#pinkTBI Summit 2016: A recap

pinktbiThe meeting at Georgetown University this past weekend was more than fruitful for this athletic trainer. I went in trying to get two things done: one, provide info to you the follower as best as possible and move along the discussion on female concussion and two, to learn something that is applicable to me as a “boot on the ground” athletic trainer.

The first was probably painfully obvious that I accomplished if you follow on Twitter and didn’t mute me and were not interested in this event (you should have been interested). The second objective I did meet by learning some techniques when working with females, not only at incident but with recovery, education and overall attitude.

Certainly I could write 4000 words on this event but that would be boring to you and I am still recovering from the weekend the the docs there asked that I “rest” my fingers. That being said I will give quick synopsis’s of each speaker, info that I took away as an athletic trainer and advocate for education about mTBI/concussion. It is entirely possible that I misrepresented some thoughts and missed some very valuable info for some out there; don’t worry speakers and audience this was done the best possible.

Lets begin, and this will be in chronological order of the event with presenters last name, in bullet form. My hope is that you will use this as furthering your info about the female sequale and in some cases change how you treat.

  • Kerr:
    • The concussion rate is higher in females in males in college and high school sports, particularly in basketball, soccer, and softball/baseball.
    • Research suggests differences in symptoms reported as well as RTP.
    • More research needed at the youth level.
  • Covassin:
    • Showed that neck strength is a confounding effect on possible injury.
    • MOI is different in the sexes: males contact with player while female is contact with ground/equipment.
  • Lincoln:
    • Exposed us to the lacrosse injury and problems that exist, which is important because this is an emerging sport.
    • No head gear in woman’s lacrosse.
  • Casswell:
    • Impact sensors and injury and how it may relate to injury.
    • Different types of injury for females vs. males (building on Covassin).
  • Colantonio:
    • Logitudial study showed about 24% of female pop has had mTBI.
    • Females seek and get less care overall.
    • Reproductive impact after a mTBI need to be understood.
  • Gioa:
    • Static and dynamic symptoms are different in female vs. males – needs research.
    • Academic performance shows no difference between sexes.  Continue reading

Thoughts on everything we are hearing and will see: An opinion

Certainly we are nearing a “too much” point in terms of concussion for most of the country. For others this is just the continuation of what we have been doing for years. From a personal perspective I do like the attention that the discovery process is getting. I am all for people getting all the info possible to make informed decisions.

I want to take this particular space in this post to assert that I am not – nor have I ever – been against any sport including football. I am, transparently, supporting flag and non-tackle football until high school. Yes, no scientific evidence proves this helps/hurts, but in all my work and research I am of the opinion that less dosage of repetitive brain trauma is better for humans.

That is where we stand, the issue really is one of repetitive brain trauma (RBT), not of sports or accidents or leisure activities. As Dr. Omalu clearly stated in his interview with Matt Chaney in 2011 and again today with Mike & Mike (hour 4); the brain does not heal itself. Damaging it, even on the microscopic level can and will leave a lasting impact. This is not just assumption, it is noted in many different studies regarding brain health after activities (see Purdue).

I am confident that with proper healing time and avoidance of re-injury the brain will find a way to function at or even better (proper learning and congnitive functioning) as people get older. The management of not only the “gross” injury of concussion and TBI is one that is getting better and as we get more research the management of the subconcussive hits and exposure, that too will be satisfactory.

What we all must do is take off the “emotional pants” and wade through the muck to find out what is important for us to make decisions for those that are not capable or even legal. Part of this is discourse and discussion (civil would be best). Everyone will be challenged intellectually and morally with this – it’s OK.

I noticed an article written by Irv Muchnick yesterday Continue reading

Before ‘Concussion’ Omalu was still Omalu

In two weeks time people will be going to the movies to see the screen adaptation of a forensic pathologist that unintentionally made the giant business of the N.F.L. weak in the knees. In the movie ‘Concussion‘ mega-actor Will Smith becomes a little known West African doctor, Bennet Omalu.

To many Dr. Omlau has been a recent discovery due mainly to this movie but also the discussion surrounding it, including Dr. Omalu’s op-ed piece in the New York Times. To a small circle of people his work and voice has been around much longer.

Early in 2011 Matt Chaney – a tireless cataloger of football catastrophic injuries and outspoken author/journalist – had an interview with Dr. Omalu. In this interview you can see that Dr. Omalu is still the same concerned medical practitioner as he is now.

With permission from Matt, I am publishing the transcript of his interview. Do with this what you will but Dr. Omalu takes on all sorts of issues surrounding the concussion discussion.

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BENNET OMALU

January 15, 2011 by telephone with Matt Chaney

Q. What football likes to do; this is what I learned in 20 years in the anti-doping issue, where we have so-called testing, and protection of players against drug use. Foremost, it’s very clear now, according to a host of experts worldwide, that so-called testing for steroids is bogus. It does not work. It’s invalid. It has huge faults in terms of its applications. Well, point being, football especially—but other sports too, especially the Olympics, and baseball, are learning by their example—football likes to [chuckle]… When it has a problem for which it’s being criticized for, it likes to go out and stable the science. It likes to go out and fund and/or hire scientists, to put together its prevention packages, and act like everything’s hunky-dory. And they do not share their science. They say they have a test, but they do not open it up to [peer review]—

Omalu: [he interrupts] A very good example, because WWE’s guilty of the same thing.

Q. Oh, really?

Omalu: This so-called ImPACT testing. That is a fraud, in my opinion. ImPACT testing is not a diagnosis tool. It is a forensic followup [model] to monitoring, to quantify or to evaluate the amount of damage. And to monitor, to see how a patient is improving.

Using the ImPACT testing in the acute phase of injury, to determine the amount of damage, actually makes the damage worse. Am I making sense?

Q. Oh, yes. Yes.

If anything, it actually makes the damage worse. OK.

I can allow you to re-cord if we’re going to talk about the science of concussions. You can re-cord, yes [pronouncing like ‘hit record’] …strictly the science ..… Just ask me questions specifically on the science.

Q. Yes, that’s kinda what I’m—what I’m interested in is the science. Let me say straight up I totally agree with your link of brain damage to football. I’m not even worried about that. I, I am, I totally agree with it, I have expert scientists, especially Chuck Yesalis of Penn State, who loves your literature, he loves your evidence, and he is also an historian on boxing injuries. He is well-familiar—he knows much of the literature that you’ve often referred to from boxing, as far as long-term brain damage—

Omalu: Why don’t you re-cord about, keep your questions strictly of the science. …

 

Continue reading

Eleanor Perfetto, PhD – Video

Been on a video binge lately…  Look for more, but for today please take a listen to Eleanor Perfetto.  There are some points that some may (including me) not agree with entirely, but she has earned the right to be heard!  Not only is she a pharmaceutical epidemiologist, she is the widow of Ralph Wenzel.

Look for more video tomorrow…

Research That Should Stop You In Your Tracks

OK, that title may be hyperbole, but the new research out of Canada should make you take a step back and realize what our fine researchers are now able to discover.  Considering the context of hockey it shouldn’t be shocking that this was found in Canada (since posting we have been informed that work was done on both sides of the border), but really for a long while now some of the best work on concussions is coming from the North, for whatever reason (no disrespect to the US scientists).

Now that I effectively pissed off a few readers with the last comment, here is what was found by Dr. Paul Echlin and team:

  • concussions alter the white matter of the brain
  • structural damage can now be seen
  • MRI was used
  • this is both males and females
  • brain vascular changes were noted in males only, but resolved at two months
  • comparison with control counterparts showed that concussed individuals had white mater changes at end of season (upon being fully resolved from injury)

From the CTV News article (video at jump);  Continue reading

Hit Count® Has Come To Fruition

Prevention of concussion is a bit of an oxymoron; nothing we know about concussions can stop them from occurring while in action.  HOWEVER, there is one way to prevent concussions – limiting exposure to the collisions that create a concussion.  Moreover, research suggests – as well as observations – that being exposed to subconcussive hits can have detrimental effects on brain function.  The subconcussive hits may even predispose someone to getting a concussion later on; this is obvious if you look at the data we have collected on NFL concussion over the past four years, (305 concussions in weeks 1-9 vs. 377 concussions in weeks 10-17) greater than a 20% increase as the season wears on.

Sports Legacy Institute has announced a certification program to further the Hit Count® initiative during a press release during Super Bowl week in New York City, today (along with the SLI Hit Count White Paper – see link below press release);

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Sports Legacy Institute Launches Hit Count® Certification Program in Collaboration with Leading Concussion Experts and Head Sensor Device Companies to Make Contact Sports Safer

Using Hit Count® Certified Products to Monitor and Minimize Brain Trauma Could Eliminate 500 Million Head Impacts in Football a Year, with the Goal of Reducing Risk of Concussion and Long-Term Brain Damage

New York City – January 27, 2014 – The non-profit Sports Legacy Institute (SLI) announced a major advance in the effort to prevent concussions and brain damage in contact sports today with the launch of the Hit Count® certification program after two years of development, which was unveiled at a press conference at the 2014 Super Bowl Media Center in New York City.

Hit Count® builds on the progress that head sensor device companies have made in developing devices that can measure acceleration of the head. Current products used on the field are focused on  alerting coaches, medical professionals, and parents when a potential concussive impact occurs.

Inspired by Pitch Counts baseball, which set limits to the number of times a player throws from the  mound to prevent arm injury, Hit Count® Certified Devices will have a second function that measures and “Counts” impacts that exceed the Hit Count® Threshold, set by a committee of  leading scientists, with the goal of minimizing brain injury.

“Research using sensor devices has revealed that each year in the United States, there are over 1.5 billion impacts to the heads of youth and high school football players,” said Chris Nowinski, Founding Executive Director of SLI who launched the Hit Count® initiative in 2012 with SLI Medical Director Dr. Robert Cantu. “Most hits are unnecessary and occur in practice. By utilizing  Hit Count® certified products as a teaching tool for coaches and a behavior modification tool for athletes, we can eliminate over 500 million head impacts next season.”

Committee member Gerry Gioia, PhD, of Children’s National Medical Center and Continue reading

Terry Ott: 3rd Down, CTE to go – FINAL Part

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE and PART 6 HERE.

It has been my pleasure to post the stylings of Mr. Ott over the past few weeks.  The guy has worked hard on this basically “paying it forward” so perhaps one person will run with the information.  I admire his spirit and “sticktoitivness”, thank you, Terry!

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AND IN THE END…THE CULTURE MUST CHANGE AND/OR THE FALL OF THE FOOTBALL EMPIRE

“In this sort of feminized atmosphere we exist today guys who are masculine and muscular…kind of old-fashioned guys run some risks.” -Brit Hume, Jan. 13, 2014

You know, I don’t really care much for the brand of “news” that FOX espouses and yet this is the second, and last time I will quote from it.

Because what Brit Hume recently said deserves to be discussed. Even though his comments may be a mile wide and only an inch deep and were not referring to the “manly” sport of football, they may in fact strike to the heart of the civil war now going on in pigskin circles regarding concussions and brain injury.

On one side of the debate are what the League of Denial authors rightly called the deniers, and the other side would seem to be the whistle-blowers. The deniers see the whistle-blowers as silly sissy Marry la-la’s trying to wreck football and the whistle-blowers see the deniers as Neanderthal numbskulls, old-fashioned guys well past their sell date.

Perhaps these are the risks that can befall the old guard, the deniers. That of being accused of being out of touch, thick, ignorant of the facts, or worse.

But does that make the whistle-blowers, those alleged soft, girly man, nanny-state purveyors “feminized”?

Well, if it means caring about football and employing common sense in a brutal arena, then sign me up for NOW, now, man.

Because pro football as we now know it is in danger-yes, real danger.

Danger of being law-suited and legislated out of acceptable existence.

And, as I have previously pointed out, shutting up about it is just plain dumb and ensures football will be KIA.

The lawyers smell money – that’s real money – and the government will most assuredly act, and maybe even in a Draconian fashion, if pro football does not get its brain injury prevention and after care act together very soon.

The NFL and their broadcast partners are joined at the hip. For the most part, this ain’t good because neither hand wants Continue reading

Terry Ott: 3rd Down, CTE to go – Part 6 – UPDATED

CBC 5th EstateThis continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE and PART 5 HERE.

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UPDATE 21:19 1/22/14 – rectified link to CBC The Fifth Estate “Head Games” (see below)

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HELLO, IS THERE ANYBODY IN/OUT THEREJUST NOD IF YOU CAN HEAR ME, IS THERE ANYONE AT HOME?

“Now I remember why I gave up speaking to journalists. They are a species of foul vermin. I wouldn’t hire people like that to guard my sewer. Journalists are morons. They’re idiots. They’re ignorant and stupid.” – The late, great, irascible Lou Reed.

Well, up here in the Great White North, the question of (seriously) addressing the serious problem of concussions in the Canadian Football League would appear to be a deaf, dumb and blind one, boy.

Or, maybe as popular as baked beans on a bus trip.

For whichever way you want to turn this thing loose, up here, it’s locked up, tight.

As I’ve written before in this series, although there has been some pretty good reporting, especially by the CBC where on their website they still carry many reports and videos about concussions, about the only report on concussions and the CFL’s role that I can find is a 2008 CBC Fifth Estate report entitled, “Head Games.”

Below is the web promo, description and link but that link does not work. (The Concussion Blog originally linked to this report several years ago when the link did work.)

CBC The Fifth Estate – “Head Games” broadcast in 2008:

“They have been called the greatest football team in the history of the CFL — the Edmonton Eskimos of the 1970s and ’80s that won five consecutive Grey Cups. But, for some of the star players on that team, the years of triumph ended ingloriously in early deaths, from heart attack, suicide and misadventure. The tragedy of those early deaths was often compounded by alcohol or drug addictions, probably caused by another, less visible, killer. Recent research by neuroscientists now shows the link between on-the-field concussions and brain damage; a permanent injury that can lead to depression, suicide and severe aberrant behaviour. The damage is so profound, the researchers say, that post-mortem examinations of the brain tissue of five former professional football players can be compared only to the tissue found in the brain tissue of advanced Alzheimer’s cases.” CBC The Fifth Estate – Head Games

This 2008 report was actually ahead of its time, and again, the only one that I know of that cornered the CFL and asked some tough, prescient questions. The former commissioner had that old deer/headlamps face a few times and newspapers at the time took a toot but then everyone went back to a snore. Comfortably numb.

But now, there is a proviso on the Fifth Estate website advising thatprior programs from 2003 were inadvertently re-posted in 2013 and therefore, contact customer service, yada, yada, yada, and blah-blah.

Yet interestingly – I said interestingly – the only Fifth Estate link that I could not get to work was…TA DAH: Head Games.

I am alleging nothing-although I may later sort of spatially speculate-but there are some conspiracy theorists out there who are very suspicious.

One of them is Phil Colwell, the former CFL running back who Continue reading

Terry Ott: 3rd Down, CTE to go – Part 5

MIPSThis continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE and PART 4 HERE.

IS “MIPS” A FOUR LETTER WORD AND (Every)THING YOU ALWAYS WANTED TO KNOW ABOUT SNAKE-OIL*

*But were unaware to ask

“The cold truth is that football players are in jeopardy.”  — Bill O’Reilly, he of the No Spin (End) Zone, Jan. 8. 2014


The Concussion Blog supremo Dustin Fink once mused to me that football, in its infancy a hundred years ago or there about, was meant to be played by (slower) men about five foot nine and weighing an average 150 pounds or so and at a time when a 200LB plus player was basically a monster, a freak.

You can appreciate the Dustin statement inference by referencing high school physics in that net (G) force equals mass times acceleration and also appreciate that now, with players routinely 50-150 pounds heavier then when the first Roosevelt was in the White House, and many now with world-class speed, the G forces generated on impact by today’s pro and college football players are exponentially greater than in Knute Rockne’s days and the resulting collisions on the field can be life threatening in the short, and long-term.

Life in big-time football today is both Darwinian-only the strong survive, and if lucky thrive, and inherently  Hobbesian-nasty, brutish and short.

But since literally millions of boys and young men seek football playing dreams, what to do?

Well, since just about all aspects of football equipment has undergone a radical revolution-footwear, pads, uniforms, gloves and eye protection-how about an update on the most important piece of football gear-the helmet.

A little history lesson: President and Rough Rider Teddy R was a big football fan, and when 9 players died in 1913 as a result mostly of skull fracture injuries, he, along with Knute Rockne advocated for a shift from three yards Continue reading

#C4CT Concussion Summit 2014

In a little over three weeks, Brewer Sports International (BSI) along with #C4CT (Coalition for Concussion Treatment) founding partner Amarantus BioScience will be hosting their 2nd Concussion Summit in New York, at the United Nations.  There have been many press releases on this event, and I have mentioned it a time or two on Twitter (and will continue).

Sure, there are many “summits” around concussions and head trauma – which is great as it keeps the dialog going – but few are populated by people with ideas on going forward.  Often, we find ourselves sitting, listening to bright people talk about what was done and can’t be done; rarely do we find the same bright people addressing the issues going forward.  Whether that be with tactical changes or with management or even the possibility of intervention with traumatic brain injury.

This edition of the #C4CT Summit on January 29, 2014 will hear from some people in many fields – you can see the current line-up HERE – focusing on the burgeoning topics of chronic traumatic encephalopathy (CTE), general neuroscience, pharmacology among other topics.

Interestingly enough, yours truly, was invited to sit on a panel and discuss how all of this information has been translated to the high school level – as an athletic trainer.  I was not only surprised by the invitation but feel it is VERY OPPORTUNISTIC for a “boot on the ground” athletic trainer to provide input.  I feel that not only have athletic trainers seemed to be seen and not heard, the vast majority of us practice in the high school setting, where the adolescents are playing sports.  I can assure you I will do my very best to be a quality representative of not only athletic training (it appears I am on the only AT in a speaking role) but those of us working with the most kids/athletes.

Anyhow the cast of speakers/presenters is indeed “star-studded” and even has some opposing view points on where we should be headed; which should make for some quality discussion.  If I can get my technology working and to NYC I will attempt to live blog/tweet the event for those that cannot make it.

Speaking of that, I know that time is short but I encourage anyone who is going to be in NYC during Super Bowl Week try to attend this event.  If there are scribes out there I am sure the wonderful support staff at BSI can arrange for you to cover and meet the star of the show – me, of course – hahahahaha, I kid.  Seriously, you can register HERE and if you have questions feel free to contact them.

I hope to see you all there!

Terry Ott: 3rd Down, Absence of CTE to go – Part 4

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE.

THE CURIOUSLY TITLED AND ENIGMATIC BRAIN STUDY, AND THE SEEMINGLY RHETORICAL QUESTION OF ’14

“We can’t solve problems by using the same kind of thinking we used when we created them.” –Albert Einstein, who knew a thing or two about brains.

Dr. Tator: Not absent

Dr. Ann McKee, professor of neurology and pathology and co-director of the Center For The Study Of Chronic Traumatic Encephalopathy at Boston University once mused in a television interview that she wondered if most if not all professional football players had some degree of CTE.

After all, the brains of former football players examined by the Center so far has found the existence of CTE was near one hundred percent.

Whether one agrees with the now famous Dr. McKee in totality regarding the prevalence of CTE in former players, her and her team are world-class doctors and researchers who have brought the serious issue of football related brain trauma into the collective consciousness of tens of millions of observers.

Most believe that the BU work on CTE was the main catalyst for the National Football League to eventually in 2009 admit that there was a cause and effect between football play and CTE and was also the key preponderance of the evidence that made for a 765 million dollar settlement between the league and former players who claimed neurological damage from playing football.

Here in the Great White North, Dr. Charles Tator, of the University of Toronto, has been referred to as the grandfather of brain research and sort of the Canuck version of BU-like CTE research.

Dr. Tator, a neurosurgeon, originally specialized in spinal cord injuries, but was leader of a study of the brains of 6 former Canadian Football League players that was published in May, 2013.

Despite the fact that Dr. Tator’s study found a fifty percent incidence of CTE among the subjects, the study was entitled “Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatically”

The detailed study places much weight on the small number of brains Continue reading

Terry Ott: 3rd Down, Absence of CTE to go – Part 3

This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE.

LEAGUE OF NON-DENIAL, DENIAL HEARS, SEES NO EVIL or KNOCKED OUT, LOADED

QUESTION: Could the Canadian Football League receive and survive a class action law suit brought on behalf of former players suffering from football concussions and related brain injury?

ANSWER: Later.

This year, when the Canadian Football League’s director of communications, Jamie Dykstra, declined to answer what he termed my “loaded” questions about concussions and how the CFL was going to address them, I told Jamie it was unfortunate and that I would have to note the league’s silence in my story. “I know,” he said.

So, I am, noting it, that is. Because, to reference some other talking heads, this ain’t no disco; this ain’t no foolin’ around.

To reiterate, my questions, posted on the Concussion Blog earlier and condensed here concerned among other things, whether baseline testing info from the teams was shared with the league, whether the CFL was looking at any new helmet technology such as MIPS and would the CFL, like the NFL in 2009 confirm that in some cases, a causal relationship between football concussions and brain injury was a possibility.

Even after I appealed to Dykstra that hitting the mute button on such an important issue seemed, well, just wrong, and that my questions were not exactly League of Denial serious as a statement of claim or heart attack, he replied that “we (the CFL) are well aware of what is going on.”

I certainly hope so, yet being “aware,” and actually having a prescient policy would appear to be two different things.

Before Dykstra stopped talking, he had earlier forwarded me some pretty white-bread CFL concussions protocols and when I picked at its crust, was told the league’s policy was “organic.”

Far out. Nice, sexy, trendy new-age word Jamie, but what does it actually mean in the real, sometimes savage head knockin’ world of Canuck pro football?

Since the CFL won’t tell me, let me introduce to you a number of quite plausible if not certain “organic” scenarios for what in some ways seems a Darwinian policy.

Unlike the NFL, the CFL right now Continue reading

Terry Ott: 3rd Down, Absence of CTE to go – Part 2

This “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE.

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THE LINEBACKER’S HEAD GAMES

Article 19 of the Universal Declaration of Human Rights, adopted in 1948, states that:

“Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.”[6]

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Former star CFL player Leo Ezerins was a ferocious linebacker through the 80s and won a Grey Cup while playing for the Hamilton Tiger Cats in 1986.

In that game, in which Hamilton was in some sports books a 22 point dog to the vaunted Edmonton Eskimos, Ezerins and company absolutely stomped and annihilated  the Eskimos, a seek and  destroy mission that in the first half forced half a dozen sacks, several forced fumbles and recoveries and a total offense by Edmonton of basically, nadda.

Here, are some highlights:

Ezerins was perhaps the 80s CFL’s answer to former Pittsburgh Steeler wild-man and Hall of Famer Jack Lambert, taking no prisoners and showing no quarter on the gridiron.

And right now, Leo is not too happy with me. I kinda feel bad about that, and here’s how it happened.

You see, Ezerins is currently the executive director of the CFL Alumni Association which boasts around 1000 participants.

The Alumni Association attempts to bring former players together in friendship, events and sometimes even modest philanthropy. Some members have been directly involved in examinations of former player
health and safety issues as well, including concussion research. Obviously, the CFL Alumni does some good work.

And so last October, I sought Ezerins out via e-mail, inquiring as to Continue reading

ABC’s ‘This Week’: Football’s Concussion Crisis

First I want to lead this off by saying it is not a “crisis” just for the NFL, or football, this is an issue for everyone.  Once again this provides me the opportunity to say; the injury of concussion is not the problem/elephant in the room, rather it is the mismanagement of those injuries that have created this problems we are facing.

This video is from YouTube and I was tipped off by Dave Pear to its existence.

It is 11 minutes in length but there are some good sound bites in it.  If you can wade your way through the minutia you will see that the repeating issue is what I have stated above.  Basically doing nothing to fix the real problem.

Guest Series by, Terry Ott – Part 1: 3rd Down, “Absence of CTE” to go.

This “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury.  His process began nearly a year ago, but Mr. Ott picked up some steam with the release of “League of Denial”.  He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL.  We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause.

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THIRD DOWN, “ABSENCE OF CTE” TO GO

The Canadian Football League claims to be the oldest professional football circuit in existence, dating back to the late 1800s.

Last year, the 100th Grey Cup league championship was played in Toronto before 50,000 fans and millions more on TV.

The league, which used to advertise that their “balls were bigger,” has recently signed a new, lucrative-for Canada-television deal, and a 18 game regular season is currently seen in the United States on three cable sports networks

In 2014, the CFL returns to one of their previous core markets in the nation’s capital, and there is talk and hope of further expansion to eventually reach at least 10 teams, bad, nation-wide, is a real possibility.

Three new stadiums have recently been built and another is on the way.

The level of play has never been better and the brand and ownership-albeit with one individual owning two teams-unlike some prior years, is strong.

The future for the CFL would seem to be bright, but…

KNOCKED OUT

Former CFL player Phil Colwell doesn’t watch the Canadian Football League.

He doesn’t live in Canada anymore, and has pretty much lost touch with all of the players he knew and played with between 1980 and 1983.

When he left the game early due to a series of injuries and questionable coaching decisions, he intended to leave it completely behind. But while he may have left the game, the game as the old saying goes, has never left him.

“Philthy” Colwell, the strapping, bearded, homegrown and swift running back then in his mid 20s, was knocked out in a game in 1981 while playing for the Toronto Argonauts, suffering a devastating concussion that to this day he says he has very little recollection of and that was most likely the participator of his premature departure from football.

Colwell had played high school football, starred for three years for his Canadian college team, and played a form of semi-pro “junior” football and even drew some interest from the New England Patriots after playing in the short lived Can Am Bowl series, before making it to the CFL’s Hamilton Tiger Cats in 1980 and appearing in the Grey Cup as a rookie.

He later shared a field with former Houston Oilers star Billy “White Shoes” Johnston and former LA Ram quarterback Vince Feragamo when they briefly came north with the Montreal Alouettes. Colwell’s quarterback when he was in Toronto was former University of Tennessee super star Conredge Holloway.

Notwithstanding the galaxy of football talent he kept company with, Colwell says that at every level of football he participated in, he knows took many concussive hits in what then was considered to be “just part of the game.”

You got “dinged,” you got “your bell rung,” and then you went right back to same game including a particularly nasty incident while playing junior football in Sarnia, Ontario, when he Continue reading

“League of Denial” (Part 2)

Coming to a bookstore and TV near you today is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

I was reminded quickly, yesterday via Twitter, that I may lack valuable perspective when it comes to concussion information (and that I am not normal – this is not breaking news).  Will Carroll of Bleacher Report let me know that this information will be new to a lot of people out there.  He is exactly right, not only that, this documentary will be easily digestible for the fan of football.  For any person just wading into this, when you tune into PBS tonight to view “League of Denial” you will be absolutely hooked from the start.

The sounds of the crowd, visuals of big hits grab your football part of the brain IMMEDIATELY, over those sounds you will quickly discover the problem NFL players have faced with brain injuries playing their sport.  Harry Carson saying “and then they are gone” when talking about former players.  A bold statement that the level of denial was “just profound.”  An NFL lawyer saying “we strongly deny those allegations that we withheld information or misled the players.”  And more video and sound of punishing hits that used to fill the highlight reel bring the opening curtain of this very important documentary.

This problem is real – it’s not just real for the professionals – and from the get go Frontline makes you understand, vividly and personally, why this is.  After listening to old radio calls of the Steel Curtain it all begins with the story of Mike Webster and the forensic pathologist who studied his brain, Bennet Omalu.

The discovery of a possible reason one of the most respected and lauded players in Pittsburgh sports pantheon fell from grace and eventually found and early demise.  If the football portion of your brain does not connect to what is being presented then I would haphazardly guess that you are not ingrained within the fabric of football.

As Harry Carson explains how the game was played and to some extent how it’s still played you can begin to understand the issue at hand.  This is hammered home when Robert Stern, PhD tells the audience blows to the brain are at forces 20 times greater than the force of gravity (20 G’s); or as he so eloquently put it “driving into a brick wall at 35mph”, 1,000 times or more in a season.

In the first 11 minutes of this 2 hour presentation you are at full attention and want to understand the “whats”, “whys” and “whos”.  If you are not engaged and ready for further explanation I can only say that you don’t care or want to bury your head in the sand.

Contributions in the film include Continue reading

“League of Denial” (Part 1)

Coming to a bookstore and TV near you tomorrow is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

In all honesty, if you have followed any part of this issue nothing revealed in either medium (thus far in the book) is seen as “BREAKING NEWS” rather an illustration of what has been happening with the research arm and policy makers of the National Football League, with regards to concussions.

“League of Denial” the Book:

In what I have been able to read thus far both Steve Fainaru and Mark Fainaru-Wada have done a good job of telling the hidden secret.  The Fainau’s went as deep as they possibly could without the help of the league itself, even as far as getting one of the original researchers to recount some of the possible misgivings in the past.

By utilizing the real stories of players that met an early demise (Mike Webster most notably) the information has an emotional connection with the reader.  While reading this you understand why this information may have been so valuable to the families and friends of those that could have been effected by repeated head trauma.

It doesn’t take a brain surgeon to tell you that repetitive brain trauma is bad for you, but the problem here is Continue reading

The United States of Football

I am staring blankly at this screen, in the dark listening to The Kyle Turley Band play “Final Drive”, trying to make sense of what I just watched.  There have been some great comments from some great people about this film by Sean Pamphilon;

The United States of Football is a passionate, unflinching, and eye-opening look at the concussion crisis in football.  Sean Pamphilon’s heartfelt concern for this issue is palpable, and the film reflects the trust he earned from many football players and families that have been tragically affected by C.T.E.”   (Steve James, director of “Hoop Dreams”)

“Pamphilon’s work is deep, fair, principled and haunting. He gives voice to the unheard, and that voice forces you to think, feel, fear and weep. His film is like the gladiators in it — uncommonly strong.”  (Dan LeBatard–sports personality)

“A compelling and revealing look at the most important issue facing the National Football League.”  (Bob Costas, broadcaster)

Even those do not do justice to what this film is.  Certainly, each person that sees this film – AND YOU SHOULD – will walk away with different takes, but there are some undeniable problems within the business of football.  The sport, at its core, remains beautiful and a test of mans will, Continue reading

Series from the Pittsburgh Post Gazette on CTE

Mark Roth of the Pittsburgh Post-Gaette put together an informational series on chronic traumatic encephalopathy; “a brain disease that afflicts athletes”.

In the first part that came out this past Sunday, Roth took a look at the global perception of CTE through the examples of Chris Henry and the possible case of still living Fred McNeill;

Chris Henry was a fleet wide receiver for the Cincinnati Bengals. During his five seasons with the team, he developed a reputation as a talented athlete on the field but a bad boy off it, even though those who knew him well say he was typically quiet and respectful. […]

Fred McNeill played 12 seasons for the Minnesota Vikings in the ’70s and ’80s. After retiring, he finished law school and became a successful attorney in Minneapolis, helping to win major class-action lawsuits.

Henry would end up dead after an accident that was predicated with some unusual actions by him, McNeill now has full-time care takers as dementia has stripped him of everything he worked hard for.

Roth begins the second piece with those that can be easily called the experts in this area, Bennet Omalu and Ann McKee; Continue reading

Bennet Omalu Recent Talk

For a long time the “father” of CTE, the first pathologist to find/identify the disease in an American football player, Bennet Omalu has been relatively quiet; going about his normal business and continuing his work with CTE.  Last week he was highlighted on the ESPN Outside the Lines/PBS Frontline story about the Junior Seau death aftermath.

Even more recently Dr. Omalu was invited to speak at the 2013 Football Veterans Conference – a sport specific event put on by Dave Pear and his blog;

Well, we just wrapped up our 2013 Football Vets’ Conference in Las Vegas at the South Point Resort and it was our best yet! In two packed days, we covered everything retired football players need and want to know, from concussion lawsuits to CTE to visual rights and everything in between. Our sessions were packed and no one wanted to miss a single discussion. And thanks to the amazing Jennifer Thibeaux, all of our discussions from Friday are already processed and uploaded so you won’t have to miss a minute of it either!

Thanks to Dave we can bring you the entire talk by Omalu – although over an hour its worth your time.

……….

Who Wants Research Monies?

There are plenty of people out there that think they have the answer to the concussion issue.  From helmets (G. Malcom Brown) to mouth gear (Mark Picot), to assessment, to rehabilitation, to research, the whole lot of it.  Well now is your chance to put forth your best effort and get some money for research on your products or your ideas.  The National Institutes of Health and the NFL have created the Sports and Health Research Program;

The Sports and Health Research Program (SHRP) is an innovative partnership among the National Institutes of Health (NIH), the National Football League (NFL) and the FNIH. Launched in 2012, the program aims to help accelerate the pursuit of research to enhance the health of athletes at all levels, past, present and future, and to extend the impact of that research beyond the playing field to benefit others in the general population, including members of the military.

There is an agenda of sorts; regarding what they are looking at going forward (see article) but they are giving grants for those that meet the criteria; Continue reading

ESPN OTL Article Sparking Quite A Debate

On the surface this article may be innocuous to many, but the the minutia of concussion research and information is coming to a head very quickly, especially pertaining to the NFL.  Tomorrow is the first hearings in front of the judge – and the possibility of total dismissal – for the concussion law suits filed by thousands of former NFL players.

ESPN and its Outside the Lines department (in conjunction with Frontline) filed this article taking a look at two of the most prominent people in the concussion research/awareness arena, Dr. Robert Cantu and Chris Nowinski;

Two prominent concussion researchers — including a senior adviser to the NFL — served as paid consultants to law firms suing the league for allegedly concealing the link between football and brain damage, according to interviews and documents obtained by “Outside the Lines” and “Frontline.”

The article written by Steve Fainaru and Mark Fainaru-Wada sheds light on the very issues the research community faces with this problem.  Some of this information can be classified as “not new” to people who participate in the constantly shifting arena of litigation and research, while some information can be deemed as scathing.  There is a very tight and ubiquitous line in this matter;

Researchers often are asked to appear as expert witnesses in legal proceedings related to their fields. The NFL suit, with the potential for billions of dollars in damages, has created a large demand for researchers with expertise in the science of concussions.

But some researchers said they have turned down such requests despite the potentially lucrative payoff out of concern the perceived conflict could compromise their research.

Conflict of interest (COI) is something we all need to pay attention to, although it applies to this current article, the COI in this field is rampant and often unchecked.  This is nothing new, players have talked about COI, other journalists have noted it, and one of our prominent commentators (Dr. Don Brady) on the site has even devoted some of his dissertation to COI.

It would seem this is nothing “new” in the world Continue reading

Concussion Conglomeration “Road Marker” (UPDATED FREE ARTICLE LINK)

A paramount review of concussions and their “long-term” effects has been published (or soon will) in Nature Reviews Neurology that I certainly hope does not slip past the masses.  Not only is the information somewhat of a “where we stand”-moment of clarity, it is authored by a very underrated and proficient researcher; Dr. Barry D. Jordan.

Jordan, B. D. Nat. Rev. Neurol. advance online publication 12 March 2013; doi:10.1038/nrneurol.2013.33 (note you need a log in).  Here is the FREE DOWNLOAD LINK

Acute and chronic sports-related traumatic brain injuries (TBIs) are a substantial public health concern. Various types of acute TBI can occur in sport, but detection and management of cerebral concussion is of greatest importance as mismanagement of this syndrome can lead to persistent or chronic postconcussion syndrome (CPCS) or diffuse cerebral swelling. Chronic TBI encompasses a spectrum of disorders that are associated with long-term consequences of brain injury, including chronic traumatic encephalopathy (CTE), dementia pugilistica, post-traumatic parkinsonism, post-traumatic dementia and CPCS.

Dr. Jordan also discussed CTE in further detail including the limitations of possible antemortem detection; including imaging and categorization.

In this Review, the spectrum of acute and chronic sport-related TBI is discussed, highlighting how examination of athletes involved in high-impact sports has advanced our understanding of pathology of brain injury and enabled improvements in detection and diagnosis of sport-related TBI.

The overriding theme I gathered from this review article is one that I have been hammering home for a very long time: the mismanagement of the original sequale may be the largest factor in discussion the multiple faces of “chronic TBI” that result from concussion.  This paper is also very succinct in demonstrating the massive amount of work that still needs to be done.

I urge you to find a copy or pay for a subscription for this article, it should be one that we look back on in 5 years as the “where have we come from” moment in this issue, regarding chronic issues from sports related concussion.

Zurich 2012 In Writing

If you all recall I went to Zurich in November to attend the “Concussion Conference”; mainly as an observer, but there was enough time and opportunity to impart my questions/knowledge as a practicing athletic trainer.  Here are the links to DAY 1 and DAY 2 of my live blogging.  By the way, the live blogging was WELL received and continues to provide great insight into what went on.  I hope that I am asked back for the next conference, or any other conference that wouldn’t mind my attendance.

Now the information gathered at the conference has been hashed and rehashed and now appears as the 4th Consensus Statement (tweeted previously).

As part of the initiative the Standardized Concussion Assessment Tool (SCAT) was looked at and changes were made to the 2nd version from 2008.  You can now find the new version by clicking SCAT3.

A new wrinkle was an assessment tool for the younger ages, the group decided on the “Child” version of the new SCAT3, that can also be found by clicking Child SCAT3.

Also included in the addendum of the Consensus Statement was a recognition pocket card, found by clicking Recognition Pocket Card.

All of the above is free and intended to be used as a resource for better concussion assessment and even early management of concussion.  Please read the Statement regarding best practices.  As always this blog is NEVER to be used to diagnose or treat a concussion.  There is a lot to be absorbed and read; one thing is for sure we as athletic trainers and concerned/educated individuals now have the most recent information at our fingertips.  I guess this blog is actually doing some good work 🙂  A side note; how about this appearing during National Athletic Trainers Month?  It might be a coincidence, but I find it serendipitous.

Aussies Study Concussions in Former Collision Sport Athletes

From Sunday Night down in Australia a story of how research on the brains of former footballers may shake up the sport;

Greg Williams is an AFL legend, and one of the hardest men ever to play the game. In his glittering 14-year career, ‘Diesel’ won a premiership, two Brownlow Medals and was named in the AFL’s Team of the Century. .

Shaun Valentine is another tough bloke: like Williams, he copped countless on field wallopings in his career in rugby league. Williams retired at 34, Valentine at just 26. Both men are now struggling with everyday life as they battle the long-term effects of so many blows to the head during their respective careers. Both men are married with children – and both are facing the biggest challenge of their lives.

In what’s been a world first study here in Australia, the results of tests on retired professional players are revealed, and they will send shockwaves through all the codes.

The video (The price of playing the game) tells the story of Williams and Valentine and gives the results of what they know to this point.  Make sure you click the link above to find it.  You will notice that there is no mention of CTE in the Aussie players – yet when they go to the US for the story CTE is the first thing talked about.  It is understood, that currently most researchers in Australia are not ready to accept CTE as a diagnosis or even its existence in former footballers.  The focus is more on dementia Continue reading