Brain Injury Lawyer - New York

New Developments in Sports-Related Concussion Conference

The University  of South Florida, College of Medicine has just announced their program for a sports-concussion conference entitled "New Developments in Sports-Related Concussion Conference" scheduled for July 24-25, 2008 at The Sheraton Station Square, Pittsburgh, Pennsylvania.

New knowledge on sport-related concussions has developed in recent years and athletic trainers and medical professional have had to rethink how they manage sport-related concussion. This conference features internationally recognized experts in concussion management and will focus specifically on new and innovative strategies for the evaluation and treatment of sports-related concussion. 

The conference planners list the following objectives for conference participants:

- Classify biomechanical, neurometabolic and neurobehavioral aspects of concussion.
- Explain appropriate on-field concussion diagnostic and return-to-play protocols.
- Compare and contrast new brain imaging diagnostic techniques for the management of concussion.
- Analyze the role of the computerized neuropsychological testing in making return-to-play decisions.
- Assess current treatment options for sports-related concussion and post-concussion syndrome.
- Implement a concussion management program at the professional, college or high school level.

Concussion conference registration information is available by clicking here.

Wrestling Association to Institute Concussion Management and Awarness Program

I just received word from my friend, former WWE star Chris Nowinski and the Sports Legacy Institute the the Wrestling Association is about to institute a concussion management and concussion awareness program.

At a mandatory meeting for all performers in early March WWE performers took a computerized neuropsychological testing protocol, which evaluates such things as memory, cognitive skills, and reaction time. They will be re-tested aggressively every 6 months to look for long term issues, as well as re-tested after suspected concussions to help determine when it is safe to return to in-ring action.

Chris and the Sports Legacy Institute he founded have been instrumental in changing the attitudes of professional and amateur athletic teams about the importance of concussion awareness and proper concussion management.  They should be congratulated for their hard work.  Similarly, congratulations to WWE for taking a proactive step in protecting the health of their athletes.

Has the Senate Forgot About The Way The NFL Handles Traumatic Brain Injury Claims?

The Senate Judiciary Committee in addition to examining the destruction of tapes by the NFL, needs to look at how the NFL and their disability fund handles claims of traumatic brain injury.

I am hopeful that the Senate committee and Senator Specter who has been getting a good deal of attention on his questioning of Commissioner Goodell on the missing tapes, spend as much time on looking at the issues of why brain injured players are not receiving the compensation they so justly deserve.  Senator Spector is quoted as saying, "We have the right to have honest football games."  We also have the right to have an honest assessment of a player's disability.

The committee needs to address the deference under ERISA laws that courts give to the paid experts for hire retained by the league to defeat the claims of players.  Despite overwhelming evidence of permanent traumatic brain injury, the league is permitted to seek paid experts to offer opinions that are flawed and based upon antiquated science.  Yet, because of the way ERISA is written, the league is given "unfettered discretion" to rely upon any expert of their choice.

This law and its interpretation defies principles of due process and needs to be changed to protect players and all injured workers.

Depression Following Concussion

Researchers at the Montreal Neurological Institute of McGill University have identified the neurological basis of depression in male athletes with persisting post-concussion symptoms. The study, published in this week's issue of Archives of General Psychiatry, has important clinical implications for the treatment of individuals who have suffered a cerebral concussion.

Although neuropsychological testing in these individuals was reported to be normal, many of these athletes reported significant symptoms of depression.  The researchers utilized funtional MRI studies which showed reduced brain activity in areas of the brain that are seen in patients suffering from major depression.

Boxer in Coma Passes Away From Head Injuries

Sadly, World Boxing Organization intercontinental champion Choi Yo-sam was officially declared dead following head injuries received in a title bout in Korea. 

Choi's death came after eight days in an injury-induced coma and following him being certified brain dead Wednesday afternoon.

Choi Yo-sam was repeatedly struck in the head during this boxing match.  Although he was knocked to the ground, he was able to recover and continue to fight.  He managed to finish the bout.  He collapsed after returning to his corner. He was taken to the hospital where a cerebral hemorrhage (bleeding in the brain) was discovered and he underwent neurosurgery to reduce the pressure in his brain and stop the bleeding. Unfortunately, he never regained consciousness.

His family has donated many of his organs to assist others.

This is not the first fighter who has tragically died following head trauma.  Many of these individuals have not been knocked unconscious during the bout and have been allowed by ring doctors to continue to fight despite having sustained numerous violent blows to the head.  Perhaps, changes need to be made requiring that fights be halted following a certain number of head blows in any given round or during the entire fight.

By this time, it should be apparent that the ringside examination is not sufficient to determine if the fighter has sustained life threatening brain damage.  Unfortunately, this cannot be determined until the fight is over and steps need to be taken to protect the lives and future health of these fighters.

Professional Football Continues to Ignore Concussion Dangers

It is truly tragic to read the story in today's New York Times, For Jets, Silence on Concussions Signals Unease.

Despite the overwhelming evidence of the long term consequences following a concussion, professional football teams still refuse to acknowledge what is not accepted medical science.  The problem includes team physicians who are being payed by the team and have an obvious conflict of interest when it comes to making return to play decisions, teams themselves which refuse to set strict policies and players who are taught that a ding is no big deal.

But now, outside medical experts are beginning to raise the heat on these teams.  One such expert, Dr. James Kelly who wrote the original standards on concussion management for the American Academy of Neurology is quoted as saying "They arrogantly assume that they are doing the right thing when it's obvious to outsiders that they mismanage the situation, Cherbret being the prime example.  It looks like they have something to hide."

Also criticizing the NFL is noted concussion expert, Steven Guskiewicz, chairman of the department of exercise and sport science at the University of North Carolina.  He along with his colleagues have published several papers on surveys of more than 2,000 former N.F.L players that found a correlation between a player's concussion history and later-in-life clinical depression, cognitive impairment and early on-set dementia.  Gurskiwicz says that the league continues to ignore his findings and recommendations.

Players need protection and if the league is not capable of making sound decisions to protect the safety of it's players, then it's time that Congress step in to act.

New Study Confirms Even Minor Impacts Can Cause Concussions and Traumatic Brain Injury

An important new study to be published in the December issue of the journal, Neurosurgery confirms that impacts considered to be minor can cause a concussion and a traumatic brain injury.

The study is based upon date obtained from sensors placed in football helmets.  Researchers at the University of North Carolina studied the amount of force that the player received on impact.

Using special accelerometers embedded in helmets, researchers were able to measure in real time the amount of g-force players' heads experienced at impact, where on the head the players were hit and the directional force of the hits -- linear (straight) or rotational (twisted). The system is called HITS, or Head Impact Telemetry System.

"People see massive hits and think, 'that's the one!' and ignore more trivial blows," said Kevin Guskiewicz, Ph.D., senior author on the papers and chair of the department of exercise and sport science in UNC's College of Arts & Sciences. "Now we know that these trivial hits may be just as serious as the harder ones."

Hopefully this information will cause those who believe that minor impacts cause no permanent injury to reevaluate their opinions.  There is no such thing as a minor head injury.  All head injury must be treated seriously.

Head Injury A Growing Problem in Skiing and Snowboarding

A review published in the journal Injury Prevention concludes that head and spinal injuries are on the rise as a result of skiing and snowboard accidents.  The authors conclude that faster speeds and complicated maneuvers are leading to more head and spine injuries among downhill skiers and snowboarders.

While injuries in general are declining in these two sports, head injury continues to rise.

Helmet use is associated with a 22 percent to 60 percent reduction in head injury risk, but helmets are not being used by the majority of those on the slopes. The U.S. Consumer Product Safety Commission estimates that half of head injuries on the slopes could be prevented by helmets, but a survey of several United States ski resorts found that helmets were worn by just one in eight skiers and snowboarders. Notably, the most-skilled athletes were most likely to wear a helmet.

Although there has been some speculation that helmets may increase the odds of spinal injury in children, the new review cites three studies showing that helmets do not raise such a risk. It is true that many parents buy helmets too big, so that kids will grow into them; a poorly fitted helmet offers less protection, impeding vision and muffling hearing. Although more study is needed, the review authors conclude that the benefits of helmet use in preventing serious head injury far outweigh any risk.

College Football Has To Be Nuts In The Way They Handle Concussions

Last Saturday,  I was watching the Stanford Notre Dame game on television and viewed the play where Stanford's quarterback Tavita Pritchard was struck so hard that it looked like his head was knocked off!  He clearly fell to the ground, struck his head hard and was unconscious of a period of time.  When he finally left the field with considerable assistance he was definitely woozy.

To my shock, later in the SAME game, the geniuses at Stamford allowed this kid to return to play. How in the world they can do this with all the mounting medical evidence of the dangers of concussions, the dangers if a player recovering from one concussion sustains a second concussion, the fact that it is impossible to determine the full effects of a concussion in the minutes and hours following the event is beyond comprehension.

I have said before that firm policies must be instituted to prevent players who have sustained a concussion or a suspected concussion from returning to play in the same game and that they should be required to undergo comprehensive physical as well as neuropsychological evaluations before being cleared.

Today's New York Times has an interesting story, Concussions Put College Players in Murky World which discusses this incident and other similar incidents where players where inappropriately allowed to return to play. The story also discusses the reaction of Pritchard's mother who is putting her faith in the decisions of the team.  BIG MISTAKE, if I can be so bold to say, you better take matters in your own hands and get some second opinions and get them fast.  Don't sacrifice your son's life for a shot at major league football.  It's simply not worth the risk.  The affects and the damages from a concussion can last a life time.  It can affect every aspect of your son's life.  It can change his personality, affect his behavior, cause insurmountable memory difficulties. I can go on and on.  Please get some good advice NOW!

Concussions in High School Athethes Featured Tomorrow Morning on ESPN: Outside the Lines

This Sunday, ESPN's Outside the Lines 9:30 AM Eastern Standard Time, will focus on concussions in high school athletes.

From ESPN.com -
"On gridirons across America, young people are playing football -- and inevitably getting hurt. Football is a contact sport and injuries are commonplace, but recent studies show that the number of high school players who get concussions each season range from five percent to as much as 47-percent. Not only are many high school programs understaffed with medical personnel, but it's also common for high school football players keep their symptoms from their coaches or trainers for fear of losing playing time. Coming up on "Outside the Lines," with the long term impact of concussions on NFL players making headlines, we examine a far bigger problem. The concussion epidemic on the high school level"

My friend, Sports Legacy Institute President, Chris Nowinski will appear as a live guest after the piece airs.  Chris is the author of Head Games, a superb book on the crisis of concussions in sports.

New Shock Reducing Foorball Helmet May Prevent Concussions

A front page story in today's New York Times, Far From Grandpa's Leather, Helmet Absorbs Shock a New Way reports on a promising new technology to protect football players from concussions.

A newly designed football helmet has a radically different method of absorbing shock and the forces transmitted to the brain which may be a primary cause of concussions in football players.  Unlike traditional helmets which contain padding this new helmet is constructed with 18 thermoplastic shock absorbers which contain air.  These shock absorbers can protect the brain from a wide range of outside forces and also provide support to the head to prevent sudden movement within the helmet.  It is this movement of the head which causes damage to the brain as it strikes the interior sharp edges of the skull.

"Football helmets present the technological challenge of protecting against all manner of blows to the head and also doing so thousands of times. (Bicycle helmets, by contrast, are designed to withstand just one major, accidental impact.) Optimally, a helmet’s interior must be forgiving enough to cushion against a routine impact while also sturdy enough to withstand a potentially lethal one — each level of force requires a different response from the material."

One leading concussion expert, Dr. Robert Cantu, according to the Times story called the new helmet "the greatest advance in helmet design in at least 30 years"

Let's hope that  further testing confirms the superiority of these newly designed helmets and that schools and teams find the extra money in their sports budgets to switch to these new helmets.  Without question, the cost of a new helmet is considerably less the than life time costs associated with concussions and the post concussion syndrome.

You can read the full Times story by clicking here.

Bicycle Accidents: Significant Cause Of Brain And Other Injuries

Bicycle-related injuries among children and adolescents in the U.S. are a significant public health concern, costing nearly $200 million in annual in-patient hospital charges, according to a new study published in the October issue of Injury Prevention.

One-third of children hospitalized for bicycle-related injuries were diagnosed with traumatic brain injury.  Many of these injuries could have been prevented or have been minimized if a helmet was used.

The national study, conducted by researchers at the Center for Injury Research and Policy at Nationwide Children’s Hospital, estimates that approximately 10,700 children are hospitalized annually for a bicycle-related injury with an average length of stay of three days.

Concussion Educational DVD's To Become Available

The National Football League (NFL), National Hockey League (NHL) and the National Hockey League Player's Association (NHLPA) have agreed to sponsor an educational program on sports concussions developed by the National Academy of Neuropsychology (NAN) and the National Athletic Trainers' Association (NATA).   

Consisting of a series of educational DVDs, this program is targeted to amateur and professional players, parents, physicians and coaches, and will provide information on how to recognize concussive injuries, seek proper evaluation, and follow appropriate return to play guidelines.

The Centers for Disease Control estimate that 300,000 brain injuries occur in sports each year. Of these reported concussions, an estimated 63,000 occur among high school athletes.  Even though these numbers alone suggest that concussions represent a significant public health concern, it is likely that many athletes with concussions fail to report their symptoms to medical personnel. These educational DVDs will increase awareness of this injury while promoting scientifically sound management guidelines that will help minimize the negative effects of traumatic brain injury.

The DVD's are currently being developed and will be released in January, 2008. The DVD's will be widely distributed through leagues, sports organizations, medical organizations, NATA and NAN.  Organizations interested in obtaining copies of the DVD's should contact the NAN office at (303) 691-3694.

Can Football Helmets Detect Concussions?

According to an article published in Scientific American,  some high school teams are now testing a new helmet sensor that promises to alert coaches when players have been hit hard enough to cause a concussion, potentially averting further brain injury.

The helmets—made by sports equipment maker Riddell Sports Group—use sensor technology developed by New Hampshire–based Simbex, LLC. The system consists of six battery-powered sensors in the helmet's padding that record the location, magnitude, duration and direction of up to 100 impacts and wirelessly send this information to a PC (within 150 yards) running data collection software. The sensors work by measuring both linear and rotational acceleration of the helmet after a player has been struck.

The costs for the concussion detection equipment reportedly are $30,000 for the computer system and $1,000 for each helmet.

This technology is still in the developmental stages and I still believe that teams need to be extremely cautious when it comes to concussions and always take the conservative approach of keeping players out of play any time a concussion is suspected to have occurred.  While this equipment may be able to record forces, there are many types of forces that the system may not be able to detect which are responsible for concussions.  Further, the individual sensitivity of each player to concussive forces makes me wonder if this product can really do what it's developers claim.

You can read the full story by clicking here.

Girls At Higher Risk for Sport Concussion Injuries

I am back from the North American Brain Injury Association (NABIS) conference on traumatic brain injury where I gave a talk to the lawyer's section on how to deliver an effective opening statement in a brain injury law suit and look forward to resuming my brain injury blog posts. 

Today's New York Times carries an important article entitled, Girls Are Often Neglected Victims of Concussions. The article reports on a study conducted at Ohio State University to be published in the Journal of Athletic Training which that concluded that girls take longer for their sports concussion symptoms to resolve and are more susceptible to concussions than boys are in the same sports.

The study found that girls playing high school soccer sustained concussions 68 percent more often than boys did and that female concussion rates in high school basketball were almost three times higher among girls than boys.  The study also found that girls consistently took longer for their post concussion symptoms to resolve.

While doctors are uncertain as to why the rates of concussions and the severity of symptoms are higher in girls than in boys, the primary theory is that girls may be more honest in reporting their symptoms and injuries than boys are.  Others also point to the fact that the neck muscles in girls are not as strong as boys so that the head is more prone to move upon impact. 

You can read the entire story by clicking here.   

More Double Talk Today at Senate Hearing Examining NFL Disability Plan

I was privileged to attend the United States Commerce Committee oversight hearing today on issues pertaining the National Football League's Disability Plan and a follow up press conference hosted by Gridirons Greats, an organization of retired players headed by Mike Ditka and dedicated to achieving fairness and fair dealing for disabled players..

Unfortunately, what I heard was a lot of double talk.  While I commend NFL Commissioner Roger Goodell for his willingness to discuss the issues surrounding the plan, take the heat and pledge reform,I really didn't hear anything that was new or different.  The true issue is how the plan gets the final say on whether or not the player has permanent brain damage.  At the conclusion of the hearing I had an opportunity to meet with Gene Upshaw, head of NFL Player's Association.  I offered to meet with him in New York or anywhere else to discuss the serious issues of traumatic brain injury and the devastating nature of this condition.  He seemed interested.  Let's hope he contacts me so we can have a serious discussion and open a dialog.

They can change all the definitions of disability they want, but when the league gets to pick its own medical consultants who have the final say and the player gets no opportunity to challenge the decision, no matter how arbitrary or capricious it is, that violates fundamental principals of fairness and due process.

I have sadly been asked to review files of former players whose have been turned down by the league despite overwhelming evidence of brain damage suffered while playing professional football.  The league will keep looking until it finds a doctor to disagree with the multiple medical experts who have already concluded that a disability exists.  They will then chose to follow the recommendation of their bought and paid for, so called medical expert.

As I have previously said, When it comes to concussions and legal determinations as to whether a player has sustained brain damage, the league's position is heads I win, tails you lose.  It is outrageous that the league has stacked the deck against its retired and disabled players. It's time for Congress to act and rectify the injustices that have deprived victim's of brain trauma their legal rights.    They must allow players access to Court's of Law to review these determinations and take away the unfettered discretion that the league now enjoys.

Senate Hearings on NFL Disability Plan

I will be in Washington, DC this Tuesday, September 18th to participate in the hearings conducted by the Senate Commerce Committee on the way that the National Football League and Player's association disability plan manages claims of disabling brain damage.

Having personally been consulted by numerous football player's who have been wrongfully turned down by the league, I can personally attest to the way that the deck is stacked against brain damaged players by the league.  The disability plan consistently ignores the evidence of brain injury presented by players; ignores prevailing medical opinions about brain injury, its cause and consequences and instead chooses to rely on "experts" bought and paid for by the league who improperly claim that the player is not brain injured or has no permanent disability. 

These so called "experts" wrongful state that their is no evidence of brain injury either because the player was never knocked unconscious or because the MRI and CT scans are normal or because they player can pass a mini mental status exam. It's time that these professionals be subject the rigors of cross examination.  The "heads I win, tails you lose attitude of the disability plan when it comes to evaluating evidence of concussions needs to change and it may be the time for Congress to step in and fix what the plan itself is incapable of correcting on their own.

Scheduled to testify on Tuesday are Commissioner Roger Goodell and NFL Players Association executive director Gene Upshaw as well as Hall of Fame tight end and former Chicago Bears coach Mike Ditka, a critic of the plan as well as several players who claim they have wrongfully been denied disability benefits despite overwhelming evidence of brain damage.

High School Football Players Fail to Recognize the Seriousness of Concussions

A fascinating story appeared in yesterday's New York Times. High School Players Shrug Off Concussions, Raising Risks. 

The lengthy story explored the troubling prevailing attitude and culture that permeates high school football.  Namely, high school players minimize their injuries, especially their concussions; they do not have any clear idea what the symptoms of a concussion are or the dangers of continuing to play while symptomatic following a concussion.

These players are not alone in failing to appreciate the serious and life long consequences of a concussion.  Not only must they be educated, their parents, trainers and coaches need to understand the issues surrounding concussions and the dangers of minimizing any type of brain injury. 

The article quotes players as saying some really dangerous things like, "It's not dangerous to play with a concussion. You've got to sacrifice for the sake of the team.  The only way I come out is on a stretcher" and "our coaches would take us out in a second. So why, would we tell them?" 

As Robert Sallis, president of the American College of Sport's Medicine said, "Poor management of high school player's concussions "isn't just a football issue.  It's a matter of public health"

Some states are beginning to require specific training for players and coaches regarding the dangers of concussions.  Sounds like a great idea that should be explored by all school districts and states.

You can read the full article by clicking here.

Learn more about Chris Benoit's Brain Injury Tonight on Geraldo At Large

Just learned that tonight at 8 PM and 11 PM EST, Sports Legacy Institute founding members will discuss their neuropathology findings and opinions concerning Chris Benoit brain damage.

Brain Autopsy of WWE Wrestler Benoit Shows Extensive Brain Damage

In a Manhattan press conference today, physicians associated with the Sports Legacy Institute announced their findings today concerning the examination of the brain of pro wrestler Chris Benoit who killed his wife, son and then himself.

Not surprisingly, the examination of his brain showed extensive areas of brain damage.  All four lobes of his brain showed extensive cell death which is consistent with the multiple concussions he sustained while engaged in professional wrestling.

Benoit's brain was examined by the research team which included noted neurosurgeons Julian Bailes and Robert Cantu who along with retired pro wrestler, Chris Nowinski, author of Head Games, established the Sports Legacy Institute to look at the mounting evidence of permanent brain damage caused by concussions sustained by athletes.  Head Games is an excellent source of information on the dangers and long term effects of concussions

The brain experts had not problem concluding that the brain damage they found were due to the multiple concussions that Benoit sustained. But, the physicians could not say with absolute certainty that this brain damage was the cause of Benoit's erratic behavior on the night of the murders. They did say however, that the this type of brain damage can cause depression and irrational behavior in an individual.  Similar brain abnormalities were also found on autopsy of the brains of other athletes who committed suicide including pro football player, Andre Walters.

A full report of the press conference can be found at ABC News. 

More Congressional Hearings Scheduled on NFL Disability Plans

Following a House Judiciary Subcommittee meeting in June on the sorry state of the NFL players disability plan and the unconscionable way that disability determinations are made in areas of brain damage and other disabilities, the United States Senate Committee on Commerce, Science and Transportation announced that they would be holding hearings on September 18th.

Let's hope that league officials attend this hearing and answer the tough questions of why players with obvious brain damage are consistently denied disability benefits and why the league's disability plan ignores the opinions of the players treating health care professionals. 

The league should not be allowed to now hide behind the vague and arbitrary standards of the social security administration in determining disability for brain injury.  Social security doesn't have any real standards for determining disability for a traumatic brain injury.  Instead social security bundles this unique condition under the term "mental disorder".  If an individual can perform any job in the economy, anywhere in the United States, social security does not consider the individual to be disabled. No consideration is given to the number of hours that an individual can work following a brain injury, that they may not be able to keep a job and may be terminated because of their social and emotional difficulties.

The NFL needs to do better than the social security administration in determining disability following brain trauma.

 

Madden NFL 08 Criticized For Violent Content

Today's Houston Chronicle contains an interesting article, In games, it's all about the big hit.  The article discusses the mounting criticism of the new Madden video football game and its emphasis on violence.

I am honored to have been extensively quoted in the article about the myths perpetuated by the NFL in licensing this product.  This new version of Madden is reportedly the most violent version ever produced.  It's emphasis on the big hit sends the message to all who view this game, that the big hit doesn't cause any head injury or brain damage. 

If the NFL is serious in their concern over concussions, they ought to rethink the image they are creating in the minds of young fans when they allow these video games to be produced under their license. The NFL should learn that the best cure for brain injuries is prevention! 

More NFL Double Talk on Concussions

Just when I thought that maybe the NFL is getting it when it comes to concussions and preventing brain damage, comes an article in today's New York Times, New Advice by NFL in Handling Concussions.

According to the news report, the NFL has finally adapted a policy prohibiting players who have been knocked unconscious to return to play during the game in which they were injured.

Not bad, but what about players who were not knocked unconscious, but sustained a concussion anyway?  Don't they need the same protection.  It's been over twenty years now that we know that serious brain damage and concussions can happen even without loss of consciousness.  Come on NFL, read the medical literature!

And their is more.  The league says that their policy is only that of erring on the side of caution.  Not that they really believe that that it is necessary to keep players who have been knocked out from returning to play.  You've got to be kidding. 

The statements made by the league in this article are truly troubling.  It's time that this league not only talk the talk. It's time that they really get serious about concussions.

New web site for Sports Legacy Institute

My good friend Chris Nowinski, author of Head Games, a wonderful book about the crisis of concussions in sports today, has just launched a new web site for the Sports Legacy Institute.

The Sports Legacy Institute  (SLI) is dedicated to studying the effects of concussions and other sports related brain injuries.  Through its efforts, SLI aims to  maximize the safety and vitality of all athletes who participate in contact and collision sports around the globe. 

If you go to the Institutes's web site, you can get on their email list to be updated on their mission.

Change the Face of Sports - Make a Donation to the Sports Legacy Institute:

To promote medical and scientific research, education, prevention, and advocacy in brain related sports injury issues, the Sports Legacy Institute relies on the financial support of people who are interested in seeing the health and wellness of athletes of all ages and the overall safety of sports improved.   Click here for further information about donating to the Sports Legacy Institute.

NFL Concussion Hotline

The NFL has just announced that it would establish a concussion hot line to report information on a confidential basis about players being forced to practice or play against medical advice.

"We want to make sure all NFL players, coaches and staff members are fully informed and take advantage of the most up-to-date information and resources as we continue to study the long-term impact of concussions," commissioner Roger Goodell said. "Because of the unique and complex nature of the brain, our goal is to continue to have concussions managed conservatively by outstanding medical personnel in a way that clearly emphasizes player safety over competitive concerns."

Let's hope that the word gets out to all players, coaches and trainers that concussions and suspected concussions must be treated seriously.  The life long consequences of concussions and the added risk from repeated concussions mandates that any return to play decision be made with an abundance of caution. 

Their is no such thing as a trivial concussion!! 

The league should be commended for taking this step and I look forward to them taking further action to educate players, coaches, trainers and family members about the signs and symptoms of concussions and proper concussion management.

The NFL also released a pamphlet of how to identify concussions and noted that not every hard hit to the head leads to one, but a concussion can "only be determined by your team doctors and athletic trainers."

According to a study released earlier this year by the University of North Carolina's Center for the Study of Retired Athletes, a survey of over 2,500 retired NFL players revealed the rate of diagnosed clinical depression had a strong relation to the number of concussions that particular player sustained.

fMRI Used To Detect Concussions and Return to Play Decisions In Athletes

fMRI (Functional MRI studies) have been reported to be used by the University of Pittsburgh to assist in making important return to play decisions following sports concussions.

A five year study funded by the National Institutes of Health is published in the August issue of Neurosurgery.  This study conducted by the Sports Medicine Concussion Program at the University of Pittsburgh School of Medicine  found that the brain activity in children and adolescents on functional MRI (fMRI) was clearly related to their performance on neuropsychological tests of attention and memory and to their report of symptoms such as headaches.

The study authors Drs Lovell and Collins conclude that the results of their study confirm crucial objective information that is commonly obtained by neuropsychological testing to help team doctors and athletic trainers make critical decisions about concussion management and safe return to playor understanding the recovery process after sports-related concussions.

The study helps define concussion and recovery for safe return-to-play and confirms information obtained by neuropsychological testing.

A concussion can occur when an athlete receives a traumatic force to the head or upper body that causes the brain to shake inside of the skull. Injury is defined as a concussion when it causes a change in mental status such as loss of consciousness, amnesia, disorientation, confusion or mental fogginess. The severity, effects and recovery of concussion are difficult to determine because no two concussions are alike, and symptoms are not always straightforward.

In recent years, research has shown that until a concussed brain is completely healed, the brain may be vulnerable to further injury, which has led to published studies that have raised public awareness and significantly changed the way sports concussions are managed. Importantly, much of this research has included data that proves the usefulness of objective neuropsychological test data as part of the comprehensive clinical evaluation to determine clinical recovery following concussion.

While neuropsychological testing has become an increasingly useful tool, no other published studies have examined the relationship between changes in computerized neuropsychological testing completed in a medical clinic and brain function as measured by fMRI.

fMRI is one of the few brain scanning tools that can show brain activity, not just the anatomy. Traditional brain scanning techniques such as MRI and CT are helpful in viewing changes to the brain anatomy in more severe cases, but cannot identify subtle brain-related changes that are believed to occur on a metabolic rather than an anatomic level.

fMRI can determine, through measurement of cerebral blood flow and metabolic changes, which parts of the brain are activated in response to different cognitive activities.

For more information on published research concerning sports concussion management, visit the UPMC Sports Medicine Concussion Program Web site .

Let's Ban Hits to the Head in Hockey

FOXSports columnist Mike Chen has come up with a good idea to protect hockey players from the dangers of concussions.

He has proposed that the National Hockey League adapt the same rule that some Canadian junior leagues have that penalize hits to the head.  Here's his suggestion:

"Any damaging contact to a player's head, whether it be by shoulder, elbow, hand, forearm, or stick, should be made a minor penalty with the potential for major as judged by the discretion of the official. Just as inadvertent high sticks are penalties, so should blows to the head. If the NHL can penalize hits below the knee, they can penalize hits from the neck up. It's as simple as calling slashing."

I always thought that the idea behind hockey was to hit the puck, not a player's head.  Why not take this worthwhile suggestion a step further and eject any player who strikes another player in the head?

The only way that we are really going to reduce the incidence of concussions in sports is when the leagues institute tough no nonsense policies that will protect the health and safety of the player without distracting from the point of the game.

Mike Chen also writes a hockey blog.

Soccer Players Show Brain Shrinkage

College-age soccer players may show some degree of brain-tissue shrinkage, according to a study published in the July 2007 issue of the Clinical Journal of Sports Medicine.   

Using high-resolution MRI brain scans, researchers found evidence of reduced gray matter in the brains of 10 male college soccer players, compared with 10 young men who had never played the sport.

Gray matter refers to the brain tissue that controls thinking and memory. The significance of the relatively smaller gray matter volume and density seen in these players is not yet clear, the researchers say.

However, some past studies have found that professional and even college-age soccer players are more likely to show problems with memory and attention than non-players.

Among players in the current study, reduced gray matter was seen in a part of the brain called the anterior temporal cortex -- which is consistent with effects from repeated knocks to the front of the head, John Adams and colleagues at the University of Cincinnati College of Medicine in Ohio report in the Clinical Journal of Sports Medicine.

The Best Cure For A Brain Injury Is Prevention

Because I feel so strongly about the need to prevent future brain injuries in are student athletes, I am reproducing an editorial Tackling football's silent killer that appears today in the Sun Chronicle:

High school sports may be safer now than they've been in years, as a recent article reported in tandem with a profile on a serious spinal injury suffered by King Philip wrestling star Donald McNeil.

However, the risk of a certain type of injury is climbing ever higher on the radar screen of school and professional sports. That's concussion, a traumatic injury to brain tissue as a result of a violent blow, shaking, or spinning. It is a sometimes nearly silent assault to the body that, without heightened awareness by coaches, teammates and parents, could go unnoticed until complications arise.

The National Football League is closely scrutinizing the injury, educating players and ensuring that concussion is reported by instituting a whistle-blower system at training camps this month.

"And if anyone feels they are being forced onto the field when they are not ready to play, we want to know about that and look into it," NFL commissioner Roger Goodell said after a conference last month in Rosemont, Ill., with medical personnel from every team in the league.

This initiative should be an added heads-up to high school coaches who soon will be starting a new season of play. Any hint of concussion must be taken seriously since longterm repercussions may be devastating.

The heightened awareness by the NFL comes amid studies indicating that players who suffered multiple concussions might be susceptible to neurological disorders later in life, reported the the Pittsburgh Tribune-Review.

The decision by parents to permit their children to play sports lies there, at home. Risks are everywhere in life. But it can pay for everyone to be educated about a brain injury that is real, common and drawing closer examination than ever.

"The real danger is when they have an injury and they continue to play and that creates a greater degree of danger in terms of their recovery," said Dr. Mark Lovell, director of the sports concussion program at the University of Pittsburgh Medical Center and director of the NFL neuropyschology program.

"Parents should be on the lookout if their kids are (suffering) symptoms like headaches, dizziness, nausea, balance problems. Difficulties with memory, if there is a sudden change in a child's personality, they should start asking questions and maybe call the coach up and ask, 'Did my son get hit today and what happened?' It's the stuff we don't know about that is really dangerous."

Football is a signature sport in this area, but there's no reason that zealousness about winning cannot co-exist with an equal passion for enhanced safety measures and vigilance.

Hopefully, parents, coaches and students themselves will take this advice to heart.

Brain Injury and Proposed Changes to NFL Disability Plan

I am pleased to be participating in an on line talk radio show tonight featuring a discussion of how the NFL disability plans deals with brain damage and proposed changes to the plan.

We are gong to be discussing the NFL proposal to use the social security disability definition of brain injury as well as the league's own definition.

Unfortunately, traumatic brain injury is poorly defined by the social security administration which does not have a specific category for disability due to traumatic brain injury.  Instead brain injury is grouped under a very confusing category entitled, "Organic mental disorders".  The grouping and the social security administration really are not looking at the extent of injury and the life long consequences to the individual and his family, but is instead focusing on what they consider to be residual functional capacity. 

The social security administration tends to focus on the physical limitations that the individual has rather than the day to day difficulties and the behavior and social limitations that are associated with traumatic brain injuries.   

The Internet broadcast can be heard at 8 pm eastern standard time on sportsmavericks.

Another Guest is Bernie Parrish, former Florida Gator Football Player and Cleveland Brown in the 1960's. Bernie was one of the professional players that strengthened the NFLPA (NFL Players Association) with the dream of making it the most powerful union in sports. Bernie is at the forefront of the Congressional hearing on the fight to restructure the NFL Pension and Disability program.

In addition, Mel Owens, former Linebacker for Los Angeles Ram who is presently a Workers Compensation and Disability Attorney will share his prospective. 

We hope to also have Sylvia Mackey, the wife of John Mackey to call in and discuss "Plan 88"

High School Football Most Dangerous For Brain Injury

The number of catastrophic head injuries in high school football far exceeds the number of such injuries in college football, a new study finds.

In addition, the number of high school players who receive such head injuries and then play with residual effects is "unacceptably high," according to the report in the July issue of The American Journal of Sports Medicine.

High school players have more than triple the risk of sustaining catastrophic head trauma compared to college players, the researchers found. High school athletes suffered 0.67 such injuries per 100,000 players compared with 0.21 injuries per 100,000 for college players.

What is particularly troubling is that about 40 percent of the injured players continued to play even though they had symptoms from the earlier head injury. Catastrophic head injuries resulted in 8 deaths, 46 permanent brain injuries and 36 serious injuries where the patient had a full recovery, the researchers found.

The study author believes high school football players should be discouraged from "leading with the head" -- using their heads to tackle. Of all the catastrophic head injuries, 81 percent resulted from helmet-to-helmet collisions and helmet-to-body collisions, he noted.

In addition, players who have received a concussion should be encouraged to report symptoms to the training staff and should be withheld from play until medically cleared.

The study also found that many catastrophic head injuries resulted not from a major blow to the head but from multiple minor collisions.

You can read more about this study by clicking here .

First reports from NFL Congressional Hearing

The long awaited congressional hearing into the unfairness of the NFL player's disability plan was held today by House Judiciary subcommittee chaired by  Rep. Linda Sanchez, D-Calif. and some of the testimony given by retired players suffering from brain damage wasn't pretty. 

Testimony about lives shattered, homelessness, years of depression, memory loss and other conditions were given my many retired players.  These players also testified to the refusal of the NFL disability fund to grant them disability benefits despite overwhelming evidence of brain injury sustained while playing professional football.

Here are some of the things that were said at today's hearing:

The players from the '50s, '60s and '70s laid the groundwork for the popularity of the NFL, a billion-dollar industry, and should be treated better, lawmakers said.

"Perhaps there ought to be a legal solution," said Rep. Chris Cannon, R-Utah.

"We have a group that should be protected, but is not being protected," said Rep. Tom Feeney, R-Fla.

"What is even more troubling is that through projects such as NFL Films, the NFL continues to profit off those very same players who are denied benefits," said Rep. Linda Sanchez, D-Calif.

What is extremely troubling to me is the failure on the part of the league to even admit that there might be a problem with a plan that has refused to acknowledge player's brain damage and other physical injuries despite the overwhelming evidence presented to them.   

You can read a full report of today's hearing by clicking here.

NFL & Concussions--Where do we go from here?

Yesterday's NFL Concussion Summit did not produce any new results concerning the crisis of concussions in professional sports.  What it did do, however is spark renewed interest in the dangers of concussions and public awareness of issues surrounding mild traumatic brain injury. 

Mild traumatic brain injury is a true public health crisis and more attention needs to be focused on injury prevention, brain injury rehabilitation programs and supports for family members and  persons who have sustained this life altering injury.

The debate that took place yesterday in Chicago between those who refuse to accept the medical truth about concussions and mild traumatic brain injury and those whose only true interest is the health and safety of the players needs to move forward.  While more research certainly needs to be done, the large body of medical research that now exists certainly supports the need for firm rules requiring players who have sustained a concussion or a suspected concussion to sit out the rest of the game and not be allowed to return to play until both their cognitive difficulties and physical difficulties have cleared.  Anything less than that is certainly unacceptable.

The league needs to change it's disability plan and provide needed benefits for those players who have sustained mild traumatic brain injuries.

I look forward to participating in these discussions and working with those concerned about players and the bigger picture of the management of concussions in sports.

You can read more about the concussion conference and the debate by clicking here.

More Evidence of the Dangers of Multiple Concussions in Professional Football

More medical evidence establishing the link between repeated concussions and permanent