Friday, December 11, 2009

Sarcasm is the sincerest form of flattery?

I suppose I could post something every day, as there are now 10+ concussion headlines daily.

However, you know that mainstream America has adopted a concept when it receives attention in The Onion:
NEW YORK—NFL commissioner Roger Goodell announced a stricter league concussion policy at a press conference Sunday, finalizing a provision that would automatically charge a fine of $10,000 to any player who suffers a concussion. "Concussions have become a serious problem in the lives of current and former NFL players, and the only way to nip this thing in the bud is to make the players accountable," Goodell said. "Ten thousand dollars for the first concussion, $30,000 for the second, and $70,000 for the third. Hopefully these fines will make our players think twice before they have their brains jostled against the insides of their skulls." Goodell later added that the league is also considering harsher punishments for more serious injury-related behavior, saying that players who sever their spinal cords would face indefinite suspension and, in most cases, be stripped of their pensions.

Tuesday, December 1, 2009

And the lawsuits begin?

.Interesting tidings in the NFL, with the resignation of Drs. Casson and Viano as co-chairs on the mild TBI committee. Now, teams will now be required to seek advice from "independent neurologists" (identified by the teams?) prior to approving a player to return after a concussion.

Interestingly, not all players are buying into the recent education and focus on concussion... while the Steelers have been pioneers in the effort to understand and manage concussions, some of their players are less convinced:
I can see some players or some teammates kind of questioning like, 'Well, it's just a concussion. I've played with concussions before. I would go out there and play.' So, it's almost like a 50-50 toss-up in the locker room (Hines Ward)

"We would have liked for him to play. If he had the opportunity, he should have played for us, but he didn't. And we didn't get the job done."(Santonio Holmes)
Perhaps the NFL is anticipating the long-term financial effects of litigation that may be coming down the pike?

Case-in-point: LaSalle University settled a lawsuit for $7.5 million to provide long-term support for a football player who sustained a 2nd catastrophic concussion in the absence of a proper concussion management program. LaSalle had since cancelled its football program...

Monday, October 26, 2009

"tough" even in dementia

In advance of a congressional hearing on the impact of football on the brain, the NFL has backed off of claims that the dementia findings in retired NFL players are unreliable.

In a new round of "he-said/she-said" the NFL is pointing at the Union, who is pointing at... well, it is not clear:
But the outside data on which he primarily based this conclusion was not only mishandled — the wrong numbers were taken from one published study, grossly overstating worldwide dementia rates — but the analysis also included several faulty assumptions, experts said in later interviews. Correcting for these errors indicated rates of dementia among N.F.L. retirees about four to five times the expected rate.

“This was a preliminary effort at the request of the union to understand the facts,” said Ell, adding that he was acting as a lawyer for the union. “I understand now that it was flawed. I believe the union wants the true facts to come out and welcomes inquiries into this area.”

Meanwhile, the now-demented ex-football players are sticking to the "tough guy" creed.
Rayfield Wright's caregiver, Jeannette DeVader, said that Wright had all the signs of early-onset dementia — including short-term memory loss and frequently getting lost — but that he would not see a neurologist, let alone apply to the 88 Plan. Wright confirmed that he did not want what he called the stigma: “Players don’t want to look at themselves that way. The truth is, you really don’t want to know.”

The wife of one player experiencing early-onset dementia, who asked not to be identified, said she would not apply for the 88 Plan while her husband was coherent enough to understand it.

“He would be devastated,” she said. “They were so proud as players. They’re not going to admit any weakness now, and I’m not going to break his heart by doing it for him.”

I didn't anticipate minimization of symptoms this late in the game...

Thursday, October 22, 2009

the perils of youth...

A number of years ago, I became involved in an ongoing research project with a colleague (pardon the shameless plug) looking at the effects of concussion on youth athletes. We found evidence of long-term effects of concussion on cognitive functioning in small sample, and then validated and extended these effects in a much larger sample. Essentially, we concluded:
seem to be subtle yet significant prolonged neuropsychological effects in youth athletes with a history of two or more previous concussions.

Cut to 2009, and a recent case reported in today's NY Times reveals that the long-term effects of concussions on the brains of professional athletes extends to the brains of high school and college athletes who never played professionally.
“I’ve looked at more than 1,000 brains, and I’ve never seen this in any individual living a normal life — it’s only through head trauma,” said Dr. Ann McKee, an associate professor of neurology and pathology at the Boston University School of Medicine and co-director of its Center for the Study of Traumatic Encephalopathy. “The fact that we are seeing this disease, and it had a devastating effect on their lives, now in a 42-year-old who never played in the N.F.L. indicates that it’s a more pervasive problem than we recognize. What are we doing with our kids? Are we doing enough to protect against their developing this awful condition?”

Wednesday, September 30, 2009

Long Term Effects

A new study "commissioned by the NFL" found that Alzheimer’s or other similar memory-related diseases occur at a greater rate in NFL players than the general public:
...have been diagnosed in the league’s former players vastly more often than in the national population — including a rate of 19 times the normal rate for men ages 30 through 49.

While this is a good first step for the NFL to recognize the relationship between repetitive concussions and long-term changes in the brain, they are not quite ready to accept these findings:
An N.F.L. spokesman, Greg Aiello, said in an e-mail message that the study did not formally diagnose dementia, that it was subject to shortcomings of telephone surveys and that “there are thousands of retired players who do not have memory problems.”

“Memory disorders affect many people who never played football or other sports,” Mr. Aiello said. “We are trying to understand it as it relates to our retired players.”

So, if I understand Aiello's logic: there are many people who get in car accidents and do not have head injuries, and there are many people who have head injuries from activities other than car accidents... therefore, car accidents and head injuries may not be related?

I hope this relationship gets cleared up before we start seeing Collegiate athletes experiencing brain changes as well. Anyone who saw Florida QB Tim Tebow sustain a concussion and then vomit on the sidelines has to wonder when the NFL and NCAA will realize that these severe concussions will have a cumulative effect. Fortunately, it appears that he is receiving proper treatment, including:
...daily testing and we continue to monitor the resolution of his symptoms.... "I talked to him for a minute," (Coach) Meyer said. "This isn't like a turf toe or a shoulder, this is a concussion."... According to Meyer, Tebow is not allowed to read or watch television "until later in the week -- maybe Thursday."

Monday, August 17, 2009

Concussions in Baseball

One does not typically think of baseball as an at-risk sport, save for the occasional collision in the outfield or on the base path. However, there has been significant attention in USA Today, the NY Times, The Washington Post, ESPN News, and online news providers, (both recent and older articles) regarding concussions in baseball:
David Wright is hit in the head by a pitch (ESPN video)

Hikiro Kuroda is hit by a line drive in the head (NBC article, YouTube video)

Scott Rolen is hit in the head by a pitch (Tornoto Star article)

(from 2005) Carlos Beltran and Mike Cameron collide in the outfield (NY Mets article with video link)

Interestingly, there is a new batting helmet designed to prevent concussions in baseball (NY Times Article), but players do not necessarily like the look/feel:
“No, I am absolutely not wearing that,” Mets right fielder Jeff Francoeur said with a laugh after seeing a prototype, as if he were being asked to put a pumpkin on his head. “I could care less what they say, I’m not wearing it. There’s got to be a way to have a more protective helmet without all that padding. It’s brutal. We’re going to look like a bunch of clowns out there.”

Before making any judgments, it's not like we all wear crash helmets when we drive...

Back from another hiatus...

Not sure why I take such long breaks at times, but I am back from my self-imposed break. I do not get many e-mails about this blog, but do occasionally receive suggestions for posts.

Recent comments pointed to a YouTube clip on the use of mouthguards to prevent concussions, as well as recognition of the benefits of mouthguards at the recent Concussion Summit meeting.

With respect to that recent meeting, the 3rd Consensus Statement on Concussion in Sports was published, with the disclaimer (I paraphrase):
Readers are encouraged to copy and distribute freely the Zurich Consensus Statement… (it) is not subject to any copyright restriction. The authors request, however, that the Zurich Consensus Statement be distributed in full and complete format.

So, I provide a link to the pdf file of the 3rd Consensus Statement.

Wednesday, February 25, 2009

Concussions in the NBA

Interesting article out of Sacramento today about an increase in concussions in the NBA. They even interviewed David Hovda:
When I hear that a player has had four of them or five or six, I honestly always double that number. They have usually also had some before or in practice or in pickup games.

In an odd twist, they make several references in the article to mouthpieces, but nothing by way of substance:
He doesn't always actually wear the mouthpiece.

Unlike football, though, there are no potential equipment advances or rule changes to help counter head injuries in basketball. There are mouthpieces to act as something of a shock absorber and advice to be careful. That's about it.

No changes. No concerns about what four concussions could mean in the future. Just a mouthpiece.

Hopefully, Gerard Wallace, quoted in the article as having sustained multiple concussions, won't end up with CTE...
"I just want to sit on the porch, watch my kids play sports, grow old, fat, gray-headed, big-bellied... however you want to call it. It's one of those things that I never worry about. You can never worry about that."

Monday, January 26, 2009

News Flash: Wrestling is Dangerous (and fake)

(disclaimer: I am not a wrestling fan. Really, I am not!) In what can be referred to as an "interesting twist" or "ironic outcome," WWE CEO Vince McMahon sustained a concussion during a stunt:
Some thought Orton made a mistake when he really kicked McMahon. But he didn't, in fact both Vince and Stephanie were happy with the way in turned out. We all know it is storyline, so Vince knew it was coming.

In fact, Vince asked for the kick to the head by Orton. That is right, Vince came up with the idea. See for a long time now, Vince has said he wants wrestling to be more realistic.


Not much detail about the actual concussion, but I thought it was a worthy topic to break my hiatus, especially in light of the fact that the WWE now requires baseline assessments for all wrestlers:
...all WWE talent undergo tests of brain function, including memory, processing speed, and reaction time. An initial analysis is conducted for new WWE talent to gather baseline results before they participate in any in-ring activity for WWE, and then thereafter as circumstances warrant if head trauma is suspected.