Post and Courier: ‘Concussions Among Young Athletes on the Rise’

Posted on February 15th, 2011 No Comments

“It was the most traumatizing time of our lives,” Sharell Welch, the mother of a local high school athlete, says of the concussion her daughter sustained playing basketball last year. “The physical part of [the injury] is bad enough, but the emotional part of it is the most devastating. It took a toll on us as her family as well as her.”

With concussions on the rise among children and young adults — a study published in Pediatrics last year found that the number ER visits for concussions among those ages 5-18 in 2005 was more than twice what it had been eight years prior — traumatic experiences such as the one sustained by Aleighsa Welch and her family are increasing as well.

Efforts by lawmakers to reduce the risk of injury associated with youth athletics have become more critical than ever, so it’s a good thing that many states have passed or are considering passing “return to play” laws for brain-injured athletes. “The process generally starts after an athlete is symptom-free for at least 24 hours,” an article on youth concussions and “return to play” laws explains. “The protocol begins with light aerobic exercise and progresses through sport-specific exercise, non-contact training drills and full-contact practice before a return to games.”

Though this can be a painful exercise in patience for young athletes, it is one that doctors and lawmakers alike hope to see halt the rise in concussions among students, and one day, reverse the trend.

Guidelines for Concussions

Posted on November 3rd, 2010 No Comments

The nation’s largest association of professional neurologists recommended earlier this week that “any athlete suspected of suffering a concussion be removed from play immediately and be seen by a physician specially trained in the evaluation and treatment of brain trauma,” adding that no player should return to play before being cleared by said physician.

The statement was issued in support of the American Academy of Neurology’s attempt to set a new, more conservative and cautious standard for the treatment of brain injury in amateur sports. The group also recommended that a certified athletic trainer be present at all games and practices at which head trauma is a prevalent risk.

These recommendations are supported by evidence set forth in a study published in Pediatrics this summer that found the number of children who sustained sports-related head injuries to have more than doubled between the years 2000 and 2005. For more information on the subject, click here.

NFL Cracks Down on Hard Hits

Posted on October 25th, 2010 No Comments

“The NFL has spoken,” a FOX Sports South article declared earlier this week. “It fined Falcons cornerback Dunta Robinson $50,000 on Tuesday for his hit on Eagles wide receiver DeSean Jackson in which Robinson himself suffered a concussion.”

Though some consider such penalties overly cautious or unfair, the League insists that it is not imposed new rules, but rather simply choosing to enforce old rules more strictly. “We will take all the criticism and all the backlash against those that say we are acting too aggressively… We are not going to be apologetic. We are not going to be defensive about it. We are going to protect our players and hopefully players at the lower levels as well by example,” executive VP of football operations Ray Anderson said. “We understand this is not just about the NFL. This is about safety at our level, at the college level, at the high school level, at the pee-wee level, because we are the standard bearer and we are committed to safety at the highest level.”

At the same time Robinson was fined last week, so were New England Patriots safety Brandon Meriweather and Pittsburgh Steelers linebacker James Harrison — $50,000 and $75,000, respectively.

There’s no denying the inherent danger of professional football (or even pee-wee, for that matter). From a health standpoint, the NFL’s decision to enforce its rules barring excessively violent hits is therefore an incredibly important step in preserving both the lives and health of the sport’s players. Traumatic brain injuries such as concussions are all-too-often preventable, and their life-altering consequences unrecognized until it’s too late. The game of football will go on, the backlash will subside, and in the end, a number of players will have the League to thank for the protection of their safety.

From "Traumatic Brain Injury — Football, Warfare, and Long-Term Effects"

Posted on October 10th, 2010 No Comments

“Public awareness of the pathological consequences of traumatic brain injury has [recently] been elevated,” an article in The New England Journal of Medicine read this summer, “not only by the recognition of the potential clinical significance of repetitive head injuries in high-contact sports… but also by the prevalence of vehicular crashes… and by modern warfare.” Citing such examples as the NFL’s creation of informational posters to be hung in team locker rooms, and the general increase in effort by automakers to improve vehicle safety measures, the article provides insight into the long term effects of traumatic brain injury (TBI).

“Many complications of traumatic brain injury are evident immediately or soon after injury,” it says. “Acute post-traumatic sensory, motor, and neurocognitive syndromes are presumed to occur as a result of contusions and axonal disruption. Seemingly mild closed-head injuries (i.e., those without skull fracture) may lead to diverse and sometimes disabling symptoms, such as chronic headaches, dizziness and vertigo, difficulty concentrating, word-finding problems, depression, irritability, and impulsiveness. The duration of such symptoms varies but can be months.”

“Data from helmet concussion monitors that are used on soldiers and football players can aid in predicting the character and location of lesions from an impact of a given force at given coordinates while improving the accuracy of diaries of people at risk for traumatic brain injury. Accurate diaries, in turn, should help in determining more accurately the number and severity of head injuries, allowing estimation of athletes’ cumulative risk. Individual differences in trauma tolerance and genetic influences must also be elucidated. These data can inform prospective studies of the cognitive, neuropsychiatric, and motor performance of soldiers, athletes, and other exposed populations, as well as informing the design of behavioral and pharmacologic interventions for prophylaxis or therapy. A challenge will be translating our improved understanding of the pathogenesis of traumatic brain injury into rational, evidence-based changes in public and sports policy that will minimize exposure to such injuries and their chronic neurodegenerative sequelae.”

For the complete article, click here.

Basketball and Brain Injury

Posted on September 13th, 2010 No Comments

In 2007, medical examiners delighted in evidence that showed the number of basketball-related injuries in American kids and teens to have decreased by 21 percent during the preceding decade. Disappointingly, however, the number of traumatic brain injuries (TBIs) sustained by the same body of players during that time rose by an astounding 70 percent. And that may be a conservative estimate—the researchers noted that as many as 30 percent of the athletes failed to recognize the signs and symptoms of a TBI and continued to play after a questionable  blow to the head.

“To address the problem of traumatic brain injuries and manage them effectively, education of coaches, athletes, and parents is vital,” lead researcher Lara McKenzie, PhD of Nationwide Children’s Hospital in Ohio says, but suggests “[not] to take your child out of a sport—particularly one that they like a lot—because there’s a lot of good benefits that really outweigh some of these negative injury risks.”

Other findings of the study (published in the upcoming October issue of Pediatrics) included:

  • Girls were more likely than boys to sustain brain and knee injuries
  • Children aged 5-10 were more likely than those aged 11-19 to injure their upper extremities and sustain TBIs, fractures, or dislocations
  • The most common injury was a strain or sprain in the lower extremities (30 percent), mostly affecting the ankle (24 percent)

For information on preventing traumatic brain injury in sports like basketball, take a look at the CDC’s Guide for Coaches here.

HeadsUp! SC

Posted on September 7th, 2010 No Comments

Attorney Malcolm Crosland Jr. speaking at a North Charleston recreational football meeting

Established in 2008, HeadsUp! SC is a nonprofit organization that aims to educate parents, players, and coaches about the signs and symptoms of traumatic brain injury in the hopes of preventing such ailments on the field. Every year, attorney and founder Malcolm Crosland Jr. attends a series of coaches meetings for recreational sports like football, soccer, lacrosse, baseball, and basketball to speak about such injuries and to offer techniques for prevention. This fall, he met with teams in Hanahan, North Charleston, Mount Pleasant, and the City of Charleston. For TheDigitel’s coverage of his efforts, click here, and for more information on head trauma and how best to avoid it, visit the HeadsUp! website by clicking here.

The Michael Kirkham Story

Posted on July 22nd, 2010 No Comments

Cage fighting. Violent, dangerous, and uninhibited, the sport has become both increasingly popular and increasingly vicious over the course of the last several years. Also known as mixed martial arts (MMA), it is defined as “a full contact combat sport that allows a wide variety of fighting techniques and skills, from a mixture of martial arts traditions and non-traditions, to be used in competitions.” It is a sport whose consequences Dennis Kirkham and his son, Michael, know all too well.

Michael was just 30 when he died last month. At 6-foot-9 and 155 pounds, the lanky Illinois-native had moved to the Carolinas after high school to start a band, but found himself intrigued by the rising popularity of MMA around the area in which he lived. He took up the sport himself, holding odd jobs in the meantime to make ends meet, and began competing regionally. On April 24, he lost an amateur fight in Columbia, SC and was given an automatic 30-day medical suspension for his technical knockout; on June 26, Michael suffered a brain hemorrhage in his pro debut at the USC Aiken Convocation Center; and on June 28, he passed away. His was the second death in U.S. history linked directly to a sanctioned MMA fight.

While it is unclear whether second impact syndrome can be blamed for the severity of Michael’s hemorrhage, there’s no question about the danger of the sport. So what can we do to ensure that these fighters’ risk of fatal injury is minimized? Fight for stricter legislation. ”South Carolina approved MMA last year, although the state’s athletic commission’s requirements fall short of the benchmarks set by Nevada and California,” an article on Michael Kirkham explains. “According to the American Association of Professional Ringside Physicians website, a full physical is not required to fight in the state, let alone an annual neurological exam that some other state commissions require.” So speak up in favor of sports requirements that exist for the benefit of your health, be smart about the risky situations in which you choose to place yourself, and always put safety first—both in and out of the cage.

After Sustaining TBI, Snowboarder Kevin Pearce Returns Home

Posted on May 4th, 2010 No Comments

On December 31 of last year, 22-year-old Kevin Pearce fell and hit his head while snowboarding in Park City, Utah–he was practicing for the Winter Olympics in which he was expected to compete as part of the US halfpipe team. Knocked unconscious and flown by helicopter to a nearby hospital, Pearce remained under medical supervision all winter and underwent a great deal of rehabilitation and therapy (both mental and physical), often for six or more hours a day. Such therapy will continue now that he has been permitted to return to his family’s home in Norwich, Vermont, and will focus on vision, balance, and memory.

For a New York Times article on Pearce’s continued recovery, click here.

For updates on the snowboarder’s health and condition from his official site, click here.

NFL Donates $1 Million for Brain Injury Research

Posted on April 22nd, 2010 No Comments

The NFL announced Tuesday that it plans to donate $1 million to a university-based, nonprofit partnership studying brain injuries. “The money will support the Center for the Study of Traumatic Encephalopathy’s (CSTE) research into the long-term effects of repetitive brain trauma in athletes,” an AP article on the matter states. The center is an alliance between the Boston University School of Medicine and the Sports Legacy Institution, and the NFL is the first sports league to financially support this research at the school.

“We obviously are very interested in the center’s research on the long-term effects of head trauma in athletes,” the article cites NFL Commissioner Roger Goodell as saying. “It is our hope this research will lead to a better understanding of these effects and also to developing ways to help detect, prevent and treat these injuries.”

The center’s research has focused primarily on examining brains donated by deceased athletes (see last month’s post titled “An Unusual Collection for an Important Cause” for more information), but will use the money to launch a clinical research program to develop methods for better protection of the brain and early detection of injuries.

To check out the CTSE’s official website, click here.

Former AFL Player Sues Over Concussion

Posted on April 6th, 2010 4 Comments

Clay Rush, a former Arena Football League (AFL) kicker, filed a lawsuit last month against a Denver doctor and clinic, saying he “suffered permanent brain damage because he didn’t get standard care after a concussion during the 2008 season,” a recent Winnipeg Free Press article reads. According to the lawsuit, he sustained a hit to the head during a game and was improperly monitored and evaluated by the team’s physician, Dr. Saurabh Mangalik.

Despite showing certain symptoms of a concussion, like headaches, nausea, dizziness, blurred vision, and insomnia, Rush continued to play and attend practice, and as a result, suffered a second injury. According to a BrainAndSpinalCord post on the subject, the lawsuit alleges that “had he been properly monitored and withheld from the game until his symptoms disappeared, he would not have suffered a permanent brain injury.” Dr. Mangalik denies giving Rush permission to play and is adamant that he warned Rush not to practice or play until his symptoms cleared.

The lawsuit seeks unspecified damages and details on further proceedings are not yet available.

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