Tag Archives: Concussions

Concussions In Lacrosse: “Lacrosse Magazine” Presents “In-Depth Q&A” With US Lacrosse Sports Science & Safety Experts On The “Biology, Risks, And Long-Term Implications Of Concussions”

Dr. Margot Putukian and Dr. Ruben Echemendia of the US Lacrosse Sports Science and Safety Committee were among presenters at the International Consensus Conference on Concussions in Zurich, Switzerland.

Dr. Margot Putukian and Dr. Ruben Echemendia of the US Lacrosse Sports Science and Safety Committee were among presenters at the International Consensus Conference on Concussions in Zurich, Switzerland

What is the biology of a concussion? What actually happens to the brain?

RE: A concussion creates changes in the chemistry of the brain that produces a “neuro-metabolic cascade” that renders cells temporarily inoperative and vulnerable to further injury. This metabolic cascade is accompanied by a disruption of the blood supply to the brain, thereby reducing the amount of glucose (fuel) available to the brain for healing. These changes affect the entire brain, not just one region.

What are the risks of playing with a concussion? What is second-impact syndrome?

MP: It is difficult to know the exact risks of continuing to play while concussed, but in the younger athlete, there has been a concern that a second insult can occur while the athlete is still recovering from a first injury, and that a dysregulation in the blood flow to the brain can then result, causing a significant increase in the pressure in the brain. Though considered controversial by some researchers, second-impact syndrome has been reported in youth athletes and associated with significant complications, including death.

RE: Continuing to play while having symptoms places the vulnerable brain at risk for additional injury that may lead to more severe, prolonged or even life-long problems with cognitive and psychological functioning. Second-impact syndrome is rare and thought to occur when an individual sustains a blow to the brain during a time when the brain has not fully recovered from a previous concussion. The blow can often be a relatively mild one.

Are there long-term health implications from concussions?

MP: The majority of concussions resolve in 10-14 days without any known long-term consequences. However, in a very small percentage, there are persistent symptoms and ongoing difficulties with cognitive function or balance.

RE: Some studies suggest there can be long-term changes in neurocognitive functioning; others do not. There is no consensus among experts in the field. The key appears to be appropriate evaluation and management of the injury.

What impact, if any, does age play in concussions?

MP: Younger athletes appear to take longer to recover and therefore should be treated with caution. Other modifiers that are associated with a prolonged recovery include an increased number and duration of symptoms and a history of prior concussion. Other modifiers that may play a role in prolonged recovery include a history of migraine headaches, attention deficit hyperactivity disorder (or other learning disorders) and history of depression, anxiety or other mental health disorders.

Besides rest (physical and mental), what else can help recovery?

MP: An initial period of rest is important, and avoiding cognitive activity, such as texting, video games and extended computer work, also is important. After a few days, light exercise can be initiated assuming it doesn’t worsen symptoms. It’s unclear if other interventions are helpful in assisting recovery, but alcohol, aspirin, narcotics and other medications that impair cognitive function or increase bleeding are typically avoided in the first few days.

RE: It is very important that athletes with concussions remain well hydrated, maintain good nutritional habits and get plenty of sleep. Keep in mind that physical and cognitive rest does not mean placing the child in a cocoon. Typical activities of daily living, including school, should be added as soon as they are tolerated without producing an increase in symptoms.

What misperceptions about concussions do you encounter?

MP: One myth is that helmets prevent concussion. Though they are effective in preventing skull fracture and bleeds, and may lessen impact forces, they do not prevent concussion. Sometimes the assumption is that putting a helmet on an athlete will protect them, when it might not. In fact, if they have a false sense of security, they may play more aggressively and therefore be at a greater risk for injury. Another myth is that the greater the impact force, the more likely that a concussion will occur or the more severe the concussion. There is not enough research to support this, and what limited data we have actually suggests that concussive injury can occur with different levels of impact.

RE: Some people still believe that you need to lose consciousness or have serious memory impairment to have a concussion. Neither is true. Some believe that a concussion is a bruise to the brain; it is not. Many believe that you have to be hit hard or be hit on the head to have a concussion. Neither is true.

Can you comment on the effectiveness of neurocognitive (baseline) testing?

RE: Baseline testing can be very useful in establishing the pre-injury functioning of the athlete. If available, athletes should take advantage of baseline testing. However, baseline testing sometimes creates significant complexity in the evaluation of an athlete’s cognitive functioning. Because of this complexity, a qualified neuropsychologist should interpret any neuropsychological testing.

MP: The utility of baseline computerized neuropsychological testing has recently been questioned. Although it appears to promising, there are several factors to consider in NP testing including the effects of fatigue, injury and motivation.

What are your opinions on the return-to-play laws that have been passed in 49 states and D.C.?

MP: The Zack Lystedt Law passed in Washington State was the first of many that have raised the awareness of the importance of this injury as well as the importance of removing athletes from play when signs and symptoms of concussion are present.

RE: These laws are a good first step towards raising awareness and providing basic guidelines for the management of concussion. The laws are not uniform across states, and hence some are better than others.

US Lacrosse contends there yet no scientific evidence to suggest helmets prevent concussions. Do you adhere to this position?

RE: Yes, this is accurate. Helmets are designed to prevent catastrophic head injury, and they are very good at doing that. They just were not designed to, and do not, prevent concussion.

MP: We need to explore the effects of various headgear options and continue to investigate the mechanisms of injury in lacrosse for both the men’s and women’s game, and evaluate interventions that can decrease injury — including rule changes, rule enforcement, coaches and player education. Whether future equipment modifications can prevent or lessen the severity of injury remains unanswered at this time.

Do you have other recommendations from the conference in Zurich?

MP: There has been a lot of research regarding the assessment and management of concussion that has led to a more cautious approach to this important injury. There are advanced neuroimaging techniques which show promise in demonstrating functional and structural injury with concussion. There also has been a significant amount of information regarding the acceleration forces that occur in different sports that quantify the number, extent and location of forces to the head with sport.

RE: Thus far we have focused a great deal of attention, effort and money on baseline testing but have not focused much on the post-injury evaluation, which is in many ways far more crucial. It is imperative that any athlete with a concussion be evaluated by a qualified medical professional who is specifically trained in the evaluation and management of this injury. The use of a multidisciplinary team of professionals — physicians, neuropsychologists and athletic trainers — is ideal.

For more:  http://laxmagazine.com/genrel/100713_what_is_a_concussion_q_and_a_with_us_lacrosse_experts

Concussions In Lacrosse: “Lacrosse Magazine” October 2013 Issue Article On Former Duke Middie Brad Ross’ “Post-Concussion Symptoms”

Lacrosse Magazine Lasting Impact Concussions

“I’m 28 years old, and I’m worried about long-term brain issues.”
-Former Duke and MLL midfielder Brad Ross on the post-concussion symptoms he has been experiencing the past two years, symptons that ended his career.
Lacrosse Magazine’s October issue focuses on some key sports science and safety issues like concussions, ACL injuries, equipment standards and more – all areas where US Lacrosse is taking an active role in helping keep the sport safe.
See what else is in this month’s issue, from stories about the Hall of Fame Class of 2013 to a look into Casey Bocklet’s UVa apartment — http://laxmag.us/XQxmkw

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Concussions In Lacrosse: Maryland Classifies Boys Lacrosse As A “Collision Sport”; Will Limit “Full-Contact” Practices, “Live Checking” Before Games

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Head Injuries In Lacrosse: “Concussion 101: Symptoms, Risk And Return To Play” From The Houston Methodist Concussion Center (Video)

Each year, approximately 3.8 million Americans suffer concussions & many of those injured are student athletes. Hear from experts at the Houston Methodist Concussion Center & Houston professional sports teams as they share the signs & symptoms of concussion & what you can do to help prevent head injuries.

Lacrosse Injuries: New Study Finds “No Scientific Evidence Concerning Concussions To Support Limiting Practice Time”; Practice Is Encouraged As “Safety And Concussion-Education Precaution”

 “So many people have added their voices to this issue, and for the first time, this study shows there’s no scientific evidence concerning concussions to support limiting practice time for young football players. In fact, we encourage practice as a safety and concussion-education precaution.”

A new study out of the University of Pittsburgh is offering the first evidence



that youth football players are at lower risk of getting a concussion during practice than games and experience an overall incidence of concussions similar to that of high school and college players.

Funded by NFL Charities, the study included 468 players from 18 youth football teams in the Pittsburgh suburban area. Concussive incidents were almost nonexistent during practice, occurring at a rate of just .24 per 1,000 exposures (or about one concussive hit in 4,000). During games, however, the rate jumped to 6.16 per exposure.

  • The incidence rate of concussions in 8- to 12-year-old players was 1.76 per 1,000 game and practice exposures, comparable to the incidence rate among high school and college players.
  • 8- to 10-year-olds were almost three times less likely to suffer a concussion than 11- to 12-year-olds, clocking 0.93 incidents per 1,000 exposures in games and practices compared to 2.53 in the older group.
  • Quarterbacks, running backs and linebackers made up 95 percent of reported concussions.

For more:  http://www.athleticbusiness.com/editors/blog/default.aspx?id=1135&topic=4,100

Lacrosse Injuries: “Decompression Nerve Surgery” Is A New Treatment For Severe “Post-Concussion Headaches”; Minimally Invasive Procedure Has Up To 95% Success Rate For Young Athletes

“…Soccer is definitely high, and basketball, lacrosse, football obviously, as well.  And believe it or not, even cheerleaders can have that with falls and direct head  injuries… surgery is an option if the Concussion Legislationheadaches persist after three months of  traditional treatment and a full neurological evaluation…the surgery is remarkably effective and has been successful in 95  percent of the kids he has treated…”

“What is absolutely astonishing is to take somebody who literally can’t study,  can’t work, can’t function normally, can’t live without medications, to be able to  have more than 90 percent of success is truly amazing,” he says.

It wasn’t the first time Hollie Byer was hit in the head  while playing soccer. But this concussion was very different. The 18-year-old from Olney, Maryland started having terrible headaches that would  not go away. The pain lasted for months — through doctor visits and traditional  drug therapy.

Peripheral Nerve InstituteThen, her neurologist, Dr. Kevin Crutchfield, started talking about something new.    The Baltimore-based physician sent her to Dr. Ivan Ducic, director of the  Peripheral Nerve Surgery Institute at Medstar Georgetown University Hospital.

Ducic is pioneering what some consider a radical idea to treat post-concussion  headaches caused by nerve damage. His approach is a new twist on an existing  procedure used to treat carpal tunnel syndrome.

Using tiny incisions, Ducic moves aside or slightly shaves tissue that is pressing  on the damaged nerve. He says it is like unbuttoning a shirt or tie that is so  tight around the neck, it restricts breathing.

“The surgery technically undoes the pressure on the nerves so the nerve can  function back again normally,” he says.

Ducic explains that decompression nerve surgery only takes about 60 to 90 minutes,   is almost always done on an out-patient basis and is considered minimally  invasive, requiring only a few stitches and no hair loss.

After receiving the treatment, Byer was able to return home the same day as the  procedure. She says the headaches went away almost immediately.

For more:  http://www.wtop.com/267/3329570/Relieving-concussion-related-headaches

Lacrosse Injuries: Pennsylvania High School Girls Lacrosse Team Using New “Kevlar Composite Protective Headband” In Pilot Program To Help Protect Players From Concussions (Video)

Unequal Technologies Kevlar Composite Headband For Concussion Protection

Unequal Technologies Kevlar Composite Headband For Concussion Protection

The same padding used to protect Ben Roethlisberger, Charlie Batch and James Harrison from hard hits is now being tested by student athletes at an Allegheny County high school.

Quaker Valley freshman Aubrey Bouchard missed nearly four months of school with two concussions playing sports.

“(There was) dizziness, (I was) not able to concentrate,” she said of her injury.

Nellie Kraus, coach of the girls’ lacrosse team at Quaker Valley High School, was so concerned about concussions, her team became part of a pilot program to test a new Kevlar composite headband.

“I see girls with symptoms of concussions on a weekly basis,” she said.

There are no helmets in girls’ lacrosse but Kraus said the play can get pretty physical.

“There’s multiple properties going on in the composite that enables us to absorb anywhere from up to 50 percent of the impact,” Rob Vito, CEO of Unequal Technologies said while showing Channel 11 the padding.

Unequal Technologies is a Pennsylvania company that created the Band, an adjustable protective headband.

“It conforms to the body. It’s flexible and malleable, but it can stop a truck,” Vito said.

“In practice I got hit in the head with a stick and I was thankfully wearing my headband that could have been my third concussion,” said Bouchard.

When the girls first got the Band, they were a quarter of an inch thick.

They told company leaders they were too uncomfortable, so Unequal went back to the drawing board and readjusted.

Now, the Band is one-eighth of an inch thick.

For more:  http://www.wpxi.com/news/news/local/product-designed-better-protect-athletes-concussio/nXs3D/