On Oct. 27, Tieri and the other District 214 athletic trainers will meet with Dr. Dino Kostas (and Dr. Daniel Hurley) from the Chicago Institute of Neurosurgery and Neuroresearch to discuss the latest sport concussion treatments. Dr. Kostas (and Dr. Hurley) worked very closely with the Red Stars professional (women’s) soccer team this year and has treated several of the players. (They) also consult with area high schools on managing concussions in football and other contact sports.

In light of recent concussion discussion in the National Football League, District 214 athletic trainers are being proactive in protecting and treating their athletes. To learn more about District 214’s concussion initiatives or specifics about the meeting with Dr. Kostas (and Dr. Hurley), please contact Tieri at (847) 718-7136 or rocco.tieri@d214.org.

More information can be obtained regarding CINN’s concussion management program at info@cinn.org

Athletic Director: “Better to look out for the next 60 years instead of the next 60 minutes of a football game”

Concussion: (n) an injury to an organ, especially the brain, produced by a violent blow and followed by a temporary or prolonged loss of function.

Up to a million high school and college athletes get them every year, and as more doctors learn about the long-term effects of the injury, the more concern there is about how they may impact the teen athlete’s brain.

While college football is where the injury may be the most obvious, a new study shows that athletes on the soccer field and on the basketball court get concussions almost nearly as often.

While an athlete may seem at first immediately following a significant fall or hard hit, alert adults may want to keep an eye out for signs of concussion hours after a game is over.

A new computer program appropriately named imPACT is helping. With imPACT, students take a special computer test before the season even begins. A player will take the test a second time after an injury. Those two scores are compared, and if they don’t match up, the player is out until they do.

Experts agree: if in doubt, sit it out.

That might be one of the hardest things an athletic director like Saint Rita of Cascia High School’s Zach Blaszak has to do, but enforcing complete rest until there’s a full recovery is crucial to protecting the young brain.

Also important, according to doctors and athletic trainers, is to recognize what’s happened out there on the field or in the court, and to immediately ask the right questions.

“Are you having a headache, are you having trouble concentrating or remembering, what was the last play you were in? Can you remember what happened to you,”neurosurgeon Dr. Gail Rosseau states as possible things to ask.

At the Chicago Institute of Neurosurgery and Neuroresearch, they’ve even created a card that parents can keep in their wallets that lists the signs of concussion, and the right questions to ask (see www.cinn.org to order your Ahead of the Game concussion reference cards).

“It’s better to look out for the next 60 years instead of the next 60 minutes of a football game,” Blaszak said.

This story is scheduled to air on Channel 5 during the 10:00 p.m. newscast on Thursday, October 29th.

CINN concussion experts strongly agree with the Zurich Consensus Statement conclusion that it is NEVER appropriate for a child or an adolescent to return to play on the same day as the injury. Furthmore, studies have shown that recouperating from a concussion takes longer in the adolescent player. In fact, some studies suggest it takes on average 26 days for an adolescent player to return to play after a concussion.

If you would like the CINN concussion team to help lead a discussion at your institution, please email ldombro@cinn.org for more information.

chicagotribune.com

Schools increase awareness of injuries that killed 50 young football players in 10 years, and how to diagnose them
By Mike Helfgot

Special to the Tribune

October 7, 2009

Josh Jaremko and a hard-charging linebacker butted helmets during a routine drill of the sophomore football team at Hinsdale Central High School in August — one of hundreds of collisions during that practice session.

He didn’t feel quite right, but returned to the field the following day.

“I especially did not think it was a concussion,” Jaremko said. “I just thought it was a good hit and I would be fine.”

Then he got hit in the same spot again and was diagnosed as having suffered two concussions. He was at risk of what is known as second impact syndrome, a condition where the brain swells rapidly and catastrophically when a second injury occurs before the first one heals.

Jaremko endured headaches for a couple of weeks and doctors’ visits before being cleared to play within a month.

Sports-related concussions have been in the news recently and are the subject of a new effort by athletic trainers in Illinois to make more coaches, parents and athletic directors aware of the symptoms and dangers of playing again too soon.

A 17-year-old, Drew Swank of Valley Christian High School in Spokane, Wash., suffered head injuries in a September game and died two days later. University of Florida star Tim Tebow was knocked out of a recent game with a head injury and it’s unclear when he might return to play.

A New York Times report found that from 1997 to 2007, head injuries caused deaths to at least 50 football players on the high-school level or younger. And another study has found former NFL players are far more likely than the general population to suffer from dementia.

High school players are vulnerable because their younger brains are at greater risk of serious and long-term injury because the brain tissue is less developed and more easily damaged.

The Illinois Athletic Trainers Association is teaming up with the Chicago Institute of Neurosurgery and Neuroresearch to get the word out about how to diagnose a concussion.

Some states are attempting to tackle the issue through legislation. Washington passed a law in May mandating guidelines for treatment and education for coaches and parents. Several other states are considering a similar law.

Michael Sullivan, trainers association president and athletic trainer at Downers Grove North, said State Senator Bill Brady initiated a meeting on concussions with the trainers association and the Illinois High School Association, but those groups did not recommend pursuing legislation. It would be difficult to implement and enforce, Sullivan said, and many schools would not have the resources to comply.

Instead, the trainers association is trying to get the word out through an informal word-of-mouth campaign and the distribution of an educational wallet card it collaborated with the neurosurgery institute to create.

One side of the card lists the symptoms for athletes (headache, sensitivity to light/noise, sluggish, dizzy, double vision, nausea, memory/concentration problem, change in sleep patterns) and the other displays the warning signs for coaches and parents (forgetful, clumsy, irritability, depression, forgetfulness).

The card can be downloaded at CINN.org.

“We’re trying to get the word out any way we can,” Sullivan said. “We’re trying to educate parents, coaches and kids on the identifiers.”

He said Illinois is typical of a national study that showed only 42 percent of the high schools in the nation have an athletic trainer on staff.

“Even within the Chicagoland area, it’s not 100 percent. Many schools hire an outreach trainer, some for game coverage, some for weekly checks. This is not meant to substitute for an athletic trainer or a physician, but at least this gives people an idea.

“There probably are not enough hours in the day for this kind of a campaign, but we can at least distribute literature that get passed on and get the word out to youth groups,” Sullivan said.

Detecting a concussion can be tricky, especially in a sport where playing with pain and discomfort is ingrained. In Brian Connor’s case, the 2009 Hinsdale Central graduate doesn’t remember feeling any — or anything immediately following a helmet-to-helmet hit in a playoff game last season. After seven plays, a teammate realized he was playing erratically and got Connor removed from the game before any more damage could incur.

“I put my head down on top of his, and the next thing I knew it was seven plays later and I’m waking up and talking to our trainers,” Connor said. “I had no idea I was out there.”

More than 3.5 million sports-related concussions occur each year in the United States, according to the U.S. Centers for Disease Control and Prevention and the Brain Injury Association of Washington. Though much is still unknown about concussions, the number continues to rise. Some schools are taking steps to react more quickly and accurately. Barrington senior Tyler Lindroth took a blow to the head in practice in early August, and before he could try to convince anyone he was fine, his coaches forced him off the field. His concussion came with two weeks of short-term memory loss, but by the end of the month, he was cleared and back on the field.

“Our school is pretty good about education on concussions,” Lindroth said. “I wanted to keep playing but they knew something was up.”

Barrington is one of 52 schools in Illinois that uses computer software from a company called ImPACT (Immediate Post-concussion Assessment and Cognitive Testing). Brain injuries don’t necessarily show up on an MRI or CT scan, but this ‘neurocognitive’ testing has proven effective in determining when an athlete with a concussion has returned to normal. The program provides a baseline test to athletes at the start of the season, which serves as a basis for comparison following a head injury. According to Barrington trainer Kevin Stalsberg, the package of 1,000 baseline tests and 100 post-injury tests costs $1,000.

“We see more concussions here,” Stalsberg said. “We’re managing three to five a week. I don’t know why that is. I’m hoping that it’s because of the education.”

Other schools can’t even afford an athletic trainer, let alone cutting-edge computer software. Harlan is among the Chicago Public Schools that does not have one.

“For football games, we have a medic on duty from the Chicago Fire Department,” said Ted Tines, Harlan’s assistant athletic director. “No one has been formally trained to look for at the signs of a concussion. We just have to go with basic common sense — dizziness, blurry vision, lightheaded. We haven’t had any cases this year.

“The board is limited with the amount of funds. I used to go to clinics, but it’s become a financial issue. Are we getting proper training? No. They would tell you they would like to send us, but it is just a financial issue.”

While some schools can’t afford baseline testing, Joseph Reda, the athletic director at Bloom in Chicago Heights, believes the price tag is reasonable enough to pursue with his board.

“I was expecting to hear 30 grand,” Reda said. “Within reason, nothing is too expensive for our kids.”

From bleacherreport.com

Tim Tebow’s Concussion Recovery: No News Is Not Good News

Reporting on the concussion recovery status of star Florida Gator quarterback Tim Tebow is kind of like trying to go out to brunch on a Sunday afternoon at the only open joint in town.

To begin with, the wait is insufferable.

Standing in line, you find yourself sandwiched between the well to do church goers, the emotionally spent college football crowd, and the NFL fans eager to find a quick cure for hard partying of the previous night.

Once seated you find that the menu contains only one tasteless and unsatisfying entree—“Tim continues to rest and recover. He also undergoes daily testing and we continue to monitor the resolution of his symptoms.”

You eat your bland meal while scanning the faces of the other patrons—hoping to catch a hint of emotion that betrays some element of original thought. You search for anything to help you present this information in a new and interesting light.

But you see none.

You leave feeling empty, cheated, and frustrated. You don’t even want to tip the wait staff.

Such is the world of attempting to report on a sports story when there isn’t much story to report.

The University of Florida has done a credible job in sharing information pertaining to the recovery of Tebow. As frustrating as it is, UF officials have shared only what they truly know and want to share—that Tebow is recovering and that his health is monitored daily.

This week in Gainesville, less is more.

Yes, rumors abound regarding Tebow’s sensitivity to light, his headaches, and his dizziness but that is all expected when you recover from a strong concussion. It’s also expected that he may actually feel a bit worse rather than better as his recovery progresses.

Concussions take time to heal, especially for first timers, and that is a difficult concept to put into a press release or announcement.

But there is something that isn’t being said that speaks volumes.

Knowing Florida head coach Urban Meyer’s love of information control one can wonder if there is an alternative motive behind this trickle of information.

Perhaps the man who owns the ultimate college football poker face is headed to the table against LSU with a load of chips and a pair of fives in his hand.

What we’re not hearing are reports that Tebow is progressing rapidly and that he is taking part in light workouts and passing drills.

We are also not hearing that the Gator football staff expects Tebow to play or start the LSU game this Saturday.

Comments on the offense are on hold with the exception of reports that backup quarterback John Brantley is working hard to prepare for the Tigers.

If one was to guess, that guess might be that Meyer and his staff are drawing near to deciding that Tebow will not be fit to play against LSU. Perhaps that decision has already been made, but not announced simply to keep LSU from focusing on preparing for Brantley.

Who knows?

The end result is that unless something truly tragic befalls Saint Tim, and that is highly unlikely, we will continue to be told that Tebow is recovering well.

Come Thursday or Friday night the veil will be lifted and an announcement will be made. It will be the major story of the day and will preoccupy the college football community until kickoff in Baton Rouge Saturday night.

Today’s money is that John Brantley will get his first start and Tebow will not dress for the game.

A Heisman hopeful is grounded and a new star attempts to shine.

The speculation continues…

From Real Sports Website: Description of concussion program that aired in September 2009.

H.S. Concussions

In the violent world of football, helmet-crushing hits that cause concussions are common. While these injuries often make headlines in pro football, few realize that head injuries at other levels of the game, specifically high school, are occurring at an astounding rate and can have deadly consequences. In the last two years alone, eight kids have died from head injuries and many more have suffered catastrophic injuries following a concussion. REAL SPORTS host Bryant Gumbel takes an in-depth look at the disturbing frequency and deadly hazards of concussions in high school football.

Correspondent: Bryant Gumbel
Producer: Tim Walker

Dementia Risk Seen in Players in N.F.L. Study
By ALAN SCHWARZ
A study commissioned by the National Football League reports that Alzheimer’s disease or similar memory-related diseases appear to have been diagnosed in the league’s former players vastly more often than in the national population — including a rate of 19 times the normal rate for men ages 30 through 49.

The N.F.L. has long denied the existence of reliable data about cognitive decline among its players. These numbers would become the league’s first public affirmation of any connection, though the league pointed to limitations of this study.

The findings could ring loud at the youth and college levels, which often take cues from the N.F.L. on safety policies and whose players emulate the pros. Hundreds of on-field concussions are sustained at every level each week, with many going undiagnosed and untreated.

A detailed summary of the N.F.L. study, which was conducted by the University of Michigan’s Institute for Social Research, was distributed to league officials this month.

The study has not been peer-reviewed, but the findings fall into step with several recent independent studies regarding N.F.L. players and the effects of their occupational head injuries.

“This is a game-changer — the whole debate, the ball’s now in the N.F.L.’s court,” said Dr. Julian Bailes, the chairman of the department of neurosurgery at the West Virginia University School of Medicine, and a former team physician for the Pittsburgh Steelers whose research found similar links four years ago. “They always say, ‘We’re going to do our own studies.’ And now they have.”

Sean Morey, an Arizona Cardinals player who has been vocal in supporting research in this area, said: “This is about more than us — it’s about the high school kid in 2011 who might not die on the field because he ignored the risks of concussions.”

An N.F.L. spokesman, Greg Aiello, said in an e-mail message that the study did not formally diagnose dementia, that it was subject to shortcomings of telephone surveys and that “there are thousands of retired players who do not have memory problems.”

“Memory disorders affect many people who never played football or other sports,” Mr. Aiello said. “We are trying to understand it as it relates to our retired players.”

As scrutiny of brain injuries in football players has escalated the past three years, with prominent professionals reporting cognitive problems and academic studies supporting a link more generally, the N.F.L. and its medical committee on concussions have steadfastly denied the existence of reliable data on the issue. The league pledged to pursue its own studies, including the one at the University of Michigan.

Dr. Ira Casson, a co-chairman of the concussions committee who has been the league’s primary voice denying any evidence connecting N.F.L. football and dementia, said: “What I take from this report is there’s a need for further studies to see whether or not this finding is going to pan out, if it’s really there or not. I can see that the respondents believe they have been diagnosed. But the next step is to determine whether that is so.”

The N.F.L. is conducting its own rigorous study of 120 retired players, with results expected within a few years. All neurological examinations are being conducted by Dr. Casson.

According to a 37-page synopsis of the study furnished to the league, the Michigan researchers conducted a phone survey in late 2008 in which 1,063 retired players — those who participated from an original random list of 1,625 — were asked questions on a variety of health topics. Players had to have played at least three or four seasons to qualify. Questions were derived from the standard National Health Interview Survey so rates could be compared with those previously collected from the general population, the report said.

Some health issues were reported by N.F.L. retirees at normal rates (kidney and prostate problems), while others were higher (sleep apnea and elevated cholesterol) and others lower (heart attacks and ulcers), the summary said.

The researchers also asked players — or a caregiver for those who could not answer — if they had ever been diagnosed with “dementia, Alzheimer’s disease, or other memory-related disease.”

The Michigan researchers found that 6.1 percent of players age 50 and above reported that they had received a dementia-related diagnosis, five times higher than the cited national average, 1.2 percent. Players ages 30 through 49 showed a rate of 1.9 percent, or 19 times that of the national average, 0.1 percent.

The paper itself questioned the reliability of using phone surveys to assess prevalence rates of diagnosed dementia, as did several experts in telephone interviews. For example, some of those affected may not be reachable; then again, N.F.L. players may have greater access to doctors to make the diagnosis. The lead researcher, David R. Weir, said in an interview that proxies might have been handled differently in past studies.

“This suggests something suspicious,” said Dr. Amy Borenstein, professor of epidemiology at the University of South Florida. “But it’s something that must be looked at with a more rigorous study.”

Dr. Daniel P. Perl, the director of neuropathology at the Mount Sinai School of Medicine in New York, agreed with Dr. Borenstein but described the Michigan work as significant. “I think this complements what others have found — there appears to be a problem with cognition in a group of N.F.L. football players at a relatively young age,” he said.

All rates appear small. But if they are accurate, they would have arresting real-life effects when applied across a population as large as living N.F.L. retirees. A normal rate of cognitive disease among N.F.L. retirees age 50 and above (of whom there are about 4,000) would result in 48 of them having the condition; the rate in the Michigan study would lead to 244. Among retirees ages 30 through 49 (of whom there are about 3,000), the normal rate cited by the Michigan researchers would yield about 3 men experiencing problems; the rate reported among N.F.L. retirees leads to an estimate of 57.

So the Michigan findings suggest that although 50 N.F.L. retirees would be expected to have dementia or memory-related disease, the actual number could be more like 300. This would not prove causation in any individual case, but it would support a connection between pro football careers and heightened prevalence of later-life cognitive decline that the league has long disputed.

After the University of North Carolina’s Center for the Study of Retired Athletes published survey-based papers in 2005 through 2007 that found a correlation between N.F.L. football and depression, dementia and other cognitive impairment, a member of the N.F.L. concussion committee called the findings “virtually worthless.”

After initiating a fund in 2007 that provides financial assistance to retirees receiving care for dementia, the league insisted that it was doing so only because the disease “affects many elderly people” well beyond N.F.L. players. And a pamphlet that the league gives every player about concussion risks states, “Research is currently under way to determine if there are any long-term effects of concussion in N.F.L. athletes.”

“It’s time to edit that brochure,” said Kevin Mawae of the Tennessee Titans, the president of the N.F.L. Players Association. “Now it’s in their words and not just other people’s.”

Duke’s Sanford School Hosts Lectures on Global Finance, Health Care

Weekend celebration includes keynote lectures by two public policy leaders

Thursday, September 24, 2009

DURHAM, N.C. — Richard Fisher, CEO of the Federal Reserve Bank of Dallas, and neurosurgeon Gail Rosseau, chief of surgery at the Neurologic & Orthopedic Hospital of Chicago, will deliver keynote lectures during a weekend celebration of Duke University’s Sanford School of Public Policy.                                          
                                                                                        
 Prominent journalists Cokie Roberts of NPR and John Harwood of CNBC will engage the lecturers in conversation. Both events are free and open to the public.

The talks are part of a series of events marking the Sanford School of Public Policy’s inaugural year. The former institute became Duke’s 10th school on July 1.

“A year ago, the nation was staring straight into the jaws of economic ruin,” Fisher said in a recent address. “The Federal Reserve stepped into the breach and did what central bankers are called to do: We assumed the role of lender of last resort … instituting unconventional measures to keep the financial lungs of the global economy from collapsing.”

“Policy experts have a very valuable role to play, and their counsel must be in partnership with the people in the trenches putting policy into action,” said Rosseau, who regularly witnesses the consequences of flaws in the current U.S. health care policies through her practice.