Tuesday Quick Hits

We have been offering suggestions to the NHL on how to change the game for the past few weeks (see here and here), as you go through the searches more and more people are doing the same, especially up north.  The Globe and Mail with author David Shoalts proposed most of the same information we had;

  • Culture change (respect)
  • Equipments
  • Treatment
    • “The NHL should tap into the long list of reputable concussion experts willing to help and develop a sensible plan for treating concussions. Then it should get the National Hockey League Players’ Association to join it in strongly encouraging the players to follow it.”
  • Rule changes (see outlawing all head contact)
  • Game changes (see speed)
  • Fighting

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NHL Concussion Thoughts

Recently there has been a spike in awareness and number of concussions in the National Hockey League.  Last year we began compiling the injuries in our database to see where the sport stands (we also do NFL, NCAA football, and Aussie Rules Football).  When Sidney Crosby sustained his initial concussion in the Winter Classic last year it seemed that NHL has begun to take notice.

It was refreshing to see The Star of the NHL deal with the brain injury with some transparency, although he endured some criticism what Crosby did was set into motion the awareness of concussions.  Last season prior to the new year it was very difficult to find actual listed concussions; they were veiled in “upper body” or “undisclosed” listings.  In some cases the injury was improperly reported as a neck or shoulder injury; a sign that the concussion was either a) not understood (unlikely) or b) needed to be hidden.

Before you read on it is important to understand the position of the blog and this author about concussions.

Concussions, brain injuries, are an inherent part of collision sports.  There is very little in the way of equipment that can prevent concussions, the only way to impact a positive change (see decrease) is to address the culture and mechanics of sports.  This does not mean that professional sports should be outlawed, rather subtly changed to protect those that play, not only for the immediate time, but for the long-term health of the athletes.  With this; Continue reading

School Getting Smart

From the Globe and Mail (Canada), St. Micheal’s College School has developed a return to school program from concussions.  As we know return to the classroom and the school environment can be just as harmful as rushing back to sports.

“There’s a lot of focus on the return to play but not on the return to the classroom, where the kids can have a number of difficulties due to their brain injury,” said Corinne Kagan, a program director at the Ontario Neurotrauma Foundation.

The classroom demands that students listen, learn and think, all of which involve brainwork. Some of the symptoms of a concussion, such as headaches, dizziness and trouble concentrating, can make this even more difficult.

What St. Michael’s has developed, Ms. Kagan said, is “a very good thing.”

I have been promoting this from the beginning here on the blog.  In fact the school I work with adopted a policy that deals with this exact thing.  I believe it to be the first of its kind in Illinois.  Simply we educate the athlete and parents about the injury and proper management; with that the school is suggesting and allowing students to be excused for up to three days before seeing a doctor.  Upon return the student will work with the guidance counselor, teachers and myself for a simple graded return to classroom activity.  Since each person is different in recovery there is nothing set in stone for academics.  We do have an understanding that if the student misses quizzes/tests they will not make up more than one a day until full recovery.  Homework is often allowed to be turned in on a “graded return”, and classroom performance is monitored by the teacher.

This is not required of the student or parents, rather a recommendation and not every kid that gets a concussion follows our guidelines.  However my limited sample size shows some serious results (based on concussions from January 2010 to present): Continue reading

The Media and Concussions

After being ignored for far too long, concussions and brain injury seem to have been rightfully recognized as the most important issue in contact sports. However, even the medical community is quick to note the dearth of good information about brain injuries. After my cycling accident and subsequent coma almost 8 years ago, the information my family was given had them constantly bracing for the worst. My mom tells me that when she was a kid and she’d ask her dad a question, the answer would invariably be, “Look it up.” That explains her career choice (librarian) and her never-ending search for more information. Yet, even she had a very difficult time finding information that would give her solace or at least an idea of what problems her son would face. Even though my brain injury was more acute and severe than a concussion, both are brain injuries. I think that an extremely important point about concussions is being lost in the extra-subjective and passionate world of pro sports.

It’s fortunate the newspapers like the Globe and Mail and the New York Times were quickly on the issue as it came to the fore in their health and sports sections. As would be expected, the Globe and Mail centres most of their attention on hockey, while the New York Times focuses primarily on football. They’ve obviously done an outstanding job of bringing the brain injury issue forward. An issue will not become important to the public by starting with explanations and definitions, but once an issue goes from afterthought Continue reading

What To Feed A Concussion

During a concussion not only is the brain experiencing a cascade of events causing the injury, but also a metabolic crisis.  Not only does blood flow become compromised but the influx of calcium and quick “ejection” of potassium makes the blood energy system chaotic.  There has always been the question; can we “feed” the injury to help with this issues occurring?  Previous research has mentioned the use of Omega-3’s, DHA, and EPA to help with inflammation.  We have even had a commenter suggest the use of creatine to help with (see comment section of the previous link), and because I had not really done research, other than his post, I was unsure.  Perhaps we are now becoming less unsure of creatine and the role nutrition plays with management of concussions.

The Globe and Mail (fast becoming a go-to source) and Ann Mehler Paperny published a story about another US Military research project, this time dealing with “feeding a concussion”;

A team of U.S. scientists has found that food can play a vital role in mitigating the damage done by traumatic brain injury – and that a speedy supply of specific nutrients can give hurting brain cells the energy and chemical cues they need to heal while preventing inflammation.

Of all the specific examples that were given in the article; creatine, protein, resveratrol (red grapes) and curcumin (turmeric), research into prophylactic use of them has yet to be studied.  What was known is that use of these nutrients very soon after Continue reading