SLI “Hit Count” Initiative

Sports Legacy Institute did in fact release their white paper today; it simply brings to the surface something that they along with others have been saying with more frequency.  Their initiative to create a Hit Count is a bold step and on that is welcomed, especially in light of the very current research from Purdue.

You can find the article on the SLI website (here) or you can read the final white paper .pdf here; there is a very good background for this idea and the simple yet powerful citation of research already performed in this area.  Their idea is mapped out very well, again the devil will be in the details as it all begins to be sorted out;

There are technological and monetary limitations to a pure Hit Count, as Hit Count systems currently are only sold for helmeted sports, and there are costs involved.  A Hit Count is not as simple as a pitch count, where coaches only need a pencil and paper.

However, hits to the head can be accurately estimated, and methods can be developed to approximate the brain trauma exposure during games and during practice based on known variables, like position.  With these estimations, rule changes and practice guidelines can be provided to ensure few, if any, athletes exceed a proposed limit. Continue reading

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Video Link

Searching the web I found this press release about a video produced by the College of American Pathologists;

Information provided by the College of American Pathologists

Former NFL player Hunter Hillenmeyer, whose career ended early due to concussions, knows firsthand that better helmets don’t always protect players from serious injury. Helmets have been shown to reduce the incidence of skull fracture, but not injury to the brain itself. That’s why Hillenmeyer is joining pathologists to educate parents, coaches, and young players about the dangers of concussions potentially leading to the brain disease, Chronic Traumatic Encephalopathy (CTE).

Hillenmeyer credits pathologists, the physicians who first diagnose CTE in football players, with performing medical research targeted to prevent future cases in today’s youth. Continue reading

Show Critiques (CNN and ESPN)

Yesterday there were two important shows that aired.  One on ESPN, the Outside the Lines presentation on helmets and the other was a documentary by CNN and Dr. Sanjay Gupta.

CNN and Dr. Sanjay Gupta presented an hour-long look into the concussion issue, mainly at the high school level.  Although the main press is with the professionals, the time spent at the high school was a HUGE KEY to making this documentary a success.  Like we have been posting on this blog for the past 18+ months the real issue with concussions begin at or earlier than high school.  This is not only because there are obviously more participants at the HS level, but it is also where kids are learning and learning how to learn.  In short the high school level is where the brain is functioning the hardest.

The presentation was excellent, it not only provided the current (subjectivity) but exploding (CTE) issues in the concussion discussion, but exposed a real solution to the issue. Continue reading

Grantland Article – Jonah Lehrer

I tweeted about it and want to put a link here on the site for those looking for information.  This article by Jonah Lehrer does a wonderful job of not only explaining the concussive injury but also explaining why there may be an issue going forward with the sport of football.  Here is an excerpt;

But we do know what happens once it’s broken. In the milliseconds after a concussion, there is a sudden release of neurotransmitters as billions of brain cells turn themselves on at the exact same time. This frenzy of activity leads to a surge of electricity, an unleashing of the charged ions contained within neurons. It’s as if the brain is pouring out its power.

The worst part of the concussion, however, is what happens next, as all those cells frantically work to regain their equilibrium. This process takes time, although how long is impossible to predict: sometimes hours, sometimes weeks, sometimes never. (The latest guidelines suggest that most concussed subjects require at least 10 days to recover, with adolescents generally needing a few days more.) While the brain is restoring itself, people suffer from a long list of side effects, which are intended to keep them from thinking too hard. Bright lights are painful; memory is fragile and full of holes; focus is impossible.

The healing also has to be uninterrupted. In the aftermath of a traumatic brain injury, the brain remains extremely fragile. Because neurons are still starved for energy, even a minor “secondary impact” can unleash a devastating molecular cascade. All of a sudden, brain cells that seemed to be regaining their balance begin committing suicide. The end result is a massive loss of neurons. Nobody knows why this loss happens. But the loss is permanent.

Teenagers are especially susceptible to these mass cellular suicides. This is largely because their brains are still developing, which means that even a slight loss of cells can alter the trajectory of brain growth. Football concussions are also most likely to affect the parts of the brain, such as the frontal lobes, that are undergoing the most intense development. (The frontal lobes are responsible for many higher cognitive functions, such as self-control and abstract reasoning. The immaturity of these areas helps explain the immaturity of teenagers.)

We have stated over and over here Continue reading

An In Depth Look At Boogaard

In case you have missed it the New York Times has been publishing a comprehensive look at Derek Boogaard, in a three-part series.  Not only the circumstances surrounding his death, but the wonderful life he had.  With the revelation that Boogaard was confirmed to have CTE all of this information is relevant to the concussion front.

The Times began the series with a look at Boogaards rise to the NHL, from an awkward skater with little scoring prowess to the massive man on skates that would fight anyone at any time, “A Boy Learns to Brawl“;

Boogaard rarely complained about the toll — the crumpled and broken hands, the aching back and the concussions that nobody cared to count. But those who believe Boogaard loved to fight have it wrong. He loved what it brought: a continuation of an unlikely hockey career. And he loved what it meant: vengeance against a lifetime of perceived doubters and the gratitude of teammates glad that he would do a job they could not imagine.

He did not acknowledge the damage to his brain, the changes in his personality, even the addictions that ultimately killed him in the prime of his career. If he did recognize the toll, he dismissed it as the mere cost of getting everything he ever wanted. Continue reading

HBOT

That is not an off-shoot of the cable channel, it is a therapy that can be used for brain injury.  Hyperbaric Oxygen Therapy has been in the distance as a treatment for head injury, specifically concussion for a few years.  The main reason is the lack of support from the insurance companies as pharmaceuticals seem to be the main concern.

What we do know is there is not a “pill” that can solve the mysteries of concussion/mTBI, but we are now starting to see results from therapeutic modalities that can help: vestibular rehabilitation, balance training, cognitive training, dual-task therapy.  However HBOT seems Continue reading

Comprehensive Article From LA Weekly

Kids are the reason there is so much buzz about concussions.  The professional player understands the risk and is getting paid to take those risks, kids are not.  The other more important reason is that a younger brain can be more adversely affected by an insult/concussion.  Steve Jansen and Gus Garcia-Roberts wrote an extensive and comprehensive article titled: Concussions Take a Terrible Toll on America’s Young Athletes.

Across the country, people have awakened to the sometimes irreversible damage of concussions, especially in high-impact professional sports. With much of the attention focused on the National Football and National Hockey leagues, Village Voice Media conducted a nationwide investigation into the consequences of concussion on youth athletes.

The article finds that there are some inherent gaps in the former and current systems for concussion recognition and return to play.  A lot of the confusion Continue reading

Corwin Brown

The former Michigan star and coach for Notre Dame has been hospitalized due to a self-inflicted wound after a stand-off in his Indiana home.  Fox News has the report;

A statement released by Brown’s family said he became suspicious, distant, gloomy, exhausted and depressed after playing eight seasons in the NFL.

“We believe Corwin is suffering from symptoms similar to those experienced by the late Dave Duerson and were caused by the many notable collisions during Corwin’s career in the NFL,” the family said. “For those reasons, Corwin chose to not disclose his symptoms, as he did not want to bring shame to any coach, team, organization or the NFL. Continue reading

Irv Muchnick and Concussion Inc. Exclusive

On August 8th, Irv Muchnick posted on Concussion Inc. an exclusive story about the possible “smoking gun” that the plaintiffs (former NFL players) now have in their pocket regarding concussion information in the pending law suit.  The basics of the argument the former players have is the NFL knowingly disregarded information about player safety as it pertains to long-term effects of concussions;

Now comes a new piece of the puzzle: discovery of a 1975 article in the journal The Lancet, entitled “Cumulative Effect of Concussion.” Historically, The Lancet is rivaled only by the Journal of the American Medical Association as the most widely quoted source in all of clinical literature. It does not seem credible that such findings could have escaped the close attention of the NFL’s Mild Traumatic Brain Injury Committee. Continue reading

In Depth Article For Fans of Combat Sports

In the blog Head Kick Legend (part of the SB Nation) author David Castillo broke down what concussions mean to fans of combat sports.  However it goes beyond sports like MMA and boxing, it paints a great picture for the reader as to what is going on; not only in the brain at a axonal level, but throughout sports.

It is a very extensive read, but worth your time if you are struggling to figure out what is happening at the cellular level;

So what exactly happens to the brain when it’s rattled? In a mild concussion, a split second hurricane of neural events occurs in which too much calcium impairs the mitochondria cells (the power centers), and leaves the brain lacking in the ability to sufficiently restore glucose in the brain. The younger you are, the more susceptible you are to long term damage. And this damage manifests itself with many different symptoms: dizziness, sensitivity to light, mood disorders, vomiting, confusion, slurred speech, and fatigue. But to dig even deeper on exactly what is being done to the brain upon trauma, experiments with axons have been highlighted off the work of Douglas Smith at the University of Pennsylvania.

Smith builds miniature brains out of rat neurons, which are then ‘hit’ with controlled puffs of air to simulate brain trauma at a molecular level. The axon is like a paperboy, sending neurological news, Continue reading

More Research From AAIC

A recent study to be presented by Chris Randolph in Paris at the Alzheimer’s Association International Conference will be “piggybacked” on the information that came out yesterday.  In a Bloomberg News report by Elizabeth Lopatto there was a small preview of what Randolph will be disclosing, and it is not good news for those that are trying to bury their head in the sand;

The study, to be presented today by Christopher Randolph of Loyola University in Chicago, found that athletes who play American football showed symptoms of mild brain dysfunction at an earlier age than nonplaying peers. In addition, there was more illness among the retired athletes than in those who were about the same age.

“You don’t play football without getting a concussion,” said Cornelius Bennett, a former linebacker for the Buffalo Bills and head of the retired National Football League Players’ Association. “We’re taught in football that if you can’t play, you lose your job, and if you don’t report concussions, you have a better chance of keeping your job.”

Very interesting, the information and the quote from Bennett; the primary issue seems to be centered around professional football.  What we need to understand is Continue reading

Live From Princeton

Welcome to the continually updated live feed from the Athletic Trainers Society of New Jersey 2nd Annual Concussion Summit.  I would like to thank the ATSNJ in particular; John Furtado, Eric Nussbaum, and Mary Jane Rogers for the help in getting things set up.  We are at the Wyndham Princeton Forrestal Conference Center & Hotel in a stunning amphitheater, attendance is anticipated to be high.  I anticipate updating this post as soon as possible after each speaker.  Follow @concussionblog for updates.

6:25am CST: Crowd flowing in with provided breakfast in hand.

———-

6:33am CST: Jason Mihalik, PhD “Biomechanics of Concussion”;

  • Concussion is a FUNCTIONAL injury not structural injury
  • Brian injury a major public health concern (showing a pyramid with the head injuries on the bottom, unseen or caring on their own)
  • Things that feed into Traumatic Brain Injury:
  • Cognition, Concussion History, Postural Stability, Mechanism of Injury, Physical Exam, Symptomatology, Knowledge/Attitude
  • Injury Prevention (anticipation, infractions, play type, closing distance)
  • Kinds of impacts that cause concussion; research obviously done primarily on animals beginning in the pre 40’s.  The coup-contracoup model was found by using animal models
  • Research moved from animal models to human analogs; wax skulls/gelatinous brains Continue reading
  • Live From Lexington

    Welcome to the intended live feed from the 2nd Annual Sports Concussion Summit here in Lexington, Kentucky.  We are at Cardinal Hill Rehabilitation Hospital, a beautiful facility.  Attendance looks to be very good, about “60 or so” according to Jonathan Lifshitz, host of the event.  I will be updating this post as we go along with a time, follow @concussionblog on Twitter for updates.

    7:05am CST:  Jonathan Lifshitz, PhD opens up the conference, a big “walk-in” group, I still think I may be the only one not from KY here.

    7:10am CST: Dr. Lifshitz had a great perspective on announcers and how the terminology of the game regarding head injuries has to slowly begun to change.

    ——

    7:50am CST: Dan Han, PsyD “Contemporary Perception on CHI: Multidisciplinary Initiatives

    • 1.7M documented TBI; 52,000 deaths per year, 275,000 Hospitalizations (CDC Numbers)
    • 75% of TBI (1.3M) are concussions/mTBI/mDAI; 300,000 are DOCUMENTED sports concussions
    • 0-4, 15-19 and 65+ y/o’s most likely to sustain a TBI
    • Females have significantly higher odds of poor outcomes
    • Documented TBI (see above) not the real issue; the undocumented TBI is the proverbial iceberg under the water
    • Diffuse Brain Injury
    • Secondary to stretching forces on the axons
    • Moderate DAI = “Classic Concussion” (unconsciousness, possible basal skull fracture)
    • Persistent confusion, retrograde & anterograde amnesia, mood/personality changes
  • Severe DAI = Brainstem Injury (high mortality rate)
  • And TCB Contributor Tracy Yatsko gets some run on a video!!!  Man girl you get around :)!
  • Postconcussional Disorder
    • LOC > 5 min or anterograde amnesia or new onset of seizures within 6 months after CHI
    • Just learned a lot about seizures; many go unnoticed
  • AND attention or memory deficit
  • Plus 3 or more symptoms present for at least 3 months following CHI
  • Significant impairment in social or occupational functioning
  • Academic achievement decline
  • HUGE Multidisciplinary Concussion Program at University of Kentucky, well on the way to being a leader in concussions
  • —–

    8:50am CST: Greg Wheeler, MD “Treatment of Sports-related concussions and return-to-play clearanceContinue reading

    Matt Chaney: Parts 3 & 4

    Following up on Part 1 and Part 2 of Matt Chaney, “pseudo-contributor”, looks at both “reform” and “research studies” as they relate to the NFL.  Chaney, although very outspoken on the matter has some very valid points, all worth just thinking about, at the very least.  His sources are some of the best and his writing is exceptional.

    In Part 3 titled “Football Brain Trauma Can Twist Personality, Spur Violence“, he takes a look at how changes in mood and overall “being” are being avoided; with such strong words/connotations of “mental disease”, “depression”, “suicide”;

    Doctors and medical researchers have long agreed boxing can cause brain damage in athletes and lead to personality disorders and outbursts, through repetitive impacts both concussive and sub-concussive.

    A 1973 study on postmortem evidence of 15 ex-pro boxers who suffered “punch-drunk syndrome” documented their “violent behavior and rage reaction” through interviews of relatives. Several of the boxers died in psychiatric wards.

    Decades earlier, boxers who became demented and deranged were known as “slug nutty,” according to a 1928 report by Dr. Harrison Martland.

    Meanwhile, yet today, the NFL and loyalist experts loathe admitting that tackle football even causes long-term impairment, much less off-field violence by players and chaos for families.

    In his latest, Part 4 titled “Research of NFL Brain Trauma Sputters Along“, he takes a look at the research involved, mainly longitudinal Continue reading

    Knowing Is Half The (UPDATE)

    UPDATE: Thanks to commenter @SpMedConcepts I should write that one test is just a piece to the puzzle.  And a comprehensive testing procedure that includes all of the available “baselines” and assessments should be used.  It becomes more difficult to cloud the picture with deception when using this approach.

    Knowing about concussions is one thing, but knowing that players may take advantage of the system is another factor.  Like anything else in this world people will look to exploit weaknesses in systems to gain an advantage.  After all isn’t that the crux of competition and sports?  We have seen Irv Muchnick open up the dialogue on Ritalin as a possible way to “cheat the system” and now Alex Marvez of Fox Sports tells us the other, more obvious way to “cheat the system”;

    Dr. Daniel Amen, who has treated current and former players for post-concussion symptoms, said some of his clients have confessed to fudging the initial baseline tests administered by NFL teams. By doing so, Amen said those players are seeking quicker clearance to return from any future head injuries they might suffer.

    If the baseline tests are to be used to compare then why try hard and excel at them, only to have that first test hinder their return?  This is the common question that the professional and adolescent athletes are dealing with.  Even though baseline tests, be it neurocognitive computer based or hand written like the SCAT2 or the new NFL test, are objective Continue reading

    Pugilistic Sports and Concussions

    Dementia Pugilistica, otherwise know as chronic traumatic encephalopathy, has its roots in the Sport of Kings, boxing.  Given that this sport and its derivatives; MMA, UFC, etc., goal is to inflict brain trauma there is surprisingly less heard about their dealings with concussions.  There could be a lot of reasons why this may be; expected, inherent work condition, informed consent, less watched, or their general dealings with head trauma.

    Quietly, these sports and their sanctioning bodies have instituted some of the more strict rules when recovering from a knock out, or concussion.  Generally each state and province sanctioning body has a “medical suspension” induced on a fighter that is KO’ed or even shows signs of a concussion, most are 30 days.  Although specific wording in each groups medical suspension varies, the base of it provides that a fighter CANNOT fight for 30 days after the incident.  Less commonly known is that this also includes sparring and training; however this clause is not in most rules, it is inferred.  That is unless you are the UFC.

    As highlighted by Morgan Campbell of TheStar.com the UFC has a policy in place, as explained by UFC Canada President Tom Wright; Continue reading

    Former NFL Players Glad For Concussion Attention

    If somebody from the other team had the football — or better yet, was about to catch it — McCoy’s own cerebellum told him to drive his helmet right through the poor fellow.Now, McCoy can’t drive home, can’t trust himself behind the steering wheel. Just staying between the white lines got too difficult. The blur was in his head.

    Mike McCoy played for the Green Bay Packers and is currently 55 years old.  McCoy learned of his dementia issues three years ago at age 52 and has caught the attention of a fellow NFL alum, Willie Buchanon;

    “Once you get away from the game, you realize, those little nicks and hiccups become a little more dramatic.”

    Far more dramatic in some than others. A product of Oceanside High and San Diego State who closed out his career with the Chargers, Buchanon has kept close tabs on McCoy since they played in the same Green Bay secondary, and he’s seen the steady decline in his friend’s mental state.

    Buchanon has also been deeply involved in the concussion issue as a by-product of being on the California State Athletic Commission.  The sport of boxing is commissioned by most State Athletic Associations and in order to box/base in each state there are rules regarding safety and injury.  One such rule deals with being knocked out in boxing;

    “A football player getting a concussion is the same thing as a boxer getting knocked out,” Buchanon said. “In boxing, you couldn’t get back into the ring to even spar for 30 days. In the NFL, in our day, we turned around and played the next week.”

    Chris Jenkins of The San Diego Union-Tribute uses this article Continue reading

    Bob Probert Found To Have CTE

    On Thursday, Boston University researchers will release findings that show Mr. Probert had chronic traumatic encephalopathy (CTE) when his heart gave out during a fishing trip last summer. The diagnosis makes him the second former professional hockey player to be found with the degenerative disease after Reggie Fleming, who died in 2009 at the age of 73 with dementia after three decades of worsening behavioural and cognitive problems.

    Like Mr. Fleming, Mr. Probert was a fighter who banged his way through more than 200 fights during 16 seasons with the Detroit Red Wings and Chicago Blackhawks. He had suffered at least three concussions and struggled with substance abuse. And in his 40s, Ms. Probert said, her normally laid-back husband may have begun to show some of the telltale signs of CTE, such as odd bouts of road rage and memory gaps.

    Bob Probert found himself, along with his wife, wanting to do something for this cause.  A mere six months prior to his death, due to a heart attack, he committed himself to the legacy of brain research and the NHL.  For reasons unknown the professional hockey Continue reading

    Recent ABC Story

    ABC has run a very extensive story about head injuries in sport (see football) in light of the Duerson suicide.  The article is good but what is striking are the videos associated with it.  Not only the embedded video on the first page, but the sourced videos below it, mainly about Mike Webster (Driven Mad?).

    Neuropathologist Bennet Omalu, MD, who was the first to identify the condition, told MedPage Today, “There is no reason, no medical justification, for any child younger than 18 to play football, period.”

    As we should know Omalu is the godfather of CTE, he first found it with Webster and subsequently other former NFL’ers, once called a “doctor of Voodoo medicine” Omalu has some of the best perspective on this injury.

    “People said then, and still are saying today, that when former athletes deteriorate into depression, drug abuse, and even violence and criminality, it’s because they don’t compete well on the field of life after competing well on the field of football,” Omalu said in an interview with MedPage Today. Continue reading

    Another Perspective on Duerson

    In an article written by Irv Muchnick we the reader get another perspective on the concussion issue, as highlighted by the suicide of Dave Duerson.

    The gruesome decades-long underground American saga that is the football concussion crisis has never gotten in our faces quite like the story of the suicide last week, at age 50, of one-time National Football League defensive player of the year Dave Duerson.

    How many levels are there to the news that Duerson put a gun to himself, but not before texting family that he wanted his brain donated for research on the brain-trauma syndrome now known as chronic traumatic encephalopathy (CTE)? Let us, like Elizabeth Barrett Browning, count them. It begins with the fact that he shot himself in the chest – perhaps with supreme confidence that by avoiding his head and leaving intact his postmortem brain tissue, it will confirm that he is around the 21st diagnosed case of CTE among former football players.

    Duerson is the latest casualty of a sport that has evolved, via training technology and industrial design, into a form of gladiatorialism whose future human and economic viability is questionable. The New Yorker and New York Times have started assessing this cultural phenomenon with their own brands of competence and Ivy League restraint. From the closeted gutter of pro wrestling, where all the same venalities play out with less pretense, I’m here to tell “the rest of the story” – such as how the same corrupt doctors who work for the NFL also shill for World Wrestling Entertainment, and how it’s all part of the same stock exchange of ethics for profits and jock-sniffing privileges.

    To read the rest of this story go to Beyond Chron, HERE.

    Video About Duerson

    Newsy.com, a Multi-source Video Analysis website, has run a video about Duerson and information surrounding his untimely death.

    VIDEO LINK HERE

    Of note in the Duerson follow-up has been the fact that he shot himself in the chest, and it is being reported that he mentioned to his family that he did that for the explicit reason of not harming his brain.

    Military Head Injury Research

    Dr. Ann McKee, of the Boston University “brain bank” associated with the Sports Legacy Institute, recently spoke to the U.S. Army during a conference on how to protect soldiers’ brains.  Her specialty is chronic traumatic encephalopathy (CTE) and finding this disease in brains sent for sampling.

    The bulk of the 66 brains in her team’s “brain bank” are boxers and football players who had experienced repeated blows to the head during their careers. But she did have in her collection the brains of five former Soldiers. The disease, CTE, is the result of repeated trauma to the head.

    “This disease does develop in military veterans — it really has been described in many different types of mild traumatic injury,” McKee said. “It’s less important how you get the injury, what’s important is that you had repetitive injury.

    Dr. McKee, along with Dr. Benett Omalu, are pioneers in this field and a lot of what they have to say is unfiltered/censored by “bigger” entities.

    SOURCE

    Omalu Study To Be Released In March

    Irv Muchnick has been through a lot in digging up information about head trauma, steroids, and other issues related to what he terms “the cocktail of death” in pro wrestling.  However, the seemingly endless roadblocks has not stopped him from great fact-finding in an effort to make the issue of head injuries, in particular CTE transparent.

    Muchnick has an exclusive find as posted today on his blog;

    In his latest letter to me last year threatening to sue me for my reporting, World Wrestling Entertainment lawyer Jerry McDevitt pointed out that Dr. Bennet Omalu’s study of dead wrestler Chris Benoit’s brain was not published in a peer-reviewed scientific journal until 2010, and then only in “an obscure nursing journal.” See “New Threats From WWE Lawyer Jerry McDevitt,” December 17, 2010, http://wrestlingbabylon.wordpress.com/2010/12/17/new-threats-from-wwe-lawyer-jerry-mcdevitt/.

    After wading through all difficulties he has found and praised Neurosurgery for their restructuring including changing editor-in-chief;

    However, I understand that Oyesiku was named to replace Dr. Michael Apuzzo as editor of Neurosurgery with a mandate that included reversing the journal’s perception as a de facto NFL house organ for academic articles answering loaded questions, which in turn served the commercial interests of the league and its contract doctors and business partners. Apuzzo, a consultant for the New York Giants, had overseen the publication of a decade’s worth of controversial studies on aspects of brain trauma in sports – including the 2006 article on the Riddell helmet manufacturer’s new design, which was co-authored by the company’s chief engineer and by Pittsburgh Steelers team neurologist and imPACT software entrepreneur Dr. Joseph Maroon, and is now the focus of a Federal Trade Commission probe of Riddell’s allegedly misleading promotional claims.

    Apparently Dr. Bennet Omalu’s third study of a professional football player (Mike Webster and Terry Long being the first two) about Andre Waters Continue reading