For my last Civic Issues blog, I thought it would be a good idea to bring the topic closer to home, with a discussion about concussions and Penn State athletes, accompanied by a brief review of the of the movie, Concussion.  Penn State’s Center for Sport Concussion Research in the College of Health and Human Development is home to a state of the art facility studying traumatic brain injury in collegiate and pediatric athletics.  In this facility, resides the innovative PSU Virtual Reality Concussion Lab.  “The Virtual Reality (VR) lab is designed to examine residual cognitive and motor abnormalities in patients suffering from a concussion.”  The lab employs unique “assessments that involve virtual reality and feature realistic 3D computer generated environments that enable the athlete to feel fully immersed in cyber-imagery.  The participant wears a special headset and stands on a platform in front of a 12′ x 10′ screen, then navigates with a joystick through a simulation of hallways and rooms, a 3D elevator, and more.”  To assess the status of an injury, an athlete will complete these same tests pre and post-concussion, so doctors have a basis for comparison. VR allows doctors in the lab to observe the patient’s brain activity second by second to see if there are any abnormalities.  These virtual reality assessment techniques are then combined with the examination of brain imaging scans, like MRIs and EEGs to evaluate the changes in brain functions and structures to more accurately diagnose and evaluate concussions.

Penn State’s Director of Athletic Medicine and multiple staff doctors work closely with all of the university’s men’s and women’s athletic teams to evaluate athletes for potential concussions and determine the course of action using the resources available in the Center.  These more innovative and evolving assessment techniques are important to the health of student athletes to prevent short and long term damage, especially when it is evident that single and even more so, multiple concussions may lead to brain damage. New research and evaluation techniques used in Penn State’s Center for Sport Concussion Research over the past few years is timely, since this topic is regularly in the news, especially with the recent release of the movie, Concussion, which follows Dr. Bennet Omalu’s discoveries of the effects of concussions and traumatic brain injury.

I finally was able to watch Concussion after waiting many months for it to be available to rent.  As a huge football fan and having played the sport from the time I was eleven years old until my senior year of high school, I am now even more thankful that I never received a more serious head injury other than one minor concussion.  Concussion really opened my eyes to the severity of this type of brain injury and the potential long-term impact of multiple concussions, causing chronic traumatic encephalopathy (CTE), a degenerative brain disease that can eventually lead to difficulty with thinking, emotions and behaviors.  After finding definitive consistent abnormalities in the brains of athletes, Dr. Omalu pursues further research.  He describes how a human’s brain is not built to withstand constant hits to the head, as he contrasts what happens to other animals accustomed to hitting their heads.  He represents a human head by shaking an egg inside of a jar to show how there are no shock absorbers around the brain.  This is in comparison to a woodpecker with a brain that is wrapped around its tongue, which is also around its skill and through its nostrils, all acting as an incredible shock absorber.  Dr. Omalu’s primary research was based on former professional football players, even though he was not familiar with American football.  Alarmed with his findings, Dr. Omalu confronted many obstacles as he tried to find a receptive audience with the NFL.

Now I don’t want to have any spoilers in this blog, since I know some of you are football fans and may want to see this movie. Whether you are a football fan or not, an athlete playing any sport or a parent with children in sports, I definitely recommend seeing the movie, Concussion.  Once you do, think about how it may have enlightened you too or even just changed your view on how to treat a potential concussion.

One last note… As concussion effects are more widely researched and understood, more professional athletes of differing ages from a variety of sports, including football, soccer, tennis and even a NASCAR driver, are now donating their brains to research to further advance these efforts.

The sport with the highest rate of concussions is starting to see some changes, even drastic changes in the eyes of many. On the college level, the Ivy League schools are leading some of these changes with a recent announcement. The last week of February marked the decision that all eight Ivy League football coaches will institute a no hitting policy in practice throughout the whole season. This development originated from the Dartmouth coach, Buddy Teevens, who also coached at Tulane, Illinois, Florida, and Stanford, ultimately ending up at Dartmouth. Since 2010, as Dartmouth’s coach, Teevens eliminated full contact during his football practices. Many coaches and players were skeptical about this move, however, “Research has shown that limiting the amount of full-contact practices can reduce the number of concussions”. With fewer injuries, player performance should improve and therefore, correspond with more team success over time. At higher levels of play, it is expected that players know the fundamentals of hitting on the field, which is something that Dartmouth coach Teevens stated during an interview, “’At this stage in their careers, these guys know how to hit and take a hit. People look at it and say we’re nuts. But it’s kept my guys healthy”. Staying healthy through out the season is paramount for the athletes and their performance, as well as their long-term well-being. This elimination of practice hitting has proven on the field success for Dartmouth, since they have had a winning season every year since 2010, ultimately sharing their division title last fall. This success, along with more concussion awareness, may have been the force to prompt other coaches in the league to implement the same practice policy that Dartmouth has had in place for five years. This implementation of no-contact practices for the entire season is the first dramatic step in reducing the number of collegiate concussions by leagues initiating their own rules, rather than rules that are forced upon by the NCAA.

Less drastic changes have been occurring in other divisions and in the NFL as well.   For example, newer NCAA rules are now limited to, “Teams that hold two-a-day practices can have full contact in one of them. Full-contact practices are allowed up to four times in a week, and a maximum of 12 times during the preseason. During the season, teams can hold full-contact practices no more than twice a week”. The NFL has implemented tighter rules as well, with regard to contact during the season. Only 14 full-contact practices are allowed during their 18-week regular season, while many teams don’t even reach that number of full contact practices. The NFL is under a lot of pressure right now because of ongoing litigation with more and more former players revealing that they too have suffered from the often debilitating effects of multiple concussions. Considering the many changes in the sport of football to protect players, the Ivy League is the first collegiate league that has its own safety rules, unlike the NCAA, which only has concussion and hitting guidelines and no safety rules.

If restrictions are not currently in place, high schools across the country should also consider adopting similar hitting restrictions during practices, because 60-75 percent of concussions in high school happen on the practice field. Many common practice drills involve head-to-head contact, and coaches have now taken the initiative to eliminate drills such as the Oklahoma Drill, which focuses on making head to head contact. If hitting is limited in practice for high school teams and concussion rates are reduced, these changes could possibly lead to more participation and less concern on the part of parents. As the numbers of players in football for adolescents and teenagers has been consistently declining over recent years, adjustments like these could possibly keep more athletes in the game.

While many see changes like this as being positive and possibly, “maybe even [saving] the game”, states Nancy Armour in a Bleacher Report article, others are reluctant since it reduces actual game-like practice experience. Many coaches across the country continue to be resistant, particularly coaches that have had success for many years. More serious football areas such as Texas, Florida and some Southern states have football machines, and it is therefore difficult to change the status quo. Modifications like some of the ones necessary to prevent concussions are not appealing to these coaches, since the results of the changes are not yet proven. However, considering the recent research and publicity surrounding concussions, no matter what changes are made to help the safety of the game, some parents of adolescents and teens will still deny their kids participation in football and other sports with higher rates of concussion occurrence.

Can policies similar to the new Ivy League no-hitting rules in football practice be applied to other sports as well?

Should soccer coaches implement a policy of no-headers in practice?

Can hockey, rugby, and basketball coaches implement similar regulations during practice that will keep their players healthier through out the season?

Do you have suggestions on how to make any sport on any level safer to reduce the rate of concussions?

It is no mystery about the seriousness a concussion can have on an individual, especially if multiple concussions occur over a period of time. There has also been much speculation about the deceptiveness of the NFL with their concussion protocol and reporting. Improvements have definitely been made regarding safety precautions while playing the game, including advancements in equipment used to prevent traumatic head injuries. With more reliable facts and information unveiled about the causes of concussions, the long lasting effects, the NFL and others have now joined to implement initiatives to make the game safer for not only professional players, but also for children and adolescents, which could also help others who participate in contact activates during their everyday job.

With more awareness and publicity, the NFL has implemented dramatic improvements with rules regulations to prevent head to head contact and reporting signs of concussions, however, this past season they took a step backwards with a significant lack of reporting. It was recorded that players received 271 concussions during practice, and preseason and games in 2015, which was a 31.6 percent increase in total concussions when compared to the same period in 2014. Head injuries during the 2015 season accounted for 182 of the 271 concussions, which was a 58.2 percent increase over 2014. Even with many more penalties and the banning of head-to-head contact in games, there were still 92 concussions, resulting from head-to-head hits. However, out of those 271 concussions reported, “only 197 of those injuries ever appeared on a team injury report, according to Concussion Watch”. According to this article, the concussion problem will not be an easy fix, because there could be a year where many more concussions were received than the prior year, which could have been an improvement, but if there are reporting inaccuracies, the data is not totally relevant. The NFL had plans to test how hard players are hitting other players and how hard they are getting hit with sensors in their helmets, but that was delayed during the end of the season. If this is testing implemented next season, it will be very interesting to analyze the results, because athletes have been growing bigger and bigger over the years and the number of serious injuries have increased along with the size of the players.

With the focus on concussion safety, there are also efforts to make the game safer on the field for not only professional players, but also high school athletes and peewee football as well. In addition to some rule modifications, the main areas of improvement have been changes in helmets. Recently, the NFL has teamed with the Army Research Laboratory to design a helmet that could be tested, look good, and be worn to reduce concussions for not only football athletes, but also service members, because they also incur heavy blows as well. One may be a little skeptical about concussions being a serious matter to soldiers, but there are quite a number of ways a soldier could obtain a concussion. There is documentation of paratrooper’s likelihood of obtaining a concussion, which is about twice as high as a normal soldier. The design that the Army Research Laboratory has developed includes ARL tethers. The ARL tethers attach to helmets with strap, possibly on shoulder pads. These tethers would allow the player to have full mobility, while protecting a player or soldier after a strike or hit and falling towards the ground.   The tethers tighten up and decelerate the motion of the head before hitting the ground. This deceleration of one’s head before hitting the ground will decrease the impact the hit has on the brain, because it will reduce the velocity and allow the head hit the ground with less force, which creates less trauma on the brain. Since this article’s publication on February 4^th, the NFL is hoping to have these tethers on the market to sell in eighteen months, which would realistically be in two seasons. I wonder if these tethers would only be implemented on the NFL field or high schools would also include them with their equipment?

I’m interested in seeing if there is any speculation and resistance with wearing these designs if they are not stylish between players or if it will be part of their contract to test these ARL tethers.

Also, will the tethers be comfortable? Could they possibly cause or contribute to other orthopedic injuries? Overall, do you think this will make the game safer and have parents more comfortable allowing their children to play the game of football?

There has been much debate over the issue of concussions and concussion prevention throughout our society in the past decade, but even more in recent years. The latest findings are the result of advanced forms of research, producing new discoveries and data that have heightened concern among many communities, including health care professionals, athletes, coaches, schools and parents. Because of these findings, parents of children have now become a driving factor in the concussion debate regarding participation in contacts sports, how to prevent injuries and how to make sure athletes are completely recovered to play again. Now, more widespread information is finally being revealed, exposing the dangers that can accompany not only the reception of one concussion, but also the drastic consequences that could result from multiple concussions. The availability of this new information on a widespread basis has changed the viewpoint of many parents regarding the participation of their children in contact sports. Parents are more concerned than ever about the risk of suffering permanent brain damage from multiple concussions, and are now pulling their children out of contact sports, especially football, at a young age.

One of the main reasons parents do not feel comfortable with children playing contact sports when they are young is because their brain is not fully developed and can be more susceptible to injury. Also, more recent revelations from medical professionals regarding former boxers and players in the National Football League (NFL), detail the effects of concussion causing chronic traumatic encephalopathy (CTE), which is a serious progressive degenerative and disabling brain disorder. As participation is on the decline for some contact sports, such as football, parent surveys are also indicating this trend may continue as more information becomes available.   The results of a study by the Barrow Neurological Institute in Phoenix indicated, 33 percent of the adults surveyed would object to their sons playing football, according to Dr. Javier Cardenes, the director of the Barrow Concussion and Brain Injury Center (azcentral). This group included 412 adults with 123 of them having children who are less than eighteen-years-old. These results are shocking, because the actual percentage of parents who would allow their kids play a contact sport went up from last year, but the percent of parents who would allow their child play football dropped dramatically. Another interesting factor to consider in football participation indicated a difference in opinion due to socioeconomic class. It was concluded that parents who make more than $55,000 per year are much more likely to not want their child to play football than parents who make less than $55,000 per year. Many of these families offer the prospect that football and other sports can provide hope for student athletes to receive scholarships to play in college and further their education, an opportunity that they may not have without sports. Dave Nicholas, a father of a child who plays football in Arizona said, “If I was a millionaire, I wouldn’t have him play football,’ he added. ‘It is his way of getting a better opportunity in life.’”

To help avoid this socioeconomic gap in participation of some contact sports, like football, safety is now emphasized more than ever. More and more data is being collected and researched to achieve the goal increasing safety. As parents and others continue to gather more information, studies like the joint effort of the University of Miami and Miami Dade High School system are helping. They implemented one the most extensive data collection initiatives by tracking every reported concussion in thirty-six of their public high school across the county including twelve thousand student athletes. By following every sport and accumulating three years of data showing how often kids receive concussions, why they might receive them, how long it takes to recover and how to prevent them, with the goal of making each game in each sport as safe as possible (Miamiherald). So far, over six hundred concussions have been evaluated, providing crucial tracking information that will ultimately help parents to make decisions regarding participation for their children. However, concern may be that even though this is a huge step forward for more transparency for schools and coaches, this data only includes concussions that are diagnosed and therefore reported. Many others remain undiagnosed and therefore will not be included in reported data.

Analyzing and evaluating this data, can help all involved to decide if there are patterns to see where improvements can be made to help make particular sports safer, implementing physical changes such as to field surfaces, adjustments to helmet fittings, additions to helmets and other gear adjustments. Football, of course, leads these statistics by a long shot, however, the detail could provide insight that may influence athletes and parents about certain positions to play on the field, with certain offensive and defensive positions, such as wide receivers and linebackers incurring concussions at a higher rate. Parents can also use this data to sway their children to safer sports with less concussion incidence. Continuously producing charts like the “Concussions by sport and gender” and “Concussions by position” as in this article on a more widespread basis could provide more insight to all sides of this debate (Miamiherald).

Have you had a concussion in the past? Have you had to deal with the consequences of recovering from a concussion or multiple concussions? With more and more of this new information available, how do you feel about playing competitive contact sports?

Welcome to Sites At Penn State. This is your first post. Edit or delete it, then start blogging!

This semester, I am going to explore an issue that has recently created a significant level of concern, controversy and debate among all levels of athletes, coaches, managers, trainers, doctors, sports reporters and analysts, parents, and even children. The thought of a concussion now makes many cringe, particularly because of the array of new information that has been exposed over the past few years. When flipping channels to any sports talk show, it seems as though this topic is constantly being discussed. The definition of a concussion is, “a traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination” (Diseases). A concussion can occur when someone suffers a blow to the head or if the head and upper body is shaken violently (Diseases). Concussions can happen anytime, but are most prevalent while participating in contact sports such as football, hockey, basketball, soccer, or types of fighting like MMA or boxing. Schools, colleges and professional athletic teams have protocols in place to diagnose and monitor concussions, but it seems as though we have had some gaps in this process. With newer discoveries about the causes and effects of concussions, there has been heightened apprehension among many, especially parents regarding the safety of certain sports for their children. Throughout the semester, I will discuss the varied aspects of concussions, including their rates of occurrence, effects, high risk groups, protocols and monitoring, safety, how more concussion awareness may affect participation in some sports, concussions in the NFL and ways sport scientists are trying to make certain sports safer for athletes.

The movie “Concussion,” which was released about a month ago, is a huge step in exposing more information about concussions to the public. The movie describes the plight of Dr. Bennet Omalu, a pathologist from Nigeria who did not know the game of football, and was the first person to discover chronic traumatic encephalopathy (CTE), which is essentially repetitive trauma of the brain. His research and discoveries about the causes and effects of repeated head related injuries are revealed, without concealing the facts. I can’t wait to see this movie, and read about Dr. Omalu’s findings about concussions, as well as evaluate the reactions of the individuals and organizations, like the NFL to this movie. “Concussion” has spurred more conversations among parents and administrators as to whether contact sports will/should be banned in high school, while there are also many others who are working together to make the necessary changes to make contact sports as safe as possible. I will touch base on this topic in more detail in later posts, but if you were a parent, would you want your child to play football or any contact sport at a young age? Also, do you think advancement in technology will ensure safety in athletes?

Over the past few years, with the increased awareness of the harm that multiple concussions can have on the brain, people have really been taking sides on this issue. As we are now discovering, multiple concussions place an individual at higher risk of acquiring chronic traumatic encephalopathy, as indicated in the recently released movie. In the article, “Concussions becoming more commonplace”, Meagan Hoffman states that, “the degenerative disease [CTE] was found in former Iowa Hawkeye Tyler Sash, who was found dead in his home in September at age 27” (Hoffman). Dr. Ann Mckee from Boston University, studied his brain and on a scale of one to four, and she found out that Tyler’s CTE level was a two, which she has only seen one other patient as young as Tyler with levels that high (Hoffman). Because of situations like Tyler’s, and the frequency of concussion related injuries, coaches and especially commissioners of the NFL are now acting in a more cautious manner regarding head injuries, implementing more enhanced training to notice the signs and symptoms of a concussions, as well as more cautious protocols for resuming play. One step that the NFL has taken this season is to enforce the elimination of head to head contact, making it illegal in a game, with ejection and increased fines for purposeful head to head contact or leads with the crown of a helmet. For myself, I have played football since I was ten years old, cherishing all the guys I played along the side of, and my incredible high school coach. However, I am glad that I am done playing football without any serious head injuries, and only receiving one diagnosed concussion. I wonder after this semester and blogging is over, if my views toward football and other contact sports will change.

“Diseases and Conditions Concussion.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 2 Apr. 2014. Web. 27 Jan. 2016.

Hoffman, Megan. “Concussions Becoming More Commonplace.” WIVB4.com. Media General Contributor, 27 Jan. 2016. Web. 27 Jan. 2016.