some help from O’Dea but from there it went wrong for the player and team; Continue reading →

Sunday Slants

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For your early reading on a Sunday here are a couple of stories; like the slant route quick hitting but you have the opportunity to go further if you wish.

Misleading Headline

“Chargers’ Dielman out for two games after concussion, seizure“…  To put a definite number on return to play is WRONG for all brain injuries; although the article hints at a longer out period the headline is poor at best.  And guess what it was published by the NFL.

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Misleading Nomenclature

There was another concussion in NCAA hoop as UConn player Andre Drummond broke his nose and was diagnosed with a concussion, but according to the player it was only “mild”;

“This sucks,” Drummond wrote. “Mild concussion and I broke my nose. Worst day ever.”

There is NO SUCH THING AS A MILD CONCUSSION, period.

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Misleading a Player

Quite possibly one of the worst revelations we have seen in sports an athlete, professional soccer player Taylor Twellman, was intentionally misled into playing; Continue reading →

Concussion Interview With Mike Ryan

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Mike Ryan is an Athletic Trainer and Physical Therapist in the NFL.  He has been very good on informing people about concussions, and with his unique experiences his words are worth listening to.  He also has a website that is extremely informative about Sports Medicine (MikeRyanFitness.com)  There was a recent interview with him on SoccerClassroom.com discussing the injury and how it is/should be handled.  Unfortunately I cannot embed the video but you can CLICK HERE to see it.

Mike does a wonderful job of telling us that the big hit is not the only hit that can create a concussion, rather any force that can transmit to the brain can cause injury.  As the interview goes on it rolls more into soccer, but that sport seems to be accruing concussions at a good rate as well.

Other subjects they touched on: equipment, baseline testing, recovery, Taylor Twellman, subjective nature of a concussion and much more.

The interview is lengthy, 24+ minutes, but it is a good interview.

Lingering Effects Of A Concussion: Girls Soccer Case

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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 →