Concussions in Professional Football

It’s a new year and we have a new podcast to add to the growing collection of CJSM podcasts which can be found on our main website [or, better yet, by subscribing to our podcast feed on iTunes].

Our guest this month, J. Scott Delaney M.D., is an Associate Professor and the Research Director, Department of Emergency Medicine, McGill University Health Centre (MUHC) and McGill Sport Medicine Clinic in Montreal, Canada.

Scott Delaney, M.D.

He is also the physician for several university and professional teams, including the Montreal Alouettes of the Canadian Football League (CFL).  In that role, he headed research on concussion awareness among professional football players, work that has just been published in the January 2018 issue of CJSM.

The study has already received considerable media exposure as it sheds light, at the highest level of play, on the behavior and motivation of athletes to report possible concussions.

Listen to the podcast conversation we just had with Dr. Delaney.  Find out why, when it comes to concussions, “It takes a village to make the diagnosis.”  And, as ever, join in the emerging conversation about this work by making comments on this blog or going to our Twitter feed and chatting up @CJSMOnLine

 

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In the News

CFL Players line up in a Grey Cup Game. Photo: Wikimedia

The year has begun and our first edition of the 2018 journal has published: the January issue marks the beginning of our 28th year focusing on the publication of original research in the field of sports medicine.

One of the highlights of this issue is a study of 454 Canadian Football League (CFL) players:  “Why Professional Football Players Chose Not to Reveal Their Concussion Symptoms During a Practice or Game.”

The lead author of the study, J. Scott Delaney MDCM is an associate professor and research director at the department of emergency medicine, McGill University Health Center, in Montreal Canada.  He has published frequently in CJSM on the topic of concussion, including a 2015 study looking at what factors influenced university athletes to report (or not) symptoms of concussion in practice or games.

In this study, he and his team focused on a different population: professional CFL players. Dr. Delaney is already being approached by media outlets for his opinions on what the study results mean for CFL players in particular, and for all athletes in general. This very day he has an opinion piece published in The Globe and Mail, often considered Canada’s national paper of record.

One of the vexing issues in contemporary sports medicine is the failure of recognition of concussion when it occurs on the field of play.   Read more of this post

Disparities in sports medicine health care

Most days of the week I see my pediatric sports medicine patients in two very different clinics:  one is within the inner city of Columbus, Ohio itself; and one is in the foothills of Appalachia, a region described in the recent bestseller, Hillbilly Elegy.  Among the patients I frequently see, I have many who could be described as urban poor (the former location), and many as rural poor (the latter).

In my care of these patients, I frequently see them (and their families) struggle with several barriers to excellent care — these range from financial issues, to issues of transportation and distance traveled, to issues of understanding related to educational levels, to a relative lack of resources at their home schools or clubs (e.g. no certified athletic trainers).  I feel at a great loss, at times, in trying to help them achieve the same results I would want for any of my patients.

I read with great interest then, in the November 2017 CJSM, a newly published, original research study: Disparities in Athletic Training Staffing in Secondary School Sport: Implications for Concussion Identification.  I found it so impactful, that I wanted to talk with the author — and so I tracked down Emily Kroshus ScD, MPH for this episode of the CJSM podcast.

Dr. Kroshus is a Research Assistant Professor of Pediatrics at the University of Washington, who is developing a body of academic work that focuses on “….identifying social and contextual determinants of help seeking behaviors, with an overarching interest in addressing disparities related to gender, race, sexual orientation, and socioeconomic status.”(1)

I hope you are as interested in this sort of research as much as I am.  So take a listen to the podcast on iTunes or go to the CJSM website for the podcast (look for the radio button) and the study itself.

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(1) Dr. Kroshus’ biography can be found at the University of Washington faculty page:  https://depts.washington.edu/uwgenped/directory/emilykroshus

It’s a long way from Boston to Denver — 5 Questions with David Howell

David Howell, alongside one of many of the research posters he has produced

When I now think of my friend, David Howell, I have this beautiful John Denver song in my head:

It’s a long way from LA to Denver
It’s a long time to hang in the sky
It’s a long way home to Starwood in Aspen
A sweet Rocky Mountain paradise
Oh, my sweet Rocky Mountain paradise

Granted, David just moved to Denver from Boston, not LA, but I can’t separate the melody from his journey, and the visions I have of him hanging out in the Rockies…..

David Howell PhD, ATC–and the team of researchers with whom he most recently worked at Children’s Hospital, Boston–has been one of the more prolific authors for CJSM in the last several years.  This summer, he moved to Children’s Hospital, Colorado, where he continues the pioneering research into kids’ sports safety that has been the hallmark of his career.

As lead author of two recently published CJSM studies, he was a natural interview for this, our most recent blog post and contribution to the recurring “5 Questions with CJSM” column.

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1) CJSM just published your new study, “Near Point of Convergence and Gait Deficits in Adolescents after Sport-Related Concussion.”  What would you state are the most important, new contributions to the literature your team made with this study?  And are there specific take-home points that the practicing clinician can use in their assessment of concussed teenagers?

DH: The idea of combining visual and gait-based measures in patients with a concussion was a result of an interdisciplinary collaboration. I was fortunate to work alongside colleagues from optometry/ophthalmology (Aparna Raghuram PhD, OD, and Ankoor Shah, MD, PhD) and sports medicine (William Meehan, MD and Michael O’Brien, MD) on this study. Based on our discussions, we were interested in the value and association of instrumented gait measures and vergence measures, since both have documented value for use within concussion evaluations. Additionally, both tests were relatively easy to administer within the sport concussion clinic at Boston Children’s Hospital. Read more of this post

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