concussions
Moderators: Mitch Hawker, east hockey, karl(east)
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Women Get Sports Concussions At Higher Rates Than Men
"When concussions make the news, it’s usually about football. But head injuries happen in other sports too, and not just to men. During a congressional hearing on concussions in youth sports on Friday, Dawn Comstock, an epidemiologist who studies sports injuries, told a House Energy and Commerce subcommittee that in sports like soccer and basketball in which girls and boys play by the same rules, with the same equipment and the same facilities, “girls have higher concussion rates than boys.” Comstock, a researcher at the Colorado School of Public Health, is the first author of a 2015 study published in JAMA Pediatrics that quantified concussions in high school soccer and found that they were about one and a half times more common in girls than in boys.
When U.S. Rep. Diana DeGette, D-Colo., asked whether more data was needed to show that girls have higher concussion rates, Comstock replied, “We already have the data that’s consistently shown this gender difference.” What we don’t have, she said, is a proven explanation for the discrepancy.
Some researchers have wondered whether women and girls are simply more likely to report their symptoms than men and boys are. “It’s a sexist way to say that they’re not as tough,” said Katherine Price Snedaker, executive director of Pink Concussions,1 an organization that is seeking answers to how concussions affect women and girls.
The group recently held a summit on female concussion and traumatic brain injuries at Georgetown University, and one of the speakers was Shannon Bauman, a sports physician who presented data from 207 athletes — both male and female — who’d been evaluated at her specialty concussion clinic in Barrie, Ontario, between September 2014 and January 2016. Bauman said concussions were often more severe in girls and women — she found differences not only in subjective reported symptoms but also in objective cognitive and visual symptoms that doctors noted during physical exams. Bauman counted objective physical signs of concussions such as trouble maintaining one’s balance and vision problems, and female patients had an average of 4.5 of them, compared with 3.6 for males. “Females are reporting more symptoms, but they’re also objectively having more physiological signs of concussion,” Bauman said.
The differences don’t stop there. Bauman’s data also showed that females take longer to heal. Thirty-four percent of men and boys who came to the clinic finished treatment within two months, yet only 12 percent of concussions in women and girls improved this fast. About 35 percent of females were still experiencing concussions six months or more after their injury.
Researchers are just starting to look for explanations for these differences, but hormones probably play some role, Snedaker said, because gender differences in concussions seem to emerge around puberty, when hormone levels change. Researchers at the University of Rochester School of Medicine and Dentistry have found that mild traumatic brain injuries heal less quickly when sustained during certain phases of the menstrual cycle, and they’ve proposed that the difference may come down to progesterone levels. Another proposed explanation, Bauman said, is that because women tend to have less neck strength than males, their necks aren’t as able to stabilize the head after they’ve been hit, resulting in more “sloshing” as the brain shifts in the skull.
The next logical question is whether women are also more vulnerable to chronic traumatic encephalopathy, or CTE, a neurodegenerative condition that may be linked to concussions. Several U.S. women’s national soccer team players have recently pledged to help find out by donating their brains after they die so research can be done into CTE. Brandi Chastain was the first, and now Abby Wambach and Megan Rapinoe have joined in too. I hope that it is many decades before their donations happen. Professional wrestler Chyna’s donation came tragically early. The WWE star died unexpectedly in April at the age of 46, and her manager reported that her brain has been donated to famed neuropathologist Bennet Omalu to look for signs of CTE.
I smashed my face in a bike wreck when I was 16, losing consciousness and breaking my jaw in two places. Whenever I find myself at a loss for a particular word or forgetting where I left my phone, I wonder if that old head injury is to blame and worry that I could be losing my mind. That’s what’s so difficult about uncertainty — in the absence of knowledge, we create our own stories, and I, for one, tend to expect the worst. More research in this area could help set my mind at ease, or at least give people like me a clearer sense of what’s in store and what we might do about it."
Women Get Sports Concussions At Higher Rates Than Men
Read more: http://fivethirtyeight.com/features/wom ... -than-men/
When U.S. Rep. Diana DeGette, D-Colo., asked whether more data was needed to show that girls have higher concussion rates, Comstock replied, “We already have the data that’s consistently shown this gender difference.” What we don’t have, she said, is a proven explanation for the discrepancy.
Some researchers have wondered whether women and girls are simply more likely to report their symptoms than men and boys are. “It’s a sexist way to say that they’re not as tough,” said Katherine Price Snedaker, executive director of Pink Concussions,1 an organization that is seeking answers to how concussions affect women and girls.
The group recently held a summit on female concussion and traumatic brain injuries at Georgetown University, and one of the speakers was Shannon Bauman, a sports physician who presented data from 207 athletes — both male and female — who’d been evaluated at her specialty concussion clinic in Barrie, Ontario, between September 2014 and January 2016. Bauman said concussions were often more severe in girls and women — she found differences not only in subjective reported symptoms but also in objective cognitive and visual symptoms that doctors noted during physical exams. Bauman counted objective physical signs of concussions such as trouble maintaining one’s balance and vision problems, and female patients had an average of 4.5 of them, compared with 3.6 for males. “Females are reporting more symptoms, but they’re also objectively having more physiological signs of concussion,” Bauman said.
The differences don’t stop there. Bauman’s data also showed that females take longer to heal. Thirty-four percent of men and boys who came to the clinic finished treatment within two months, yet only 12 percent of concussions in women and girls improved this fast. About 35 percent of females were still experiencing concussions six months or more after their injury.
Researchers are just starting to look for explanations for these differences, but hormones probably play some role, Snedaker said, because gender differences in concussions seem to emerge around puberty, when hormone levels change. Researchers at the University of Rochester School of Medicine and Dentistry have found that mild traumatic brain injuries heal less quickly when sustained during certain phases of the menstrual cycle, and they’ve proposed that the difference may come down to progesterone levels. Another proposed explanation, Bauman said, is that because women tend to have less neck strength than males, their necks aren’t as able to stabilize the head after they’ve been hit, resulting in more “sloshing” as the brain shifts in the skull.
The next logical question is whether women are also more vulnerable to chronic traumatic encephalopathy, or CTE, a neurodegenerative condition that may be linked to concussions. Several U.S. women’s national soccer team players have recently pledged to help find out by donating their brains after they die so research can be done into CTE. Brandi Chastain was the first, and now Abby Wambach and Megan Rapinoe have joined in too. I hope that it is many decades before their donations happen. Professional wrestler Chyna’s donation came tragically early. The WWE star died unexpectedly in April at the age of 46, and her manager reported that her brain has been donated to famed neuropathologist Bennet Omalu to look for signs of CTE.
I smashed my face in a bike wreck when I was 16, losing consciousness and breaking my jaw in two places. Whenever I find myself at a loss for a particular word or forgetting where I left my phone, I wonder if that old head injury is to blame and worry that I could be losing my mind. That’s what’s so difficult about uncertainty — in the absence of knowledge, we create our own stories, and I, for one, tend to expect the worst. More research in this area could help set my mind at ease, or at least give people like me a clearer sense of what’s in store and what we might do about it."
Women Get Sports Concussions At Higher Rates Than Men
Read more: http://fivethirtyeight.com/features/wom ... -than-men/
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Abnormalities in Diffusional Kurtosis Metrics Related to Head Impact Exposure in a Season of High School Varsity Football.
"single season of HS football can produce DKI measurable changes in the absence of clinically diagnosed concussion"
http://www.ncbi.nlm.nih.gov/m/pubmed/27042763/
"single season of HS football can produce DKI measurable changes in the absence of clinically diagnosed concussion"
http://www.ncbi.nlm.nih.gov/m/pubmed/27042763/
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Do females concuss differently than males? ncaa article
Key point: "In self-report data that we will explore further in a future column, college female ice hockey players have the highest odds ratio of developing concussion, even when considering football, a male-only event."
Do Female Athletes Concuss Differently than Males?
By: Brian Hainline, MD
Do females concuss differently than males?
It’s a compelling question among concussion researchers. Despite the intrigue of this question, there is little media attention to this matter. The tendency of the media is to focus on football. The advantage of this column is that I can choose the topics that need to be communicated to a broader audience. Therefore, I am devoting this column to explore concussions in female athletes.
A female’s brain is different than a male’s brain. This is a statement of fact, not judgment. One difference in particular has to do with a female’s susceptibility to migraine between puberty and menopause. During the child-bearing ages, females undergo considerable hormonal fluctuation on a monthly basis in preparation for possible pregnancy. Estradiol in particular reaches peak levels as the uterus becomes prepared for possible embryo implantation, and then drops precipitously if no implantation takes place. Estradiol fluctuation is one of the primary culprits in driving migraine. Before puberty and after menopause, males and females suffer with migraine equally. During child-bearing ages, females are about four times more likely to suffer with migraine. Estradiol interacts specifically with the trigeminal vascular complex, which is an area of the brain that controls migraine pathophysiology.
Why do we care about migraine when discussing concussion in females? Because migraine and concussion share similar pathophysiological expressions. During a migraine aura (often experienced as visual hallucinations), there is an excitatory electrical phenomenon in the brain that is followed by an inhibitory electrical phenomenon. This inhibitory electrical phenomenon is known as ‘spreading depression.’ Spreading depression refers to waves of depressed electrical activity in the brain and has nothing to do with emotions, per se. Think of a pebble that is dropped in a still lake. There are observable waves that emanate from the epicenter of the dropped pebble, and these waves are conceptually similar to the spreading depression waves that occur during a migraine aura. As a result of the progressive inhibitory electrical spread, there is associated neurological dysfunction, ranging from visual loss to difficulty speaking to confusion to vertigo to loss of consciousness.
Scientists have also described spreading depression as an acute manifestation of concussion. Following an impact to the brain sufficient to cause a concussion, there are multiple areas of the brain that may develop spreading depression waves, and this may be an important contributing factor to concussion symptomatology. This also explains why concussion symptoms can worsen for hours following the inciting event. For female athletes during their child bearing years, there is a statistically increased likelihood that a female with migraine susceptibility will become concussed, and such females have a lower threshold to developing secondary spreading depression. In other words, females with migraine susceptibility are more vulnerable to developing worsened symptoms relative to their non-migraine counterpart. At present, the spreading depression hypothesis needs further scientific study; however, it is an intriguing explanation of male-female differences. Spreading depression may help to explain studies that demonstrate the following:
• Female concussed athletes report more concussion symptoms than their male counterparts, including poor concentration, lightheadedness, increased fatigue, headache, and visual hallucinations such as seeing stars.
• Female concussed athletes suffer with greater cognitive decline and slowed reaction time relative to males.
• College female concussed athletes perform more poorly on BESS (Balance Error Scoring System) following concussion relative to males.
In addition to suffering with more concussion symptomatology, females have a higher rate of concussion compared to males when playing the following sports:
• Soccer (2.1 x greater risk)
• Softball versus baseball (up to 3.2 x greater risk)
• Basketball (up to 1.7 x greater risk)
In self-report data that we will explore further in a future column, college female ice hockey players have the highest odds ratio of developing concussion, even when considering football, a male-only event. Thus, female athletes seem uniquely predisposed to suffering with more concussion and worsened concussion symptomatology relative to males. What is startling is that even in lacrosse, female athletes seem to suffer concussion at a similar incidence to males, but female lacrosse is not a contact sport, whereas male lacrosse is a contact sport.
Studies have also demonstrated that females have more injuries due to player-surface contact and player-equipment contact compared to males (males have more injuries from player-player contact compared to females). Females also may have a higher proportion of recurrent concussions compared to males. There may be factors beyond brain physiology that help explain these differences. One aspect of concussion is the biomechanical readiness of protecting the head from sudden acceleration-deceleration and rotational forces. From this framework, females may be at a disadvantage because they have less neck strength than males. This can translate into less ability to counteract mechanical forces that can cause head and neck acceleration-deceleration and rotation. Consider the following statistically significant difference in females compared to males when measuring head-neck strength components and concomitant acceleration forces:
• Females have 25 percent less head-neck segment mass than males.
• Females have 5 percent less head-neck segment length than males.
• Females have 12 percent less neck girth than males.
• Females have 50 percent less isometric neck flexor strength than males.
• Females have 53 percent less isometric neck extensor strength than males.
• Females have up to 44 percent greater head acceleration than males following contact, and have 10 percent greater head accelerations than males during non-contact.
We need to explore female-male concussion differences in more detail. Meanwhile, we all need to spread the word: yes, female athletes also suffer with concussion, and they may be uniquely predisposed to this neurological event.
Read more: http://www.ncaa.org/health-and-safety/m ... ntly-males
Do Female Athletes Concuss Differently than Males?
By: Brian Hainline, MD
Do females concuss differently than males?
It’s a compelling question among concussion researchers. Despite the intrigue of this question, there is little media attention to this matter. The tendency of the media is to focus on football. The advantage of this column is that I can choose the topics that need to be communicated to a broader audience. Therefore, I am devoting this column to explore concussions in female athletes.
A female’s brain is different than a male’s brain. This is a statement of fact, not judgment. One difference in particular has to do with a female’s susceptibility to migraine between puberty and menopause. During the child-bearing ages, females undergo considerable hormonal fluctuation on a monthly basis in preparation for possible pregnancy. Estradiol in particular reaches peak levels as the uterus becomes prepared for possible embryo implantation, and then drops precipitously if no implantation takes place. Estradiol fluctuation is one of the primary culprits in driving migraine. Before puberty and after menopause, males and females suffer with migraine equally. During child-bearing ages, females are about four times more likely to suffer with migraine. Estradiol interacts specifically with the trigeminal vascular complex, which is an area of the brain that controls migraine pathophysiology.
Why do we care about migraine when discussing concussion in females? Because migraine and concussion share similar pathophysiological expressions. During a migraine aura (often experienced as visual hallucinations), there is an excitatory electrical phenomenon in the brain that is followed by an inhibitory electrical phenomenon. This inhibitory electrical phenomenon is known as ‘spreading depression.’ Spreading depression refers to waves of depressed electrical activity in the brain and has nothing to do with emotions, per se. Think of a pebble that is dropped in a still lake. There are observable waves that emanate from the epicenter of the dropped pebble, and these waves are conceptually similar to the spreading depression waves that occur during a migraine aura. As a result of the progressive inhibitory electrical spread, there is associated neurological dysfunction, ranging from visual loss to difficulty speaking to confusion to vertigo to loss of consciousness.
Scientists have also described spreading depression as an acute manifestation of concussion. Following an impact to the brain sufficient to cause a concussion, there are multiple areas of the brain that may develop spreading depression waves, and this may be an important contributing factor to concussion symptomatology. This also explains why concussion symptoms can worsen for hours following the inciting event. For female athletes during their child bearing years, there is a statistically increased likelihood that a female with migraine susceptibility will become concussed, and such females have a lower threshold to developing secondary spreading depression. In other words, females with migraine susceptibility are more vulnerable to developing worsened symptoms relative to their non-migraine counterpart. At present, the spreading depression hypothesis needs further scientific study; however, it is an intriguing explanation of male-female differences. Spreading depression may help to explain studies that demonstrate the following:
• Female concussed athletes report more concussion symptoms than their male counterparts, including poor concentration, lightheadedness, increased fatigue, headache, and visual hallucinations such as seeing stars.
• Female concussed athletes suffer with greater cognitive decline and slowed reaction time relative to males.
• College female concussed athletes perform more poorly on BESS (Balance Error Scoring System) following concussion relative to males.
In addition to suffering with more concussion symptomatology, females have a higher rate of concussion compared to males when playing the following sports:
• Soccer (2.1 x greater risk)
• Softball versus baseball (up to 3.2 x greater risk)
• Basketball (up to 1.7 x greater risk)
In self-report data that we will explore further in a future column, college female ice hockey players have the highest odds ratio of developing concussion, even when considering football, a male-only event. Thus, female athletes seem uniquely predisposed to suffering with more concussion and worsened concussion symptomatology relative to males. What is startling is that even in lacrosse, female athletes seem to suffer concussion at a similar incidence to males, but female lacrosse is not a contact sport, whereas male lacrosse is a contact sport.
Studies have also demonstrated that females have more injuries due to player-surface contact and player-equipment contact compared to males (males have more injuries from player-player contact compared to females). Females also may have a higher proportion of recurrent concussions compared to males. There may be factors beyond brain physiology that help explain these differences. One aspect of concussion is the biomechanical readiness of protecting the head from sudden acceleration-deceleration and rotational forces. From this framework, females may be at a disadvantage because they have less neck strength than males. This can translate into less ability to counteract mechanical forces that can cause head and neck acceleration-deceleration and rotation. Consider the following statistically significant difference in females compared to males when measuring head-neck strength components and concomitant acceleration forces:
• Females have 25 percent less head-neck segment mass than males.
• Females have 5 percent less head-neck segment length than males.
• Females have 12 percent less neck girth than males.
• Females have 50 percent less isometric neck flexor strength than males.
• Females have 53 percent less isometric neck extensor strength than males.
• Females have up to 44 percent greater head acceleration than males following contact, and have 10 percent greater head accelerations than males during non-contact.
We need to explore female-male concussion differences in more detail. Meanwhile, we all need to spread the word: yes, female athletes also suffer with concussion, and they may be uniquely predisposed to this neurological event.
Read more: http://www.ncaa.org/health-and-safety/m ... ntly-males
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
US may be greatly undercounting pediatric concussions
Majority of concussions are diagnosed at primary care sites, not in emergency department
Read more: https://www.sciencedaily.com/releases/2 ... 112705.htm
Majority of concussions are diagnosed at primary care sites, not in emergency department
Read more: https://www.sciencedaily.com/releases/2 ... 112705.htm
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Post-concussion syndrome blog
Esther Lovett is a 16-year-old high school student who has suffered three diagnosed concussions and struggles with post-concussion syndrome (PCS). Esther is writing a blog for the Concussion Legacy Foundation to help spread awareness about the effects of PCS and to reach others suffering with its pervasive symptoms.
"Post-concussion syndrome presents a variety of symptoms which are invisible to others and often ignored or misunderstood. I have often felt that I’ve been lying to myself and to everyone for the past three years about my concussions. I have tried to conceal symptoms because I felt that an athlete is supposed to take hits and be fine—you are expected to push through injuries.
The truth is, I’m not fine. I have had daily chronic headaches, sometimes so severe I vomit; I feel dizzy when I stand up or turn around quickly; sometimes my vision blurs and I struggle to see the classrooms’ whiteboards; and despite my pre-concussion razor-sharp memory, I now sometimes struggle to remember the name of the main character in a book I just read. These things are not normal without a concussion, and it’s ok to acknowledge that.
There have been so many times that having PCS has embarrassed me. Over Christmas, I went to a party with family friends whom I had known since I was very young. These were people who care about me, yet I was so anxious going in there because I didn’t want to tell them that I had to take a medical leave from school. At the party, I avoided eye contact and talked to as few people as possible, which is very unlike me. I was worried that even these friends wouldn’t understand and would think that I wasn’t strong or driven enough to continue. I was even worried about telling some of my extended family. Several of my cousins had graduated from the same high school and I felt awkward having to admit that I had to defer my junior year to recover, though it was certainly no fault of my own.
Nobody should be embarrassed about having PCS. You didn’t ask for this injury, and PCS is a very real condition that is difficult to deal with. If you’re trying your best, that is all you can do and all anyone can ask of you. You should be able to talk about it.
I never liked to talk with most people about my lingering concussion symptoms. I didn’t want to look weak or feel like a victim. Even though I was coping pretty effectively with the injury, and still performing well in school, I feared that if I shared my symptoms, they would make me look subpar.
The main reason that I kept silent was that I worried that people wouldn’t understand. I definitely get weird looks, disbelief, and a lot of questions when I have to tell someone that I’m still suffering with concussion symptoms after three years. Even a sports trainer who should be informed about PCS said in front of teammates that I didn’t have a concussion when I had been suffering with PCS for two years. That is tough to deal with when you are already self-conscious about being concussed. All in all, I often felt it was better to not give anyone a chance to say something hurtful.
In retrospect, it is better to never stop talking about it. What you are dealing with is probably one of the hardest things you’ve gone through, more than most kids your age have had to endure, and you deserve to talk about it.
If someone doesn’t understand your suffering, don’t feel bad and get filled with self-doubt, but educate him or her. Tell them about PCS and your experiences and inform them about the medical evidence if they question. For every few people who roll their eyes or ask you if you’re “milking it,” there will be a true friend who cares and tells you that you’re strong and that you are doing a fantastic job coping. Those are the people you keep in your corner. I regret not standing up to more people when they questioned my injury.
There’s a balance between acknowledging that you have PCS and that it is hard, but not letting it consume you and your life.
I definitely had trouble with the acknowledging part. My mentality was to just keep on going, and not to dwell on what I had lost and how PCS was affecting me daily. After a while, the symptoms just become normal. When I eventually had to take a medical leave from school after my second concussion, and there was no more pretending that nothing was wrong, the years of symptoms and losses hit me so hard. All of the emotions of having to leave my school community, my friends, my great teachers, my beloved extracurriculars plus two and a half years of pent up frustration and losses hit me all at once.
I encourage you to keep checking in with yourself. Ask yourself how you’re really doing and give yourself an honest answer—don’t push those questions away to save for later. Find those good, supportive friends or family members and keep talking to them. Be honest with them as well. I have found that talking about it with others is often the most therapeutic and you shouldn’t have to go through this alone.
It’s ok to not be ok. It’s ok to ask for help. Always keep fighting, but it’s about the big picture, not each little battle. If you can’t do a homework assignment, don’t stay up late with an excruciating headache to try and finish because you aren’t getting anything out of it and you’re hurting yourself. Give yourself a break and go to bed. Your teacher will understand. Look at your recovery in its entirety and be happy with how far you’ve come and how much you’ve achieved.
Don’t get hung up on all of the losses, but allow yourself to acknowledge all that you have been through. Only then can you truly move on."
Post-soccer: acknowledge losses, embrace changes
Read more: http://concussionfoundation.org/story/p ... ce-changes
"Post-concussion syndrome presents a variety of symptoms which are invisible to others and often ignored or misunderstood. I have often felt that I’ve been lying to myself and to everyone for the past three years about my concussions. I have tried to conceal symptoms because I felt that an athlete is supposed to take hits and be fine—you are expected to push through injuries.
The truth is, I’m not fine. I have had daily chronic headaches, sometimes so severe I vomit; I feel dizzy when I stand up or turn around quickly; sometimes my vision blurs and I struggle to see the classrooms’ whiteboards; and despite my pre-concussion razor-sharp memory, I now sometimes struggle to remember the name of the main character in a book I just read. These things are not normal without a concussion, and it’s ok to acknowledge that.
There have been so many times that having PCS has embarrassed me. Over Christmas, I went to a party with family friends whom I had known since I was very young. These were people who care about me, yet I was so anxious going in there because I didn’t want to tell them that I had to take a medical leave from school. At the party, I avoided eye contact and talked to as few people as possible, which is very unlike me. I was worried that even these friends wouldn’t understand and would think that I wasn’t strong or driven enough to continue. I was even worried about telling some of my extended family. Several of my cousins had graduated from the same high school and I felt awkward having to admit that I had to defer my junior year to recover, though it was certainly no fault of my own.
Nobody should be embarrassed about having PCS. You didn’t ask for this injury, and PCS is a very real condition that is difficult to deal with. If you’re trying your best, that is all you can do and all anyone can ask of you. You should be able to talk about it.
I never liked to talk with most people about my lingering concussion symptoms. I didn’t want to look weak or feel like a victim. Even though I was coping pretty effectively with the injury, and still performing well in school, I feared that if I shared my symptoms, they would make me look subpar.
The main reason that I kept silent was that I worried that people wouldn’t understand. I definitely get weird looks, disbelief, and a lot of questions when I have to tell someone that I’m still suffering with concussion symptoms after three years. Even a sports trainer who should be informed about PCS said in front of teammates that I didn’t have a concussion when I had been suffering with PCS for two years. That is tough to deal with when you are already self-conscious about being concussed. All in all, I often felt it was better to not give anyone a chance to say something hurtful.
In retrospect, it is better to never stop talking about it. What you are dealing with is probably one of the hardest things you’ve gone through, more than most kids your age have had to endure, and you deserve to talk about it.
If someone doesn’t understand your suffering, don’t feel bad and get filled with self-doubt, but educate him or her. Tell them about PCS and your experiences and inform them about the medical evidence if they question. For every few people who roll their eyes or ask you if you’re “milking it,” there will be a true friend who cares and tells you that you’re strong and that you are doing a fantastic job coping. Those are the people you keep in your corner. I regret not standing up to more people when they questioned my injury.
There’s a balance between acknowledging that you have PCS and that it is hard, but not letting it consume you and your life.
I definitely had trouble with the acknowledging part. My mentality was to just keep on going, and not to dwell on what I had lost and how PCS was affecting me daily. After a while, the symptoms just become normal. When I eventually had to take a medical leave from school after my second concussion, and there was no more pretending that nothing was wrong, the years of symptoms and losses hit me so hard. All of the emotions of having to leave my school community, my friends, my great teachers, my beloved extracurriculars plus two and a half years of pent up frustration and losses hit me all at once.
I encourage you to keep checking in with yourself. Ask yourself how you’re really doing and give yourself an honest answer—don’t push those questions away to save for later. Find those good, supportive friends or family members and keep talking to them. Be honest with them as well. I have found that talking about it with others is often the most therapeutic and you shouldn’t have to go through this alone.
It’s ok to not be ok. It’s ok to ask for help. Always keep fighting, but it’s about the big picture, not each little battle. If you can’t do a homework assignment, don’t stay up late with an excruciating headache to try and finish because you aren’t getting anything out of it and you’re hurting yourself. Give yourself a break and go to bed. Your teacher will understand. Look at your recovery in its entirety and be happy with how far you’ve come and how much you’ve achieved.
Don’t get hung up on all of the losses, but allow yourself to acknowledge all that you have been through. Only then can you truly move on."
Post-soccer: acknowledge losses, embrace changes
Read more: http://concussionfoundation.org/story/p ... ce-changes
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
2 more stories
Ally Smith
"The worst part about my concussion is the price I have to pay after the fact:/ no hockey for a season yay me!!!"
https://mobile.twitter.com/allyally1211 ... 1287969793
Kit Hamada
"Nothing like playing in a fast scrimmage post-concussion to feel slow and dumb #hockey"
https://mobile.twitter.com/coveredinfis ... 9790453761
"The worst part about my concussion is the price I have to pay after the fact:/ no hockey for a season yay me!!!"
https://mobile.twitter.com/allyally1211 ... 1287969793
Kit Hamada
"Nothing like playing in a fast scrimmage post-concussion to feel slow and dumb #hockey"
https://mobile.twitter.com/coveredinfis ... 9790453761
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Concussions tied to more school problems than other injuries
Concussions tied to more school problems than other injuries
"High school and college students who get concussions may struggle more with academics than their peers who get other types of sports injuries, a small U.S. study suggests.
Researchers surveyed 70 students who received emergency treatment for concussions and 108 teens and young adults treated for other injuries.
With a concussion, students took an average of 5.4 days to return to school, compared with 2.8 days for other injuries.
One week after getting hurt, 42 percent of the students with concussions received academic help such as tutoring or extra time for tests, compared with 25 percent with other injuries. One month afterwards, 31 percent of the concussion group got help, as did 24 percent of the other students.
“After a concussion, there is an energy crisis in the brain; the brain needs more energy to heal than it has available,” said lead study author Erin Wasserman of the University of North Carolina at Chapel Hill.
“Because of this, individuals experience symptoms like headache and dizziness, they have trouble sleeping, they may experience depression, and they often have trouble concentrating and remembering things,” Wasserman, who completed the study at the University of Rochester, said by email.
“All of these symptoms are known to cause problems in school,” Wasserman added.
To assess how concussions impact schoolwork, Wasserman and colleagues surveyed student athletes treated at three emergency departments in the Rochester, New York, area from September 2013 to January 2015.
They excluded students who went to the emergency department more than 24 hours after the injury or who were hurt badly enough to require a hospital admission.
For the comparison group without concussions, researchers only included athletes with isolated injuries to the extremities, such as an arm broken in one place. Concussed students were excluded if brain scans showed what’s known as acute intracranial lesions, or badly damaged tissue.
Researchers asked about symptoms and school performance one week and one month after injuries. Questions touched on things like their concentration skills, ability to do well on tests or quizzes, and symptoms like headaches and dizziness. Scores ranged from 0 to 174 with higher scores indicating worse academic difficulties.
At one week, 83 percent of the concussed students reported impairments in at least one area that they didn’t experience before the injury, as did 60 percent of students with extremity injuries, researchers report in the American Journal of Public Health.
Also at one week, concussed students had academic dysfunction scores 15 points higher on average than their peers with other injuries at 63 and 48, respectively. After one month, though, their scores were similar: 42 with concussions and 40 with other injuries.
One limitation of the study is that 24 percent of concussed students hadn’t returned to school within a week of their injury and were excluded from the analysis. That may mean only the less-impaired students were included and for others impairment after concussion could be worse than observed in the study.
With concussions, students may also have vision problems or difficulties with eye movements that impact school performance, said Anthony Kontos, research director of the sports medicine concussion program at the University of Pittsburgh Medical Center.
“Some students may experience difficulty shifting from near to far – like from a textbook to a chalkboard – following concussion,” Kontos, who wasn’t involved in the study, said by email.
With the potential for vision and concentration issues as well as symptoms like headaches and dizziness to complicate schoolwork, doctors advise students to take frequent breaks and try to stop work before symptoms get bad, said Dr. John Leddy medical director of the concussion management clinic at the University at Buffalo.
“We don’t know for sure what the cause of difficulty with concentration and memory in school is but a common report is that of cognitive intolerance; that is, students cannot do their work for sustained periods of time before becoming very fatigued and thus unable to process new information,” Leddy, who wasn’t involved in the study, said by email.
“Academic problems likely reflect an issue of cognitive intolerance due to an inefficient brain after concussion,” Leddy added."
SOURCE: bit.ly/1TE74ha American Journal of Public Health, online May 19, 2016.
Concussions tied to more school problems than other injuries
Read more: http://mobile.reuters.com/article/healt ... YG2H6?il=0
"High school and college students who get concussions may struggle more with academics than their peers who get other types of sports injuries, a small U.S. study suggests.
Researchers surveyed 70 students who received emergency treatment for concussions and 108 teens and young adults treated for other injuries.
With a concussion, students took an average of 5.4 days to return to school, compared with 2.8 days for other injuries.
One week after getting hurt, 42 percent of the students with concussions received academic help such as tutoring or extra time for tests, compared with 25 percent with other injuries. One month afterwards, 31 percent of the concussion group got help, as did 24 percent of the other students.
“After a concussion, there is an energy crisis in the brain; the brain needs more energy to heal than it has available,” said lead study author Erin Wasserman of the University of North Carolina at Chapel Hill.
“Because of this, individuals experience symptoms like headache and dizziness, they have trouble sleeping, they may experience depression, and they often have trouble concentrating and remembering things,” Wasserman, who completed the study at the University of Rochester, said by email.
“All of these symptoms are known to cause problems in school,” Wasserman added.
To assess how concussions impact schoolwork, Wasserman and colleagues surveyed student athletes treated at three emergency departments in the Rochester, New York, area from September 2013 to January 2015.
They excluded students who went to the emergency department more than 24 hours after the injury or who were hurt badly enough to require a hospital admission.
For the comparison group without concussions, researchers only included athletes with isolated injuries to the extremities, such as an arm broken in one place. Concussed students were excluded if brain scans showed what’s known as acute intracranial lesions, or badly damaged tissue.
Researchers asked about symptoms and school performance one week and one month after injuries. Questions touched on things like their concentration skills, ability to do well on tests or quizzes, and symptoms like headaches and dizziness. Scores ranged from 0 to 174 with higher scores indicating worse academic difficulties.
At one week, 83 percent of the concussed students reported impairments in at least one area that they didn’t experience before the injury, as did 60 percent of students with extremity injuries, researchers report in the American Journal of Public Health.
Also at one week, concussed students had academic dysfunction scores 15 points higher on average than their peers with other injuries at 63 and 48, respectively. After one month, though, their scores were similar: 42 with concussions and 40 with other injuries.
One limitation of the study is that 24 percent of concussed students hadn’t returned to school within a week of their injury and were excluded from the analysis. That may mean only the less-impaired students were included and for others impairment after concussion could be worse than observed in the study.
With concussions, students may also have vision problems or difficulties with eye movements that impact school performance, said Anthony Kontos, research director of the sports medicine concussion program at the University of Pittsburgh Medical Center.
“Some students may experience difficulty shifting from near to far – like from a textbook to a chalkboard – following concussion,” Kontos, who wasn’t involved in the study, said by email.
With the potential for vision and concentration issues as well as symptoms like headaches and dizziness to complicate schoolwork, doctors advise students to take frequent breaks and try to stop work before symptoms get bad, said Dr. John Leddy medical director of the concussion management clinic at the University at Buffalo.
“We don’t know for sure what the cause of difficulty with concentration and memory in school is but a common report is that of cognitive intolerance; that is, students cannot do their work for sustained periods of time before becoming very fatigued and thus unable to process new information,” Leddy, who wasn’t involved in the study, said by email.
“Academic problems likely reflect an issue of cognitive intolerance due to an inefficient brain after concussion,” Leddy added."
SOURCE: bit.ly/1TE74ha American Journal of Public Health, online May 19, 2016.
Concussions tied to more school problems than other injuries
Read more: http://mobile.reuters.com/article/healt ... YG2H6?il=0
-
greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
IIHF Concussion Conference
IIHF Concussion Conference
“Prevention and informing the players of all the possible risks should be the high priority, because the after injury care and treatment can already be a late intervention to the life of individuals,” said Vyletelka who added that approximately ten percent of patients suffer amnesia after having suffered a concussion.
Slovakia hosts medical congress
http://www.iihf.com/home-of-hockey/news ... b249cdbcea
“Prevention and informing the players of all the possible risks should be the high priority, because the after injury care and treatment can already be a late intervention to the life of individuals,” said Vyletelka who added that approximately ten percent of patients suffer amnesia after having suffered a concussion.
Slovakia hosts medical congress
http://www.iihf.com/home-of-hockey/news ... b249cdbcea
-
greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Not admitting you have a concussion risks a longer recovery
Not admitting you have a concussion risks a longer recovery
"It’s clear that we still have a long way to go to encourage athletes to report symptoms and not hide them. In fact, 51.5% of the college athletes in this study did not initially report symptoms."
Not admitting you have a concussion risks a longer recovery
Read more: http://www.drdavidgeier.com/not-reporti ... -recovery/
"It’s clear that we still have a long way to go to encourage athletes to report symptoms and not hide them. In fact, 51.5% of the college athletes in this study did not initially report symptoms."
Not admitting you have a concussion risks a longer recovery
Read more: http://www.drdavidgeier.com/not-reporti ... -recovery/
-
greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Life in the shadows of the concussion debate
Life in the shadows of the concussion debate
"I’m in the kitchen pouring rice into a cup when my husband asks a question. I look towards him but my brain can’t do two things at once. The rice hits the floor. Thousands of grains scatter under the counter, the oven, the fridge. I grab a broom but can’t focus. My neurons are in overdrive: dinner is late, I have to get downtown but I can’t drive that far and the 45-minute streetcar ride seems daunting.
This is the new me. The old me ran a half-marathon and researched a book while working towards a master’s degree and writing TV scripts to pay the bills.
The new me gets flustered cooking rice. This is what concussion has made of me. And I hate every second of it.
“Just go,” my husband says, taking the broom from my hand. “Go to your workshop.”
So I do. It’s about, of all things, persistent symptoms of concussion.
A brain injury is hard to grasp second-hand. Even my closest friends don’t really get it. Everyone get headaches. Everyone gets tired. Lots of people forget where they parked the car. The difference is qualitative. I walk around constantly aware that my head isn’t right. It’s like jogging on a bum knee all day long, knowing the thing could blow at any second. But you can rest a bad knee by sitting down. A bad head follows you everywhere.
On good days, I fight through the brain fog and write in spurts at the computer. I run around a bit with my kid. On bad days, the fatigue is crushing. There’s this pressure in my head as if a blunt object is expanding inside my cranium, straining to get out. If I do too much — walk too far, read for too long, forget to pace myself — a piercing headache erupts. Every day is a calculation: how much will be too much?
When symptoms like mine linger, it’s called post-concussion syndrome or PCS. Over time, you learn what your brain can’t handle: loud noises (air brakes, espresso machines, wailing children including your own), crowded spaces (dinner parties, food courts, stadiums) and anything requiring focus. Sometimes just following a recipe can make my head spin.
Ten months post-injury, I still live like this. So do tens of thousands of Canadians.
Pro athletes own the concussion debate but the rest of us live in the shadows — minus the multimillion-dollar salaries and billion-dollar lawsuits — just waiting for our brains to heal.
And unlike Sidney Crosby, we’re invisible.
It’s a full house at the workshop. A few dozen people sit on folding chairs in a conference room at Toronto Western Hospital. We all look healthy enough. But many have been suffering for years. And many have had multiple concussions. With each hit, the brain becomes more vulnerable to the next.
My troubles started with a pup tent, a raucous game of hide-and-seek and a head-on collision with my preschooler. Four years later, a freak accident: two people fell on my head, knocking me backwards on a patio couch. It wasn’t a monumental crash but the next day I could barely stand.
At the workshop, we learn that 85 per cent of people recover from a concussion within three months. Research can’t yet tell us why we’re the unlucky minority. It also can’t tell us how to heal. “Currently, there is no accepted standard of care/treatment,” the handout tells us starkly. We’re encouraged to try exercise, meditation and cognitive behavioural therapy to cope with symptoms.
In a lively Q & A, people ask about vestibular therapy, nerve blockers, vitamins, acupuncture, physiotherapy, chiropractic — anything that might help. The answer is always the same: no supporting research but try it if you’d like.
I’ve tried some of these with little success. “If there’s a magic bullet out there, I think I’d know about it,” my specialist says patiently. He’s a leading concussion clinician and researcher. I’m just now coming to accept what he’s said all along: rest between activities, take it easy, be patient.
I’m not naturally inclined to any of those things. But I’m luckier than most. I have excellent doctors, a supportive family and (barely) enough family income to survive my loss of pay. I’m otherwise healthy. And I haven’t endured the stress of battling skeptical insurance companies or lengthy legal cases in which I must convince others that my injury is real.
I’m getting better. But I’m still so far from who I was.
After the workshop, in a crowded elevator, a young woman (a yoga instructor pre-injury), punches numbers into her phone. “I forgot my password!” she announces brightly. “I do that all the time now.”
We all share a chuckle. “You’ve gotta laugh,” she says. Then the elevator doors open and we disperse, vanishing into the crowds on Dundas St. W.
The doctors’ view
Every year Canadians sustain about 200,000 concussions. With roughly 15 per cent resulting in post-concussion syndrome, that’s 30,000 new cases each year.
“It’s a gigantic number,” says Dr. Charles Tator, a renowned neurosurgeon and concussion researcher at Toronto Western Hospital. “We think it is a significant public health issue.”
Tator’s schedule is crammed with PCS patients, each suffering in their own way. “It is profoundly disruptive no matter what stage in life you are. If you’re a kid then it prevents you from going to school and learning … If you’re in the working population you can’t work.” Symptoms can be so life-altering that depression and anxiety take hold. “The mental health issues of PCS are very severe in many people.”
The demand for help outstrips supply: too few skilled specialists, too few treatment options, too few research dollars. Even reliable information is hard to come by, which is why Tator helped create the workshops I attended."
“There just isn’t a lot out there for people having more persistent symptoms,” says Dr. Lesley Ruttan, the workshop leader and a neuropsychologist at the Toronto Rehabilitation Institute. “It can be a difficult system to navigate.”
Despite rising awareness of concussion in sport, PCS remains largely invisible and poorly understood. Invisible because its sufferers wear no casts or bandages, meaning support can be elusive. And invisible because its effects on the brain continue to evade modern science. No blood test or scanner can reliably detect it. No drug or therapy can reliably treat it. Tator’s prescription for patients is by nature imprecise: a graduated return to activity as symptoms allow.
“We’re starting from almost zero,” he says. “We don’t even understand where in the brain concussion occurs … It’s not surprising that treatments are not available.”
The vacuum has filled with inconsistent medical advice and unproven, often pricey treatments.
“You’re seeing lots of concussion clinics popping up here and there, and there may be claims made,” Dr. Ruttan says. “We really want to recommend to people to be cautious and to understand that it’s complex. Further research is certainly needed to try and decipher what’s happening in people when symptoms are more persistent.”
Here’s just a hint of what we still don’t know about PCS:
Why do some people struggle for years while others recover quickly?
“Not much is known about susceptibility,” says Tator. Women seem to be more susceptible but the reasons are unclear, perhaps related to thinner neck muscles providing less stability for the head. There may also be a genetic link. (My son and I, for example, both suffer from PCS.) “We’re looking for the responsible genes, but so far they’re not apparent.”
Does the type of hit or location of the brain injury matter?
“Not enough research has been done,” says Tator. Multiple concussions may be a factor but “that’s debatable.” His data suggest that 20 per cent of people with PCS have had just one concussion. Smaller “sub-concussive” hits accumulated over many years without apparent symptoms may play a role.
How does concussion affect the brain?
Is PCS a biochemical injury only or are there structural changes that have yet to be detected? Understanding the mechanisms of injury is the first step to better diagnostics and treatments.
“We need a lot of both fundamental research and clinical research,” Tator concludes. “But it’s not cancer, it’s not heart disease. We’re not a Canadian favourite. We’re way down the list.”
‘Everybody was looking at me strangely’
David Bourque, 60, musician
On a sunny day in June, David Bourque miscalculated a turn on a country road. His motorcycle skidded and he flew 15 metres in the air, landing in a ditch. When he came to, he hurt everywhere. “I should have been killed. There was pavement in my helmet,” he recalls. “Clearly it wasn’t my time.”
At the hospital overnight, they watched for signs of organ damage and prescribed painkillers for five fractured ribs. But no one mentioned anything about brain injury. “They sent me home with no head injury routine and no followup.”
At first, Bourque attributed the confusion and spacey feeling in his head to the painkillers. Doctors said his symptoms were normal. He soon went back to work, as a clarinetist with the Toronto Symphony Orchestra.
To his surprise, he couldn’t perform. Suddenly, at 53 and at the peak of his musical career, he was like a ninth grader, playing wrong keys and rhythms, forgetting fingerings. One night during a performance of Shostakovich’s Symphony No. 11, he hit a long, fast clarinet solo. “I’m not sure what came out,” he says, still sounding astonished. “Everybody was looking at me strangely.”
Bourque had been in car accidents before and taken hard hits playing hockey in his youth, even dislocating his jaw. But he’d never had symptoms like this. He kept performing, somehow muddling through until he slowly started to recover.
Then, a year after his crash, on holiday in Paris with his girlfriend, the top of his head hit a low-hanging window frame. He tried to shake it off with a walk but somehow couldn’t make his way across the road. “That,” he says, “was the beginning of the end.”
His memory worsened, he was often confused and couldn’t follow conversations. He forgot the names of musical pieces. “People say, ‘Oh, that happens all the time.’ And I say, ‘Not like this it doesn’t.’ I know the name of the piece. It’s in here,” he says, tapping his forehead, “inside a little door that’s locked.”
Doctors call this “loss of executive function” and at times it reduced him to tears. He struggled with depression. And after a few months of trying, he stopped working.
For nine months he lived with no income while the insurance company processed his disability claim, then denied it, then denied an appeal. He considered a lawsuit but the added stress, he says, “would likely prolong and even worsen symptoms. The insurance companies count on this.”
Finally, at 56, David Bourque put down his clarinet. He retired from the TSO. “I’ve not played great music with great players in an orchestra setting since then,” he says quietly. “And I never will.” He equates the grief to the death of his father. “To think that I could never play a Mahler symphony again … It was a really significant loss.”
Since his concussion, Bourque has learned to live with all kinds of loss. His girlfriend split, his sister became estranged. But with proper medical care — including a sleep study that revealed a drastic disruption in sleeping patterns, quickly repaired with a few months of medication — many symptoms have subsided. His depression is in check. “My soul is intact.”
What does he want people to know about living with PCS? “People say ‘Ah, well, you’re just faking.’ You can think whatever you want, but this is very real. And it is extraordinarily difficult.”
‘I’m not Sidney Crosby’
Laurie Carmichael, 43, senior program adviser, Ontario government
As falls go, Laurie Carmichael’s was unremarkable. Walking to a restaurant, turning to speak to her husband, she caught a boot on an uneven sidewalk and toppled sideways. “Just a totally clumsy, spastic move but I fell down kind of hard.”
At lunch she felt nauseous and fuzzy-headed. She returned to work but struggled.
But a concussion it was, confirmed a few days later by a family doctor who instructed her to take it easy mentally and physically. No mean feat for a woman with a full-time job and two young children. She took a few days off work but it was December: the kids had school concerts, she had a work deadline and she admits, “I was kind of addicted to my iPhone.”
In the weeks ahead, she couldn’t escape the headaches, light and noise sensitivity. She took sporadic days off work. She closed the office blinds, dialled down the computer screen brightness. “By the end of the day I was really struggling.”
Home offered little respite. “We’re a busy household and there’s always lots of volume.” Told to avoid another fall, she gave up skating and skiing with the kids. A lifelong recreational runner, she now found even a dash to the streetcar could be too much.
“I always felt a bit like people thought I was exaggerating. Even a few weeks after, there was always people that would say ‘Really? Are you seriously still feeling symptoms?’ … or ‘I had concussions before and I got right back into the swing of things.’ I just felt like I was weaker.”
Six months in, she tried a short run. “I swear I felt nauseous for almost three weeks after.”
Now, a year and a half after her fall, Carmichael is much improved. Her symptoms are manageable. But she still gets headaches. And she still can’t run. It’s her “new normal” — a place she never expected to be.
“I’m not Sidney Crosby. I’m not a pro athlete,” she says. “You feel like you’re in a space that you don’t belong.”
‘It’s like your body is in molasses’
Trevor Bullen, 48, high school vice-principal
Tim Bullen, 48, recruitment executive
Excited teens hover outside the vice-principal’s office at Riverdale Collegiate: an identical twin is in the house. Students giggle at the matching shaved heads, broad shoulders, big smiles. But the VP, Trevor Bullen, and his brother share something else that no one sees.
Tim Bullen was first to the concussion dance, almost three years ago, at the back of a whitewater raft when it took a five-metre drop. His head whipped back and that’s all it took. “It wasn’t a real head hit.”
Almost a year later, Trevor was standing at a school fundraiser and nursing a cold. His wife cracked a joke and he laughed — so hard it triggered a massive coughing fit. He passed out, falling backwards, his head striking a buddy’s knee on the way down.
It was Trevor’s first diagnosed concussion, Tim’s third.
“I did it for him,” Trevor says.
Tim laughs. “He just wanted to join the party.”
Life post-concussion has been anything but.
Jocks since childhood, they both took blows to the head playing school football and other sports with no lingering effects. But this is different.
“There isn’t a time of day where I’m like ‘Oh, I don’t feel concussed,’” Tim says plainly.
Push too hard and debilitating fatigue takes hold. “It’s like your body is in molasses,” Trevor explains. “To get across a room is a concerted effort.”
But both have demanding jobs and teenagers at home. Tim co-partners a business. Sometimes he works from home, takes a nap then works some more.
Both must carefully manage their days, their energy — or they wind up in bed with the curtains closed. It’s hard for family to understand. “Internally you’ve changed,” says Trevor, “and externally it doesn’t look that way.”
“It just takes away who you are,” Tim says. “You were a big, strong, active, strapping person … We used to play basketball every Monday night. Running was a big thing we both liked to do. And those days are gone.”
Both have tried multiple therapies, exercise and doctors. They’re positive-minded guys and they do what they can. But for all they share, there is one difference:
“I’ve kind of in a way resigned myself,” says Tim. “I don’t think it’ll ever go away.”
Trevor is “a little more optimistic. I’ve seen improvement every year, so hopefully we keep moving forward …
“Hopefully down the road there’ll be that magic pill that we take and feel instantly better.”
Life in the shadows of the concussion debate
Read more: https://www.thestar.com/news/insight/20 ... ebate.html
"I’m in the kitchen pouring rice into a cup when my husband asks a question. I look towards him but my brain can’t do two things at once. The rice hits the floor. Thousands of grains scatter under the counter, the oven, the fridge. I grab a broom but can’t focus. My neurons are in overdrive: dinner is late, I have to get downtown but I can’t drive that far and the 45-minute streetcar ride seems daunting.
This is the new me. The old me ran a half-marathon and researched a book while working towards a master’s degree and writing TV scripts to pay the bills.
The new me gets flustered cooking rice. This is what concussion has made of me. And I hate every second of it.
“Just go,” my husband says, taking the broom from my hand. “Go to your workshop.”
So I do. It’s about, of all things, persistent symptoms of concussion.
A brain injury is hard to grasp second-hand. Even my closest friends don’t really get it. Everyone get headaches. Everyone gets tired. Lots of people forget where they parked the car. The difference is qualitative. I walk around constantly aware that my head isn’t right. It’s like jogging on a bum knee all day long, knowing the thing could blow at any second. But you can rest a bad knee by sitting down. A bad head follows you everywhere.
On good days, I fight through the brain fog and write in spurts at the computer. I run around a bit with my kid. On bad days, the fatigue is crushing. There’s this pressure in my head as if a blunt object is expanding inside my cranium, straining to get out. If I do too much — walk too far, read for too long, forget to pace myself — a piercing headache erupts. Every day is a calculation: how much will be too much?
When symptoms like mine linger, it’s called post-concussion syndrome or PCS. Over time, you learn what your brain can’t handle: loud noises (air brakes, espresso machines, wailing children including your own), crowded spaces (dinner parties, food courts, stadiums) and anything requiring focus. Sometimes just following a recipe can make my head spin.
Ten months post-injury, I still live like this. So do tens of thousands of Canadians.
Pro athletes own the concussion debate but the rest of us live in the shadows — minus the multimillion-dollar salaries and billion-dollar lawsuits — just waiting for our brains to heal.
And unlike Sidney Crosby, we’re invisible.
It’s a full house at the workshop. A few dozen people sit on folding chairs in a conference room at Toronto Western Hospital. We all look healthy enough. But many have been suffering for years. And many have had multiple concussions. With each hit, the brain becomes more vulnerable to the next.
My troubles started with a pup tent, a raucous game of hide-and-seek and a head-on collision with my preschooler. Four years later, a freak accident: two people fell on my head, knocking me backwards on a patio couch. It wasn’t a monumental crash but the next day I could barely stand.
At the workshop, we learn that 85 per cent of people recover from a concussion within three months. Research can’t yet tell us why we’re the unlucky minority. It also can’t tell us how to heal. “Currently, there is no accepted standard of care/treatment,” the handout tells us starkly. We’re encouraged to try exercise, meditation and cognitive behavioural therapy to cope with symptoms.
In a lively Q & A, people ask about vestibular therapy, nerve blockers, vitamins, acupuncture, physiotherapy, chiropractic — anything that might help. The answer is always the same: no supporting research but try it if you’d like.
I’ve tried some of these with little success. “If there’s a magic bullet out there, I think I’d know about it,” my specialist says patiently. He’s a leading concussion clinician and researcher. I’m just now coming to accept what he’s said all along: rest between activities, take it easy, be patient.
I’m not naturally inclined to any of those things. But I’m luckier than most. I have excellent doctors, a supportive family and (barely) enough family income to survive my loss of pay. I’m otherwise healthy. And I haven’t endured the stress of battling skeptical insurance companies or lengthy legal cases in which I must convince others that my injury is real.
I’m getting better. But I’m still so far from who I was.
After the workshop, in a crowded elevator, a young woman (a yoga instructor pre-injury), punches numbers into her phone. “I forgot my password!” she announces brightly. “I do that all the time now.”
We all share a chuckle. “You’ve gotta laugh,” she says. Then the elevator doors open and we disperse, vanishing into the crowds on Dundas St. W.
The doctors’ view
Every year Canadians sustain about 200,000 concussions. With roughly 15 per cent resulting in post-concussion syndrome, that’s 30,000 new cases each year.
“It’s a gigantic number,” says Dr. Charles Tator, a renowned neurosurgeon and concussion researcher at Toronto Western Hospital. “We think it is a significant public health issue.”
Tator’s schedule is crammed with PCS patients, each suffering in their own way. “It is profoundly disruptive no matter what stage in life you are. If you’re a kid then it prevents you from going to school and learning … If you’re in the working population you can’t work.” Symptoms can be so life-altering that depression and anxiety take hold. “The mental health issues of PCS are very severe in many people.”
The demand for help outstrips supply: too few skilled specialists, too few treatment options, too few research dollars. Even reliable information is hard to come by, which is why Tator helped create the workshops I attended."
“There just isn’t a lot out there for people having more persistent symptoms,” says Dr. Lesley Ruttan, the workshop leader and a neuropsychologist at the Toronto Rehabilitation Institute. “It can be a difficult system to navigate.”
Despite rising awareness of concussion in sport, PCS remains largely invisible and poorly understood. Invisible because its sufferers wear no casts or bandages, meaning support can be elusive. And invisible because its effects on the brain continue to evade modern science. No blood test or scanner can reliably detect it. No drug or therapy can reliably treat it. Tator’s prescription for patients is by nature imprecise: a graduated return to activity as symptoms allow.
“We’re starting from almost zero,” he says. “We don’t even understand where in the brain concussion occurs … It’s not surprising that treatments are not available.”
The vacuum has filled with inconsistent medical advice and unproven, often pricey treatments.
“You’re seeing lots of concussion clinics popping up here and there, and there may be claims made,” Dr. Ruttan says. “We really want to recommend to people to be cautious and to understand that it’s complex. Further research is certainly needed to try and decipher what’s happening in people when symptoms are more persistent.”
Here’s just a hint of what we still don’t know about PCS:
Why do some people struggle for years while others recover quickly?
“Not much is known about susceptibility,” says Tator. Women seem to be more susceptible but the reasons are unclear, perhaps related to thinner neck muscles providing less stability for the head. There may also be a genetic link. (My son and I, for example, both suffer from PCS.) “We’re looking for the responsible genes, but so far they’re not apparent.”
Does the type of hit or location of the brain injury matter?
“Not enough research has been done,” says Tator. Multiple concussions may be a factor but “that’s debatable.” His data suggest that 20 per cent of people with PCS have had just one concussion. Smaller “sub-concussive” hits accumulated over many years without apparent symptoms may play a role.
How does concussion affect the brain?
Is PCS a biochemical injury only or are there structural changes that have yet to be detected? Understanding the mechanisms of injury is the first step to better diagnostics and treatments.
“We need a lot of both fundamental research and clinical research,” Tator concludes. “But it’s not cancer, it’s not heart disease. We’re not a Canadian favourite. We’re way down the list.”
‘Everybody was looking at me strangely’
David Bourque, 60, musician
On a sunny day in June, David Bourque miscalculated a turn on a country road. His motorcycle skidded and he flew 15 metres in the air, landing in a ditch. When he came to, he hurt everywhere. “I should have been killed. There was pavement in my helmet,” he recalls. “Clearly it wasn’t my time.”
At the hospital overnight, they watched for signs of organ damage and prescribed painkillers for five fractured ribs. But no one mentioned anything about brain injury. “They sent me home with no head injury routine and no followup.”
At first, Bourque attributed the confusion and spacey feeling in his head to the painkillers. Doctors said his symptoms were normal. He soon went back to work, as a clarinetist with the Toronto Symphony Orchestra.
To his surprise, he couldn’t perform. Suddenly, at 53 and at the peak of his musical career, he was like a ninth grader, playing wrong keys and rhythms, forgetting fingerings. One night during a performance of Shostakovich’s Symphony No. 11, he hit a long, fast clarinet solo. “I’m not sure what came out,” he says, still sounding astonished. “Everybody was looking at me strangely.”
Bourque had been in car accidents before and taken hard hits playing hockey in his youth, even dislocating his jaw. But he’d never had symptoms like this. He kept performing, somehow muddling through until he slowly started to recover.
Then, a year after his crash, on holiday in Paris with his girlfriend, the top of his head hit a low-hanging window frame. He tried to shake it off with a walk but somehow couldn’t make his way across the road. “That,” he says, “was the beginning of the end.”
His memory worsened, he was often confused and couldn’t follow conversations. He forgot the names of musical pieces. “People say, ‘Oh, that happens all the time.’ And I say, ‘Not like this it doesn’t.’ I know the name of the piece. It’s in here,” he says, tapping his forehead, “inside a little door that’s locked.”
Doctors call this “loss of executive function” and at times it reduced him to tears. He struggled with depression. And after a few months of trying, he stopped working.
For nine months he lived with no income while the insurance company processed his disability claim, then denied it, then denied an appeal. He considered a lawsuit but the added stress, he says, “would likely prolong and even worsen symptoms. The insurance companies count on this.”
Finally, at 56, David Bourque put down his clarinet. He retired from the TSO. “I’ve not played great music with great players in an orchestra setting since then,” he says quietly. “And I never will.” He equates the grief to the death of his father. “To think that I could never play a Mahler symphony again … It was a really significant loss.”
Since his concussion, Bourque has learned to live with all kinds of loss. His girlfriend split, his sister became estranged. But with proper medical care — including a sleep study that revealed a drastic disruption in sleeping patterns, quickly repaired with a few months of medication — many symptoms have subsided. His depression is in check. “My soul is intact.”
What does he want people to know about living with PCS? “People say ‘Ah, well, you’re just faking.’ You can think whatever you want, but this is very real. And it is extraordinarily difficult.”
‘I’m not Sidney Crosby’
Laurie Carmichael, 43, senior program adviser, Ontario government
As falls go, Laurie Carmichael’s was unremarkable. Walking to a restaurant, turning to speak to her husband, she caught a boot on an uneven sidewalk and toppled sideways. “Just a totally clumsy, spastic move but I fell down kind of hard.”
At lunch she felt nauseous and fuzzy-headed. She returned to work but struggled.
But a concussion it was, confirmed a few days later by a family doctor who instructed her to take it easy mentally and physically. No mean feat for a woman with a full-time job and two young children. She took a few days off work but it was December: the kids had school concerts, she had a work deadline and she admits, “I was kind of addicted to my iPhone.”
In the weeks ahead, she couldn’t escape the headaches, light and noise sensitivity. She took sporadic days off work. She closed the office blinds, dialled down the computer screen brightness. “By the end of the day I was really struggling.”
Home offered little respite. “We’re a busy household and there’s always lots of volume.” Told to avoid another fall, she gave up skating and skiing with the kids. A lifelong recreational runner, she now found even a dash to the streetcar could be too much.
“I always felt a bit like people thought I was exaggerating. Even a few weeks after, there was always people that would say ‘Really? Are you seriously still feeling symptoms?’ … or ‘I had concussions before and I got right back into the swing of things.’ I just felt like I was weaker.”
Six months in, she tried a short run. “I swear I felt nauseous for almost three weeks after.”
Now, a year and a half after her fall, Carmichael is much improved. Her symptoms are manageable. But she still gets headaches. And she still can’t run. It’s her “new normal” — a place she never expected to be.
“I’m not Sidney Crosby. I’m not a pro athlete,” she says. “You feel like you’re in a space that you don’t belong.”
‘It’s like your body is in molasses’
Trevor Bullen, 48, high school vice-principal
Tim Bullen, 48, recruitment executive
Excited teens hover outside the vice-principal’s office at Riverdale Collegiate: an identical twin is in the house. Students giggle at the matching shaved heads, broad shoulders, big smiles. But the VP, Trevor Bullen, and his brother share something else that no one sees.
Tim Bullen was first to the concussion dance, almost three years ago, at the back of a whitewater raft when it took a five-metre drop. His head whipped back and that’s all it took. “It wasn’t a real head hit.”
Almost a year later, Trevor was standing at a school fundraiser and nursing a cold. His wife cracked a joke and he laughed — so hard it triggered a massive coughing fit. He passed out, falling backwards, his head striking a buddy’s knee on the way down.
It was Trevor’s first diagnosed concussion, Tim’s third.
“I did it for him,” Trevor says.
Tim laughs. “He just wanted to join the party.”
Life post-concussion has been anything but.
Jocks since childhood, they both took blows to the head playing school football and other sports with no lingering effects. But this is different.
“There isn’t a time of day where I’m like ‘Oh, I don’t feel concussed,’” Tim says plainly.
Push too hard and debilitating fatigue takes hold. “It’s like your body is in molasses,” Trevor explains. “To get across a room is a concerted effort.”
But both have demanding jobs and teenagers at home. Tim co-partners a business. Sometimes he works from home, takes a nap then works some more.
Both must carefully manage their days, their energy — or they wind up in bed with the curtains closed. It’s hard for family to understand. “Internally you’ve changed,” says Trevor, “and externally it doesn’t look that way.”
“It just takes away who you are,” Tim says. “You were a big, strong, active, strapping person … We used to play basketball every Monday night. Running was a big thing we both liked to do. And those days are gone.”
Both have tried multiple therapies, exercise and doctors. They’re positive-minded guys and they do what they can. But for all they share, there is one difference:
“I’ve kind of in a way resigned myself,” says Tim. “I don’t think it’ll ever go away.”
Trevor is “a little more optimistic. I’ve seen improvement every year, so hopefully we keep moving forward …
“Hopefully down the road there’ll be that magic pill that we take and feel instantly better.”
Life in the shadows of the concussion debate
Read more: https://www.thestar.com/news/insight/20 ... ebate.html
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greybeard58
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- Joined: Sat Aug 21, 2004 11:40 pm
Concussion safety bill passes in Erie County
Concussion safety bill passes in Erie County
"Erie County legislators signed-off 10-1 Thursday on new requirements for youth contact sport coaches.
The new concussion safety law, co-sponsored by Legislator Patrick Burke (D-District 7) and Legislator Joseph Lorigo (R-District 10) requires coaches, parent supervisors, and officials to complete concussion safety and awareness courses through the state, or face a $100 fine from the county.
“This will be good. Because it will increase awareness,” said Dr. Michael Freitas of UBMD Orthopaedics and Sports Medicine.
“Everyone knows about the NFL and that’s fine, but you don’t typically think of the youth sports and it happens probably more frequently there,” he said.
Dr. Freitas is used to treating youth concussions, but said he should be treating a lot more.
Experts report less than 10 percent of youth concussions actually get diagnosed.
“One of the biggest challenges is proper recognition, that that injury may have happened,” said Barney Walsh, President of Buffalo Bison Hockey Association, a youth hockey league in North Buffalo.
Two time Olympian and Youth Hockey Director for the Buffalo Bison Hockey Association, Shelley Looney, is also for the extra education.
“We as coaches need to be aware of what can occur. We’re no doctors but at the same time we’re watching and observing and taking care of these kids when they’re in our care,” Looney told News 4.
She thinks parents need to be involved in training too.
Buffalo Bison Youth Hockey is a nonprofit association, and separate from school sports. Walsh noted that athletes don’t always keep coaches in the loop about injuries they sustain during their other activities; he feels keeping parents and coaches on the same page is paramount.
It’s not just youth hockey players at risk for concussions, and it’s also not just boys.
“Very high on that list are soccer, men’s and women’s soccer, or boy’s and girl’s. And actually more so in girl’s than opposed to boy’s that play the same sport,” Dr. Freitas said.
According Freitas, that’s likely due to neck strength. Typically girls have less muscle in their neck, and those muscles can ease forces on the brain during impact.
Legislator Lorigo told News 4 both he and Legislator Burke have young children. The more they learned about the long-term dangers of concussions, the more they felt the county needed to take preemptive measures.
Concussion safety bill passes in Erie County
http://wivb.com/2016/06/23/concussion-s ... ie-county/
"Erie County legislators signed-off 10-1 Thursday on new requirements for youth contact sport coaches.
The new concussion safety law, co-sponsored by Legislator Patrick Burke (D-District 7) and Legislator Joseph Lorigo (R-District 10) requires coaches, parent supervisors, and officials to complete concussion safety and awareness courses through the state, or face a $100 fine from the county.
“This will be good. Because it will increase awareness,” said Dr. Michael Freitas of UBMD Orthopaedics and Sports Medicine.
“Everyone knows about the NFL and that’s fine, but you don’t typically think of the youth sports and it happens probably more frequently there,” he said.
Dr. Freitas is used to treating youth concussions, but said he should be treating a lot more.
Experts report less than 10 percent of youth concussions actually get diagnosed.
“One of the biggest challenges is proper recognition, that that injury may have happened,” said Barney Walsh, President of Buffalo Bison Hockey Association, a youth hockey league in North Buffalo.
Two time Olympian and Youth Hockey Director for the Buffalo Bison Hockey Association, Shelley Looney, is also for the extra education.
“We as coaches need to be aware of what can occur. We’re no doctors but at the same time we’re watching and observing and taking care of these kids when they’re in our care,” Looney told News 4.
She thinks parents need to be involved in training too.
Buffalo Bison Youth Hockey is a nonprofit association, and separate from school sports. Walsh noted that athletes don’t always keep coaches in the loop about injuries they sustain during their other activities; he feels keeping parents and coaches on the same page is paramount.
It’s not just youth hockey players at risk for concussions, and it’s also not just boys.
“Very high on that list are soccer, men’s and women’s soccer, or boy’s and girl’s. And actually more so in girl’s than opposed to boy’s that play the same sport,” Dr. Freitas said.
According Freitas, that’s likely due to neck strength. Typically girls have less muscle in their neck, and those muscles can ease forces on the brain during impact.
Legislator Lorigo told News 4 both he and Legislator Burke have young children. The more they learned about the long-term dangers of concussions, the more they felt the county needed to take preemptive measures.
Concussion safety bill passes in Erie County
http://wivb.com/2016/06/23/concussion-s ... ie-county/
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
http://www.nfhs.org/articles/direct-ind ... imization/
Direct, Indirect Contact to the Head Penalties in High School Ice Hockey Continue Focus on Risk Minimization
By Maddie Koss on May 19, 2016
nfhs news
Share
In continuing efforts to minimize the risk of injury and spread concussion awareness in high school ice hockey, specific definitions for direct contact and indirect contact to the head, along with specific penalties for each, have been added to provide clarity.
These revisions and seven other rules changes were recommended by the National Federation of State High School Associations (NFHS) Ice Hockey Rules Committee at its April 25-26 meeting in Indianapolis. All 2016-17 ice hockey rules changes were subsequently approved by the NFHS Board of Directors.
In its ongoing attempt to minimize the risk of injury in the sport, the Ice Hockey Rules Committee added two new articles to Rule 7-6 to clarify between direct contact and indirect contact to the head. Previously, the rule stated: “No player shall make contact from any direction with an opposing player’s head or neck area in any manner, including, but not limited to, with the shoulder, stick, elbow, etc.”
Now, Rule 7-6-2 defines direct contact to the head as when the initial force of the contact occurs to the head or neck area, resulting in a flagrant foul. Direct contact carries a major or game disqualification penalty. According to Rule 7-6-3, indirect contact to the head occurs when the initial force of the contact begins below the neck and progresses upward to the head or neck area. Indirect contact carries a minor penalty, unless the contact is flagrant, in which case, a major or game disqualification is assessed.
“The change is consistent with the committee’s goal to spread awareness of head injury and concussions,” said Dan Schuster, NFHS director of educational services and liaison to the Ice Hockey Rules Committee. “This change appropriately penalizes players for hits to the head. This will certainly provide clarity for officials, but it will also be a positive for high school hockey and help create a safe playing environment for participants.”
Language regarding penalty shots in Rule 4-7-3 was revised to include language to address the designation of a replacement player due to injury. The revised rule states if the fouled player is injured, the shot may be taken by any player of the non-offending side who is on the ice when play is stopped.
In addition, a new article was added to Rule 4-6 regarding major penalties and suspensions. The current wording only refers to players, when the intent of the disqualification penalty is to have the same consequence apply for all participants. The new addition states: “All provisions of Rule 4-6, including the major penalty and suspension, shall apply for a game disqualification assessed to a coach or other team personnel.”
In order to create consistency regarding the penalty structure within Rule 2-3, the committee added a penalty to both Article 1 and Article 2 to create a consequence for noncompliance regarding players in uniform.
Addressing warm-ups, previously players were allowed to skate the entire ice surface until a team assumed its own end. The rules committee removed that language from Rule 9-10-3 and replaced it with “each team shall proceed to its end of the ice and continue activity to its own end of the rink for the duration of the warm-up.” This change was made to avoid unnecessary interaction between teams during the warm-up.
Language regarding participant conduct in Rule 6-1-6 was added to reinforce the zero tolerance policy for insensitive language. The rules committee added that no gender slurs shall be used by players, coaches or other team personnel.
Previously, Article 5 of Rule 9-1 described the location of where players and sticks should be during a faceoff. Now it states: “Excluding goalkeepers, players shall take a stationary position on all faceoffs before the puck is dropped,” which will help clarify the process of a faceoff and eliminate motion prior to faceoffs.
“Motion prior to the faceoff can certainly serve as an advantage for a team. This rule change will eliminate the advantage and level the playing field for faceoffs,” Schuster said.
The final rules change addresses when a puck is grasped by hand and play is stopped. The rules committee moved 9-1-8j to 9-1-11j to make this infraction consistent with similar infractions, such as high-sticking and hand passes. The resulting faceoff will now take place in the defending zone of the offending team, not the nearest faceoff spot.
A complete listing of the ice hockey rules changes will be available on the NFHS website at www.nfhs.org. Click on “Activities & Sports” at the top of the home page, and select “Ice Hockey.”
According to the 2014-15 NFHS High School Athletics Participation Survey, there are 35,875 boys participating in ice hockey in 1,603 schools across the country, and 9,418 girls playing the sport in 615 schools.
Direct, Indirect Contact to the Head Penalties in High School Ice Hockey Continue Focus on Risk Minimization
By Maddie Koss on May 19, 2016
nfhs news
Share
In continuing efforts to minimize the risk of injury and spread concussion awareness in high school ice hockey, specific definitions for direct contact and indirect contact to the head, along with specific penalties for each, have been added to provide clarity.
These revisions and seven other rules changes were recommended by the National Federation of State High School Associations (NFHS) Ice Hockey Rules Committee at its April 25-26 meeting in Indianapolis. All 2016-17 ice hockey rules changes were subsequently approved by the NFHS Board of Directors.
In its ongoing attempt to minimize the risk of injury in the sport, the Ice Hockey Rules Committee added two new articles to Rule 7-6 to clarify between direct contact and indirect contact to the head. Previously, the rule stated: “No player shall make contact from any direction with an opposing player’s head or neck area in any manner, including, but not limited to, with the shoulder, stick, elbow, etc.”
Now, Rule 7-6-2 defines direct contact to the head as when the initial force of the contact occurs to the head or neck area, resulting in a flagrant foul. Direct contact carries a major or game disqualification penalty. According to Rule 7-6-3, indirect contact to the head occurs when the initial force of the contact begins below the neck and progresses upward to the head or neck area. Indirect contact carries a minor penalty, unless the contact is flagrant, in which case, a major or game disqualification is assessed.
“The change is consistent with the committee’s goal to spread awareness of head injury and concussions,” said Dan Schuster, NFHS director of educational services and liaison to the Ice Hockey Rules Committee. “This change appropriately penalizes players for hits to the head. This will certainly provide clarity for officials, but it will also be a positive for high school hockey and help create a safe playing environment for participants.”
Language regarding penalty shots in Rule 4-7-3 was revised to include language to address the designation of a replacement player due to injury. The revised rule states if the fouled player is injured, the shot may be taken by any player of the non-offending side who is on the ice when play is stopped.
In addition, a new article was added to Rule 4-6 regarding major penalties and suspensions. The current wording only refers to players, when the intent of the disqualification penalty is to have the same consequence apply for all participants. The new addition states: “All provisions of Rule 4-6, including the major penalty and suspension, shall apply for a game disqualification assessed to a coach or other team personnel.”
In order to create consistency regarding the penalty structure within Rule 2-3, the committee added a penalty to both Article 1 and Article 2 to create a consequence for noncompliance regarding players in uniform.
Addressing warm-ups, previously players were allowed to skate the entire ice surface until a team assumed its own end. The rules committee removed that language from Rule 9-10-3 and replaced it with “each team shall proceed to its end of the ice and continue activity to its own end of the rink for the duration of the warm-up.” This change was made to avoid unnecessary interaction between teams during the warm-up.
Language regarding participant conduct in Rule 6-1-6 was added to reinforce the zero tolerance policy for insensitive language. The rules committee added that no gender slurs shall be used by players, coaches or other team personnel.
Previously, Article 5 of Rule 9-1 described the location of where players and sticks should be during a faceoff. Now it states: “Excluding goalkeepers, players shall take a stationary position on all faceoffs before the puck is dropped,” which will help clarify the process of a faceoff and eliminate motion prior to faceoffs.
“Motion prior to the faceoff can certainly serve as an advantage for a team. This rule change will eliminate the advantage and level the playing field for faceoffs,” Schuster said.
The final rules change addresses when a puck is grasped by hand and play is stopped. The rules committee moved 9-1-8j to 9-1-11j to make this infraction consistent with similar infractions, such as high-sticking and hand passes. The resulting faceoff will now take place in the defending zone of the offending team, not the nearest faceoff spot.
A complete listing of the ice hockey rules changes will be available on the NFHS website at www.nfhs.org. Click on “Activities & Sports” at the top of the home page, and select “Ice Hockey.”
According to the 2014-15 NFHS High School Athletics Participation Survey, there are 35,875 boys participating in ice hockey in 1,603 schools across the country, and 9,418 girls playing the sport in 615 schools.
-
greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
What A Race Car Crash Does To Your Brain
Great article-- different sport but still head injury
"Concussions damage the myelin sheath which protects nerves in the brain, reports the Vancouver Sun. Myelin is also the substance that is damaged in multiple sclerosis patients’ brains. Specially tuned magnetic resource imaging of hockey players’ brains showed that the myelin appears to separate from the nerve in a concussion. Researchers found that the myelin gradually repairs itself over a two month period following a concussion. Thus, concussions may need more time to heal than symptoms suggest."
What A Race Car Crash Does To Your Brain
Read more: http://blackflag.jalopnik.com/what-a-ra ... 1778499867
"Concussions damage the myelin sheath which protects nerves in the brain, reports the Vancouver Sun. Myelin is also the substance that is damaged in multiple sclerosis patients’ brains. Specially tuned magnetic resource imaging of hockey players’ brains showed that the myelin appears to separate from the nerve in a concussion. Researchers found that the myelin gradually repairs itself over a two month period following a concussion. Thus, concussions may need more time to heal than symptoms suggest."
What A Race Car Crash Does To Your Brain
Read more: http://blackflag.jalopnik.com/what-a-ra ... 1778499867
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Washington Post article
An intelligent step forward for concussion prevention
Tracking youth injuries remains difficult, so the CDC’s plan to create a national monitoring system is wise.
https://www.washingtonpost.com/opinions ... story.html
Tracking youth injuries remains difficult, so the CDC’s plan to create a national monitoring system is wise.
https://www.washingtonpost.com/opinions ... story.html
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
2 more stories
Haleigh Daigle
"My concussion has shown me my true strength but I honestly just wish I could play hockey again."
https://mobile.twitter.com/Haleigh687/s ... 4646348800
Hockey Parent
"As a parent of three children (young adults) all of whom suffered concussions playing hockey and rugby ~ I applaud Rowan's Law."
https://mobile.twitter.com/Deadhead1968 ... 5458235392
"My concussion has shown me my true strength but I honestly just wish I could play hockey again."
https://mobile.twitter.com/Haleigh687/s ... 4646348800
Hockey Parent
"As a parent of three children (young adults) all of whom suffered concussions playing hockey and rugby ~ I applaud Rowan's Law."
https://mobile.twitter.com/Deadhead1968 ... 5458235392
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
100% of parents 'affected in some way by concussions'
100% of parents 'affected in some way by concussions'
http://www.usatoday.com/story/sports/20 ... /87338008/
http://www.usatoday.com/story/sports/20 ... /87338008/
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
UM study finds multiple concussions could cause serious harm
UM study finds multiple concussions could cause serious harm
"New research at the University of Montana found that concussions can have a long-term impact on learning ability.
Alex Santos and Sarj Patel are two of the professors who have studied the effects of concussions at UM. They recently tracked the progress of student athletes at the university and discovered athletes can have prolonged symptoms if they return to the field before their brains are fully healed from a concussion. They're also more likely to suffer a second concussion.
Patel, Santos and their team have been developing technology that tracks small changes in the body's central nervous system to determine the severity of concussion symptoms.
"Some of the studies that we are just developing no (are) showing that in a certain percentage (of students), they do not recover completely," said Santos. "We're talking about not only days or moths, we're talking about years."
"Our lab is primarily focused on trying to understand how the brain changes following traumatic brain injury," Patel said.
They say one concussion is unlikely to do permanent damage, but multiple can be devastating to a person's learning ability.
"Those are starting to show us that in some cases, in a portion of those individuals that have had repetitive injuries, also have issues potentially with working or learning memory," Patel added. "These injuries can have long term affects on being able to concentrate, being able to work for long periods of time, fatigue."
They say before athletes hit the field again, they should have a doctor's note to acknowledge vision, balance and cognitive tests are where they need to be.
One of the machines at the University of Montana's Neural Injury Center tests balance. The machine tests the natural sway and stability of your body. Researchers say one concussion symptom is unstable balance.
There is also a vision test to determine a person's reaction time. Subjects wear special goggles and follow red dot light patterns that monitor reaction time--a vital tool in athletics and learning.
"One of the most important things that you have to have is the ability to recognize your environment and then act upon that," Santos added.
"The cornerstone of our research here at the university is to at least help identify individuals and then maybe plan the best course of action or treatment for them," Patel said.
They advise anyone who thinks they may have received a concussion to seek a doctor's advice immediately and not continue to play their sport until fully recovered."
UM study finds multiple concussions could cause serious harm
http://www.nbcmontana.com/news/keci/um- ... rious-harm
"New research at the University of Montana found that concussions can have a long-term impact on learning ability.
Alex Santos and Sarj Patel are two of the professors who have studied the effects of concussions at UM. They recently tracked the progress of student athletes at the university and discovered athletes can have prolonged symptoms if they return to the field before their brains are fully healed from a concussion. They're also more likely to suffer a second concussion.
Patel, Santos and their team have been developing technology that tracks small changes in the body's central nervous system to determine the severity of concussion symptoms.
"Some of the studies that we are just developing no (are) showing that in a certain percentage (of students), they do not recover completely," said Santos. "We're talking about not only days or moths, we're talking about years."
"Our lab is primarily focused on trying to understand how the brain changes following traumatic brain injury," Patel said.
They say one concussion is unlikely to do permanent damage, but multiple can be devastating to a person's learning ability.
"Those are starting to show us that in some cases, in a portion of those individuals that have had repetitive injuries, also have issues potentially with working or learning memory," Patel added. "These injuries can have long term affects on being able to concentrate, being able to work for long periods of time, fatigue."
They say before athletes hit the field again, they should have a doctor's note to acknowledge vision, balance and cognitive tests are where they need to be.
One of the machines at the University of Montana's Neural Injury Center tests balance. The machine tests the natural sway and stability of your body. Researchers say one concussion symptom is unstable balance.
There is also a vision test to determine a person's reaction time. Subjects wear special goggles and follow red dot light patterns that monitor reaction time--a vital tool in athletics and learning.
"One of the most important things that you have to have is the ability to recognize your environment and then act upon that," Santos added.
"The cornerstone of our research here at the university is to at least help identify individuals and then maybe plan the best course of action or treatment for them," Patel said.
They advise anyone who thinks they may have received a concussion to seek a doctor's advice immediately and not continue to play their sport until fully recovered."
UM study finds multiple concussions could cause serious harm
http://www.nbcmontana.com/news/keci/um- ... rious-harm
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
13 Concussions | The Players' Tribune
13 Concussions | The Players' Tribune
"Do not hide it... If you feel alone, you aren't."
13 Concussions
http://www.theplayerstribune.com/casey- ... ncussions/
"Do not hide it... If you feel alone, you aren't."
13 Concussions
http://www.theplayerstribune.com/casey- ... ncussions/
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Lola Mormino
“Lola, who turns 14 in July, is the only girl on her Ventura Mariners bantam team. She completed her second Gretzky Hockey School camp earlier this month.
“It’s cool for the girls to fit in with the boys,” said Ty Gretzky, a 2009 Oaks Christian grad who runs the camp. “Lola fits in right here. It’s so cool to see how much she’s improved.”
“She’s breaking the stereotype,” said her sister, Mia, an incoming senior camptain of Westlake’s dance team.
Lola can hang with the boys.
“A year ago she couldn’t shoot a puck to save her life,” said her father, Carmen Mormino.
She’s now one of the most promising youth hockey players in Ventura County.
Lola’s dreams aren’t ordinary.
They are extraordinary, just like her.
“I want to be in the NHL,” Lola said. “They’ve never said girls can’t play, so I might as well be the first.”
Lola isn’t just a hockey player.
She’s a fighter.
...Two years ago, Lola had hip surgery.
In the summer before fifth grade, she lost the use of her legs for three weeks. Doctors couldn’t figure out why she temporarily couldn’t walk.
She’s even had a concussion playing the game she loves.”
Hockey Hero: Westlake Girl Inspires
Read more: http://m.toacorn.com/news/2016-06-30/Sp ... 3bsS_Q8LCS
“Lola, who turns 14 in July, is the only girl on her Ventura Mariners bantam team. She completed her second Gretzky Hockey School camp earlier this month.
“It’s cool for the girls to fit in with the boys,” said Ty Gretzky, a 2009 Oaks Christian grad who runs the camp. “Lola fits in right here. It’s so cool to see how much she’s improved.”
“She’s breaking the stereotype,” said her sister, Mia, an incoming senior camptain of Westlake’s dance team.
Lola can hang with the boys.
“A year ago she couldn’t shoot a puck to save her life,” said her father, Carmen Mormino.
She’s now one of the most promising youth hockey players in Ventura County.
Lola’s dreams aren’t ordinary.
They are extraordinary, just like her.
“I want to be in the NHL,” Lola said. “They’ve never said girls can’t play, so I might as well be the first.”
Lola isn’t just a hockey player.
She’s a fighter.
...Two years ago, Lola had hip surgery.
In the summer before fifth grade, she lost the use of her legs for three weeks. Doctors couldn’t figure out why she temporarily couldn’t walk.
She’s even had a concussion playing the game she loves.”
Hockey Hero: Westlake Girl Inspires
Read more: http://m.toacorn.com/news/2016-06-30/Sp ... 3bsS_Q8LCS
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Athletes may have white matter brain changes 6 months afte
Athletes may have white matter brain changes 6 months after a concussion
AMERICAN ACADEMY OF NEUROLOGY
CHICAGO - New research finds white matter changes in the brains of athletes six months after a concussion. The study will be presented at the Sports Concussion Conference in Chicago, July 8-10, hosted by the American Academy of Neurology, the world's leading authority on the diagnosis and management of sports-related concussion. The conference brings together leading experts in the field to present and discuss the latest scientific advances in diagnosing and treating sports-related concussion.
The study involved 17 high school and college football players who experienced a sports-related concussion. The participants underwent MRI brain scans and were assessed for concussion symptoms, balance problems, and cognitive impairment, or memory and thinking problems, at 24 hours, eight days and six months following the concussion. Researchers also assessed 18 carefully matched athletes who had not experienced a concussion.
At all time points, all participants had advanced brain scans called diffusion tensor imaging and diffusion kurtosis tensor imaging to look for acute and chronic changes to the brain's white matter. The scans are based on the movement of water molecules in brain tissue and measure microstructural changes in white matter, which connects different brain regions. Those who had concussions had less water movement, or diffusion, in the acute stages following concussion (24 hours, six days) compared to those who did not have concussions. These microstructural changes still persisted six months after the injury. Also, those who had more severe symptoms at the time of the concussion were more likely to have alterations in the brain's white matter six months later.
Despite those findings, there was no difference between the group of athletes with and without concussion with regard to self-reported concussion symptoms, cognition, or balance at six months post-injury.
"In other words, athletes may still experience long-term brain changes even after they feel they have recovered from the injury. These findings have important implications for managing concussions and determining recovery in athletes who have experienced a sports-related concussion," said study author Melissa Lancaster, PhD, of the Medical College of Wisconsin in Milwaukee. "Additional research is needed to determine how these changes relate to long-term outcomes."
Athletes may have white matter brain changes 6 months after a concussion
Read more: http://www.eurekalert.org/pub_releases/ ... 070616.php
AMERICAN ACADEMY OF NEUROLOGY
CHICAGO - New research finds white matter changes in the brains of athletes six months after a concussion. The study will be presented at the Sports Concussion Conference in Chicago, July 8-10, hosted by the American Academy of Neurology, the world's leading authority on the diagnosis and management of sports-related concussion. The conference brings together leading experts in the field to present and discuss the latest scientific advances in diagnosing and treating sports-related concussion.
The study involved 17 high school and college football players who experienced a sports-related concussion. The participants underwent MRI brain scans and were assessed for concussion symptoms, balance problems, and cognitive impairment, or memory and thinking problems, at 24 hours, eight days and six months following the concussion. Researchers also assessed 18 carefully matched athletes who had not experienced a concussion.
At all time points, all participants had advanced brain scans called diffusion tensor imaging and diffusion kurtosis tensor imaging to look for acute and chronic changes to the brain's white matter. The scans are based on the movement of water molecules in brain tissue and measure microstructural changes in white matter, which connects different brain regions. Those who had concussions had less water movement, or diffusion, in the acute stages following concussion (24 hours, six days) compared to those who did not have concussions. These microstructural changes still persisted six months after the injury. Also, those who had more severe symptoms at the time of the concussion were more likely to have alterations in the brain's white matter six months later.
Despite those findings, there was no difference between the group of athletes with and without concussion with regard to self-reported concussion symptoms, cognition, or balance at six months post-injury.
"In other words, athletes may still experience long-term brain changes even after they feel they have recovered from the injury. These findings have important implications for managing concussions and determining recovery in athletes who have experienced a sports-related concussion," said study author Melissa Lancaster, PhD, of the Medical College of Wisconsin in Milwaukee. "Additional research is needed to determine how these changes relate to long-term outcomes."
Athletes may have white matter brain changes 6 months after a concussion
Read more: http://www.eurekalert.org/pub_releases/ ... 070616.php
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Sport must come clean over risks of concussion
"Sport must come clean over risks of concussion - governing bodies cannot be allowed to control vital research into a dangerous problem.
There are many, many good people involved in sports administration who have athletes’ best interests at heart. Yet, as these examples demonstrate, the temptation to soft-peddle or bury the risks can be overwhelming. The only safeguard can be that all future research is fully independent, peer-reviewed and kept at arm’s length from the tentacles of the sports governing bodies.
Anything else is open to abuse."
Sport must come clean over risks of concussion
Read more: http://www.telegraph.co.uk/rugby-union/ ... ing-bodie/
There are many, many good people involved in sports administration who have athletes’ best interests at heart. Yet, as these examples demonstrate, the temptation to soft-peddle or bury the risks can be overwhelming. The only safeguard can be that all future research is fully independent, peer-reviewed and kept at arm’s length from the tentacles of the sports governing bodies.
Anything else is open to abuse."
Sport must come clean over risks of concussion
Read more: http://www.telegraph.co.uk/rugby-union/ ... ing-bodie/
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
football story
http://www.bostonherald.com/sports/coll ... riola_sues
Former Boston College running back Glenn Capriola sues school, NCAA over concussions
Jordan Graham Saturday, July 09, 2016
A former Boston College star running back has filed a federal lawsuit against his alma mater and the NCAA, claiming they failed to protect players from concussions.
Glenn Capriola, who played for BC from 1974-77, filed the suit in U.S. District Court in Massachusetts Thursday.
“While being subjected to repetitive (traumatic brain injuries) in practices and games for the profit and promotion of Boston College, neither Boston College nor the NCAA ever informed or educated Capriola of the short-term and long-term health risks associated with TBI and never instituted appropriate health and safety protocols to monitor, manage, and mitigate risks associated with TBI,” the complaint says.
The complaint alleges both BC and the NCAA have known for decades the danger of concussions and failed to implement policies to protect players.
“He was a kid when he was at Boston College, he was an 18-year-old kid who has put his trust into his coaches and the school and the conferences and the NCAA to take care of him,” said Christopher Dore, an attorney involved in the suit. “That, in our opinion, is not what happened, that there was a failure at every level to actually act in the best interest of these kids, of these students.”
Capriola suffered multiple concussions at BC, including during a game against Temple in 1975, the complaint says.
“Capriola was knocked unconscious, but regained consciousness and was put back in the game. After the game, Capriola could not recall the second half of play,” the complaint says.
Capriola suffers from memory loss, anxiety and neurological disorders, the complaint says.
The suit is one of more than a dozen brought by former college football players against their schools and the NCAA, but the first brought against a Massachusetts school.
“We have clients who have had difficulty holding down a job, who have had issues affect their marriages and their family relations, and we believe that they are entitled to real monetary compensation to help them continue to live their lives and also to compensate them for what has happened in the past,” Dore said.
Capriola was a two-year starter for BC, and was named MVP All-East and an AP All-American honorable mention in 1976, according to the complaint. He was drafted in 1977 by the Baltimore Colts, and signed shortly after with the Detroit Lions. He only played one year.
A spokesman for BC declined to comment. The NCAA did not respond to requests for comment.
Former Boston College running back Glenn Capriola sues school, NCAA over concussions
Jordan Graham Saturday, July 09, 2016
A former Boston College star running back has filed a federal lawsuit against his alma mater and the NCAA, claiming they failed to protect players from concussions.
Glenn Capriola, who played for BC from 1974-77, filed the suit in U.S. District Court in Massachusetts Thursday.
“While being subjected to repetitive (traumatic brain injuries) in practices and games for the profit and promotion of Boston College, neither Boston College nor the NCAA ever informed or educated Capriola of the short-term and long-term health risks associated with TBI and never instituted appropriate health and safety protocols to monitor, manage, and mitigate risks associated with TBI,” the complaint says.
The complaint alleges both BC and the NCAA have known for decades the danger of concussions and failed to implement policies to protect players.
“He was a kid when he was at Boston College, he was an 18-year-old kid who has put his trust into his coaches and the school and the conferences and the NCAA to take care of him,” said Christopher Dore, an attorney involved in the suit. “That, in our opinion, is not what happened, that there was a failure at every level to actually act in the best interest of these kids, of these students.”
Capriola suffered multiple concussions at BC, including during a game against Temple in 1975, the complaint says.
“Capriola was knocked unconscious, but regained consciousness and was put back in the game. After the game, Capriola could not recall the second half of play,” the complaint says.
Capriola suffers from memory loss, anxiety and neurological disorders, the complaint says.
The suit is one of more than a dozen brought by former college football players against their schools and the NCAA, but the first brought against a Massachusetts school.
“We have clients who have had difficulty holding down a job, who have had issues affect their marriages and their family relations, and we believe that they are entitled to real monetary compensation to help them continue to live their lives and also to compensate them for what has happened in the past,” Dore said.
Capriola was a two-year starter for BC, and was named MVP All-East and an AP All-American honorable mention in 1976, according to the complaint. He was drafted in 1977 by the Baltimore Colts, and signed shortly after with the Detroit Lions. He only played one year.
A spokesman for BC declined to comment. The NCAA did not respond to requests for comment.
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Kaitlyn Byers
Kaitlyn Byers
"In January, they played the same team again. But this time things turned physical.
"They were really rough that whole game," said Byers.
Then at one point Byers said a player on the other team cornered her, dug his stick into her ribs, and slammed her head into the ice.
“As I went down he said, ‘That’s what you get b$&@!.’”
“All I knew is that I couldn’t breathe,” she said. “Everything was starting to fade out.”
As she was carried off the ice, chaos erupted around her. She could hear her dad pounding on the glass, the other coach laughing, and people shouting that she shouldn’t play boys’ hockey if couldn’t “take the pain.”
By the time an ambulance arrived, her whole torso was spasming. She ended up in hospital with a concussion and cracked ribs.
“If you had targeted a guy like this he would have been just as injured.”
Fed up, she and her parents went back to the league. They wanted to see someone suspended, at minimum, so they pushed for an incident report and for a sexual harassment policy.
“Absolutely nothing was done,” she said."
This Teen Hockey Player Says “Nothing Was Done” After She Got Rape Threats On The Ice
Read more: https://www.buzzfeed.com/laurenstrapagi ... .ek1ajaAbv
"In January, they played the same team again. But this time things turned physical.
"They were really rough that whole game," said Byers.
Then at one point Byers said a player on the other team cornered her, dug his stick into her ribs, and slammed her head into the ice.
“As I went down he said, ‘That’s what you get b$&@!.’”
“All I knew is that I couldn’t breathe,” she said. “Everything was starting to fade out.”
As she was carried off the ice, chaos erupted around her. She could hear her dad pounding on the glass, the other coach laughing, and people shouting that she shouldn’t play boys’ hockey if couldn’t “take the pain.”
By the time an ambulance arrived, her whole torso was spasming. She ended up in hospital with a concussion and cracked ribs.
“If you had targeted a guy like this he would have been just as injured.”
Fed up, she and her parents went back to the league. They wanted to see someone suspended, at minimum, so they pushed for an incident report and for a sexual harassment policy.
“Absolutely nothing was done,” she said."
This Teen Hockey Player Says “Nothing Was Done” After She Got Rape Threats On The Ice
Read more: https://www.buzzfeed.com/laurenstrapagi ... .ek1ajaAbv
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greybeard58
- Posts: 2569
- Joined: Sat Aug 21, 2004 11:40 pm
Concussions -- Less could mean more
Concussions -- Less could mean more
"Davis said that burnout along with injury, which might include the dreaded “C” word feared so much in the world of sports, is more likely to occur with increased ice time.
Based on a University of Buffalo study published in 2011 which examined concussions in the Burlington (Ontario) Minor Hockey Association, 66 percent of those concussed sustained the injury in “accidents” as opposed to intentional physical contact like a bodycheck.
“When you try and take your child, your player and try to cram in their 10,000 hours before their 10th birthday by enrolling them in all these on-ice activities, all you are really doing is increasing the probability that they are going to have a slip, trip or fall and sustain a concussion,” he said. “Just by virtue of being on the ice which is an inherently dangerous activity, there is that risk.”
Read more: Less Could Mean More https://ca.sports.yahoo.com/blogs/eh-ga ... 05723.html
"Davis said that burnout along with injury, which might include the dreaded “C” word feared so much in the world of sports, is more likely to occur with increased ice time.
Based on a University of Buffalo study published in 2011 which examined concussions in the Burlington (Ontario) Minor Hockey Association, 66 percent of those concussed sustained the injury in “accidents” as opposed to intentional physical contact like a bodycheck.
“When you try and take your child, your player and try to cram in their 10,000 hours before their 10th birthday by enrolling them in all these on-ice activities, all you are really doing is increasing the probability that they are going to have a slip, trip or fall and sustain a concussion,” he said. “Just by virtue of being on the ice which is an inherently dangerous activity, there is that risk.”
Read more: Less Could Mean More https://ca.sports.yahoo.com/blogs/eh-ga ... 05723.html