Fish Oil Revisited

This post originally appeared on the blog in 2011, not much has changed in this area, it is still not definitively known if this is good, bad or indifferent (probably the latter).  However, this is a supplement that is good for all athletes for a myriad of reasons. I have chosen to post this again because it is one of the most popular and commented on post in the blog history.

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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

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Concussion by Sport (revisited five years later)

This was another very early post of this blog back in 2010, September to be exact. As you can tell I was very green to the whole linking of articles and writing. However, this is an important article regarding concussion statistics by sport from five years ago. I would be interesting to do a follow-up to this with what we know now. Looking back at my observations have not changed much in the five years, I may move wrestling above cheerleading but that is about all.

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Concussions are not exclusive to American football, although it is the most covered sport as it relates to concussions.  This is a good time to note that in the United States the next most concussive sport, is soccer, the number one sport in the world.

A reasearch project by University of North Carolina reported concussion rates by 100,000 athlete-exposures Continue reading

The Need for Sleep

This post appeared in the infancy of this blog back in October of 2010, I have made some editorial changes since that time.

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It used to be that doctors would tell you to keep people awake with head injuries.  That has changed, quite a bit.  Keeping someone awake might be indicated for a possible brain bleed, but concussions need the sleep and recovery time.

Sleeping is first. If you’re not sleeping, forget it,” said Cara Camiolo Reddy, the co-director of the UPMC Rehabilitation Institute brain program and the medical adviser to the Sports Medicine concussion program. Sleep is vital in the recovery process because the injured brain needs rest to begin to heal itself. The concussion program and Camiolo prescribe medications, however, only to post-concussion syndrome sufferers who are three weeks or longer into their injury.

This quote was from and article by Chuck Finder of Scrips Howard News Services and appeared on NewsChief.com today.

In the article you will find that this prescription is not widely accepted by the community that deals with concussion management.  However in my experience it is vital to let the brain rest.  When I am debriefing with the athlete and their parents, the most often question I get is “can you sleep too much?”.  My answer is no. Parents often time are apprehensive if they subscribe to the old method of waking every hour, but I try to educate using the snow globe example. If the must wake their child I encourage it at infrequent and few times as possible.

With my experiences at the schools I’ve been an AT at, the kids and parents that abided by the recommendations of sleep and complete brain rest have recovered at a much quicker rate.  The kids and parents that did not listen often times have delayed recovery.

I know that is not a research study in its most proper form, but the observational evidence tells us, and those in the above article that sleep is indeed needed.

Borland, Now What?

If you are interested in sports or the brain trauma/concussion debate you probably did not miss the news about Chris Borland’s abrupt retirement from the NFL and the San Francisco 49ers.  In case you missed it, he broke this news to Outside the Lines on ESPN.

Since he made his decision there has been quite the discussion regarding why and what this means in the long-term; not only for football but for the awareness angle of this injury he has cited for his reason for hanging them up.

But what does it really mean, beyond the #hottakes from all over the internet?

When Borland decided it was his time walk away he knew there would be great interest, well had to know.  It has not been the norm to see a 24-year-old to retire due to concerns over long-term effects of repetitive brain trauma.  Most people in his position, now and going forward, are probably more concerned about making a living playing a game they love and a good one at that.  But think about the ripple effect of this news.

First, remember when Jake Locker decided to retire?  Hardly now, I bet.  Or Patrick Willis, from the same 49er team?  A bit more memorable because of his stature, I bet.

But both of those decisions were pale in comparison to the news from Borland, who until he retired I and many hardly knew him outside of very devout followers of the league and team.  The reaction was a combination of mass hysteria and shock with everyone waiting to chime in their opinion.  We saw nothing like that from the other two more “high-profile” players before Borland.  Why was this… Continue reading

Concussions: Not Just Male; Not Just Football

Here at The Concussion Blog, we talk all things concussions. Concussions are brain injuries and they are definitely something we must continue to learn more about and continue to educate the youth and the parents. Dustin and I are both Certified Athletic Trainers at the high school level and I really believe that puts us on the “front lines” when it comes to concussions and concussion education. But I think something that gets lost in the whole concussion issue that a concussion is NOT a football problem; it is a SPORTS concern. This article will once again present another sport that brings its own risks of concussion and it needs to be brought forward once again. Cheerleading, girls basketball, and girls soccer are all prime examples of concussion sports that slide underneath many people’s radar. Continue reading

Saint Francis Medical Minute

This is a short video highlighting concussions and local athletic trainers.  Dr. Bowen is the team physician for the Southeast Missouri State University Redhawks, and works with the athletic trainers of the various college teams as well as high school athletes.

Dr. Bowen talks about the common phrase of “getting your bell rung,” and why that needs to go away.  People need to understand that concussions are serious.  Also, he mentions the ImPACT tests in use at the area high schools through Saint Francis Medical Center.

The Medical Minute is a series that Saint Francis Medical Center out of Cape Girardeau, MO produces for local television.

VIDEO

Futbol Concussions

Grant Wahl of Sports Illustrated posted an article about concussions in soccer.  Did you know that soccer only trails football and hockey in number of concussions reported?

Football may be attracting the most attention for head injuries in sports these days, but fútbol has also suffered a rash of concussions that have derailed the careers of prominent U.S. players. According to Dr. Robert Cantu, a concussions expert at the Boston University School of Medicine, soccer provides the third-highest number of his patients among professional athletes, behind only football and ice hockey. But unlike those sports, soccer has two big differences: Its players don’t wear helmets, and the pro and international games allow only three substitutions per match with no chance to return, putting pressure on teams to make hasty decisions to keep injured players on the field.
The MLS has formed a Concussion Program Committee and it has 12 members and a chairman.  One of the members on the committee is Taylor Twellman (remember him) and his experiences with post-concussion syndrome.  The committee has yet to have written policies, but is working hard to create some direction for soccer.  FIFA does not have a policy and either does the Champion Leagues of Europe.  This would be a great opportunity to set a policy for the world to follow.

Rugby Article

The Associated Press ran an article about rugby and how it compares with football in terms of concussions.

Rugby players are taught to never use their head in making the tackle, and without a helmet to protect them, the logic is pretty clear. Any player leading with the head is almost certain to get hurt as badly as the person he’s trying to hit.

The injury rate in rugby varies, however the most recent study suggests concussions account for 19% of all head injuries reported.

A study done by the B.C. Injury Research in Canada says rugby injuries come at almost three times the rate as those in football and soccer. But another study performed by the Eastern Suburbs Sports Medicine Centre in Sydney and the Australian Rugby Union found that while head injuries were most common in the collection of games they studied — adding up to 25 percent of all injuries — three–quarters of those injuries were lacerations, while only 19 percent were concussions.

Meanwhile, both sports struggle to keep accurate concussion statistics.

Finally, rugby may have more of a problem of players failing to report concussion symptoms.

Last season, the NFL mandated that any player who gets a concussion should not return to action on the same day if he shows certain signs or symptoms. The International Rugby Board has a rule that calls for players to take a three–week break after being diagnosed with a concussion.

That three-week break may make some competitors more reluctant to report head injuries.  Obviously there needs to be a balance, and playing without a helmet may not be the answer either.

AP Article via TMCnet.com (link not working for AP story).

Sleeping is Good

It used to be that doctors would tell you to keep people awake with head injuries.  That has changed, quite a bit.  Keeping someone awake might be indicated for a possible brain bleed, but concussions need the sleep and recovery time.

Sleeping is first. If you’re not sleeping, forget it,” said Cara Camiolo Reddy, the co-director of the UPMC Rehabilitation Institute brain program and the medical adviser to the Sports Medicine concussion program. Sleep is vital in the recovery process because the injured brain needs rest to begin to heal itself. The concussion program and Camiolo prescribe medications, however, only to post-concussion syndrome sufferers who are three weeks or longer into their injury.

This quote was from and article by Chuck Finder of Scrips Howard News Services and appeared on NewsChief.com today.

In the article you will find that this prescription is not widely accepted by the community that deals with concussion management.  However in my experience it is vital to let the brain rest.  When I am debriefing with the athlete and their parents, the most often question I get is “can you sleep too much?”.  My answer is no.  To make the parents feel better I have them arouse the concussed individual at infrequent rates to observe their arousal response.  I also have the parents ask the three words that we asked the person to remember right after the concussion episode.

With our experience at our school, the kids and parents that abided by the recommendations of sleep and complete brain rest have recovered at a much quicker rate.  The kids and parents that did not listen are still dealing with symptoms and have yet to be cleared.

I know that is not a research study in its most proper form, but the observational evidence tells us, and those in the above article that sleep is indeed needed.

57

The week 7 injury reports have been released (except for NYG and DAL, MNF).  And the total number of injuries listed as concussion, head, or migraines is 57 (with pre-season news reports).

Last

First Position Team Week
1 Curry Aaron LB SEA -1
2 Murphy Louis WR OAK -1
3 Sicko Scott TE DAL -1
4 Grant Ryan RB GB 0
5 Addai Joseph RB IND 0
6 Clayton Mark WR BAL 0
7 Ware DJ RB NYG 0
8 Bing Darnell LB HOU 0
9 Thomas Jay CB OAK 1
10 Ghee Brandon CB CIN 1
11 Lacey Jacob CB IND 1
12 Keiaho Freddy LB JAX 1
13 Sorensen Nick S CLE 1
14 Furrey Mike WR WAS 1
15 Ware DeMarcus DE DAL 2
16 Ryan Clifton DT STL 2
17 Bradley Stewart LB PHI 2
18 Hillenmyer Hunter LB CHI 2
19 Moore Matt QB CAR 2
20 Kolb Kevin QB PHI 2
21 Boss Kevin TE NYG 2
22 Martin Charly WR CAR 2
23 Gay Randall CB NO 3
24 Bryant Anthony DT WAS 3
25 Follett Zack LB DET 3
26 Davis Will LB ARI 3
27 Dahl Craig S STL 3
28 Moore Evan TE NYG 3
29 Witten Jason TE DAL 3
30 Mitchel Carlton WR CLE 3
31 Redding Corey DE BAL 4
32 Ryan Clifton DT STL 4
33 Trusnik Jason LB CLE 4
34 Manningham Mario WR NYG 4
35 Cooper Riley CB PHI 5
36 Samuel Asante CB PHI 5
37 Cutler Jay QB CHI 5
38 Martin Sherrod S CAR 5
39 Scheffler Tony TE DET 5
40 Shipley Jordan WR CIN 5
41 Gay Randall CB NO 6
42 Johnson Landon LB DET 6
43 Macintosh Rocky LB WAS 6
44 Bell Jacob OL STL 6
45 Rodgers Aaron QB GB 6
46 Thomas Demaryius WR DEN 6
47 Robinson Dunta CB ATL 7
48 Garrard David QB JAX 7
49 Cribbs Josh WR CLE 7
50 Massaquoi Mohamed WR CLE 7
51 Cooley Chris

TE

WAS 7
52 Ryan Clifton DT STL 7
53 Jackson DeSean WR PHI 7
54 Cooper Riley WR PHI 7
55 Edelman Julian WR NE 7
56 Brandon Myers TE OAK 7
57 Abdullah Husain S MIN 7

-1 = Training Camp, 0 = Preseason

Some notes; 90 regular season games and 49 listed head injuries…  .5444 concussions/game, or just over 1 concussion every 2 games…  8.167 concussions per week…  At current concussion/week rate there would be 139 concussions in the year…   The concussion rate for NFL players would be 8.2%…  That concussion rate is lower than all other levels of football…  Players listed multiple times were removed from the injury list for at least one week then reappeared (Clifton Ryan)…  Teams on byes do not have to list concussions (Detroit & Indy amongst others this week)…  Concussions by position; WR-13, DB-12, LB-10, TE-7, QB-5, RB-3, OL-1…  Top 3 teams with listed head injuries PHI-6, CLE-5, NYG-4…  Teams without concussions; BUF, KC, MIA, NYJ, PIT, SD, SF, TEN, TB…

All regular season injuries were posted at NFL.com on their Injury LINK

FEEL FREE TO COMMENT…

NHL Concussion Report 10/18

These players are listed as having a concussion or head injury.

  • Ondrej Pavelec, ATL
  • Marc Savard, BOS
  • Jason Pominville, BUF
  • Raitis Ivanas, CAL
  • Rene Bourque, CAL
  • Peter Mueller, COL
  • Jamie Benn, DAL
  • Johan Franzen, DET
  • Pierre-Marc Bouchard, MIN
  • Marcel Goc, NAS (upper body)
  • Matthew Lombardi, NAS (upper body)
  • Bryce Salvador, NJ
  • Ian Laperriere, PHI
  • Cam Janssen, STL
  • Keith Ballard, VAN

11 concussions last week, 9 still remain from last week, 6 new ones.  TOTAL = 17

Again the NHL has a problem with fully disclosing head injuries (well any injury), the Goc and Lombardi concussions are found via web search about the injuries.  C’mon NHL.

Xenith’s Building the Enlightened Warrior

Vin Ferrara is the CEO of Xenith and believes that he has found a way to make a football helmet that could revolutionize the game in terms of concussive episodes.  The X1 helmet is used by a very small number of professional players, because they are not provided by the NFL/team due to contracts with Riddell and other makers.

Mr. Ferrara is working hard on getting his product out, including great programs with lower level football, extending down to the high school level and earlier.  There is a purchasing program they have developed to get these helmets on heads as fast as possible.

I have yet to work with these helmets at my school, however I have convinced the administration and coaches to purchase some for our use.  It’s a tough task to eliminate the concussions, and we probably will not, but prevention is the best medicine, as well as being prepared.

Please click on the link to the left (Enlightened Warrior) to see what Mr. Ferrara has in mind and has put on paper.  Here is a quote:

BELIEVE IN PREVENTION
First and foremost, anyone involved in athletics should believe that prevention of neurological injury is of paramount importance. An undercurrent of “concussions are inevitable, we just have to manage them” permeates the sports world. Just because some concussions may still occur, this does not warrant an attitude of complete resignation towards preventing the injury. Prevention is possible. Prevention is critical.

I would also like to thank Mr. Ferrara for recognizing the importance of certified athletic trainers as well.

Quad City Times Concussion Series

 

Rock Island trainer Tim Mangold, left, and Dr. Thomas Von Gillern tend to the Rocks’ Chris Glover on Oct 8. Glover was shaken up on the play but did not sustain a concussion. (Louis Brems/Quad-City Times)

This is the second part to the concussion series being run by The Quad City Times and the prep section, written by Doug Green.  The first one was yesterday and focused on the injury itself.  Today’s story is about the athletic trainer and how they are at the front line of this issue.

 

As an athletic trainer I feel that our profession is not only capable but NEEDED at all levels of sports.  Either on-site for the games/practices or a phone call away.  A lot of educational time is devoted to head injuries for athletic trainers, and our continuing education requirements offer us the ability to continually learn in this area.  Sure, we are not MD’s/DO’s but our experience and rate of seeing these injuries make the athletic trainer somewhat of an “expert”.

As one doctor in the article states, deferring to the athletic trainer to know if the athlete is “right” is, in fact, a prudent and important step in returning athletes.

“I rely on the trainer to know what an athlete is normally like,” said Jessica Ellis, who is the team doctor for the Davenport school district and St. Ambrose University. “I have standardized tests with memory, cognition, balance checks.”

Read the rest of the story HERE.

Know what an athletic trainer is, HERE.

Harrison Not Remorseful

James Harrison is not showing remorse in a post game interview published by the Cleveland Plain Dealer.  I will let you read it and decide for yourself.  However here are some quotes from him;

“I thought Cribbs was asleep,” said Harrison, the 2008 NFL Defensive Player of the Year. “A hit like that geeks you up — it geeks everybody up — especially when you find out that the guy is not really hurt — he’s just sleeping. He’s knocked out, but he’s going to be OK. The other guy, I didn’t hit that hard, to be honest with you. When you get a guy on the ground, it’s a perfect tackle.”

Well James, you don’t just go to sleep playing football unless you sustain a brain injury.  Now Harrison speaks on the Massaquoi hit:

“If I get fined for that, it’s going to be a travesty,” Harrison said. “There’s no way I could be fined for that. It was a good, clean, legit hit. He came across, I put my head across the bow. I could have put a lot more into that hit than I did.”

I am going to say he will be fined 20 large or more.  And in the NFL, you do have to have the warrior mentality, but one should know that lowering the head to use the helmet as a weapon is not only dangerous to the other guy, buy yourself.

Cutler Coming Back

It is being reported the Jay Cutler, quarterback for the Chicago Bears, is cleared to return after his concussion on Monday Night Football against the Giants over 10 days ago.  However, they are now reporting that this is his 5th known concussion which leads us to a good point.

The old grading scale used to have limits to playing contact sports if you had sustained multiple concussions.  The thought process has changed, and no longer is a certain number a disqualification for the athlete.  Every person reacts differently to a concussion, therefore there is not an all encompassing number that would be “too many” for someone.

As long as the individual has FULLY recovered from the concussion and can pass the graded return to play criteria they would be allowed to play contact sports.  But, with each successive concussion it becomes harder to progress in a timely manner, as your brain has been compromised previously, it is now working harder to do the same work.  Once you have had a concussion you are more susceptible for another concussion.

What we need to understand and be aware for is the multiple concussions in the adolescent, in particular getting concussed before all brain function and symptoms have resolved.  It is of my professional opinion that if you have kids getting 3 or more concussions in a high school career, it is time to take a closer look at what they are doing.  And with each successive one it may be time to limit their actions, or make severe corrections in their actions.

 

Friday Night Lights (Week 6)

Had the morning off today and really was just sittn’ around thinking about things.  One topic that I had with myself was about the concussions I have seen at school.

I told a mother the other day that I did not believe that there were more concussions, just that they are now being reported more frequently.

Then I caught myself typing in the previous post about how I felt there are “more concussions than usual”.

During my 15 minute conversation with myself, while watching some Ryder Cup, I am firmly convinced that there are not more concussions than usual.  Last year at this time I had 4, and the previous year I had 3, this year is 6 at the beginning of October, so it looks like an increase…  BUT, at least two were spotted and reported to us by teammates, and another was one that I was highly suspicious of, due to knowing the personality of the individual.  So in reality we have a steady number as the past, if there was not heightened awareness from all involved.

That brings me to the point of the self conversation…  135,000 ER concussions reported in under 18-year-old individuals, I would venture to guess that there is 10x that total each year…  Which means we are missing roughly 1.2 million concussions, and there are 1.2 million kids struggling with post-concussion syndrome. Continue reading