CJSM Podcast 7: Chris Nowinski

jsm-podcast-bg-1Our second podcast of the year focuses on the on-going sport ‘concussion crisis,’ a topic we have explored in previous podcasts with guests such as Drs. Cindy Chang and Matt Gammons of the American Medical Society for Sports Medicine (AMSSM) and Drs. Oliver Leslie and Neil Craton of the Canadian Academy of Sport and Exercise Medicine (CASEM/ACMSE).


Chris Nowinski

We’re happy to have Chris Nowinski as our guest for this podcast.  He is the author of Head Games, the co-founder and chief executive officer of the Sports Legacy Institute, and a published author in the pages of the Clinical Journal of Sport Medicine.

Our conversation ranged from the issues of underreporting of brain injury in sport to the use of helmet sensors in helmeted sports to identify possible concussive and sub-concussive hits; from youth football to elite soccer, and more.

We appreciate the time Chris gave us from his busy schedule, and we hope you enjoy the conversation.  Share with us your comments–here on the blog or on our twitter feed, @cjsmonline.


Like Turkey & Gravy: Thanksgiving and the NFL


Male turkey, photo courtesy of Nordelch.

Yep, they ‘go together’ …..well, maybe not like “….rama lama lama ka dinga da dinga dong,” but the fit is surely as tight and traditional as turkey and gravy.

Today is Thanksgiving; I have the day off; and I’ll be sitting down for a feast, both of food and of football.

The day is loaded with gridiron football:  Lions v. Bears, Cowboys v. Eagles, and Seahawks v. 49ers. The colleges, too, have some intriguing games:  can TCU win and perhaps leap into the top 4 of the college football playoff standings?

Whether or not you are a fan of their respective teams, who can’t get interested in the rivalry between Pete Carroll and Jim Harbaugh, which extends back to their days at USC and Stanford.

“We bow to no man, we bow to no program at Stanford football,” said Harbaugh.  And the two men–and programs they run–continue to go after each other at the professional level. The Seahawks/Niners game should be a good one.

Yes, it will be a great day to enjoy football.

It sure has been a difficult season to do the same.

The New York Times ran a very interesting piece in their Sunday magazine earlier this month:  “Is Football the Next Tobacco?” speculating on whether NFL quarterback will go the way of, well, the Marlboro Man.  America, the magazine of the U.S. Jesuits, also ran a thoughtful piece on ‘what will become of football.‘  And going from the angels to the devils, so to speak, the journalists at Vice sports wrote what I think is a very insightful analysis of what they term the ‘concussion-industrial complex.’  The author echoes many of my concerns over the nexus of sport/injury/fear/business that sports-related concussion has come to represent in modern sport.

Even Saturday Night Live has riffed on the subject, with a very funny segment that aired last week and lampooned several aspects of the ‘concussion crisis.’

On the evidence-based, sports medicine side, we continue to contribute to the conversation over how best to diagnose and manage concussions in our athletes.  In our most recent, November journal, we have a Letter to the Editor from the former President of CASEM Pierre Fremont which addresses concerns over an earlier editorial in CJSM on whether it is time to re-think the Zurich consensus statement and guidelines on concussion.  We were able to interview the authors of that statement in our first podcast; that would make an enjoyable listen for this holiday weekend.  And don’t forget to check our “Published On-Line First” section of the journal’s website, which includes a queue of original research articles that are lined up to be published in print in 2015….but can be viewed right now on-line.  The offerings include a study with important findings on what is special about pediatric concussions by Johna Register-Mihalik et al.

The topic of concussion comes up frequently in the blog as well, of course.  Our review of the television documentary, “League of Denial,” is just one of the many posts we have written on sports-related concussions over the last few years.

Football and feast:  whether you are enjoying this Thursday as the Thanksgiving holiday in the United States, or getting closer to your weekend elsewhere…..I hope you all have a restful and safe few days ahead of you.  For all of us here at CJSM, I can tell you this Thanksgiving how thankful we are to have you engaged with this journal in advancing the research into the health and safety of the athletes we al care for.

All the best.

New Concussion Research from CJSM


claire and katie

With the dog days of summer come concussions. And with concussions come research!

I think of August as the ‘lull before the storm':  with the dog days of summer come two-a-days in American football.  Around the country, the school  fields fill with kids playing the most popular contact sport in the U.S.:  football, to an American; ‘gridiron football’ to the rest of the world.

And with these days we begin, in our clinics, to see a steady, inexorable rise in the number of concussions to be evaluated. By mid-September, we can’t seem to open enough clinic space to see everyone clamoring to get in.

Last year, at this time, I wrote a post on the freely available concussion offerings we have at CJSM, and I am re-posting that entry(see what follows this new entry, below) for folks to read and see what we have in store when you visit the main website.

Over the past year, we have published many additional research articles, some of which are in the print queue and only available on line.  I wanted to draw your attention to a couple of those offerings, as they have real, clinical impact on the way we may practice.

The authors Carrie Rahn, Barry Munkasy, Barry Joyner et al.  looked at the BESS test as performed on the sideline of actual events, and found that the test performance deteriorated when compared to more controlled environments.  They conclude that ” Clinicians need to consider the role of the local environment when performing the BESS test and should perform postinjury tests in the same environment as the baseline test.”

And a very interesting article with a group of authors including Bob Cantu and Chris Nowinski looked at the efficacy of concussion education programs and determined:  “Preseason concussion knowledge was not significantly associated with in-season reporting behavior. Intention to report concussion symptoms was significantly related to in-season reporting behavior.”   Important to the understanding of this article is their discussion on the psychosocial construct of ‘reporting intention.’  As ever, one finds in the realm of public health that education alone is unlikely to alter behavior.

Read these studies: “Sideline Performance of the Balance Error Scoring System During a Live Sporting Event” and  “Concussion Reporting Intention:  A Valuable Metric for Predicting Reporting Behavior and Evaluating Concussion Education,” by Emily Kroshus, Christine Baugh, Daniel Daneshvar, et al.

There’s a lot to learn!



Originally posted on Clinical Journal of Sport Medicine Blog:

We’ve been profiling sports-related concussions (SRCs) in the August posts here on the CJSM blog.

We’ve taken a peek at the use of computerized neurocognitive tests in the diagnosis and management of SRCs; conducted a poll on the entity known as “Second Impact Syndrome”; and interviewed Dr. Jason Mihalik of the University of North Carolina, who is one of the principal developers of a celebrated app helping laypeople identify when an athlete might be concussed.

In this post, I wanted to alert the readership to a special set of journal articles CJSM is releasing for free for a limited time, a set devoted to this issue of SRCs.

chris hughes 2 No, that’s not “Big Brother,”
that’s the CJSM Editor-in-Chief,
Christopher Hughes MBBS, MSc

Our Editor-in-Chief, Dr. Chris Hughes, describes the special collection of ten journal articles in this YouTube video.

I am very excited to pass this…

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Published On-Line First


What we once dubbed ‘Published Ahead of Print’ (PAP), we now call ‘Published On-Line First‘ (POLF???). Whatever the phrase or acronym, I can attest to the benefit as an editor, a reader, and an author.  The publication flexibility that publishing on line provides is extraordinary.  We get many excellent manuscripts submitted for consideration.  The few that make it through our rigorous peer review must then wait in the queue to get on the actual pages of the journal; and so, with publishing on line, we can make the authors’ scientific findings available immediately, even before we have copy on paper.  The articles are immediately found on PubMed and are citable with their unique digital object identifier (DOI) number.

As a reader, I enjoy this functionality.  I rarely get my medical information any more from paper.  I still receive CJSM and other journals (Sports Health, JAMA, MSSE, etc.) in the mail.  I might page through them as I eat breakfast; I will have them on my nightstand to skim prior to sleep.  But most of the time, I am reading my medical journals on the laptop or iPad.  Or I’m sharing a link to a study with someone on twitter.  All of this can only be done with an on-line publishing functionality.  It’s brilliant.

Finally, as an author:  it is always exciting to get your manuscript through peer review.  Always exciting to see the months to years of hard work culminate with an accepted manuscript.  Historically, one would then wait for some time before actually seeing the manuscript in print.  Now, once a CJSM author has completed their post-acceptance corrections, reviewed the galley proofs, and so on, their work can be disseminated immediately.  As an example, here is a recent bit of excitement I just had as an author in the pages of CJSM: ‘Reliability of a computerized neurocognitive test in baseline concussion testing of high school athletes.’ 

I am off on vacation, and so I thought I would share a post on PAP from 2013.  More soon!

Originally posted on Clinical Journal of Sport Medicine Blog:

Time to time, I like to share with readers of this blog some of the features of CJSM with which they may not be familiar.  Our journal’s website has a wealth of resources that I’d encourage you to check out regularly.

For instance, besides publishing the full journal every two months, we frequently disseminate breaking sports medicine research in a more fluid, continuous fashion via our “Published Ahead of Print” (PAP) feature.  PAP allows us to pursue a major goal we editors have:  to contribute to the world of clinical sports medicine in a contemporary fashion, taking advantage of the multi-media offerings of the digital world.   This goal is reflected in this blog itself; in the podcast feature we have just begun; in our engagement with you on social media; and in the journal’s iPad functionality.

“When you want it….where you want it…the way you want it.”  That’s…

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