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

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

Exciting New Online Education

I was recently contacted by Sport Safety International to take a look at and provide feedback to online concussion education courses.  We do get a lot of these type of emails, usually with flattering introductions trying to get publicity.  And to be honest as time warrants I do my best to investigate every single one of them.  You have seen that I have looked at and informed the audience about many products and services for concussions.  So this was somewhat routine for me, to take a look and give honest feedback (sometimes the feedback is not what companies and people want or expected to hear).  However Sport Safety International has something that was not only worth every second of my time, but worth ANYONE’S time.

I am gladly going to go as far as promoting this service, mainly because it is FREE to coaches, athletes and parents (see general public).  Here is their own words; Continue reading

The Mighty ‘C’ Word

I am hoping to bring the information about a concussion to a level that everyone can understand.  Recently I have been on a media blitz and am finding out that people know about a concussion but not what a concussion is.  The hope is that this original article will help with understanding.  You may link and use parts of this article as needed, however you may not reprint it without expressed written consent from The Concussion Blog and Dustin Fink, MS, ATC.  I hope you enjoy and looking for some feedback as well, ALL feedback!!!

What is a Concussion?

Simply put a concussion is an injury to the brain.  There are much more complex pathophysiological (I know huge word, sorry bout that) mechanisms happening to the brain.  What is not so complex is that your brain, my brain, our brains do not repair themselves, nor do we have the technology to repair them.  Every individual is given ONE brain, and really it amounts to a mound of jello suspended in fluid, pretty fragile, eh?

As the brain is violently and abruptly shifted inside its case (skull) it creates a cascade of events down to the cellular level.  Instead of boring you with medical terminology just think of your brain as a snow globe.  When all is good the flakes in the globe are at rest and the water is clear.  Now shake the snow globe.  The flakes are flying everywhere without rhyme or reason; this is a concussion (at its basic level).

During the excitement of the flakes the brain does not function correctly sending the body signals that are impairing function such as; headache, blurred vision, balance disturbance.  The brain wants to function normally however with all the chemicals, hormones and such “flying” around – out of order – the normal responses to signals the brain is used to sending is no longer happening.  We as clinicians have been able to, through research, identify areas of the brain impacted by the sudden insult to the brain due to the types of signs and symptoms presented.

In order for the brain to return to normal functioning every single flake in that snow globe must come to rest, and be at a complete restful state.  Returning to activity – ALL ACTIVITY includes physical and COGNITIVE stresses – too soon makes it MUCH easier to excite the flakes once again, and even make the symptoms and reaction much worse (think Sidney Crosby).  Getting a second insult to the brain before all the chaos has subsided WILL translate into a longer recovery period, and in adolescents this can lead to Second Impact Syndrome, a killer.  Even if there is one little tiny flake floating around in your snow globe, your brain is NOT READY for any more trauma, PERIOD.

What to look for

With a concussive episode the brain sending improper signals results in SIGNS and SYMPTOMS; Continue reading