‘Don’t Tell Coach’: Playing Through Concussions

By Jan Hoffman
The New York Times - Well
Originally published November 5, 2013

Here is an excerpt:

An extensive report about sports-related concussions in young people, released last week by the Institute of Medicine and the National Research Council, made recommendations that included bolstering research, collecting data, examining injury protocols and educating the public. But the report identified one particularly stubborn challenge: the “culture of resistance” among high school and college athletes, who may be inclined to shrug off the invisible injuries and return immediately to the field.

“There is still a culture among athletes,” the report said, “that resists both the self-reporting of concussions and compliance with appropriate concussion management plans.”

The entire story is here.

Researchers Press for Broad Ban on Hockey Fights

By JEFF Z. KLEIN
The New York Times
Published: October 9, 2013

Researchers at a Mayo Clinic conference on concussions in hockey called Wednesday for a ban on fighting at all levels of the sport, eight days after a Montreal Canadiens enforcer was hospitalized because of a fight on opening night of the N.H.L. season.

“Science has responded to the game on the ice,” said Ken Dryden, a Hall of Fame Canadiens goalie and a member of the Canadian Parliament, who spoke at the conference. “Now it’s time for the game to respond to the science.”

The entire story is here.

Concussion Study Makes Case for Reducing Contact Drills for Youth Players

By KEN BELSON
The New York Times
Published: July 25, 2013

Youth football players are not more vulnerable to head hits in games if they take part in fewer contact drills during practices, a new study published in the Annals of Biomedical Engineering showed.

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The study’s conclusion — that the amount of practice does not influence the number of head hits absorbed during games — may bolster calls to reduce the frequency of contact drills in youth football leagues. N.F.L., college and high school teams have already scaled back the number of contact drills in practices.

The entire story is here.

New Guidelines Raise Safety Bar on Concussions

By Alan Mozes
Medicinenet.com
Originally published March 18, 2013

Any athlete who suffers a suspected concussion should be withdrawn from play and stay on the sidelines until a qualified health care professional determines that all symptoms have subsided and it is safe to return to the field, new guidelines state.

Issued by the American Academy of Neurology, the latest recommendations aim to keep young athletes as safe as possible.

"With the older guidelines, we were trying to rate concussions at the time of the injury and predict recovery times, but now we know, 'When in doubt, sit 'em out,'" said guideline co-author Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery with the David Geffen School of Medicine at the University of California, Los Angeles, and Mattel Children's Hospital.

"The point is that no single quick test is really a litmus test for a concussion," he said. "We know now that we need to make sure a player has had a thorough and proper evaluation, involving a symptoms checklist, a standardized assessment and balance and cognitive testing, before being returned to play. This evaluation has to be done on a case-by-case basis, so each person goes through an individualized recovery process."

The entire story is here.

The entire journal article in Neurology is here.

Is college football doing enough about head injuries to protect players?

By Jon Solomon | jsolomon@al.com
on January 03, 2013
Alabama.com

Some chilling images of head injuries loom over this college football season.

There was the huge hit USC wide receiver Robert Woods took against Utah while blocking for a teammate. Woods got up, staggered around and fell to the ground. He was checked on the sideline and returned after missing one play.

There were two hits to the head Arizona quarterback Matt Scott received on one play against USC. He vomited on the field as the television announcers almost pleaded for Scott to be taken out. Scott stayed in the game to throw the winning touchdown.

There was the hit Connecticut quarterback Chandler Whitmer sustained against Cincinnati that he would later describe as a "bullet to the head." Whitmer, who had suffered a concussion the previous week, missed one play. He soon took another hit, needed help getting to the Connecticut sideline, and this time his day was over.

As college football reaches its national championship game Monday night, a question is being asked publicly with more frequency: Is college football doing enough to keep players safe?

The entire article is here.

Report Urges ‘Cultural Shift’ as Hockey Coaches Defy Concussion Specialists

By JEFF Z. KLEIN
The New York Times
Originally Published: November 30, 2012

Despite several years of intensive research, coverage and discussion about the dangers of concussions, the idea of playing through head injuries is so deeply rooted in hockey culture that two university teams kept concussed players on the ice even though they were taking part in a major concussion study.

The study, which was published Friday in a series of articles in the journal Neurosurgical Focus, was conducted during the 2011-12 hockey season by researchers from the University of Western Ontario, the University of Montreal, Harvard and other institutions.

“This culture is entrenched at all levels of hockey, from peewee to university,” said Dr. Paul S. Echlin, a concussion specialist and researcher in Burlington, Ontario, and the lead author of the study. “Concussion is a significant public health issue that requires a generational shift. As with smoking or seat belts, it doesn’t just happen overnight — it takes a massive effort and collective movement.”

The study is believed to be among the most comprehensive analyses of concussions in hockey, which has a rate of head trauma approaching that of football. Researchers followed two Canadian university teams — a men’s team and a women’s team — and scanned every player’s brain before and after the season. Players who sustained head injuries also received scans at three intervals after the injuries, with researchers using advanced magnetic resonance imaging techniques.

The entire article is here.

Safety in Youth Sports Act becomes Law in Pennsylvania

PPA Press Release
Originally released 11/14/2011

Governor Corbett signed the Safety in Youth Sports Act today in a ceremony at Lower Dauphin High School, Dauphin County. The state General Assembly passed it on November 1. The legislation is Senate Bill 200, introduced by Sen. Patrick M. Browne (R-Lehigh). It was shepherded through the House by Rep. Timothy P. Briggs (D-Montgomery), who had introduced the companion bill, House Bill 200.

This bill established standards for managing concussions to student athletes. In order to return to play the athlete must be cleared by a licensed psychologist trained in neuropsychology, by a physician who is trained in the evaluation and management of concussions, or by certain other health care providers under the supervision of the physician. The Pennsylvania Psychological Association's advocacy was instrumental in this bill's passage. The association's past president, Dr. Mark Hogue stated, "This new law will be extremely important to any athlete who suffers a concussion. Athletes who return to play prematurely are at risk of a second concussion, which can be life-threatening." Dr. Hogue is a clinical and sport psychologist from Erie.

The bill will require the state Departments of Health and Education to develop and post on their websites information on the nature of concussions in athletic activities and the risks associated with continuing to play or practice after a concussion. Student-athletes and their parents or guardians must sign an acknowledgment of receipt of an information sheet on concussions prior to participation in athletics. It will require coaches to complete a concussion management certification training course before coaching any athletic activity. During an athletic contest coaches will be required to remove athletes from competition if they exhibit signs of a concussion.

The legislation will become effective on July 1, 2012, in time for the next school year. It does not pertain to private schools, but only to public schools. It covers interscholastic athletics as well as other sports associated with a school entity, and includes cheerleading, practices, and scrimmages.

In N.H.L., Disclosure of Concussions Is Lagging

By Jeff Z. Klein

The New York Times

Hockey

Concussions continued to cast a long shadow over the N.H.L. on Thursday.

The Rangers said there was no update on the condition of defenseman Marc Staal, who has not played this season and is still recovering from a concussion sustained in February that the club did not disclose until September.

Pittsburgh’s Sidney Crosby, who has been sidelined by a concussion since early January, was cleared for contact a month ago and has practiced all week, including Wednesday, when he took several hard hits. Despite speculation that he would return for Friday’s home game against the Dallas Stars, Coach Dan Bylsma said Crosby would not play in either of the team’s games this weekend. That leaves Tuesday’s game against the Colorado Avalanche as the earliest possible return date for Crosby.

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The N.H.L. has earned praise this season for taking measures to reduce concussions, including introducing stronger rules against boarding and checks to the head, and strictly enforcing those rules through fines and suspensions. But questions persist about a league policy that allows teams to be vague about disclosure of injuries, and a recent incident suggested that in-game concussion protocols might be inconsistently applied.

The entire story can be read here.

Concussions on the Rise for Young Athletes

By Denise Mann

WebMD Health News

There was about a 60% increase in the estimated number of concussions and other traumatic brain injuries (TBI) seen among young athletes during the past decade, according to the CDC.

In 2001, there were an estimated 153,375 traumatic brain injuries among people from birth to age 19. This number rose to 248,418 in 2009.

Many of these injuries occurred among bicyclers, football players, and children in playgrounds. Basketball and soccer players are also at risk for TBI, according to a new report in the CDC's Morbidity and Mortality Weekly Report.

Exactly why we are seeing this uptick is not known, but "I believe this is, at least, in part due to increased awareness," says study researcher Julie Gilchrist, MD. She is a pediatrician with the CDC's Division of Unintentional Injury Prevention in the National Center for Injury Prevention and Control in Atlanta.

"We are hoping that awareness has gotten up to the point that parents, teachers, and coaches recognize the signs and symptoms of concussion and make sure that children are evaluated," she says.

The entire story can be read here.

The Pennsylvania Psychological Association helped to pass concussion management legislation.  Through active advocacy efforts, one of our aspirational ethics, psychologists are independent professionals able to assess and determine return to play for teenagers who suffered a head injury.

N.F.L. Plans Broader Concussion Research

By Sam Borden

The New York Times

The N.F.L’s first attempt at a long-range study on the effects of concussions was riddled with problems from the manner in which data was collected to conflicts of interest for those overseeing it. After criticism from outside experts and even members of Congress, the study was shut down by the league in late 2009.

Nearly two years later, however, the N.F.L.’s committee on concussion research is planning a considerably broader study — an effort that could begin gathering data as soon as next season, according to one of the doctors involved.

The doctor, Mitchel S. Berger, the chairman of the neurological surgery department at the University of California San Francisco, said Monday that he and the N.F.L.’s subcommittee on former players and long-term effects of brain and spine injury had been holding conference calls regarding the study every two weeks with representatives from the players’ union. He added that he hoped to make a final presentation to the union and Commissioner Roger Goodell “in the near future.”

Berger said he was aware of the issues surrounding the previous study, and said the latest model was completely different.

“There was no science in that,” Berger said in reference to the study coordinated by Dr. Ira Casson, who was also the league’s primary voice in discrediting outside research on concussions. Asked if he might use any of the data from Casson’s work, Berger shook his head.

The entire story can be read here.

Sports Concussions & Psychology

Here is a brief video on psychologists' role in sports psychology and concussions.  The video features PPA's Drs. Rex Gatto and Don McAleer.