Will Carroll

“League of Denial” (Part 2)

Dustin Fink9 Comments

Coming to a bookstore and TV near you today is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

I was reminded quickly, yesterday via Twitter, that I may lack valuable perspective when it comes to concussion information (and that I am not normal – this is not breaking news).  Will Carroll of Bleacher Report let me know that this information will be new to a lot of people out there.  He is exactly right, not only that, this documentary will be easily digestible for the fan of football.  For any person just wading into this, when you tune into PBS tonight to view “League of Denial” you will be absolutely hooked from the start.

The sounds of the crowd, visuals of big hits grab your football part of the brain IMMEDIATELY, over those sounds you will quickly discover the problem NFL players have faced with brain injuries playing their sport.  Harry Carson saying “and then they are gone” when talking about former players.  A bold statement that the level of denial was “just profound.”  An NFL lawyer saying “we strongly deny those allegations that we withheld information or misled the players.”  And more video and sound of punishing hits that used to fill the highlight reel bring the opening curtain of this very important documentary.

This problem is real – it’s not just real for the professionals – and from the get go Frontline makes you understand, vividly and personally, why this is.  After listening to old radio calls of the Steel Curtain it all begins with the story of Mike Webster and the forensic pathologist who studied his brain, Bennet Omalu.

The discovery of a possible reason one of the most respected and lauded players in Pittsburgh sports pantheon fell from grace and eventually found and early demise.  If the football portion of your brain does not connect to what is being presented then I would haphazardly guess that you are not ingrained within the fabric of football.

As Harry Carson explains how the game was played and to some extent how it’s still played you can begin to understand the issue at hand.  This is hammered home when Robert Stern, PhD tells the audience blows to the brain are at forces 20 times greater than the force of gravity (20 G’s); or as he so eloquently put it “driving into a brick wall at 35mph”, 1,000 times or more in a season.

In the first 11 minutes of this 2 hour presentation you are at full attention and want to understand the “whats”, “whys” and “whos”.  If you are not engaged and ready for further explanation I can only say that you don’t care or want to bury your head in the sand.

Contributions in the film include Continue reading →

More Helmet News: Oversized Helmet?

Dustin Fink1 Comment

Will Carroll (@injuryexpert) pointed out an article this morning from the Miami Herald regarding Dolphins running back Daniel Thomas;

Thomas said he passed the NFL-mandated cognitive tests Monday, and will now practice and play with an oversized helmet designed to minimize trauma to the brain.

I immediately thought to some of the many emails I receive regarding concussions, it was from ProCap; the soft shield placed on the outside of the helmet to reduce linear forces.  It has been re-branded and changed a bit to conform to the newer helmets (as you can see in the picture above).

This is no different from the CRT Technology that was in the previous Harrison post; it possibly will reduce the linear forces, but again how does it affect the acceleration/deceleration/rotation of the head which in turn effectively “moves/sloshes” the brain around inside the skull.

Without seeing what Thomas will be wearing this is our best guess, we will be interested to see any photos of what he is donning.

Monday Quick Hits

Dustin Fink1 Comment

Some interesting notes, not from this past Sunday, rather the week prior as two stories caught our eye.  The first is dealing with Houston Texan quarterback Matt Schaub and the handling of his injury evaluation after he got hit in Denver;

The Houston Texans were questioned by the league about the team’s handling of quarterback Matt Schaub’s return to action after one play in last week’s win over the Denver Broncos after he suffered a jarring blindside hit by linebacker Joe Mays, sources said.[…]

The recommendation from the league’s Head, Neck and Spine Committee is that a player involved in a significant collision should be removed from the field so the doctor can utilize the NFL Sideline Concussion Tool, which has six basic cognitive tests, all of which must be passed by the player. On average, a medical source said, the test takes about eight to 10 minutes to administer.

As I was watching the game I wondered out loud how he was not being evaluated for a concussion.  The blow was to his head and he grabbed his head and writhed in pain on the field.  The sideline assessment can take as short as four minutes but usually is longer as they take the player back in the tunnel or locker room for assessment.  Last Monday Will Carroll asked what I thought and I told him that I was very concerned that nothing was done, especially with how vigilant the league is trying to be.

With the conversation with Will I also theorized why, Continue reading →

Fink on the Nickel

Dustin Fink1 Comment

Will Carroll is not only a talented writer, for Sports Illustrated, he also has is very own podcast.  It is a unique show as it melds sports and technology – one of the few podcasts I catch when they come out.  Will took the time to interview me about two weeks ago about the concussion issue in the NFL, and although it was only about 15 minutes in length we could have talked for hours.

In this episode, titled “Big Dog” Will discusses the NFL, MLB and concussions; my interview can be found at the 47 minute mark.

Comments About Wagner/Deadspin Article

Dustin FinkLeave a comment

The comments on this blog have been on point but I was able to find some other very informed comments regarding the information provided in the Deadspin article via Football Outsiders;

by MJK :: Thu, 06/21/2012 – 6:46pm

Interesting article, but there’s some things in it that are decidedly wrong, and others that are completely ridiculous. The idea that increasing intracranial pressure through trapped blood accumulation could somehow “cushion” the brain and reduce the impact force of the brain as it “sloshes” in side the skull was obviously dreamed up by someone that has no grounding in biomechanics whatsoever. First, many head “mild” injuries (the ones that don’t involve skull fracture or haematoma) occur because of rotation of the head, not linear impacts, and suppressing brain motion relative to the skull won’t do a thing to help that. Secondly, CSF is essentially water from a physical response standpoint–and if you have an object floating in water, increasing the pressure in the water doesn’t do a single thing cushion the object floating in it.

The other major issue that I can see is, based on the doctors and biologists I’ve talked to, the accumulation of tau protein associated with CTE can take a minimum of many months, and more generally several years, to occur after the head traumas that triggered it. Also, apparently once you hit a critical threshold level of tau buildup, it becomes self propagating, even if you don’t have any additional head trauma. So monitoring the increase in tau protein wouldn’t be a good way to decide when to hang up the cleats…you could quit when you were still at a “healthy” level, it could take a couple of years to accumulate more, hit the threshold, and you could still end up with early onset of dementia or other lasting brain injury.

The article also touches briefly on, but glosses over, an alternative diagnosis technique that does show promise…diffusion tensor imagine MRI. Although poorly understood, there’s some really promising research about using it to track the biomechanical insults that could lead to long term tau protein buildup.

==========

by akn :: Thu, 06/21/2012 – 7:25pm

This entire article sounds like the author took the researchers’ grant proposal and Continue reading →

CTE Insight from the Bostonia: but take time to remember the real pioneer

Dustin Fink12 Comments

Shortly before this blog began in September of 2010 there was a brilliant article written in Bostonia regarding the work that Boston University was doing.  This article did not fall into my lap until yesterday during the Junior Seau reporting, it was found tweeted out by none other than Will Carroll, @injuryexpert.

We have come to understand a bit more about chronic traumatic encephalopathy (CTE) though the work of those in Boston.  It would be an absolute shame to not mention the person who first found this brain issue, Dr. Bennet Omalu.  Dr. Omalu found it but then was unceremoniously Continue reading →

Will Carroll’s Med Check

Dustin Fink7 Comments

If you don’t follow Will you really should.  He runs a weekly Med Check on injuries in the NFL, he often utilizes this blog for information regarding concussions.  Will has been all over the concussion issue, not just recently, rather for as long as I have known him.  I appreciate his dedication to sports medicine, athletic trainers (even though his publications say “trainer” he knows and represents the differences), and injuries in general.

In his most recent Med Check he opened up with some very poignant information and editorial;

Mike Florio of NBC has offered both reasonable coverage and interesting suggestions, but inside the game, there’s been quite a bit of pushback. Instead of using their bully pulpit to rally for change to how we treat injuries, ex-players like Merrill Hoge and Mike Golic are against any changes. They go to “back in my day” stories, calling players that come out of games “quitters.” That Hoge, a player who had his career ended early due to concussions, takes this position is amazing. Hoge was cleared to play just five days after a severe concussion and when he suffered another, he ended up being resuscitated Continue reading →

The Need for Indpendent Evaluators on NFL Sidelines

Dustin Fink1 Comment

We have discussed the NFL policy on concussions from preseason until last week when we discussed the apparent “dirt in the eye” issue that Vick dealt with.  We have even delved into some of the concerns and issues that face team medical staff’s when dealing with injuries, especially with high-profile athletes;

This has been a major issue in all professional sports; who pulls the most weight?  The athlete, coach, agent, owner or medical staff.  I would like to think that the organization would hire very competent medical staff’s (except some “team doctors” actually pay for the privilege), that would make decisions based upon safety.  I do know the AT’s do get a check from the organization so if they are hired by the club then shouldn’t they be listened to?  I mean, coaches are hired to make play calls and players are hired to run said plays, do the organizations meddle in their business (see Jerry Jones).  I would expect that teams would allow the AT’s and doctors to do what is right, and with that hope that the medical teams forgo score/importance and be proactive.

There was a specific line in the most recent NFL memo that sparked the above comment from me; “the NFL is telling medical staffs that they have the authority Continue reading →

Bill Simpson Enters Football Helmet Race

Dustin Fink10 Comments

As we learn more about the concussion issue there are people trying their hardest to provide as much protection as possible for those that play the game.  From new assessment techniques to proper rehabilitation of the injury there is a myriad of different ways we can help out.  The most important is erasing the stigma and educating all those involved in sports, particularly football.

Right now (and for the discernible future) there is no equipment, including helmets, that can protect/attenuate/prevent concussions, it is just a physics impossibility.  However technology has come a long way in reducing the force transmitted to the head via helmets, with Riddell, Schutt and Xenith being the main focus and Rawlings a recent entry.  There have been a lot of people looking at auto racing helmets for their ability to disperse forces, but there is a problem with them. Continue reading →

Pioneer Moving On

Dustin Fink2 Comments

There is one person in the media that can be classified as the pioneer of “concussion coverage”, his name is Alan Schwarz.  Since roughly the mid-2000’s Schwarz has been on the beat of national stories involving concussions.  He was recently nominated for a Pulitzer for his work in the area and now he has moved on.  According to Irv Muchnick, Schwarz’s title has changed to “national education reporter.”

I echo the sentiments of Muchnick; Schwarz opened up the national dialogue on concussions, he is one of the main reasons people have begun to pay attention.  Just think without him and the New York Times we may have never heard about Chris Nowinski, Bennet Omalu, the Boston University Brain Bank, etc.  No matter where anyone stands on the current protocols/research/assessment for concussions, A LOT of this discussion should be attributed to Alan Schwarz.

To be honest it was a huge “bucket list” goal that I was quoted in a Schwarz article Continue reading →