Tag Archives: Concussions

American Orthopaedic Society for Sports Medicine study: Over-conditioning kills: Non-traumatic fatalities in football is preventable

13 Jul

@Life360 discussed the dangers of participating in sports in The Hidden Dangers of Competitive Sports:

I think Wall identifies the real danger of sports on your health — long-term injuries. While we’re most likely to think of sprains and broken bones, teens are able to recover from those well; it’s damages that affect growth which should be of more concern.
We can all agree that sports nurture a positive discipline for exercise, but it’s easy for that regiment to go too far. Personally, I’ve seen competitive sports spur unhealthy habits. In high school, I was on the wrestling team in the winter and rowing team in the spring. Since weight is such an important issue with both of those sports, I was encouraged to watch what I ate very carefully. While my coaches never suggested making unhealthy changes to my diet, there is often an unspoken pressure for young athletes to do so. That’s not to say that wrestling and rowing are bad sports (in fact, I’d argue the opposite), but in a competitive atmosphere, even high school kids can take things too seriously. Eating disorders from sports isn’t all that uncommon.
Though I’ve only discussed the cons of high school athletics, I still think the positives — both physical and mental — outweigh the negatives. But I think both young athletes and their parents should be aware of the dangers, and understand when to realize that they’re taking sports too seriously. https://www.life360.com/blog/the-hidden-dangers-of-competitive-sports/

American Orthopaedic Society for Sports Medicine released a study which examined the dangers of over-conditioning.

Science Daily reported in Over-conditioning kills: Non-traumatic fatalities in football is preventable:

Most non-traumatic fatalities among high school and college football athletes do not occur while playing the game of football, but rather during conditioning sessions which are often associated with overexertion or punishment drills required by coaches and team staff, according to research presented today at the American Orthopedic Society for Sports Medicine Annual Meeting. The research was presented by Dr. Barry P. Boden of The Orthopaedic Center, Rockville, Md.

Football is associated with the highest number of fatalities of any high school or college sport, but the number of traumatic injuries incurred while playing football have declined significantly since the 1960s.
However, the annual number of non-traumatic fatalities has stayed constant with current rates that are two to three times higher than traumatic fatalities.
Heat and sickle cell trait fatality rates were compared pre- and post-implementation of the NCAA football acclimatization model in 2003 and sickle cell screening policies implemented in 2010, respectively.
Boden and his team reviewed 187 non-traumatic football fatalities that occurred between 1998 and 2018. The researchers obtained information from extensive internet searches, as well as depositions, investigations, autopsies, media and freedom of information reports.
Of the 187 fatalities, more than half (52 percent) were due to cardiac issues; 24 percent were caused by heat; and five percent from asthma.
“The majority of deaths occurred outside of the regular season months of September through December, with the most common month for fatalities being August,” Boden reported.
Boden said many of the fatalities had three issues in common: the conditioning sessions were supervised by the football coach or strength and conditioning coach; irrationally intense workouts and/or punishment drills were scheduled; and an inadequate medical response was implemented…. https://www.sciencedaily.com/releases/2019/07/190713103944.htm

Citation:

Over-conditioning kills: Non-traumatic fatalities in football is preventable
Date: July 13, 2019
Source: American Orthopaedic Society for Sports Medicine
Summary:
Most non-traumatic fatalities among high school and college football athletes do not occur while playing the game of football, but rather during conditioning sessions which are often associated with overexertion or punishment drills required by coaches and team staff, according to new research.

Here is the press release from American Orthopaedic Society for Sports Medicine:

July 13, 2019
Over-conditioning kills: Non-traumatic fatalities in football is preventable

by American Orthopaedic Society for Sports Medicine

Most non-traumatic fatalities among high school and college football athletes do not occur while playing the game of football, but rather during conditioning sessions which are often associated with overexertion or punishment drills required by coaches and team staff, according to research presented today at the American Orthopedic Society for Sports Medicine Annual Meeting. The research was presented by Dr. Barry P. Boden of The Orthopaedic Center, Rockville, Md.
Football is associated with the highest number of fatalities of any high school or college sport, but the number of traumatic injuries incurred while playing football have declined significantly since the 1960s.
However, the annual number of non-traumatic fatalities has stayed constant with current rates that are two to three times higher than traumatic fatalities.
Heat and sickle cell trait fatality rates were compared pre- and post-implementation of the NCAA football acclimatization model in 2003 and sickle cell screening policies implemented in 2010, respectively.
Boden and his team reviewed 187 non-traumatic football fatalities that occurred between 1998 and 2018. The researchers obtained information from extensive internet searches, as well as depositions, investigations, autopsies, media and freedom of information reports.
Of the 187 fatalities, more than half (52 percent) were due to cardiac issues; 24 percent were caused by heat; and five percent from asthma.
“The majority of deaths occurred outside of the regular season months of September through December, with the most common month for fatalities being August,” Boden reported.
Boden said many of the fatalities had three issues in common: the conditioning sessions were supervised by the football coach or strength and conditioning coach; irrationally intense workouts and/or punishment drills were scheduled; and an inadequate medical response was implemented.
The average annual rate of heat-related fatalities remained unchanged at the collegiate level pre- and post-implementation of the NCAA football acclimatization model in 2003. The average annual number of sickle cell trait deaths in collegiate football declined 58 percent after the 2010 NCAA sickle cell screening policies were implemented. At the high school level, where there are no sickle cell guidelines, the number of sickle cell fatalities increased 400 percent since 2010.
The football acclimatization model implemented by the NCAA in 2003 has failed at reducing exertional heat-related fatalities at the collegiate level. Sickle cell trait screening policies adopted by the NCAA in 2010 have been effective at reducing fatalities in college athletes and similar guidelines should be mandated at the high school level.
“Conditioning-related fatalities are preventable by establishing standards in workout design, holding coaches and strength and conditioning coaches accountable, ensuring compliance with current policies, and allowing athletic health care providers complete authority over medical decisions,” Boden reported.

Explore further
Athletes with sickle cell traits are at more risk to collapse: here’s why
More information: http://www.sportsmed.org/aossmimis/me … AM2019-Abstracts.pdf
Provided by American Orthopaedic Society for Sports Medicine

Faye Reid wrote in Moderation And Fitness | What Is The Balance?

The fact of the matter is that while an extreme and explosive shred workout is a great thing, it becomes useless without moderation. Regardless of what your goals are, sustainability has to at least be somewhere in your priority list. Whether you are training for a sports match, a competition, or for summer, one would generally want to be able to get back into the gym after completing such a goal. But where one trains with ferocity without moderation, injuries and burn-outs leave a fitness career with an early death.
The most important ingredients to a good training regime can all by injected with a healthy dose of moderation to ensure sustainability and longevity…. https://www.myprotein.com/thezone/training/moderation-and-fitness-what-is-the-balance/

The choicest pleasures of life lie within the ring of moderation.
Benjamin Disraeli

The Sports Concussion Institute has some great information about concussions http://www.concussiontreatment.com/concussionfacts.html

Resources:

Concussions
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Concussion
http://www.emedicinehealth.com/concussion/article_em.htm

Concussion – Overview
http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Northwestern University School of Medicine study: Concussions and female middle school students

2 Aug

According to Michelle Healy of USA Today, 1.35 million youths a year have serious sports injuries http://www.usatoday.com/story/news/nation/2013/08/06/injuries-athletes-kids-sports/2612429/ Among those injuries are concussions. Kids Health has some great information about concussions at their site:

What Is a Concussion and What Causes It?
The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can move around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion — a temporary loss of normal brain function.
Most people with concussions recover just fine with appropriate treatment. But it’s important to take proper steps if you suspect a concussion because it can be serious.
Concussions and other brain injuries are fairly common. About every 21 seconds, someone in the United States has a serious brain injury. One of the most common reasons people get concussions is through a sports injury. High-contact sports such as football, boxing, and hockey pose a higher risk of head injury, even with the use of protective headgear.
People can also get concussions from falls, car accidents, bike and blading mishaps, and physical violence, such as fighting. Guys are more likely to get concussions than girls. However, in certain sports, like soccer, girls have a higher potential for concussion.http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Don’t ignore concussions


See, Update: Don’t ignore concussions https://drwilda.com/2012/05/20/update-dont-ignore-concussions/
More studies are pointing to the risks of girls playing contact sports.

Science Daily reported in Middle-school girls continue to play soccer with concussion symptoms:

Concussions are common among middle-school girls who play soccer, and most continue to play with symptoms, according to a study by John W. O’ Kane, M.D., of the University of Washington Sports Medicine Clinic, Seattle, and colleagues.
Sports-related concussions account for 1.6 to 3.8 million injuries in the United States annually, including about 50,000 soccer-related concussions among high school players. Injury-tracking systems for younger players are lacking so they are largely unstudied, according to the study background.
Using an email survey and interviews, the authors evaluated the frequency and duration of concussions in young female soccer players, as well as whether the injuries resulted in stopping play and seeking medical attention. Their study included 351 soccer players (ages 11 to 14 years) from soccer clubs in the Puget Sound region of Washington.
Among 351 players, there were 59 concussions with 43,742 athletic exposure hours. Concussion symptoms can include memory loss, dizziness, drowsiness, headache and nausea. Cumulative concussion incidence was 13 percent per season with an incidence of 1.2 per 1,000 athletic exposure hours. Symptoms lasted a median four days (average 9.4 days). Heading the ball accounted for 30.5 percent of concussions. Most players (58.6 percent) continued to play with symptoms, with almost half (44.1 percent) seeking medical attention, according to the results.
The authors note that the rate of 1.3 concussions per 1,000 athletic exposure hours was higher than what has been reported in other studies of girls soccer at the high school and college levels…. http://www.sciencedaily.com/releases/2014/01/140120173456.htm

Another study from Northwestern School of Medicine, Concussion and Female Middle School Athletes focuses on girls. Coaches and parents must be alert to signs of concussion. WebMD has a good description of what a concussion is and the signs of concussion http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

Citation:

From The JAMA Network | August 01, 2014
Concussion and Female Middle School Athletes FREE ONLINE FIRST
Cynthia LaBella, MD1
[+] Author Affiliations
JAMA. Published online August 01, 2014. doi:10.1001/jama.2014.6668
Text Size: A A A
Article
References
JAMA Pediatrics
Concussion Among Female Middle-School Soccer Players
John W. O’Kane, MD; Amy Spieker, MPH; Marni R. Levy, BS; Moni Neradilek, MS; Nayak L. Polissar, PhD; Melissa A. Schiff, MD, MPH
Importance Despite recent increased awareness about sports concussions, little research has evaluated concussions among middle-school athletes.
Objectives To evaluate the frequency and duration of concussions in female youth soccer players and to determine if concussions result in stopping play and seeking medical care.
Design, Setting, and Participants Prospective cohort study from March 2008 through May 2012 among 4 soccer clubs from the Puget Sound region of Washington State, involving 351 elite female soccer players, aged 11 to 14 years, from 33 randomly selected youth soccer teams. Of the players contacted, 83.1% participated and 92.4% completed the study.
Main Outcomes and Measures Concussion cumulative incidence, incidence rate, and description of the number, type, and duration of symptoms. We inquired weekly about concussion symptoms and, if present, the symptom type and duration, the event resulting in symptom onset, and whether the player sought medical attention or played while symptomatic.
Results Among the 351 soccer players, there were 59 concussions with 43 742 athletic exposure hours. Cumulative concussion incidence was 13.0% per season, and the incidence rate was 1.2 per 1000 athletic exposure hours (95% CI, 0.9-1.6). Symptoms lasted a median of 4.0 days (mean, 9.4 days). Heading the ball accounted for 30.5% of concussions. Players with the following symptoms had a longer recover time than players without these symptoms: light sensitivity (16.0 vs 3.0 days, P = .001), emotional lability (15.0 vs 3.5 days, P = .002), noise sensitivity (12.0 vs 3.0 days, P = .004), memory loss (9.0 vs 4.0 days, P = .04), nausea (9.0 vs 3.0 days, P = .02), and concentration problems (7.0 vs 2.0 days, P = .02). Most players (58.6%) continued to play with symptoms, with almost half (44.1%) seeking medical attention.
Conclusions and Relevance Concussion rates in young female soccer players are greater than those reported in older age groups, and most of those concussed report playing with symptoms. Heading the ball is a frequent precipitating event. Awareness of recommendations to not play and seek medical attention is lacking for this age group.
JAMA Pediatr. 2014;168(3):258-264. doi:10.1001/jamapediatrics.2013.4518.

Parents must be alert to what is happening with the children when they participate in athletic events and activities.

Resources:

Concussions http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Concussion http://www.emedicinehealth.com/concussion/article_em.htm

Concussion – Overview http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

Related :

Study: Effects of a concussion linger for months https://drwilda.com/2012/12/13/study-effects-of-a-concussion-linger-for-months/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

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Concussions: American Academy of Pediatrics issued recommendations for “return to learn” checklists

27 Oct

Moi wrote in Don’t ignore concussions:
Kids Health has some great information about concussions at their site:

What Is a Concussion and What Causes It?
The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can move around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion — a temporary loss of normal brain function.
Most people with concussions recover just fine with appropriate treatment. But it’s important to take proper steps if you suspect a concussion because it can be serious.
Concussions and other brain injuries are fairly common. About every 21 seconds, someone in the United States has a serious brain injury. One of the most common reasons people get concussions is through a sports injury. High-contact sports such as football, boxing, and hockey pose a higher risk of head injury, even with the use of protective headgear.
People can also get concussions from falls, car accidents, bike and blading mishaps, and physical violence, such as fighting. Guys are more likely to get concussions than girls. However, in certain sports, like soccer, girls have a higher potential for concussion.http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Don’t ignore concussions


See, Update: Don’t ignore concussions https://drwilda.com/2012/05/20/update-dont-ignore-concussions/

Jan Hoffman reported in the New York Times article, Concussions and the Classroom:

Because of heightened awareness about the hazards of sports-related concussions, many states have implemented standards determining when an injured student may resume playing contact sports. But only a few states have begun to address how and when a student should resume classwork.
On Sunday the American Academy of Pediatrics issued recommendations for “return to learn” checklists to alert doctors, school administrators and parents to potential cognitive and academic challenges to students who have suffered concussions.
“They’re student athletes, and we have to worry about the student part first,” said Dr. Mark E. Halstead, the lead author of “Returning to Learning Following a Concussion,” a clinical report in this week’s Pediatrics.
For adolescents prone to risk-taking behaviors, concussions are not just the nasty by-products of sports. Dr. Halstead, an assistant professor in pediatric sports medicine at Washington University, recently treated a 15-year-old girl whose concussion came not from a soccer match, but because “she was running backwards in a school hallway and cracked heads with someone.”
The academy emphasized that research about recovery protocols and cognitive function is scant: There is no established rest-until-recovered timeline. The new recommendations are based on expert opinions and guidelines developed by the Rocky Mountain Youth Sports Medicine Institute in Denver.
Doctors generally recommend that a student with a concussion rest initially, to give the brain time to heal. That may mean no texting, video games, computer use, reading or television. But there’s a big question mark about the timing and duration of “cognitive rest.” Experts have not identified at what point mental exertion impedes healing, when it actually helps, and when too much rest prolongs recovery. Although many doctors are concerned that a hasty return to a full school day could be harmful, this theory has not yet been confirmed by research.
The student’s pediatrician, parents and teachers should communicate about the incident, the recommendations said, and be watchful for when academic tasks aggravate symptoms such as headaches, dizziness, sensitivity to light and difficulty concentrating. The academy acknowledged that case management must be highly individualized: “Each concussion is unique and may encompass a different constellation and severity of symptoms.”
Most students have a full recovery within three weeks, the article said. But if the recovery seems protracted, specialists should be consulted.
Many school officials do not realize they can make simple accommodations to ease the student’s transition back to the classroom, the academy said.
To alleviate a student’s headaches, for example, schedule rests in the school nurse’s office; for dizziness, allow extra time to get to class through crowded hallways; for light sensitivity, permit sunglasses to be worn indoors. Students accustomed to 45-minute classes might only be able to sit through 30 minutes at the outset, or attend school for a half-day.
“Parents need to follow up with schools and make sure plans are being followed,” Dr. Halstead said…. http://well.blogs.nytimes.com/2013/10/27/concussions-and-the-classroom/?ref=education&_r=0

Citation:

From the American Academy of Pediatrics
Clinical Report
Returning to Learning Following a Concussion
1. Mark E. Halstead, MD, FAAP,
2. Karen McAvoy, PsyD,
3. Cynthia D. Devore, MD, FAAP,
4. Rebecca Carl, MD, FAAP,
5. Michael Lee, MD, FAAP,
6. Kelsey Logan, MD, FAAP,
7. Council on Sports Medicine and Fitness, and Council on School Health
Abstract
Following a concussion, it is common for children and adolescents to experience difficulties in the school setting. Cognitive difficulties, such as learning new tasks or remembering previously learned material, may pose challenges in the classroom. The school environment may also increase symptoms with exposure to bright lights and screens or noisy cafeterias and hallways. Unfortunately, because most children and adolescents look physically normal after a concussion, school officials often fail to recognize the need for academic or environmental adjustments. Appropriate guidance and recommendations from the pediatrician may ease the transition back to the school environment and facilitate the recovery of the child or adolescent. This report serves to provide a better understanding of possible factors that may contribute to difficulties in a school environment after a concussion and serves as a framework for the medical home, the educational home, and the family home to guide the student to a successful and safe return to learning.

Here is the press release:

After a Concussion Students May Need Gradual Transition Back to Academics
10/27/2013
American Academy of Pediatrics offers new guidance on “returning to learning” after concussion
ORLANDO, Fla. — A concussion should not only take a student athlete off the playing field – it may also require a break from the classroom, according to a new clinical report from the American Academy of Pediatrics (AAP).
In the clinical report, “Returning to Learning Following a Concussion,” released Sunday, Oct. 27 at the AAP National Conference & Exhibition in Orlando, the AAP offers guidance to pediatricians caring for children and adolescents after suffering a concussion.
“Students appear physically normal after a concussion, so it may be difficult for teachers and administrators to understand the extent of the child’s injuries and recognize the potential need for academic adjustments,” said Mark Halstead, MD, FAAP, a lead author of the clinical report. “But we know that children who’ve had a concussion may have trouble learning new material and remembering what they’ve learned, and returning to academics may worsen concussion symptoms.”
Dr. Halstead will deliver a plenary address on concussion injuries at 10:30 a.m. ET Oct. 27 at the Orange County Convention Center. A news briefing on the new clinical report will immediately follow. Reporters interested in covering either event should check in at the press room, W203B.
Research has shown that a school-aged student usually recovers from a concussion within three weeks. If symptoms are severe, some students may need to stay home from school after a concussion. If symptoms or mild or tolerable, the parent may consider returning him or her to school, perhaps with some adjustments. Students with severe or prolonged symptoms lasting more than 3 weeks may require more formalized academic accommodations.
The AAP recommends a collaborative team approach to help a student recovering from a concussion. This team should consist of the child or adolescent’s pediatrician, family members and individuals at the child’s school responsible for both the student’s academic schedule and physical activity. Detailed guidance on returning to sports and physical activities is contained in the 2010 AAP clinical report, “Sport-Related Concussion in Children and Adolescents.”
A symptom checklist can help evaluate what symptoms the student is experiencing, and how severe they are.
“Every concussion is unique and symptoms will vary from student to student, so managing a student’s return to the classroom will require an individualized approach,” said Dr. Halstead. “The goal is to minimize disruptions to the student’s life and return the student to school as soon as possible, and as symptoms improve, to increase the student’s social, mental and physical activities.”
Because relatively little research has been conducted on how concussion affects students’ learning, the AAP based its report primarily on expert opinion and adapted it from a concussion management program developed at the Rocky Mountain Hospital for Children, Center for Concussion in Denver, Colo. The AAP calls for further research on the effects and role of cognitive rest after concussion to improve understanding of the best ways to help a student recovering from a concussion.
Information for parents about returning to learning after a concussion also will be available on HealthyChildren.org (starting Oct. 27).
###
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit http://www.aap.org.

Parents must be alert to what is happening with the children when they participate in athletic events and activities.

Resources:

Concussions
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Concussion
http://www.emedicinehealth.com/concussion/article_em.htm

Concussion – Overview
http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

Related :

Study: Effects of a concussion linger for months

Study: Effects of a concussion linger for months

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/