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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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

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).

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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.

Enjoy!

Like Turkey & Gravy: Thanksgiving and the NFL

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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.

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