“…like the Oscars, but with concussions.”

Oscars….or Super Bowl? Justin Timberlake — photo Mark Briello, Wikimedia

It would be hard to have spent any time this past month in the United States, my home country, and not be aware that today is “Super Sunday,” when the Philadelphia Eagles and the perennial champion New England Patriots will be playing the final game of the NFL Season.  For all the marbles. For the big kahuna. For (insert your favorite, overused metaphor here).

I woke up this Sunday in my customary manner:  with some coffee and the New York Times. The newspaper had several articles about the upcoming Main Event, including profiles of the halftime highlight, Justin Timberlake.  The story that most resonated with me was a piece by Bruce Weber, whom I find to be an uncommonly funny writer.  He wrote of the Super Bowl’s grandiosity, with its “…pregame blah, blah, blah….the rollout of new advertisements at a cost that might otherwise stabilize Social Security, and the betting line in Vegas, where gamblers risk enough to underwrite a single-payer health care system.”

He summarized:  the Super Bowl is “not so much a ballgame as a happening, like the Oscars but with concussions.”

Spot on.

Eagles or Patriots?  It’s hard to say, though the line favors the Patriots slightly (and most neutral observers with whom I’ve spoken say it’s an, er, no-brainer, the Patriots will be winning) — but one bet that is a sure thing: there will be injuries. And very likely, a high profile concussion, which may or may not be mishandled.

Who can forget the game three years ago (which the Patriots won): Julian Edelman sustained a hit which appeared certain to require medical evaluation, but remained in the game.  And then caught the go-ahead touchdown.

Concussions and gridiron football– the pairing appears in the pages of CJSM nearly every issue, so common is the injury and so prominent the issue.  Our first issue of the year contained cutting-edge, original research on the frequency with which professional football players hide their potential concussions. The article is free, but if you don’t have time to read it, you can even ‘listen in’ on what the author has to say about the study in our most recent podcast.

Super Sunday is upon us. There’s a game, yes, and a whole lot more. Will we see a hologram of Prince? Will Janet Jackson make a reprise showing and sing a duet/have a wardrobe ‘malfunction’ with Timberlake?  What will be the most memorable commercial?

And, oh yes, who will win:  Eagles or Patriots?

Enjoy the game and/or its attendant bells and whistles, if you’ll be watching.  And share your reactions with us on Twitter [@cjsmonline ] if you have thoughts about one of the injuries you’re bound to see.

Super Sunday

rachel nichols

Some of the media absurdity, and social media fun, in the run up to the Super Bowl

Why is Marshawn Lynch not talking?

Will #DeflateGate show up in the next edition of Webster’s dictionary?

Might Richard Sherman be in a hospital labor and delivery room rather than the stadium on Super Bowl Sunday?

The two week period between the NFL conference championships and the Super Bowl is at last, blessedly, over and it’s time for the real deal, the big kahuna, the game itself:  #PatriotsVsSeahawks.

There is so much room to fill in this fortnight that the media gets a little loopy, and many of the questions being asked with bated breath are, as the above sampling would indicate, fairly ridiculous.

One redeeming dimension to this tempest is that some clever folk get the opportunity to emphasize the absurdity of it all: I especially enjoyed the Jimmy Kimmel spoof of the DeflateGate controversy, “I am the locker room guy,” for which I owe Rachel Nichols a big thank you:  her tweet first made me aware of this hilarious video.

There has been the opportunity, as well, for what I think are intelligent analyses of the current state of the NFL, and of American football itself.  Mother Jones–a magazine not typically paired with, say, Sports Illustrated–recently ran an article entitled “The NFL’s Terrible, Horrible, No Good, Very Bad Year” and which began with a statement which sounds like the NFL apocalypse is nigh:  “From domestic violence and concussions to racist team names and angry cheerleaders, 2014 was a rotten year for pro football.”  Katy Perry–the singer who will perform at halftime this Sunday and the person with the largest twitter following on the planet–made what I think was a particularly concise evaluation of the multiple domestic violence issues occurring this season:  “It wasn’t an image problem–it was a problem.”

Many of the articles I’ve been reading in various periodicals have direct relevance to those of us in the universe of sports medicine.  The New York Times has done a great job in the past several days profiling the increasing awareness of injury risks associated with football; examples include an article on NFL outreach to mothers to assure them of football’s relative safety (and ensure for the league a pipeline of young talent coming their way) and an article profiling the recent study in Neurology purporting to demonstrate the long-term cognitive effects of initiating contact before the age of 12.

The Guardian even stepped into the fray with a very interesting piece on the potential for a measles outbreak in Arizona:  the massing of large populations; the recent outbreak of the disease in nearby California; and the relative lack of herd immunity (thanks to historically low rates of vaccination), contribute to a ‘perfect storm’ of contagion. The most deadly of childhood febrile exanthems–according to the CDC–may make for a post-Super Bowl hangover that won’t go away.

Like many of us who go into sports medicine, though, I do love sports, warts and all.  I am looking forward to a good game between New England and Seattle…..and a respite from the silly stories.

I am looking forward, too, to the research that will eventually come out of the NFL Player’s Association $100 million dollar grant to Harvard looking at player safety.  That’s a 10 year project, and so much of what will be found is still years away.  I am confident, as the evidence comes in, that some of the manuscripts to be published will be found in the pages of CJSM.  I am eager to discuss that research with you along the way.  Super Bowl L (actually Super Bowl 50–the NFL is dispensing with the Roman numerals for a year) will surely have more medically relevant stories seen in a new, evidence-based context…..and, of course, more inanity.

For now:  good luck to both teams.  May the players stay safe on Super Bowl Sunday. And….one last question:

Will Marshawn Lynch grab his crotch in celebration?

See you all next week.

Pre-game intravenous hyperhydration, anyone?

The #NFL #SuperBowlXLVIII takes place this weekend, and we revisit one of our most talked about studies in the last few years.  Thanks to our Executive Editor Chris Hughes, @SportsDoc_Chris, for this 2011 post.

Clinical Journal of Sport Medicine Blog

The editorial in this month’s CJSM by Coombes and colleagues on Intravenous Rehydration in the National Football League highlights the widespread prevalence of the practice of pre-game hyperhydration as reported in the study by Fitzsimmons and colleagues, also in this month’s Journal here .

Fitzsimmons and colleagues surveyed the head athletic trainers of 32 NFL teams using an online survey tool and managed to achieve an impressive 100% response rate. They found that 75% of all teams had used pre-game hyperhydration with iv fluids, with an average of 5 to 7 players per team per game receiving intravenous fluids prior to play. The most common reasons for this strategy cited by trainers were to prevent muscle cramps (23 out of 24), prevent dehydration (19), at the request of the player (17), to prevent heat illness (14), and to improve player exercise tolerance (8).

It is somewhat alarming to find out that this practice…

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