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Illinois Paves the Way for HS Football Policy

Dustin Fink6 Comments

ihsa-1487882592-2402It has been a long time coming… Not a new post on this blog, rather, a proactive and thoughtful policy/plan for high school football safety. This process has not been easy and there is no way I can take full credit for this but I do have some rather exciting news regarding something that I, personally, have been working on for six years.

Today the Illinois High School Association Board of Directors approved a new policy, Policy 13 that states:

Weekly Player Limitations for Football
1. A player shall not play in more than 2 games in any one week, and shall not play in more than one game in a single day. For the purposes of this section, a week is defined as the seven-day period running from Sunday through the following Saturday. (It is recommended that if a player does play in 2 games in a given week, one of those games is only as a one way player. [i.e., only plays on offense or defense or special teams])]
2. Players cannot play in games on consecutive days or be involved in live contact/thud in practice the day after playing in a game.
3. 1 play in a game equals a game played.
NOTE: If a player plays in a game that is stopped due to weather or other circumstances and completed the next day, the player can participate in the resumed game the following day.

Back in 2012 I wrote this piece on what I thought would be a better way to protect our athletes Continue reading →

IL Advisory Council on Player Safety Meeting Minutes 3/31

Dustin Fink2 Comments

It is a little late but the Illinois Advisory Council on Player Safety (or PSAC as we call it) met at the end of March to keep this tremendous ball rolling. The minutes are below but the take home from my perspective was:

  • The group as a whole is very committed to being proactive (noted by the including of the psychological safety, push for athletic trainers/MDs, changing of outdated restraints for injuries)
  • Input from all in attendance was exceptional and it is nice to have varying “stakes” at one table looking out for players.
  • Personally I think I get way to passionate about this and think things can be changed in a New York minute, but I am learning about how these processes work.
  • There seemed to be a commitment to continue this committee going beyond the one year trial period, which is good because we are doing good work behind the scenes.
  • I really appreciate the IHSA and Kurt Gibson for overseeing this process/committee and taking notes and hearing our presentations/concerns.

Here are the minutes.

PSAC Meeting Minutes for March 31, 2016

You can also find the minutes and previous minutes at the Play Smart Play Hard Website by going to the Advisory Council tab. We already have added a resource for the “Health & Well Being” of the athlete on the Resources tab. While you are there take a minute to Take the Pledge for playing smart and playing hard.

As always, I am open to comments, questions and inquires about the PSAC. You can drop them here or in the inbox.

Wow Moment! Must Watch for Active Learners

Dustin Fink1 Comment

EIM ConcSo I am neck deep in a continuing education course that will take many months to complete. One that I was very hesitant to take on due to my very busy schedule (not so much as an athletic trainer but as a dad and husband).

Long story short Jess Schwartz convinced me to take on the Evidence in Motion Concussion Management Course.

The course has been brilliant in the four short weeks I have been at it, mainly learning about the Therapeutic Neuroscience Education. The education is not simple watch/read and test; this involves active learning and constant dialogue as part of the grade. I am learning a ton just writing about the courses and conversing with the many other professionals in this cohort.

However, today one of our group leaders posted a link to a video that is not in the course but for ancillary learning. The group post simply asked if we had seven minutes to watch it.

I had and I did. What happened next was this post. This video below is not only for me but for EVERYONE. I highly suggest you find the time and watch this:

I would also suggest to any practitioner out there that is looking for more information about treating concussion, this course is one that seems to be on its way. Time will tell how this course/certification will apply to me and others but just the mere fact that I have changed the way I approach concussion care (in a good way) in this short time leads me to believe we are on the right path.

There will be follow ups regarding this as the course progresses.

 

International Summit on Female Concussions and TBI

Dustin Fink3 Comments

I am very excited to inform you and implore you to attend this first of its kind conference. Katherine Snedaker – a good friend and ally – along with her planning committee have done a wonderful job of creating a great place to discuss a subset of this head injury issue.

The International Summit on Female Concussions and TBI will be held a month from now at Georgetown University in Washington, DC. This summit is unique because this will only be about sex and gender-based research on females, from pediatrics to the elderly.

As much as we think we know about head injuries and concussions we don’t know squat, globally. Let alone in one gender over the other; females have been painfully overlooked/lack of attention because most of the noise and spotlight is on male dominated sports. Although, females choose to play many of the collision sports (rugby, hockey, lacrosse) there are other issues we know that impact females differently.

The summit is over two days and will eventually culminate in a consensus statement about female issues surrounding and within the concussion paradigm. This is also going to be a first of its kind, and appreciated at least from me.

The Topics (briefly summarized):

  • Menstrual Phase and its impact
  • Age and Sex and its impact on symptoms
  • Domestic Violence
  • Female Soldiers
  • Pediatrics
  • Female Sport Concussions
  • Concussion Recovery male vs. female
  • Female RIO Data
  • Clinical Spectroscopy of Female brain
  • Return to School
  • Social Interactions
  • Ice Skaters
  • Psychology of Concussoin
  • And more

Here are the presenters, moderators and planning committee members (as of this post):  Continue reading →

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

Dustin Fink9 Comments

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

Dustin Fink4 Comments

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.

==========

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 →

Gridiron Heroes and the Movie

Dustin Fink4 Comments

mv5botqxotq2ntixmv5bml5banbnxkftztgwotazotu3nte-_v1_sy317_cr60214317_al_Being part of the concussion space there are many different things that come to my inbox. Much of that is garbage and thinly veiled attempts at advertising for something that I am not interested in.

A couple of weeks ago I received an email about a movie that I had heard of in passing; Gridiron Heroes. I did not know what it was all about but the co-director, Seth Camillo, encouraged that I see this. He never said it was ground breaking but told me it is “documentary about the important issue of brain and spinal cord injuries that are sustained on the football field.”

I was given the opportunity to screen the film and I must say that I was not disappointed by the hour and 17 minutes. (Trailer below)

It begins with a overview and reason for a foundation called Gridiron Heroes Spinal Cord Injury Foundation; the injury and subsequent paralyzation of Chris Canales. Although rare in occurrence this type of injury does happen on the football field. Instead of being overwhelmed by this difficult situation and blaming the game the Canaleses went about helping others that found them selves in this unfortunate situation.

Catastrophic injury and death should never be tolerated in sport, but like in life there are circumstances where they happen in freak accidents. This is not unlike car accidents that are no fault of anyone and understanding that life comes with some risk. The Gridiron Heroes Spinal Cord Injury Foundation set upon trying to heal and help those that have no clue what is happening and how to come to grips with the “finality” of these injuries.

The movie interviews former professional players – most notably Decon Jones’s raw and honest opinions, “players in the game” like Alan Schwarz, as well as those afflicted regarding the sport and where it sits in their eyes. The movie even takes on the issue of repetitive brain trauma and concussion.

This movie is not about tearing down the game/sport it is about facing the realization that football can be a risky endeavor for some and that instead of ignoring and looking past the issues, taking them on is the better way to approach this.

I am not a movie reviewer, per say, but I can tell you that this is worth your time and money (all profits from the film go to the Gridiron Heroes Spinal Cord Injury Foundation). This would be appropriate for anyone that is around football a lot like coaches and parents. It is not intended to scare but to inform, mainly about the foundation, but about the sport.

Seth Camillo and Andy Lauer did a fine job of telling a trying story not only of Chris Caneles and those like him, but of the sport of football.

You can get the movie on iTunes, Amazon Instant Video, Walmart Entertainment, Google Play and Dish Network.

If you have seen it feel free to comment on it, here.

The Case Keenum Case: Why It Matters

Dustin Fink4 Comments

Adam Schefter said it well on ESPN this morning “This is an abject failure,” in referring to this:

As you may have already have seen and heard about this incident in the St. Louis and Baltimore game yesterday I will not go through all the mechanics of what happened and why this was so utterly ridiculous.

What I would like to focus on with this post is why this matters.

As evidenced by Twitter there are many fans – I would hazard more than who tweeted – who could care less about this. The overriding theme is that the players are professionals and this is no big deal because they are paid to play and they know the risks.

I tend to agree with this, but only at the professional level, they are adults and have as much info as possible. However, in the moment of injury and the few seconds following it the player must be protected from themselves and from further injury. This is why the vaunted and much promoted concussion and injury surveillance protocols are in place.

If there are not people in place to make the decisions that a player cannot make of sound mind, in that moment, then why even have it. Although this is one failure and there have been cases of players being removed due to the policies in place; this one incident goes to show nothing is perfect, even in the face of a most obvious situation.

At some point the players are going to have to put their foot down and demand that the medical personnel take care of them; playing time and winning the game be damned.

This failure on a spectacular level also has ramifications beyond the NFL and even the sport of football.

Allowing Keenum to play, not even missing a snap, sends the wrong message to other players of the sport or sports that are not at the professional level. Can you imagine Continue reading →

Call for Abstracts: National Summit on Female Concussion, TBI and Headache

Dustin Fink4 Comments

pink concIf there has ever been a tenacious and relentless person in the concussion space my observation is that it is this one person. Not a researcher, not a physician, not a policy maker…  A mom… Her name Katherine Snedaker.

She has been mentioned many times (Pink Concussions) here and has been a commentor on this blog as well, but what Katherine is pulling off this coming February is nothing short of monumental for the concussion space.

On Saturday February 27th she will be presenting the National Summit on Female Concussion, TBI and Headache, at the Georgetown School of Medicine.

Part of the program will include presentations of abstracts, which they are currently calling for. The Program Committee is accepting abstracts for presentation on “Sex/Gender-based Concussion Research” on concussion, TBI and headache from the areas such as:

  • Pediatrics to Geriatrics: Concussions and other TBIs across the female life cycle
  • Sports and Sports Medicine – Youth, High School, College, Olympics
  • Domestic Violence and Shaken Baby Syndrome
  • Military Service

As you probably can imagine these areas are so under-researched, mainly because head injuries are often associated with sport and male type activities. However, women are part of this issue to – a huge part. Females are also very different than males in many ways but we have recently have come to know that their response to head injury/concussion is not the same as males.

There will be more to follow on this summit – consider this post as a save the date – “ATs are one of our target groups we want,” Katherine said in an emial.

This post is directly aimed at the researchers in the community that want to share their info at this very important and unique event. Please spread the word about this to anyone you know that would be interested.

From the Call for Abstracts link at Pink Concussions:

Click the brain below to upload your abstract in a PDF form.

  • Abstracts submission portal closes 1/5/16 at 11.00pm EST Abstract acceptance letters will be sent 1/15/2016
  • Abstracts must include: Title, Authors, Affiliations, Background, Objective, Methods, Results, Conclusion plus 2 tables or graphs may be included
  • Abstract character count, excluding spaces and the words “Background, Objective, Methods, Results, Conclusion” is 350 words
  • Only reports of original research may be submitted
  • The data may have been published in a manuscript or e-publication

Address questions to either the Scientific Chair, Dr. Dave Milzman at milzmand@georgetown.edu or Executive DirectorKatherine Snedaker, LMSW at Katherine@PINKconcussions.com

You can also access the submission form HERE.

It is my pleasure to promote this event for someone that I call a friend and someone that has battled more than just stereotypes to bring awareness and education.

Seeing Is… Starting… To Believe (Video Link)

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Inside DrillWith one day of the Vector Mouthguards in the book – a lightning shortened one – and a warp speed implementation it was time to get this puppy up and running.

The players had not lost a mouthguard overnight, which is quite amazing because they always seem to lose their other ones, and all were on the chargers overnight. The clock struck 5:30 and it was go-time. The antenna receiver on the sidelines and players not wondering what it was going to feel like, just getting to practice.

As the system fired up the tiny computers in their helmets were reporting to my laptop, one green light after the other, it was working as promised. A few of the mouthguards took a minute to “warm up” with spit, I guess, but when it was time to hit I had nearly all on-line. Of the 40 issued, 32 were communicating with 2 of them on injured personnel (not concussion), we will get more in-depth about that later.

As practice started I did not want to be tethered to the computer so I could do my job as an athletic trainer so I left the base station and went about my business. The way our coach practices is in five-minute segments, flying around. It is high intensity and constant moving on my part to keep a keen eye on where it is needed and on who it is needed. I basically forgot it was over there other than the occasional parent or media asking what that “radar” looking thing was.

At the first water break I stepped over to see the computer and the hits it had captured. I was able to scroll through all the registered hits in about two seconds and only stopped on any that were above 40g. The graph like output of the system makes this a breeze. I also had noted that every hit is time stamped so when there was a hit that I thought should be captured I made note of the time and cross referenced that in the system, and yes they were there.

As the team went to a segment with inside run drill work it happened to be next to my base station for filming purposes. I yelled up to the camera operator and asked if the film time stamps and he said no. Because I had two students with me I was able to hold the tablet and look at that between reps. After every play the screen changed with more impacts; the DL, LB and RB getting the lions share of the notices. I was impressed at the speed and accuracy of the information given to me in real-time. But, one of the LB’s who was delivering the hits on D was also rotating on O as a RB and his mouth guard was not communicating, I was a bit concerned. Was this really going to keep the data in the mouthguard until it was able to communicate, like they promised? Was I going to miss out on some of his hits. And just then…  He was smashed by the defense right to the left earhole. He was none worse for wear but it was a noteworthy hit as the team yelled out due to the collision like all other teams do when that happens. He was just fine and I didn’t even take a step towards him.

As practice progressed all was going well, I was taking notes on times of hits and they all looked good and none that I found concerning in viewing them live or on the data. That’s when I scrolled across a player that had taken the largest hit seen, a Continue reading →

It Is Actually Happening, Impact Sensors At My School.

Dustin Fink1 Comment

Over the years I have researched many, tried a few and heard all about impact sensors, and for the time the blog has been going you have all known I have had a “standoffish” approach to them. That is not because I don’t think they may have a place but it is because of what they can actually do and how reliable they actually are.

I have made it well-known that the “most applicable” system I have seen is the HITs system that is exclusive to Riddell helmets. It is not the best because of factors that include: cost, helmet exclusivity, and it – like all other sensor systems – is not without scientific flaws.  However, what makes HITs near the top is the information that can be gained as well as the feedback/real-time information. There are other types of impact sensors you will see “certified this, certified that” but many of them attach to the helmet making the NOCSAE warranty invalid as well as some helmet manufacturer warranties. Most, if not all do not take center of mass into effect either, making some of the objective numbers askew. As you can see I have had issue trying to adapt to one or the other, enough so that I would be willing to try it out on our teams.

I and our school cannot afford the HITs system and we promote the use of any helmet that fits properly on each kid, because of that I have been looking for other sensors and complete systems that may actually be of help to me as an athletic trainer. I did remember that I have always been intrigued by a mouthguard sensor and when the Vector Mouthguard started making its debut in colleges I started doing more and more research about it. That led me to a conversation – a very honest and blunt one – with CEO Jesse Harper.

After that conversation I did even more dirt digging on what I could and asked many people about the system and what it purportedly could do and all the scientific and mechanical engineering stuff I could comprehend. I came away satisfied, satisfied enough to invest some time and resources to try to procure this system for use in the Fall. Basically, I am ready to dive into this sensor phenomena head-on (pun not intended), finally.

Key Support

Before getting this event set in motion, school administration needed to be apprised of the plan and they would ultimately have to say yes. That conversation occurred in May when I approached the Principal and Athletic Director about this.

It did not take long to explain the benefits of this, not only from a player safety issue but from a coaching aspect as well. They both liked the idea of us looking out for player safety and showing it by being innovative, if nothing else than in perception.

They only had one statement/question for me, “there are not any drawbacks to this, unless we are missing something?”

Hurdle cleared.

Fund Raising

With most any product, good ones, the biggest barrier for most is going to be cost; that was no different here. Starting in early May I started to ask around for donations and support for this system. Although I really only had to get enough for the Continue reading →

An Understudied Area of TBI

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Although this blog primarily focuses on mild traumatic brain injury (mTBI) – concussion – and the ramifications on adolescents there are many segments of society that deal with brain injury. The most severe of this is traumatic brain injury (TBI); the difference at its basics is that there is actual physical findings of damage to the brain itself – a bleed, skull fracture, hematoma, etc. I am sure there may be a better way to put it but for the sake of being simple that is the difference.

The morbidity rate of TBI is extremely high and thusly we should be very cognizant of this.

A silent portion of the TBI problem comes from domestic abuse, silent because many of the suffers of the brain injury often don’t speak up. There are no actual numbers on this due to the many reasons one would not report incidents. Take car accident TBI’s for example, we have a very definitive number on them because most if not all are seen in emergency rooms but the silence in the domestic abuse realm makes us guess, at best.

This looks to change with a new study on this, below is the press release of a first-of-its-kind;

Sojourner Center Launches First-of-its-Kind Effort to Study Link Between Domestic Violence and Traumatic Brain Injury

Sojourner BRAIN Program to develop innovative screening, deliver treatment and share best practices

 

PHOENIX – Sojourner Center, one of the largest and longest running domestic violence shelters in the United States, announced plans to develop the first world-class program dedicated to the analysis and treatment of traumatic brain injury (TBI) in women and children living with domestic violence, a largely unrecognized public health issue.

With its Phoenix-based Continue reading →

When and How ‘Not a Concussion’ Becomes a Concussion: Klay Thompson Injury

Dustin Fink5 Comments

The Western Conference Finals not only provided an opportunity for the Golden State Warriors a chance at winning an NBA title it has provided a wonderful opportunity for people to learn more about concussions. The knee-jerk reaction to incidents like we have seen in Games 4 and 5 are often a mix of truth, hyperbole and eye-rolling; however what is clear they are cases that we can use to forge further understanding and education.

Last night in the would be close-out game of the WCF, Klay Thompson shot faked and the defender rose as he [Thompson] ducked and the defender’s knee blasted the side of Thompson’s head right in his right ear.

Unlike his teammate from the game before, Steph Curry, Thompson did not show overt signs, to my trained eyes, of a concussion. His face was “scruntched” in pain and he immediately grabbed for his ear, plus after the incident he immediately rose to his feet and walked straight to the locker room without assistance. As noted in Tuesday’s post signs are paramount when making critical in-game decisions about return to play; if they are there, there should be no doubt about removal.

The next report we received on TV or Twitter was about Thompson having an ear laceration and that they didn’t need to do a concussion evaluation. Which is entirely possible but unlikely, because I do believe they did a concussion “screen” at the time. The Warriors med staff probably didn’t do the full-blown evaluation because five minutes would not have been sufficient for that, but that was enough time to go over any symptoms and quick balance assessment (think roadside sobriety test). It is also important to know that because concussion are mainly subjective that a massive portion of any concussion evaluation is the interview: talking, questions and mental challenges about venue/score/date/etc.  Continue reading →

Play Smart. Play Hard.

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PSPHlogo

Today the Illinois High School Association (IHSA) launched a national initiative for overall student-athlete safety and participation in sport. It is called Play Smart. Play Hard. 

The campaign will focus on education and equipping athletes, parents, coaches and schools on ways to better safeguard the heath and welfare of student-athletes, including minimizing the risk of head injuries.

The main function of this campaign is to have readily available information and tools for player safety; taking on the current issues/risks as well as being forward-thinking and discussing and formulating plans for other issues that are of concern in sports. At the center of Play Smart. Play Hard. are the resources including a Player Safety Toolkit which is directed at concussions at this time. When going to the Play Smart. Play Hard. page (www.playsmartplayhard.org) in the resource tab you can find all the current Illinois and IHSA concussion information as well as the National Federation of State High School Association (NFHS) and Centers for Disease Control (CDC) concussion info.

Play Smart. Play Hard. may have been trumpeted by the IHSA and Illinois but there are many other state high school association supporters of this innovative approach, 27 to be exact, check the site to see if your state is part of it.

As mentioned on the blog yesterday Continue reading →

Illinois Advisory Council on Player Safety

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It was last month and I was routinely checking the inbox when I noticed a correspondence from the Illinois High School Association (IHSA) with the subject line “IHSA Request”. Of course this piqued my interest because it is not often I get information from the state high school organization and the ‘request’ portion may have been dealing with athletic training. As I opened the message I simply thought this was a blasted email with necessary information from the IHSA…  I was wrong, on so many levels.

This is how the email opened;

Good morning, Dustin.  I hope things are going well.

I wanted to write you today to invite you to be a member of the Illinois High School Association’s (IHSA) newly established Illinois Advisory Council on Player Safety, which aims to influence, shape and strengthen the IHSA’s commitment to protecting the welfare of all those involved in interscholastic competition in Illinois.

Needless to say I was kind of taken aback, but after that fleeting moment I was honored and excited and quickly read the entire correspondence and even more quickly responded to the IHSA with a definite yes (I didn’t want them to second guess my invitation, hahaha).

The Illinois Advisory Council on Player Safety aims to be a well-rounded plenary body – with much and varying expertise – that can guide discussion on ways the Illinois high school athletic community can improve, advance, set initiatives and create higher standards for player safety. This body cannot create policy but it can influence decisions and create internal debate. Initially the main focus will be on head injuries, however, it is thought that the Council will eventually take time to look at all player safety issues going forward (heat illness, sudden cardiac death, and many more). The Illinois Advisory Council on Player Safety is a part of a greater campaign that the IHSA is unveiling tomorrow (more on that then).

The Council is going to be made up of eight members from across the state; student-athletes, coach, official, athletic trainers, alumni and state legislators.  Below are the quick bios of the Council at this time: Continue reading →

NFHS Develops Concussion Guidelines for Football

Dustin Fink7 Comments

In what has been a long time coming the National Federation of State High School Associations (NFHS) has released the long-awaited guidelines from their concussion summit in July.  The NFHS is basically the governing body that most, if not all, states look to when implementing rule changes in sports, policies for participation and for sports medicine advice/guidelines.  Many states do not act, even with good information, with out the NFHS “seal of approval”.

This has been evidenced in the past when it comes to concussion “mitigation”, in terms of undue risk – contact limitations.  There have been many states that have not waited for the NFHS (California, Arizona, Wisconsin come to mind) while there are others that sat on their hands regarding this topic.  Regardless of where your state is/was it now has some guidelines to follow when it comes to the controversial topic of impact exposure.

Before I post the full press release from the NFHS, I would like to highlight the recommendations from the 2014 NFHS Recommendations and Guidelines for Minimizing Head Impact;

  • “Live” and “Thud” are considered full-contact
    • I really like that there is a clear definition
  • Full-contact should be allowed in no more than 2-3 practices a week; 30 min a day and between 60-90 minutes a week.  Only glossed over was the fact that theNFHS strongly suggests that there should not be consecutive days of full-contact.
    • A great place to start, although there are a vast majority of programs, around here, that do not do more than 2-3 times a week.
    • The time limits are great.
    • Unaddressed is the specific back-to-back days of games to practice.  For example a Monday game and Tuesday full-contact practice.  Sure common sense should prevail, but there will be plenty of loophole finding on this issue.
  • Recognition of preseason practices needing more contact time to develop skills.
    • Obviously a sign that these guidelines are taking everything into consideration.
  • During 2-a-days only one session should be contact.
    • THANK YOU!
  • Review of total quarters played for each player
    • This has been one of my biggest points of contention with any concussion policy.  The risk for injury during a game is much higher and kids that play multiple levels have an exponentially higher risk.
    • Although nothing more was stated than above, this should get people talking and moving.  The issue, of course, will be monitoring this.  Regardless, the fact that this important point is included is a massive thumbs up!
  • Considerations for contact limits outside of traditional fall football season
    • Acknowledging the ever-growing practice of off-season practices.
  • Implementing a coach education program
    • Ideal for understanding all of this and the issues we face.
  • Education of current state laws and school policies (if schools don’t have one they should)
    • Putting pressure on the institutions to take some onus.
  • Emergency Action Plans (EAP) and Athletic Trainers should be utilized
    • AT’s should be at both games and practices.
    • EAP’s should be in place and the best person for taking care of an EAP is an AT.
    • The first “governing” body that has firmly suggested the use of athletic trainers for football at all levels in practice and games.  This is truly noteworthy, and appreciated.

Auspiciously omitted from this document was USA Football’s “Heads Up” tackling program.  They referenced the USA Football definitions of level of contact and coaching courses; but never mention the embattled “Heads Up” program.  I must say, my confidence in the NFHS has skyrocketed after reading this, and a lot has to do with the people on the task force.  I am looking squarely at: Mark Lahr, Tory Lindley, Steve McInerney and John Parsons.  Those gentleman are of the highest quality and character when it comes to athlete safety.

Here is the full press release…  Continue reading →

This Is Unacceptable, In My Humble Opinion

Dustin Fink20 Comments

Yesterday I wrote about concussions and the difference between professionals and adolescents using Jamaal Charles as an example.  What happened last night on the professional field with millions watching was completely unacceptable, professional athlete not withstanding.

Late in the third quarter of the game, last night, San Diego’s defensive back Jahleel Addae (#37) ran into a pile to finish the tackle on the Denver running back.  He was running at full speed and led with his left shoulder, but as he made contact with the RB his head dropped and he also made (incidental) helmet to helmet contact with the runner.  This type of collision is very frequent and looked innocuous…  Until you saw the after math…

Addae was bounced back, still on his feet, and began “short circuiting” for the national audience to see.  He begins to look around, kind of, and stumble, kind of, and lose full control of his extremities, all of them.  As a medical professional and athletic trainer I would have documented this OBJECTIVE finding as “unsteadiness and disorientation”.  It looked like a boxer/MMA fighter catching a fist/kick in the face late in a boxing match; the type of reaction that any referee in those sports would stop a match for and award a TKO to the other guy.

It happens from time to time in this and other sports, that is not the issue here.  The issue is that Addae returned to the game (oh, it gets worse).  Here is the tweet from last night (h/t to Brady Phelps’ Vine);

From what I can piece together this play was the last of the 3rd quarter and reports had him taking the field on the first play of the 4th quarter.  HE DIDN’T MISS A SINGLE SNAP!  Even with the long commercial break between quarters there is a maximum of 4 minutes, but if my DVR time was correct it was between 2 and 3 minutes.  This is not nearly enough time for a full concussion evaluation, by anyone.

“Maybe he was screened, like you said yesterday, Fink.”

There was absolutely no reason for a cursory “screen” in this situation, Addae showed a clear and overt sign of neurological impairment, in concussion recognition jargon: a sign.  When any player shows a sign there is no screen it means Continue reading →

Terry Ott: Concussion Coverage from Canadian Media is Woefully Lacking

Dustin Fink1 Comment

The original purpose of The Concussion Blog was – and still is – to inform those that choose to look about concussions.  Part of this goal has been looking deeper into issues and “lip service” given to the brain injury we know as concussions.  In 2010, when the blog began, this was a novel idea and much of what was written here was “breaking news”.  Along with that, opinions that I shared on the issue were meant to be coming from someone with vast and dynamic experience in concussions.  The initial thought was this was to be a “clearinghouse” for concussion information – and it succeeded.  As years have passed and the media here in the United States has slowly caught on and passed along, mostly, the correct messages TCB has been slower.  However, that does not preclude us from posting information/opinion that we feel needs noticed.  Examples of this have been our white paper on NFL Concussions, the mouth gear controversy and general editorials on published research.

In the past year TCB has been lucky enough to have a journalist spend his own time investigating a part of the global concussion story, in Canada.  Terry Ott, as you may have noticed many of his articles here on the blog.  To be clear, this was all his work and I have become his one and only outlet for his sleuthing and writing.  As he can attest to I don’t always agree with his tact or his tone, but his information is important, especially because in Canada there seems to be a void in the information that would be important to most.  We here at TCB are glad to file his reports as long as he and others understand this is a conduit for discussion and discovery.  I have zero intention of “killing a sport” or “getting someone in trouble”, rather shedding light on some of the problems and issues we face when dealing with concussions.

All of that being said I present to you Ott’s latest (hopefully last here because someone in Canada needs to pick him up) on the concussion issue as it relates to the Great White North.

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WHEN IT COMES TO FOOTBALL CONCUSSIONS, CANADIAN MEDIA BADLY OFFSIDE

Recent New York Times Article Throws Flag

Hamilton, Ontario

October 22, 2014

For the past year readers of The Concussion Blog have learned about the nascent football concussion awareness movement going on in the Great White North, mostly pertaining to how the Canadian Football League, and the mainstream media, have handled-for lack of a better word-the issue.

Years behind the National Football League on the matter, the CFL nonetheless saw the first concussion-related lawsuit come its way last July, accompanied by media attention, much of which was a critical and sometimes downright hostile questioning and smack-down of former 2013  CFL’er Bruce’s groundbreaking statement of claim against the nine member teams of the CFL, neurosurgeon Dr. Charles Tator, Tator associate Leo Ezerins, and several other parties.

The lawsuit, among other things, alleges that the CFL member teams, and specifically some of Dr. Tator’s published research on TBI and CTE-partly funded by the CFL-mislead Mr. Bruce into believing he was not vulnerable to serious and long-term consequences from concussions he received while playing for the BC Lions. None of the allegations have been proven in court and Tator has filed a defense-covered here previously-that asks for the suit against him to be dismissed, with costs.

Yet other than one small article on former 80s era CFL player Phil Colwell, whose brief story and concussion-related problems appeared in his hometown KW Record paper in Ontario, last spring, your correspondent has been unable to place a single word in any other publication in Canada.

If it were not for Andrew Bucholtz of the Yahoo! Canada CFL 55 yard Line Blog sometimes linking to my stories here, few outside of the Concussion Blog’s sphere ever would have known about what did, and what continues to go on in Canada regarding football concussions and especially, their aftermath. Besides a small mention in the Vancouver Sun by journalist Mike Beamish when the Bruce story hit, no one in Canada besides Bucholtz saw the story as important enough to follow-up, and he has done fine work on his own regarding the concussion problem. As of now, I don’t believe Andrew is on many CFL General Manager or team PR weasel Christmas card lists.  (TSN, the CFL’s television carrier did do a piece on their website about the lawsuit in September that mentioned The Concussion Blog, but it was subsequently removed from their archive shortly after my last story for this site last month, and for reasons so far presumed, but actually unknown at this time to this writer. And I have not seen another story in the Canadian media on the lawsuit since.)

And a week ago, after reading in the Winnipeg Free Press a flattering tome on Dr. Tator from last July that appeared just before he was named as a defendant in the Bruce lawsuit, your correspondent reached out to the paper inquiring whether they would entertain a slightly different take on Tator’s research and related concussion issues via an Op-Ed.

However, after being ping-ponged back and forth between editors at the paper, I was told by an Op-Ed editor that the concussion issue was not “topical,” despite the Jevon Belcher CTE story breaking that week and despite the fact that Winnipeg is home to a CFL franchise. But rather, I was informed,  “Ebola” was of more import to their readers than what is essentially a real world and serious public health concern right now that surely can not be adequately explained by just one or two opinions, opinions which are even controversial within the medical and research community.

Likewise a kiss-off from my hometown CBC News website, whose editor, after some initial back and forth, just stopped responding to my e-mails and never published a piece I wrote on concussions in July even though it partly concerned the former Hamilton Tiger Cat, Phil Colwell.

TVO, the Canadian version of PBS, runs a show called The Agenda-and hell, the guy that hosts it has Hamilton roots!-that never met a contentious or important issue it did not glom on to and yet after receiving one return e-mail from a producer back in July commenting on my “unique” insights, I never heard another word.

Even the nice gal who runs TVO’s documentary film division, after initially offering to ask around if any of the filmmakers she had association with would be interested in the concussion story, none of my further e-mails were answered.

And, after being shut-out by nearly every institution purporting to be doing valid research into football concussions in Canada, I endured a recent 6 week runaround afforded me by the University of Western Ontario in London, Ont. which is supposed to be “partnering” with the Canadian version of the Sports Legacy Institute, but certainly did not do much for their reputation for cooperation with journalists trying to ask valid questions.
So after over a month of BS and excuses, I got nadda from them. I actually felt bad for the PR lady who drew the short stick to deal with me, and then she just stopped responding altogether.
To say that some of my dealings with the Canadian media and medical academia would be a joke, would only serve to denigrate comedy.

So obviously, the question is, why?

A veteran of the sports medicine community in Canada speaking on condition of anonymity said that many in the medical community were “afraid” of upsetting Dr. Tator, who carries much weight in medical academia and research grants around these parts.

The source said that many in the closed community are “buzzing” about Tator  being named in the Bruce lawsuit but do not want to be featured in any story seeming to critique the doctor the TSN story described as “renown.”

However, the New York Times apparently does not have a problem featuring a different Canadian medical professional who, unlike Dr. Tator, does not believe CTE  from football concussions is still open for (serious) debate.  Continue reading →

Players Against Concussions (PAC) Foundation Begins

Dustin Fink3 Comments

PAC Image

I received an email and press release about a new foundation for awareness on concussions.  PAC was conceived by Jim McMahon (NFL) and Jeremy Roenick (NHL). PAC’s mission is to become a global leader in concussive education, research and treatment. They have many athletes on board to support this mission as you can see from the invite (bottom). The athletes are the voice in telling their personal stories.  I thought I would pass it along.

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Jim McMahon and Jeremy Roenick Launch Players Against Concussions (PAC) Foundation To Support Concussion Awareness and Prevention

Foundation Kicks Off With Star-Studded PAC Golf Event in Westchester, NY October 6th

Greenwich, Conn. (September 22, 2014)—The numbers are staggering: In 2012, nearly four million athletes suffered concussions, double the number from 2004. Every year, 20% of high school athletes suffer a concussion during any given sports season, and concussion rates are even on the rise among middle schoolers. Concussions often go undiagnosed and multiple concussions can lead to higher risk for permanent neurologic disability. On the flip side of these troubling statistics, sports brings joy to millions and is, without question, a cherished part of our society and culture. Players Against Concussions (PAC) is a new nonprofit organization founded on the uniting principles that we all love sports—but we all want to make them safer. Conceived by Super Bowl-winning quarterback Jim McMahon and NHL All-Star Jeremy Roenick, PAC’s mission is to unite the full spectrum of the sports world—athletes, leaders in research and medicine, coaches, parents, athletic brands and equipment manufacturers—to create a forum and platform where innovation and ideas can be shared to advance the end goal of preserving the sports we love—while making them safer for all who play them.

The PAC mission begins on Monday, October 6th, when celebrities and professional athletes from across the country converge on the Pelham Country Club in Westchester, New York to participate in the First Annual Players Against Concussions Golf Outing. Sponsored by Guidepost Solutions, the daylong kick off event will begin with a morning brunch and press conference from 10am – Noon, followed by an afternoon round of golf, and will conclude with a cocktail hour and dinner beginning at 5pm. Athletes scheduled to attend include Jeremy Roenick, Jim McMahon, Mario Lemieux, Michael Strahan, Darius Rucker, David Cone, David Wells, Ken Daneyko, Rick Rhoden, Bode Miller, Tony Siragusa, Nat Moore, Richard Dent, Otis Wilson, Kevin Millar, Stephane Matteau, Roy Green, Jackie Flynn, Victor Green, Kevin Butler, Joe DeLamielleure, Claudio Reyna, Debbie Dunning, and Jeremy Lincoln (with more athletes and celebrities to be confirmed).

“This is a deeply personal issue for me as both a player and a parent,” said McMahon. “I loved every minute of the football I played as a kid and during my professional career, but Continue reading →

Terry Ott: Canadian Concussion Law Suit Begins Its Slow Crawl To Resolution

Dustin Fink5 Comments
In July this blog broke the news that Canada was facing its first law suit based on concussions in their professional football league.  Since that time there has been plenty of information, misinformation and general commentary about this issue in Canada.  The fact remains that this is a long way from getting settled, if you remember correctly the concussion issue in America took over a year to get “settled” and even now it is not completely final/finished.  Although there has been coverage in Canada (which has limited this blogs need to post/present about it) Terry Ott continues to beat the trail and get information to  present in his unique way.  With that backdrop I give you Mr. Ott’s latest filing…
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DEE-FENCE!
“Absence Of CTE” Doctor Files Defense in CFL Arland Bruce Concussion Lawsuit, But Claims to be “Outside The Knowledge Of” On Many Relevant Concussion Issues
HAMILTON
September 23, 2014

Just as it was a long way to Tipperary, it is surely a long way to go before the Arland Bruce III concussion lawsuit against the CFL, its member clubs, CFL Alumni director Leo Ezerins and Dr. Charles Tator and Krembil Neurosciences Center (KNC) ever comes close to a courtroom, or even any kind of resolution.

However, the legal equivalent of a punt has begun, and court documents obtained for this story provide for a very interesting if limited insight as to what can be expected in this first of its kind case in Canada.

On Sept. 10, the Vancouver BC firm of Harper Grey LLP, and attorney Nigel Trevethan filed a defense on behalf of Dr. Charles Tator,  denying or described as “outside the knowledge of the defendant” all but three parts of Bruce’s claim, only excepting that:  1. Tator is affiliated with Krimbil, 2. the KNC is based in Toronto,Ont. and 3. that Dr. Tator is the director of the Canadian Sports Concussion Project; these are the only facts that “are admitted” in Bruce’s 47 page statement of claim.

And while much of the above is pro-forma legal to-and-fro tiddlywinks, some of the “denied” and “outside the knowledge of the defendant” defenses as described in the Tator response to the civil claim are, ah, questionable to this reporter. (See attachments provided below.)

For instance, according to the filed document of defense Dr. Tator denies that he knew or should have known that:  Continue reading →

MomsTEAM Presents Youth Safety Summit

Dustin Fink2 Comments

It is approaching quickly, but if you are in the northeast a week from Monday you really should check into SmartTeams Play Safe™: Protecting the Health & Safety of the Whole Child In Youth Sports By Implementing Best Practices.  There is a myriad of topics to be included:

  • Sport-related concussion best practices
  • The evolving landscape of youth sports safety
  • Injury prevention strategies in youth sports
  • Reducing injury risk in youth football
  • Cognitive rest and return to learn
  • Gender influences on sport-related concussions and outcomes
  • Preventing sudden death in young athletes
  • Cost-effective youth sports injury prevention
  • Overuse injuries, early specialization, and burnout
  • Bullying, emotional and psychological injury prevention
  • InSideOut Coaching: transforming the lives of young athletes
  • Preventing sexual abuse of youth athletes
  • Role of game officials in injury prevention
  • The power of the permit in youth sports safety

The speaker list is studded with some very bright individuals including: Brian Hainline of the NCAA and Doug Casa of the Korey Stringer Institute at the University of Connecticut and many more.

The cost is $45.00 and looks to be well worth your time and money.  Click the above link for further information and registration.  Tell them The Concussion Blog sent ya!

The day-long event will take a holistic approach to youth sports safety which addresses not just a child’s physical safety, but emotional, psychological and sexual safety as well, and will show how, by following best practices, youth sports programs can stem the rising tide of injuries that have become an all-too-common and unfortunate by-product of today’s hyper-competitive, overspecialized, and over-commercialized youth sports environment.

Thanks Brooke for the press release…  The following is the media contact information:

Media Contact:

Sheila M. Green

Office: (617) 337-9514

Cell: (339) 224-3914

Email: sgreen@thecastlegrp.com

#TheConcussionChallenge

Dustin Fink1 Comment

It’s really simple…  Watch this video, then RT or forward in email or post on Facebook…  It’s not as fun as cold water and you won’t be donating money, but you will be understanding concussion and passing that along…  This was the idea of my good friend Katherine Snedaker-Price…

 

At the time of this post there were 787 views, I would like to see that at 2,000 by next week…  Lets do it!!!