Concussions End A Baseball Career

Drew Cumberland of Pensacola, Florida and Pace High School was a fast rising star since being drafted by the San Diego Padres.  by the age of 22 he had seen action at the AA level and even appeared in a spring training game for the parent club.  However his career is now over, as a player, due to concussions and vestibular issues.  Bob Heist of pnj.com wrote a good story on how a promising career was ended.

Cumberland is like any other typical high school “stud” that played many sports, also a true competitor that would play through pain and a little “headache”.  His earliest known/documented concussion came in 2003 as a freshman in football but later Continue reading

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Great Resource About Concussion Myths

Matt Chaney has been busy this summer with work, but he found some time to forward a bunch of links regarding concussions.  There were a lot dealing with the state laws and the mandates now in place across the sporting landscape, all with very valid opinions.  Some dealt with his area of expertise, steroid and PED detection.  However there was one that I must share with you; a link to a NASP Communique (National Association of School Psychologists)

The link was very resourceful but the gem was the attached .pdf that dealt with the myths we commonly hear with concussions.  Due to the rudeness of ripping off all the information below you will see the myths they took on, and for the actual facts please click on the .pdf link above;

Identifying Concussions

  • Professionals agree on the definition of a concussion.
  • A more accurate term for concussion is a head injury rather than a brain injury. 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.

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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
  • Former CFL Star Shares Dark Memories

    The memories of Matt Dunigan are both good and bad from his years in the Canadian Football League.  Unfortunately, the recent thoughts to his past have made a profound statement about concussions in sports, in particular football;

    How far has post-concussion syndrome penetrated the culture of sport? Witness the tear-streaked face of former CFL star Matt Dunigan in his interview with Brian Williams last Friday on TSN. In a shockingly personal segment, Williams led Dunigan though the hell brought on by at least twelve diagnosed concussions in his playing career. The troubled private life of a very public athlete (Dunigan won two Grey Cups) was put in a new perspective as he wept beside his wife.

    His wife went on to tell the audience the Dunigan forgot how to laugh and lost his sense of humor, basically becoming a Continue reading

    New Jersey Concussion Summit

    The Athletic Trainers’ Society of New Jersey is hosting its second annual Concussion Summit on July 17th.  It is after the “early registration” however the line-up is certainly worth a look.  This is the same organization that produced the very well put together tutorials on concussions, SEE HERE.

    • Steve Broglio, PhD, ATC – Assessing Balance in Concussion
    • Robert Cantu, MD – Long-term Effects of Concussions
    • Annegret Detwiler-Danspeckgruber, EdD – Imaging Concussions: DTI and fMRI
    • Ruben Echemendina, PhD, PSY – The Role of Neurocognitive Testing
    • Jason Mihalik, PhD, CAT(C), ATC – Biomechanics of Concussions Continue reading

    Return-to-Play Test?

    Perhaps.  University of Buffalo doctors and researchers believe that they may have a tool that can provide definitive answers and take the “chance” out of the impending second injury.  John J. Leddy, MD, Karl Kozlowski, PhD and Barry Willer, PhD are authors of a study aimed at just doing that;

    University at Buffalo researchers have developed a test to determine when it’s safe for athletes to return to play after a concussion.

    Currently no standardized method exists to assess when the time is right. It is usually a judgment call made by team physicians.

    “We believe this new approach could change the way professional and amateur sports team physicians make decisions about concussion recovery.”
    Barry Willer, PhD
    professor of psychiatry and rehabilitation medicine and senior author on the paper

    The treadmill test devised by UB concussion specialists in the Department of Orthopedics could change that by providing a systematic approach to evaluate readiness.

    “In the past, how a team physician and trainer made this decision was left to chance,” says Barry Willer, PhD, professor of psychiatry and rehabilitation medicine.

    Willer is senior author of a paper titled Reliability of a Graded Exercise Test for Assessing Recovery from Concussion, published in the Clinical Journal of Sport Medicine.

    Using the Balke standardized treadmill test the subjects were taken to either symptom exacerbation or perceived exhaustion.  Starting Continue reading

    Live From Lexington

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

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

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

    ——

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

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

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

    Footballer’s Migraine: What is that?

    As we highlighted in “More Education Needed Down Under” the prevailing thought in Australia/New Zealand about head injuries is that concussion is a very bad word.  In fact the medical society is even using a term “footballer’s migraine” (FM), that is over 40 years old, to describe lasting effects of being hit in the head.  The Sydney Morning Herald and Nicky Park has just posted a story about the condition;

    Footballer’s migraine, a condition that has forced Wallaby Berrick Barnes to take an indefinite break from rugby, remains a mystery to sports medicine experts.

    Shane Brun from Sports Medicine Australia says the link between recurring migraine and continuous blows to the head is cloudy.

    Symptoms of “footballer’s migraine” are the same as a standard migraine – throbbing head, sensitivity to light, nausea and ringing in the ears.

    Of course FM remains elusive, it is extremely outdated, proposed by W.B. Matthews in 1972 the condition has been radically surpassed Continue reading

    A Calling For Ease: Drew Fernandez’s Story

    (Project Brain Wave)  High school football is one of the most exciting, defining, and proud markers of American culture, and is a level of play that to many, extends beyond being just a game.  The dreaded months of training camp, the long hours in the weight room and practice field, and the time spent studying playbooks to perfect a team’s system all contribute to the same goal—that being the unforgettable feeling of standing beneath the lights on a Friday night before your home crowd, set to take on the opponent you have prepared for.  This feeling that empowers our student athletes, that makes our parents proud and supportive, that makes our friends anxious to witness game day, is what the coaches and players live for.  High school football is defining, and is home to life lessons to be learned and experiences to cherish.  But for the Fernandez family, the high school football season of 2008 is one they will never forget.

    Drew Fernandez, a young up and coming running back for his high school’s football program that was known for state championships in seven of the previous ten years, was productive both on the field, and off the field, executing plays on the field and performing well in his studies in the classroom.  His older brother had also been part of their high school’s championship legacy, and Drew was looking forward to contributing to such successes as well.  His first year in high school was in 2008, and it would be the first time he would have an opportunity to be a part of his hometown’s illustrious football program also.  According to his mother, Tracey, “football was everything to him.”

    But such a mentality would soon be combated during one of his freshman football games, as Drew received the ball at running back during play, and then took hits from defenders in both the front and back of his head while he was being tackled.  Drew had sustained a concussion, and would be removed from play.  His mother told me of what events would then follow after her son took a blow to the head, resulting in his diagnosis.

    “The trainer of the opposing team (the game was away) called me to tell me Drew suffered a concussion, and asked me if I wanted him to go back to school on the team bus or if he should call the paramedics,” said Tracey.  “I asked him to call the paramedics, and I met them at the ER.  The last thing Drew remembers from the day of his injury was riding on the bus to the game.  He has no recall of the trip to the ER via ambulance or anything thereafter until the next morning when he woke up at home.” Continue reading

    Marquette Soccer Player Has To Give Up Soccer

    Shannon Walsh has posted a two-part story about Marquette soccer player Scott Miller and his decision to forgo his senior season due to concussions.  The stories have been posted on TopDrawerSoccer.com (LINK to Part I) and are very informative, well worth your time.  Here are some excerpts;

    In April 2010, Miller collided with a goalkeeper against Northern Illinois(m), leaving him with a broken nose and concussion. Though Miller experienced symptoms of the concussion, he decided not to tell the team medical staff or coaches, and was cleared to play ten days later against Milwaukee(m) in the Wisconsin Cup.

    “That was the biggest mistake of my career at Marquette,” Miller said of his decision to play against UWM. “I told the team doctor and coaches that I felt normal and would be ready to play. Going into the game against UWM, I did not feel well but decided to play. It was one decision that if I had done differently probably would have saved my career.”

    Underlining the need for awareness and education, Miller exemplifies exactly the stigma associated with concussions.  In retrospect Continue reading

    Professional Athlete With Proper Perspective

    We all know that head injuries can be sustained anywhere at anytime, obviously concussions occur at a higher rate in sports.  Non “mainstream” sports in America have their share of concussions as well, in fact sports like soccer, rugby and woman’s hockey have an extremely high incidence rate of concussions.  Perhaps some of the professional players in the more “recognized” sports can take a clue from a professional soccer player.

    After Tyler Twellman has his career soccer career cut short by reoccurring symptoms of concussions other players are starting to realize there is more to life than soccer.  Take for example Chad Marshall, of the Columbus Crew;

    The next head injury Chad Marshall suffers could be the last of the hulking Crew defender’s Major League Soccer career.Marshall is expected to play tonight in an exhibition game against New England after missing time because of concussion-like symptoms following a head injury on Feb. 21. He said the end is possible every time he takes a blow to the head.

    “Every time I get hit in the head or kicked in the face, my mind immediately goes there,” said Marshall, who has suffered from concussion-like symptoms following head injuries at least seven times in his playing career. “It would be tough to hear someone say I had to stop. But I’m someone who wants to go on and have a family and be able to play with my children without having to stop and go sit down.”

    With soccer, and especially as a defender the chances of sustaining a head injury are pretty good.  Granted there is not “full contact” Continue reading

    Adults Now Looking Back and Wondering

    Beverly Smith of The Globe and Mail ran an article about adults looking back and not ready going forward; the past head injuries/concussions bring a lot of doubt in their mind.

    Mr. Greenaway believes he suffered five or six concussions from the time he was 10, playing football in Toronto until he was 30, when he played a University of Toronto alumni football game and landed in hospital, getting a CT scan and waking up to his nephew and niece giggling at him.

    But with all the revelations that have surfaced recently about long-term, profound neurological degeneration among hockey and football players, Mr. Greenaway doesn’t think it’s funny any more. He hears stories about how to help vulnerable young athletes and National Hockey League players, but knows there are hundreds of people like him who suffered multiple concussions years ago. What do they do to prevent symptoms like those of Bob Probert, Reggie Fleming and Marty McSorley?

    Smith also spoke to Dr. Charles Tator and Dr. Shannon Bauman Continue reading

    Vonn Now Saying Right Things

    As we discussed last Friday, Lindsey Vonn had suffered a concussion in a training run leading up to the Finals of the World Cup.  We were concerned with how her and her team were handling the issue, however the tune has changed, for the better.  Vonn is now saying what all professional athletes should be;

    “The second I have a headache or focus problems, I’m going to stop,” Vonn said. “I want to be really careful from here on out. It’s a pretty bad sign that I had symptoms again after the super-G, which means that I’m not recovered yet, so I’m not going to take any chances.

    “This is a dangerous downhill, and if I don’t feel like I can focus then I’m not going to do it.””The second I have a headache or focus problems, I’m going to stop,” Vonn said. “I want to be really careful from here on out. It’s a pretty bad sign that I had symptoms again after the super-G, which means that I’m not recovered yet, so I’m not going to take any chances.

    “This is a dangerous downhill, and if I don’t feel like I can focus then I’m not going to do it.”

    Another good sign is US Woman’s ski team doctor, William Sterret, is also saying all the right things and making her recovery very transparent for all to see;

    “If there are positive symptoms – things like nausea or headache or feeling like you’re in a fog – any of those things, then you’re shut down for sure,” Sterett told The AP. “Once these symptoms become negative, then we go onto more cognitive testing – balance, memory, repetition – things that are easily defined and measured.

    “Again, if you don’t pass that then you’re done again. Once you pass that, then we take a step backwards to the subjective test list and try to slowly increase the stress or exertion on an athlete.”

    Hey HOCKEY, get a clue!!!

    SOURCE

    Savard Saga

    Marc Savard of the Boston Bruins who began the season on the NHL injury list due to post-concussion syndrome was released to play after 2 months into the season.  However the last two games have been a test to his recovery as he was hit at Buffalo on Thursday and again in Denver yesterday.  Neither hit was reported as afoul of the rules, never-the-less Savard is not going to the West Coast rather back to Boston for a re-evaluation.

    Instead, Savard will remain in Denver tonight and fly home to Boston tomorrow to be re-evaluated. Claude Julien said Savard was not showing any concussion-related symptoms after he was belted by Matt Hunwick in the second period.”He seemed fine when I talked to him,” Julien said. “So we’re hoping it’s all minor.”

    At 3:19 of the second period, after dishing the puck to Michael Ryder, Savard absorbed his second head shot in the last week. Julien said it was a clean check by Hunwick…

    SOURCE via @ewheeler1976

    Bust Out The Fish Oil

    After posting about the “7 Ways To Help With Concussion Management” I realized that I had not posted about the possible benefits of Omega-3 fatty acids/DHA supplements for concussion management.

    In a July publication of The Journal of Neurosurgery, Dr. Julian Bailes (BIRI) and Dr. Barry Sears (leading authority on anti-inflammatory nutrition, creator of Zone-Diet) found that supplementing rats with O3/DHA after head injuries reduced the observed issues with a concussion; (SOURCE via weightlosingideas.com)

    “Animals receiving the daily fish oil supplement for 30 days post concussion had a greater than 98 percent reduction in brain damage compared with the animals that did not receive the supplement,” Dr. Sears said. “It is hypothesized that the omega-3 fatty acids in the fish oil reduced the neural inflammation induced by the concussion injury.”

    O3/DHA has been documented to help with the inflammatory response of the body, many people use this SAFE and AVAILABLE supplement when training to temper swelling.  It is also has shown great promise for the cardiovascular system, mainly heart health.  Further investigation is underway Continue reading

    Good News From Minnesota

    The professional sports in the state of Minnesota received good news on two fronts today in terms of players out with concussions.

    Minnesota Wild player Pierre-Marc Bouchard will return to the ice for the first time since the 2008-2009 season.  Bouchard has missed over a year due to post-concussion symptoms and finally has been given the clearance to play.  According to his agent and TwinCities.com, “Butch is back,” and “It’s official.”

    Also in the Twin Cities, the Twins first baseman, Justin Morneau proclaimed that he will be ready to resume baseball come this spring.  Morneau has been out of baseball since July 7th when he took a knee to the head sliding into second base.

    “There’s not a doubt in my mind I’ll be ready for spring, especially with what I’ve done this week and how it’s reacted and how I’ve felt,” Morneau said. “That’s something that hasn’t even crossed my mind.”

    “Two months ago I couldn’t have come out and sat for that long and signed,” he said. “It’s come a long ways. It’s a lot better. It’s not all the way there yet, but it’s close.”

    LINK

    Doug Collins Concussion

    The head coach of the NBA Philadelphia 76ers missed last nights preseason game, and is going to miss at least one more due to Post Concussion Syndrome.  Coach Collins is reported to have sustained the concussion over the Memorial Day weekend.  His headaches and dizziness has persisted and intensified leading him to sit out games and seek further medical attention.

    ESPN.com LINK

    Vestibular Rehab For Concussions

    We all know, or should know, that balance issues are a primary concern with concussions and post-concussion syndrome.  Along with memory problems, balance disturbance is high on the predictor list for duration of symptoms ergo severity.

    As an athletic trainer one of our primary tests, and “go-to” is the Rhomberg Test, or sobriety test as most may know it as.  What is tested there is the gross balance and fine motor movements controlled by the brain and vestibular system of our ears.  During a concussive episode the synapses (or messages being sent) between the neurons in the brain get disrupted, each individual will experience different durations.  Using the knowledge that balance is commonly and most immediately affected by a concussion the Rhomberg provides great feedback.

    During the Rhomberg the athlete is challenged with single leg balance, tandem walking, spatial awareness and other concentration efforts that would otherwise be very simple.  These menial tasks become very difficult when you are concussed.  Now imagine those small but difficult tasks and dizziness plaguing you on a daily basis days, weeks or even months after you have sustained a concussion.

    Alsalaheen, Mucha, et al. provided a research study in which they Continue reading

    NHL Opening Night

    There will be a lot of eyes (those in attendance, TV is scarce for this sport) on the opening of the National Hockey League.  The Philadelphia Flyers head to Pittsburgh and breaking the new digs for the Penguins.

    Sydney Crosby et al. will be looking to start a season full of hope.  The Igloo was shut down last year the home of Penguin Hockey since the 60’s.

    Why am I blogging about this?  The Flyers will be with out one of their stars, Ian Laperriere, who is battling post-concussion symptoms, even though he played in the playoffs last season after suffering his concussion.

    Using Experience to be The Best

    Thomas Bottiglieri made a decision to give up football and pursue his career of choice, medicine, after multiple concussions.  Now living and practicing in Englewood, New Jersey, Bottiglieri has become one of the most respected concussion specialists in the area.

    He was one of those kids who suffered debilitating symptoms but kept them to himself to stay on the field. He hid them until he could no longer play or study.

    Even after quitting football in 1996, he nearly lost the opportunity to become a doctor. His academic struggles were so serious that his adviser suggested that he change his major.

    “I just went into this major funk, depression. And I started flunking classes, which is something I had not experienced in my whole life,” said Bottiglieri, who also serves as team doctor for several North Jersey high schools.

    “I remember the depression being the worst part of it. There was no highs, it was all just very, very low. Not only was my sport taken away, but I had a headache everyday. I couldn’t pass my classes. No one could understand what was happening to me.”

    I can only imagine how hard it was to spell his name after concussions.

    Concussion Prevention Begins In School

    As I have stated time and time again, education is the key to prevention of any injury.  But none is as important as the head injury.  Education Week published a story by Christina A. Samuels about such prevention.

    “Football is such a macho sport. There’s a pervasive mentality in that sport” to ignore injuries, said Mike Carroll, the head athletic trainer at the 1,000-student Stephenville High School in Stephenville, Texas. “I really have to emphasize that this is not something you can walk off.”

    Mr. Carroll, who has been at his school for 20 years, doesn’t have to fight too hard with the coaches when it comes to holding students out who have received concussions. But some students are still slow to report their injuries. Recently, one student who was injured Continue reading

    Another Cardinals Catcher to Retire Due To Concussions

    Although he was not a “career” St. Louis Cardinal, catcher Jason LaRue is reportedly going to hang up his gear.  He was in the midst of the brawl between the Cardinals and Cincinnati Reds he was kicked in the head by Johny Cueto.  According the to the story from The Canadian Press, LaRue has sustained about 20 concussions over his athletic career.

    Canadian Press Story

    Marc Savard Continues with Post-Concussion Effects

    Marc Savard of the Boston Bruins took a big hit last year while playing in the regular season.  He was scratched from playing for 20 games leading up to the playoffs.  Then as expected symptoms cleared and he passed his required testing and given an all clear for return during the NHL Playoffs.

    But as we know or SHOULD know… Continue reading