A picture can be worth a thousand words, right? We think so too, especially when it comes to this interesting graphic from the National Academy of Science on the breakdown of concussion rates in high school athletes by sports.
Though we just found this infographic recently, it was developed in concert with a study published in October 2013 that found young athletes in the U.S. face a “culture of resistance” to reporting when they might have a concussion and to complying with treatment plans. As noted in this new report from the Institute of Medicine and National Research Council, that behavior could endanger their well-being. Overall, reported concussions rates are more frequent among high school athletes than college athletes in some sports — including football, men’s lacrosse and soccer, and baseball; higher for competition than practice (except for cheerleading); and highest in football, ice hockey, lacrosse, wrestling, soccer, and women’s basketball. Concussion rates also appear higher for youths with a history of prior concussions and among female athletes.
What do you think about this graphic? While football injuries tend to get the most attention, were you surprised to see youth concussion rates in other kinds of sports?
Last month, the non-profit Sports Legacy Institute (SLI) announced a major advance in the effort to prevent concussions and brain damage in contact sports with the launch of the Hit Count® certification program after two years of development, which was unveiled at a press conference at the 2014 Super Bowl Media Center in New York City.
Hit Count® builds on the progress that head sensor device companies have made in developing devices that can measure acceleration of the head. Current products used on the field are focused on alerting coaches, medical professionals, and parents when a potential concussive impact occurs.
Inspired by Pitch Counts baseball, which set limits to the number of times a player throws from the mound to prevent arm injury, Hit Count® Certified Devices will have a second function that measures and “Counts” impacts that exceed the Hit Count® Threshold, set by a committee of leading scientists, with the goal of minimizing brain injury.
“Research using sensor devices has revealed that each year in the United States, there are over 1.5 billion impacts to the heads of youth and high school football players,” said Chris Nowinski, Founding Executive Director of SLI who launched the Hit Count® initiative in 2012 with SLI Medical Director Dr. Robert Cantu. “Most hits are unnecessary and occur in practice. By utilizing Hit Count® certified products as a teaching tool for coaches and a behavior modification tool for athletes, we can eliminate over 500 million head impacts next season.”
Committee member Gerry Gioia, PhD, of Children’s National Medical Center and George Washington University School of Medicine, unveiled that the Hit Count® Threshold will be set at the subconcussive level of 20 g’s of linear acceleration. “This is the beginning of a major research and public health effort to limit brain trauma in sports. While current science does not provide a “safe” or “unsafe” Hit Count®, our goal is to eventually provide clear guidance for coaches and parents. We will need the youth sports, sensor manufacturer, and medical science communities to work together to provide reliable answers.”
Hit Count® Certified products will go through a rigorous test protocol developed by the University of Ottawa Neurotrauma Impact Laboratory in conjunction with engineers from the six Hit Count® Initiative sponsors, including Battle Sports Science, G-Force Tracker, i1Biometrics, Impakt Protective, MC10, and Triax.
Three-time Super Bowl Champion Ted Johnson, a former linebacker for the New England Patriots who retired from post-concussion syndrome in 2005, said, “I track the number of steps I take each day to lower my risk of heart disease. I owe it to my son to count the number of Hits to his head in sports to lower his risk of concussions and subconcussive brain damage.”
To learn more about this initiative, visit www.sportslegacy.org.
There are many terrific organizations that focus on preventing youth sports injuries or educating others about the growing concussion crisis. However there has not been as much attention focused yet on the connection between sports-related concussions and academic performance. That is why we wanted to introduce you to Saving Young Minds, Inc., (SYM) a non-profit group whose mission is to educate and protect the young minds of student-athletes from under-privileged communities.
Created by school psychologist Alberto Gamarra, PhD, SYM is primarily focused on providing concussion awareness education and baseline assessments of cognitive, neurological, and balance functioning in the hopes of preventing unnecessary risks to student-athletes who sustain brain injuries that often go unrecognized and untreated. Here is our Q&A with Dr. Gamarra:
Q: How does Saving Young Minds make a difference in helping young student-athletes protect their minds from your perspective as a school psychologist, especially in light of the growing concussion crisis?
A: What I have learned during the past three years is that there is very little “profession-wide” understanding of this area. In creating this organization, I have been able to use my credibility as a psychologist to draw the connection between sports-related concussions and academic performance. We’ve only just begun to get the word out, and it has been an uphill struggle to get organizations and parents to listen. Saving Young Minds provides a different platform, separate from my private practice, where I can play the exclusive role of a student/athlete advocate with no monetary strings attached. It also allows me to present research-based information and opinions impartially to a wider audience and this ultimately moves us closer to our mission of educating and increasing awareness. We want to be a community-based resource for credible and practical information.
Q: Why is it important to look at the issue of sports concussions from the school psychology vantage point?
A: For the first few years I researched the topic of sports-related concussions, the emphasis was on player safety and the return-to-play (RTP) decision. Who makes the call, when, and for how long? The focus population began at the professional level and has gradually trickled down to collegiate and high schools. Just look at the emphasis on the development of the assessment tools; as an example, IMPACT’s computer-based assessment has only been validated as low as age 14, but because they were the first ones out of the gate, they have cornered the market and almost every group uses their product. From my perspective, there are tens of thousands of student-athletes under that age participating in organized sports like soccer, lacrosse, and roller hockey. The recently passed legislation in Florida, where we are located, only requires baseline assessments beginning in high school (age 14), which demonstrates to me a lack of understanding of the available research. This legislation is reactive and has little in the way of preventing injuries by focusing prevention efforts at the earliest ages. For the last two years I have presented at the Florida Association of School Psychologists’ annual conference (FASP) on the role of the school psychologist in managing the return-to-learn (RTL) process for student-athletes, as well as other traumatic brain injured students. As a profession, I felt that there is a disconnect when it comes to involving ourselves with student-athletes and handling their post-concussive returns to academics.
Q: How can others get involved?
A: As a fledgling organization with high hopes and scant resources, we are always in the process of learning and sharing our message. I have developed a protocol for assessments, multiple sport specific presentations (soccer, football, rugby, etc.) and audiences (coach, parent and athlete). We also encourage people to talk to the coaches and directors at their local sports club/league/academy and demand a full presentation and resources from a knowledgeable professional. SYM appreciates site visits and any efforts to support our fundraising and awareness efforts!
To learn more about Saving Young Minds, Inc., visit www.SavingYoungMinds.org
Often when a kid has a concussion, the first thing they want to do is get back to their routine – returning to school and using familiar electronic devices like computers, smart phones, gaming systems and televisions. But a recent study published in Pediatrics Magazine on January 6 revealed that resuming their everyday life activities too quickly might actually delay recovery. The recommended solution? Youth suffering a concussion should try to rest their brains for a few days before jumping back into their busy lives full-force.
“After a concussion, we recommend rest because kids tend to do too much,” study author, Dr. Naomi Brown, a physician in the division of sports medicine at the Children’s Hospital of Philadelphia, told HealthDay.
The study included 335 patients between the ages of 8 and 23 who visited the sports concussion clinic at Boston Children’s Hospital. The study team found that almost half of the children and young adults in the study who didn’t reduce their mental strain took 100 days or longer to completely recover. Almost all participants who cut back the most on their daily mental strain had recovered by 100 days, most within two months.
Co-author Dr. William Meehan said while vigorous mental exertion appeared to be detrimental to recovery, more modest levels of mental effort do not seem to delay recovery. “We recommend a period of near full mental rest after injury – approximately three to five days – followed by a gradual return to full levels of mental activity,” said Meehan, director of the Sports Concussion Clinic at Boston Children’s Hospital.
In the study, participants were asked to describe their symptoms and how much mental work they had done since their last visit. They were given five options for describing their amount of mental work during studies and video games: complete mental rest, minimal mental activity, moderate mental activity, significant mental activity or full mental activity.
Researchers emphasized that only those who reported the highest level mental activity took the longest time to completely recover and parents should take the study’s findings as a reason to keep their child away from mental activities. “If you shut down completely, meaning you don’t go to school or do any reading or screen time, or if you do a little bit less than normal, you recover in the same time period – an average of 20 to 50 days,” Brown said.
The doctor said young people who suffer a concussion should slowly resume standard daily mental activity, possibly working only until symptoms such as headaches begin to appear. “We are not recommending complete abstinence from school, especially after the first week,” she said. “If you go to school for a couple of hours and you are doing OK, then the next day you can go for a little bit more and slowly test it out.”
Brown added that every concussion and every patient is different. For more information, visit the Children’s Hospital of Philadelphia blog.
G-Max might sound like the name of a new character in Marvel’s popular “Avengers” movie franchise. But it’s actually a measurement of acceleration that relates to the maximum force of a collision, gauges the hardness and shock absorption properties of a turf field. With an estimated 10% of concussions and brain injuries incurred during sports are caused by playing surface impacts, the G-Max level on a field matters more than ever before.
Higher G-max numbers mean a player will sustain more force upon impact, increasing the chance of concussive and subconcussive injuries. While pristine natural grass of less than 100 g’s is the ideal playing surface, it is difficult to achieve when athletes practice and play multiple sports on a field for more than 20 hours a week. As a growing number of users turn to synthetic turf for its durability, installing Brock PowerBase underneath those fields ensures fields achieves the less than 120 g’s optimum balance of player safety and field performance. As a point of comparison, ASTM International (formerly known as American Society for Testing and Materials) deems any playing field with a G-max exceeding 200 to be unacceptable and is currently considering lowering that standard to 165 g’s in recognition of greater safety benefits.
Recognizing that lowering G-max levels on sports fields can reduce the risk and severity of concussion, Brock International, the sponsor of Safer Sports From the Ground Up, has announced an industry-first Field G-max guarantee of no greater than 120 g’s for the life of a synthetic turf field. Brock PowerBase, the company’s innovative shock pad and drainage layer used underneath synthetic turf fields, has helped NFL teams, major universities, hundreds of schools and community parks nationwide maximize player safety and field performance.
“We are passionate about improving safety and reducing injuries in sports starting from the ground up,” explained Dan Sawyer, CEO of Brock International. “After a decade in the market, fields with Brock PowerBase have proven to be safer and more durable in all weather conditions, mimicking the 100 g’s levels of perfect natural turf. Athletes of all ages deserve and need that kind of surface to help address the nations’ head injury crisis in sports. That’s why we created this unique Field G-Max guarantee to optimize player safety and field firmness throughout the life of the turf.”
Brock PowerBase is currently installed underneath stadium and practice fields for the San Francisco 49ers, at the Gillette Stadium practice field, home of the NFL’s New England Patriots, the Houston Texans, Arizona Cardinals, the University of Maryland, University of Oregon, Boston College, Boise State, UCLA, Georgia Tech, Stanford and hundreds of high schools and middle schools nationwide. In 2012, the company launched Brock PowerBase Youth Safety Research (YSR), the first synthetic turf shock pad engineered specifically to the ideal footing requirements and safety of high school and middle school athletes.
Research firm BioMechanica, LLC studied the estimated risk of head injury on synthetic turf surfaces with Brock underlayment and found the product reduces G-max, which the lab tests indicated should reduce the risk and severity of concussion; provides the same playability as a pristine natural grass field and mitigates field hardening over time. In evaluating Head Injury Criteria (HIC), also known as critical fall height, Sports Labs LLC found that Brock PowerBase offered significant improvement in HIC when compared to a turf field that featured a stone base.
If you’d like to learn more about why lower G-Max levels can help create safer playing fields, contact Brock International at http://brock-international.com/.
Nearly 100 influential U.S. landscape architects, engineers, testing laboratories, thought leaders and manufacturers met at the Brock International Educational Seminar in Boulder, Colorado, on October 16 – 18 to learn about the latest trends in building safer, more environmentally-friendly synthetic turf playing fields. The unique conference featured presentations from award-winning experts on eco-effectiveness, injury prevention and field design.
“Our goal was to create an event that focused on issues of deep importance to the sports field industry,” explained Dan Sawyer, CEO of Brock International. “From making a positive impact on the environment instead of just minimizing damage, to getting value even in a low bid environment, to the severity of the head injury epidemic in youth sports, presenters gave us a broader world view of what a sports field means, and how it ‘impacts’ people around it.”
Safety was a major focus of the meeting, particularly in light of the U.S. sports concussion crisis. While much attention is focused on player helmets and gear, it is estimated that about 10% of brain injuries are caused by playing surface impacts. Sports Legacy Institute Founder Chris Nowinski discussed injury prevention trends in his “Safety in Sports” presentation, noting that playing surfaces were recently added to the non-profit’s concussion prevention check-list in recognition of its potential impact in preventing injuries. John Sorochan, PhD of the University of Tennessee Center for Athletic Field Safety discussed “Athlete Safety and Performance on Natural and Synthetic Athletic Fields,” in his presentation while Jennifer Himmelsbach, MS, of Biomechanica addressed “Tuning the Surface for the Player.”
The Keynote Speaker was Professor Dr. Michael Braungart, one of the foremost international authorities on eco-effective products and closed-loop production processes, which go beyond being not only harmless to man or nature, but actually beneficial. Co-author of the groundbreaking bestsellers “Cradle to Cradle” and “The Upcycle,” Braungart discussed the importance of going beyond sustainability to focus on designing for abundance. Patrick Maguire, MLA, RLA, LEED AP, continued the discussion on eco-effectiveness with his presentation on “LEED, Cradle to Cradle Practices and Synthetic Turf.”
Thought leaders in landscape architecture and engineering also made presentations on improving industry practices. Ron Kagawa, ASLA LEED AP, Division Chief, Park Planning, Design+Captial Development; City of Alexandria, Virginia discussed “Cheapness vs. Economy: Strategies in a Low Bid Environment. “Alternatives to Stone Base Construction” was presented by George Saunders, PE, of Geodesigns, Inc. and John Amato, PE of JJA Sports, while Jeffery L. Bruce, FASLA, LEED, ASIC, GRP and Ryan Teeter, PE, IDD Sports discussed “How fields age – what we’ve learned over the past 10 years.”
“In 30 years of practice it was by far the best educational seminar I have attended, definitely about more than just improving our knowledge of synthetic turf systems,” noted seminar attendee Carl Armanini, RLA, ASLA, Woolpert Design. “We were confronted with examining our everyday processes and how making simple decisions correctly allows us to create better places and products that result in better health, environment and life overall.”
Safety and sustainability are key values for Brock International, the sponsor of our outreach program, whose industry-leading shock pad and drainage layer used underneath synthetic turf fields has been proven to reduce G-max, which may reduce the risk and severity of concussion. Their Brock PowerBase product is currently installed underneath playing and practice fields for the San Francisco 49ers, at the Gillette Stadium practice field, home of the NFL’s New England Patriots, the Houston Texans, Arizona Cardinals, the University of Maryland, Boston College, Boise State, UCLA, Georgia Tech, Stanford and hundreds of high schools and middle schools nationwide. In 2012, the company launched Brock PowerBase Youth Safety Research (YSR), the first synthetic turf shock pad engineered specifically to the ideal footing requirements and safety of high school and middle school athletes. In October 2011, Brock became the first company in the industry to have a Cradle to Cradle Certification CM for its combined drainage and shock pad product. Offering the only product in the market that can be closed loop recycled, Brock PowerBase is certified to the world’s most stringent environmental standards.
While men’s football concussions are in the headlines daily from former and current players, there’s rarely news about how concussions are impacting female athletes. Recognizing that their experiences are being overlooked, advocacy group Pink Concussions and Clemson University researchers have launched a national study of female athletes and concussions – and you can help.
Though mainstream media doesn’t often focus on female athletes, they experience a significant number of concussions. In fact, data from the American Medical Society for Sports Medicine Position Statement: Concussion in Sport 2012 suggested that in sports with similar rules, female athletes sustain more concussions than their male counterparts. In addition, female athletes experience or report a higher number and severity of symptoms as well as a longer duration of recovery than male athletes in several studies.
Running from October 1 through October 31, this new study will be focused on female athletes from all sports, and their past and present experiences with concussions. Current and former female athletes worldwide, aged 18 and over, are eligible to participate. The online study takes 20 minutes to complete, and asks participants about their experiences with sports and non-sport concussions, and reporting concussions. If you would like to participate, here is the survey sign-up form and you can visit www.pinkconcussions.com to learn more.
The results of this survey will help further concussion research by focusing on the communicative element present in this issue, which is helpful for athletes, parents, administrators, physicians, and advocates. This research will also be beneficial in shedding light on female athletes’ experiences with concussions and reporting concussions, and concussion advocates in raising more awareness.
Ever heard the adage a picture is worth a 1,000 words? The physician-researchers at The Children’s Hospital of Philadelphia’s “Minds Matter” program certainly think so, as they developed an innovative series of infographics to help prevent and treat youth concussions.
Just in time for back-to-school and fall sports, they released a series of six infographics that aims to educate players, parents, nurses and coaches about concussion symptoms and treatments, so they can keep their heads in the game. These materials offer the most up-to-date tips for detection and treatment of youth concussions. All six of the infographics and more information about concussions can be found at: http://www.chop.edu/service/concussion-care-for-kids/concussion-educational-tools/.
The Children’s Hospital of Philadelphia (CHOP) takes youth concussions very seriously. Beginning in 2011, an interdisciplinary team of concussion experts from across CHOP joined forces to develop a comprehensive network-wide pediatric concussion management program to streamline and standardize concussion diagnosis, treatment and follow-up care. The program is called “Minds Matter: Improving Pediatric Concussion Management.”
The Minds Matter team reviewed current practices across CHOP and the scientific literature on best practice for diagnosis and management of pediatric concussion and developed a new model of care. To make sure each child receives prompt diagnosis and early treatment, CHOP supports its primary care network providers with concussion-specific training, tools for clinical diagnosis and management, as well as patient-family education resources like their website and infographics.
When the students at Holy Innocents’ Episcopal School in Atlanta entered their high school assembly today, they had more on the roster to talk about than pep rallies and new regulations. Student-athlete safety was the primary topic of discussion as their school honored classmate Brendan Rosenberg and Jacob Schlanger (of nearby North Springs High School) for winning Brock’s Safety MVP Contest.
As reported earlier this summer, the national contest asked student participants to showcase why safety is as important as winning to their school sports team. Brendan and Jacob took top honors for their humorous “Sports Center” video collaboration on the topic, winning the competition’s grand prize of $5,000 for the sports program at Holy Innocents’ Episcopal School.
During the assembly, Athletic Director Ruth Donohue praised the video, which included appearances by football team members and Coach Ryan Lizvey, who shared safety tips. Brock spokesperson Shira Miller talked about the company’s commitment to helping prevent youth concussions and other injuries from the ground up. Then Brendan and Jacob took the stage, receiving a long round of applause from their peers.
The school elected to use the prize money for a more permanent fixture in the form of a new field goal post. You can check out the winning video here.
If you pay attention to headlines about sports injuries, you’ve probably heard a lot recently about chronic traumatic encephalopathy (CTE), a brain disease associated with repeat brain trauma including concussions in athletes. On August 21, new research was released from the largest CTE study of its kind that shows the disease may impact people in two major ways: initially affecting behavior or mood or initially affecting memory and thinking abilities. CTE has been found in amateur and professional athletes, members of the military and others who experienced repeated head injuries, including concussions and subconcussive trauma.
“This is the largest study to date of the clinical presentation and course of CTE in autopsy-confirmed cases of the disease,” said study author Robert A. Stern, PhD, a professor of neurology and neurosurgery at Boston University School of Medicine. “However, the overall number of cases in the study is still small and there may be more variations in CTE than described here.”
For the study, scientists examined the brains and reviewed medical records of 36 male athletes, ages 17 to 98, diagnosed with CTE after death, and who had no other brain disease, such as Alzheimer’s. The majority of the athletes had played amateur or professional football, with the rest participating in hockey, wrestling or boxing. Family members were also interviewed about the athletes’ life and medical history, specifically dementia, changes in thinking, memory, behavior, mood, motor skills or ability to carry out daily living tasks. Some of the findings included:
- A total of 22 of the athletes had behavior and mood problems as their first symptoms of CTE, while 11 had memory and thinking problems as their first symptoms. Three of the athletes did not show any symptoms of CTE at the time of death.
- Those with behavior and mood problems experienced symptoms at a younger age, with the first symptom appearing at an average age of 35, compared to an average age of 59 for those with memory and thinking problems. Almost all people in the mood/behavior group, or 91 percent, experienced symptoms of memory and thinking decline at some point, but fewer in the cognition group experienced mood and behavior symptoms throughout their disease, with 55 percent experiencing behavior symptoms and 64 percent experiencing mood symptoms at some point.
- The group that experienced mood symptoms was more explosive, out of control, physically and verbally violent and depressed than the group that experienced memory and thinking deficits, with family members reporting that 73 percent of those in the first group were “explosive,” compared to 27 percent in the second group. A total of 64 percent of the first group were described as being “out of control,” compared to 27 percent of the second group, and 68 percent were physically violent, compared to 18 percent. A total of 74 percent were verbally violent, compared to 18 percent. And 86 percent had depression, compared to 18 percent of those with memory symptoms.
The study was supported by the National Institutes of Health, the Department of Veterans Affairs, the National Operating Committee on Standards for Athletic Equipment, the Sports Legacy Institute, the National Football League (NFL) and the Andlinger Foundation. The neuropathological examinations were conducted by Ann McKee, MD, professor of neurology and pathology at BUSM. McKee and Stern were co-founders of the Boston University Center for the Study of Traumatic Encephalopathy, along with neurosurgeon Robert Cantu, MD, and Christopher Nowinski, Executive Director of Sports Legacy Institute.