#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

An Understudied Area of TBI

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

Concussion = Brain Injury (revisited)

This post originally appeared in February of 2012, it is a good summation of the minutiae surrounding concussion.


For years we in the medical community have been struggling with the terms “concussion” and “traumatic brain injury”; is there a difference?  The simple answer is no.  As you have seen on the blog, we use the term interchangeably, however just like anything in life semantics make a difference.  The perception of a “concussion” is that of sports and “not really that big of a deal”, and that would be horribly wrong.

As Broken Brain — Brilliant Mind posts today this injury is to the brain and confusion about semantics need to be cleared in order to gain a firm grasp on the issue at hand;

I’ve been giving a fair amount of thought to concussions over the past couple of years. In the course of my tbi rehab, my neuropsych has referred to my mild tbi’s as “concussions” and oddly, I never really thought of them that way. I’m not sure why I didn’t make the connection. I guess I thought, like so many others, that concussions are not that big of a deal — just a bump on the head. Getting your bell rung. Getting dinged. Big deal, right? Then, when my neuropsych talked about all the concussions I’ve had, the light went on.

My mild traumatic brain injuries were concussions. Concussion sounds a lot less dramatic than TBI, but essentially, it’s the same thing (I won’t go into the distinctions that SUNY-Buffalo Concussion Clinic people make).

By the way if you have not been going to BB–BM you should, as his/her perspective on dealing with brain injury is a massive resource.  Needless to say, whether you use the term “concussion” or “brain injury” the results Continue reading

Capt. Peter Linnerooth – US Army

I was just minding my business reading the news and getting lost in my Sunday mindless exercise, when I came upon a news story that shook me – on many levels.  This story is about Captain Peter Linnerooth; a story worth noting and sharing.  Does it have to do with concussions, I don’t know and I don’t care, it has to do with the well-being of humans – a plight that is part of the concussion story.

Regardless the Sharon Cohen authored story on Capt. Linnerooth is well worth your time;

He had a knack for soothing soldiers who’d just seen their buddies killed by bombs. He knew how to comfort medics sickened by the smell of blood and troops haunted by the screams of horribly burned Iraqi children.

Capt. Peter Linnerooth was an Army psychologist. He counseled soldiers during some of the fiercest fighting in Iraq. Hundreds upon hundreds sought his help. For nightmares and insomnia. For shock and grief. And for reaching that point where they just wanted to end it all.

Linnerooth did such a good job his Army comrades dubbed him The Wizard. His “magic” was deceptively simple: an instant rapport with soldiers, an empathetic manner, a big heart.

The man knew how to handle others and create an atmosphere for helping on a battlefield and beyond;

He was, as one buddy says, the guy who could help everybody – everybody but himself. […]

“There’s no cavalry to save the day,” McNabb explains. “You ARE the cavalry. There was no relief.” […]

For about half his tour, Linnerooth’s office was a 12-by-12 trailer. His heavy-metal soundtrack – he banned the Beatles and Pink Floyd, deeming them too sad – provided a sound buffer. A thermal blanket serving as a makeshift room divider also provided a modicum of privacy.

Linnerooth brought hope to those gripped by hopelessness. In a desert, he could always find the glass half full.

He turned tragedies into cathartic moments: When a platoon lost a member, he’d encourage the survivors to deal with their grief by writing letters to the children of the fallen soldier, recounting the great things about their father.

Then the pressures were too much; Continue reading

Melissa Gilbert returns to DWTS

And this is another example of poor concussion management that sends the wrong message to the general public.  Gilbert has returned to rehearsal, reported here and via her twitter account;

Very happy to be back on campus rehearsing with @MaksimC . Now back home to bed.

At the very least she is going home to rest and it seems she was told to sleep.  I surely hope that she recovers in a quick and safe manner; as my wonderful wife thinks she is performing very well, and has a soft spot for “Little Laura”.

We will continue to monitor this situation.

It Happens on DWTS

Even though watching the performance you would have not noticed, because there was not a single event, Melissa Gilbert of Dancing with the Stars tweeted that she was concussed;

I’m alright. Mild concussion and whiplash. Very soon I will be safely home resting and being taken care of.

Hey Melissa no such thing as a mild concussion, LOOK HERE.

It will be interesting to follow her course of management/recovery.  And, yes…  I was watching…


I just finished Slaughterhouse Five by Kurt Vonnegut. It’s about Billy Pilgrim, an optometrist in Ileum, New York who was a World War II POW in Dresden, Germany when it was fire bombed (Vonnegut, himself, was a POW in World War II in Dresden in Schlachthof Fünf (Slaughterhouse Five). He, like his future character, Billy Pilgrim, was there during the bombing in February 1945). After the war (in human time – more on that further down) he becomes an optometrist, has a wife, daughter and son, and is abducted by aliens to their planet of Tralfamadore and ends up with an ability to haphazardly time travel within his life. It’s funny and makes its anti-war points through satire. This is not a book review, I just figured I would give a general overview of the book before I launched into an exhortation about my brain injury and the Tralfamadorian view of life.

The Tralfamadorian view kind of relates to my point that I wouldn’t change a thing about my being brain injured because it leads me to where I am now. The Tralfamadorian view of life is that no one ever dies, they just jump around to different parts of their life and that things that happen will always happen and have always happened. By no means am I saying that I can travel through time Continue reading

Quiet Weekend

Other than some good football games and the occasional college basketball game the weekend was pretty quiet in terms of concussions.  There were a few players that were taken out of games for quick checks; subsequently only three were listed as concussions:

All three were easy to see on the field plus another in my opinion; Jimmy Graham had a two separate incidents of slamming his head against the turf in San Francisco and not “being himself”, it was OK because we found out later that it as just “back spasms” (see sarcasm).

As the football season winds down we will be focusing on NHL and NBA concussions, the former being a hot issue the later just getting the first concussion of the season: Continue reading

Broken Brain Brilliant Mind

To the new followers of this blog; there is one other blog that I find speaks volumes about the experience of brain injury.  Broken Brain – Brilliant Mind is a blog from a person that basically speaks to the world about how a human being is dealing with the after effects of a brain injury (see about the blog HERE).  BB’s blog is very insightful for those that are dealing with post injury problems or the support groups surrounding those people.

There are many kind of posts but it mostly centers around how BB gets through the struggles that present themselves from day-to-day.  BB recently cross linked a story that I checked out, his post speaks volumes about struggles that many do not Continue reading

Observations: Nick Mercer

I watch Jersey Shore. I am neither proud nor ashamed of that. I just watch it. I doubt I’d watch it the same way if I hadn’t done a biology degree. Everything from examining ecosystems and watching vigilance behaviour to detailing the lives of fruit flies was based on objective observation. It is with that eye of an unimpassioned observer that I tend to watch any reality show, especially those shows that are trying to depict life in an ‘open’ environment. It’s fairly obvious that, although not scripted, Jersey Shore takes place in a well controlled, or at least well influenced environment. The Situation (Mike) – a nickname he seemingly gave himself – recently slammed his head into a wall. Purposefully I might add!

He went to hospital,was diagnosed with whiplash, given a foam neck brace and told to lay low for a week (not go out to clubs – a near nightly occurrence on the show). The Situation was never a favourite member of the house; he always drew attention and animosity to himself. He is also depicted as being aggressive, arrogant and naive. About to get into a fight, he got himself riled up and threw his head into the wall. After the shock and concern about his immediate well-being had subsided 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
  • Concussion Now Worthy of Purple Heart

    And it is about DANG time the military came around on this.  I say military but really the Army is taking the lead as they have recently reviewed their designations for the Purple Heart, and concussions will now be considered for the honor.  There is hope that the other branches will follow suit and make concussions worthy of a Purple Heart.

    It wasn’t like the Army did this on their own, it took pressure from the civilian sector, namely the NPR;

    In response to the ProPublica/NPR reporting, which showed that Army commanders denied some soldiers the Purple Heart even after they suffered documented concussions, the Army’s Chiarelli called for a review of the guidelines. On Wednesday, he announced clarified rules, including a checklist of valid treatments (bed rest and Tylenol among them), that will make it easier for war veterans to receive the Purple Heart after sustaining concussions.

    I must say this is great news, because by making this distinction more awareness will be given to “closed head trauma” and making the ‘invisible’ injury more visible to everyone.  And I echo the sentiments Continue reading

    I Am Away

    While the cat is away the mice will play…  I am away for a couple of days to help with this:

    This is the newest addition to the family.  In the meantime, you will be in the capable hands of Gonoude and Lutz.  Feel free to send us links and information to compile for next week.  In related news, I will be on CBC Toronto discussing hockey and concussions; I taped an interview this morning.

    NFL Forces Toyota Commercial Edit

    Via Deadspin and Reuters, the NFL forced Toyota to edit a car commercial which depicted a helmet-to-helmet hit.  Toyota is running an advertising campaign depicting how their technology can be put to good use in other fields.  This particular commercial explains how Toyota’s technology in studying head injuries of crash victims can be used by researchers to develop better football helmets.

    The NFL told Toyota it could no longer air during games, but Toyota simply edited out that particular hit.  It’s at the 0:17 mark of the video:

    So, I guess the moral of the story is to just pretend these things don’t happen.



    That Was Quick

    I am a relative noob when it comes to blogging/journalism “light”; being hopeful this blog had and will have an impact seemed naive at best, guess I have been deemed wrong again and again and again…


    Remember my post about Chicago moving an ordinance along about concussions?  (It is just two below this one)  And how I pretty much screamed for the state legislature to get the move on, even inviting an email for any needed guidance… I didn’t get an email…  But I did get a phone call, again from a source wanting to remain unnamed (seems to be a pattern with this unnamed sources recently) letting me know that there is a push for this issue and that the Chicago ordinance caught EVERYONE “flat-footed”.  There will be something “soon” I was told.

    Good, and thank you for visiting The Concussion Blog!


    A fellow athletic trainer recently emailed us to tell me that he has been following since Post 1.  He figured we were going in the right direction and used it as a resource but figured, like myself, that it’s a blog and it has its limits.  He was wrong and so am I, as his medical director asked him about it and shared with him that the stuff we are putting out is good and very informational.


    Dr. Broglio of the University of Illinois wanted to let everyone know he is very thankful for your participation in the research and that the audience of The Concussion Blog has been and will continue to be very, very helpful in further projects!


    As an information “nerd” I like to see our website stats, not so much how many people are visiting but seeing who is linking this information, and would it shock you, as it did me, that; Sports Illustrated, Deadspin, ESPN, Uniwatch and loads of message boards (shout out to Illinois High School Sports.com) have linked us?  Just hope the later of those are not tearing us to shreds too much!


    This leads me to a simple…  Thank You!  And keep all the information coming, everyone can participate in this experience…

    Musical Savant

    A man in Colorado says that he became a musical savant after a swimming pool injury.  He claims that he sustained a concussion after hitting his head diving into a swimming pool, then shortly after he was able to compose and play the piano.

    Is it possible?  I don’t know, but I have seen (very recently) a high school student become smarter after a concussion.  His grades improved and he reported that school was easier.  Add to that his ImPACT test was off  the charts after his concussion, as compared to his pretest.


    The musical savant recently went to the Mayo Clinic and had his brain analyzed.  He is the first to have this condition documented from a concussion.

    Non-Sport Head Injuries Also Problem

    I know we usually focus on the concussions and head injuries in sports, however head injuries, especially those that go unchecked can create very dire situations as well.

    According to the Belleville News-Democrat (Illinois), a 42 year-old man shot and killed his wife before fleeing and taking his own life.

    What makes this an interest to us:

    It all may have started with a head injury from a car crash that led to a personality change in the man, police said.

    If the police are saying that, this early in the investigation there may be something there.  The key point of this part of the story is the “personality changes” as it related to post head injury.  As we have seen with research into CTE, former high-profile athletes have also had similar anecdotes prior to their deaths (Andre Waters, Chris Benoit come to mind).

    Sports can be our vehicle to take steps to stop this kind of stuff.