SportsLetter

Guidelines for managing concussions in sports

SportsLetter has been harping on sports head injuries for the past several weeks, but enough with the think pieces and news stories.  What are some practical measures that coaches, parents and athletes can take to deal with concussions in sports?  For comprehensive advice for medical non-professionals, we suggest the Center for Disease Control’s youth sports concussions toolkit.  You also may want to check out the concussion management guidelines of the National Federation of State High School Associations.

The NFL makes a move on concussions

In recent weeks the NFL has been under pressure to address the alarming number of concussions in its game, and to recognize its influence on the way coaches and administrators handle head injuries at the youth level.

The NFL has responded to the demand for action, as outlined in a communiqué from Roger Goodell to club officials:

The NFL plan includes the development of publication information campaign aimed at the youth game. 

Here is Commissioner Goodell’s statement.

"We have undertaken a series of initiatives that will enhance the substantial progress we have made in recent years in concussion-related matters," said Commissioner Goodell in a memo to NFL clubs. "Our goal remains to make our game as safe as possible, protect the health and safety of our players, and set the best possible example for players at all levels and in all sports."

The memo lists steps the NFL has taken as well as other items still under consideration:

First, the NFL is strengthening and expanding the membership of its medical committee that has studied the subject of concussions and overseen concussion-related research for the past 15 years. The current co-chairmen, Drs. Ira Casson and David Viano, have resigned from those positions and will continue to assist the committee. The NFL is currently identifying their replacements and additional members who will bring to the committee independent sources of expertise and experience in the field of head injuries.

"I appreciate the valuable contributions of Drs. Casson and Viano and their commitment to the committee and to NFL players," said Commissioner Goodell.

Second, each club is identifying local neurosurgeons or neurologists who will be available to provide an independent "second opinion" in cases involving players who have had a concussion and been removed from a game or practice. Before these players return to practice or play, they must be evaluated and cleared by both their team doctor and the independent neurologist or neurosurgeon. The NFL and the NFL Players Association medical advisor are reviewing the expertise and qualifications of, and approve, each doctor proposed for this role.

Third, members of the NFL Competition Committee are continuing to evaluate potential changes in playing rules that are intended to reduce head impacts and related injuries in a game setting. Commissioner Goodell met yesterday with Committee co-chair Rich McKay and reviewed specific types of plays for that purpose.

Fourth, John Madden, in his role as special advisor to the Commissioner, is chairing a committee of coaches that is exploring ways of providing players with a safer environment that would reduce the risk of head trauma on non-game days. Among the considerations are reducing the overall amount of offseason work, and/or limiting the use of helmets (and therefore contact) in practice, minicamps, OTAs, and training camps. Madden’s group will report its recommendations to the Competition Committee and Commissioner Goodell.

Fifth, in conjunction with the Centers for Disease Control (CDC), the league has developed an NFL public service message directed primarily at young athletes and their parents and coaches on the importance of head injury awareness. It will debut on the air on Dec. 10. In addition, the league also is working with the CDC and other organizations to distribute educational material to young athletes and high school coaches, and to develop an overall certification program for coaches at those levels addressing player health and safety.

Sixth, as part of its continuing educational effort, the NFL will hold another medical conference in Washington, D.C., in June 2010 on concussions for team medical staffs and representatives of the NFLPA, similar to the conference that took place in Chicago in 2007. The NFL will again invite leading doctors and scientists to present the most current information regarding this injury. Club medical personnel will be required to attend.

Seventh, the NFL will continue to invest in research designed to improve equipment safety and will urge players to make informed choices regarding the use of the most technologically advanced helmets.

Commissioner Goodell told the clubs that these developments are the latest in a series of steps in recent years that have improved player safety, especially relating to concussions and other head injuries. He said he expects to advise them in the near future of additional steps that he has identified. These steps include new medical guidelines and research directed at the issue of long-term effects of concussions.

"Our game today is played with the understanding that medical decisions must always take priority over competitive interests," added Commissioner Goodell. "As a result, our sport is safer than it was previously. But we always strive to do better and the steps announced today will enhance the substantial progress we have made in recent years."

Coach Mom

Drive by any field where girls are participating in sports and more often than not you’ll see men coaching the girls.  Where are the women coaches?  It’s an issue author Michael Messner explored in his book "It's All for the Kids: Gender, Families, and Youth Sports:”

… why, in this day and age, do we see so few women coaches in youth sports?  Why is this happening now, despite the fact that many women today are post-Title IX mothers who have a lot of athletic experience and whose own daughters are now playing sports? 

Emilie Liebhoff, founder of Moms as Mentors and the Director of Strategic Initiatives at the National Coalition of Girls’ Schools, wondered the same thing in a short piece on fairgamenews.com by asking, “Where are the moms?” 

Contrary to popular belief, you can coach even if you haven’t played the sport. And – truly – your participation matters.  Just in case you need the nudge, here are six reasons why it’s beneficial for your daughters to see you coach:

1.    Doing something together other than shopping at the mall is a fun and alternative way to bond.

2.    She will see you as a whole new person (not just the one upset by the messy room) including as a skilled sportsperson, something we value in our society.

3.    You will feel important and proud of yourself – particularly if it’s a new sport for you.  (Note: When you feel good, your daughter will notice!)

4.    You can share firsthand in your daughter’s accomplishments as an athlete, plus she’ll develop her own self-confidence by wanting to show off her skills!

5.    Learning about your daughter’s sport allows you to be an educated fan and cheerleader.  Dads need not have a monopoly on sports knowledge and when you can talk about the passing game or staying goal-side when defending, she’ll notice.  It will take you from mom role to mentor role.

6.    Mothers can make great mentors, especially when daughters pursue sports.  And the benefits can go both ways. Getting involved in your daughter’s sport may inspire you to ramp up your own activity level. It can be an opportunity to get back to something you love or to redefine yourself!

You can leave your hat … off?

The hottest off-the-field topic this football season is head injuries in the sport, and the post-career problems they pose.  In the course of the debate, Congress has involved itself and the NFL has defended itself.  And the concussions continue.

In the midst of the hue and cry, an article in today’s Wall Street Journal asks a simple question:  Do the players have to wear helmets?  If one of the leading causes of concussions are so-called “helmet-to-helmet” hits, does it stand to reason that if helmets are removed from the equation, players can’t use them as weapons, thus limiting their exposure to head injuries?  Andrew McIntosh, a researcher at Australia's University of New South Wales, thinks so:

One of the strongest arguments for banning helmets comes from the Australian Football League. While it's a similarly rough game, the AFL never added any of the body armor Americans wear. When comparing AFL research studies and official NFL injury reports, AFL players appear to get hurt more often on the whole with things like shoulder injuries and tweaked knees. But when it comes to head injuries, the helmeted NFL players are about 25% more likely to sustain one.

Andrew McIntosh … says there may be a greater prevalence of head injuries in the American game because the players hit each other with forces up to 100% greater. "If they didn't have helmets on, they wouldn't do that," he says. "They know they'd injure themselves."

Dhani Jones, a linebacker for the Cincinnati Bengals who has played rugby, too, says head injuries in that sport do happen, but they're mostly freak accidents. "In football, you're taught to hit with your face," he says. "You're always contacting with your 'hat,' which is your head."

Taking away helmets might have other benefits for the sport. It would bring down the cost of equipment, which can be crippling for some schools. A slower game might also be more palatable to some parents.

McIntosh’s point is interesting.  It should be noted, however, that there are several rule differences between American and Australian football that also account for fewer head injuries.  And even with those rule differences, a 25% greater chance of head injury doesn't seem a significant enough factor to get American football administrators to make such a drastic change to the game.

Perhaps a similar study of rugby injuries might be in order.

SL Interview: What does it takes to be a cheerleading champion?

"Blood, Sweat & Cheers" is a new documentary film that explores the culture of competitive cheerleading.  The movie follows Pop Warner cheerleaders from Burlington, Mass., as the girls in the junior midget division (ages 10 to 13) seek to win the national championship.  The team has finished second for three consecutive years; this will be the final opportunity for the oldest members on the squad to taste victory.

In "Blood, Sweat & Cheers" (Award Productions / Amazon), cheerleading is shown to be part-sport, part-competition. At the elite level of Pop Warner, teams vie in regional competitions to qualify for nationals.  Coaches spend hours breaking down tape so they can design and implement the most innovative and daring two-and-a-half-minute routines.  The girls endure hours of grueling practices in order to master elements of gymnastics, intricate tumbling, syncopated athleticism and teamwork.

Cheerleading, the film shows, is not for the faint of heart, with the more dangerous maneuvers involving daredevil leaps, throws and flips.  The film notes that a ninth-grader from a neighboring town died from injuries after falling while performing a stunt.  Indeed, in a recent story in the Los Angeles Times, journalist Melissa Rohlin wrote that "cheerleading injuries resulting in emergency room visits have increased almost sixfold since 1980, to nearly 30,000 in 2008, the U.S. Consumer Product Safety Commission reported."

SportsLetter recently spoke with Laura Molta, the president of Molta Media and the producer of "Blood, Sweat & Cheers."

--David Davis

Mascot

Chip

Way back in March 2008 SportsLetter reported on the surprising loss of Michigan State’s Sparty to Tennessee’s Smokey at the 2008 Universal Cheerleading Association National Championships.

Well, with the January excitement of the BCS Bowl Games, the Australian Open and the beginning of college basketball’s regular season, SportsLetter just plumb forgot to report the results of the 2009 contest.  Consider that oversight rectified.

The 2009 Universal Cheerleading Association/Universal Dance Association College Cheerleading and Dance Team National Championships were held in January at Walt Disney World's Wide World of Sports Complex (soon to be the ESPN Wide World of Sports Complex).  In the Division 1A Mascot competition, former champs Sparty and Smokey placed 4th and 5th respectively.  Second and third place went to Aubie (Auburn) and Goldy Golpher (Minnesota).  And, your 2009 mascot champion, from the University of Colorado: Chip!

YoUDee, from the University of Delaware, took the Open Mascot competition. 

Finally, SportsLetter wasn’t there to judge, but … really, Sparty?  What’s up with the Captain America underpants?

 

The 2010 College Cheerleading and Dance Team National Championship will be held on January 15 - 18, 2010.  SportsLetter won’t let you down. 

Well, probably not.

But, if your cheerleading competition Jones can’t wait, maybe a trip to Bremen, Germany is in your near future.  The International Federation of Cheerleading’s 5th Cheerleading World Championships will be held in that historic German city November 28th and 29th. 

According to IFC President Setsuo Nakamura: “IFC and the local organizing committees expect upwards of 20 countries from all corners of the globe to participate and create a unique opportunity for cultural exchange and further cement the reputation of cheerleading as a serious global sport.”

Rah!

Malcolm Gladwell on football and dogfighting

Malcolm Gladwell, author of The Tipping Point and Outliers, in the October 19, 2009 New Yorker examines brain trauma in football and poses the question: How different are dogfighting and football?

Football players and fighting dogs, notes Gladwell, suffer serious injury and even death in an activity staged for the enjoyment of spectators. In both football and dogfight, “gameness” or “courage and grit” are highly prized.

Gladwell’s attempt to liken football to dogfighting is undermined by the obvious point that football players, unlike dogs, have some choice in whether to particpate or not.  Nevertheless, his discussion of the potential dangers of playing football is worth reading.  Gladwell refers to the work of Kevin Guskiewicz, who runs the Sports Concussion Research Program at the University of North Carolina.  He writes:

For the past five seasons, Guskiewicz and his team have tracked every one of the football team’s practices and games using a system called HITS, in which six sensors are placed inside the helmet of every player on the field, measuring the force and location of every blow he receives to the head. Using the HITS data, Guskiewicz was able to reconstruct precisely what happened each time the player was injured.

Gladwell goes on to describe the experience of one lineman on the team.

"The first concussion was during preseason. The team was doing two-a-days," [Guskiewicz] said, referring to the habit of practicing in both the morning and the evening in the preseason. "It was August 9th, 9:55 A.M. He has an 80-g hit to the front of his head. About ten minutes later, he has a 98-g acceleration to the front of his head."

To put those numbers in perspective, Guskiewicz explained, if you drove your car into a wall at twenty-five miles per hour and you weren’t wearing your seat belt, the force of your head hitting the windshield would be around 100 gs: in effect, the player had two car accidents that morning.

When we think about football, we worry about the dangers posed by the heat and the fury of competition. Yet the HITS data suggest that practice—the routine part of the sport—can be as dangerous as the games themselves.

When Guskiewicz reviewed data for the first day of training camp he discovered that the lineman had been hit in the head 31 times.  His concussion seemed to be the result of cumulative blows to the head.  "This is a crucial point," Galdwell contends.  The problem, according to concussion specialist Robert Cantu, is repetitive subconcussive trauma, "not just the handful of big hits ... It’s lots of little hits, too."

Gladwell estimates that a 10-year NFL lineman, when high school and college careers are factored in, probably has been hit in the head 18,000 times … “that’s thousands of jarring blows that shake the brain from front to back and side to side, stretching and weakening and tearing the connections among nerve cells, and making the brain increasingly vulnerable to long-term damage.”