FIFA World Cup 2018 — Will There be Concussion Miscues Again?

FIFA World Cup apperances 1930 – 2018 Picture courtesy of Dufo, from Wikimedia Commons

Ah, the long, lazy days of summer have arrived….or have they?

With a caveat that I must be mindful that fellow colleagues in different parts of the world may be experiencing different workloads right about now, I have been feeling of late both a sense of lassitude and a sense of professional, shall we say, anxiety.

My children’s school year has wrapped up — they certainly are in the mode of being lazy.  The multiple school sports I cover as a pediatric sports medicine physician have largely wrapped their respective seasons too.  There is a bit of a lull in my clinics.

On the other hand, in the larger sporting world, the schedule is most definitely heating up.  I find this to be one of the most interesting times of the year for sport.  In the USA, we are in the midst of the NBA and NHL basketball and hockey finals, and MLB baseball offers multiple games daily.  To our north, the CFL has just started its season.  In Europe, the tennis stars Rafael Nadal, Garbine Muguruza and others are experiencing the joys of Roland Garros.  Golf’s U.S. Open is just around the corner.

And, of course, in less than two weeks, the FIFA World Cup kicks off in Russia. The quadrennial event — alongside the Olympics probably the biggest global sporting event on the planet — opens on June 14 and will continue for a month, until the championship game on July 15.

Like many of my colleagues, I am a fan of sport as well as a physician.  I care about who plays, and find myself cheering on certain teams and certain players [Vamos El Tri!]

Like many of my colleagues as well, however, I am also eyeing this World Cup as a doctor, and I approach the event with concerns over how concussions will be handled in 2018. Read more of this post

Ice Hockey & Head Injury — can we have one without the other? The podcast

I am pleased to introduce our most recent guest to the CJSM podcast: Aynsley Smith, RN, PhD of the Mayo Clinic.  She is the lead author of a new General Review in our September 2017 issue: Concussion In Ice Hockey: Current Gaps and Future Directions in an Objective Diagnosis.

Dr. Smith and the Mayo Clinic have been at the forefront of research into the prevention, diagnosis and management of concussion in ice hockey.  The Mayo Clinic has hosted three semi-annual ‘ice hockey concussion summits,’ the most recent having just taken place at the end of September

It’s probably always a good time to talk about concussions in ice hockey, but perhaps never better than the start of the NHL season  [my hometown Columbus Blue Jackets open their season tonight!]

In our conversation, Dr. Smith and I cover a lot of ground:  old time Stanley Cup drama, fighting, promising new developments in objective diagnoses, and the potential for rules changes and more to minimize the risk in this exciting, fast-moving contact sport.

The review is open access — which means it’s freely available.  So….subscribe to the CJSM podcast on iTunes, or go directly to our website for a listen to the conversation I had with Aynsley.  And then get the article itself for your weekend reading.

Return to Play Decisions: The hits and the HIT (system).

It’s October, and I thought I’d share a blog post I previously wrote about return to play decisions (see below). The football teams I cover are smack dab in the middle of their seasons; I, like all my colleagues covering teams this fall, have been busy making plenty of ‘return to play decisions.’

What do you all do with your 7 and 8 year olds? Yes, your 7 and 8 year olds……little did I know when I started my career that I would be making ‘return to play’ decisions for this age group, but that is among my duties here at Nationwide Children’s Hospital in Columbus, Ohio. How about you?

With that sort of return to play decision in mind, I could hardly find a more relevant piece of original research than the study on head impact exposure in youth football in the September 2014 CJSM.  The authors–a group from Virginia Tech and Wake Forest–are well known for recently publishing various studies on head  impact exposure using the ‘Head Impact Telemetry’ (HIT) system.   The HIT system is being used more regularly at various levels of football in helping to determine when an athlete may need a sideline evaluation.  As we all know, athletes in the heat of competition are not always the most forthcoming in sharing when they may have had a symptomatic hit; for that matter, the collective body of sideline physicians, athletic trainers and coaches don’t always pick up on the hits that occur right in front of our eyes:  just ask Brady Hoke and the Michigan Wolverines.

Returning to youth sport… my friends at MomsTeam have written, “the day when monitoring of head impact exposure in football and other contact and collision sports becomes commonplace is closer at hand than one might think.”  Here’s a list of what’s available right now for players from youth level on up to the pros (again, thanks MomsTeam for the reference).

I can forsee the time when I will integrate head impact exposure data along with what I find with my other concussion assessments to determine when I will release one of my youth athletes back to the field.  Next season, I will likely be involved with coverage of a high school which uses “Shockbox” technology.  However, I don’t currently use such systems; that is to say, none of the teams I cover, high school or university, use the HIT system or any other impact exposure technology.  Are you already using such technology in your determinations? Let me know if you are.  I’d like to learn more.

Enjoy the reblogged post below.


Clinical Journal of Sport Medicine Blog

535001_10201384038456502_1470889600_n Though a beautiful time of year, fall is not
the most idyllic for a sports medicine clinician

Like many of the readers out there, my colleagues and I are deep in a football season, where we are managing various teams and their mounting injuries.  For a sports medicine physician, fall in America must be a bit like early spring for an accountant (tax day = April 15):  it’s the time to buckle down and crank through patients, the time, from a certain perspective, to see the volume of patients that will sustain the business through leaner times of the year.

When I’m out of the clinic and on the sidelines, I’m also doing one of the parts of my job that is the most fun, and I’m sure my colleagues out in the blog sphere will agree.  But I wouldn’t describe the work as an idyll.  I can be enjoying…

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