Tag Archives: Sports Science And Safety Committee

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

“Lacrosse Magazine Oct 2013” Issue Features Sports Science & Safety, ACL Injuries, Hall Of Fame Class, Chesapeake Bayhawks’ John Grant Jr And Casey Powell, And Team USA Men’s Lacrosse


Lacrosse Magazine Oct 2013 Issue

COVER STORY — Sports Science and Safety
From concussions to ACLs and everything in between, US Lacrosse has established itself as a leader in sports science and safety.
Lasting Impact
“I’m 28 years old, and I’m worried about long-term brain issues.” Concussions have real-life consequences. Just ask Brad Ross, the former Duke All-American and MLL champ whose symptoms may never go away.
by Corey McLaughlin
ACL Confessions
What happens after you hear the dreaded pop? Jen Adams, Shannon Gilroy, Shawn Nadalen and Michelle Tumolo chronicle their experiences with ACL injuries and rehabilitations.
by Clare Lochary
Features
Hall of Fame Class of 2013
Eight greats – Jim Berkman, Quinn Carney, Michele DeJuliis, Sue Heether, Bill Miller, Tracy Stumpf, Ryan Wade and Michael Watson – will be inducted into the National Lacrosse Hall of Fame October 26th. These are their stories.
Online Extras: Hall of Fame Home Page w/ Biographies | Video – 2013 Inductess Share Their Thoughts About Joining HOF
The Stuff of Legends
They say the MLL is a young man’s league. But in leading the Chesapeake Bayhawks to their third title in four years, John Grant Jr. and Casey Powell showed once again they’re in a league of their own.
by Corey McLaughlin
Online Extra: McLaughlin’s Favorite Championship Weekend Moments
Columns
From the Editor: Misson of the Mag
Her Space: It’s Not All Hocus Pocus
His Space: Take His Whistle
Departments
Lifestyles
Call him Cactus Jack, Dude Love or Mankind. However, you know WWE Hall of Famer and horedcore legend Mick Foley, we’ll just call him one of us.=.
World Lacrosse 2014
Who will represent the U.S. men on home soil? The training team is set and all 52 have high hopes for making it all the way to Denver next summer.
Your Edge
Take a journey inside the mind of Ohio Machine attackman and newly-hired Johns Hopkins women’s assistant coach Steele Stanwick as he works from behind the goal, then see how Penn’s Shannon Mangini uses a rare motorcycle grip for draws.
Give and Go
Former Penn State goalie Dana Cahill wants to take women’s lacrosse to new heights with Team STX.

Injuries In Lacrosse: US Lacrosse Endorses “Youth Sports Concussion Act”, Congressional Legislation That Increases Disclosure Of “Protective Benefits And Limitations Of Sports Equipment”


“US Lacrosse supports efforts, such as the Youth Sports Concussion Act, which seek to increase the accountability of sporting goods Concussion Legislationmanufacturers to accurately represent the protective benefits and limitations of equipment to mitigate injury and risk,” said Ann Carpenetti, managing director of game administration at US Lacrosse. “We have invested extensively in the area of injury research and prevention in the sport of lacrosse, and having sport specific equipment that performs to meet a protective standard is critically important to ensure player safety on the field.”

US Lacrosse is among the national sports organizations publicly endorsing the Youth Sports Concussion Act, a new bill that is expected to be introduced shortly US Lacrosse Sports Science & Safetyin the U.S. Senate. The proposed congressional legislation is aimed at reducing youth sports concussions by empowering both the Consumer Product Safety Commission and the Federal Trade Commission to take stronger actions in guaranteeing equipment safety standards and claims by sporting goods manufacturers. Congressman Tom Udall (D-N.M.) is the primary sponsor of the bill.

Essentially, the new legislation hopes to extend the impact of the findings from a National Academies report on sports-related concussions, due to be released publicly no later than January 2014. That report is expected to include product safety standards that equipment manufacturers will need to consider for voluntary adoption.

The proposed bill also allows the Federal Trade Commission to take stronger action against manufacturers who make false and deceptive product safety claims in advertising and marketing campaigns.

The U.S. Senate’s Committee on Commerce, Science and Transportation will be charged with initial review and approval of the bill before it advances to the full Senate for consideration.

To date, the Youth Sports Concussion Act has received public endorsements from numerous organizations and associations, including the American Academy of Neurology, Brain Injury Association of America, Brain Trauma Foundation, Cleveland Clinic, National Association of State Head Injury Administrators, National Athletic Trainers’ Association, National Football League, NFL Players Association, NCAA, National Hockey League, National Federation of State High School Associations, and U.S. Soccer.

About US Lacrosse
US Lacrosse, a 501(c)(3) nonprofit corporation, is the national governing body for men’s and women’s lacrosse. US Lacrosse is the parent organization of the U.S. men’s and women’s national teams program. US Lacrosse has more than 415,000 members in 64 regional chapters around the country. Through responsive and effective leadership, US Lacrosse strives to provide programs and services to inspire participation while protecting the integrity of the game.
– See more at: http://www.uslacrosse.org/TopNav/NewsandMedia/PressReleases/USLEndorsesConcussionLegislation.aspx#sthash.QM4kSC8N.dpuf

Concussions In Lacrosse: “US Lacrosse Sports Science And Safety Committee” Sponsors Study To “Understand Relationship Between Stick Checks And Head Injuries” In Women’s Lacrosse (Video)


Dr. Trey Crisco, a member of the US Lacrosse Sports Science and Safety Committee, led a July 26 “crash test dummy” research session at Brown University, where several female lacrosse players, aged 12 to 28, were asked to take 36 swings at a headform.

“The primary aim of this part of our study is to understand the relationship between stick checks and head accelerations. This grant that we received through both US Lacrosse and NOCSAE is just one piece in trying to understand what the potential injury mechanism is for head injuries in girls’ lacrosse. Previously, there have been epidemiological studies and surveillance studies that have found that the majority of head injuries in girls’ lacrosse occur from the stick. These are inadvertent, obviously, and could be a result of follow-throughs from shots, or fore checks. Unlike the boys’ game, where head injuries are dominated by body-to-body or head-to-head contact, in the girls, we don’t see that; but we are seeing the stick impacting the head. So the goal of this study was to get an understanding of the relationship between the severity of the stick checks and the resulting head accelerations.”

“That’s the holy grail of concussion studies, to document the relationship between head acceleration and concussion. We’re not there yet. We know that above 90Gs or 120Gs, you are more likely than not to get a concussion, but there’s not a definitive threshold. It’s unlikely that there will be across all people because people are different and there’s variability. But there are other factors, like where you get hit and what your previous exposures were. We’re still in the process, through other studies, of coming up with that relationship.”

For more:  http://www.laxmagazine.com/high_school/girls/2011-12/news/080912_study_leader_explains_crash_test_dummy_head_trials