The @MomsTeam Summit in Boston #PlaySmart

September 21, 2014 by 1 Comment

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Dr. Brian Hainline, Chief Medical Officer for the NCAA, discussing how to ensure the physical and mental health of youth athletes.

It truly was inspiring being part of a special day of talk and action that took place on Monday.  As I wrap up my work week (condensed into a few busy days after flying back home to Columbus, OH from Boston, MA) I now have the time to reflect a bit on the day.

MomsTeam Institute hosted a summit at Harvard Medical School, “SmartTeams Play Safe™: Protecting the Health & Safety of the Whole Child In Youth Sports By Implementing Best Practices,” and I was honored to be one of the speakers.

I’ve written about MomsTeam, a non-profit organization implementing best practices in youth sport safety, before; but I don’t believe I’ve ever shared with you what a strong band of clinicians and researchers comprise the group.  Monday, many of my fellow speakers formed a veritable ‘Who’s Who’ of sports medicine, and to a person they gave some wonderfully memorable talks:  ranging from Doug Casa speaking broadly about the subject of heat injury prevention in youth sports  to Brian Hainline, the NCAA’s Chief Medical Officer, to Holly Silvers-Granelli who spoke about ACL prevention in female youth athletes, emphasizing neuromuscular training programs (a subject which is central to one of our CJSM podcasts), and Tracey Covassin who spoke about gender differences in concussions.

A particularly poignant moment came when Dr. Hainline had us watch the video from Designed to Move, a “Physical Activity Action Agenda.”   Read more of this post

Filed under General Interest, Psychology in Sport, Public Health in Sports and Exercise Medicine, Youth Sport Tagged with , , , , ,

New Concussion Research from CJSM

August 11, 2014 by

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!

 

 

sportingjim's avatarClinical 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…

View original post 291 more words

Filed under Concussion in Sport, General Interest, Public Health in Sports and Exercise Medicine Tagged with ,

The World Cup Final and More

July 13, 2014 by 4 Comments

Maracana_Stadium_2013

Maracana Stadium, site of the 2014 final….and site of more medical controversy?

At last. we have reached the final game of the 2014 FIFA World Cup.  Who will be crowned the victor, Argentina or Germany?  We will soon find out.

There has been plenty to write about and talk about in this tournament, which began back on June 12 at Arena Corinthians in Sao Paulo.  On the sport medicine front, we have seen issues ranging from Neymar’s fractured vertebra to the concussion seen ’round the world:  Uruguay’s Alvaro Pereira and his return to the pitch immediately after his injury were the focus of our post a few weeks back.

I haven’t yet had the chance to discuss with you all the incident which occurred in the semi-final between Argentina and the Netherlands, involving Javier Mascherano.  Since he’ll be playing for Argentina in today’s final, I thought it high time to discuss his injury and the further implications such events have for sports medicine clinicians covering sports around the world.

Like many of you I was watching the semi-final live.  [Full disclosure:  I was rooting for Argentina (I still am….hoping for a triumph of faith over reason in today’s final!)].  For those who were watching you will remember, that Mascherano went down toward the end of the game after colliding with an opponent’s head while the two were attempting to head the ball.  The medical staff worked on him for several minutes.  While this was going on, my son correctly worried that should he not be able to return to the pitch, Argentina would have to play a man down, as they had already used their limit of three substitutions for the match.

Like a lot of sports medicine folks watching, I was surprised to see Mascherano make it back to the pitch; it seemed clear that he had possibly suffered a concussion, and should probably have been removed.  The field-side decision-making was roundly criticized subsequently.  The player himself went on to perform a possibly game-saving tackle on Arjen Robbens after returning to the field.

The complexity of decision-making in these settings is immense.  I re-posted a blog post from our Executive Editor Chris Hughes in the wake of the Perreira incident exploring precisely this issue of same-day return-to-play clearance.  The most immediate consequence of proceeding with what was arguably the correct medical call would have been to consign Argentina to playing a man down the rest of the match.  It’s not difficult to start imagining parallel renderings of what ‘might have been’ for the Netherlands had Argentina finished the match a man down……without Mascherano on the field, who is there to block Robbens’ shot?

All of us clinicians who manage sideline medical care face such decisions.  Regarding concussions, the information is readily available, albeit still up for debate!  You can go to our pages to access the 2012 Zurich Consensus Statement on Concussion in Sport, which argues against same-day return to play and argues for “Sufficient time for assessment and (that) adequate facilities should be provided for the appropriate medical assessment both on and off the field for all injured athletes” (my itals).  You can go to our freely available ‘Concussion Collection,’ which contains some of the research published in our pages on this rapidly evolving field.  You can even listen to our Podcast, with Canadian authors Drs. Oliver Leslie and Neil Craton, who provide a powerful critique of the Zurich statement. Read more of this post

Filed under Concussion in Sport, Elite sport, Public Health in Sports and Exercise Medicine Tagged with , , , ,

5 questions with Robert Zayas, New York State Public High School Athletic Association

May 7, 2014 by

State Wresting Championships 2013 II

Robert Zayas (left) at New York State Wrestling Championships 2013

We are delighted to have Robert Zayas, Executive Director of the New York State Public High School Athletic Association (NYSPHSAA), join us today for our “Five Questions with CJSM”  feature.

I met Robert at an inaugural meeting of the National Youth Council on Sports Safety (NCYSS) in Washington, D.C. last November, and I have been after him ever since to sit down with us to share his unique perspective on American youth sports.  He’s a busy man, as you’ll see, and so we’re all fortunate to have him join us.

With a clinical practice in pediatric sports medicine, youth sports are never far from my mind.  In D.C. Robert and I had a chat about some of the challenges facing the kids and adults involved in contemporary youth sports:  early sport specialization (the focus of an earlier blog post); the rise of youth league sports in parallel with interscholastic sports; the unique pressures the American athletic scholarship phenomenon places on young athletes; the evidence that participation rates are declining in landmark sports like football and soccer……it’s a world in flux, with lots of questions.

And so it’s great to have people like Robert Zayas involved in guiding the ship through these changing seas.

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1) CJSM: Congratulations! You have recently been named to the National Council on Youth Sports Safety.  Can you tell us a little bit about the goals of the council, and what you hope to contribute to the process?

RZ: Thank  you; it is truly an honor to serve as a member of the National Council on Youth Sports Safety.

In its first year, the NCYSS will meet quarterly to review existing research, explore alternative solutions, and develop a strategic plan for the implementation of a national set of guidelines on youth sports safety. The second year will include a best practices tour where the public will be provided with opportunities to learn about scientific and technological advancements, effective coaching and training techniques, and contribute feedback on methods that have led to a decline in injury in their respective communities.

I hope to represent the high school sports view-point on the council.  Most importantly, I hope to ensure interscholastic, education based sports are seen as an extension of the classroom and the impact concussions are having on the “student” in all areas of education.

2) CJSM: You are the Executive Director of the NYSPHSAA.  Can you tell us a bit about your background and what you see as the mission of the association?

RZ: My background in education and athletics spans a very short period of time when compared to other Executive Directors throughout the country.  Read more of this post

Filed under General Interest, Preparticipation Evaluation and Screening, Public Health in Sports and Exercise Medicine, Youth Sport Tagged with ,

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