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Concussions: More of a silent killer than we knew

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As a youth sports coach, I’m taught to look for concussion symptoms to help a player avoid further damage. However, new research is showing that the damage could already be happening even if a player is showing no outward signs of injury. From the Chicago Tribune:

…[A] new study of an Indiana high school football team hints that some athletes are suffering brain injuries that go undiagnosed, allowing the players to continue getting battered, unaware of the possible cognitive damage that has been done.

Of 21 high school players monitored for a full season by a team of researchers from Purdue University, four players who were never diagnosed with concussions were found to have suffered brain impairment that was at least as bad as that of other players who had been deemed concussed and removed from play.

“They’re not exhibiting any outward sign and they’re continuing to play,” said Thomas Talavage, an associate professor at the Weldon School of Biomedical Engineering at Purdue and the lead researcher on the study. “The cognitive impairment that we observed with them is actually worse than the one observed with the concussed players.”

The report, published in the latest edition of the Journal of Neurotrauma, found that some players received more than 1,800 hits to the head during practices and games, some with a force 20 times greater than what a person would feel while riding a roller coaster.

The research is coming out as the debate rages over what is more damaging: one hard, individual hit, or the cumulative effects of multiple collisions. The science is rapidly pointing to the latter. It helps explain why the brain of the late Cincinnati Bengals wide receiver Chris Henry showed concussion damage, even though he was never diagnosed with such a condition, and why the brain of Penn player Owen Thomas, who committed suicide in August, showed trauma, even though he had never been diagnosed with a concussion.

In the Chicago Tribune article, players and coaches aren’t dismissive of the study’s results. Their worry is more about whether their players and teammates will play hard if they’re worried about head injuries.

“It’s a tough slope because you could end up scaring kids away from even playing football, and you see that a lot,” said Michael Holmes, the football coach at Leo High School in Chicago. “We make our kids conscious of it, but we don’t try to scare them.”

Reilly O’Toole, quarterback at Wheaton [Ill.] Warrenville South High School, said he doesn’t think at all about head injuries.

“If you think about injuries or concussions, that’s when they happen,” he said. “Once you start playing not to get hurt, that’s when you get hurt. It’s a contact sport. If you don’t like contact, you shouldn’t be playing.”

The Purdue researchers aren’t (yet) calling for the end of tackle football, but they are recommend scaling back full-contact practices so kids don’t have to take so many hits.

By the way, the Purdue researchers, citing their continuing study, are not telling the Lafayette Jefferson High players which of the four have signs of, not to put too fine a point on it, brain damage. If it were my kid, I would be demanding to know if mine was one of the four.

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Chris Henry, and why your football-playing child may already have brain damage

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GREEN BAY, WI - SEPTEMBER 20: Wide receiver Ch...

Image by Getty Images via @daylife

Chris Henry was a talented wide receiver, but he was far better known for almost single-handedly giving the Cincinnati Bengals the reputation as criminals thanks to his numerous arrests. When Henry died during the 2009 season after falling off the back of a moving pickup truck — on which he had jumped during a fight with his fiancee, who was driving — it appeared to be a tragic but not unexpected end for someone who just couldn’t control himself.

Now it appears there was a reason Henry was out of control: His brain was  knotted and beaten up from repeated blows to the head, according to researchers.

At age 26, he already showed signs of progressive generative disease known as Chronic Traumatic Encephalopathy, or CTE. From the June 28 Pittsburgh Post-Gazette:

Julian Bailes and Bennet Omalu, with the Brain Injury Research Institute in Morgantown, W.Va., have examined 10 other retired players, among them ex-Steelers Mike Webster, Terry Long and Justin Strzelzcyk. The researchers found frightful similarities between those brains and that of Mr. Henry. Those men were older than Mr. Henry and had taken thousands of blows to the helmet during long football careers. …

“It didn’t look like the brain of a 26-year-old,” said Dr. Omalu, a former Allegheny County pathologist who first found CTE in an autopsy of Mr. Long in September 2005.

“This is not something to celebrate. It is not something to be joyful about. It is something that is very humbling, very introspective. It is a call to action.

“I’m not calling for the eradication of football; no, I’m asking for full disclosure to the players. Like the surgeon general considers smoking to be dangerous to your health, repeated impacts of the brain are dangerous to your health and will affect you later in life. Period. The players need to know this.

“I think it’s an epidemic. It’s beneath the radar. We simply didn’t identify it [early and properly]. The more I encounter NFL players, the more I realize … it is much more prevalent than we had identified.”

For all the laudable attention on ensuring that children are promptly identified and treated for concussions, the implications of this look at Henry means that brain damage among football players is more extensive and pervasive than we could have ever dreamed. Despite not having reached 30, Henry’s brain, and the dementia he was likely suffering, were much like that seen in an 80-to-90-year-old.

So what do we do with this information? Ban football? Take the head out of the game? There are some serious questions to be answered, because who knows how many high schoolers, having played since age 6 or 7, are already on their way to serious brain damage.

One thing the doctors in Henry’s case recommend is genetic testing, because there is one gene that is common to all the players they’ve examined who have suffered extensive damage: Apolipoprotein E, which is found in roughly 25 percent of the general population. APOE is considered one of the biggest genetic risk factors for development of Alzheimer’s Disease. Does that mean every baby should be tested for APOE, and if found positive, should never play a sport with a high risk of head injury?

I don’t know. But I do know I’m feeling even better about my kids having no interest in playing football.

The pussification of pussy

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Whatever the merits, or lack thereof, of Texas Tech wide receiver Adam James’ prima donna attitude in lighting the spark that fired head coach Mike Leach a few days back, on this there can be no doubt: a lot of people think James is a pussy. Hey, Nancy, you’re bitching about being stuck a room with your “mild” concussion? You whine about playing time? Get the sand out of your vagina, you pussy.

Pussy. That’s a word that gets thrown around a lot by men when a man is acting in a way deemed unmanly. What are you, a pussy? Shake it off, you pussy. Aww, looks like somebody’s pussy got hurt. The kids need to wear helmets? There goes the pussification of America! When someone, particularly a male someone, isn’t tough enough, suddenly he’s a bigger pussy than a wall-sized Georgia O’Keeffe.

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Pussies.

Exactly why is the pussy the standard of whether a man is weak? I’ve seen my wife give birth four times, and I can personally attest I’ve seen a pussy perform incredibly tough, painful work no man would ever dare. Plus, if a pussy is so bad, why are so many men willing to do any comical thing possible to get some? It seems like if you want to call someone a body part that can’t take pain, call him a cock-and-balls.

Of course, that wouldn’t speak to the feminizing, gay fear behind the word pussy. If you don’t think gay fear is behind what men call each other, look at dick and asshole. A dick is a jerk, an asshole only exists to give you shit, and if a dick and an asshole get together, someone is getting fucked.

Written by rkcookjr

January 1, 2010 at 6:40 pm

Laws sought to curb youth sports concussions

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A little slice of health reform that Hines Ward might not back: Sen. Robert Menendez, D-N.J., on Dec. 4 announced he would sponsor legislation that would seek to fight concussions in youth sports. From The Associated Press:

The bill … would establish a grant program to states to come up with ways to prevent, diagnose and treat sports-related concussions in high schools and middle schools. It also calls for the Department of Health and Human Services to develop concussion management guidelines, including standards for athletes to return after concussions.

It’s called the Concussion Treatment and Care Tools Act, or ConTACT Act. The legislation comes as concussions among athletes at all levels has been getting a look in Congress.

Menendez is following the lead of fellow New Jersey Democrat Bill Pascrell Jr., who filed a similar bill March 5, before fighting concussions was cool. Pascrell’s bill hasn’t moved anywhere since it was referred to committee. But it does have 10 Democratic and two Republican co-sponsors, which is practically lovey-dovey bipartisanship in this day and age. And Menendez’s bill comes as there is additional pressure on the NFL over how it handles concussions, state-level legislation about youth sports concussions, and a growing sentiment that leagues at all levels have a history of underestimating long-term and short-term concussion damage.

You might even say that, in the parlance of old concussion language, the sports world has gotten its bell rung.

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A clip from the Sept. 15 episode of HBO’s Real Sports with Bryant Gumbel, which featured a piece on concussions in high school football. Gumbel is talking to the mother and teammates of Ryne Dougherty, who died of a brain hemmorhage after a hit on the field in October 2008. The family is suing  because Ryne had been cleared to play after two previous concussions.

Written by rkcookjr

December 4, 2009 at 6:07 pm

Youth sports can be hazardous to your child's health

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The other day the NFL agreed to allow doctors not on individual teams’ payrolls to evaluate and monitor player concussions, as evidence mounts that traumatic brain injuries do long-term damage, that the NFL for years has underestimated that damage, and that this misunderestimation takes place at all levels of all sports, right down to the bitty, barely formed-cranium level. The numbers on youth sports injuries are so stark, sometimes it makes letting your kids play video games all day, every day, seem like the better option.

For good reason, concussions and other youth sports injuries are getting more attention, particularly as it’s clear that parents and coaches, most of them not being physicians or medical personnel, are pretty adept at self-misdiagnosing them. For example, one study out of Canada this year found that most parents and coaches believe you have to lose consciousness to suffer a concussion (you don’t), and that hockey players at the youth level suffer 2.8 concussions per 1,000 player ice-hours. Also, this year Washington became the first state to require a youth player diagnosed with a concussion to get medical clearance before returning to action. That law was inspired by 13-year-old Zackery Lystedt, who got a concussion after a hard football hit, went back in the game, got hit again, got another concussion, and spent 30 days in coma.

The reason the NFL (and other leagues) are taking so much heat about concussions is because of players who, not wanting to buck years of tradition or lose their job, come back too soon after suffering such an injury. The video below shows then-Chicago Blackhawk Martin Havlat taking a vicious hit from Detroit’s Niklas Kronwall in game three of their NHL playoff series last year. Rather than being dead, Havlat came back to play game four. Great for hockey, terrible for Havlat, who someday will be drooling in a cup from the damage he suffered in whatever number concussion this was.

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One major survey found a rapid increase in youth sports injuries that coincided with the rapid increase in the obesity rate, with the report’s authors, American Sports Data, surmising that’s because more kids are getting into more intense organized activities at earlier ages. A study released recently by the American Association of Orthopedic Surgeons counted a current annual count of 3.5 million sports injuries for athletes younger than 14, with half of those injuries coming from another subject of great concern — overuse injuries, another result of kids specializing in a single sport at an early age.

In my mind, that number isn’t just about kids (and/or their parents) pushing for that elusive college scholarship or pro career. It’s also about a family building its entire social life and network around youth sports. I know of people (I won’t say who they are to protect the guilty) who were told, after their teenaged son suffer two concussions in hockey (the first one, his coach sent him back on the ice, even after he blacked out and threw up), their doctor told them to get him off the ice immediately if they ever wanted their son to go to college. Given the family had traveled all over the country and establishing themselves as Hockey Parents since their son was 5, they were hesitant to follow that advice — and didn’t. Their son, a bright kid, ended up barely graduating high school. Oh, and he played lacrosse, too — just the sport for someone with a history of head injuries.0405091950a

Of course, you don’t have to be a hardcore travel sports parent to feel the pressure of coming back quickly from injury. There seems to be something primal as an athlete that doesn’t let you easily accepting being hurt. My then-11-year-old son last year sprained his right foot in the third quarter of his final basketball game of the year. I had to carry him off the court. Yet in the fourth quarter, my son, not the most competitive person I’ve ever known, asked if he could get back in the game. I said, uh, no. Later, when we went to the urgent care center to confirm the sprain, my son (right, waiting to go to his X-ray) made sure to tell everyone he misdirected the shot taken right before he landed on the shooter’s foot.

On the fifth- and sixth-grade team I’m coaching now. I have two kids who are asthmatic. I have to instruct the referee and the boys’ mothers to jump in if they see anything wrong, because I tell the kids to raise their hands if they’re hurting, but I’m not sure they will. One of the boys, for whatever reason, never told me he was asthmatic. I learned only in a quarter break when he went to throw up. The other boy is growing more intense with every game, and doesn’t want to get off the floor.

So, in that sense, they are no different than the 30 of 160 players who told The Associated Press in a survey that they have downplayed the effects of a concussion.

In light of all this, what are we supposed to do to prevent sports injuries? The first thing to do might be to make sure we never get the idea we can make sports injury-free, and that we can make athletes recover as long as the rest of us do when we get hurt. Accidents will happen, and athletes will want to play. It appears the best efforts are to see where we can best mitigate risk, and protect athletes from themselves. The efforts on concussions are good places to start, as well as the growing awareness of how single-sport specialization causes injury.

But perhaps on a youth level, the strongest message needs to be made to the coaches and parents that the child playing is not a million-dollar athlete, or even a potential one. Above all else, you need to protect children, so when they’re hurt, you treat them like normal people, not like pieces of athletic meat. If it means you lose a game, if it means you lose a chance at a scholarship (assuming the child ever had one), so be it.

Maybe I’m the weirdo, but I think children are better served, mentally and physically, exploring all sorts of different activities, sports and elsewhere. Some kids do find their niche early, and that’s great. But you also have to be a parent and let your child get exposed to other things just in case that niche isn’t going to work out. At least pro athletes who suffer injuries have team-paid medical care and their million-dollar contracts to fall back on. Generally, your child does not.

Written by rkcookjr

November 24, 2009 at 1:53 pm