Posts Tagged ‘head injuries’

Balancing the Concussion Hype

Looking at both sides of the sensationalism

Over the past few years, the media has kept concussions, particularly with respect to football, in the headlines – some would argue ad nauseum. But the truth is, the press attention and research into causes, long-term effects and prevention is provoking both good and bad outcomes.

The best outcome is the awareness being brought to the general public about diagnosis, second-impact syndrome, removal, and return-to-play policies. Players who have been clocked are no longer being told to “just suck it up.” There are now concussion laws on the books in all 50 states and the District of Columbia and required concussion training for youth coaches and athletic trainers.

However, there is definitely a downside to the hysteria, according to Rance A. Boren, a Texas neurologist. “The notion that everyone who plays football going to be mentally unstable in 15 years is just not true,” he said.

Boren points out that the majority of sports concussion research has focused on professional and college level athletes, not high school athletes. This generally points to the number of hits a player sustains over a period of time, as opposed to the force of a few hits. A player with a decade-long professional career preceded by four years of college ball who likely also played youth football is an example of someone at risk for the long-term injuries frequently seen in the media. The kid who started playing football at 12 and stopped after three or four years of high school ball is hardly ever in that risk category.

It’s important to understand that CTE is not a risk associated with young football athletes –  only a small fraction of NFL and college players exhibit its effects.  CTE is not caused by a single or even multiple concussions that have been properly treated. The word chronic in CTE means the trauma resulted from multiple sub-concussive brain injuries sustained over a long period of time. CTE is usually something boxers or NFL linemen might experience after sustaining thousands of blows to the head over the course of their careers.

However, second-impact syndrome and unreported concussions resulting in subsequent injuries are more common at the high school level. Susceptibility to second-impact syndrome is biological. Boren explains that “metabolic buffering syntheses” haven’t been able to reset. So if you are hit again during that short period between an initial hit and recovery, then you are going to do more damage. If you are then hit again, then you do even more damage.”

It’s for this reason that the University Interscholastic League instituted a 10-day return-to-play rule. The 10-day period begins after all symptoms of concussion have subsided. Returning to play too soon can affect reaction time and vision, which leaves players vulnerable to other injuries.

We invite you to read our many articles on concussions and concussions relating to football

Source: Travis M. Smith, “Concussions: A headache of a problem,” 23 June, 2015.



Pop Warner Tackles 3-Point Stance

Concerns over concussion prompts reconsideration

Citing concussion and chronic traumatic encephalopathy (CTE) concerns, Pop Warner may eliminate the 3-point stance for linemen. This is the latest of several steps the league has taken after its numbers continue to drop due to parental anxieties over head injuries.

According to ESPN’s Outside The Lines, Pop Warner’s participation levels have dropped in 2011 and 2012 by 5.7% and 4.0% respectively. Although the drop is likely due to several factors, the primary factor is thought to be  brain injury concerns resulting from the adverse publicity over the NFL players’ lawsuit and negative statements by former NFL players.

Pop Warner has adopted an educational program called “Heads Up Football” and has cut back on the number of hours of contact allowed during practices. The latter has been criticized as ineffective as studies show that the vast majority of concussion occur during games.

The next step is to consider additional rules changes to lessen head-to-head impacts. Pop Warner’s chief medical officer, Julian Bailes, stated that “requiring players to start upright would cut down on head-to-head collisions that can lead to brain injuries.

Executive director Jon Butler expressed his concern that “with a rule that sweeping is that politically it’s going to change the game to the point where people get turned off. My personal feeling is that that is where football is ultimately going to go. The question is how we get there.”

What are your thoughts on this potential new rule change? Is there enough medical evidence at this point to justify this change for youth tackle football or should we wait until the scientific community has had more time to study these issues?

Source: Steve Fainaru and Mark Fainaru-Wada, “Youth Football Participation Drops,” 14 Nov. 2013.

Study Validates Reduced Practice Contact

But are the findings reliable?

Increased practice time in youth tackle football devoted to learning how to hit and absorb hits does not translate to a decrease in game time injuries, according to a recent study by  researchers at Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences. This refutes concerns that failure to teach kids how to hit in practice would result in them getting “blown away” during games. Researchers concluded that the amount of contact exposure in practice can be greatly reduced, which would protect participants against brain injuries.

The study included three youth tackle football teams in Virginia and North Carolina. Six accelerometer monitoring devices were placed in each of the helmets and the number of hits and the forces from each hit were measured during practices and games. The study drew its conclusions from the fact thaconcussion-law-art-gfcmm22o-104-middleschool-concussions-clh-jpgt the differences in the number of hits were about the same for practice and games.

In my opinion

I’m not sure that the data collected in this study should result in the conclusion that was drawn. It would seem to me that the study would need to compare the same results between teams with average and reduced practice time devoted to full contact.

Source: Sporting Kid; Fall 2013. “Youth Football Contact Drills Don’t Lead to Improved Protection on Game Day, Study Finds.”

Key Points of NFL Concussion Settlement

Tentative settlement doesn’t include Workers’ Compensation claims

The NFL reached a tentative settlement agreement of $765 million with some 18,000+ retired football players (whether they sued or not) who alleged that the NFL misled them about the hazards of concussions. Evidently, if approved, this settlement would not stop the current Workers’ Compensation claims that are ongoing. However, players who have filed Work Comp claims may opt to drop such claims and accept the settlement offer instead if it would be more favorable to their cause, depending on state law.

The settlement would be structured as follows:

  • $75 million for baseline medical exams for retired players
  • $675 million to compensate former players and their families to be paid over the next 17 years. Each player will receive a different amount based on their particular diagnosis and medical condition, age and years played in the NFL.
  • $10 million to fund concussion research
  • The balance for players’ legal fees.

The settlement offer is not an admission of liability by the NFL that concussions were the cause of the players’ injuries. However, it is speculated that the offer was prompted to uphold the reputation of the NFL with its fans and avoid expensive litigation.

The litigation and concussion settlement agreement would likely hinder similar future lawsuits from current players (based on concussion risks being withheld), said attorney Ronald S. Katz. This is because it would be harder to prove negligence since the concussion risks are now heavily publicized and current players assume a known risk when they participate in the game. However, negligence-based lawsuits would still be a possibility because of failure to diagnose concussions and too soon return to play.

The 32 General Liability insurers that are being sued by the NFL to participate in the defense and settlement (such as Travelers, Fireman’s Fund, AIG, Chubb, XL) are currently playing “hot potato” with the outcome still up in the air.

Source: Business “Despite Football Concussion Settlement, Insurers Role In Paying NFL Costs Unclear.” Sept. 9, 2013.

Concussion Facts from HeadZone

The effects of previous concussions and inadequate recovery time

HeadZone, a company that specializes in concussion baseline testing, published a list of concussion facts relating to children. Below are some of the more interesting ones:

  • Long term decreases in GPA occur when children have a history of two previous concussions.
  • Children with prior concussions are three times more likely to suffer an additional concussion.
  • Children with at least three prior concussions take longer to recover from the next concussion – greater than one month in most headball
  • Participants 18 years old and younger account for 95 percent of all catastrophic second-impact concussion syndromes.
  • 90 percent of children return to classes within four days of suffering a concussion, which is generally considered to be too soon. Two-thirds of those have a drop in their GPA for two months.

HeadZone offers eye tracking, memory, and cognitive tests that range from $15 to $35, depending on the age group.

I’ve personally witnessed the physical and academic impacts on some of my children’s’ teammates who suffered concussions while playing soccer.

Youth Football Concussions During Practice

Results of study surprise many

In a prior blog on concussion rule changes, we stated that the new Pop Warner Football concussion rule to limit contact in practice would have a limited effect as only 28 percent of all youth football concussions occur in practice according to American Youth Football (AYF) injury statistics.

Now, a new study by the University Of Pittsburgh and University of Pittsburgh Medical Center and funded by the NFL has drawn a similar but more compelling conclusion. The study found that youth tackle football players aged 8 to 12 were at a low risk of suffering a concussion in practice.  (.024 incidences per 1000 exposures), but that the risk was 26 times higher in games (6.16 incidences per 1000 exposures).

“This finding suggests that reducing contact-practice exposures in youth football, which some leagues have done recently, will likely have little effect on reducing concussion risk, as few concussions actually occur in practice. Instead of reducing contact-practice time, youth football leagues should focus on awareness and education about concussions,” said Anthony Kontos, an associate professor at UPMC.

Many experts agree that practice time should focus on proper tackling techniques and instruction instead of head contact.

Leaning on science, not the media

These recommendations are exactly what AYF has been preaching. We recommend against knee jerk reactions to the media frenzy on the concussion issue.  Making hasty safety rule decisions that are not backed by science isn’t a wise move. Instead, wait on the results from the ongoing scientific studies.  In the meantime, focus on educating coaches on recognizing the signs and symptoms of concussions, concussed player removal and medical treatment, and return-to-play protocol. In addition, concentrate on proper tackling technique.

AYF has included concussion awareness training in its coach certification program.

More interesting statistics from the study

The incident rate of concussions in practice and games combined is three times higher in the 11 to 12-year-old age category as compared to 8 to 10-year-old age category.  Just as the AYF injury studies have revealed, there is a direct correlation between age and injuries in youth tackle football. The older athletes are stronger, faster, and more coordinated, hitting with harder force. See our prior blog on the issue of age only vs age/weight categories.

Player in the “skill positions of  quarterback, running back, and linebacker make up 95 percent of youth football concussions.

Source: “Study: Kids Get Fewer Concussions In Practices Than In Games.” June 6, 2013.

Head Injuries and Concussions in Youth Sports

Reducing the chances of inherent sports risks

Concussion diagnosisAll sports carry some type of inherent risk, but what are they? For contact sports, a very common occurrence is the concussion (defined by Websters as “a stunning, damaging, or shattering effect from a hard impact; a jarring injury of the brain resulting in disturbance of cerebral function.”) According to the CNN report below, there is increasing evidence that brain damage actually occurs during a concussion.

What are some ways that your local organization is being pro-active in preventing head injuries or putting measures into place to nurture the injury or prevent further injury once it has occurred?