As school starts, so do youth sports injuries
The University of Michigan’s new Michigan NeuroSport Concussion Program seems to be cropping up everywhere, and as far as I can tell, it’s all part of a coordinated effort by the University. They already claim to have one of the only pediatric sport programs in the country, and now they’re expanding it with a clinical and research focus on “neurological sports injuries.”
In related news, the latest CDC Morbidity & Mortality Weekly Report includes an analysis of the numbers for “Heat Illness Among High School Athletes” from 2005 to 2009. The study examined 100 schools and nine sports, and found that heat-related illness was most common in football, and that August was the worst month for such afflictions.
AHCJ has a rich pool of resources for journalists looking to report beyond the press releases on stories like these, including:
Tip sheets
Concussions in young athletes
Reporting on sports injuries in school-age children
Health and education: Two intersecting beats
Health and education: Reporting resources
Blog posts
Tougher concussion rules from high school assn.
GAO evaluates youth concussion databases
Concussion more likely when hit is unexpected (Youth hockey study)
Attention focuses on football’s neurological effects
AP story: Hundreds of PTSD soldiers likely misdiagnosed
Concussion-related trauma masquerades as ALS
The New York Times‘ Alan Schwarz reports on what he says is “the first firm pathological indications that brain trauma results in motor-neuron degeneration.” The headline behind that conclusion, of course, is that researchers say some athletes with concussion and impact-induced brain injuries may have been misdiagnosed as ALS victims.
Photo by peterjr1961 via Flickr
In interviews, the study’s authors even speculate that Lou Gherig, who gave the disease its popular name, may have instead suffered from a similar disease caused in part by brain injuries.
The finding was not unexpected, given that ALS seemed to occur at much higher rates in concussion-heavy populations like athletes and soldiers.
Schwarz’s summary of the study:
Doctors at the Veterans Affairs Medical Center in Bedford, Mass., and the Boston University School of Medicine, the primary researchers of brain damage among deceased National Football League players, said that markings in the spinal cords of two players and one boxer who also received a diagnosis of A.L.S. indicate that those men did not have A.L.S. at all. They had a different fatal disease, doctors said, caused by concussionlike trauma, that erodes the central nervous system in similar ways.
It’s in the emergence of that second disease that really seems to have attracted Schwarz’ attention. It behaves similarly to ALS, but shows a distinct protein pattern that only seemed to emerge in patients with a history of head injury. There is not, however, a 1:1 relationship. Other factors seem to also be at play, Schwarz writes.
Gary Schwitzer of HealthNewsReview.org examines the story more closely and concludes that, while this is an “important and fascinating area of research,” the story “did not exhibit the best of health/medical/science journalism.” He lists seven points of criticism and includes comments from one of the site’s medical editors.
John Gever of MedPage Today offers more scientific coverage of the study and points out that there was no mention of Gehrig in the study but that “a New York Times reporter coaxed McKee into suggesting that Gehrig may have been among those misdiagnosed – even though, as a first baseman, he did not routinely experience violent collisions. (He was, however, beaned at least twice during his 14-year career with the New York Yankees.)”
Tougher concussion rules from high school assn.
The National Federation of State High School Associations has released tougher rules about removing players with potential concussions from the field. The initial release outlines the changes:
Photo by Les_Stockton via Flickr
The previous rule directed officials to remove an athlete from play if “unconscious or apparently unconscious.” The previous rule also allowed for return to play based on written authorization by a medical doctor. Now, officials are charged with removing any player who shows signs, symptoms or behaviors consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, and shall not return to play until cleared by an appropriate health-care professional.
The Tampa Tribune’s Mary Shedden and Katherine Smith reported on how the change would affect Florida high school football and on how implementations of the new rule vary from district to district.
Language in the new rule is vague, stating a player can’t return until cleared by a “health-care representative.” In Hillsborough and Pinellas counties, players will need a doctor’s clearance, but Pasco officials may interpret the rule to include medical officials who were at the game, said Phil Bell, Pasco’s supervisor of athletic programs and facilities.
The best-known guidelines for returning to the game come from a sports medicine expert consortium in Zurich. It recommends athletes gradually return to activities, from light aerobic activity to noncontact drills to game day. Each step takes a minimum of 24 hours, and if symptoms return, an athlete must revert to the previous step.
Texas, Oregon and Washington have state laws mandating when players should be taken off the field; many other states rely on their athletic associations to format such rules. With the school year and football season getting under way, this would be a good time for reporters to check on the policies at local schools. Read more about concussions, including some recent reports and Congressional testimony.
NFL to post concussion warning in locker rooms
In The New York Times, football concussion reporter Alan Schwarz examines the content and ramifications of a new warning poster the NFL will be putting in every locker room. An image of the poster can be seen here.
Photo by Eagle102.net via Flickr
The poster lists symptoms that players should look out for, including headaches, confusion, memory problems and feeling more emotional, and warns them not to ignore symptoms.
In addition to strictly medical information — including the most starkly worded warnings yet from the league — the poster reminds players that concussions can also have long-term negative impacts on their families and on the health of those youngsters who idolize pro athletes.
Greg Aiello, a league spokesman, said in an e-mail message that the poster, spearheaded by the league’s new head, neck and spine medical committee and written in collaboration with the players union and the Centers for Disease Control and Prevention, “is intended to present the most current and objective medical information on concussions and will be distributed to the players and clubs in the near future.”
GAO evaluates youth concussion databases
Filed under: Health data, Hot Health Headline, Public records, Studies
In a recent report, the Goverment Accountability Office reviewed national efforts to track concussions in youth sports (highlights). The report evaluates local and national laws designed to keep young athletes safe, but the most immediately useful component may be the identification and evaluation of three incomplete national databases now being maintained.
High School Reporting Information Online database
Provides national estimates of occurrence of concussion, it covers only 20 sports for high schools with certified athletic trainers. It may underestimate occurrence because some athletes may be reluctant to report symptoms of a possible concussion to avoid being removed from a game.
The Consumer Product Safety Commission’s National Electronic Injury Surveillance System
Provides national estimates only on concussions treated in an emergency room.
The National Center for Catastrophic Sports Injury Research database
Provides information only on cases of concussion with serious complications and cannot provide national estimates of the occurrence of all concussions.
Related
- Last week, the House of Representatives’ Education and Labor Committee held a hearing to examine the prevalence of concussions among high school athletes and how the injury can impact academic achievement.
- Previous coverage of concussions
Concussion more likely when hit is unexpected
There’s anecdotal evidence that athletes are less likely to get concussions if they were ready for the impact before it arrived, but it’s not an easy premise to test. The primary concerns are ethical ones, of course, as it’s hard to justify enrolling patients in a condition that calls for “sneaking up and, when they’re least expecting it, whacking them in the skull hard enough to deliver a concussion.”
Photo by sphilp1225 via Flickr
Fortunately, researchers for a study published in the June issue of Pediatrics found a clever way to isolate those conditions in a place where they “naturally” occur, namely a youth hockey game.
They started by fitting the young players’ helmets with monitors to measure impact data, then let them play. Researchers then divided the impacts into two categories: Those that occurred along the boards where players expect to be checked, and those that happened mid-ice and were thus more likely to come as a surprise.
Chicago Tribune blogger Julie Deardorff, who alerted us to the study, describes the results:
Of 666 body collisions, 421 took place along the playing boards, and the remaining 245 hits occurred on the open ice. On average, the open-ice collisions were more severe than those occurring along the playing boards, the study authors found.
Deardorff then evaluates youth hockey impacts relative to those in other sports, and ends with the recommendation that youth hockey players “skate through” checks, and keep moving instead of staying put along the boards and absorbing all the kinetic energy of the blow.
Focus on hockey’s head injuries grows
Poynter Institute’s Al Tompkins takes a look at hockey injuries, especially head injuries.
Photo by Alex Kehr via Flickr
He points to an article in the Globe and Mail about the long-term effect of concussions and what Canada is doing to combat the issue, contrasted with what some places in the United States are doing to better treat and prevent concussions.
The article cites a study in the March 2009 issue of Brain that found former athletes were still suffering the effects of their head injuries more than 30 years after their last concussion.
Tompkins also notes the National Hockey League – which had 10 players out with head injuries in November – is confronting the problem by banning “blindside hits” to the head.
Attention focuses on football’s neurological effects
Friday Night Lights author Buzz Bissinger, writing in Time, looks at two things he claims are being overlooked during the most recent uproar over football injuries: High school athletes and spinal injuries. Bissinger has strong opinions and two anecdotes, one of which includes a source who said that roughly two Texas high school football players suffer catastrophic spinal injuries each year.
Bissinger praises Alan Schwarz’ work on concussions at The New York Times, but openly doubts whether the advances Schwarz is helping force at the professional level will ever translate to high school.
I know the focus will not trickle down to where it is needed most: the high school level. Research has shown that young players are far more susceptible than older ones to serious injuries. …
There should be an ambulance at every high school game. There should be trainers. But don’t bet on it, as school districts cry a lack of money. Kids will continue to suffer serious head injuries. Kids will continue to become paralyzed because they never learned how to properly tackle, with their heads up. The game’s violence will continue because that’s exactly why we like it, our gladiatorial lust still intact 16 centuries after the Romans. The bigger the hit, the greater the roar.
Not a new concern
In an Op-Ed piece in The New York Times, Deborah Blum, a professor of science journalism at the University of Wisconsin, writes about a warning published in The Journal of the American Medical Association that said the medical profession can no longer ignore that “There is a very definite brain injury due to single or repeated blows on the head or jaw which cause multiple concussion hemorrhages” in a report about professional athletes.”
But what really makes the research and its conclusions so interesting is its timing: it appeared in The Journal of the American Medical Association on Oct. 13, 1928. This raises the question – at least for me – as to why we are announcing the athlete concussion-dementia link as a new, and still somewhat debatable, issue some 80 years later.
House Judiciary forum
Watch a video webcast of the Feb. 1 “House Judiciary Committee Forum on Head Injuries and Other Sports Injuries in Youth, High School, College and Professional Football,” or read about Republican’s reluctance to hold said forum in Houston.
Dan Rather report
Dan Rather’s latest investigative effort was a far-reaching look at concussions and football, with emphasis on both the high school and professional games. He frames it as part of the pre-Super Bowl concussion awareness push (PDF Transcript).
ESPN to air ‘Head Games’
ESPN reporter Greg Garber, on “Outside the Lines,” will look at the issue of concussions and the NFL at 8 a.m. ET on Sunday. Harold Donald Carson, a former linebacker and inductee into the Pro Football Hall of Fame, “has become one of the leading spokesmen for the NFL’s retired players. Passionate and eloquent, he is in some ways the league’s conscience on the subject.”
Carson, who played 13 seasons for the New York Giants, estimates he suffered about a dozen concussions during his career, but none of them were documented. While he believes concussions among former football players will escalate into an epidemic, Dr. Joseph Maroon, the Steelers’ neurosurgeon for nearly three decades and a member of the NFL’s concussion committee for the past three years, disputes that:
“Because we know that there are millions of high school kids, college kids, youth leagues, as well as other who play football annually, I think we are not seeing the epidemic at that level people are speculating about,” Maroon said.
Related
- Advanced MRI reveals damage in brains of retired NFL football players
- Tim Tebow’s head fuels concussion debate
- Technology in play to help make football safer
- Brain damage caused by football is cumulative
- ‘Playing through’ concussions is damaging
NYT’s Schwarz discusses football concussion beat
For the Columbia Journalism Review, Brent Cunningham talked to The New York Times‘ Alan Schwarz about his work as the nation’s leading (and probably only) full-time football head injury reporter. Schwarz, whose work covering concussions brought him to the Times in 2007, talks about how he got started on the beat and how his work has impacted the sport as a whole.
It’s all interesting stuff, especially when he discusses how his background in mathematics has helped him report on sports injuries and medicine, but the real payoff comes when Cunningham finally gets Schwarz to divulge his personal stance on concussions in youth football. It’s a crystallization of all Schwarz has learned, as well as a delicate balancing act between his personal and professional ethics.
Photo by Eagle102.net via Flickr
CJR: Let’s assume for a minute that your son, who you said is three years old, is actually ten years old and he is clamoring to play Pop Warner football. Would the fact that you would then have to decide disqualify you from covering the story?
Schwarz: No, it wouldn’t disqualify me, though of course that’s up to my editors. But there is something about working here—and I’m not saying we’re better than everyone else, blah, blah, blah—but there is something that really inspires you to do the right thing, and to do the thing that helps you to cultivate the trust that allows readers to take you seriously. So I would probably let him play because if I didn’t it would compromise the reporting. It would compromise the trust that others and even the league may have in me. Now, I would not send him out to slaughter, but getting one concussion is not that big of a deal—it just isn’t. And to suggest otherwise is incredibly irresponsible. So if my kid gets one concussion then yeah, he doesn’t play anymore probably. But to not allow him on the field is, frankly, an overreaction. And if I didn’t allow him to play then yeah, it would be harder to cover the story, if only in my own mind. I believe that the cost to others of my not being able to cover this story as well would be greater than the cost of my kid getting one concussion and never playing again. I’m a very mathematical guy. I follow certain precepts. And those are the things that make sense to me. And I can’t tell my kid he can’t play, because then what am I going to tell the league? What am I going to tell my editors? It doesn’t work. It’s dissonant.
Related
- Tip sheet: Concussions in young athletes
- Tim Tebow’s head fuels concussion debate
- Technology in play to help make football safer
- Brain damage caused by football is cumulative
- ‘Playing through’ concussions is damaging
Covering Health: First year’s most popular posts
With a year of posts behind us, we thought it would be a good time to look back and see what posts proved to be the most popular – or at least the most read:
- Lewin group linked to private insurers
- Autism news raises question: When is an embargo not an embargo?
- Hensley joins NPR’s expanding health team
- Report: $25,000 buys access to Post’s health reporters
- CDC monitors H1N1 swine flu-human reassortment
- Oransky to take helm at Reuters Health
- Top N.Y. neurosurgeons suspended, sued
- Pharma industry still finding its way in social media
- Hospital says it gives content to short-staffed media
- Kuklo scandal spotlights DoD/Medtronic ties
- ‘Playing through’ concussions is damaging
- Where to find the facts on health care reform
- CBS questions CDC’s H1N1 prevalence estimates
- VA officials seize reporter’s audio recording
- Oprah’s health advice needs a shot in the arm
- Autism and vaccines: A failure to communicate
- Will pharmacists play a role in H1N1 vaccinations?
- Covering Obama’s stance on stem cell research
- Appleby to report for Kaiser Health News
- Prevention vs. treatment in global health
- FDA staff calls for end to corruption, wrongdoing
- Mentally ill patients, elderly mix in nursing homes
- Three health-care issues Obama, Congress will face
- Jost discusses consumer-driven health plans
- Tim Tebow’s head fuels concussion debate
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
