There Be Monsters

sportingjim:

As I prepare for the 2015 OSU Sports Medicine Concussion Symposium (I am in front of my computer working on my Powerpoint Presentation), I am reminded of the post I penned exactly a year ago and am re-blogging today. Attending the 2014 symposium I shared my thoughts (see below) about the future of contact sports in our new world of concussion concern.

The intervening year has seen a veritable slew of new research and new thought on the attendant problems.  In our March 2015 CJSM, for instance, we have an editorial by Iain Murray on the need for a ‘culture change’ in sports concussion and several pieces of original research, including a study on the detection of concussion using cranial accelerometry.

I am looking forward to what co-panelists in the symposium have to say, including Stan Herring, who wears among many other hats that of co-author of the Zurich 4th International Consensus Statement on Concussion in Sport.  I am thankful to my friend Jim Borchers, the course co-director and Team physician for the Ohio State Buckeyes, for the chance to talk as well.   I’ll be sure to post the high points of the symposium, both here on the blog and on Twitter @CJSMonline

Originally posted on Clinical Journal of Sport Medicine Blog:

“In like a lion, out like a lamb,” that’s what they say about March.

To the extent that expression applies to the weather this month and to this blog, I think 2014 may be the exception that proves the rule!  We may be going out like a lion in both areas.

The east coast of North America is ready for spring, but this month that opened up with winter is ending the same way.  If there was an outdoor lacrosse game in Buffalo, New York this weekend, the players were dealing with snow!

Mike_Fisher_throws_check_May_29_2006 More like a lion than a lamb: an NHL body check.

As for this blog, we opened the month with a post that had both sound and teeth, like the proverbial carnivore itself:  our first podcast was a discussion with Drs. Neil Craton and Oliver Leslie, the authors of the March 2014 CJSM lead editorial, 

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Death Valley: The ‘Baddest’ Sports Venue in the USA

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Dunes in Death Valley National Park

I’m on spring vacation with my wife and children in, naturally, Death Valley.

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Lounging in the Dead Sea

While other folks seek their spring sun and sand dunes by the oceans, I have taken my family out to the hottest, driest, lowest area of the United States:  Badwater Basin is fully 282 ft (86m) below sea level.  The only place on this planet I’ve been ‘lower’ is the Dead Sea in Israel.

Hey, the Dead Sea:  combines desert and water.  That could be Spring Break Destination 2016!

In truth, I’ve been intrigued by such places my whole life.  The fascination may resemble that which grips some members of the sporting community:  those desirous of  scheduling endurance events in some of the more inhospitable places on the planet.

There is the Hotter ‘N Hell 100, which takes place Aug 29 2015 in Wichita Falls, Texas–not a place one normally goes at that time of year, and certainly not a place one normally goes to bike a century:  the average daily high is 96.6 F (35.9 C)!

And, of course, there is the famous Badwater 135, which takes place in Death Valley itself.  After a one year hiatus, it returns this year and will be run July 28 – 30.  A 135 ultramarathon run at the hottest time of the year in Death Valley!  No wonder the event bills itself as “the world’s toughest foot race.”  (there’s competition for that moniker; the Marathon des Sables, held in the Sahara desert, would quibble over this issue I’m sure)

There is some great sports medicine research that comes out of these very human attempts to push the limits. Read more of this post

A Blue Card for Rugby

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“All Blacks Haka” by Sonya & Jason Hills from London, UK

Rugby is wildly popular in New Zealand, and that’s no news for anyone who follows sports.

It may be less appreciated how much medical research on rugby and other sports comes from the Land of the Long White Cloud.  The University of Otago in Dunedin, for instance,  conducts a good amount of research on sports medicine in general, and on concussions in particular.  Recently, the University hosted a conference entitled ‘Understanding sports concussion:  facts and fallacies.’

Our intrepid reporter from New Zealand, Dr. Hamish Osborne, is on the editorial board of CJSM and has previously done some guest blog posts when he was attending the annual ACSP conference in Australia.  He was one of the faculty at the Otago lecture and I asked him to share with us any of the important topics addressed .  What follows is the current breaking news on how NZ Rugby is managing concussions.  Thanks Hamish!

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New Zealand Rugby Rolls out Concussion Blue Card (Dr. Hamish Osborne)

New Zealand rugby has approved the rollout of the “Blue Card” system to all levels of rugby in New Zealand with the exclusion of the professional programs.  Soccer has the yellow and red cards systems for misdemeanors. Rugby has a similar system for misdemeanors. The Blue Card will be shown to anybody who leaves the field or is required to leave the field for a suspected concussion.

Under the present rules of the game “an athlete with any symptoms following a head injury must be removed from playing or training. It is then recommended that a player is referred to a medical professional for diagnosis and guidance, even if the symptoms appear to have gone They must not return to activity until all symptoms have cleared.”The International Rugby Board (now known as ‘World Rugby’) regulation 10 New Zealand Domestic Law Safety Variation says that any player in New Zealand who has been concussed or suspected of being been concussed must follow IRB regulation 10 and the IRB concussion guidelines and clearance to return to play by a medical practitioner must always be obtained.2

Until now there has no been no paper trail to confirm that these rules are abided by. Read more of this post

Rugby’s Big Year(s)

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Sam Boyd Stadium, Las Vegas Nevada, site of the annual Rugby 7s tournament.

It’s amazing how time flies.  How is it already March?

It’s almost 7 p.m. and I’m writing by the light of a sun that is still above the horizon, thanks to one of my favorite inventions of the modern world: daylight savings time, which arrived last night.

This realization is a personal reminder, however, that I have been delinquent: meaning to write a blog post about an event that took place three weeks ago…..but, my oh my, business has just swamped me, I guess.

As the swallows return annually to San Juan Capistrano, so do the Rugby 7 squads of Kenya, South Africa, New Zealand and other countries come each February to the desert:  Las Vegas hosted the USA leg of the HSBC Sevens Series Feb 13 – 15.  It is the largest annual rugby tournament held in North America. and Las Vegas has been its host since 2010.

As followers of the blog will know, USA Rugby conducts an outstanding medical symposium every year just prior to the tournament, and I was out for some education as well as sport.  It was a fabulous conference, and I do hope you all get a chance to attend some day.

Tim Hewett, who is well known to readers of this blog, gave a great talk on original research of the difference in injury rates between collegiate rugby and American football players.  We are most definitely looking forward to seeing that research published.  Hey, Tim, if you’re looking for a place to send that manuscript for peer review, send it our way.

His colleague from Ohio State, the orthopaedic surgeon and OSU Team Doc Chris Kaeding, gave a great talk as well, regarding data on knee outcomes coming out of the ‘Multicenter Othopaedic Outcomes Network,’ or MOON group, some of whose research we have published in CJSM.

With the George North story on everyone’s mind, we were all eager to hear what concussion experts such as Chris Nowinski of the Sports Legacy Institute had to say about minimizing injury risk in rugby.  Nowinski presented one of the best and most nuanced talks I have heard on the ‘concussion crisis’ in sports. I enjoyed it so much I caught up with him after the conference, and the interview I had with him is now available as a podcast. Read more of this post

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