Posts by: CAPP

Football is no game for boys to play: Matt Chaney’s Take on Bob Costa’s Remarks

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On a rare break from his sabbatical from football, Matt Chaney added his incredible historical insight and commented on Bob Costa’s stance on youth football:

Great comments and position by Bob Costas, regarding juveniles and brain risk and outcome of tackle football. America’s child protection structure is faulty, even ridiculous without the prohibition of collision football, at least in the public sector. The institutions of medicine, education and law have head in sand–for at least 110 years, since JAMA editors declared ‘that football is no game for boys to play,’ backed by a significant group of medical professionals, football insiders, educators and more authorities of the period [see 1907 JAMA below/attached].
1907.12.21 JAMA editorial ‘FB Mortality Among Boys’

The 3rd revision of USA Football’s Rebuttal to the NYTimes

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Here is the third reversion in two days of the USA Football’s Response to the July 27 NYTimes article with my comments in red.

USA Football third revision of their statement on New York Times article about Heads Up Football

7/28/2016

By Scott Hallenbeck Now Scott adds his name and photo to this mess. Run, Scott, Run.

USA Football developed Heads Up Football in 2012 with no research, just a marketing plan to improve the safety of the sport and deal with the growing concussion concern. We deliver education, resources and best practices without evidence and a marketing plan to recruit to youth organizations and high schools and their coaches, players and parents.

In our continuing effort to improve player safety and to try to defend the program we had been selling for two years, USA Football commissioned the Datalys Center for Sports Injury Research and Prevention paid for to conduct an independent study to review the effectiveness of Heads Up Football since we had already been marketing it for two years for children age five and up. The New York Times story published July 27 has raised issues (blew the whistle we lied in congress) with how the research conducted by Datalys was reported – No, how USA Football used the study that Datalys conducted and clearly lists the limitations on page 7 of the report. We have acknowledged our error in using (marketing to parents and children) preliminary data since Feb after the study was peer reviewed and published (was not published until July). In early July, we informed our partners and constituents of this issue and have since set a policy that when USA Football commissions research, we will share it only once it has been peer reviewed and published. (But in a bad move for us, we had already summited and presented the false data in congress under oath on May 13).

USA Football stands behind the efficacy of Heads Up Football because we have nothing else to offer to make football safer. We are proud that nearly 70 percent of youth football organizations and a growing number of high schools have  joined us (been hoodwinked into) in working toward a better, safer game (which there is evidence in the study that HeadsUp alone cannot provide).

***

Allow me to reinforce (repeat) the facts that demonstrate the impact and value of Heads Up Football.

FACT: We believe in this program – THIS IS NOT A FACT, it is a desperate belief we are clinging to despite the facts

Heads Up Football is an important football safety program, and it is having a positive effect on youth organizations and high school programs nationwide.

FACT: USA Football is changing behavior for the better – NOT A FACT 

Through the program, coaches learn not only how to teach proper fundamentals and techniques but how to communicate with players and parents in order to foster a positive football experience (Coaches learn to talk to kids?).

Before Heads Up Football, there was no national focus on teaching and training football coaches, parents and players on concussion recognition and response, heat preparedness and hydration, equipment fitting, sudden cardiac arrest, Heads Up Tackling and Heads Up Blocking. (This only should be under the category of crimes that until 2013 NONE OF THESE ISSUES were addresses by USA Football). This has led to hundreds of thousands of coaches being trained in the highest standards in the sport, resulting in a safer and more positive environment for the players.

FACT: Heads Up Football is more than tackling – (important to point out since it doesn’t reduce head injuries)

This program delivers the sport’s highest standards (sad this is the best we can do) on all-player football fundamentals and mechanics (with the decades old ploy of setting up “proper way to play” to then be able blame kids for their injuries if they get hurt because they didn’t use proper technique) alongside important health and safety components.

Through a (we don’t have money to train everyone) train-the-trainer model, Heads Up Football is (marketing) changing behavior by unifying the football community under consistent terminology and techniques.

Launched nationwide in 2013 (with no scientific evidence), Heads Up Football originally included the core elements of:

In (marketing to) working with youth and high school football organizations, alongside input from our Medical Advisory Committee and Football Advisory Committee, the program has since added Heads Up Blockingand sudden cardiac arrest protocols as part of the only nationally accredited youth coaching certification program available in the sport.

FACT: Heads Up Football is more than a course

Heads Up Football is a multi-pronged approach (to hide the fact it doesn’t help concussions) that works hand-in-hand with other USA Football resources to (confuse the issue) create a positive learning environment in which millions of young athletes can learn the sport more safely. These resources are available to all youth leagues, and USA Football strongly recommends their implementation by all coaches to further advance safety.

  • National Practice Guidelines for Youth Tackle Football. Released (finally) in February 2015, these guidelines include a limit of 30 minutes per day (per day NOT A LIMIT FOR THE WEEK) for drills operated at full-contact speed defined by USA Football’s Levels of Contact.
  • Levels of Contact. USA Football is the first national organization in the sport to formally define full contact within practice sessions, breaking drills down into non- or light-contact levels (Air, Bags, Control) and full contact (Thud, Live).
  • Practice Planner. Youth football coaches can organize their drills quickly and easily while assigning a level of contact and time for each drill.

FACT: Heads Up Football is being embraced (hugged?!? without scientific evidenced)

More than 6,300 youth organizations and 1,100 high schools signed up for Heads Up Football in 2015, improving the quality of the sport for their athletes (because they fell for our marketing).

Since Heads Up Football’s inception (in 2012 without scientific evidence or any testing), USA Football has trained thousands of Player Safety Coaches, selected by their leagues to serve as the conduit for the program, along with certifying hundreds of thousands of coaches. Player Safety Coaches are responsible (for the safety of millions of children playing tackle football):

  • Completing USA Football’s Level 1 online coaching education course
  • Attending a one-day clinic led by a USA Football-trained Master Trainer (one day for all of those safety issues)
  • Overseeing his or her organization’s implementation of Heads Up Football
  • Ensuring that all coaches are certified
  • Holding in-person clinics for head coaches
  • Attending practices and games to serve as a reference point for coaches and parents while ensuring that Heads Up Football elements are being taught

FACT: Heads Up Football continues to evolve (because it is our marketing plan)

USA Football works alongside experts in medicine and sport to constantly evaluate and improve what it offers through Heads Up Football.

As we have added elements and other materials to help coaches do their job better, we will continue to seek and recognize information that adds to the value and benefit of the sport and the children who enjoy playing it.

FACT: Research is showing Heads Up Football works (NO, THIS STUDY DOES NOT SHOW THAT AND IF YOU READ THE STUDY, YOU CAN SEE THAT)

Heads Up Football reduces injury rates (NOT CONCUSSIONS) during practices by 63 percent, as shown by a peer-reviewed and published study in The Orthopaedic Journal of Sports Medicine (OJSM) in July 2015 (linked). (BECAUSE THEY USED POP WARNER CONTACT LIMITS NOT HEADSUP AND YOU LIED TO CONGRESS ON THIS POINT)

There also is additional independent research that underscores Heads Up Football’s efficacy in reducing concussions at the high school level:

  • Fairfax County (Va.) Public Schools, the 10th-largest school district in the country, has (You fail to inform parents that Fairfax Schools implemented reduced contact practice guidelines in 2013) employed Heads Up Football since 2013. In this time, the district has reported a 43.3 percent decline in concussions among its 3,000 football-playing student-athletes within its 25 high school programs, all of which are enrolled in Heads Up Football. Overall football injuries have declined 23.9 percent.
  • High schools within the South Bend (Ind.) Community School Corporation (SBCSC), with approximately 1,000 football-playing student-athletes reported concussions from football to decline by 40 percent from 2014 to 2015, the first year the school system implemented Heads Up Football district-wide.

FACT: People believe in Heads Up Football – THIS MAYBE A FACT BUT IT IS BECAUSE OF YOUR MARKETING NOT SCIENCE

A number of constituents have provided statements of support of Heads Up Football and its effectiveness.

Bill Curran, the director of student activities and athletics for Fairfax County (Va.) Public Schools  (Fairfax Schools implemented reduced contact practice guidelines in 2013), has made the following statement:

“In our three seasons within USA Football’s Heads Up Football program, our independent data clearly show that our student-athletes are benefitting from it. We are seeing significant returns. Since adopting the program in 2013, total injuries spanning practices and games among our football-playing student-athletes have decreased 23.9 percent and concussions have decreased 43.3 percent. I have 25 high school football coaches who will tell you Heads Up Football works.”

***

Dr. Michael Koester, (Stay tuned after I contact him) chairperson of the Oregon Schools Activities Association’s Sports Medicine Advisory Committee, states:

“Heads Up Football is the logical next step forward as sports medicine experts continue to work with coaches to implement innovative ways to minimize the risk of football injuries. The Oregon School Activities Association’s endorsement of the program – and requiring our football-playing schools to adopt Heads Up Football – is an important opportunity for high school coaches statewide to set an example for youth leagues in their communities. As a team physician and the parent of a high school football player, I stand behind Heads Up Football as a leading intervention for safer play.”

***

Jon Butler, (JON IS IN THE SAME SINKING BOAT AS SCOTT) executive director of Pop Warner Little Scholars, Inc., is also standing behind Heads Up Football stating:

“As we continue to make football safer and better for young people, Pop Warner places value on changes that make a difference. That’s why we have done things like reduce contact to twenty-five percent of practice time, eliminate kickoffs for our youngest divisions and require that any player who suffers a suspected head injury receive medical clearance from a concussion specialist before returning to play. Giving our coaches the tools they need to teach the game the right way enhances those efforts. It’s why we made USA Football’s Heads Up Football training mandatory for all Pop Warner coaches. Because we’re confident that a well-educated coach is critical to a safer football experience.”

USA Football’s Claims on HeadsUp Study must be reviewed by Congress

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The July 27 New York Times article on Monday did not catch anyone by surprise who had read the original study. Please take the time to read the highlighted sections of this study available right here —->USA Football Report.

And rather than admit they misrepresented the findings, USA Football’s statement this morning in response to the NYTimes article just repeated they stand behind this study.

Please write your representatives in DC to act now.

We must ask congress to determine if USA Football knowingly lied in the May 13, 2016, congressional hearing using data they knew was false from an earlier report.

If so, parents must hear the truth about this recycled, manipulated, fantasy-based safety program directed at hiding the truth about the dangers of tackle football for children.

The timeline is clear.

Feb 2015 – Datalys gives US Football the initial “positive results” of a study based on ONE 2014 fall season. Marketing materials are pumped out to the public.

July 2015 – The formal study is published with a far different story showing a reduction in concussions only when HeadsUp is combined with Pop Warner PW contact limit rules. There was no control group to show PW alone. To be fair to Kerr, the list of “Limitations” on page 7 tell the story that this initial incomplete study must be followed up by further research which was never done.

10 months pass –  NFL/USA Football does not change the marketing marketing of the discrepancies from the peer-reviewed study, even when this study is to be used the keystone of the NFL/USA Football’s written testimony, oral presentation and the accompanying slide deck.

On May 13, 2016, ANDREW GREGORY, M.D., Medical Advisory Committee Member of USA Football and Associate Professor at Vanderbilt University Medical, gives official congressional testimony under oath based on the Feb not July data.

 

Please ask your representative to act on this for the sake of so many children – boys and girls – who are being exposed to brain injury at the hands of the NFL!!

Source Document:

USA Football Report

Comprehensive Coach Education and Practice Contact Restriction Guidelines Result in Lower Injury Rates in Youth American Football

Zachary Y. Kerr,* PhD, MPH, Susan Yeargin,† PhD, ATC,
Tamara C. Valovich McLeod,‡ PhD, ATC, FNATA, Vincent C. Nittoli,§ MS, ATC, James Mensch,† PhD, ATC, Thomas Dodge,|| PhD, ATC, Ross Hayden,* MA, and Thomas P. Dompier,*{ PhD, ATC

Investigation performed at Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA

Why isn’t football modified for U12 players like other sports?

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Current policies on Contact or Heading for US Lacrosse, USA Hockey and US Soccer  

Why doesn’t youth football have “youth brain injury sensitive” rules such as graduated contact or no heading rules for the U12 group like soccer, lacrosse and hockey have enacted?
Why is football is the only one to not modify their sport for their youngest players?

Official US Lacrosse Policy

US Lacrosse polices are written with to try to eliminate violent collisions at all ages.

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Note: No take-out checks/excessive body checks at any age
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Rules limited body checks for U15 and U13 – rules based on peripheral vision may not be fully developed in many boys before 15

No body checking U11 and U9

 IMG_0165

USA Hockey

 Body checking in 12 and under prohibited
IMG_0169 IMG_0168

 

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Official US Soccer Statement on Headings

US SOCCER

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Why did AAP reverse its policy against Youth Tackle Football?

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WHY DID THE AMERICAN ACADEMY OF PEDIATRICS CHANGE THEIR VERY CLEAR OFFICIAL 1950’S POLICY AGAINST TACKLE FOOTBALL FOR KIDS UNDER 13 TO ITS CURRENT 2015 POLICY SUPPORTING YOUTH TACKLE?

In the 1950’s, the American Academy of Pediatrics had a clear policy concerned youth contact sports such as tackle football, boxing, and hockey. The AAP policy stated that these high risk sports had “no place in programs” for kids 12 & under —  and this in a time when sporting activities for kids included Lawn Jarts, backyard pool diving boards and free-fall trampolines — activities which today would completely freak out the current generation of parents. 

Over the last 65 years, a new law banned the Jart, insurance rates ended backyard diving boards and the firm policy of the AAP lead to adding nets to trampolines. Also in this same time frame, AAP’s revised their policies (which are in effect for five years at a time) towards these three contact sports for youth with three completely different approaches. Any statement issued by AAP over the last 65 years as held to opposition to youth boxing, while it’s policy from hockey changed from opposed to a youth game to approving the sport with limiting checking for players 15 years of age and younger. 

But the one sport were there has been a completely reversal of policy — the one complete outlier in AAP’s policy in youth contact sports – is youth tackle football.

When the AAP felt youth tackle football had “no place in programs for kids” in the 50’s; now in 2015,this is a game so sacred to our society that while, modifying “would likely lead to a decrease in the incidence of overall injuries, severe injuries, catastrophic injuries, and concussions” the AAP cannot recommend limiting tackle for young children as “the removal of tackling from football would lead to a fundamental change in the way the game is played.”

And unlike the cases of boxing and hockey where the AAP had taken a clear stand to inform parents of the risks, in the case of football, children and their parents must decide the health risk of football injuries themselves against the benefits of the game if tackle is conducted in the “proper way.” 
“Removing tackling from football altogether would likely lead to a decrease in the incidence of overall injuries, severe injuries, catastrophic injuries, and concussions. The American Academy of Pediatrics recognizes, however, that the removal of tackling from football would lead to a fundamental change in the way the game is played. Participants in football must decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling”. 2015 AAP Report
 
 

AAP Policy towards Youth Boxing

The AAP has had a very clear policy in its opposition to youth boxing in effect for 20 of the last 65 years with 2015 policy in place for the next five years until 2020.
1953  AAP policy spoke at conference —  “opposed to boxing”
1957 expires 1962  Statement of Policy by the AAP — “boxing has no place”
1968 expires 1973  Policy Statement on Competitive Athletics for Children of Elementary School Age was approved by AAP —  “Boxing has no place in programs for children”
 
Gap of 24 years
 
1997 expires 2002  January 1997 “Vigorously oppose boxing as a sport for any child, adolescent, or young adult” + educate patient + suggest alternative sports
2011 expires 2015  September 2011  Revised – the three recommendations above plus “appropriate medical care is provided for children and adolescents who choose to participate in boxing, ideally including medical coverage at events, preparticipation medical examinations, and regular neurocognitive testing and ophthalmologic examinations.”
2015 expires 2020  June 2015 Reaffirms 2011 Policy

TIMELINE OF AAP POLICY and Contact Sports

AAP Policy towards Youth Hockey

The AAP has also had a clear policy in its opposition to youth hockey in effect for 15 years from 1953 to 1968, then it modified this policy only if a “school or community only could provide exemplary supervision medical and educational.” And for the last 16 years, 2000 to 2017, AAP policy has firmly recommended limiting checking in hockey players 15 years of age and younger.
 
1953  AAP Policy at conference —  “opposed to hockey”
1957 expires 1962  Statement of Policy by the AAP — 
1968 expires 1973  Policy Statement on Competitive Athletics for Children of Elementary School Age was approved by AAP —  Hockey along with other sports – “ Unless a school or community can provide exemplary supervision medical and educational it should not undertake a program of competitive sports, especially collision sports, at the pre-adolescent level.”
 
Gap of 27 years
 
2000 expires 2005 Pediatrics. 2000 The American Academy of Pediatrics recommends limiting checking in hockey players 15 years of age and younger as a means to reduce injuries
2014 expires 2019   However, because of ongoing concerns that a high number and proportion of boys’ ice hockey injuries are attributable to body checking, the AAP has elected to reassess its 2000 recommendation that “body checking should not be allowed in youth hockey for children age 15 years or younger.” — In the continued interest of promoting boys’ youth ice hockey as a safe, lifelong recreational pursuit, the AAP recommends: Expansion of nonchecking programs for boys aged 15 years and older. Pediatricians should advocate for development of these programs in their communities and encourage their patients to participate in them.
 

AAP Policy towards Youth Football

Over the last 65 years, the AAP was clear on opposing youth tackle football, modified its opposition and then after a gap of 43 of no officially policy, completely flip-flopped its football to letting parents decide the risks. This new policy is now in place for the next five years until 2020.
1953  Quote at conference —  “opposed to football”
1957 expires 1962  Statement of Policy by the AAP — “football has no place”
1968 expires 1973 Policy Statement on Competitive Athletics for Children of Elementary School Age was approved by AAP —  Football along with other sports – “ Unless a school or community can provide exemplary supervision medical and educational it should not undertake a program of competitive sports, especially collision sports, at the pre-adolescent level.”
 
Gap of 43 years
 
2015-2020 2015 AAP Statement on Tackle Football – Children and parents left to decide the risks vs benefits if played properly.     

How the AAP Policy on Contact Youth Sports evolved based Source Documents from AAP website and in public record

The first reference to the AAP and youth football, boxing and hockey was found in a newspaper article from 1953, with a quote from a doctor representing the AAP at two-day conference at the National Education Association: (Sources are all listed at the end of this post):
Strongly opposed to tackle football, boxing and ice hockey and other contact sports was Dr. George Maksim, representing the American Academy of Pediatrics. “Children under 13 aren’t mature enough for such sports,” Dr. Maksi said, “and the risk of permanent bone and joint injuries is just too great.”
In the 1957’s Statement of Policy by the AAP, the AAP’s position on youth tackle football and boxing was also very clear:
1957-page-2-e1458913280547.jpeg
1957-Page-3-e1458913239850.jpeg

In 1968-1973, a Policy Statement on Competitive Athletics for Children of Elementary School Age was approved by American Academy of Pediatrics which held to the probation for boxing. There was an allowence for contact sports including football and hockey but with several caveats, a discussion of risk and a number of high standards to be met. 

Boxing has no place in programs for children of this age because its goal is injury and the educational benefits attributed to it can be realized through other sports. Sports with varying degrees of collision risk include baseball, basketball, football, hockey, soccer, softball, and wrestling. The hazards of such competition are debatable. The risks are usually associated with the conditions under which practice and play are conducted and the quality of supervision affecting the participants. Unless a school or community can provide exemplary supervision, medical and educational, it should not undertake a program of competitive sports, especially collision sports, at the pre-adolescent level.
From this point on there would be a 24 year gap in policy towards boxing, 27 year gap towards hockey and a 43 year gap before a policy towards football would be announced.
 

AAP BOXING POLICY

 
In the official 1997 Statement, the AAP was still “vigorously opposed” boxing for youth; and officially, states in Pediatrics January 1997, VOLUME 99 / ISSUE 1, a policy would stay in effect until 2002:
The American Academy of Pediatrics recommended that pediatricians:
  1. Vigorously oppose boxing as a sport for any child, adolescent, or young adult
  2. Educate “at risk” patients about the medical risks of boxing and provide information that supports the Academy’s opposition to the sport; and
  3. Encourage young athletes to participate in sports in which intentional head injury is not the primary objective.
The 2011 AAP Policy (2011-2015) was revised to keep the three recommendations from 1997, above plus “appropriate medical care is provided for children and adolescents who choose to participate in boxing, ideally including medical coverage at events, preparticipation medical examinations, and regular neurocognitive testing and ophthalmologic examinations.”
In 2015, the AAP did not let their policy on boxing lapse, and with the 2015 AAP Policy, they reaffirmed their 2011 Policy.
 

AAP HOCKEY POLICY

 
After a gap of 27 years, in 2000, The American Academy of Pediatrics recommended in Pediatrics limiting checking in hockey players 15 years of age and younger as a means to reduce injuries. This policy would expire in 2005.
 
In 2014, AAP Policy (2014-2019) because of ongoing concerns that a high number and proportion of boys’ ice hockey injuries are attributable to body checking, the AAP has elected to reassess its 2000 recommendation that 
 
“body checking should not be allowed in youth hockey for children age 15 years or younger.” — In the continued interest of promoting boys’ youth ice hockey as a safe, lifelong recreational pursuit, the AAP recommends: Expansion of nonchecking programs for boys aged 15 years and older. Pediatricians should advocate for development of these programs in their communities and encourage their patients to participate in them.
 

AAP TRAMPOLINE POLICY

 

On a side note, in 1999, the AAP’s issued a stern policy on Youth and Trampolines for parents, parks and schools after a high number of injuries and six deaths over a 9 year period. 

83,400 trampoline-related injuries occurred in 1996 in the United States… supports the American Academy of Pediatrics’ reaffirmation of its recommendation that trampolines should never be used in the home environment, in routine physical education classes, or in outdoor playgrounds… Since 1990, the CPSC has received reports of six deaths involving trampolines. Victims ranged in age from 3 years through 21 years, although the 21-year-old died 6 years after being injured on a trampoline…Catastrophic cervical spine injuries are rare. However, head and neck injuries constitute a notable number of the more serious injuries requiring hospitalization…

AAP RECOMMENDATIONS

Despite all currently available measures to prevent injury, the potential for serious injury while using a trampoline remains.The need for supervision and trained personnel at all times makes home use extremely unwise.

  1. The trampoline should not be used at home, inside or outside. During anticipatory guidance, pediatricians should advise parents never to purchase a home trampoline or allow children to use home trampolines.
  2. The trampoline should not be part of routine physical education classes in schools.
  3. The trampoline has no place in outdoor playgrounds and should never be regarded as play equipment.

 

AAP YOUTH TACKLE FOOTBALL POLICY

 
While there are a number of studies and discussion listed in the AAP over the years on youth tackle football, there is not any official AAP policy towards tackle football from and the librarian at the AAP was not able to locate any additional policies. AAP policies expire after five years and so after 1973, the 1968 Policy Statement on Competitive Athletics for Children of Elementary School Age would no longer be in effect.
 
After what seems to be a gap of 43 years, in 2105, with the NFL lawsuit and scientific evidence pointing to brain injury in pro players, the AAP’s response to the controversy around youth tackle football was the publication of an official statement, several blog posts and a video:

The findings of the report can be summarized in this quote from the report itself:

 
“Removing tackling from football altogether would likely lead to a decrease in the incidence of overall injuries, severe injuries, catastrophic injuries, and concussions. The American Academy of Pediatrics recognizes, however, that the removal of tackling from football would lead to a fundamental change in the way the game is played. Participants in football must decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling.” 2015 AAP Report
 
The AAP clearly leaves everyone else on the hook to decide. Are children left to decide for themselves? Parents? Coaches? And further more the AAP implies there is a “proper” way to tackle… How do we know? What independent research has been done? 
In the comment section under AAP statement in Dec 2015, was a single comment – a reply from by Lewis H. Margolis, Associate Professor of Maternal and Child Health, University of North Carolina, Gillings School of Global Public Health, in which he asks of pediatricans, “Whatever Happened to First Do No Harm?” 
 
In his post, Marigolis points out the irony in an official report by the AAP, that parents, not doctors, are asked to weigh the risks for their children to play tackle based on the uncertain, flimsy data which is stated is unclear, even to top medical experts.
 
Marigolis points out how in the hemming and hawing of the report he counted: 
… over 40 uses of terms like “unclear,” “unknown,” “limited,” and “without scientific basis” in the statement, which, while adequately reflecting the state of an uncertain literature, do not support evidence-based recommendations.
The key problem with the AAP report is the concept of:
Advising parents to “decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling” undermines the concept of empowerment, because of the absence of information.
Then he cuts to the chase to pose the question: 
Until those [safety] questions are answered through rigorous research, pediatricians should advance primum non nocere, “first do no harm,” by advocating for the end of youth football.
  • 30 November 2015  — Whatever Happened to First Do No Harm?
    • Lewis H. Margolis, Associate Professor of Maternal and Child HealthUniversity of North Carolina, Gillings School of Global Public Health

    The Council on Sports Medicine and Fitness policy statement, Tackling and Youth Football, assures that many young athletes will suffer debilitating brain injuries.1 As the Council acknowledges, little is known about tackling per se, so that a statement limited to tackling is misleading about the risks of football where the risk of concussion is greater than for any other sport.2 Further, football participation dwarfs other sports, so this one sport contributes 60% or more of sport-related concussions in high school.3 Dompier et al. estimate that 99,000 youth players experience at least one concussion annually.4 These facts alone should raise questions about our culture’s willingness to tolerate, not to mention encourage, this cause of harm. Add to this the acknowledgement by experts that we are as yet ignorant of the long-term consequences of concussions. Meehan notes that “medicine has not figured out how many concussions is too many. And in fact, it is likely no such number exists.”5(p.125)

    The evidence supporting the effectiveness of the recommendations is meager. Indeed, there are over 40 uses of terms like “unclear,” “unknown,” “limited,” and “without scientific basis” in the statement, which, while adequately reflecting the state of an uncertain literature, do not support evidence-based recommendations.

    It is important for pediatricians to empower parents and their young potential football players. Advising parents to “decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling”1(p.e1426) undermines the concept of empowerment, because of the absence of information. If parents wanted to make an evidence-based choice, to whom would they turn other than pediatricians? And yet, the Council advises that “participants in football must decide whether the potential risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling.”1(p.e1426)

    Perhaps the millions of dollars being devoted to the diagnosis, acute treatment, and long-term management of concussions will help us answer questions like “can we end tackling?” and “can we make tackling safer?” Until those questions are answered through rigorous research, pediatricians should advance primum non nocere, first do no harm, by advocating for the end of youth football.

    1. COUNCIL ON SPORTS MEDICINE AND FITNESS. Tackling in youth football. Pediatrics. 2015;136(5):e1419-30. doi: 10.1542/peds.2015-3282 [doi].
    2. Institute of Medicine (IOM) and National Research Council (NRC). Sports-related concussions in youth: Improving the science, changing the culture. Washington, DC: The National Academies Press; 2013.
    3. Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions among united states high school and collegiate athletes. J Athl Train. 2007;42(4):495-503.
    4. Dompier TP, Kerr ZY, Marshall SW, et al. Incidence of concussion during practice and games in youth, high school, and collegiate American football players. JAMA Pediatr. 2015;169:659-665.
    5. Meehan WP. Kids, sports, and concussions. Santa Barbara, CA: Praeger; 2011.

The 2015 AAP report leaves so many questions unanswered, and one must look at the conclusions and wonder how is a parent to know the risks for their children if the doctors cannot take a stand as they clearly did with boxing and football and even trampolines. Should youth sports organizations who operate without any government oversight calculate risks and do their own research? And in the end, do parents, players, sports organizations, the AAP or the government have responsibly to make the call?

  • Who is responsible to collect the data on injury rates for youth sports or any activities for children ?
  • Who is responsible to inform parents of risks in sports without any alternative motive?
  • Who is responsible to determine safety claims like the new “safe tackle football” proposed by HeadsUp Tackling is a scientifically valid or just a recycling PR concept tried in past decades?
Doctors, parents, kids? The AAP clearly avoids their responsibility they felt so clearly with other contact sports.

CONCLUSION

This is America, and within the law, parents have the freedom to chose what sports their children play and decide what risks they take. But how is a parent to know the risk of injury in any particular sport for their child? 

Parents have always looked towards their pediatricians for health information about their children, and the AAP is the source of policy for these doctors. Over the last 65 years, the American Academy of Pediatrics been clear on its position against boxing, has had modified position to support hockey with no checking U15, but completely reversed it’s policy against to supporting tackle football without a modification for younger children. 

Now with NFL research determined to be flawed, what guarantee is there that injury risk in tackle football for youth been honestly portrayed for parents? The same parents who have been left by the AAP to make those life-changing decisions for their children. 

Source documents

Boxing

AAP Policy in Reference to Boxing
1953 – a quote from a doctor representing the AAP at two-day conference at the National Education Association:
Strongly opposed to tackle football, boxing and ice hockey and other contact sports was Dr. George Maksim, representing the American Academy of Pediatrics. “Children under 13 aren’t mature enough for such sports,” Dr. Maksi said, “and the risk of permanent bone and joint injuries is just too great.”
 
 1957 –  Statement of Policy by the AAP, the AAP’s position on Youth Tackle Football was also very clear:
1957-page-2-e1458913280547.jpeg
1957-Page-3-e1458913239850.jpeg

1968 –  a Policy Statement on Competitive Athletics for Children of Elementary School Age was approved by American Academy of Pediatrics:

Boxing has no place in programs for children of this age because its goal is injury and the educational benefits attributed to it can be realized through other sports. Sports with varying degrees of collision risk include baseball, basketball, football, hockey, soccer, softball, and wrestling. The hazards of such competition are debatable. The risks are usually associated with the conditions under which practice and play are conducted and the quality of supervision affecting the participants. Unless a school or community can provide exemplary supervision medical and educational it should not undertake a program of competitive sports, especially collision sports, at the pre-adolescent level.
 
1997

This Policy Is A Revision Of The Policy In

Pediatrics
January 1997, VOLUME 99 / ISSUE 1

Participation in Boxing by Children, Adolescents, and Young Adults

Committee on Sports Medicine and Fitness

The overall risk of injury in amateur boxing is actually lower than in some other collision sports such as football, rugby, and ice hockey. However, as opponents of boxing have emphasized, boxing is the only sport where direct blows to the head are rewarded and the ultimate victory may be to render the opponent senseless. Participants in boxing are at risk for dementia pugilistica, a chronic encephalopathy caused by the cumulative effects of multiple subconcussive blows to the head. Numerous studies of professional boxers document this hazard and its potentially devastating consequences on long-term health.2,4-

RECOMMENDATIONS

The American Academy of Pediatrics recommends that pediatricians:

  1. Vigorously oppose boxing as a sport for any child, adolescent, or young adult;

  2. Educate “at risk” patients about the medical risks of boxing and provide information that supports the Academy’s opposition to the sport; and

  3. Encourage young athletes to participate in sports in which intentional head injury is not the primary objective.

2011

This Policy Is A Reaffirmation Of The Policy Posted

Pediatrics
September 2011, VOLUME 128 / ISSUE 3
From the American Academy of Pediatrics

Policy Statement

Boxing Participation by Children and Adolescents

AMERICAN ACADEMY OF PEDIATRICS, COUNCIL ON SPORTS MEDI

Abstract

Thousands of boys and girls younger than 19 years participate in boxing in North America. Although boxing provides benefits for participants, including exercise, self-discipline, and self-confidence, the sport of boxing encourages and rewards deliberate blows to the head and face. Participants in boxing are at risk of head, face, and neck injuries, including chronic and even fatal neurologic injuries. Concussions are one of the most common injuries that occur with boxing. Because of the risk of head and facial injuries, the American Academy of Pediatrics and the Canadian Paediatric Society oppose boxing as a sport for children and adolescents. These organizations recommend that physicians vigorously oppose boxing in youth and encourage patients to participate in alternative sports in which intentional head blows are not central to the sport.

INTRODUCTION

Amateur or Olympic-style boxing is a collision sport that is won on the basis of the number of clean punches landed successfully on an opponent’s head and body (Appendix).1,2 A match is won outright if an opponent is knocked out. Participants in boxing are at risk of serious neurologic and facial injuries.3,–,7 Despite these potential dangers, thousands of boys and girls participate in boxing in North America. In 2008, more than 18 000 youths younger than 19 years were registered with USA Boxing (Lynette Smith, USA Boxing, written communication, August 2009).

The societal debate regarding boxing has raged for decades. Many authors and medical organizations have called for boxing to be banned (Table 1), citing medical, ethical, legal, and moral arguments.8,–,13 Others state that participants should be allowed to make autonomous decisions about participation and that the role of the medical profession should be restricted to the provision of injury care, advice, and information only.14

TABLE 1

Position Statements on Boxing

Organization Position
American Medical Association9(2007) Recommends that until boxing is banned, head blows should be prohibited
American Academy of Pediatrics8(1997) Opposes boxing as a sport for any child, adolescent, or young adult
Australian Medical Association10(2007) Opposes all forms of boxing; recommends the prohibition of all forms of boxing for people younger than 18 y
British Medical Association11(2007) Opposes amateur and professional boxing; calls for complete ban on boxing; recommends banning boxing for those younger than 16 y
Canadian Medical Association12(2002) Recommends that all boxing be banned in Canada
World Medical Association13(2005) Recommends that boxing be banned

 

Supporters of amateur boxing state that the sport is beneficial to participants by providing exercise, self-discipline, self-confidence, character development, structure, work ethic, and friendships.14 For some disadvantaged youth, boxing is a preferential alternative to gang-related activity, providing supervision, structure, and goals.14 The overall risk of injury in amateur boxing seems to be lower than15 in some other collision sports such as football, ice hockey, wrestling, and soccer.4,16 However, unlike these other collision sports, boxing encourages and rewards direct blows to the head and face.

The American Academy of Pediatrics and the Canadian Paediatric Society oppose boxing and, in particular, discourage participation by children and adolescents.8

CONCLUSION

Despite the ongoing debate regarding boxing and clear opposition from medical associations around the world (Table 1),8,9,–,13 boxing continues to be available to youths under 19 years. Because the sport encourages deliberate blows to the head, participants are at risk of head injuries that may be cumulative and even fatal. Pediatricians should strongly discourage boxing participation among their patients and guide them toward alternative sport and recreational activities that do not encourage intentional head injuries. For those youth who, despite education and counseling, choose to participate in boxing, appropriate medical care should be ensured by boxing organizations, including medical coverage at events, preparticipation medical examinations, and regular neurocognitive and ophthalmologic screening examinations, which should be provided by physicians who are knowledgeable about common boxing injuries and appropriate RTP guidelines after any injury.

RECOMMENDATIONS

The American Academy of Pediatrics and the Canadian Paediatric Society recommend that pediatricians:

  1. vigorously oppose boxing for any child or adolescent.

  2. educate patients who may be engaged in or considering engaging in boxing, as well as parents/caregivers/teachers/coaches, regarding the medical risks of boxing.

  3. encourage young athletes to participate in alternative sports in which intentional blows to the head are not central to the sport, such as swimming, tennis, basketball, and volleyball.

  4. advocate that boxing organizations ensure that appropriate medical care is provided for children and adolescents who choose to participate in boxing, ideally including medical coverage at events, preparticipation medical examinations, and regular neurocognitive testing and ophthalmologic examinations.

 
2015
Pediatrics
June 2015, VOLUME 135 / ISSUE 6
From the American Academy of Pediatrics

Policy Statement

AAP Publications Reaffirmed or Retired

Policy Statement: Boxing Participation by Children and Adolescents. Pediatrics. 2011;128(3):617–623. Reaffirmed February 2015

 

AAP Policy in Reference to Hockey

 
1953 – a quote from a doctor representing the AAP at two-day conference at the National Education Association:
Strongly opposed to tackle football, boxing and ice hockey and other contact sports was Dr. George Maksim, representing the American Academy of Pediatrics. “Children under 13 aren’t mature enough for such sports,” Dr. Maksi said, “and the risk of permanent bone and joint injuries is just too great.”
_________________________________________________________________________________________
 
 1957 –  Statement of Policy by the AAP, the AAP’s position on Youth Tackle Football was also very clear:
1957-page-2-e1458913280547.jpeg
1957-Page-3-e1458913239850.jpeg

1968 –  a Policy Statement on Competitive Athletics for Children of Elementary School Age was approved by American Academy of Pediatrics:

Boxing has no place in programs for children of this age because its goal is injury and the educational benefits attributed to it can be realized through other sports. Sports with varying degrees of collision risk include baseball, basketball, football, hockey, soccer, softball, and wrestling. The hazards of such competition are debatable. The risks are usually associated with the conditions under which practice and play are conducted and the quality of supervision affecting the participants. Unless a school or community can provide exemplary supervision medical and educational it should not undertake a program of competitive sports, especially collision sports, at the pre-adolescent level.
1997

This Policy Is A Revision Of The Policy In

Pediatrics
January 1997, VOLUME 99 / ISSUE 1

Participation in Boxing by Children, Adolescents, and Young Adults

Committee on Sports Medicine and Fitness

The overall risk of injury in amateur boxing is actually lower than in some other collision sports such as football, rugby, and ice hockey. However, as opponents of boxing have emphasized, boxing is the only sport where direct blows to the head are rewarded and the ultimate victory may be to render the opponent senseless. Participants in boxing are at risk for dementia pugilistica, a chronic encephalopathy caused by the cumulative effects of multiple subconcussive blows to the head. Numerous studies of professional boxers document this hazard and its potentially devastating consequences on long-term health.2,4-

…
 
Supporters of amateur boxing state that the sport is beneficial to participants by providing exercise, self-discipline, self-confidence, character development, structure, work ethic, and friendships.14 For some disadvantaged youth, boxing is a preferential alternative to gang-related activity, providing supervision, structure, and goals.14 The overall risk of injury in amateur boxing seems to be lower than15 in some other collision sports such as football, ice hockey, wrestling, and soccer.4,16 However, unlike these other collision sports, boxing encourages and rewards direct blows to the head and face.
 
…
 

The American Academy of Pediatrics and the Canadian Paediatric Society oppose boxing and, in particular, discourage participation by children and adolescents.8

Pediatrics. 2000 Mar;105(3 Pt 1):657-8.
 

Safety in youth ice hockey: the effects of body checking. American Academy of Pediatrics. Committee on Sports Medicine and Fitness.

[No authors listed]

Abstract

Ice hockey is a sport enjoyed by many young people. The occurrence of injury can offset what may otherwise be a positive experience. A high proportion of injuries in hockey appear to result from intentional body contact or the practice of checking. The American Academy of Pediatrics recommends limiting checking in hockey players 15 years of age and younger as a means to reduce injuries. Strategies such as the fair play concept can also help decrease injuries that result from penalties or unnecessary contact.
PMID:
10699128
[PubMed – indexed for MEDLINE]
Pediatrics
June 2014, VOLUME 133 / ISSUE 6
From the American Academy of Pediatrics

Policy Statement

Reducing Injury Risk From Body Checking in Boys’ Youth Ice Hockey

COUNCIL ON SPORTS MEDICINE AND FITNESS

Conclusions  http://pediatrics.aappublications.org/content/133/6/1151

Abstract

Ice hockey is an increasingly popular sport that allows intentional collision in the form of body checking for males but not for females. There is a two- to threefold increased risk of all injury, severe injury, and concussion related to body checking at all levels of boys’ youth ice hockey. The American Academy of Pediatrics reinforces the importance of stringent enforcement of rules to protect player safety as well as educational interventions to decrease unsafe tactics. To promote ice hockey as a lifelong recreational pursuit for boys, the American Academy of Pediatrics recommends the expansion of nonchecking programs and the restriction of body checking to elite levels of boys’ youth ice hockey, starting no earlier than 15 years of age.

However, because of ongoing concerns that a high number and proportion of boys’ ice hockey injuries are attributable to body checking, the AAP has elected to reassess its 2000 recommendation that “body checking should not be allowed in youth hockey for children age 15 years or younger.”

…
 A recent study of high school sports revealed that the concussion rate in boys’ ice hockey (5.4 per 10 000 AEs) was second only to football (6.4 per 10 000 AEs); however, concussions accounted for a greater proportion of total injures in boys’ ice hockey (22.2%) than any of the other 20 sports, with 30% of the concussions in ice hockey resulting from a player being body checked. 20 
…

Official Policy of Medical Associations Regarding Hockey Safety

Since the 2000 AAP statement, the American Osteopathic Academy of Sports Medicine (2002), the Canadian Academy of Sports Medicine (2007), and the Canadian Pediatric Society (2012) have released position statements about injuries in youth ice hockey. USA Hockey raised the age of legal body checking in games from Pee Wee (11 and 12 years of age) to Bantam (13 and 14 years of age) for the 2011–2012 season subsequent to the 2010 Ice Hockey Summit, which called for postponing legal body checking in youth games until 13 years of age. State and local youth hockey associations can offer leagues without body checking—often called “recreational”—at all ages, but competition with high school and other elite hockey programs that may promise the potential for advancement to higher levels of ice hockey, which typically sanction body checking, may make this option rare in many communities.

…

Conclusions

There is consistent evidence that body checking remains a significant risk factor for injury at all levels of boys’ youth ice hockey. Concussion is a particularly concerning problem and is often the result of body-checking activity. Body checking can also be associated with more aggressive play that further increases the risk of serious injury. The delay of body checking to higher ages has been shown to decrease risk of injury in 11- and 12-year-olds. Although data for older boys is less extensive, it is reasonable to conclude that removing body checking would reduce injury rates and severity at all ages, particularly benefitting 13- and 14-year-olds, who may be more vulnerable because of wide discrepancies in physical maturity.

Recommendations

In the continued interest of promoting boys’ youth ice hockey as a safe, lifelong recreational pursuit, the AAP recommends:

  1. Expansion of nonchecking programs for boys aged 15 years and older. Pediatricians should advocate for development of these programs in their communities and encourage their patients to participate in them.

  2. Restriction of body checking in boys’ ice hockey games to the highest competition levels (eg, AAA, AA, Tier I, Tier II), starting no earlier than 15 years of age. Body-checking skills could be taught in practices starting at 13 years of age for those players geared to elite participation.

  3. Strict enforcement of zero-tolerance rules against any contact to the head, whether incidental or intentional.

  4. Reinforcement of rules to prevent body contact from behind, particularly into or near the boards.

  5. Continued emphasis on coaching and education to prevent body contact from behind.

  6. More research into the effects of legal body checking, including specific attention to injury risk attributable to differences in size and physical maturity.

Omalu: The Force Awakens?

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Slide1Seeing the movie Concussion is like seeing the new Star Wars movie, Omalu: The Force Awakens without watching the six previous films.

So based on Matt Chaney’s history of football, here the six movies that need to be made to bring the universe back in balance.

Episode I: Head Injury: The Phantom Menace

Based in the Greek and Roman times, the first film features the earliest doctors who wrote about head injuries in gladiators and soldiers. Even without modern medical equipment, doctors could “see” the phantom menace of invisible brain injury. And in this film, the helmet industry begins their two thousand year odyssey to find a better way to protect the head.  

Episode II: Knights in Armor or The Attack of the Clones

The second film, set in the Middle Ages, stars knights who fight in “clone-like” shells of metal in competitive games and war. Over the centuries, the helmet changes form as craftsman try to use different shapes and materials to protect the warriors’ head. Despite massive changes in ships, weapons, and technology over time across the Star Wars Series, notice the Storm Troopers’ helmet stays the same shape much has been true in the last decades of football with only a change in color for this latest film. In space as on the earth, there is only so much one can do with a helmet but metallic paint does look cool even if it does nothing to protect the brain. 

Episode III: Football invented: Revenge of the Sith

In the third film, the game of football rises from the ashes of the Civil War. While heralded as the “All American Game” with war-like training to make boys into men, a dark side emerged as boys and men are wounded and killed in this new “battle” sport.

Coaches and doctors scramble to find balance between the light and the dark of football while the universe waits for a hero to save the day.

Episode IV: Teddy: A New Hope

President Teddy Roosevelt rises as the “New Hope” of football in the fourth film. Jedi Teddy wins the battle to save football with his new rules making football safer from the Dark Side (thus the Death Star is destroyed) and order is restored to the universe.  

Episode V: The Empire Strikes Back

However, in the fifth film set in the 1920-30s, the Dark Side is still present as scientists and doctors continued record brain damage in football players’ and boxers’ head injuries using terms like “Punch Drink,” Dementia pugilistica, and even CTE (Yes, the term was used before Omalu was even born). 

Despite the American Association of Pediatrics AAP twice clearly stating in 1957, and 1967, that football should be banned for children 12 and under, football’s popularity grows and this battle game expands to kids so we leave the film having to wait for the sequel.

Episode VI: Return of the Jedi

In the sixth film in the 1960-80s, the NFL rises to power towering over football seeking to control all aspects of the game. And like the real sixth Star Wars movie, this film is rather incestious as the family ties emerge and it is hard to see who is on which side?

(In the real sixth film, Luke finds out Darth Vader is his dad and Leia is is his sister… The same is true in the football saga. The team doctors on the NFL sidelines have internal conflicts over player health since the doctors are employees of the NFL.

Again, additional NFL rules changes are supposed to destroy the dark side of football (or the latest Death Star) and it seems to be the end of the conflict by the time the credits run. A tidy end to the saga?

Episode VII: Omalu: The Force Awakens

Not to spoil the real movie for you, but like every other action movie, our hero, Jedi Omalu, single-handily battles the re-packaged version of First Order or the new “Safer Football” NFL. But knowing the real history, it is hard to cheer on Omalu’s claims to be the first Jedi to have an epic battle with the Dark Side of Football. Also, missing in Concussion is Chris Nowinski who like Luke is left out of the seventh film.

Yes, Omalu found CTE in Webster’s brain while personally funded his quest, but the film’s lack of placing Omalu on the shoulders of those who came before him, leave one feeling that the film is telling less than the truth. That is unless the six missing movies are filmed…

A final note: It is very convenient for the Dark Side to have this new film which links the “discovery” of brain damage in football to 2002, the year of Omalu rather than an earlier date… say, 1894.

Yes, 1894… Not a typo.

“A 1894 New York Evening Post editorial ripped the incorrigible violence of college football, chiding the hypocrisy—or calculated rhetoric—of organizers and supporters who tried to label boxing the only barbaric pastime.” 

The Post opined:

“There is one characteristic of the new football which all those who promise us its reform seem to overlook, and that is that it is the only athletic sport which brings the whole bodies of the players into violent collision.

In short, is not the distinction between the ring and college football as played Saturday a distinction without a difference? Is not the attempt to make a [perceived] difference a bit of sophistry of which the champions of the game ought to be ashamed? It is true [the boxer] plays a game which consists in wasting his adversary’s strength so that he can no longer resist.

But how does this differ from college football? Is not the slugging of the enemy’s best men so as to close their eyes, strain their hips, break their noses, and concuss their brains, and thus compel them to withdraw from the field, exactly the pugilist’s policy?”

Read more of the truth: http://fourwallspublishing.com/BlogMChaney/?p=629

Best Resources for Concussion Education Recommend by Katherine Snedaker

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These three educational videos and app can provide you the motivation, the education and the tool YOU can use to help any child or adult with a possible concussion.

It is always best to have an athletic trainer be the first responder to a possible concussion, but without an AT, here is how a student, parent or volunteer coach can prepare:

Why you need to be educated?

Video recommended for middle and high school athletes, coaches and parents. Parents, please watch first before showing to younger children. 4 minutes

What you need to know?

Video recommended for all age kids plus coaches and parents. Video uses humor to educate. 4 Minutes

UPDATE: The term “Rest” used in the video is now referred to as “Reasonable Rest” or “Sensible Rest.” The outdated treatment plan of laying in a dark room for weeks at a time has been shown to increase anxiety, stress and add to the recovery challenge. Too much activity is also detrimental. Finding the sweet spot in-between is a joint effort of the concussion team consisting of the medical provider, family and school to assess and plan for each individual student.

 

How best to recover after a concussion (but watch it now)

Recommended for kids, parents and coaches by international experts, Dr. Mike Evans and Dr. Gerry Gioia.  11 minutes

 

THE APP to have on your phone when a possible concussion happens. Screen Shot 2014-10-23 at 1.09.29 PM

 

FREE SmartPhone App guides coaches and parents step by step on how to assess an injury and respond by providing current CDC guidelines on when a child should be removed from play and when to call 911.

This app is recommended for coaches to notify parents of a possible head injury based on the most current CDC information, and time and geo stamps the final report. This report is emailed from with the app from coach to parent, manager and team. The app also records information which will be useful for the doctors and parents at a later time to judge RTP and guide a recovery plan.

The app is available at the Apple® App StoreSM and Google Play.

 

My Review of the PAR CRR App is A+

Why would this help kids? After a possible head injury, this app guides coaches and parents on how to assess the injury and how best to respond by providing current medical guidance on when to call 911 or if the child should be removed from play. The app also records information which will be useful for the doctors and parents at a later time to judge RTP and guide a recovery plan.

Example of use: A youth sport athlete suffers a hit on the soccer field. The athlete is taken to the sideline, accessed with the app and the parent is emailed the information about the athlete with ACE care materials.

What is it? An app

Who uses it? Coaches or parents

When? At the first sign of any suspected head injury

To do what? After a possible head injury, coach or parent are led through set of questions about the child’s current signs, symptoms and behaviors. The user is given a set of conditions when to stop using the app and call 911, and if none of those conditions are met then to proceed to ask the athlete how he or she feels. The app records information which will be useful for the doctors. A summary of the answers to the question can be emailed to the parents with care instructions.

How do I get this app? Download on it on your smart phone from the app store

Who supplies the info? Coach or any adult

Cost? Free

Compliance? HIPPA and FERPA Compliant

Liability issues? Could decreases liability for coach and team

No Smart Phone?

I have developed a paper version of the app above for organizations who have members without smart phones. Dr. Gerry Gioia has reviewed and approved this paper form.

Screen Shot 2015-12-16 at 10.41.02 AM

Download CRR Non-Med Sheet1

Going for the Jugular

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QTY002_20150317_PhotoRenders01-3_lowres

The product which is yet unnamed.

A carefully scripted unveiling of a “potential new technology” that “possibly could be a solution to prevent sports concussions” in “the future” was presented today in New York City to potential investors and various members of the press.

My intern, Alex, and I were delayed by traffic, and so unfortunately Dr. Julian Bailes was already part way into his talk when we arrived.

Why I was there

I was invited to the presentation and decided to attend to ask my signature question if females were being included in the research. Specifically, I wanted to know in the testing of this product were female athletes included, at what levels of development and how many females were included.

After the presentation and the modeling of the band by two male and two female athletes, I was able to ask my question sin the Q&A. But despite the fact two of four model athletes were females, I was told females were not being used in the sports research currently on-going to test the product.

At the end of event, I was given follow-up information by the company that females had been used during the safety trials in the lab test, and the company would address the lack of females in future sports studies in the field.

What I want to know from you

In the rest of this post I will try to explain the science of the collar as it was explained to us using a combination of my photos of slides, information provided by the event and some short videos I shot. I am interested to see any one knows if this concept has been tried in past?

I have learned from Matt Chaney’s research that much what is being presented as “new” such “Get head out of the game” techniques and “hit sensors” have all been tested in past decades, and are currently being recycled as new. If you have some additional information behind this concept, please comment below or email me?

NOTE: Video of today’s presentation will be posted on the company per the press release (posted at the end of this blog) and I will link this when it is available.

From the official press release…

IMG_1666

The stage today

Performance Sports Group Ltd. (NYSE: PSG) (TSX: PSG) (“Performance Sports Group” or the “Company”), a leading developer and manufacturer of high performance sports equipment and apparel, along with several leading medical experts today unveiled what the Company and presenting doctors believe could be a significant breakthrough in addressing mild traumatic brain injury (“mTBI”) in sports.

The potential breakthrough, a proprietary yet easy-to-use band worn on the neck, was unveiled during a presentation that featured leading experts in neurology and medical research.

Taking part in the presentation was:

  • Dr. Julian Bailes, Chairman of the Department of Neurosurgery and Co-director of the NorthShore University HealthSystem Neurological institute;
  • Dr. Gregory Myer, Director of Research for the Division of Sports Medicine at Cincinnati Children’s hospital;
  • Dr. Neilank Jha, Neurosurgeon and Spine Surgeon and Chairman of KONKUSSION; and
  • Dr. Charles Tator, Senior Scientist, Toronto Western Hospital.
  • Kevin Davis, CEO of Performance Sports Group
  • Mark Messier, six-time Stanley Cup winner and member of the Hockey Hall of FameDr. Gregory Myer mapped out the path the unnamed product has taken starting at the bottom working up this pyramid diagram.

IMG_1667

The first section, Biomimetics, covered the woodpecker and rams, then how helmets are limited to keep the brain from moving.IMG_1671

IMG_1669

 

“Studies demonstrate that helmets (with 3 inches of foam) reduce a 25 G football impact… to 24.5 G.”

How thick does the foam in a helmet need to be to reduce impact?

 

 

 

So if we cannot improve the helmet anymore, can we do something inside the brain to help?

This was core question for the rest of the presentation.

IMG_1672

 

Is it possible to reduce biomechanically induced damage to the brain?

 

 

 

 

Here is the Slosh Theory behind the collar.

Slosh is the movement of the brain, which is floating in cerebrospinal fluid inside the skull. When the head experiences an impact, or sudden, extreme movement, the brain sloshes inside the skull and can rotate or strike the inside walls of the cranium, often tearing brain fibers. The result of these impacts can produce mTBI.

The band is designed to address mTBI through the application of light pressure on the neck, which in turn mildly increases blood volume in the vein structure of the brain. This increase in blood volume is intended to minimize the sloshing of the brain inside the skull.

“This is the first solution to address mTBI from inside the skull,” said Bailes, a founding member of the Brain Injury Research Institute who is portrayed in the upcoming Sony Pictures film Concussion for his work to identify Chronic Traumatic Encephalopathy (CTE) in former professional football players. “By increasing the volume of blood in the cranial cavity, there’s less room for the brain to move which reduces the overall slosh effect which we believe reduces mTBI. The research results are very encouraging and we are excited to work with Performance Sports Group to continue the important research and bring this technology to market.”

FullSizeRender

 

 

The video below shows what happens when left skull with the air space between the top of the skull and the yellow liquid — and the right skull with no air space — hit the wall.

Dr. Myers reported…

In two separate peer-reviewed research studies, which were published in the medical journals Neurosurgery and Journal of Neurosurgery, respectively, the researchers found an 83 percent reduction in the number of torn fibers in a standard concussion model when the band was utilized. In addition, Dr. Myer cited several other studies during the presentation that showed promising results for the band.

My video clip on…

  • “Nature’s Jugular Compression Device”
  • “Slosh Theory = Intracranial Solution?”
  • “Slowing down blood flow out of the brain to make a bubblewrap of the brain”

My video clip on…

  • Head ramming sheep
  • Rio Data to see if reduced concussions at higher altitudes (not any part of the collar study)
  • “Is this safe for kids wear?”

After the presentation, we could don collars and wear them for the rest of the event, if we wished. Our necks were measured, and we were given collars based on neck size.

IMG_0236

The bands arranged by size here starting at 11.

IMG_0232

Alex, one of the PINKconcussions interns, modeling the collar.

IMG_0235

 

IMG_0237

(After the event, I was also able to discussing the need for the donation of more female brains to the nation’s brain banks with Dr. Bailes. See upcoming blog on this conversation.)

As I am on the third week of a concussion, the collar increased my headache in the few minutes I wore it. It wasn’t uncomfortable, but it did make my already present headache throb so it was uncomfortable.

At the end of the event, I did ask the models – students from Harvard – if they felt anything adverse wearing the collars. They said after the first few minutes they didn’t feel the collars at all and they had worn them a few hours.

Model Photos provided in the media kit – again females were shown wearing the collars.

The Official Press Release

Performance Sports Group and Leading Medical Experts Unveil First-of-its-Kind Technology to Address Mild Traumatic Brain Injury
Simple Device Worn on the Neck Shown to Reduce Indicators of mTBI in Independent Research Studies 

NEW YORK — November 17, 2015 — Performance Sports Group Ltd. (NYSE: PSG) (TSX: PSG) (“Performance Sports Group” or the “Company”), a leading developer and manufacturer of high performance sports equipment and apparel, along with several leading medical experts today unveiled what the Company and presenting doctors believe could be a significant breakthrough in addressing mild traumatic brain injury (“mTBI”) in sports.The potential breakthrough, a proprietary yet easy-to-use band worn on the neck, was unveiled during a presentation that featured leading experts in neurology and medical research. Taking part in the presentation was Dr. Julian Bailes, Chairman of the Department of Neurosurgery and Co-director of the NorthShore University HealthSystem Neurological institute; Dr. Gregory Myer, Director of Research for the Division of Sports Medicine at Cincinnati Children’s hospital; Dr. Neilank Jha, Neurosurgeon and Spine Surgeon and Chairman of KONKUSSION; and Dr. Charles Tator, Senior Scientist, Toronto Western Hospital. Kevin Davis, CEO of Performance Sports Group and Mark Messier, six-time Stanley Cup winner and member of the Hockey Hall of Fame, also took part in the discussion.“It was exciting to bring together such a renowned group of medical experts in the field of mild traumatic brain injury and have them agree that this technology – and the supporting science behind it – could be a step forward in addressing mTBI in sports,” Davis said. “As a leading manufacturer of protective sports equipment, we believe it is our obligation to do everything we can to help bring this exciting new technology to athletes around the world.”The band is the first technology of its kind that is intended to reduce mTBI internally by using the body’s own physiology rather than through the use of external protective devices, such as helmets. The band addresses the “slosh theory,” which was identified by Bailes, Dr. Joseph Fisher, Senior Scientist, Toronto General Research Institute; and Dr. David Smith, Visiting Scientist, Cincinnati Children’s Hospital and Medical Center as one of the key causes of mTBI.Slosh is the movement of the brain, which is floating in cerebrospinal fluid inside the skull. When the head experiences an impact, or sudden, extreme movement, the brain sloshes inside the skull and can rotate or strike the inside walls of the cranium, often tearing brain fibers. The result of these impacts can produce mTBI. The band is designed to address mTBI through the application of light pressure on the neck, which in turn mildly increases blood volume in the vein structure of the brain. This increase in blood volume is intended to minimize the sloshing of the brain inside the skull.“This is the first solution to address mTBI from inside the skull,” said Bailes, a founding member of the Brain Injury Research Institute who is portrayed in the upcoming Sony Pictures film Concussion for his work to identify Chronic Traumatic Encephalopathy (CTE) in former professional football players. “By increasing the volume of blood in the cranial cavity, there’s less room for the brain to move which reduces the overall slosh effect which we believe reduces mTBI. The research results are very encouraging and we are excited to work with Performance Sports Group to continue the important research and bring this technology to market.”In two separate peer-reviewed research studies, which were published in the medical journals Neurosurgery and Journal of Neurosurgery, respectively, the researchers found an 83 percent reduction in the number of torn fibers in a standard concussion model when the band was utilized. In addition, Dr. Myer cited several other studies during the presentation that showed promising results for the band.Performance Sports Group acquired the exclusive perpetual, worldwide license from Q30 Sports, LLC (“Q30”) in October 2015 to use its patent and technology assets in the development of products that are intended to address mTBI in sports and athletic activities. The Company has initiated the process of obtaining the necessary regulatory approvals from the United States Food & Drug Administration (FDA), Health Canada and other regulatory bodies in order to market and sell the band to athletes in the global marketplace.“There is more research that needs to be conducted and we are working with the relevant regulatory bodies to ensure we are following the appropriate and requisite steps to bring this technology to market,” Davis said. “Subject to completion of all the required testing, we would hope to potentially begin offering this product to athletes within the next 12-24 months.”To see a video of the entire presentation, visit www.performancesportsgroup.comAbout Performance Sports Group Ltd.Performance Sports Group Ltd. (NYSE: PSG) (TSX: PSG) is a leading developer and manufacturer of ice hockey, roller hockey, lacrosse, baseball and softball sports equipment, as well as related apparel and soccer apparel. The Company is the global leader in hockey with the strongest and most recognized brand, and it holds the No. 1 North American position in baseball and softball. Its products are marketed under the BAUER, MISSION, MAVERIK, CASCADE, INARIA, COMBAT and EASTON brand names and are distributed by sales representatives and independent distributors throughout the world. The Company is focused on building its leadership position by growing market share in all product categories and pursuing strategic acquisitions. Performance Sports Group is a member of the Russell 2000 and 3000 Indices, as well as the S&P/TSX Composite Index. For more information on the Company, please visit our website.Forward-Looking StatementThis press release includes forward-looking statements within the meaning of applicable securities laws, including with respect to the use of Q30’s patent and technology assets in the development of products that are intended to reduce the incidence of mTBI in sports and athletic activities, obtaining and maintaining approvals from the FDA, Health Canada and other regulatory bodies that are necessary to market and sell products applying the relevant licensed patent and technology assets, and successfully bringing to market products within the next 12-24 months that may have the ability to reduce the incidence of mTBI in sports and athletic activities. The words “may”, “will”, “would”, “should”, “could”, “expects”, “plans”, “intends”, “trends”, “indications”, “anticipates”, “believes”, “estimates”, “predicts”, “likely” or “potential” or the negative or other variations of these words or other comparable words or phrases, are intended to identify forward-looking statements.Forward-looking statements, by their nature, are based on current assumptions and estimates and are subject to important risks and uncertainties. Many factors could cause outcomes to differ materially from those expressed or implied by the forward-looking statements. Technology that may be considered medical devices are subject to complex regulatory approval processes, which are lengthy and the outcome of which is uncertain. Obtaining regulatory approval is subject to the discretion of regulatory agencies and there is no assurance that any device or product incorporating the Q30 technology will be approved by the applicable regulatory agency on a timely basis, or at all. Any failure or delay to obtain or maintain regulatory approvals could affect the manufacturing and marketing of products and our ability to generate revenue from such products, either of which could adversely affect our business and financial condition. In addition, the manufacture, marketing and sale of the technology will be subject to ongoing and extensive governmental regulation in each country in which the Company intends to market its products. Failure to comply with any of these post-approval requirements can result in a series of sanctions, including withdrawal of the right to market a product. Our success depends on, among other things, the value and reputation of our products or brands. Any new products that are not favourably received by consumers could damage our reputation. The lack of market acceptance of such products or our inability to generate satisfactory revenues from such products to offset their costs and investments could have an adverse effect on our business and financial condition. Furthermore, we cannot be assured that the technologies for which we have obtained licenses are adequately protected to prevent imitation by others. Additional risk factors are detailed in the “Risk Factors” section of the Company’s Annual Report on Form 10-K dated August 26, 2015 and in the Company’s first quarter report on Form 10-Q, which are available on EDGAR at www.sec.gov, on SEDAR at www.sedar.com and on the Company’s website.Furthermore, unless otherwise stated, the forward-looking statements contained in this press release are made as of the date hereof, and we have no intention and undertake no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by applicable law. 

US Soccer Sets Youth Header Limits & New Concussion Protocols #TheFIFA5

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While this settlement did not accomplished all the goals of the lawsuit, the door had been opened for change and improvement now the elephant in the room has been acknowledged. 

In a nut shell…

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From the NYTimes…

      Screen Shot 2015-11-10 at 9.37.06 AM 

                                                         To read the NYTimes article

 

And here are the settlement papers:

             FIFA_SettlementAgreement 2

Here are comments from attorney Derek Howard, lead attorney, from Big Win for American Soccer: Youth Concussions Settlement Makes US World Leader Posted Monday, November 9, 2015 at 9:00 pm ET/6:00 pm PT:

Co-Lead Counsel Derek Howard, representing the plaintiffs, said, “This is a big win for American soccer.” Howard, an attorney who has coached youth soccer in the San Francisco Bay area for three decades, said, “Teamwork gets results. By working together, the plaintiffs and US Soccer US will allow our country to lead the world in preventing concussions in soccer and educating coaches and parents.”

Here are quotes from two of the plaintiffs, two of five the women who made up the #TheFIFA5:

Plaintiff Rachel Mehr said, “I am happy to see that US Soccer is taking steps to protect the players and making the game safer than it was when I played.” The case is Mehr et al v. FIFA et al (14-cv-03879 PJH). It was filed August 27, 2014 in U.S.D.C. Northern District of California.

Plaintiff Kira Aka Seidel said, “In my eyes, ensuring the protection of developing minds is of the utmost importance. While there is always more that can be done to keep our youth safe, I am confident that this agreement will help reduce the risk of concussion on the soccer field and provide the necessary tools to properly address a situation in which a head injury occurs.”

From Chris Nowinski, Concussion Legacy Foundation Founding Executive Director formerly known as SLI:

“These guidelines are a major victory for the Safer Soccer campaign and a fantastic first step in making the world’s most popular sport safer to play for children,” said Chris Nowinski. “Together the supporters of the Safer Soccer campaign showed there is widespread support for the elimination of headers for children, and U.S. Soccer heard our message.”

From Dr. Bob Cantu, Concussion Legacy Foundation Founding Medical Director:

“We’re thrilled that progress is being made, but there is more we can do,” said Dr. Robert Cantu. “Research has shown that delaying the introduction of headers to age 14 would prevent over 35,000 concussions in middle school players per year. These new rules still leave many of those middle schoolers at risk, so we will continue to campaign to raise the age further.”

For more background on the lawsuit please read my blog posts.

Congratulation to so many people who worked for this change.

Norwalk 1st to hold Youth Concussion Summit to coordinate Schools, Youth Sports & Medical Providers

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Norwalk, CT  On Monday evening, August 24, 2015, Mayor Harry Rilling, Norwalk Department of Health and Katherine Snedaker, will host The Norwalk Youth Concussion Summit at 7 pm at Norwalk City Hall in the Community Room. The summit will review how Norwalk has lead the state by taking a citywide approach to addressing youth concussions. This event is an opportunity for medical providers, youth sports leaders and school officials review the success of the Norwalk Concussion Guidelines, and discuss a plan for the coming school year as Norwalk officially becomes a “Concussion Care Connected Community.”

Along with political and school leaders from neighboring towns, following Norwalk Hospital and the Norwalk Public Schools administrators are scheduled to attend the summit:

  • Dr. Steven J. Adamowski, Superintendent of The Norwalk Public Schools
  • Michael J. Daglio, President of Norwalk Hospital and Senior Vice President of Western Connecticut Health Network
  • Dr. Benjamin Greenblatt, Chair of the Department of Emergency Medicine
  • Vicki Smetak, MD, Chair of the Department of Pediatrics at Norwalk Hospital

There will also be a dedication of the Norwalk Concussion Guidelines in the name of Jonathan Brown, a late resident of Norwalk who died in 2012, in the memory of his love for sports and for the message for young kids participating in any physical activities to never take a head injury lightly

There will be a review of Norwalk Concussion Project by Katherine Snedaker, Executive Director of the non-profit, Pink Concussions, and advocacy organization SportsCAPP, and a clinical update for medical providers by Patricia McDonough Ryan, PhD, from the Gaylord Hospital Center for Brain Health. The summit will conclude with a discussion of plans for 2015-2016 school year and the proposed IRB research study with Dr. Theresa Miyashita, Ph.D., ATC, PES, CES, Program Director, Athletic Training Education Program at Sacred Heart University.  

The meeting is free and open to anyone but please RVSP to Katherine Snedaker at Katherine@PINKconcussions.com to guarantee seating is available.

Norwalk was the first city in CT to enact concussion guidelines for organized youth sports programs which utilized Norwalk recreation facilities. The guidelines were created to close the loophole that exists in the current Connecticut Concussion Law which protects only public middle and high school athletes who play for their school-sponsored teams.  Only one out of every 11 Norwalk Students is covered by the state law. The Norwalk Guidelines increased protections to 6 out of every 11 students when it was passed in April 2015, by the Norwalk Rec & Parks and the Norwalk Common Council.

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“We Don’t Own the Soccer Fields” = Soccer Latest Excuse

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Screen Shot 2015-04-30 at 10.47.39 AMFIFA and US National Soccer Organizations’ newest excuse (#5 if you are keeping count) to abandon any responsibility toward concussion is they do “n0t own the soccer fields.”

This is the latest development of #TheFIFA5 Lawsuit that pits three mothers and two female college students vs FIFA, soccer’s worldwide governing body—the Fèdèration Internationale de Football Association, soccer’s worldwide governing body and affiliated soccer organizations in the United States – US Soccer, US Club Soccer USCS, American Youth Soccer Organization AYSO, and California Youth Soccer Association, Inc, in the class action lawsuit filed on August 27, 2014. 

A second round of paperwork filed by FIFA and the US national soccer organizations adds a new twist to the “Concussions are not our problem” argument by arguing they don’t own the soccer fields to the claim of “no direct contact with players” thus powerless and landless, they have no influence over youth concussion policy.

Screen Shot 2015-04-29 at 6.51.25 PM

For a quick review of the the first round of Motions to Dismiss papers, the international or national soccer organizations stated they were NOT responsible to change any rules around concussion issues because:

  1. They “lack direct contact with the players.” THUS SHIFTING BLAME TO THE VOLUNTEER COACHES
  2. They “have no duty to make the game safer or to ameliorate risks inherent in the sport; their only duty is to not increase such risks. “ STATUS QUO IS STATUS QUO
  3. FIFA clearly states it “has no legal duty to Plaintiffs to prevent risks that are inherent in the sport, like those from heading a soccer ball.”  PARENTS – YOU KNEW THE RISKS FOR YOUR CHILDREN
  4. US Soccer states, “Legislature in each of those states has specifically addressed the issue of concussion management for youth sports, and none has imposed such obligations on an organization like US Soccer. Rather, like the Consensus Statement, the focus of the various state concussion laws is on educating and assigning responsibility to those individuals who have direct contact with the players to prevent a child suspected of having suffered a concussion from returning to play without first obtaining clearance from the child’s medical provider.” THOSE THE VOLUNTEER COACHES AGAIN…

And now a fifth reason:

      5. They don’t “own the soccer fields.”  THUS SUE THE TOWN AND THE SCHOOLS

These papers a chilling read as “not our responsibility” approach will do more to scare the volunteer coach away from working with kids than asking them to do 20 min online CDC training course as Norwalk has so successfully done. Norwalk’s City Concussion Plan has addressed concussion education and policy by using their ownership of the sports fields and gyms for the greater good of youth sports. Unfortunately, FIFA, US Soccer, US Club Soccer USCS, American Youth Soccer Organization AYSO, and California Youth Soccer Association, Inc, seem to believe they are powerless and blameless over a simple policy change which would make the beautiful game safer for all.

New Concussion Research on Laws + New Excuses by Soccer Bode Well for Citywide Concussion Plan

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A new research study and a new defense by soccer organizations in the #TheFIFA5 lawsuit seem to confirm a citywide concussion plan maybe a very effective way to make sports safer for kids and lower liability for teams and city alike.

Highlights

  • ALL FOR ONE: Norwalk, CT successfully launches new citywide concussion plan for all youth sports
  • CONCUSSION LAWS WORK: Dr. Trojian published new study showing the positive effect of The Connecticut State Concussion Law
  • WE DON’T OWN THE FIELDS: Fifa and national soccer organizations’ new excuse to avoid taking a stand on youth concussion

All For One (City)

On April 15, 2015, Norwalk, CT became the first municipality in the country to enact a citywide Youth Concussion Plan governing all sports teams who use city and school fields/gyms. The plan was unanimously approved by the city council and the Norwalk Concussion Guidelines took effect on April 15, 2015, covering the over 6,000 youth players and 800 coaches who were not covered by the state’s concussion law due to a legal loophole. Based on the SportsCAPP model, I proposed the citywide plan to help youth sports teams to address concussions in young athletes and try to reduce liability exposure for coaches and the city.

As of end of April, all spring-season sports have successful trained their volunteer coaches using the online CDC training course. The Norwalk sports teams have almost unanimously responded with support, before and after the city vote, as they saw the potential benefits of increased safety and lowered liability . A few teams had fears of increased administrative work but were able to meet the deadline with less effort than they thought.

And this week at opening day and first team meetings, parents are given CDC fact sheets and/or emailed links to engaging, cartoon videos to educate the video-centric youth players. Parents and team managers alike have been pleased with the program so far as the first phase of implementation draws to a close.

Now as the season starts, coaches will be required to pull any athlete suspected of a possible concussion, notify parents, and only allow the athlete to RTP with a doctor’s note. The teams are also required to report any suspected concussions to parks and rec using the CRR a free concussion app or an paper form I created (to use until CRR hopefully creates a paper version).

Preparations are being made to hold a citywide medical training in July for all providers to update their practices in concussion evaluation and management because I expect more young athletes will seek medical care for possible concussions.

Concussion Laws Work

A new study shows that concussion laws do seemed to increase the number of athletes who seek medical care for their concussions. Dr. Thomas Trojian of Drexel University College of Medicine was lead author of a new study that showed a sharp increase in the number of youth athlete receiving medical treatment for sports-related concussions after CT concussion laws were passed in 2010. The findings are published in Springer’s journal Injury Epidemiology:

Dr. Trojian and his team’s study is among the first to investigate whether such a state law has had an effect on the medical system. They analyzed the emergency room records of two major trauma centres in Connecticut. A marked increase in the frequency of high school students being treated for sports-related concussions was found. This went up from 2.5 visits per month prior to the law being passed, to almost six per month thereafter. This suggests that the state’s sports-related concussion law has helped to improve the evaluation and detection of such injuries among high school students, by increasing obligatory emergency room visits.

Source: Trojian, T. et al (2015). The Effects of a State Concussion Law on the Frequency of Sport-Related Concussions as Seen in Two Emergency Departments, Injury Epidemiology . DOI 10.1186/s40621-015-0034-7

“We Don’t Own the Soccer Fields”

FIFA and US National Soccer Organizations’ newest excuse to abandon responsibility is they do “n0t own the soccer fields.”  This is the latest development in the second round of #TheFIFA5 Lawsuit that pits three mothers and two female college students vs FIFA, soccer’s worldwide governing body—the Fèdèration Internationale de Football Association, soccer’s worldwide governing body and affiliated soccer organizations in the United States – US Soccer, US Club Soccer USCS, American Youth Soccer Organization AYSO, and California Youth Soccer Association, Inc, in the class action lawsuit filed on August 27, 2014. 

A second round of paperwork by FIFA and the US national soccer organizations adds a new twist to the “Concussions are not our problem” argument by arguing they don’t own the soccer fields to the other claims of no direct contact with players thus they have no influence over concussion policy.

Screen Shot 2015-04-29 at 6.51.25 PM

 

For more on this, read “Excuse #5: We Don’t Own the Soccer Fields”

This continued “not our responsibility” approach by soccer will do more to scare the volunteer coaches away from working with kids than asking them to do 20 min online CDC training course as Norwalk has so successfully done.

Summary

Norwalk’s City Concussion Plan has addressed concussion education and policy by using their ownership of the sports fields and gyms for the greater good of youth sports. Unfortunately, FIFA, US Soccer, US Club Soccer USCS, American Youth Soccer Organization AYSO, and California Youth Soccer Association, Inc, seem to believe they are powerless and blameless over a simple policy change which would make the beautiful game safer for all.

A Step-by-Step Guide: Reduce Risk+Lower Liability for Youth Sports Concussions

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1. WHAT IS THE PROBLEM? 

Our youngest child athletes by being coached by adult volunteers with little or no concussion education.

2. WHY IS THIS A PROBLEM?

Untrained coaches who do not know how to recognize and respond to a possible concussion, increase the risk of more serious injury for child athlete. Ignoring the signs of a concussion and not removing a child from play also increases risk of liability for coaches, teams and city/school (whoever owns the fields on which the sports are being played).

3. HOW CAN YOUTH SPORTS INCREASE SAFETY AND LOWER LIABILITY?

Three key elements need to be in place:

  1. Free resources for training/education via online training/videos, paper flyers, and smart phone apps
  2. Proper concussion policy
  3. A coach/parent/player concussion plan MUST BE MANDATED by the city and/or the sports organization

4. IS IT POSSIBLE TO MANDATE CONCUSSION TRAINING AND NOT UPSET COACHES?

Yes, programs which have done so report that coaches find the training of value to them.

5. WHERE HAS MANDATED COACH TRAINING BEEN SUCCESSFUL?

The BokSmart Program: A COUNTRY WIDE PROGRAM

  • 100% of Youth Rugby Coaches in South Africa are trained 
  • 78,000 coaches trained across the country in concussion education plus other first aid skills
  • 8 hour course – must be taken first BEFORE a coach can coach a game. Refs check training cards before each match
  • 100% of youth rugby players in the country now have trained coaches plus ALL INJURIES are tracked (KEY)

TCYFL – The Chicagoland Youth Football League: A REGIONAL PROGRAM

  •  42 Communities in the Chicago Metro area
  • 1857 coaches trained in concussion management using 90 min video
  • 100% of Injuries are tracked weekly using injury reporting software (KEY)
  • 360 teams all have at least 5 trained coaches
  • 8615 youth football players now have trained coaches
  • 180 games each weekend all covered by certified athlete trainers
  • 360 team’s practices are covered by safety player coaches
  • 0 the number of coaches who left due to the additional burden of concussion training
  • 2 parents complained the first year and none the second

The City of Norwalk: A CITY PROGRAM (VIA PARKS AND REC) – Start date April 15, 2015

  • 6,000 youth players
  • 700 coaches
  • 30 minute CDC Coach Training for all coaches, CDC fact sheets for parents/athletes
  • Affects five baseball leagues, two soccer leagues, citywide lacrosse league plus the town sponsored basketball, field hockey and football teams

6. BASED OF THE SPORTSCAPP.COM MODEL, WHAT ARE THE NORWALK CONCUSSION GUIDELINES?

  • User Groups or Organizations = mean any group or organization that has been granted permission to use any City of Norwalk recreation facility
  • Athletic Activities and/or Athletic Programs = all activities including practices, training, performances, scrimmage, games and other organized competitions involving athletic activities such as sports and dance

To use any City of Norwalk recreation facility, a “User Group” providing “Athletic Activities or Programs” to children (age 7 to 18) must:

  1. Educate Coaches, Parents, and Athletes: 
    • Inform and educate coaches, through FREE CDC ONLINE training
    • Educate athletes and parents and guardians about concussion via CDC concussion information sheet
  2. Remove From Play any Athlete who is showing signs, symptoms, behaviors of concussion
  3. Obtain Permission to Return to Play: An athlete can only return to play or practice after at least 24 hours and with permission from a health care professional
  4. Record and submit to Parks & Rec any concussions over the season

7. WHY IS DATA COLLECTION ESSENTIAL?

Only by collecting data can programs and policies be benchmarked and reviewed. All policy should be based on data.

8. HOW DO COACHES ACCESS FREE CDC ONLINE TRAINING?

9. PER THE CDC WEBSITE, WHICH ORGANIZATIONS SUPPORT THE CDC CONCUSSION TRAINING?

  • US Lacrosse
  • US Soccer
  • USA Baseball
  • USA Football
  • USA Rugby
  • USA Volleyball
  • YMCA of the USA
  • Amateur Athletic Union
  • Amateur Softball Association/USA Softball
  • American Academy of Neurology
  • American Academy of Pediatrics
  • American Academy of Physical Medicine and Rehabilitation
  • American College of Sports Medicine
  • American Medical Society for Sports Medicine
  • American School Health Association
  • American School Health Association
  • American Sports Education Program
  • Brain Injury Association of America
  • Brain Trauma Foundation
  • Center for Injury Research and Policy, the Research Institute at Nationwide Children’s Hospital
  • Children’s National Medical Center
  • Defense and Veterans Brain Injury Center
  • Emergency Nurses Association
  • Health Resources and Services Administration, EMS for Children
  • Health Resources Services Administration, Traumatic Brain Injury Program
  • Massachusetts Department of Public Health
  • Matthew Alan Gfeller Sport-Related TBI
  • Research Center, University of North Carolina at Chapel Hill
  • Mayo Clinic
  • MSU, Institute for the Study of Youth Sports
  • National Academy of Neuropsychology
  • National Alliance for Youth Sports
  • National Association of School Nurses
  • National Association of Secondary School Principals
  • National Council for Youth Sports
  • National Education Association
  • National Education Association Health Information Network
  • National Federation of State High School Associations
  • National Interscholastic Athletic Administrators Association
  • National Program for Playground Safety
  • National Recreation and Park Association
  • North American Brain Injury Society
  • Pop Warner Little Scholars, Inc.
  • President’s Council on Physical Fitness and Sports
  • Safe Kids Worldwide
  • Safe States Alliance
  • Sarah Jane Brain Foundation
  • Society of State Directors of Health, Physical Education & Recreation 
  • Sports Legacy Institute
  • University of Pittsburgh Medical Center, Sports Medicine Concussion Program

10. HOW OFTEN SHOULD THE COACHES TRAINING COURSE BE TAKEN?

Due to the quick pace of coaches aging through youth sports teams, SPORTSCAPP.com recommends this test be taken on a yearly basis.

11. CAN THE COURSE BE TAKEN IN A GROUP SETTING RATHER THAN ON SOLO ON A COMPUTER OR SMART PHONE?

Yes, this is ideal way to train and since a live Q&A session can provide sports’ specific experience. Some local football and lacrosse teams have already provided this type of training. But the course can also be taken by an individual anywhere there is internet access and a computer, iPad or iPhone.  

12. HOW CAN A CERTIFICATE BE GENERATED TO SHOW THE COACH TOOK THE COURSE?

  1. When the coach clicks on the course link, he/she will be asked to providIMG_8776e their full name before the course begin
  2. At the end of the course, the program will offer a certificate to print or download as a PDF or a palm card
  3. The certificate can then be printed and scanned then emailed to the team administrator. A PDF can simply be mailed

13. WHO SHOULD GET A COPY OF THE CERTIFICATE?

Documentation of the coach successfully completing the course should be:

  1. Kept by the coach accessible practices and games – saved on phone or paper
  2. Sent to the team or User Group or Organization and produced for verification of compliance by the Recreation Department prior to any permit or license being granted for the use of any City of Norwalk facility for each sport season
  3. There are plans which will be announced in the near future of a centralized registry

14. WHAT IS A FREE APP WHICH CAN INCREASE SAFETY FOR PLAYERS AND LOWER LIABILITY FOR COACHES? 

Screen-Shot-2014-10-23-at-1.09.29-PM-150x150CONCUSSION RESPONSE GUIDE + PARENT NOTIFICATION TOOL = ONE APP

This FREE SmartPhone App is recommend for coaches/parents to help a youth player with a possible head injury, and officially notify parents of the head injury based on the most current CDC information. With time and geo stamps on final report, the coach can officially emailed from the app to the parent, the manager and the team. The report records information which will be useful for the doctors and parents at a later time to judge RTP and guide a recovery plan. 

  • Why would this help kids? After a possible head injury, this app guides coaches and parents on how to assess the injury and how best to respond by providing current medical guidance on when to call 911 or if the child should be removed from play. The app also records information which will be useful for the doctors and parents at a later time to judge RTP and guide a recovery plan.
  • Example of use: A youth sport athlete suffers a hit on the soccer field. The athlete is taken to the sideline, accessed with the app and the parent is emailed the information about the athlete with ACE care materials
  • What is it? An app
  • Who uses it? Coaches or parents
  • When? At the first sign of any suspected head injury 
  • To do what? After a possible head injury, coach or parent are led through set of questions about the child’s current signs, symptoms and behavoirs. The user is given a set of conditions when to stop using the app and call 911, and if none of those conditions are met then to proceed to ask the athlete how he or she feels. The app records information which will be useful for the doctors creating a recovery plan. A summary of the answers to the question can be emailed to the parents with care instructions. 
  • How do I get this app? Download on it on your smart phone from the app store
  • Who supplies the info? Coach or any adult
  • Cost? Free
  • Compliance? HIPPA and FERPA Compliant
  • Liability issues? Decreases liability for coach and team. While it is always best to have an athletic trainer be the first responder to a possible concussion, this tool can direct a parent or volunteer coach to respond in a responsible way.

15. WHAT EDUCATION DO PARENTS AND ATHLETES NEED?

For coaches to be successful with concussion emergency plans, athletes and parents also need education on:

  • Current practice in proper injury prevention techniques and skills
  • The signs and symptoms of concussion = CDC Handouts – Links below
  • The procedure for notifying parents when an athlete has been removed from play for a head injury or suspected concussion = PER EACH ORG’s RULES

16. WHAT CDC RESOURCES EXIST FOR PARENTS AND KIDS? 

Information for Parents

Information for Athletes

17. WHAT ARE BEST FREE VIDEOS TO EDUCATE STUDENTS, PARENTS AND COACHES? 

Screen-Shot-2014-10-23-at-1.00.06-PM-150x150VIDEO #1: Why you need to be educated? 4 min Powerful Video (Note: Click link and scroll down half-way down the article to play the video of Peter Robinson talking about his son) Recommended for high school athletes, coaches and parents. Parents, please watch first before showing to your children. Link: http://www.theguardian.com/sport/2013/dec/13/death-of-a-schoolboy-ben-robinson-concussion-rugby-union 

Screen-Shot-2014-10-23-at-1.00.26-PM-e1414084615169-150x143VIDEO #2: What you need to know? 4 min Funny Cartoon Recommended for all age kids plus coaches and parents. – really well done and funny. Link: http://brain101.orcasinc.com/5000/ 

 

Screen Shot 2014-10-23 at 1.21.11 PMVIDEO #3: How best to recover after a concussion (but watch it now) – for kids, parents and coaches by Top Doctors Dr. Mike Evans and Dr. Gerry Gioia. Link: http://www.sportscapp.com/2014/08/28/best-concussion-video-of-2014-rtl/ 

 

 

18. IS THERE REALLY A LIABILITY RISK IN YOUTH SPORTS?

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19. HOW DID U.S. YOUTH SOCCER AND FIFA RESPOND TO A LAWSUIT DEMANDING A BETTER CONCUSSION PLAN? 

Here are some quotes from the Motion to Dismiss papers (attached below) from the current youth soccer lawsuit filed by FIFA, US Soccer, Defendant National Association of Competitive Soccer Clubs, Inc., d/b/a US Club Soccer (“USCS”), American Youth Soccer Organization (“AYSO”), California Youth Soccer Association, Inc.

  • FIFA  and all the others named stated they “lack direct contact with the players.” SHIFTING BLAME TO THE VOLUNTEER COACHES
  • FIFA (and others) have no duty to make the game safer or to ameliorate risks inherent in the sport; their only duty is to not increase such risks. “ STATUS QUO IS LEGAL
  • FIFA (and others) clearly state it “has no legal duty to Plaintiffs to prevent risks that are inherent in the sport, like those from heading a soccer ball.”  YOU KNEW THE RISKS FOR YOUR CHILD.
  • US Soccer clearly states, “Legislature in each of those states has specifically addressed the issue of concussion management for youth sports, and none has imposed such obligations on an organization like US Soccer. Rather, like the Consensus Statement, the focus of the various state concussion laws is on educating and assigning responsibility to those individuals who have direct contact with the players to prevent a child suspected of having suffered a concussion from returning to play without first obtaining clearance from the child’s medical provider.”

Please open and read these papers:

20. IS IT REALLY POSSIBLE TO INCREASE SAFETY AND LOWER LIABILITY?

Yes, and please contact me if you have any doubts or questions.

There are also low cost smart phone apps to manage injury reporting and make parents email/children’s emergency information accessible to coaches on the field. Please contact me for more info. I have no financial ties with any of these companies.

Norwalk Public Schools’ Concussion Count – Aug 1 to Jan 31

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While the new CT State Law requires all districts provide a number for concussions diagnosed in their students, the Norwalk School Concussion Project is going a step further and shedding the light on the various types of sport and non-sport concussions across our K-12 schools.

For the next semester, I want to breakout gym class concussions from the sports tally, and look for causes in the “home, but non-sports” concussions, especially in the high school girls.

All of this is possible because of the efforts of the Norwalk school nurses and ATs to track these students, and I am so grateful for their efforts.

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The first chart below explains which concussion this school year have been covered by the state concussion law (22 concussions in green) and the second chart shows the youth sports concussions (19 concussions in red) which will be covered by the Norwalk guidelines as of April 15, 2015. The 19 youth concussions so far this year were not covered under the state law and those athletes would not have any of the benefits of the state law.

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Has Norwalk, Connecticut Become the Safest City in the Country When It Comes to Concussions?

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Reposted permission from http://concussionpolicyandthelaw.com/

The City of Norwalk, Conn. made history last month when the Norwalk Common Council voted 15 to 0 to approve Youth Sport Concussion Guidelines for its 6,000 youth athletes and 700 coaches who use municipal fields, gyms and facilities.

Connecticut’s Concussion Law only applied to Norwalk’s 1,145 high school athletes, meaning city guidelines were needed to extend the concussion protocol to the remaining youth athletes. To illustrate that point,

“Norwalk has set a new ‘standard of care’ for young athletes ages 3 to 18,” said Snedaker. “These guidelines are the most progressive for any city in Connecticut and maybe even in the United States.”Katherine Snedaker, a Norwalk resident and Executive Director of the non-profit PinkConcussions.com, told Concussion Litigation Reporter that 75 students in Norwalk public schools have reported concussions with 19 of them coming from non-school sports, which were not covered by the state law.

Snedaker, who was instrumental in getting the guidelines passed, said the guidelines will apply to all City of Norwalk-sponsored Athletic Activities and Programs and to those Athletic Activities and Programs operated or conducted by any user group or organization on or in facilities belonging to the City of Norwalk.

Athletic Activities and/or Programs can be defined as “all activities including practices, training, performances, scrimmage, games and other organized competitions involving athletic activities such as sports and dance.”

As of April 15, 2015, any sports team which wants to obtain a permit to use city fields, gym or courts must:

1.     Train Coaches and Educate Parents, and Athletes

a.     Train coaches, through FREE CDC online training

b.    Educate athletes and parents and guardians about concussion with FREE CDC concussion information fact handouts

2.     Remove From Play ANY Athlete who is showing signs, symptoms, behaviors of concussion

a.     REMOVE POSSIBLY INJURED PLAYERS showing the signs, symptoms and/or behaviors of a possible head injury

b.    Immediately notify parents of injury

c.     Request evaluation from a medical provider

d.    Hold out athlete from returning to play for at least 24 HOURS

3.     Obtain Permission to Return to Play
An athlete can only return to play or practice after at least 24 hours and with written permission from a health care professional

4.     Record Concussions and submit injury report via official online form to Rec & Park for all concussions

Snedaker said the guidelines are “win-win” for all involved.

“While no law can prevent a concussion, these guidelines will increase safety for children while lowering risk liability for coaches, leagues and the town,” she said. “It is a win-win for all.”

She hopes other cities in Connecticut will recognize their value.

“There are certain groups in our state, who are scared to have youth sports added to the state law. Norwalk’s success at passing the guidelines with all leagues supporting, and not one angry phone call, shows it can be done.”

US Youth Soccer’s Lame Concussion Protocol

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**Update: I have now written John Sutter, President of US Youth Soccer, and asked him to remove this document and replace with current, best practices**

NOTE: My thoughts in red text below. Disclosure: I am parent and a social worker, not an athletic trainer or a doctor. From the parent’s eye, here are the obvious holes I see in this NEW Policy which was uploaded Feb 2015. Am I being too harsh? Let me know…

I do not have permission to post this. But since this important protocol is only supplied as a downloadable PDF (which you cannot link to), I needed to download it and repost it here.

The lawsuit against US Youth Soccer has merit I believe based this document alone…

US Youth Soccer Concussion_Procedure_and_Protocol_rev_2_15

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Concussion Procedure and Protocol

For US Youth Soccer Events

Concussion: a traumatic brain injury that interferes with normal brain function.  Medically, a concussion is a complex, pathophysiological event to the brain that is induced by trauma which may or may not involve a loss of consciousness (LOC). Concussion results in a constellation of physical, cognitive, emotional, and sleep-related symptoms. Signs or symptoms may last from several minutes to days, weeks, months or even longer in some cases.

CONCUSSION SIGNS, SYMPTOMS, AND MANAGEMENT AT TRAINING AND COMPETITIONS

Step 1:

Did a concussion occur?

Doesn’t ask if there was a blow to the body and head, jerking of the head?!?  With this protocol as spelled out, most kids on the team would have a concussion based on these descriptions alone.

Evaluate the player and note if any of the following signs and/or symptoms are present:

(1)   Dazed look or confusion about what happened.

(2)  Memory difficulties.

(3)   Neck pain, headaches, nausea, vomiting, double vision, blurriness, ringing noise or sensitive to sounds.

(4)   Short attention span.  Can’t keep focused.

(5)   Slow reaction time, slurred speech, bodily movements are lagging, fatigue, and slowly

answers questions or has difficulty answering questions.

(6)   Abnormal physical and/or mental behavior.

(7)   Coordination skills are behind, ex: balancing, dizziness, clumsiness, reaction time.

THE SECTION ABOVE IS MISSING: 

  • Repeats things 
  • Cannot call events before 
  • Cannot call events after
  • Feeling tired
  • Sensitivity to light
  • Numbness or tingling
  • Difficulty concentrating
  • Difficulty remembering
  • Feeling fogy/groggy
  • Feeling slowed down
  • Irritable
  • More emotional
  • Doesn’t feel right

AND NO MENTION OF WHAT TO DO IF THESE SIGNS ARE PRESENT? HOLD THEM OUT? PUTTING THEM BACK IN THE SECOND HALF AFTER A REST? THIS IS SUPPOSED TO BE THE “MANAGEMENT PLAN” AS STATED ABOVE.

Step 2:

Is emergency treatment needed?

This would include the following scenarios: WOULD THIS BE JUST ONE OF THESE OR MORE, AND IF IT IS AN EMERGENCY WHAT IS COACH SUPPOSED TO DO?

(1)   Spine or neck injury or pain.

(2)   Behavior patterns change, unable to recognize people/places, less responsive than usual.

(3)   Loss of consciousness.

(4)  Headaches that worsen

(5)   Seizures

(6)  Very drowsy, can’t be awakened

(7)  Repeated vomiting

(8)  Increasing confusion or irritability

(9)  Weakness, numbness in arms and legs

      THIS SECTION IS MISSING: 

  • One pupil largers than another
  • Slurred speech
  • Will not stop crying/cannot be consoled
  • Increasing restlessness

AND NO MENTION OF WHAT TO DO IF THESE SIGNS ARE PRESENT? HOLD THEM OUT? PUTTING THEM IN YOUR CAR AFTER THE GAME AND GO TO A HOSPITAL? THIS IS SUPPOSED TO BE THE “MANAGEMENT PLAN” AS STATED ABOVE.

Step 3:

If a possible concussion occurred, but no emergency treatment is needed, what should be done now?

Focus on these areas every 5-10 min for the next 1 – 2 hours, without returning to any activities: DOESN’T SAY “STAY OUT 24 HOURS” – JUST TWO HOURS?

THIS NEXT PART IS JUST STUPID – YOU ARE SUPPOSED TO CHECK THE KID 24 TIMES IN 2 HOURS AND HOW ARE YOU SUPPOSED TO CHECK THESE AS A PARENT OR A COACH?!?

(1)   Balance, movement.

(2)   Speech.

(3)   Memory, instructions, and responses.

(4)   Attention on topics, details, confusion, ability to concentrate.

(5)  State of consciousness

(6)  Mood, behavior, and personality

(7)  Headache or “pressure” in head

(8)  Nausea or vomiting

(9)  Sensitivity to light and noise

OK IN TWO HOURS, NOW DO WHAT?

Step 4:

A player diagnosed with a possible concussion may return to US Youth Soccer play only after release from a medical doctor or doctor of osteopathy specializing in concussion treatment and management. DOESN’T EVEN MENTION “STAY OUT 24 HOURS”

 

Step 5:

If there is a possibility of a concussion, do the following: LOTS OF DETAIL ON WHAT FORMS TO FILL OUT

(1)   The attached Concussion Notification Form is to be filled out in duplicate and signed by a team official of the player’s team.

(2)   If the player is able to do so, have the player sign and date the Form. If the player is not able to sign, note on the player’s signature line “unavailable”.

(3)   If a parent/legal guardian of the player is present, have the parent/legal guardian sign and date the Form, and give the parent/legal guardian one of the copies of the completed Form. If the parent/legal guardian is not present, then the *******KEY POINT BURIED team official is responsible for notifying the parent/legal guardian ASAP by phone or email and then submitting the Form to the parent/legal guardian by email or mail. When the parent/legal guardian is not present, the team official must make a record of how and when the parent/legal guardian was notified.  The notification will include a request for the parent/legal guardian to provide confirmation and completion of the Concussion Notification Form whether in writing or electronically.

(4)   The team official must also get the player’s pass from the referee, and attach it to the copy of the Form retained by the team.

References:

Kissick MD, James and Karen M. Johnston MD, PhD.  “Return to Play After Concussion.” Collegiate Sports Medical Foundation.  Volume 15, Number 6, November 2005. 2005 TEN YEARS AGO?!?! http://www.csmfoundation.org/Kissick_-_return_to_play_after_concussion_-_CJSM_2005.pdf.  April 22, 2011.

National Federation of State High School Associations.  “Suggested Guidelines for Management of Concussion in Sports”.  2008 NFHS Sports Medicine Handbook (Third Edition).  2008 77-82. THIS WAS WRITTEN IN THE DARK AGES: CONCUSSIONS WERE GRADED IN 2008

http://www.nfhs.org.  April 21, 2011. WHY 2011?!? It is a website which should updated?!?

AM I BEING TOO HARSH? HONESTLY, MY KIDS COULD WRITE A BETTER PROTOCOL FOR CONCUSSION SIGNS, SYMPTOMS, AND MANAGEMENT AT TRAINING AND COMPETITIONS. 

Unofficial Update on #TheFIFA5 Lawsuit

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bigstock-Soccer-Ball-In-Goal-47239690 2For six months, I have been anxiously waiting to see how FIFA, US Soccer, US Club Soccer USCS, American Youth Soccer Organization AYSO, California Youth Soccer Association, Inc, would respond to the class action lawsuit filed against them on August 27, 2014,  This lawsuit pit three mothers and two female college students vs FIFA, soccer’s worldwide governing body—the Fèdèration Internationale de Football Association, soccer’s worldwide governing body and affiliated soccer organizations in the United State.

This lawsuit demands no financial rewards but only that FIFA and the soccer other organizations mentioned, make the following changes to their program:

  1. Implement up-to-date guidelines for detection of head injuries
  2. Implement up-to-date RTP after a concussion
  3. Regulation of heading by players under 17 years old
  4. Eliminate heading under 14 years old age groups
  5. Implement a rule change to permit substitution of players for medical evaluation purposes. (Currently, FIFA rules generally allow only three substitutions per game with no clear provision for head injuries. If an athlete bleeds, even from a scrape, removal is required, but no similar rule exists for concussions. FIFA provides no guidance on substitutions in youth games in the U.S.)
  6. Implement medical monitoring for soccer players who received head injuries in the past

Filed on January 30, 2015, Motions to Dismiss Papers by FIFA and the others make it very clear who should be held liable in future concussion lawsuits. Take a guess? No, flip through 1 or 2 of these.

I had hoped this soccer lawsuit would force the hands of these international and national leaders in soccer to produce a unified concussion plan for youth players. Instead I was sadden to read the responsibly being pushed down squarely upon the shoulders of the volunteer coach – the one with “direct contact” with the children. 

In my non-legal opinion, the Motions to Dismiss papers, in nutshell, state that none of the international or national soccer organizations are responsible to change any rules around concussion issues because:

1. They “lack direct contact with the players.” THUS SHIFTING BLAME TO THE VOLUNTEER COACHES

2. They “have no duty to make the game safer or to ameliorate risks inherent in the sport; their only duty is to not increase such risks. “ STATUS QUO IS STATUS QUO

3. FIFA clearly states it “has no legal duty to Plaintiffs to prevent risks that are inherent in the sport, like those from heading a soccer ball.”  PARENTS – YOU KNEW THE RISKS FOR YOUR CHILDREN

4. US Soccer states, “Legislature in each of those states has specifically addressed the issue of concussion management for youth sports, and none has imposed such obligations on an organization like US Soccer. Rather, like the Consensus Statement, the focus of the various state concussion laws is on educating and assigning responsibility to those individuals who have direct contact with the players to prevent a child suspected of having suffered a concussion from returning to play without first obtaining clearance from the child’s medical provider.”

These papers a chilling read for I think this “not our responsibly” approach will do more to scare the volunteer coach away from working with kids than asking them to do 20 min online CDC training course. Sadly, this fear-based response will not help to make a sport I love any safer for our kids. There is no reason to fear concussion safety education unless you fear knowing CPR or the Heimlich Maneuver, too?

Just as parents and older teens take the safe boating course before they head out for a day on the water, all adults and older teens heading out to play land sports should take the 20 minute, FREE, online CDC Coaches Training for the sake of their own liability.

Don’t wait for FIFA to lead the way… Just take the CDC course and go coach youth soccer!!

Youngest Concussion Researcher in the World

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His name is Carson Barry and he is 12 years old. Carson has been researching concussions for over two years since his brother, who suffered several hockey concussions, committed suicide.

Carson lives in Butte, Montana, and plays on a youth hockey team. He is the youngest of four brothers; and in this photo from 2009, the boys sitting left to right are Tanner, Cullan, Travis, and Carson.

Born into a hockey family, Carson was on skates by the age of two and as soon as he was old enough, he began to play youth hockey like his older brothers had done. In this photo, Carson, age 2, being helped by brother, Cullan, and his mom, Christine. This day was Carson’s first time on skates.

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I first learned about the Barry Family from Christine Barry’s post on TheConcussionBlog.com, Sept. 17, 2011:

Our son, Cullan Barry, died from suicide May 13, 2011. He was a hockey player and had received a concussion on Feb 26, 2011; but in Dec 2009, he also had been sent to the hospital by ambulance following an illegal hit in the back that sent him down like a rag doll. They did a CAT scan of his head said it was fine and focused on his knee that had hit the boards. He was off the ice for six weeks with the knee injury but had ongoing migraines. No doctor every told us that ongoing migraines could be tied to a brain injury form the hockey hit, no doctor ever told us to watch for such things. 

His grades dropped he had difficulty with insomnia with fatigue, with concentrating on things like English and math, but we kept thinking his migraines were food-related. Now I believe the headaches, insomnia, and fatigue were all related to that big hit injuring his brain and other hits in hockey continuing to injure his head. However, doctors assured us the CAT scans were fine. 

At the Feb. 2011 (ER visit), the ER doctor did not even come into the room to check him and just told the nurse what to do and say. We were given standard do not play for couple weeks and he was released with no discussion of symptoms to look for of ongoing brain trauma. Cullan had a migraine the night he died. I think ER doctors need to be greatly more informed about concussions and parents of athletes need this information about post concussion syndrome, brain injuries caused by multiple impacts over time. 

I reached out to Christine, Carson’s mom, to hear more about her son, and we spoke on the phone about Cullan’s life, his tragic death and wondered what role concussions may have played in his decision to take his life. We promised to stay in touch.

Christine wrote me in the Fall of 2013, and asked me to participate in her youngest son’s science fair project. I offered to help Carson with the project which was a Facebook survey about suicide and contact sports.

From: Christine 

Subject: Science project results

Date: March 21, 2014 at 11:00:29 PM EDT

To: Katherine

Dear Katherine,

Thank you for your help with Carson’s survey.

Carson won a blue ribbon for 5-6th grade science projects, a gold medal for behavioral science projects, an award for best 5-6th grade science projects, and an award for top ten science projects out of 482 5-8th grade projects at the Montana regional science fair. He is only in 5th grade so was too young to go to the state science fair. 

So thank you for your responses to his survey.

I have included the graphs of his results which he, I and evidently the judges found jaw dropping:

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The best of all this is he is already planning what he wants to do for next year which is he wants to get helmet sensors and measure how hard an impact can cause a concussion and how hard of an impact would cause kids to report symptoms to coaches or parents. He wants to use his hockey team, 10-12 year olds. This would give impact results on much younger kids as most research is on college or pros and would also give some insight into reporting tendencies of children in sports. 

So do you have any ideas about what helmet sensors would be the best? There are several out there including one that has a phone app to alert when a kid may have had too hard of a hit or need a concussion eval.

Thank you,

Chris

I was excited to see if I could help Carson and reached out to some sensor people I knew. But first, I asked Carson to write me a letter explaining what he wanted to accomplish so I could pitch his project to some sensor companies. These research-grade sensors are extremely expensive and I needed evidence that this 12 year old was a serious researcher and not like my own kids who just hit my sample sensors with baseball bats.

Here is a letter I received from Carson explaining his project:

Reducing Suicide Risk by Reducing Brain Injuries and Concussions

My name is Carson Barry and I have been researching concussions and a possible link to suicide for my school science projects for the last 2 years. I am 11 years old and I go to Silver Bow Montessori School in Butte Montana.

My interest in this research started after my brother committed suicide at the age of 17 following a series of concussions he had in an 18 month period. My family and I have felt his death was related to the concussions. We lobbied the Montana legislator to pass a concussion education and return to play law in our state.  We hosted a concussion education and safe play clinic at our hockey rink last fall. 

photo (7)Last year for my fourth grade science project I surveyed 3 high school hockey teams about whether players had experienced concussions, how many concussions, what symptoms they had and how long it took for them to be symptom free.  I found 27 players who had concussions or a whole hockey team.  Contrary to what my brother had been told by doctors who treated him that it would take about 2 weeks to heal from a concussion, I found it was taking the hockey players an average of 3- 6 months to be symptom-free and several players were still having symptoms after a year. I also found that 67% of the players reported that they had thoughts of self harm while recovering from their concussions.

The fact that 67% of hockey players recovering from a concussion had thoughts of self-harm seemed very alarming. I thought someone needed to research whether a brain injury was a suicide risk. So this year for my fifth grade science project I put a survey on Facebook asking people who had lost a loved one to suicide if that person had a previous brain injury and if they had played a contact sport where they could have had an unreported or misdiagnosed concussion. My results found that 70% of the suicides had a previous brain injury. When I added in suicides who had played a contact sport the number jumped to 84%. This again was alarming. I felt that if these athletes could better identify when their brain is injured,  better report their symptoms, or be better treated for the injury these deaths could be prevented.

For my science project next year, I would like to research what force or impact it takes to cause a concussion in youth athletes. I want to compare the impact force to when and what symptoms a player reports. I want to see if players tend to under report or brush off symptoms compared to when an impact sensor says they should be evaluated.  I would like to use helmet sensors on my PeeWee hockey team (ages 10-13).  Then I would like the players to fill out symptom checklists after a game and for the next week.  Most impact helmet sensor research has been done on college or pro athletes and I think it is the younger athletes’ brains who are more fragile. I think my findings can help players protect their brains and reduce their risk of suicide.

I was wondering if your organization could help me get helmet sensors for my project. My hockey team will have 10-12 players next season.

I can be reached at my Mom’s e-mail at 

Thank you very much,

Carson Barry

image001With Carson’s letter in hand, I reached out to Danny Crossman CEO of Impakt Protective to see if his company could loan Carson research-grade quality sensors. Danny agreed to help and would able to loan Carson some sensors when the UPMC researchers were finished with their project thus Carson’s project was set for the fall of 2014.

Working with sensors is not easy for adults, and Danny cautioned me this would be a difficult project for a young researcher:  

“Carson should know that studying one team of 10-12 years olds (15-20 kids) wont yield a lot of data (usually 2-3 hits over 40g per contact game) and certainly won’t yield a lot of concussions (probably 3-5 per season at most).”

But Carson was determined, so the now the wait for the sensor began.

In October, we got the good news from Danny…

From: Danny

To: Christine

CC: Katherine

Subject: RE: Good news

Date: Mon, 27 Oct 2014 12:04:29 -0400

20 Shockbox sensors will ship out to you this week for Carson to use. They are used (during a University of Pittsburgh hockey study) and  will come with chargers and user cards. They are the HD-R (research) version and are equipped with a gyro to measure rotation (this is an estimate since it is hard to do accurately) and a 3-axis accelerometer to measure linear peak g (this is the standard measurement for head impacts). 

I was so excited for Carson to have the chance to fulfill his dream project and I wanted to stay in the loop so I asked Christine and Carson to send me photos and progress reports on the project.

From: Christine 

To: Katherine 

Subject: RE: sensors

Date: November 4, 2014 at 8:23:48 PM EST

I am sure he would love to send you updates, it would be good for him to log as he goes for his project IMG_0476anyway. He was cute as we were driving home from school, he saw a UPS truck and said “Oh I bet they have my sensors, hurry Mom we have to get home!” And indeed they arrived about 30 minutes later. [The photo is Carson with the newly arrived sensors.)

After a great deal of work learning how to use [including charging, syncing, recording data, and understanding the results] the sensors and convincing adults and kids to participate in the project, Carson used the sensors for 7 games total for his project. Not once did a ref ask about themIMG_0474 so refs didn’t even really noticing them. I did not tell the refs prior to games they were wearing them and I was a bit leary of refs questioning them but they did not seem to even notice. I did ask the MAHA board if they could wear them in league games, they asked if they enhance performance? I had to explain them to the board and then they said no problem.

IMG_0475Here are some of the boys right before they head to ice, right after putting sensors.

[For more about the Carson’s results, stay tuned to my next post]

Carson worked very hard on his project and his efforts paid off. Last week, Carson won a blue ribbon and a gold medal at his school science fair then top fifth/sixth grade science project and $50 at regional fair. There were 450 projects at the fair of which half of those fifth/sixth grade projects so he did very well said his proud mom.

Carson goes to a Montessori school and presented his project to the whole school on last Thursday. The whole school was impressed with his work.

IMG_0545IMG_0553Note the red hat that Carson is wearing in the picture. This hat belonged to his brother, Cullan. Carson’s mom can rarely get Carson to take the hat off and is getting very tattered now. Carson’s grandfather bought the hat for Cullan when he went to a USA hockey conference. Carson has adopted it and worn it quite religiously since Cullan died.

Carson promised his mom he would take it off when speaking to the judges, but as you can see  in the photos he wore it both before the judges came and has it right back on after they left.

I look forward to hearing the next report from the Montana State Science fair to see how many more people are touched by this amazing young researcher. 

Carson will be presenting his project at state fair on March 16 and  17; and March 17 happens to be Cullan’s birthday.

[If you want to congratulate Carson, please leave a comment below and I will forward to his mom]

Norwalk is 1st in CT to approve Concussion Program for all Youth Sports

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Mayor Harry Rilling, Katheine Snedaker, Jerry Petrini and Wyatt Machette at a press conference announcing new concussion guidelines for Norwalk youth sports. Photo Credit: Casey Donahue

My city of Norwalk, CT, made history this week when Norwalk Common Council unanimously approved Youth Sport Concussion Guidelines extending concussion education and training for the 6,000 Norwalk youth athletes and 700 coaches who use town fields, gyms and facilities. I believe this is the most progressive in the United States a new “standard of care” for young athletes age 3 to 18. I am truly grateful and thrilled to have accomplished this with such a broad ban of supporters.

While no law can prevent a concussion, these guidelines will increase safety for children while lowering risk liability for coaches, leagues and the city. These benefits were obvious to the City of Norwalk who unanimously approved Youth Sport Concussion Guidelines for the 6,000 youth athletes who use town fields, gyms and facilities. The current state law only protected Norwalk ’s 1,145 high school athletes. There was no opposition to the vote as all major Norwalk youth sports organizations supported the new guidelines.

These guidelines were necessary as the Connecticut State Concussion Law of 2010 (updated in 2014) only protected the 1,145 public high school athletes who played for their school teams, not the 6,000 youth athletes and their coaches. Under the new guidelines, any team using municipal facilities must adhere to this new standard of care.

Norwalk youth sports organizations and city government agreed expanding these safety guidelines to all age children was a “no-brainer” and clearly a win-win situation for everyone – increasing safety for an additional 6,000 children while lowering risk liability for coaches, leagues and the city. 

Before the vote was taken, public pledges of support for the new guidelines were given by: 

  • Norwalk Junior Soccer Association
  • Norwalk Youth Football and Cheer
  • Norwalk Cal Ripkin Baseball
  • Norwalk Little League
  • Norwalk Lacrosse Association

As of April 15, 2015, any sports team which wants to obtain a permit to use city fields, gym or courts must:

1. Train Coaches and Educate Parents, and Athletes:

a. Train coaches, through FREE CDC online training

b. Educate athletes and parents and guardians about concussion with FREE CDC concussion information fact handouts

 

2. Remove From Play ANY Athlete who is showing signs, symptoms, behaviors of concussion

a. REMOVE POSSIBLY INJURED PLAYERS showing the signs, symptoms and/or behaviors of a possible head injury

b. Immediately notify parents of injury

c. Request evaluation from a medical provider 

d. Hold out athlete from returning to play for at least 24 HOURS

 

3. Obtain Permission to Return to Play: An athlete can only return to play or practice after at least 24 hours and with written permission from a health care professional

 

4. Record Concussions and submit injury report via official online form to Rec & Park for any concussions over the season

The Norwalk Daily Voice

Norwalk Makes History With New Concussion Guidelines For Youth Sports

by Casey Donahue 02/27/15 

NORWALK, Conn. – Norwalk has become the first city in the state to approve a concussion program for its youth sports designed to protect injured kids and prevent them from further …  Read more

SportCAPP’s Picks for Best Online Concussion Info

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BEFORE A CONCUSSION 

In 8 minutes, here is the motivation, education and a FREE tool YOU CAN USE to help any child or adult. It is always best to have an athletic trainer be the first responder to a possible concussion, but without an AT, here is how a parent or volunteer coach can prepare:

Screen Shot 2014-10-23 at 1.00.06 PM

Why you need to be educated?

4 min Powerful Video scroll down half-way down article to see video about Ben

 

 

 

Screen Shot 2014-10-23 at 1.00.26 PMWhat you need to know?

4 min Funny Cartoon for kids and adults

 

 

 

Screen Shot 2014-10-23 at 1.09.29 PMHow can you be prepared?

Free SmartPhone APP for all coaches and parents to download now

 

 

 

AFTER A CONCUSSION

This 10 minute video is the best guide for how to recover created by Dr. Mike Evans and Dr. Gerry Gioia, published August 2014.

 

NFHS announces guidelines on football full contact

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I have expressed my displeasure before on this blog of the slow nature of NFHS to respond to the concussion issue. I will let the documents speak for themselves and check out my good friend, Dustin’s blog.

For the guidelines themselves, click link below:

NFHS announces guidelines on football full contact

For Dustin’s thoughts see http://theconcussionblog.com/2014/11/13/nfhs-develops-concussion-guidelines-for-football/

And here is the official Press Release…

NATIONAL FEDERATION OF STATE
HIGH SCHOOL ASSOCIATIONS

NEWS RELEASE

NFHS Concussion Task Force Recommendations to be Discussed by State Associations for Implementation in 2015

FOR IMMEDIATE RELEASE​Contact: Bob Colgate

INDIANAPOLIS, IN (November 13, 2014) — The National Federation of State High School Associations (NFHS) has finalized its position paper from the NFHS Concussion Summit Task Force, which met in July to develop recommendations for minimizing the risk of concussions and head impact exposure in high school football.
The recommendations, which have been shared with the 51 NFHS-member state high school associations, and approved by the NFHS Sports Medicine Advisory Committee (SMAC) and the NFHS Board of Directors, will be discussed by state associations at the NFHS Winter Meeting in early January for implementation in the 2015 football season.
The 24-member task force, which featured medical doctors, athletic trainers, high school coaches and key national leaders in high school sports, developed nine fundamentals for minimizing head impact exposure and concussion risk in football. They were designed to allow flexibility for state associations that collectively oversee the more than 15,000 high schools across the country that have football programs. As a result, each state high school association will be developing its own policies and procedures for implementation in the 2015 season.
Many of the recommendations focus on reducing the amount of full contact, including limiting the amount of full contact in practices during the season.
The Concussion Summit was the latest effort by the NFHS to minimize risk for the almost 7.8 million student participants in high school sports. In 2008, the SMAC advocated that a concussed athlete must be removed from play and not allowed to play on the same day. For the past five years, all NFHS rules publications have contained guidelines for the management of a student exhibiting signs, symptoms or behaviors consistent with a concussion. In 2010, the NFHS developed on online course – “Concussion in Sports – What You Need to Know” – and about 1.7 million individuals have taken the course through the NFHS Coach Education Program at www.nfhslearn.com.
The “Recommendations and Guidelines for Minimizing Head Impact Exposure and Concussion Risk in Football” position paper is posted on the NFHS website at www.nfhs.org.

About the National Federation of State High School Associations (NFHS)
The NFHS, based in Indianapolis, Indiana, is the national leadership organization for high school sports and performing arts activities. Since 1920, the NFHS has led the development of education-based interscholastic sports and performing arts activities that help students succeed in their lives. The NFHS sets direction for the future by building awareness and support, improving the participation experience, establishing consistent standards and rules for competition, and helping those who oversee high school sports and activities. The NFHS writes playing rules for 16 sports for boys and girls at the high school level. Through its 50 member state associations and the District of Columbia, the NFHS reaches more than 19,000 high schools and 11 million participants in high school activity programs, including more than 7.7 million in high school sports. As the recognized national authority on interscholastic activity programs, the NFHS conducts national meetings; sanctions interstate events; offers online publications and services for high school coaches and officials; sponsors professional organizations for high school coaches, officials, speech and debate coaches, and music adjudicators; serves as the national source for interscholastic coach training; and serves as a national information resource of interscholastic athletics and activities. For more information, visit the NFHS website at www.nfhs.org.

MEDIA CONTACTS:​Bruce Howard, 317-972-6900
​Director of Publications and Communications
​National Federation of State High School Associations
​bhoward@nfhs.org

​Chris Boone, 317-972-6900
​Assistant Director of Publications and Communications
​National Federation of State High School Associations
​cboone@nfhs.org

Unofficial Summary of #TheFIFA5 Lawsuit

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SEE UPDATE

soccer-ball-300x200This summary is based on information posted on the Hagens Berman S Shapiro LLP website and is my unofficial review of the lawsuit I have hash tagged as #TheFIFA5. NOTE: I am not a lawyer, and am merely outlining the suit as I read it. I welcome comments and thoughts.

On August 27, 2014, a Class-Action Lawsuit Filed Against FIFA, U.S. Youth Soccer Over Concussions made headlines. This lawsuit pits three mothers and two female college students vs FIFA, soccer’s worldwide governing body—the Fèdèration Internationale de Football Association (FIFA)—and affiliated soccer organizations in the United States

  • US Soccer Federation
  • U.S. Youth Soccer + American Youth Soccer (over 3 US million child and adolescent soccer players)

Note: In 2013, FIFA reported $1.386 billion in revenue.  The 2014 World Cup brought FIFA $1.2 billion from U.S. broadcasters. This lawsuit states FIFA has failed to enact the policies and rules needed to protect soccer players. FIFA and the others mentioned…

  1. Failed to adopt effective policies to evaluate and manage concussions, at all levels of the game
  2. Lacked of effective policies poses a greater danger to women and children players, who may more vulnerable to traumatic and long-lasting brain injury
  3. Ignored medical community called for changes over a decade ago
  4. Ignored simple, best-practice guidelines, which have been updated three times since the initial international conference on concussions (FIFA even hosted)

FIFA has made progress…

  1. With Concussion Marketing and policy materials, which tout a commitment to player safety
  2. By implemented policies to address other health threats (cardiac arrest and performance-enhancing drugs)
  3. Hosted 2012 concussion conference that updated concussion guidelines

This lawsuit demands FIFA and others mentioned…

  1. Implement up-to-date guidelines for detection of head injuries
  2. Implement up-to-date RTP after a concussion
  3. Regulation of heading by players under 17 years old
  4. Eliminate heading under 14 years old age groups
  5. Implement a rule change to permit substitution of players for medical evaluation purposes. (Currently, FIFA rules generally allow only three substitutions per game with no clear provision for head injuries. If an athlete bleeds, even from a scrape, removal is required, but no similar rule exists for concussions. FIFA provides no guidance on substitutions in youth games in the U.S.)
  6. Implement medical monitoring for soccer players who received head injuries in the past

Crossed posted on PinkConcussions.com

The Concussion Conference 3.0 Connecticut

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The new 2014 CT Concussion Law applies to students K-12 as well as athletes.

Is your school ready with updated policies/practices for the 2014-15 year?

The Concussion Conference: 2014 Connecticut Concussion Law & Research-Based Best Practices for K-12 Schools

Wednesday, Sept 24, 2014
Hosted by Quinnipiac University Medical School, North Haven Campus
Produced by Katherine Snedaker, LMSW
Sponsored by Gaylord Center for Concussion Care

Register at TheConcussionConference.com

Opening Remarks ESPN’s TJ Quinn
Keynote “Sports Concussions: What do we really know?”  Anthony Alessi, MD

Presentations from Medical, Academic, Legal and Athletic Concussion Experts for all levels of school staff

Administration Superintendents, Principals, Headmasters, Business Managers, ADs, Heads of Pupil Services
Athletic Dept. Staff ADs, ATs, Coaches
Clinical and Academic Staff School RNs, Guidance Counselors, Psychologists, Social Workers, ATs, Teachers

Schedule All Participants can come partial, half or full day

Continental Breakfast    7:45 AM
Administration Sessions  8 AM -10 AM
Athletic Dept. Sessions  8 AM-12 PM
Clinical/Academic Sessions  8 AM-4:30 PM  

Questions Katherine Snedaker 203-984-0860 Katherine@SportsCAPP.com

Speaker Final

AFL Courts Danger With Suppressive Concussion Stance

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Guest post by Jamie Lyall

Australia — It was rather telling that when Dr Alan Pearce was asked on Monday whether he would be attending the forthcoming Australian Football League concussion workshop, he replied, “What workshop?”

Over the past year, Pearce’s research at Deakin University, Melbourne has brought the struggles of several former AFL and rugby league stars to the Australian public, and so thrust sports concussion into the limelight Down Under.

The cognitive impairments and short-term memory problems suffered by the likes of ex-Carlton midfielder Greg “Diesel” Williams and Test-level forward Ian Roberts are well-documented – both have featured prominently on national television – while, more worryingly, Pearce found that their amateur counterparts are liable to exactly the same symptoms minus the corresponding level of medical care and financial security.

It is surprising then that while the wise medics and scientists of Australian Rules football come together to talk concussion this week, the man whose findings brought the entire debate to a head in Australia will be sat alone in his office on the other side of Melbourne’s sprawling concrete jungle. He may as well be on the moon.

But perhaps we shouldn’t be so surprised; we’ve seen this before, after all.

The closed-shop, suppressive nature of the AFL’s handling of the concussion debate finds worrying resonance in the path trodden by their transatlantic cousins in the National Football League for many years.

The Australian administrators have tried desperately to distance themselves from the Stateside furore, and the findings made by Boston University’s team of researchers, who have posthumously diagnosed degenerative brain disease in hundreds of former athletes.

But a brilliant investigative report by ABC’s Wendy Carlisle last week revealed the true extent of the AFL’s deficiencies. She found that their official definition of concussion was false. That their flagship research programmes only began in 2012, had collected no data as yet, and were not in their fifth year of running as the body had claimed in its annual reports. That Associate Professor Paul McCrory, the man recognised as Australian Rules’ concussion expert-in-chief, had not published an original research article in over a decade.

Carlisle didn’t have to do much digging to scrape away the façade of PR progressiveness churned out to the masses and reveal the lingering beast of rejection and denial that lurked beneath, head wedged firmly in sand.

The AFL was not best pleased by what it saw as an affront on its treasured brand. Tough, I say.

Covert conferring between those almost exclusively funded by the body itself of or by one of its constituent clubs is exactly what the administrators must avoid. The debate shouldn’t be hemmed in, restricted to the nods, murmurs and consensus among researchers voting with their grant money.

McCrory in particular is renowned in the science community for discounting ideas and methodology proposed by new research groups, on the grounds that he once undertook similar investigations with far more primitive equipment and came up with nothing. Yet his comments regarding media hype and sensationalism reek of irony given it is his views that fuel much of the coverage.

The likes of McCrory and Associate Professor Gavin Davis, another member of the AFL working group who shares the increasingly flawed logic inherent in the former’s position are emerging as little more than water-muddying mouthpieces. Davis especially has blasted the Boston research – just months after leading concussion campaigner Chris Nowinski had addressed the body and the Players’ Association – during an unsavoury radio interview with Roberts.

Funded directly or indirectly by the AFL, they tell their research paymasters just what they want to hear in the face of mounting evidence to the contrary. Their stance grows more untenable with each passing weekend, each damning report, each player that returns to football concussed, each former hero battling through middle-age with a brain that cannot cope with simple, everyday tasks.

It is no fluke that in the days after Carlisle’s report was broadcast, the AFL dished out a spin-laden press release detailing their plans to screen and scan the brains of retired players in their much-vaunted MRI machine.

The study format itself appears encouraging and is certainly long overdue. The announcement was merely another indicator of the AFL’s determination to avoid accepting the true risks posed by head injury, and so its failure to look after those its success as a sport depends upon.

By Jamie Lyall

Jamie is a 20-year-old sportswriter based in Scotland, specialising in rugby union and soccer, and with a special interest in investigating, reporting and commenting on sports concussion.

Twitter @JLyall93

jamie.lyall@hotmail.com


Son’s Death leads to the Scottish & Ireland Concussion Campaign

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Guest post by Peter Robinson

An account of the events by Peter Robinson, father of Benjamin Robinson who died at age 14, after playing a school Rugby game.

29th January 2011

  • Whilst playing in a schools Rugby Union match, Benjamin is accessed 3 times for Concussion and allowed to play on, finally collapsing in the final minute unconscious.

31st January 2011

  • Benjamin does not recover and his Life Support is switched off his organs are donated and in fact go on to save 5 other lives.
  • Initial report describes it as a freak accident.
  • Initial Cause of Death Diffusal Axonal Head Injury.

20th July 2011

  • Karen Benjamin’s Mother meets Professor Jack Crane State Pathologist in N. Ireland.
  • A copy of the Match Video given to family as the police did not analysis the video this was done by myself and it was found to be vital during the inquest in proving that Benjamin had indeed played a full half with Concussion.  Benjamin had been involved in a tackle at the start of the first half he remained on the ground for 1 minute 38 seconds, he was treated by the coach who pulled him to his feet and allowed him to play on.  (It is this incident that we later find out to be where Benjamin had been knocked out).
  • Second Impact Syndrome is discussed, Professor Jack Crane, Professor Brian Herron and Professor Stephen Cooke believe that Benjamin’s injuries are consistent with Second Impact Syndrome, family are informed of this by professor Crane, he advises the family that if Benjamin had been removed from play after the first concussion and protocol had been followed he would probably still be alive today.

Initial Police Investigation fails to establish what happened to Benjamin during the match.

October 2011

  • At a chance meeting by Karen with Mathew Davidson (a team mate) whilst at Benjamin’s grave, discloses that he believed Benjamin had been knocked out during the game.

As a result of the family insistence other statements were noted from a few of Ben’s teammates who stated that Ben had been confused and could not remember the score of the game, a spectator of the game also provided a statement in which he stated that he heard the Referee say Ben should come off now.   The noting of statements from all the players was prevented as the school felt that this was too traumatic for the boys to revisit the events of that day.

An adult member of the opposite team was first to attend to Ben when he collapsed, when he was asked for a statement he declined, the police advised Karen (Ben’s mother) to take the statement herself.

The family decide to instruct a solicitor Gabriel Ingram to try and support the Coroner’s investigation and speak for the family at the Inquest.

We are informed that the School will have a Barrister present to represent them.

30th August 2012 to 6th September 2012 – Initial Inquest – 1 day set aside, family request further time (Inquest actually lasts 6 days)

  • Inquest begins we hear evidence about Benjamin being treated on the pitch, at no stage was he removed to be assessed.
  • Referee gave evidence in which he said Benjamin appeared dazed but he had not heard of Scat 2 PCRT and indeed a year later still did not have a copy.
  • Ben’s coach was also the medic and linesman. Ben had been checked for concussion at least 3 times. (3 occasions that can be seen on video and 1 more confirmed in witness statements).
  • Inquest adjourned as the Coroner asked for further time to establish if other witnesses would come forward.

I re-examine the video and have it slowed down, it becomes very apparent that Ben had suffered a concussion at the start of the second half, throughout the second half of the video he is seen to stagger and hold his head and appears confused.

September 2013

Inquest resumes 1 year later.

  • Coroner concludes that the cause of death is Second Impact Syndrome, possibly the first recorded case of this in the UK, she recommends that changes are made to ensure this never happens again, she writes to the Education Minister for Northern Ireland and the IRFU.
  • Family decide to campaign for change throughout the UK.
  • Contact by email to all UK Education and Ireland Ministers asking to meet with them.

19th September 2013

  • Scottish Minister is first to respond and agree to highlight the issue by issuing a leaflet to all schools and sporting bodies in Scotland, this is issued in January 2014.
  • Agree to use “Concussion can be fatal “and” If in doubt sit them out “ slogans.

15th October 2013

  • Northern Irish Minister and Sports Minister meet family, very positive meeting.
  • Agree lessons need to be learned from Ben’s death.
  • Also agree to slogans in Information leaflet to pupils.

16th October 2013

  • Family travel to Dublin and meet IRFU, speak about children being the high risk group, ask that mandatory training be introduced to schools re coaches.
  • Separate information re children in other words age appropriate.
  • Request that information re Concussion should have the words “ CONCUSSION CAN BE FATAL”

12th November 2013

  • Chief Medical Officer in N.Ireland Mr Michael McBride writes to all GPs warning of the dangers of Concussion and especially Second Impact Syndrome.

November 2013

  • Meeting with Welsh Minister for Education, highlight the Dangers of Concussion and the failings re Ben’s death.

25th November 2013

  • Meeting with Chris Bryant Labour MP re Concussion in Sport also in attendance is Sam Peters from Daily Mail (Paper now running Concussion Campaign) Dr Willie Stewart on conference call.

27nd January 2014

  • Telephone conversation with Southern Irish reps from Education Department re Dangers of Concussion, they will liaise with N.Ireland counterparts re information on Concussion.

22nd January 2014

  • Scottish Government officially launch Concussion in Sport Leaflet to all schools.

4th March 2014

  • Attend Westminster re Concussion in Sport roundtable, chaired by Chris Bryant MP, also in attendance Dr Willie Stewart, Dr James Robson, Chris Nowinski, Lewis Moody, Rory Lamont,  Baroness Tanni Grey-Thompson and Reps from  FA, RFU, and Boxing.
  • Ben’s family also attend meeting with representatives from the English Education Department.

30th April 2014

  • N. Ireland Launch Recognise and Remove Leaflet, Poster and Pocket Recognition Tool, nearly 800,000 leaflets, 16,000 Posters and 26,000 Pocket Recognition Tools. Government working on e-learning modules.  Stated that they would review awareness and if need be to introduce “Ben’s Law.”

Late Spring 2014

  • Welsh Government they are currently working on leaflet and are being advised by Dr Willie Stewart, the leaflet soon to be published.
  • Southern Ireland Government also in talks re Concussion Leaflet.
  • We are waiting on Chris Bryant’s MP findings from the Concussion in Sport round table.
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