Have To Keep Educating & Holding People Accountable

The education of concussions is great, the legislation is in the right place but there is absolutely no accountability for instances where athletes are “failed”.  Before I go on, I am not perfect, I have and will continue to miss some things here and there (I missed an ACL in football which bothers me).  In fact, looking at the pressure I put on myself and hoping the world puts on my chosen profession of athletic training it may be a bumpy road.  However, missing obvious problems of health and welfare of athletes when one is an athletic trainer is inexcusable.  I implore anyone out there that feels I have missed something to call my ass to the carpet as well.

This brings me to something that I found in my inbox recently and it made me sick and should be handled.  This particular incident occurred in a state that has similar mechanisms for concussions as here in Illinois.  To create the back story on the “mechanisms” in play you should understand the state legislation and high school association concussion education;

  • Players, parents and coaches all have been given information regarding concussions
  • Officials have been given authority to remove player for concussion signs or suspicion including mechanism of injury (MOI)
  • Once removed they cannot return unless cleared by approved medical professional (IL is ATC, MD, or DO only)

With that information here is the email from a fellow athletic trainer – emphasis added is mine – (obviously stripped of identifying information);

Still have a long road ahead of education.

I was at a basketball game Friday night as a spectator and watched a player bounce [their] head off the floor.  Opponent had set a screen and athlete ran right into [defender], bounced off and landed on floor bouncing head off the floor.  The player then rolled around on the floor grabbing head and could tell [athlete] was in pain.  Time was called by the officials to attend to the player.   MOI would strongly Continue reading

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Research

A diagram of the forces on the brain in concussion
Image via Wikipedia

This JAMA article is from 2003, but it does well to expose what we are currently seen with the concussion.  It is good to note that this study was with college aged individuals with a developed brain.  This study did not deal with the developing brain of adolescents.

Conclusions  Collegiate football players may require several days for recovery of symptoms, cognitive dysfunction, and postural instability after concussion. Further research is required to determine factors that predict variability in recovery time after concussion. Standardized measurement of postconcussive symptoms, cognitive functioning, and postural stability may enhance clinical management of athletes recovering from concussion.

Philadelphia Eagles Medical Staff Under Fire

The Eagles’ team doctors and medical staff was cleared of wrong-doing when dealing with on the field concussions.  NFLPA Medical Director Dr. Thom Mayer determined that the medical staff followed proper procedures.  The return-to-play guidelines for the NFL are not un-similar to general guidelines for all athletes.

The issue arose when Stewart Bradley took a hit and struggled to get to his feet, and when he did, he did his best interpretation of a “punch-drunk” boxer.  That was an OBVIOUS sign of a mTBI/Concussion and should have been disqualified from further activity.  However, the medical staff did not see any of this as they were tending to a previous head injury sustained by Kevin Kolb.  Both players returned to play in the 2nd quarter and did not play again after the half.

According to the linked article, courtesy of ESPN and Sal Paolantonio, both players regressed in their initial on the field evaluation during half time, and were sidelined.

Andy Reid, the Eagles head coach, was also supportive of the initial decision for them to return-to-play.  Now the team will not practice either player until Friday at the earliest and continue to monitor their injuries.

As one can see there are issues with the RTP of concussions, at all levels.  But more importantly we can see that the injury known as a concussion is very different in presentation and resolving.  The great thing is that more and more people are aware, the next step is getting a policy in place that everyone can agree on.