Bombshell Found in Sports Illustrated Vault

Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, […] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. […] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading

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Former NFL CB hangs it up due to concussions

Randall Gay, formerly of the New Orleans Saints and the New England Patriots has decided that football is no longer his career of choice, due to concussions.  Gay is 30 years old and feels he is having effects due to too many head traumas;

“But then it gets to the point where you don’t know enough about head injuries to just say I can deal with it. You might be able to deal with it today, but you don’t know what tomorrow holds. That’s the scary thing about it. That’s the decision you don’t want to make.

“I love the game of football, and I feel like I can deal with the headaches or just being nauseous. Just being a little dizzy, I can deal with it, but you just never know what it’s going to bring later.”

Gay was particularly frightened when he heard about former teammate Junior Seau, Continue reading

Keeler Article

A very poignant and descriptive article about concussions in the NCAA.  Sean Keeler of Fox Sports penned this article with the perspective of a collegiate athlete and how the machismo of those that play and support cause the biggest issue;

Lazetich is 34 now. An old 34. He suffered seven concussions playing football in his teens and 20s, including five — by his count — during a two-year stretch at Manhattan. The doozy, he says, came against Temple in the 1999 season opener.

“My first memory of the day was coach Snyder coming to see me in intensive care,” Johnno recalls. “I don’t remember tying my tie. I don’t remember the game at all. And then (three) weeks later, I’m back starting again — it’s a (nationally televised) game with Brent Musburger announcing at Texas Stadium, just because I passed the concussion test at the time.

“We do a lot of stupid things. Looking back on it, it probably wasn’t the smartest thing I did.”

More than a decade later, the scars throb — and linger. Lazetich suffers lapses in concentration. The short-term memory comes and goes. The headaches are killer, although they pop up a lot less frequently than they did five years ago.

“Still, if you ask me to close my eyes and shake my head back and forth as hard as I can, I’d tell you to go (expletive) yourself,” says the native of Continue reading

Concussion Information from UB

Dr. John J. Ledy performed a webinar for the Brain Injury Association of New York State.  It is a very interesting topic; how to utilize controlled exercise in concussion recovery.  This video was published on YouTube by BIANYS, it is over an hour in length but like most stuff I put on here it is worth the listen.

Again this falls under the mantra “none of us is as smart as all of us.”

The Reaction in Media to Seau’s Death

We have seen a snippet of what the former players have said, in this post I will pass along articles and samples of them.  The underlying current is troubling for football.  We have posted and posted and posted about this from the word go here, caution and education seem to be the tenants to keeping football safe, however it will never be completely “safe” but in regards to traumatic brain injuries there are answers.

If one wants to really divest themselves of emotion over the sport of football then the answers are clear.  However the current answers are only a STEP in the right direction.  Eventually finding all independent information about repeated blows to the head in sport may be a doomsday for some.

The first article to highlight is by Andy Staples of SI.com; Continue reading

Former Players Reaction to Seau

With all the illogical conclusions that are happening in the press there are some small positives already.  The biggest of which, less than 24 hours after the untimely death of a great individual is the former players speaking out about depression and post-career condition.  No longer has it become taboo to talk of depression.

Now players need to take stock of their physical and mental health, some players are such as Emmitt Smith;

“Depression & suicide are serious matters and we as current and former NFL players should demand better treatment. Lack of info … no more!!!,” former Dallas Cowboys Hall of Fame running back Emmitt Smith said on his Twitter account.

“And for you current players who think this issue doesn’t effect u. Get your head out of your but. Where u r 2day was his (Seau’s) yesterday.”

In the same article James Johnston Jr., had this comment on former NFL’ers; Continue reading

Now what?

So I turn 32 today. It’s kind of a non-age. In my mind, 33 is a bit of a milestone, 30 is an obvious milestone, but 32, that’s nothing. Of course, I couldn’t care less either way. Age means very little to me now, but I guess this is as good a day as any for me to reminisce/write about the past 9 years (8 years and 9 months, actually) and where I am now.

I’m fairly surprised about how happy I am now and how good I feel. On this day 9 years ago, I was with a friends in London, ON, on a inter-term break from my Master’s program (in Public Administration – MPA) from the University of Victoria. The next day, I would get picked up in Toronto and would get a ride  to the Ottawa River, near Cobden, to go whitewater rafting for the weekend (along with about 15 more friends). Good times!

I then went back to Victoria for term 2 of my MPA program and I continued training for triathlon, a sport I tried for the first time in January of that same year. Three months later, I crashed into a tree and my life changed.

When we were rafting/bouncing our way Continue reading

Possible treatment for concussion?

As we progress on the concussion front there are many aspects of this PROCESS that we are still finding out about.  One of the most pressing is how to treat the after-effects of the injury.  Current management can help abate the symptoms of roughly 85% of those suffering from the injury, for the other 15% there are few “treatments” that have worked across the board.  Off label use of FDA approved drugs has shown promise for some, like Hillary Werth;

Werth, a brakeman who was considered an Olympic hopeful, had her bobsledding career cut short by a series of concussions she suffered while competing in Germany and Canada.

Despite the injuries, she said she doesn’t regret her relatively brief time with the team. And she is thankful for the novel intravenous treatments she received after the concussions — treatments for which scientists are seeking Food and Drug Administration approval because they believe millions of stroke patients across the country could benefit. Continue reading

Innovative Concussion Care Concept

It seems that I often am applauding the efforts north of the border in Canada, it really seems that they have put a concerted COMBINED effort to seek out and implement innovative ideas.  I don’t think it says much about the United States other than we are all trying to do our best in our own little areas.  There is little consortium or conglomeration of effort, rather “‘A’ has found this”, “‘B’ has discovered this”, “‘C’ is saying this”, etc, etc, etc…

It may be the same up north but with the population centers mainly in fewer areas in Canada it seems that the Toronto, Ottawa, Montreal, and Vancouver areas seem to all be on the same page.  This could also be because of the overall influence of the Brain Injury Association of Canada and its influence on such things.

This idea is not from the BIAC, but it has some solid foundations none the less, including our partner in concussion awareness stopconcussions.com with Kerry Goulet and Keith Priemeau at the lead.  They have created a vision and group of like-minded individuals to create what they are calling Sports Concussion Care Clinic.  Here it is in a press-release; Continue reading

Now This is a Possible Game Changer

There have been many attempts to create a concussion “game changer”, something that will bring the assessment and/or recovery into better focus and provide more concrete answers for all of us.  One thing many people keep forgetting is that the human brain is not only very complex but it is also very individual.  Creating blanket statements, guidelines, and recommendations are very difficult; unless of course you use a multidisciplinary approach that touches on every part of the concussion sequale.

If you have read long enough and seen the comment section you will know that we have been clamoring for a more comprehensive, evidence-based, set of recommendations that broach all four parts of a concussion: physical, cognitive, sleep, and social/behavioral.  Perhaps the Ontario Neurotrauma Foundation has done just that (.pdf at end of post and in “Current Concussion Management Page” or you can go to the ONF website);

ONF is pleased to publicly release the Guidelines for Mild Traumatic Brain Injury (MTBI) and Persistent Symptoms.  The Guidelines were generated through a consensus process using existing evidence and clinical expertise. 10 to 15% of people who sustain MTBI do not recover well or as expected. The guidelines are therefore aimed at treating and reducing the impact of persistent symptoms following MTBI in adults.  On behalf of the project team that oversaw this work, ONF welcomes feedback on the Guidelines to info@onf.org

There have been other guidelines, one we hold as the standard (note not gold standard) Continue reading

Concussion – After Injury Care

Most cases of concussion resolve spontaneously over time, we have had discussions on here that vary from 72 hours to 6 months or longer – however, people/researchers are trying to find a way to help along recovery.  Most of this is an inexact science, to say the least, it is almost the ol’ adage of “throw crap on the wall and see if it sticks.”

Lindsay Barton wrote a great summation of current ideas for therapy for lingering effects of concussion, in some cases being classified as PCS, or post concussion syndrome, for Mom’s Team.  I do like his list which includes;

  • Craniosacral therapy
  • Chiropractic Neurology
  • Vestibular Rehabilitation
  • Amantadine
  • “Buffalo Protocol”
  • Epsom Salts

The first three are very “hands on” Continue reading

Family Travels Long Road of Recovery – TCB Suggestion

Brooke de Lynch of Mom’s Team sent over this article and video about a family and their dealings with post-concussion syndrome and the long recovery after a very “innocent” looking hit.  It begins as most complex cases often do, with incorrect initial management;

On the evening of Friday, February 12, 2010, my then 15-year-old daughter Heidi was hit on the head by the stick of a teammate as she was warming up in goal before a hockey game.

It was not a catastrophic brain injury requiring a trip by ambulance to the hospital. But the blow did result in a concussion; one that turned out to be far more severe, complicated and long-lasting than initially thought.

Because multiple mistakes were made in the immediate aftermath of the injury by all parties – including by me, her mother – which exacerbated her symptoms, that cold winter’s night marked the beginning of what would turn out to be a fourteen-month long search for answers to the enigmatic riddle that is post-concussion syndrome.

Another great perspective from a mom, this time about a girls hockey player.

Listen, all cases are not as drawn out like this one, in fact stats tell us that some 75-90% of all cases of mTBI/concussion recover in 7-10 days.  Remember that the “recover” portion of that last sentence is from symptoms AT REST.  This brings me to my soap box moment of the day… Continue reading

Research From The Past

There have been some very valuable resources to this blog, one who continually provides a vast amount of information both for posting and in the comment section is Don Brady, PhD, PsyD, NCSP, LMFT.  He along with his wife, Flo, have written to often cited pieces of information on concussions.  The first is the Communique on Sport-Related Concussions from the NASP.  The second is the common myths associated with concussions.  Let us not forget some the excerpts from his dissertation.

Recently Dr. Brady has sent me a couple of articles, neither of which were earth shattering in content, rather they were interesting due to the publication dates on them.

The first is a guest editorial by Allan J. Ryan, MD and appeared in The Physician and Sports Medicine, in 1987, 25 years ago (emphasis mine);

Rimel et all found that such events may be followed for weeks or months by symptoms and disorders of brain function that can be measured objectively. Gronwall and Wrightson found that persons who have sustained concussion show a reduced information-processing rate that may persist beyond 35 days when other post concussion symptoms (such as poor concentration, irritability, and fatigue) are present. Also, 20 young adults had less information-processing ability and took longer to recover following a second concussion that controls who had sustained only one concussion.  Thus, a cerebral concussion is a serous event that is indicative of an injury to the brain, and should be taken very seriously.

Continue reading

New Doctor, Different Results: Tracey Mayer

Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there.  As time allows she will be submitting posts for you to read.  I truly hope that everyone gets a chance to read about concussions from yet another perspective.  Thank you Tracey!

My son, Drew, suffered a severe concussion during a freshman high school football game in September, 2008, and has not played football since.   He would have stepped back on the field the next week and would still do so if he was allowed to.   It was not his first concussion, but it was clearly the most severe.  My earlier posts on here explain the details of what he has gone through.  Clearly, he has made tremendous progress, but he still has some cognitive difficulties.  He also suffers from migraines, which are typically provoked by intense focusing or from being hit on the head.  It does not happen often, but there have been a handful of incidents over the past 2 years.  Two weeks ago, he was elbowed in the head very hard during a basketball game, which resulted in a migraine with major fatigue that lasted for 4 days.

Drew saw a leading neuropsychologist out of Loyola who is an expert in concussive injury last week.   I chose to not reveal his name Continue reading

MMA and CTE

The hot button topic in the research world with concussions is chronic traumatic encephalopathy (CTE), the degenerative brain disease, twin (fraternal) sibling of dementia pugilistica first found by Dr. Bennett Omalu.  This brain disease is debated and some times discounted (as you will see tomorrow) for its links to repetitive brain trauma, i.e. multiple concussions.  It does however have a place in the discussion with combative sports like MMA.

Recently a former fighter named Gary Goodridge has said he believes to be suffering from its onset.  Steven Marrocco of MMAjunkie.com wrote a piece on Goodridge and the debate of CTE in the sport;

The damage, he noted, was not extensive enough that it had caused irreversible trauma. But had the fighters continued to compete, he believes they would have been candidates for CTE.

“What I’m saying is that mixed martial arts belongs to the high-risk group of CTE,” Omalu said. “I would consider mixed martial arts just like I would boxing.” Continue reading

NYT Op-Ed by Joe Nocera

I had missed this article but thanks to an email I think everyone should take a look at this op-ed piece from the New York Times by Joe Nocera titled “The Cost of Football Glory“.  He begins with discussing his initial thoughts after reading a 36 year-old article by Clark Booth.  If you would like to read it as well here is Clark Booth at the Super Bowl: Death & Football.

But no one had ever written an article like that before Clark Booth went to Miami. I remember being thunderstruck reading it. D.D. Lewis of the Dallas Cowboys talked about having nightmares and his fear of breaking his neck. Lee Roy Jordan, a veteran Cowboys linebacker, was asked by Booth why he kept playing with a sciatic nerve condition.

“By the time I’m 55, I feel they’ll have learned enough to medically treat me,” he said. “If they can’t, I can accept that.”

Booth asked sportswriters and ex-players about the worst injury they had ever seen. 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

Tuesday Quick Hits

Kris Dielman would most likely do it all over again.  In a piece done by the Associated Press and posted on ESPN, Dielman explains that the drive for the ring would make him do dumb stuff;

“This was definitely a scare,” said Dielman, known for his hard-nosed, blue-collar demeanor. “Waking up in the hospital with my wife standing over me, that was pretty scary. I don’t scare easy, but that was something different.”

Dielman went on to explain that having a family and kids would most likely make the decision harder, if it were to happen again, to return.  This is the first opportunity the media has had to talk with Dielman, as players on the IR are not allowed to be interviewed by the press.

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Marc Staal makes return to ice in Ranger uniform, outdoors in Philly.  Staal had been out since February last year Continue reading

Wonderful Retrospective Article

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

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

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

Chaney Tracks Catastrophic Injuries

If you have read the blog much you will find a fair amount of information and commentary from Matt Chaney regarding his position on head/brain injury.  One thing that Matt does well, from his journalistic background, is document the many cases of catastrophic injury related to football in America.

Chaney is not the only one who does this, he just appears to be more transparent about it than the national foundation for such tracking, the National Center for Catastrophic Sport Injury Research (NCCSI).  In his most recent post on his blog, Chaney gives us the list he has compiled for 2011, both by the NCCSI criteria and his extended criteria (which deserves credit).

The rate of catastrophic injuries in American football could be a record in 2011, with more than 70 survivor cases of conditions such as brain hemorrhage and spinal fracture, according to an intensive electronic survey by this reporter.

See the complete annotated list of cases below, with juveniles comprising the large majority of victims.

The findings belie talk of “culture change” by football officials, their popular claim of “safer” football in America, and raise question whether catastrophic injuries of the inherently brutal sport are significantly under-reported in record-keeping of the present and past.

Last year the National Center for Catastrophic Sport Injury Research (NCCSI) logged only 24 survivor cases—barely half the 2010 cases still available online, including players with brain bleeds and spinal paralysis missed in the report.

Now stronger accounting is assured for 2011, standing on results of my daily searching of Google banks that’s garnered a solid 70 survivor cases for verification as catastrophic football injuries, defined by the NCCSI as affecting the brain, skull, spinal cord and/or vertebral column.

My cases include the following: Continue reading

Symptoms & Perspective: Nick Mercer

Symptoms with which I am familiar are primarily dizziness and fatigue. The biggest symptoms I deal with are my balance/movement and double vision, but apart from immediate vision problems most people have after a brain injury, I think balance /movement and double vision lasting over 8 years is more specific to serious brain injuries, so I won’t talk about them per se.

The severity of my symptoms has lessened over these 8 years and I have never had to deal with headaches (apart from an intense and especially long one after the doctors replaced my bone flap), but the dizziness and fatigue, however diminished, remain. That’s not to say that I deal with serious episodes of these symptoms every day, but they are there frequent. As I wrote in a previous post, standing up quickly or abruptly turning my head to the side can result in dizziness. Fatigue is another animal altogether. I don’t know when it will be intense.

For people dealing with the immediate symptoms of a brain injury, these are unfamiliar and must be Continue reading

ESPN OTL Takes on Cantu’s Stance

Outside the Lines on ESPN interviewed Dr. Robert Cantu after he made public his stance on the issue of youth sports.  I have embedded the video from ESPN via YouTube.

I would like to highlight not only Dr. Cantu’s take but also a VERY GOOD journalist that has covered concussions, Peter Keeting at the back end of the video.

In the accompanying story by Ian O’Connor of ESPNNewYork, Harry Carson believes that the state of football and its aftermath may be similar to playing Russian Roulette;

Carson played through all of his undiagnosed concussions, if only because that’s what NFL players did in the ’80s. He knew something was wrong when he struggled with his vocabulary during interviews, a problem that inspired him to secretly listen to language tapes on his drives home from practice in the hope, he said, “of retraining my brain.”

Carson was diagnosed with post-concussion syndrome Continue reading

Previous Concussion Research

Information about concussions seems to have been suddenly placed upon all of us; the information and management has changed multiple times since the mid 2000’s – maybe not.  As early as the 1800’s other professions were relaying information to doctors that appear to symptoms of concussions (Caplan, 1995Erichson, 1997 – Keller, 1995), the authors focused on the railroad industry.  Information about concussion and it’s debatable cousin, Post Concussion Syndrome.

Information about concussions and PCS has been documented very well by R.W. Evans as early as 1987, here is the list of his symptoms;

  • Headaches
  • Muscle contraction type
  • Migraine
  • Occipital neuralgia
  • Secondary to neck injury Continue reading

Post-concussion symptoms, see concussion symptoms

I was brain injured in 2003 while cycling in Victoria, BC. Concussions are also known as mild traumatic brain injuries and while what I sustained was a coma-inducing severe traumatic brain injury, from what I hear, and what makes sense to me, there seem to be many overlapping symptoms. I read about how Marc Savard has “post-concussion” symptoms and I’m really wondering why they call them post-concussion symptoms and why I always say ‘I was brain injured’. I guess the major traumatic blow to my head  is a thing of the past, so, on a technicality, I can get away with saying “was brain injured”, but plain logic is enough to tell you that you don’t have symptoms from an injury that doesn’t exist. I still have major symptoms and even though you can’t see my injury just by looking at me today, doesn’t mean that my brain has completely healed. Some parts of my brain seem unaffected, but 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