concussions

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greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

Post-Concussion Misophonia

Post by greybeard58 » Thu Dec 22, 2022 7:36 pm

Post-Concussion Misophonia

KEY POINTS
• Misophonia is disgust at the sound of others eating.
• A concussion can cause misophonia.
• Misophonia causes distress and impair social functioning, and there are no easy treatments.

My husband over dinner: “Chew. Chew. Smack. Smack. Swallow. Swish. Grind. Clink.”

“Why are you chewing so loudly?!” I loudly gripe.

“It’s kale salad. You are making the same amount of noise I am.” He answers, aggravated.

As he chews, I hear “Slob-slob-sloberry sounds” filling my whole soundscape. Then my whole sensory landscape. I can see the saliva in my mind. I am pressed against the window in a car wash with rivers of mucus-ey saliva dripping down in front of my face.

My body screams “Flee! Flee! Escape!” As my heart races. I quickly slap my hands over my ears and yell “Stop that slop-slop-slobbering!” I can’t wait one second for him to stop, and bolt out of the room to get my noise-blocking headphones. Another dinner ruined.

I wasn’t always this way. Not until my concussion.

Last April I was laying on the floor putting a textbook on the bottom shelf of a floor-to-ceiling bookcase. There was a garland of wooden sea creatures dangling down from the very top of the shelf where it was hooked onto the tall graceful neck of a brass egret. The garland toppled down on me and the brass bird slammed into my head from a bit over 6 feet above.

At first, I was sensitive to all sounds. Even normal speech was booming. Loud sounds like alarms were intolerable. Over the next few months, the sensitivity to voices went back to normal. Beeping alarms were still aggravating and unpleasant, but no longer a cannon hitting my head. But eating sounds — hearing others eat remains excruciating. By an unknown mechanism, the initial hyperacousis after the concussion had transitioned to misophonia. Since it remains present over a year later, I suspect it is permanent.

Misophonia is common, affecting about 3.2% of people. Surveys of people with misophonia find sounds of eating, drinking, and breathing are the main triggers. Interestingly, the misophonic triggers are sounds similar to those made by people with Tourette’s Syndrome. And the reactions of misophonia sufferers (emotional, motor, speech, and autonomic arousal) are similar to the responses of people with obsessive-compulsive disorder. The typical responses to misophonia triggers are anger or aggravation, stress or anxiety, feeling trapped and impatient, and disgust. The sound is expressed as, or felt in, a different modality, or emotion, not unlike synesthesia. There are many pathways to misophonia. Some develop it idiopathically as children or adolescents. Others like myself are misophonic after a brain injury, others from noise or barometric damage. There is a relationship between hyperacousis and tinnitus and misophonia, and 60% of those with tinnitus also have misophonia.

Misophonia has a negative impact on my life. It causes stress in my family. I am not generally in enough control to speak diplomatically while I am fleeing in disgust. My husband does not appreciate my describing his entirely typical eating as slobbering. I am leery of attending professional or family events where food is served, as my reaction is humiliating.

What’s going on in my brain during misophonic reactions? Am I actually perceiving quiet sounds as loud, as a subtype of hyperacousis, or am I simply oversensitive? Has my perception changed or my sensitivity? And can people’s perceptive ability change? Oliver Sacks described this occurring in The Man Who Mistook His Wife for a Hat. He presented the case of a medical student who took methamphetamines and had massively enhanced smell perception to the point where he could tell people apart by their smell. This was an overnight change, and not a slow adaptation. Is there an innate, but underused, perceptive ability in our brain? Or a different way of processing sensory information that can be accessed by drug use, brain injury, or changes to hearing? I always had strong hearing and even as a child would awaken to an animal in the backyard that did not awaken my family. Now I am distracted by ticking clocks on TV shows that no one else notices. So, there is an element of perception that appears to be enhanced after my concussion, but only gustatory sounds trigger the emotional response.

What is known about how the brain operates in people with misophonia versus controls? Kumar and Denys’ studies discussed in a Nature Scientific Reports paper both used fMRI and demonstrated that typical misophonic triggers cause activation of the anterior insula and abnormal signals to the hippocampus and amygdala. Controls do not have this, nor do either controls or misophonics react to aversive, but not gustatory stimuli—for example, violent imagery. Based on how I and other misophonics respond, it isn’t surprising that regions involved in emotion processing, regulation, and salience, are involved. Along with these brain changes, the same studies showed there is autonomic activation seen by increased heart rate and skin conductance. A measurable neurological and physiological process is occurring.

For now, my noise-blocking headphones are a lifesaver. But avoidance and isolation are not a solution. I can’t stop the world from eating.

Post-Concussion Misophonia
Read more: https://www.psychologytoday.com/us/blog ... misophonia

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

Re: concussions

Post by greybeard58 » Sat Dec 24, 2022 2:25 pm

"they've been routinely used to mask and combat concussion symptoms in sports"

One whiff and Ezekiel Elliott's eyelids begin to flutter, his mouth falls oddly agape and his pupils roll back in his head. It's Week 4 of the NFL season, and kickoff is just moments away inside AT&T Stadium, where Elliott and a handful of his Cowboys teammates are breathlessly engaged in the latest, strangest sports ritual: huffing the stomach-turning noxious fumes found in smelling salts.

The ammonia-based inhalant is manufactured for the express purpose of treating or preventing fainting, but at some point, NFL players and other athletes discovered they could repurpose the decongestant properties and adrenaline-pumping side effects into a perfectly legal, low-tech pick-me-up ... even though there's zero proof of any performance benefit. In fact, this will be the first of at least eight capsules for Elliott today. Using hand movements reminiscent of his trademark "feed me" gesture, Elliott inhales a capsule before donning his helmet for each Dallas drive in a 35-30 loss to the Rams. He's far from alone, on either team. Directly behind Elliott, two members of the Cowboys' game-day staff, dressed in matching blue slacks and white polos, are busy sniffing away on their own ammonia capsules. Just a few minutes into the game, the Cowboys have discarded so many capsules that the area in front of their bench looks like the floor of a kid's bedroom after trick-or-treating. (Don't change the Cowboys' moniker to Ammonia's Team just yet. There are dozens of discarded smelling salts capsules on the Rams' sideline too.)

Near the end of the first half, six members of the Dallas defense can be seen simultaneously hitting the salts before taking the field. The group includes veteran cornerback Orlando Scandrick, who jogs onto the field while using his right hand to make the sign of the cross and his left hand to sniff salts, and defensive end Demarcus Lawrence, the NFL's sack leader through four games.

Lawrence says he can't drink coffee for a quick jolt during the game because it might affect his stomach, so he has turned to smelling salts. "The ammonia wakes you up, opens your eyes," Lawrence explains. "You'll be on the bench, you start to get a little tired and you got to wake your body up, and that's what that little ammonia does for you."

But that simple explanation, like the entire smelling salts fad itself, doesn't quite pass the sniff test.

ONCE PRESCRIBED TO Victorian-era women plagued by fainting spells, ammonia inhalants are now manufactured in single-use capsules the size of a small stick of gum. Each sealed white plastic wrapper contains a .3-milliliter mix of alcohol (35 percent), ammonia (15 percent), water, oils and red dye that, when crushed between two fingers, stains the wrapper a telltale pink. Aerated by the alcohol, the ammonia fumes pack such a rancid punch -- imagine military-grade concentrations of Windex, wasabi and Vicks VapoRub that get T-shirt-cannoned up both nostrils -- that most users instinctively snap their heads back to escape the stench.

The initial discomfort is quickly followed by a sensation that your breathing pathways have not just opened up but expanded exponentially while ramping up your alertness to an almost euphoric level. This phase is short-lived, however: Lawrence says that for him, it lasts about one set of downs. Also, the initial wave can sometimes be followed by prolonged bouts of nausea that serve as a vivid reminder of why household ammonia products come with the warning: Avoid inhalation of vapors.

"The claim is that smelling salts arouse your consciousness and focus, but how many of us in our daily lives think it's appropriate during a tough day at work to open a bottle of ammonia and start sniffing the fumes?" says Dr. Joseph Estwanik, a fellow with the American College of Sports Medicine. "Ammonia's intended use is for cleaning. Giving a highly trained elite athlete ammonia to help them perform at their peak is like throwing a drowning man a cup of coffee."

The company that manufactures the NFL's capsules, the New Jersey-based James Alexander Corp., has repeatedly stated that the product is designed to treat or prevent fainting. A company spokeswoman had no response when asked about the widespread misuse of smelling salts in the NFL. Ignoring the topic seems to be the common response when it comes to the league's secret little helper. Even though the capsules are typically distributed by athletic trainers, the National Athletic Trainers' Association wouldn't discuss the topic and doesn't have official guidelines on the use of ammonia capsules.

There is one clear, though indirect, danger to using smelling salts: In the past, they've been routinely used to mask and combat concussion symptoms in sports such as boxing and football. In 2011, after quarterback Terry Bradshaw began experiencing the effects of brain damage suffered during his Hall of Fame career in Pittsburgh, he wrote: "When I played for the Steelers and I got my bell rung, I'd take smelling salts and go right back out there. All of us did that."

For that reason, the practice of using salts has been banned for decades by major boxing organizations, and in the NFL, league spokesman Brian McCarthy says "team medical staffs do not use [smelling salts] in any way for the treatment of any concussion or other injury.

"We have seen no proven performance enhancement and minimal risk," he says. "Team medical staffs monitor all aspects of their players' care."

In college football, salts are already common. And Estwanik wants the NFL to outlaw ammonia before the league's huffing habit becomes just as widespread on the high school level, where there isn't enough medical supervision to prevent the use of ammonia to mask conditions such as asthma, dehydration and head injuries.

IN THE NFL, players sure don't seem concerned about the dangers, and they don't seem all that bothered by the fact that there's no scientific proof smelling salts actually work. Instead, they remain focused on anecdotal evidence that suggests the ammonia in smelling salts irritates the highly sensitive membranes in the nose and lungs, disrupting normal breathing patterns and inducing what's known as an "inhalation reflex," or the body's emergency survival instinct to restore stasis. The ammonia may also hyperstimulate the large trigeminal nerve that runs from the nostrils to deep inside the brain stem and thalamus. While doctors and trainers remain skeptical, athletes swear that this combination of responses to the gas triggers the nervous system's powerful fight-or-flight response, temporarily spiking levels of breathing, heart rate and alertness.

Even if it's all the result of a placebo effect, NFL players just know it's legal and it works ... kinda. "It's such a painful smell, it's like a slap in the face," says Rams linebacker Connor Barwin, who was photographed making a Dr. Seuss-like face after sniffing salts during a 2013 game. "If you're going to go hit somebody, you better be ready, so this just wakes you up a bit, gets you locked and ready and alert."

Because of that effect, perceived or not, former U.S. men's national soccer team star Landon Donovan popped a capsule before every match. Extra-strength smelling salts featuring brand names like Nose Tork and Wake Up Mother are targeted toward the powerlifting market. Ammonia capsules also remain popular in the NHL, except maybe in Boston, where in 2013, then-Bruins center Tyler Seguin accidentally tossed a discarded capsule into a fan's beer.

Photo of smelling salts labelled:
FOR INHALATION ONLY
ALCOHOL 35%, AMMONIA 15%
KEEP OUT OF RACH OF CHILDREN
JAMES ALEXANDER CORPORATION
3316 LOT CODE ON END SEAL
Users break the .3-milliliter smelling salts capsule to activate the chemicals inside: a mixture that includes 35 percent alcohol and 15 percent ammonia.

In the NFL, where Brett Favre, Peyton Manning, Bengals coach Marvin Lewis and scores of others have been photographed while indulging, one former trainer estimated that more than 80 percent of players use smelling salts. (Former Giants star Michael Strahan once put that number in the 70 to 80 percent range too.) If they were used strictly as a treatment for fainting, a football team should go through maybe a handful of capsules the entire season. In just that one game against the Rams, the Cowboys left more than 100 broken capsules on their sideline. "The term I keep coming back to with the NFL and smelling salts is 'not for the intended use,'" Estwanik says. "And a similar term for that is just 'abuse.'"

The optics aren't exactly ideal for an image-conscious corporation like the NFL. YouTube clips and social media threads of players sniffing salts typically inject snide references to drug use. In a Week 3 Monday night game against the Cardinals, cameras captured what looked like a scene straight out of an after-school special on inhalants when an oblivious Elliott huffed away while Dallas running backs coach Gary Brown yelled in his ear. Days later, network TV cameras in Green Bay captured a Gollum-eyed Clay Matthews enjoying several long, seemingly mind-altering pulls before taking the field against the Bears. These days, Tom Brady might be a well-known health food nut who won't poison his body with so much as a single tomato, but just a few years ago he could regularly be seen on the Patriots bench rewiring his thalamus with a cupful of ammonia capsules alongside his wide receivers. "We all do it," Brady told a Boston radio station when network cameras discovered his smelling salts habit. "It's kind of a receiver-and-quarterback thing."

“Smelling salts are a classic, comical example of how NFL players think.” - FORMER NFL TRAINER

Instead of something sinister, though, what the widespread use of smelling salts really reveals is the increasingly bizarre culture created by the NFL's (win-at-all-costs pressure cooker. Extreme parity, the minuscule margin of error, the constant threat of injury and million-dollar stakes all push players to exploit any shortcut, no matter how weird, gross or pitiful. More than a century ago in major league baseball, players like Hall of Fame pitcher Pud Galvin thought consuming ground-up monkey testicles was the answer (seriously). A decade ago, football found deer antler spray. Now it's smelling salts.

The NFL mentality has always been: If a little pregame caffeine is good, six Red Bulls is even better. If a little spray Stickum is good for the hands, then several cans can only be better. Therefore, if there's even a chance that one dose of ammonia improves breathing, alertness and performance, then 10 capsules a game can only be better. "Smelling salts are a pretty harmless way for players to clear their heads before battle," says a former NFL trainer with more than 30 years' experience. "They're also a classic, comical example of how NFL players think. If one guy does it and he has even some small bit of success with his new routine or superstition, the next week everyone will be doing it."

So does it matter if all the benefits are in players' heads?

"It might provide a psychological advantage, whether it actually helps or not," says Dr. Robert Cantu, a former president of the American College of Sports Medicine and a senior adviser to the NFL Head, Neck and Spine Committee. "If Elliott thinks smelling salts work, then in his mind, he's going to gain more yardage if he uses them."

Not always. Back in Dallas, Elliott has 139 all-purpose yards and two touchdowns, but he's overshadowed by Rams running back Todd Gurley, who gains 215 all-purpose yards and puts Los Angeles ahead for good in the third quarter with a 53-yard touchdown reception. The Cowboys have a chance to win on their final possession, but with 36 seconds left to play, the drive stalls on fourth-and-10. Elliott is stopped at the 39. Yep, just a whiff shy of the first down.

Waiting to inhale
They offer players a putrid punch in the nose but likely little actual performance boost. So how exactly did smelling salts become an essential part of NFL game days?
Read more: https://www.espn.com/espn/feature/story ... salt-users

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

"the study is the first to examine the long-term consequences of brain trauma in young hockey players"

Post by greybeard58 » Thu Dec 29, 2022 12:42 pm

"the study is the first to examine the long-term consequences of brain trauma in young hockey players"

A prominent Canadian neurosurgeon who led a new study exploring the prevalence of post-concussion symptoms (PCS) in minor hockey players who suffered brain injuries is calling for the introduction of bodychecking in the sport to be delayed until players are 18 years old.
“The brains of 16- and 17-year-old hockey players are still too vulnerable,” Dr. Charles Tator said in an interview on Wednesday with TSN. “We are seeing that too many players are suffering the effects of brain trauma from permitted bodychecking, and in some cases, the symptoms can be there forever.”
Dr. Tator’s study was published Sept. 23 in the Canadian Journal of Neurological Sciences.
“There is a common misconception that introducing bodychecking at an early age can help prevent injuries such as concussion by ensuring that children are skilled in how to withstand a bodycheck, when in fact there is no data to support this,” the study said.
“Youth hockey leagues should raise the age of permissible bodychecking to 18 from the current age of 13-14. We show the potential to prevent 85 per cent of bodycheck-caused concussions by raising the permissible bodychecking age from its current age of 13-14 to 18 years of age. There is also the potential to eliminate years of suffering from bodycheck-induced PCS.”
Tator, a neurosurgeon in Toronto with the Canadian Concussion Centre who was invested in 2000 as a member of the Order of Canada for his work researching brain injuries, said he understand leagues, teams, parents, and possibly players will probably resist his recommendation. But he pointed out that NHL players pushed back when helmets and then later visors were made mandatory in the professional game.
“Each step in protecting players has met with resistance,” he said. “It’s expected because change is disruptive.”
Tator’s study followed a cohort of 87 youth hockey players (66 males, 21 females) who were between the ages of 10 and 18 when they suffered concussions between 1997 and 2017.
Bodychecking was responsible for 34 players’ concussions, the study said. Other events that caused concussions included fighting, being hit with sticks and pucks, falls, and elbows to the head.
“In the present study, [post-concussion syndrome] occurred in 70 (80.4 per cent) of the 87 concussed youth players including 24 of the 34 (70.6 percent) patients concussed by bodychecking,” the study said. “The potential severity of this condition is emphasized by one of our cases who remained symptomatic for 14 years (168 months). Most of the bodycheck cases were boys: only three of 21 girls had concussion from a bodycheck.”
Post-concussion syndrome symptoms can include fatigue, irritability, difficulty concentrating, memory problems and sometimes depression. The syndrome can lead to behaviors such as impulsiveness, easy frustration, poor social judgment and dramatic personality changes.
Tator said the study is the first to examine the long-term consequences of brain trauma in young hockey players.
“…these young hockey players often change teams and locations, especially those wishing to pursue college or professional play, and also, they may be reluctant to admit the occurrence of concussion and persistence of symptoms,” the study said. “The importance of longitudinal studies of concussion and PCS is that such studies help to detect and treat the early and long-term consequences of concussion including mental health issues of anxiety, depression and PTSD, cognitive decline, and catastrophic conditions such as the second impact syndrome…”
Most leagues within Hockey Canada permit bodychecking in boys’ hockey beginning at age 13, the study said.
In 2013, Hockey Canada raised the minimum age for bodychecking from 11 to 13. Four years later, in 2015, The Globe and Mail quoted a University of Calgary study that reported the policy change contributed to a 50 per cent drop in injuries among 11- and 12-year-old players in Alberta.
Also in 2015, the Greater Toronto Hockey League, the largest minor hockey league in world, voted to eliminate bodychecking for all players under 18 at the Single-A level. There is also a moratorium on bodychecking in house league and select leagues. In the more competitive Double-A and Triple-A programs, bodychecking is allowed when players are 14.
Tator said that leagues should commit to a ban on bodychecking for all players under the age of 18 – even if it impacts those who might want to play major-junior hockey, where bodychecking is permitted between players typically aged 16 to 20.
“Delay players going to the Canadian Hockey League for two years until they are 18 then,” Tator said. “It’s a small price to pay. How much is one brain worth?”

New study recommends youth hockey leagues ban bodychecking until age 18
Read more: https://www.tsn.ca/new-study-recommends ... -1.1855136

greybeard58
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Alyssa Grogan

Post by greybeard58 » Sun Jan 01, 2023 11:24 pm

15 in 15 for WW18

In one week the IIHF Ice Hockey U18 Women’s World Championship will mark the 15th edition of the premier junior event for women. Started in 2008 in Calgary, the U18 provides a vital link between high school and college, and the senior levels, and in the last 15 years virtually every superstar at the top level started with their national team at the WW18 level. Herewith are the 15 best players to have appeared at the U18.

Alyssa Grogan
Although she played in only the 2008 WW18, Grogan had a spotless 5-0 record and allowed just four goals, leading the U.S. to victory in Calgary. She was named Best Goalkeeper, and is in fact the only goalie at the WW18 level to win five games in one tournament. Her career was hampered by a serious concussion, however, and she never managed to make it to the Women’s Worlds level.

15 in 15 for WW18
Read more: https://www.iihf.com/en/events/2023/ww1 ... 5_for_ww18

greybeard58
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Minnesota family opens up about their daughter's concussion journey to help others

Post by greybeard58 » Fri Jan 06, 2023 10:06 am

Minnesota family opens up about their daughter's concussion journey to help others

From pro athletes to young athletes taking a timeout, concussions can be a serious health concern. For the first time, one Minnesota family is opening up about their daughter's journey, and share what they wish they had done differently.

Meredith Umbreit is a multi-sport athlete. Her main focus is soccer and basketball. However, a concussion during a basketball game sidelined her last year. It was her third in two years, and second in six months.

"I went for it and she tripped and her elbow came down and whacked me right above my eye, and that one I knew was probably something bad," Meredith said.

The hit happened near the end of the game.

"I remember going back into the gym and the lights were just way bright, super bright, and all the people in there and the music," Meredith said.

Doctors had her take a break from school to rest after the head injury. Symptoms like headaches and dizziness persisted.

"I had a lot of vision problems, it was hard to track things. I had balance problems for a little bit," Meredith said.

Meredith says it was scary. Doctors diagnosed her with post-concussion syndrome.

"The second one was the one that ... I feel like that one was the worst one," mother Jennie Umbreit said.

The second happened during a header in soccer. She continued to play, heading the ball again, exacerbating the symptoms. Meredith was checked out at an urgent care and cleared to play.

"We didn't know better and we let her go back into sports I think too soon. And then the third one happened and it was just all cumulative, that kind of just built on top of each other," Jennie said.

Meredith says she still doesn't feel like herself.

"I don't feel as like social and I don't feel as vibrant as I used to be," Meredith said.

Her parents worry about the damage done, and if it will be long lasting.

"It almost seems like she gets more overwhelmed with things. School, sports, just activities in general," Jennie said.

"She's not as happy-go-lucky as she used to be. Sometimes things bother her that didn't bother her before," father Mark Umbreit said.

And they say there's a lot of guilt.

Meredith is now working on getting back to feeling like herself. She goes through physical therapy, and has started acupuncture. She hopes this will help others understand every concussion journey is unique.

"Don't judge someone just by looking at them. You don't know what really is going on with how hard it is to live your everyday life," Meredith said.

And she says there's a lesson for all athletes, advisors and caregivers.

"To stop and think, 'Is a high school sport or any sport that you're playing worth a brain injury for the rest of your life?'" Meredith said.

Meredith hoped she'd be cleared to play this current basketball season. She says the fear of getting hit in the head again stops her. And doctors told her she'll need to be symptom-free for six months before they can begin talking about a return to play. She's participating as the team manager.

Former Gov. Mark Dayton signed Minnesota's Concussion Law in 2011. It requires coaches to sit athletes in youth sports who show signs of a concussion. The law tightens return-to-play standards. It also provides training for coaches and offers access to information for parents.

It's a good idea to check with the school athletic director about your district's specific return-to-play policy.

Minnesota family opens up about their daughter's concussion journey to help others
Read more and watch the video at: https://www.cbsnews.com/minnesota/news/ ... ssion-pkg/

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

Experts investigate the association between concussion history and academic standing

Post by greybeard58 » Thu Jan 12, 2023 11:09 am

Experts investigate the association between concussion history and academic standing

Adolescents who experience a concussion in the past 12 months could be 25% more likely to be in poor academic standing than youths who have no concussions, suggests a study published online in the journal Injury Prevention.

A concussion is a temporary brain injury caused by a bump, blow or jolt to the head or by a hit to the body which causes the brain to move rapidly back and forth. Common signs of a concussion include loss of consciousness, dizziness, glazed look in the eyes, headache, amnesia, vomiting, memory problems, and loss of focus.

In the USA, almost two million youth concussions happen every year which can lead to lasting physical, cognitive and emotional changes but there is a lack of clear, standard guidance across the country about how to reintegrate students with concussion back into academic work.

There is also a lack of evidence about what impact concussions can have on the adolescent's academic performance.

Therefore, a team of researchers from the University of Washington in Seattle set out to investigate whether or not there was an association between concussion history and academic standing among high school students.

They analyzed data on 10,756 adolescents from the 2019 Youth Risk Behavior Survey – a semi-annual survey that monitors health risks among students across the USA.

Of the more than 10,000 high school students analyzed, 14.9% reported they had at least one sports and activity related concussion in the past 12 months.

Most adolescents who reported no concussions were female (50.9%), while most who reported one or more than two concussions were male (53.1% and 63.5% respectively).

Students who self-identified as black or African American represented a higher proportion of students with two or more concussions (15.6%) compared with students with zero or one concussions (10.6% and 9.4% respectively).

Overall, a large majority of adolescents (78.8%) reported to be in good academic standing.

The researchers calculated that having at least one concussion in the past 12 months was associated with a 25% higher risk of poor academic standing and this association was stronger with a history of repeated concussions.

The association varied by race/ethnicity, but the authors said future studies were needed to examine the interaction of race/ethnicity on the association.

The authors acknowledge that their study had some limitations in that it did not allow them to assess the change in academic standing before and after the reported concussions, self-reporting from the students about their concussion and outcome was not checked for verification, and the study did not incorporate socioeconomic variables such as family income and location of residence.

Nevertheless, the authors conclude: "History of concussion was significantly associated with poor academic standing and experiencing multiple concussions could be particularly harmful on student outcomes.

"School-based injury prevention efforts, including promotion of helmet use, school screening for concussions and adherence to return-to-play and return-to-learn guidelines, to reduce multiple concussion in sports, particularly for racial and ethnic groups most affected, may prove beneficial to students with concussion."

Experts investigate the association between concussion history and academic standing
Read more: https://www.news-medical.net/news/20220 ... nding.aspx

greybeard58
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How Americans perceive the risk of injury and concussion in hockey and 10 other sports

Post by greybeard58 » Fri Jan 20, 2023 7:03 pm

How Americans perceive the risk of injury and concussion in hockey and 10 other sports

High-profile sports injuries often spark concern from parents that contact sports are too risky for their children to play.

A pair of recent YouGov polls surveyed Americans' opinions about the risks of injury or concussion from 11 sports. Our poll shows that a majority of Americans believe that sports-related injuries and concussions are common in boxing and football. Four in five Americans (80%) say concussions are very or somewhat common in boxing, and the same share say so about football. Even more say that sports-related injuries, in general, are common in the two contact sports (84% in boxing; 88% in football).

Ice hockey (70% concussions, 80% injuries), rugby, and soccer are also perceived as high-risk sports for injury and concussion.

Other sports are associated more with general injury risk than with concussion risk. For instance, 75% of Americans say injuries are common in gymnastics, but only 46% say the same about concussions in the sport. Similarly, 71% believe basketball injuries are common, but only 43% say concussions in basketball are common.

For some people, the perceived risk of injury in sports is so significant that they would prevent their children from participating in the activity — hypothetically speaking. For instance, 45% of Americans who believe concussions are very or somewhat common in boxing say they would prevent a hypothetical child of theirs from participating in the sport because of injury concerns and 41% say the same about concussion concerns. More than one-third (35%) express the same concern about injuries in football, and 34% do about concussions.

How Americans perceive the risk of injury and concussion in football, boxing, and nine other sports
See the chart at: https://today.yougov.com/topics/sports/ ... ssion-risk

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

How sports science is neglecting female athletes

Post by greybeard58 » Sat Jan 21, 2023 1:42 pm

How sports science is neglecting female athletes

Research on the science of sport is heavily skewed towards male athletes, finds a review of hundreds of sports-medicine studies. The imbalance leaves large gaps in knowledge about female sports and sport-related injuries.

A review of this type is long overdue, says Willie Stewart, a neuroscientist at the University of Glasgow, UK, who studies concussion. “It reflects the general neglect of female sport.”

Researchers reviewed 669 studies published between 2017 and 2021 in 6 leading sports-science journals. They wanted to put some numbers to their observations that there were many more studies on male sports compared with female sports. “We wanted to quantify these discrepancies in the current sports-medicine research to show that there is a need for female-athlete-centered research, especially as we continue to learn how females experience different injuries than males across many sports,” says co-author Meghan Bishop, a surgeon at the Rothman Orthopedic Institute in Philadelphia, Pennsylvania.

Just 9% of the studies focused exclusively on female athletes, whereas 71% focused only on male athletes. “While stark, these results were not particularly surprising,” says Bishop. The starkest comparison between sexes, she adds, was in baseball and softball, with 91% of studies focusing on male players and only 5% focusing on female players.

The disparity, Bishop says, is for several reasons, from financial incentives to the availability of data in public databases and an over-representation of male researchers in the studies’ leaders. Bishop says that more female orthopedic surgeons could help redress the balance.

Michael Grey, a neuroscientist at the University of East Anglia in Norwich, UK, who specializes in sports injuries, says he isn’t sure that a lack of female surgeons is the problem, but agrees that funding is a big driver. “People focus on men’s sport because that’s where the money is. Not only in the sport itself but in the research,” he says. “And it shouldn’t be that way.”

Slight improvement
There has been a slight improvement in the past few years, the study shows. The proportion of studies that focused solely on women or girls, or included both male and female athletes, has started to increase gradually over the past few years (see ‘Slow progress’). This change is partly because of greater awareness of the issue in researchers, and partly because some funding agencies, such as the US National Institutes of Health (NIH) require the clinical studies they fund to include data on different sexes, Stewart says.

“I’m excited to see studies on female athletes being represented in the literature,” says Martina Anto-Ocrah, an epidemiologist at the University of Pittsburgh in Pennsylvania. “It will be great to see more rigorous studies that connect studies of this nature to female injuries, treatment options, interventions and recovery.”

Grey says that a lack of data on female athletes leads to inappropriate extrapolation, especially in his area of research. “We know that certainly with respect to concussions, the protective elements of the brain are different in women and men,” he adds. “We must be studying women and cannot be extrapolating from men to women. That’s just wrong.”

How sports science is neglecting female athletes
Imbalance impedes progress in prevention and treatment of injuries among female players.
Read more: https://www.nature.com/articles/d41586-022-04460-3

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

Understanding the Concussion Symptoms You May Not Expect

Post by greybeard58 » Tue Jan 24, 2023 2:31 pm

Understanding the Concussion Symptoms You May Not Expect

On top of the well-known symptoms you may experience after a head injury—including short-term memory deficits, difficulty focusing and concentrating, fatigue, noise and light sensitivity, headaches, vomiting or nausea, vision problems, balance issues, emotional dysregulation, and sleeping disturbances—there are a host of other lesser known effects to brain and body functioning that can occur. These symptoms can continue for months or even years, despite the severity of the injury.

As a certified brain injury specialist and clinical psychologist specializing in treating car accident survivors, I see a large gap between brain injury research findings and the treatment of patients’ often extensive TBI fallout. Many of my patients report experiencing cravings for sugary foods, changes to blood pressure—including fainting spells or feeling lightheaded—difficulty regulating body temperature, noticing an increase in bouts of the flu or colds, or suffering from a constant runny nose.

Why Do These Lesser-Known Effects Occur?

Recent scientific studies on head injuries help to explain what is actually occurring in the brain and the body to cause these issues.

The brain’s main source of energy is glucose. After a head injury, the brain requires an increased amount of energy to assist in healing and maintaining the blood flow for neuronal connections—hence the cravings for sugar that some patients report.

However, if you have a TBI, there is a danger in consuming too many refined sugars, as they can increase the brain’s already existing inflammation. Stick to anti-inflammatory and antioxidant foods such as dark chocolate and fruit instead.

A study from UCLA reported that “the level of brain glucose use in people who suffer mild concussions is similar to that in comatose, severely brain-injured patients. Even mild head injuries result in major changes in the brain’s metabolism.” The study’s findings are further evidence that simply labeling a concussion or brain injury as “mild” does not mean that the symptoms experienced are any less debilitating than those from a more severe head injury. In fact, there are studies that suggest that recovery from an mTBI (mild traumatic brain injury) can be much more prolonged than recovery from a moderate or severe TBI.

We know that a head injury can cause dysfunction in the autonomic nervous system, which can result in high or low blood pressure, and may also result in POTS (postural orthostatic tachycardia syndrome). Many concussion patients experience lightheadedness, vertigo, or dizziness as a result of these blood pressure changes.

Nervous system dysfunction can also cause difficulties with regulating body temperature, causing the feeling of always being too cold or too hot. Temperature instability can occur due to metabolic changes in the brain as well as neuro-inflammation and/or injury to the hypothalamus, the structure in the brain that coordinates the activity of the nervous system and the pituitary gland.

The neuroinflammation that a brain injury leaves in its wake also compromises the immune system, leaving many patients more at risk for suffering colds and the flu more frequently. There are some interesting studies that suggest that some of the neurodegenerative effects from a head injury are caused by the body’s immune system response to the injury with postulations that the immune system attacks the brain after injury. More research in the area of immunology as it relates to brain trauma is needed.

To further complicate the symptom presentation picture after a head injury, experiencing a runny nose, headaches, clear fluid coming out of your ears, blurred or double vision, changes in hearing, neck pain, dizziness, vertigo, light sensitivity, nausea, vomiting, balance or gait problems may be attributed to a CSF (cerebrospinal fluid) leak. Some of the symptoms are often mistaken for recurring migraines, sinus infections, or allergies.

In my book on car accident recovery, I highlight the particular importance of ruling out a CSF leak. If a leak is suspected, it’s crucial to have your healthcare providers run imaging and diagnostic tests as the condition is treatable.

For TBI sufferers up against a healthcare system that tends to be overly focused on acute neurological care—along with the unfortunate reality that there is still a great deal we have yet to understand about the intricacies of healing the brain after trauma—it’s important that those treating concussions address all of the varied symptoms a patient may be experiencing. I argue that neurorehabilitation after a brain injury needs to do much more to address lesser-known concussion effects and requires a holistic, interdisciplinary team approach that may include a neurologist, neuropsychologist or neuropsychiatrist, clinical psychologist, rehabilitation physician and nurses, pain management specialist, naturopath, dietician, neuroendocrinologist, physiotherapist, occupational therapist, speech and language therapist, social worker, case manager, and family and friends. With a more multi-dimensional, comprehensive team approach based on the sharing of research and knowledge amongst disciplines and an appreciation that no two brain injuries are the same, concussion patients could achieve greater recovery over a shorter time span.

Understanding the Concussion Symptoms You May Not Expect
Symptoms like sugar cravings and temperature shifts can be confusing.
Read more: https://www.psychologytoday.com/intl/bl ... not-expect

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

"downplayed the severity of their traumatic brain injuries or other physical ailments by pressuring them to return too s

Post by greybeard58 » Sat Jan 28, 2023 9:48 am

"downplayed the severity of their traumatic brain injuries or other physical ailments by pressuring them to return too soon or to play through excessive pain"

Katey Stone’s 26th season as the Harvard women’s ice hockey coach, brimming with promise most of the way, suddenly was sinking — and Stone’s anger was rising.

Her 2021-22 team, champions of the Ivy League and ECAC regular seasons, had entered the regional ECAC playoffs as the top seed, only to be upended in the first round by a mediocre Princeton rival.

As the Crimson skated through a subpar practice before the ultimate challenge, the NCAA tournament, Stone’s whistle shrieked. She abruptly curtailed the practice, profanely ordered everyone to the locker room, then stood before her players, two of whom proudly identified as North Americans of Indigenous descent.

In an outburst that witnesses described as degrading and dispiriting, Stone accused the players she had recruited of showing her too little respect and devolving into a collection of skaters “with too many chiefs and not enough Indians.”

Maryna Macdonald, a junior starting defenseman from the Ditidaht First Nation of Canada’s Vancouver Island, said Stone looked her in the eye when she made the remark.

“I had learned to navigate a lot of her toxic environment,” Macdonald said. “But now she was disrespecting me and my family and my heritage in front of everybody.”

Macdonald has since left the team, as has Taze Thompson, the 2021-22 Ivy League Rookie of the Year, who is descended from the Cree Nation of Alberta, Canada. Sydney Daniels, an assistant coach who had captained the 2016-17 Harvard team and is a member of the Mistawasis Nehiyawak First Nation of Saskatchewan, also abruptly departed before suing Harvard for alleged racial and other forms of discrimination related to Stone and the athletic department. Harvard has until Feb. 8 to respond to the complaint.

Stone’s tirade led to a review by the university, which decided to retain her as head coach, and triggered a backlash that continues to reverberate among former players who say Stone has emotionally damaged them, all while she has established herself as one of the most renowned coaches in the history of women’s ice hockey.

Sixteen of Stone’s former players told the Globe they fault Harvard for keeping her on the job despite numerous complaints about her alleged abusive coaching practices. Macdonald and Thompson are among 14 recruited players who have left Stone’s program since 2016, including three this season.

Stone declined to comment, as did Harvard athletic director Erin McDermott and the university.

Stone, in a letter e-mailed to her current team after being contacted by the Globe about this story, wrote, “This year, I have made it a priority to acknowledge and respond to direct feedback from the women in my program about my coaching style, and make a concerted effort to better support my players’ experiences.”

McDermott forwarded Stone’s letter to hundreds of former Harvard women’s hockey players, about 45 of whom then sent the Globe a letter supporting her.

Stone’s supporters, in interviews and e-mails, effusively praised her for developing them as students, athletes, teammates, and leaders. They called her kind, caring, and swift to respond to personal crises and tragedies.

“Harvard hockey is just short of holy to me, and that’s because of Coach Stone,” said Lauren McAuliffe, Class of 2004, a former captain who later served as an interim head coach at Northeastern. “It wasn’t just the four years I was there. It impacts me almost every day.”

Categories of complaints

Stone, 56, built the Harvard program into a national power after she took over in 1994. She has coached 24 All-Americans, 15 Olympians, and six winners of the Patty Kazmaier Award, the top individual honor in collegiate women’s hockey. The letter supporting her was signed by eight of those players, including Julie Chu, a four-time Olympic medalist, three-time All-American, and Kazmaier winner.

“I had a very positive experience playing for Coach Stone,” Chu said. “I felt very accepted for who I was as an Asian American and also as someone who was figuring out how to come out as gay to family and friends during my university time.”

The former players who detailed alleged abusive treatment by Stone represent a cross-section of backgrounds and skill levels: captains, marginal players, standouts who played professionally, players from elite private schools with family connections to Harvard, and players such as Macdonald with no ties at all. Their careers with Stone spanned nearly 25 years, and most asked not to be identified for fear of retribution from her supporters, the university, and its powerful alumni network.

Several former players said McDermott, while addressing the team after Stone’s outburst, said a 2019 survey of players commissioned by the Faculty of Arts and Sciences ranked the women’s hockey team last among the university’s 42 varsity sports programs in the quality of its student-athletes’ experiences.

“It’s a culture of complete fear when it comes to [Stone],” said Ali Peper, a captain of the 2019-20 Harvard team. “There is clearly a way to coach without making people hate their lives.”

By many accounts, Stone has created an environment — she calls it a “meritocracy” — that values talent, toughness, obedience, and a team-first ethic that generally prioritizes hockey over the rigors of Harvard academics.

Her critics say she accommodates her favored players while mistreating others, creating fragile and sometimes fractured team dynamics. They detailed a litany of complaints, many of which they said they have shared with Harvard administrators to little or no avail. The complaints fall into seven broad categories:

▪ Negative motivation. Each of the 16 former players said Stone denigrated them or their teammates in ways that made them demoralized, anxious, confused, or seeking mental health support. “Winning and fostering a supportive, non-toxic environment are not mutually exclusive,” said Chloe Ashton, a junior forward who left the team in December. “The best coaches produce good results by inspiring athletes physically and mentally. Unfortunately, that was not my experience in the Harvard women’s hockey program.”

▪ Insensitivity to mental health issues. Stone was described by numerous former players as having little tolerance for those confronting emotional challenges. A former team leader who requested anonymity said that when Stone learned she was receiving mental health care, the coach told her, “You need to toughen up and not be a burden to your teammates.”

▪ Pressure to return from concussions and other injuries. Several players said Stone downplayed the severity of their traumatic brain injuries or other physical ailments by pressuring them to return too soon or to play through excessive pain. Peper said Stone pushed her to play with a badly damaged hip that ultimately required surgery. “I will never forget the fear I lived in and the physical pain from injuries that were pushed past their breaking point as a result of the environment fostered by Coach Stone,” she said.

▪ Body shaming. Several players reported developing eating disorders after Stone harshly criticized their physiques as too thin or too heavy.

▪ Adverse influence on academics. Former players said Stone negatively impacted their educational goals in various ways, including advising them to take easier courses, to drop second majors, and to prioritize hockey practices over conflicting lab sessions and other class assignments.

▪ Contradictory disciplinary standards. Former team members said Stone cut one player for a drinking infraction, then gave her a second chance, permitting her to train with the team for several months, only to cut her again. Yet when several seniors reported to Stone that one of her favored players had driven drunk and run a red light on Memorial Drive, the coach accused them of betraying the player and imposed no discipline, they said.

▪ Hazing. As long ago as 2000 and as recently as 2016, Stone’s first-year players were subjected to initiation practices that included mandatory costume-wearing across campus, forced alcohol drinking, and role playing with sexual overtones, according to personal accounts shared with the Globe. “It made me feel extremely uncomfortable, and that feeling never really left,” a player from the 2016-17 team said.
The player reported the hazing and other concerns about Stone to Harvard in a signed survey document circulated by the school, she said, but she never heard from anyone in the administration.

“I thought that if I reported an illegal activity, someone would have reached out to me,” she said.

No one alleged that Stone was directly involved in hazing, but anti-hazing specialists say coaches are responsible for protecting student-athletes in their programs from bullying and hazing.

Stone’s supporters pushed back against most of the complaints, including her response to their emotional issues, academic challenges, and injuries.

“People are angry and really upset by this,” McAuliffe said. “I hope I’m clear that I really do question the motivation and what the impetus for these kids is. It feels petty and vengeful to me.”

Dr. A. Holly Johnson, Class of 1996, a former captain who served as team physician for the US Olympic women’s hockey team that Stone coached in 2014, said, “I don’t know the allegations against Katey, but what I do know is that as women working in a male-dominated field, we are held to a different standard.”

Johnson described Stone as a close friend and mentor, a passionate advocate for her players, a gifted motivator, and an honorable leader she hopes her daughter will play for one day.

Peper, the former team captain, said that she, too, values the friends and memories she made in the program. But there are painful memories, too.

“I will always cherish my time at Harvard,” she said. “But it was not without its physical and emotional scars. It saddens me that other young women were subjected to this culture long before I arrived, and its persistence is not fair to future Harvard players.”

Falling short in finals

Stone’s rise to prominence at Harvard began with her winning a national title in the American Women’s College Hockey Alliance in 1999. She has since qualified for 12 NCAA tournaments and reached the championship game four times, although she has yet to win an NCAA title and has advanced to the finals only once in the last 17 years.

In 2010, when she became the career leader in victories in college women’s hockey at the time, Harvard quoted Stone as saying, “I’d be lying if I said it wasn’t important. I’m a very competitive person. I want to be the best.”

Which is why her most prestigious moment in the international arena ended so painfully in 2014. As the first female coach of a US Olympic hockey team, Stone guided the Americans to the gold medal game in Sochi, only for her team to squander a two-goal lead with less than four minutes to play and lose, 3-2, in overtime to Canada.

The crushing finish was not unfamiliar to Stone, whose Harvard teams had lost three straight NCAA title games from 2003-05.
“The sting doesn’t go away,” she told reporters in Sochi.

Last February, her team was collapsing again in the ECAC playoffs after a regular season that earned her Ivy League Coach of the Year honors. Morale sank as Stone tried to root out what she described as unspecified players causing internal problems, according to several team members.

“We were all looking around thinking we don’t have issues here,” Macdonald said. “But when the coach says you have issues, then issues arise.”

Then came Stone’s ethnic comment, which Macdonald reported to the athletic department. Within hours of Macdonald’s report, Stone apologized to the team, but morale remained low, and the Crimson were no match for Minnesota-Duluth in their final game of the season, a 4-0 loss in the NCAA tourney’s opening round.

The administrative review ensued. Players were interviewed, some sharply criticizing Stone, others offering support, according to team members. Nearly six months later, the review ended with an email from McDermott to the team.

“Most importantly, I want you to know that Coach Stone is our head coach and will remain our head coach,” McDermott wrote. “The findings of the review affirm that decision while also identifying opportunities for improvement, particularly with communication across several areas.”
Three days after McDermott’s letter, Northeastern announced that Thompson, the daughter of former NHL player Rocky Thompson, was transferring to play for the Huskies, a stunning move for a Harvard student-athlete.

Nearly every other player who has left Stone’s team since 2016 has remained as a student at Harvard.

Thompson, who in 2021 was named the Harvard team’s top scholar as a member of the ECAC’s All-Academic team, declined to comment. In 2022, the entire Harvard team received ECAC All-Academic honors for earning grade-point averages of at least 3.0.

Thompson is now a key contributor on a Northeastern team ranked first in Hockey East and fifth nationally at 23-2-1. Stone’s current team is 6-12-3.

Daniels, the former captain and assistant coach who cut ties with the Harvard program after the ethnic remark, now scouts for the NHL’s Winnipeg Jets. She declined to comment.

Another member of the 2021-22 team said she would not discredit anyone else’s experience with Stone but said hers was entirely positive.
“We all struggle in our own ways throughout our Harvard hockey careers, as any Division 1 athlete really does,” she said. “Coach is definitely hard on us. She asks a lot of us, and those demands can sometimes seem too high, but those demands helped shape me into a better person, 100 percent.”

Last straw for this player

In Macdonald’s case, it was no secret on campus before Stone’s “too many chiefs” statement that her heritage was central to her identity. The Harvard Gazette published a story in 2020 that cited Macdonald’s Indigenous roots, including her grandmother enduring the forcible removal by the Canadian government of her and other Indigenous children from their homes into residential schools. The goal was to assimilate them into white culture.

A Canadian national commission has described the forced removals as cultural “genocide.”

“The legacy of that trauma has really impacted my family,” Macdonald told the Globe. “I try to honor every day how much my ancestors went through for me to be able to go to a place like Harvard.”

She remains close to her grandmother, and she often volunteers to help her mother, who is the principal of the All First Nations Haahuupayak Elementary School on Vancouver Island.

At Harvard, Macdonald enlisted her hockey teammates to participate in Orange Shirt Day, which recognizes survivors of the residential schools. She also raised awareness about the crisis of missing and murdered Indigenous women by posting on social media an image of a red handprint across a woman’s mouth — a symbol of the movement — each time she scored a goal.

But Macdonald said she felt ill-treated by Stone almost from the start, in part for minimizing her traumatic brain injury.

Stone accompanied Macdonald in an ambulance after she was knocked unconscious in a game at the University of New Hampshire just before Christmas break of her freshman season. But when Macdonald returned from break 10 days later, still suffering from severe concussion symptoms and not cleared for hockey activities, she missed the morning session of the team’s first two-a-day practices, and Stone was furious.

“She never asked why I was late,” Macdonald said. “She just ripped me apart, said I was selfish and a disgrace to the program, that I didn’t deserve to wear the jersey.”

Stone’s sharp reprimand sent Macdonald into an emotional tailspin, she said, in which she contemplated suicide. Later, she said, Stone claimed to have forgotten about her concussion at the time of the rebuke.

Still, Macdonald said, Stone continued to single her out for ridicule, as she did last February when Macdonald arrived late from physical therapy to a team video session, and Stone began clapping and chanting, “I hate Mac,” encouraging her teammates to join in.

“It was strange and sad,” one of Macdonald’s teammates said.

When the university ended its review by keeping Stone’s job intact, Macdonald formally quit the team. She is due to graduate from Harvard in May, with an eye toward attending law school and with a year of intercollegiate hockey eligibility remaining.

“I still valued my teammates and wanted to keep playing with them,” Macdonald said. “But this program needs to heal and move forward, and that can’t happen without new leadership.”

‘A culture of complete fear’: Harvard women’s hockey coach Katey Stone under fire for alleged abusive behavior
Read more: https://www.bostonglobe.com/2023/01/27/ ... ns-hockey/

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

“I had eight concussions, when it’s all said and done … in all different sports but mostly hockey,”

Post by greybeard58 » Tue Jan 31, 2023 2:51 pm

“I had eight concussions, when it’s all said and done … in all different sports but mostly hockey,”

Nicole Bade competed in basketball, volleyball, track, hockey and rowing, but they weren’t her first sports.

“My first sport was figure skating,” Bade said. “My parents tried to get me into figure skating, but it didn’t quite fit my personality. My parents let me try out for boys hockey, and I just loved it.”

Bade earned 11 letters at Frankenmuth High School in basketball, volleyball and track, before competing at Michigan State in women’s hockey and women’s rowing.

Bade, who is married to Jon Weirauch, is a member of the 2022 Class of Inductees to the Saginaw County Sports Hall of Fame, with the induction banquet Sunday, Nov. 6 at Horizons Conference Center. Bade joins her mother and former coach, Sharon Bade, as the first mother-daughter members of the Hall of Fame.

Sharon Bade was the volleyball head coach at Frankenmuth during her daughter’s high school career. Nicole Bade led Frankenmuth to the state quarterfinals in 2005 and 2007, finishing third in the Miss Volleyball voting as a senior. Bade, a first-team all-stater in 2007, holds Frankenmuth volleyball records for career kills, season kills and kills in a best-of-5 match.

“I bumped heads with my mom a few times,” Bade said. “I was a teenage girl. She was my mom. When you’re a teenager in high school, you think you know more than your parents, even when you don’t. Sometimes I acted like a typical high schooler and ended up having to run some suicides.

“But playing volleyball for my mom was one of the best parts of my career. That was the highlight, playing for my mom and the four teams I played on. The girls I played with were so special.”

Bade also competed in basketball and track, earning all-conference in both sports.

But she loved hockey.

“I played guys hockey until the guys got a little too big,” Bade said. “In high school, I played a lot of girls hockey and ended up getting recruited by Michigan State.”

During her freshman year of high school, Bade was picked to participate in the United States Olympic Development Program in New York. She eventually landed at Michigan State, where she was part of a team that finished third in the nation in 2009.

But she was forced to quit hockey after a series of concussions.

“I had eight concussions, when it’s all said and done … in all different sports but mostly hockey,” Bade said. “When you get one really bad, the next time it only takes a bump or a hit in the wrong spot. After eight, the doctors said it’s just not worth it.

“My first concussion was in the fourth grade just playing pond hockey. I fell wrong, hit my head and was in the hospital for about a week. I was sick to my stomach every half hour for a week. In college, I got a couple in hockey and one in a car accident. It just wasn’t worth it anymore.”

But instead of going to the sideline, Bade looked for other sports, eventually landing a spot on the MSU women’s rowing team.

“To be honest, I went to try out for the volleyball team before I went into rowing,” Bade said. “I made the team, but I would be on the bench. The coach told me that at 5-foot-9, I wasn’t going to get much time in the front row trying to get the ball through a 7-foot block.

“But after hockey and volleyball didn’t work out, my dad (Dan Bade) said to look around and see what other sports they had, see what you can find. I had a meeting with the rowing coach, went to a tryout and made the team.”

Bade earned a full scholarship and made two appearances in the NCAA National Championships. She was part of the varsity eight boats and claimed a gold medal at the 2011 Big Ten Championships. Bade’s boat qualified for the NCAA Championships in Sacramento, California, where her boat finished sixth in the country. She was named MSU’s Most Outstanding First-Year Rower in 2010 and captain her senior season.

“I hadn’t rowed before then,” Bade said. “It was so much harder than I thought. It’s so much more technical than I think anyone expects. It’s like trying to get eight girls to get the technical skills of a perfect golf swing … all at the same time. It’s very difficult technically and very difficult endurance-wise.

“When they look for rowers from people who have never rowed before, they’re looking for that athletic build and athletes who have been coached all their lives. It’s easier to teach them the technical aspects of it. They’re more receptive to the technical coaching.”

Bade, 32, and her husband have a 2-year-old daughter, Claire Weirauch, with another baby expected in January. Bade is a wealth management client associate with Merrill Lynch.

“I had such a unique life,” Bade said. “I have no regrets. God bless my parents for the sacrifices they made, being able to be a part of all the sports I was in.

“They never discouraged me from trying anything. God bless them.”

Nicole Bade brings multi-sport success to Saginaw Sports Hall of Fame
Read more: https://www.mlive.com/highschoolsports/ ... -fame.html

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

"Keeping quiet about a head injury is not honorable or courageous"

Post by greybeard58 » Mon Feb 06, 2023 12:23 pm

"Keeping quiet about a head injury is not honorable or courageous"

As a student-athlete, I learned at an early age not to complain about injuries.

Playing hurt was a mark of valor. It was a price I was prepared to pay. It offered me the benefit of advancing my status on the team and gaining the respect of my coaches and teammates.

Consequently, I played with broken bones, severe ankle and knee sprains, bruised ribs, painful contusions and head injuries.

In my years playing contact sports I never once told a coach that I was injured or hurting. It was their job to figure it out and decide whether or not I should be pulled. Playing hurt and keeping quiet were learned behaviors and values I lived with like a badge of honor.

Once when watching game films, my high school football coach chewed me out when I appeared to be stumbling in slow motion during a kickoff. He ridiculed me, to the delight of my teammates who convulsed in laughter as he played the film clip over and over again. Public humiliation was a rite of passage. It was just my turn.

What did not make it into the frame of the game film was the full-speed collision just moments before my screen debut. I took a knee to the head which left me seeing stars and staggering about, trying to maintain my balance.

I was out cold on my feet. I stayed on the field, continued to play and never told a soul. It was my first concussion. More were to come.

By now it is well known that concussions in sports have reached dangerous proportions, a silent epidemic and a public health issue. TikTok and YouTube routinely post sports collisions among children and adults, often head-to-head impacts, to the delight of millions of viewers.

The Journal of American Medical Association reported in 2019 that 62,816 head injuries occur annually among high school varsity athletes across the country. It may surprise you to know that girls are more vulnerable to concussions than boys.

JAMA reported in 2021 that, in a survey of more than 80,000 high school soccer players in Michigan, girls are nearly twice as likely to experience concussions than boys.

Nature magazine cited a growing body of data, also in 2021, that suggests “female athletes are at significantly greater risk of a traumatic brain injury event than male athletes” and they “fare worse after a concussion and take longer to recover.”

I doubt that early advocates of Title IX of the Educational Amendments Act of 1972, a federal law prohibiting sex discrimination in educational institutions, anticipated that as young women and girls exploded onto the sports scene, they might one day be as susceptible to head injury as men and boys.

Although male concussions occur mostly through collisions with teammates or opponents, as illustrated above, female concussions are most often the result of contact with a ball, or whiplash contact to the ground in soccer or ice surface in hockey.

If this is a public health issue we must insist that all children and teenagers and their parents be educated early on about the risks, consequences, signs and symptoms of head injury. Lingering symptoms might include headache, memory loss, fuzzy thinking, difficulty concentrating, difficulty sleeping and mood issues, according to Fort Myers, Fla., pediatrician Dr. Tom Schiller.

Adults who care about kids need to offer alternative models for demonstrating courage and heart. We must provide a counterforce to the dangerous and false belief that putting one’s well-being or life in danger when playing a game is noble.

Competitive sports involve sacrifice, perseverance, loyalty, honor, and courage, all values that will serve one well throughout life. However, maintaining a code of silence about a serious injury that can lead to lifelong consequences is another matter. Keeping quiet about a head injury is not honorable or courageous.

On the contrary, it is ignorant and a betrayal of one’s body and mind, and one’s loved ones.

We must demand that those in power in youth, interscholastic and intercollegiate sports protect our children; and we must help our children, from an early age, to think critically and to develop the good sense and courage, without shame, to break the silence.

The Back Road: Breaking the silence about head injury in youth sports
Read more: https://theisland360.com/opinions-100/t ... th-sports/

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

People who suffer 3 or more concussions in a lifetime are at risk of serious brain damage, study finds

Post by greybeard58 » Thu Feb 09, 2023 3:13 pm

People who suffer 3 or more concussions in a lifetime are at risk of serious brain damage, study finds

• New research suggests recurring, mild head injuries can stack up to serious neurological issues.
• Three concussions seems to be a turning point for brain issues, and further injury worsens symptoms.
• Researchers say more safety precautions are needed to protect high-risk athletes and workers.

Head injuries are a major risk factor for brain problems later in life, and even minor damage may stack up over time, new research suggests.

Just one moderate-to-severe concussion, or multiple milder concussions, can causing lasting issues with memory and attention later in life, and each subsequent injury may worsen symptoms, according to UK researchers.

The research team from the University of Oxford, University of Exeter, and Kings College London looked at data from more than 15,000 UK residents between age 50 and 90, comparing their lifetime history of head injuries with changes in their cognitive functioning over time.

Their findings, published January 27 in the Journal of Neurotrauma, show that experiencing three mild concussions is linked to worse attention span and problem-solving ability.

Experiencing four or more concussions was linked to memory problems and slower processing speed. People who experienced a single moderate or severe concussion also had issues with attention span, problem solving, and processing information.

The study, the largest of its kind, also indicates that the lasting effects of brain injury can worsen over time with repeated head injuries, according to Dr. Vanessa Raymont, senior author of the study and senior clinical researcher in the department of psychiatry at the University of Oxford.

"We know that head injuries are a major risk factor for dementia, and this large-scale study gives the greatest detail to date on a stark finding - the more times you injure your brain in life, the worse your brain function could be as you age," Raymont said in a press release.

She added that the findings suggest the importance of proactive safety measures for people at high risk of head injuries through work or sports, and said that organizations should prioritize protecting their athletes and employees from repeated impacts.

Pro athletes have raised concerns about concussions in the NFL and other contact sport organizations

The latest concussion research adds to a growing awareness around the risks of contact sports like American football, which has a well-documented history of serious injuries and lasting damage to athletes.

Most recently, Miami Dolphins quarterback Tua Tagovailoa suffered two head injuries in four days. The incident prompted changes to the NFL's safety protocols.

Former NFL players have reported ongoing issues with brain health potentially related to chronic traumatic encephalopathy, or CTE, progressively worsening cognitive decline after repeated head injuries, Insider previously reported.

Other contact sport organization such as the UFC have also outlined concussion safety measures in recent years, reflecting concerns about cumulative damage to athletes' brains.

People who suffer 3 or more concussions in a lifetime are at risk of serious brain damage, study finds
Read more: https://www.msn.com/en-us/health/medica ... r-AA16XEbI

Lifetime Traumatic Brain Injury and Cognitive Domain Deficits in Late Life: The PROTECT-TBI Cohort Study
Read the study at: https://www.liebertpub.com/doi/10.1089/neu.2022.0360

greybeard58
Posts: 2511
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Deanna Fraser concussion

Post by greybeard58 » Fri Feb 10, 2023 7:47 am

Deanna Fraser concussion

The No. 2/4 Quinnipiac women’s ice hockey team was all business Saturday afternoon, sinking conference-rival No. 9 Cornell in a runaway 6-1 victory.

The Big Red were without some key names, most notably junior goaltender Deanna Fraser, who entered concussion protocol following Cornell’s win against Princeton on Friday. Head coach Doug Derraugh opted instead to send sophomore Belle Mende to the crease.

However, it would be a quick trip to the bench for Mende, who stood no match to Quinnipiac’s powerhouse offense.
Senior forward Shay Maloney got the party started, finding freshman forward Madison Chantler on the backhand for the game’s first score no less than a minute into the opening period.

With one goal already under their belts, the Bobcats went to work. A little over five minutes into the game, graduate student defensemen Courtney Vorster and Zoe Boyd passed around to find senior forward Jess Schryver, who banged home the game’s second goal.

Smelling blood in the water, Quinnipiac looked to put the game out of reach in just the first period. Mende would surrender her third and final goal to sophomore forward Maya Labad with just 5:15 left to play.

Labad’s goal was her thirteenth of the year, breaking a tie between her and the team’s leader in total points, junior forward Olivia Mobley, for the most goals on the team this season.

With that, Derraugh had seen enough, pulling his netminder in favor of sophomore backup and usual third-stringer Brynn DuLac. DuLac would finish the period cleanly for the Big Red, as Quinnipiac entered the first intermission up 3-0.

As the second period came and went, the Bobcats continued to dominate puck possession and offensive production. Senior forward Alexa Hoskin found fellow senior forward Sadie Peart for yet another Bobcats goal 4:06 into the period. Hoskin was credited with the assist, one of two that she had on the day.

Later in the period, Schryver would once again find the back of the net on a wrist shot from the left circle, this time on the power-play. Freshman defenseman Alyssa Regalado took the penalty for the Big Red, setting the Bobcats up easily for their fifth score of the game.

Quinnipiac would tack on one last goal in the final period of play, with Maloney getting in on the scoring frenzy about halfway through the period. Scooping up the puck in the neutral zone, she faked to the forehand before swapping to the backhand, sliding the puck past DuLac.

Graduate goaltender Logan Angers flirted with her sixth shutout of the season for nearly the entire game, needing to survive just 45 seconds to secure it. But Cornell freshman forward Avi Adams would not be denied, stuffing in the Big Red’s first goal of the game on the power-play to cut Quinnipiac’s lead to 6-1.

It was just the third goal all year surrendered by Quinnipiac’s penalty-kill unit in 50 power-play opportunities, good for a 94% success rate – which leads the NCAA.

The Bobcats’ performance Saturday proved once again that they are a national force to be reckoned with, bringing their overall record this season to a staggering 22-3-0, and their conference record to an equally-as-impressive 12-1-0. Cornell falls to 10-6-2 overall and 8-3-1 in conference play.

Quinnipiac will be back in action next Friday at 6 p.m. when they take on Brown.

Cats on cruise control: No. 2/4 Quinnipiac blows past injury-riddled No. 9 Cornell in 6-1 win
Read more: https://quchronicle.com/79865/featured/ ... n-6-1-win/

jg2112
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Re: concussions

Post by jg2112 » Fri Feb 10, 2023 1:35 pm

Thoughts go out to Deanna Fraser. I can't imagine dealing with a concussion and Ivy League coursework is easy on the psyche. I hope she is alright.

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

Kayla Shaffer "a sophomore, had just returned from a concussion"

Post by greybeard58 » Sun Feb 12, 2023 10:21 am

Kayla Shaffer "a sophomore, had just returned from a concussion"

Kayla Shaffer’s first high school goal on Thursday night ended the second longest girls’ hockey game in state history and gave Blaine a 2-1 win over Anoka in the Class 2A Section 7 Quarterfinals at Fogerty Arena.

Shaffer scored at 10:29 of sixth overtime, ending the game in 119 minutes and 29 seconds. Since the 5:40 mark of the second period it was a draw. The winning goal came at 11:04 p.m., 4 hours and 4 minutes after the start of the game.

Blaine coach Steve Guider said Shaffer, a sophomore, had just returned from a concussion. She was declared symptom-free on Saturday.

“Having her in the game at all was a blessing for us,” he said.

Blaine goalie Hailey Hanson made 49 saves. Anoka goalie Gretchen Paaverud had the bigger task; She made 89 saves as Blaine defeated Anoka 91-50. Guider said he knew Paaverud missed parts of the season due to health issues.

“She’s a very good goalkeeper,” he said. “This year she hasn’t played that many games. Last year she was good against us.

“We would like our filming to be better than she was, but she stood there and got the job done.”

The longest girls’ hockey game in state history came in 2016 when East Ridge defeated Apple Valley in the Class 2A, Section 3 quarterfinals, 3-2 in six OTs. This game lasted 121 minutes and 58 seconds. Apple Valley goalie Taylor DeForrest made 111 saves in the game.

The longest game in girls’ state tournament history was a Class 2A semifinal between Minnetonka and Lakeville North in 2013. That game also went over six OTs but ended in 113 minutes and 29 seconds.

The longest game in boy-state tournament history is a five-overtime game between Apple Valley and Duluth East in 1996. That game lasted 93-12. At the 1955 state tournament, Minneapolis South and Thief River Falls played 11 overtimes before South won 3-2. Because overtime was shorter, this game was played in 86 minutes.

Guider said he was pleased that his team made it through to the quarterfinals. Blaine will play Grand Rapids/Greenway in Saturday’s section semifinals.

“It’s a huge relief,” Guider said. “Really, the section’s quarter-final game is one of the toughest because when you’re seeded high you’re playing against a team that has nothing to lose. You want to make sure you disconnect it right away. I had told our kids they have a couple of goalies that can take you out.”

It took six overtimes, 141 shots, to decide the Minnesota girls’ division hockey game Read more: Read more: https://localtoday.news/mn/it-took-six- ... 47339.html

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

Hicks experienced the third concussion of her career and injured her wrist

Post by greybeard58 » Sun Feb 12, 2023 7:28 pm

Hicks experienced the third concussion of her career and injured her wrist

Rhéa Hicks never gets too high or low, always keeping a level head.

When she learned she was one of forty people invited to try out for Team Canada for the upcoming International Ice Hockey Federation U18 World Championship, she was unfazed. “I had to almost like fish it out of her. The thing about her is she likes to keep things on the ‘down low,’ not wanting to step on anyone else’s toes,” said Sydney Lynch, a former teammate and current freshman defenseman at Merrimack. As a freshman forward at Syracuse, Hicks has tallied four goals and 10 assists for 14 points this season. In 25 games, she earned CHA Rookie of the Week honors after her performance in SU’s series against St. Lawrence. But, before Hicks suited up for the Orange, she was a standout player for her home country.

During tryouts, players woke up at 6 a.m. to go over tactics before hitting the ice around 1 p.m. After the first team practice, players received an hour to workout individually from 3 to 4 p.m., before coming back for the nightly scrimmage that evening.

“There’s a lot of people who come into that camp super nervous and gripping their stakes pretty tight,” former teammate Sara Swiderski said. “I feel like after the first day, things get a little bit better because people are more comfortable.”

When tryouts finished, players were placed in a room without technology to prevent communication with each other. One by one, coaches called each player to tell them if they made the team. Players who made the team congregated together in a separate area.

When Hicks made the team, she ran into a familiar face. “I actually saw Rhea as I was walking into the room, and that was amazing,” Holy Abella said. “We have been playing with each other since we were young, because we were in the same area.” Abella, a freshman at Northeastern, played recreational hockey against Hicks when they were young in their hometown of Brampton, Ontario. The pair competed against each other for years, occasionally training together and refining their stickwork in the offseason. Immediately after the camp, the team traveled to Minnesota for four days before heading to Wisconsin for the championships. Because of the pressure surrounding playing for a hockey powerhouse like Canada, it was important for Hicks and her teammates to get their minds off of the sport at times. “When we were away from the ice, we didn’t talk about hockey as much just because we had that connection from Ontario,” said Alex Law, another teammate. “We talked about stuff just back at home, helping to get away from the stress.”

On the ice, Canada boasted a roster full of D-1 players, including Madison Chanter (Quinnipiac), Brook Disher (Boston) and Sarah MacEachern (Cornell). Hicks wasn’t a headlining name, but still made an impact on the fourth line.

In the preliminary rounds, Canada dropped its opening game against Finland. The team played Sweden next and needed a win. Hicks had her best game of the tournament, scoring two goals in a 3-0 win for Canada.

Up 1-0 in the first period, Canada tried killing off the last few seconds of a power play. Sweden tried keeping the puck in the Canadian zone, but Jordan Baxter intercepted a pass, springing a counterattack.

Baxter slipped a pass to Alexa Aubin, receiving the pass before the blue line. As Aubin closed in on the goal, Hicks sprinted to join the attack. Aubin slid the puck across to Hicks, who slotted home a shot to double Canada’s lead.

Fifteen minutes later, she scored her second goal of the game. After Hicks battled for a faceoff, the puck slid out in front of the net. Hicks got to it first. Reacting quickly, she picked up possession to go five-hole on the goalie, putting Canada up 3-0. “Everyone brought their own talent, and I think she found her role, being able to drive that puck in the net and just be in the right spot at the right time,” teammate Sara Swiderski said. Swiderski mentioned Hicks’ goals “gave the team momentum,” motivating others to “find their role” on the team. Hicks showed that everyone had the capability to influence the game in their own ways. Hicks’ goals against Sweden advanced Canada to the knockout round. After beating Slovenia in the quarterfinal, Canada defeated Finland 2-1 to advance to the final against the United States. Avenging a 7-0 loss earlier in the tournament, Canada came out on top 3-2 to win the championship. “It’s crazy because growing up you always see these girls on TV and … you never really know them,” Lynch said. “But then there I was at home watching her play and it’s crazy to say, ‘hey, I grew up playing with that girl.’”

Lynch knew Hicks was always going to play at a high level. After playing for her local team in Brampton, Hicks switched to the Mississauga Hurricane, a step up in competition. Playing in the Provincial Hockey League, Hicks made the transition seamless, continuing to score goals. There was always a “gap” between her and other players on and off the ice, Lynch said. Hicks put in the work, lifting weights with Lynch outside of mandatory sessions while refining her stick skills during small group workouts.

But in her final season with Mississauga, Hicks experienced the third concussion of her career and injured her wrist. This kept her out for two and a half months, but even when she wasn’t playing, Hicks made an impact. “She still found a way to have a presence in the room that made us feel comfortable,” Lynch said. “She would talk at times when we needed it, even though she wasn’t on the ice it still felt like she was a part of the team.”

As a freshman, Hicks has made an impact for Syracuse. With four goals, Hicks is the leading freshman scorer with 10 assists, making her third on the team. She recorded two multi-assist games against Lindenwood on Nov. 4. and Penn State on Dec. 4.

“She’s always been the player to score a goal to change how the game’s going when it’s needed,” Lynch said. “She’s always been able to find that extra level to dig deep and change the momentum of the game, and then help the rest of the team get going again.”

Rhéa Hicks struck gold, helping Canada’s U18 team win at IIHF World Championships
Read more: https://dailyorange.com/2023/01/rhea-hi ... pionships/

greybeard58
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“It did not go very well last year, especially after we lost our goalie with a concussion”

Post by greybeard58 » Thu Feb 16, 2023 5:05 am

“It did not go very well last year, especially after we lost our goalie with a concussion”

Mahtomedi entered into a pairing agreement for a sport — girls hockey — for the first time in school history this school year. Former Zephyr athletes are now skating with Roseville/Mahtomedi.

“It was a little rough at first, but we are coming together. It’s working out well,” said Victoria Nelson, Mahtomedi junior who leads the team in scoring.

The Marauders, that a their new nickname, started the season with two losses on a northern trip against Proctor/Hermantown and Duluth, got their first win against Mounds View/Irondale, and lost their fourth game 9-0 to No. 3 ranked Minnetonka. However, they’ve won six of their last eight, and hold second place in the Suburban East Conference with a 7-2 record. Last week, the Marauders (7-5 overall) beat White Bear Lake 3-1 and lost to East Ridge 5-4 in overtime.

“They are getting along really well, on and off the ice,” said coach Craig Rosenthal, who was Roseville’s coach previously. “On top of that, they are buying into our team strategy and are very coachable.”

Mahtomedi was 3-22 last season and 7-12 the year before.

“It did not go very well last year, especially after we lost our goalie with a concussion,” said Nelson.

Roseville, meanwhile, was 16-9-2, its third straight winning season, but was concerned about numbers. "Both schools needed and wanted to coop,” Rosenthal said. “Roseville had low numbers. Mahtomedi didn’t have a goalie and had OK numbers. With many players from our communities/youth programs going to private high schools, coupled by already low numbers, it forces (schools to enter) co-ops.”

A pairing agreement was reached in May, and the two groups starting getting to know each other in summer training sessions.

Nelson and her Mahtomedi schoolmates like Rachel and Julia Fussy, Hailey Moosbrugger and Rylee Bogren moved to the Suburban East Conference from the Metro East. “We knew it would be tougher competition, and that’s what we wanted,” said Nelson.

Nelson has logged 12 of the team’s 30 goals. (She had 14 goals, 10 assists last year.) Bogren has four goals.

Lily Peterfeso, sophomore from Roseville, is the goalie, holding strong with an .898 save percentage that has risen steadily since the rough start. The next-leading scorers, Olivia Martin, Ruby Eskin and Kylie Jones are from Roseville.

The Marauders home rink is Roseville Ice Arena. Practices are held there and at Ramsey County Arena and Polar Arena as they share ice time with the Roseville boys team.

Scoring in the 3-1 win over the Bears on Wednesday were Martin, Jones and Nelson (empty-netter). Amanda Smythe scored for the Bears (2-8).

The Marauders fell behind East Ridge 4-0 in the first period Saturday before Kylie Wiltse scored on a power play with :18 left. Still down 4-1 after two periods, the Marauders stormed back in the third with Nelson scoring twice on power plays, sandwiched around a Martin goal, to force OT. But Lily Fetch won it for the Raptors (7-2) in OT.

Mahtomedi skaters enjoying new team, new conference with Roseville/Mahtomedi
Read more: https://www.presspubs.com/white_bear/sp ... c79ef.html

greybeard58
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"With lots of health issues and a concussion, it felt like a broken season, a broken dream."

Post by greybeard58 » Thu Feb 16, 2023 2:40 pm

"With lots of health issues and a concussion, it felt like a broken season, a broken dream."

With the female game beginning to take shape throughout Asia, including parts of the Pacific rim and segments of the Middle East, an enthusiastic and compelling figure from Kazakhstan has become an ambassador for its growth. Bulbul Kartanbay, a competitor for the national team and a star player for Tomiris Astana, ponders the future with profound purpose.

Looking to give back to the game, dedicated towards providing opportunities for a new generation of players, the commendable focus of Kartanbay represented the realization of a dream. Taking on the role of builder, in addition to remaining competitive on the ice, her hockey odyssey encompassed a combination of tenacity with desire to succeed, the type of qualities for younger players to emulate.

Discovering the game as a teenager, upon her family relocating to the Almaty region, Kartanbay quickly became a promising player. Earning a place on the Kazakhstan Under-18 National Team, the first step in a career that later involved participation in a pair of Olympic qualifying tournaments; her efforts remain focused on opportunity. Launching a Women’s Hockey Academy in 2021, with a current attendance of 82 players, it holds the potential to be her greatest legacy.

Spearheading another exciting initiative, organizing an International Women’s Ice Hockey Camp for spring 2022, the first of its kind in Kazakhstan, Kartanbay may have established the foundation upon which to spur unprecedented growth. Held in Nur-Sultan (Astana) at Barys Ice Arena, even speaking to the city’s mayor about her initiative, with players from several nations participating, including nearby India and the United Arab Emirates, the fostering of friendship and encouragement strengthened a shared love of the game.

Worth noting, Alena Mills, a participant for Czechia at the 2022 Beijing Winter Games took on the role of guest instructor at said Camp. Providing a significant highlight, Mills acumen and experience were most welcome, her presence encompassed the objective of uniting players from different places. Simultaneously, the camp was an extension of Kartanbay’s highly admirable efforts to stimulate the game’s growth in Kazakhstan, positively influencing the sporting culture. In addition to the Camp, her Kartanbay Foundation provides an integral assist, helping aspiring players obtain equipment, while providing an environment to see their skills develop.

“The first International Women’s Hockey Camp in Kazakhstan was my dream since I was in New Jersey, USA during 2019. I saw the difference between our levels of play. I was impressed with how big hockey is in Canada and the USA.

Additionally, I was looking to developing women’s hockey in Kazakhstan. When I was 13 years old, I did not have that many options. This way, the girls will benefit.

I am trying to give them a big chance to grow the game and get more passionate about the sport. It is also a healthy lifestyle. I wanted to involve more international players together. They feel stronger and confident, plus it is fun and enjoyable.

It was enjoyable that Alena Mills was able to travel and serve as an instructor. She showed me lots of cool stuff, along with my coaches and my students. I enjoyed the work of the girls from Emirates, who did great. I admire them very much!”

Akin to many other international players, a strong North American influence was the stimulus to succeed. Kartanbay’s path included competition in both Canada and the United States. Inspired by a meeting with goaltender Sami Jo Small, a Winter Games gold medalist who is highly articulate and a wonderful ambassador for the game’s growth internationally, Kartanbay aspired to play in the CWHL, a league Small helped co-found.

Selected by the Boston Blades in the 2017 CWHL Draft, Kartanbay also attended the Calgary Inferno’s training camp in 2018. Spending the 2018-19 season with the Southern Alberta Women’s Hockey Association, she amassed 29 points as a member of the Calgary Coyotes, demonstrating her offensive skills, along with the potential to reach new summits in her career.

The following season, Kartanbay ventured to the American Northeast. Making history as the first player born in Kazakhstan to compete in the NWHL (rebranded as the PHF), Kartanbay donned the jersey of the Metropolitan Riveters. Wearing the number 99, approaching the season with high hopes, the lessons learned extended beyond the competitive atmosphere.

Making her Riveters debut on October 5, 2019, a 4-2 loss versus the Boston Pride, Kartanbay managed one shot on goal. Before Christmas, a December 14, 2019 affair against the Minnesota Whitecaps represented her final appearance for the season.

Although a series of unforeseen setbacks prevented Kartanbay from enjoying a full season, the exposure to such a high caliber of play proved highly worthwhile. Also serving as a head coach in the Princeton Tiger Lillies organization in 2019-20, working in their 14U division, it stood as testament to her passion for the game. Despite the season not turning out as planned, the display of character and growth as both, player and person, provided a highly positive learning experience.

“It was a great time, but also the toughest time in my life. The successes and the issues came together. Unfortunately, I was not able to get my paperwork done until the middle of season. Plus, I also had a very bad car accident on December 31, 2019. I missed half the season.

With lots of health issues and a concussion, it felt like a broken season, a broken dream. Yet, I am glad that I was able to get through it, as it made me mature and stronger.

Overall, it was a great experience. I grew in the game and saw my opportunities as a player. To see how fast I could be and how good I could shoot. To come all this way to the NWHL and play in the league was amazing!”

Resuming her career in Kazakhstan following the experience of wearing Riveters colors, the sense of homecoming provided an essential theme. With an enterprising spirit, the passion has never wavered on or off the ice for Kartanbay. Of note, a display of entrepreneurial drive resulted in her becoming the proprietor of Omnomnom Eco Bakery, offering sugar and gluten-free cookies.

As the 2021-22 season saw Kartanbay compete for Tomiris Astana, she previously played for the club in 2017-18. Amassing a solid 24 points in only 12 games played, she finished third in team scoring, trailing Daria Moldabai (25 points) and Olga Shirokova (48 points), an alum of Tornado Dmitrov, in the club’s scoring race. Worth noting, Tomiris Astana finished second overall in the league standings, while Aisulu Almaty finished first.

Coincidentally, Kartanbay’s lone season with Almaty, recording seven appearances in 2016-17, provided another unique linkage to the CWHL. Among her teammates that season were former Calgary Inferno skaters Chelsea Purcell (the first team captain in franchise history) and Karolina Urban.

Undoubtedly, Kartanbay is also taking on a unique element of celebrity. Recognized in 2021 among the 100 New Faces of Kazakhstan, an honored place on the Forbes Kazakhstan 30 under 30 added another element of relevance. Simultaneously, each honor raises awareness of women’s ice hockey.

Helping transform the nation’s sporting zeitgeist, augmenting the conversation about the role women in sport can hold in her homeland, the key foundation always remains an enjoyment of the game. With the rink becoming a hub for friendship and encouragement, the potential to expand the sport for women is attributed to Kartanbay’s admirable efforts, enabling dreams to flourish.

“I play at home and that is the sweetest part. My family and my friends are here. I am also working on my first Women’s Hockey Academy in Kazakhstan. We opened up in July 2021. Right now, we have so many successes, which is my favorite part. Several are paying little attention to women’s sports and young skill players. I feel that we are getting a chance to move forward and it is amazing.”

Bulbul Kartanbay building the game in Kazakhstan
Read more: https://womenshockeylife.com/bulbul-kar ... azakhstan/

greybeard58
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How sports science is neglecting female athletes

Post by greybeard58 » Sun Feb 19, 2023 1:39 pm

How sports science is neglecting female athletes

Research on the science of sport is heavily skewed towards male athletes, finds a review of hundreds of sports-medicine studies. The imbalance leaves large gaps in knowledge about female sports and sport-related injuries.

A review of this type is long overdue, says Willie Stewart, a neuroscientist at the University of Glasgow, UK, who studies concussion. “It reflects the general neglect of female sport.”

Researchers reviewed 669 studies published between 2017 and 2021 in 6 leading sports-science journals. They wanted to put some numbers to their observations that there were many more studies on male sports compared with female sports. “We wanted to quantify these discrepancies in the current sports-medicine research to show that there is a need for female-athlete-centered research, especially as we continue to learn how females experience different injuries than males across many sports,” says co-author Meghan Bishop, a surgeon at the Rothman Orthopedic Institute in Philadelphia, Pennsylvania.

Just 9% of the studies focused exclusively on female athletes, whereas 71% focused only on male athletes. “While stark, these results were not particularly surprising,” says Bishop. The starkest comparison between sexes, she adds, was in baseball and softball, with 91% of studies focusing on male players and only 5% focusing on female players.

The disparity, Bishop says, is for several reasons, from financial incentives to the availability of data in public databases and an over-representation of male researchers in the studies’ leaders. Bishop says that more female orthopedic surgeons could help redress the balance.

Michael Grey, a neuroscientist at the University of East Anglia in Norwich, UK, who specializes in sports injuries, says he isn’t sure that a lack of female surgeons is the problem, but agrees that funding is a big driver. “People focus on men’s sport because that’s where the money is. Not only in the sport itself but in the research,” he says. “And it shouldn’t be that way.”

Slight improvement
There has been a slight improvement in the past few years, the study shows. The proportion of studies that focused solely on women or girls, or included both male and female athletes, has started to increase gradually over the past few years (see ‘Slow progress’). This change is partly because of greater awareness of the issue in researchers, and partly because some funding agencies, such as the US National Institutes of Health (NIH) require the clinical studies they fund to include data on different sexes, Stewart says.

“I’m excited to see studies on female athletes being represented in the literature,” says Martina Anto-Ocrah, an epidemiologist at the University of Pittsburgh in Pennsylvania. “It will be great to see more rigorous studies that connect studies of this nature to female injuries, treatment options, interventions and recovery.”

Grey says that a lack of data on female athletes leads to inappropriate extrapolation, especially in his area of research. “We know that certainly with respect to concussions, the protective elements of the brain are different in women and men,” he adds. “We must be studying women and cannot be extrapolating from men to women. That’s just wrong.”

How sports science is neglecting female athletes
Imbalance impedes progress in prevention and treatment of injuries among female players.
Read more: https://www.nature.com/articles/d41586-022-04460-3

greybeard58
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Kendall Cooper's concussion

Post by greybeard58 » Tue Feb 21, 2023 5:03 am

Kendall Cooper's concussion

A single goal was all that separated Quinnipiac from its first Frozen Four appearance in program history last season. This year, the Bobcats have the roster and the hunger to take that leap.

That success is no guarantee though, something that head coach Cass Turner is well aware of.

“It’s a new year,” Turner said. “There’s no continuation of success from the previous season and I think that’s important for our group to understand that we’re going to have to fight as hard or harder than we did last year to even get to where we got.”

The road to success starts in-conference, where Quinnipiac will yet again have to battle night-in and night-out to earn wins.

The Bobcats were tabbed No. 8 in both the DCU/USCHO and USA Today/USA Hockey preseason national polls, the former featuring a remarkable seven ECAC Hockey teams, solidifying the notion that the conference is the nation’s strongest.

“Having seven teams ranked in the poll, it’s pretty amazing to look at the depth we (the ECAC) have,” Turner said. “It puts you in a position where essentially most weekends you’re playing a top 10 team in the country … that means that when it comes time for playoffs, you’re battle-tested, and that’s exactly the type of experience that our students want and that’s the type of competitiveness that’s going to help us win national championships.”

Zooming in past the depth of the conference, Quinnipiac itself is a deep team, returning nine of its top 10 scorers from last season and five of its top six defensemen.

“Looking out at practice and seeing the depth through our forward lines, it’s exciting,” Turner said. “But every year, there’s always some new surprises and opportunities. We have some players on our team who had phenomenal summers … and it may not be the names that you’re always thinking of that maybe you saw in our top nine last year.”

This depth was on display as the Bobcats took on UConn in an exhibition matchup last Saturday, dominating possession for a significant portion of the game en route to a 2-1 win.

Up front, graduate student transfer Shay Maloney centered junior Olivia Mobley and senior Sadie Peart on the Bobcats’ first line. Maloney looked comfortable for her first time in blue and gold, controlling the flow of the offense and aggressively battling for the puck when dispossessed.

Maloney, who transferred from conference foe Brown this past offseason, captained the Bears in 2021-22, leading the team with 11 goals and 19 points in 29 games.

“She knows how to put the puck in the net,” Turner said. “She’s strong, she’s physical, and it’s exciting to see what she’s doing already. She’ll play an important role for us, right from the start.”

The Bobcats’ second line of sophomore Veronica Bac, senior Alexa Hoskin and freshman Madison Chantler plays a crash-the-net heavy offensive style. Hoskin’s speed allows her to beat defenders wide and cut hard to the net, opening up rebound opportunities for her line mates.

Look for Bac to break out this season. The Huntley, Illinois, native only recorded three points in 2021-22, but looked strong in Saturday’s contest and is sure to see a significant increase in scoring opportunities moving up from the fourth line into a top-six role this season.

Chantler, who is fresh off a point-per-game season at the U22 level with the Ontario Women’s Hockey League’s London Devilettes, looked experienced in her collegiate debut. The 17-year-old made plays and moved the puck up ice with the confidence of a veteran.

The Bobcats’ offensive production won’t just be limited to its top six, as Quinnipiac’s third unit may be deadly this season. Senior Jess Schryver, one of the best passers on this roster, is centering the line, with sophomore Maya Labad and junior Nina Steigauf on the wings.

Steigauf was third on the team in goals last season and doesn’t look to be slowing pace in 2022-23, potting the opening goal against UConn on Saturday off a sweet backdoor feed from Schryver.

On the other wing, Labad is also primed for a big-time offensive year, fresh off a solid rookie campaign, the goal-scoring second-year has the skill and the players around her to take the jump on the stat sheet.

“She really emerged at the end of the season last year,” Turner said. “She was really impactful for us, scoring in the NCAA tournament, but I think looking at what her spring looked like was even more exciting for us. She trained incredibly hard and her fitness level was one of the top three in our program.”

Turner attributes her improvement in part to a fantastic development camp with Hockey Canada this summer.

“At that development camp she played a phenomenal style of hockey and really, I think, gained a step in her confidence,” Turner said. “To see her now in practice, she really has emerged as one of those sophomores that I think is going to make a big impact on how we play.”

Noticeably absent from the lineup on Saturday were graduate student forward Lexie Adzija and sophomore forward Ann-Fréderik Naud.

Naud led Quinnipiac’s freshman class in points last season with 16 and played big minutes for the Bobcats, including scoring the opening goal in the NCAA Regional Final against Ohio State. A source confirmed to The Chronicle that she is not returning to the team this season.

Adzija, fresh off a summer with Hockey Canada’s Women’s National Development Team, will don the “C” for the Bobcats this season alongside defenseman Zoe Boyd.

Freshman defenseman Zoe Uens is another newcomer set to step into a big role this season. The Belleville, Ontario, product played most of her debut on Quinnipiac’s third pairing and looked solid in a majority of her shifts. Her presence on the offensive blue-line is impressive for a player of her age, and likely a reason why she saw time on the Bobcats’ second power-play unit.

Turner spoke of Uens and Chantler as a collective, both of whom had played at the national level with Hockey Canada.

“Both of them have jumped immediately to this level in practice,” Turner said. “I know they’re going to add great depth and they’re going to impact our lineup.”

Aside from Uens, the Bobcats’ defensive core looks very similar to last season, their only major loss to graduation being team captain Olivia Konigson, with Boyd and Courtney Vorster both returning for a fifth year.

Quinnipiac may have to look to another new face to slot into its defensive rotation to start the season, however, as junior Kendall Cooper, who mans the right point on the Bobcats’ top pairing, reportedly suffered a concussion in the game against UConn.

Sophomore Mia Lopata, who red-shirted her freshman season, and freshman Tiana McIntyre are both options for the Bobcats to turn to if Cooper remains out for an extended period of time.

It’s potentially a huge loss for Quinnipiac, as the Burlington, Ontario, native carried a significant portion of the offensive load for the Bobcats’ defense last season. She tallied 25 points, which was sixth on the team and led all defensemen by 10 points.

As a whole, this Bobcats’ defensive unit, when healthy, looks to be just as effective as in 2021-22, where it finished third in the NCAA in scoring defense, allowing an average of 1.51 goals per game.

Though they had a few defensive lapses, Quinnipiac played smothering defense in the slot area for a majority of the game against UConn. Most of the shots the Huskies managed came from the periphery and the only goal they managed came from an odd angle in what was essentially a 5-on-4, as it was the same play Cooper was injured on.

Freshman Tatum Blacker was in net for the Huskies’ lone goal, and aside from that play looked remarkably solid in her first collegiate appearance, facing UConn’s strongest offensive advances of the day while in goal.

“She is a very different goalie than our other goalies,” Turner said. “She’s very athletic, she’s a little bit smaller, but she’s somebody who puts herself in position to make saves and battles like none other, so we’re excited to see her continue to grow.”

Graduate student Logan Angers and junior Catie Boudiette complete the Bobcats’ goaltending trio for the season. These two will see the bulk of the action for Quinnipiac, likely playing a similar tandem system to what Angers and BU transfer Corrine Schroeder managed last year, with Angers getting the 1A starts in Schroeder’s place.

“You look at last year, no doubt Corinne Schroeder had a phenomenal season, but quietly beside her Logan Angers did too,” Turner said. “She played a lot of big games for us, she beat Yale, she beat Cornell 4-0, she … has a lot of experience and confidence behind her being in her fifth year here.”

Turner was quick to share praise for Boudiette as well.

“Catie Boudiette had a phenomenal summer and is really coming into her own,” Turner said. “And if we backtrack two years ago and look at the COVID year, she didn’t allow a goal in any game she played that year, so I think we have great depth and great opportunity at the goaltending position.”

Up and down the lineup, this Quinnipiac team has the pieces to do something special. Five months and 34 games of trial by fire will determine whether or not they will.

‘That’s going to help us win national championships’: Quinnipiac women’s hockey is built for success
Read more: https://quchronicle.com/77947/sports/th ... r-success/

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

Goalie Suzanne LaFlamme suffered a head injury and was sent to the hospital

Post by greybeard58 » Tue Feb 21, 2023 11:11 am

Goalie Suzanne LaFlamme suffered a head injury and was sent to the hospital

In a game that could be a preview of next month’s state finals or a Frozen Four game, the Smithfield/Coventry/Moses Brown co-op girls’ hockey team came out hot last Friday night in its battle for first place with La Salle Academy at the Smithfield Municipal Ice Rink.

But after the home team took a 2-0 lead midway through the second period, the Rams took over from there and scored twice in each of the next two periods to defeat the co-op team, 4-2, and remain undefeated.

The Rams, who less than 24 hours later, cruised to an 8-0 victory over the East Bay co-op team, which contains players from Barrington, Mount Hope, and Portsmouth, entered Wednesday’s night action with a record of 10-0-1. Their only tie was a 2-2 draw with the Smithfield co-op team back on Dec. 18. La Salle hasn’t lost a regular-season game since the 2018-19 season

The Smithfield co-op team, meanwhile, fell to 7-2-2 and into a three-way tie for second place with the Burrillville/Ponaganset/Bay View co-op team, which is 8-2, and the South County Storm, which is 7-3-1 (with an overtime loss) and features players from North Kingstown, South Kingstown, and Narragansett.

“Overall, we played well, but it wasn’t the outcome we wanted,” Smithfield co-op head coach Kerri Nadeau said. “I think we got a little comfortable after we got a two-goal lead. We took a couple of shifts off and I think that definitely hurt us. (La Salle) is a team you have to play a full 45 minutes against them because they are going to play a full 45. I think just taking those little shifts off definitely hurt us.”

In the first period, sophomore Camylle Ursillo scored the co-op team’s first goal 6:03 into the game, as sophomore Ginger Dow passed the puck to Ava Lourenco, who set up Ursillo’s goal that she shot past La Salle goaltender Kate Grivers.

“Camylle has been doing a great job on defense,” Nadeau said. “All four of our ‘D’ are very strong, and we have a lot of faith in them. She did exactly what we asked them to do, she put pucks toward the net. I don’t know if it hit somebody else before it went in, but it was a great shot. She’s one of those kids that whatever we tell her to do, she’ll go out and do it.”

The co-op team carried its 1-0 lead into the second period, as the Rams had penalty trouble and went to the box. The hosts had a 5-on-3 power play for 25 seconds in the opening minutes, but could not capitalize on it, as the Rams came out of the box and put pressure on Smithfield’s defense and goalie Ava Porter, who ended up with 20 saves.

Porter did her job and sophomore Suzanne LaFlamme did a great job getting the puck out of her zone, but at the end of the second period, LaFlamme suffered a head injury and was sent to the hospital.

The co-op team doubled its lead with 5:24 to play in the period on sophomore forward Keira Goffe’s state-leading 13th goal of the season, as she took a pass from her classmate, Meghan Falls, skated in on Grivers, and fired the puck past her.

“Keira’s a natural goal scorer, and she made a really good move,” Nadeau said. “Last year, she led the league (in scoring), and she’s always giving us scoring opportunities. "But things fell apart quickly for the co-op team. Forty-seven seconds later, the Rams got on the board as Maddie Bradley scored, and 29 seconds later, Eliza Barber tied the score.

The Rams then scored twice in the first five minutes of the third period. They started the period on a power play for 52 seconds, but after the co-op team killed it off, Barker gave La Salle the lead 1:08 into the period. La Salle added a power-play goal with 4:50 to play when Adriana Dooley slipped the puck past Porter.

The co-op team has three games left on its regular-season schedule, including Friday’s 6:30 p.m. game against the Mount Saint Charles/Cumberland/Lincoln co-op team at Adelard Arena and next Monday’s 3 p.m. game against the Toll Gate/Pilgrim co-op squad in Smithfield. The final game is on Friday, Feb. 24, back on its home ice against the South Country Storm.

As for La Salle, “hopefully it’s not the last time we see them,” Nadeau said. “We didn’t get to see them at all last year, so it was exciting to finally get to play them and see how well we matched up with them.”

Last year, girls’ hockey was divided into two divisions, but everyone played each other, no matter the division. The Sentinels, who went undefeated and captured the Division II championship, was supposed to play La Salle last winter, but the game was postponed because of weather and never made up.

This year, all eight teams in the state are playing in one division, and the top six teams will qualify for the playoffs, with the top two seeds receiving a quarterfinal-round bye. The third through six seeds will skate in the best-of-three quarterfinals during the first weekend of March, and the winners of those games will face the top two seeds in the RIIL’s new one-game “Frozen Four” semifinals on Friday, March 10, at Providence College’s Schneider Arena.

Those winners will then return to Schneider Arena on Saturday, March 18, at 7 p.m. to play in the state championship game. The Burrillville/Ponaganset/Bay View co-op team is the defending state champion.

“Games mean a lot more,” Nadeau said. “It’s been a lot of fun. I think it’s a much more competitive league, and we are enjoying it a lot more. Even the teams that were lower last year are a little better. It’s pretty balanced now.”

Heading into the playoffs, Nadeau hopes her team can continue executing what they have been preaching.

“We have to make sure we stick to playing as a team,” she said. “I think sometimes we like to try and do things on our own, but when we play as a team, we play a much better game. Just having that consistent team play and getting pucks to the net are our biggest goals this year.”

Smithfield co-op girls' hockey team loses showdown with undefeated La Salle
Read more: https://www.valleybreeze.com/sports/smi ... 39b3c.html

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

Studies support the claim that gender bias in medicine routinely leads to a denial of pain relief for female patients

Post by greybeard58 » Tue Feb 21, 2023 8:12 pm

Studies support the claim that gender bias in medicine routinely leads to a denial of pain relief for female patients

One woman was told she was being “dramatic” when she pleaded for a brain scan after suffering months of headaches and pounding in her ears. It turned out she had a brain tumor.

Another was ignored as she cried out in pain during a 33-hour labor. She was supposed to be getting pain medication through her epidural, but it had fallen out.

Dozens of women complained of torturous pain as their vaginal walls were punctured during an egg retrieval process. They were told their pain was normal, but, in actuality, they were getting saline instead of anesthesia.

These are just some of the stories of women who say their pain and suffering has been dismissed or misdiagnosed by doctors. Although these are anecdotal reports, a number of studies support the claim that women in pain often are not taken as seriously as men.

This year, the Journal of the American Heart Association reported that women who visited emergency departments with chest pain waited 29 percent longer than men to be evaluated for possible heart attacks.

An analysis of 981 emergency room visits showed that women with acute abdominal pain were up to 25 percent less likely than their male counterparts to be treated with powerful opioid painkillers.

Another study showed that middle-aged women with chest pain and other symptoms of heart disease were twice as likely to be diagnosed with a mental illness compared with men who had the same symptoms.

“I was told I knew too much, that I was working too hard, that I was stressed out, that I was anxious,” said Ilene Ruhoy, a 53-year-old neurologist from Seattle, who had head pain and pounding in her ears.

Despite having a medical degree, Ruhoy said she struggled to get doctors to order a brain scan. By the time she got it in 2015, a tennis ball-sized tumor was pushing her brain to one side. She needed surgery, but first, she rushed home, hugged her 11-year-old daughter and wrote her a letter to tell her goodbye.

Ruhoy did not die on the operating table, but her tumor had grown so large it could not be entirely removed. Now, she has several smaller tumors that require radiation treatment.

She said many of her female patients have had experiences similar to hers. “They’re not validated with regards to their concerns; they’re gaslit; they’re not understood,” she said. “They feel like no one is listening to them.”

Doubts about women’s pain can affect treatment for a wide range of health issues, including heart problems, stroke, reproductive health, chronic illnesses, adolescent pain and physical pain, among other things, studies show.

Research also suggests that women are more sensitive to pain than men and are more likely to express it, so their pain is often seen as an overreaction rather than a reality, said Roger Fillingim, director of the Pain Research and Intervention Center of Excellence at the University of Florida.

Fillingim, who co-wrote a review article on sex differences in pain, said there are many possible explanations, including hormones, genetics and even social factors such as gender roles.

Regardless, he said, “you treat the pain that the patient has, not the pain that you think the patient should have.”

Women say reproductive health complaints are commonly ignored
Women often cite pain bias around areas of reproductive health, including endometriosis, labor pain and insertion of an intrauterine device, or IUD.
When Molly Hill made an appointment at a Connecticut clinic in 2017 to get an IUD, she said she was warned it would be uncomfortable, but she was not prepared for “horrific” pain. Hill, now 27 and living in San Francisco, recalled that during the procedure, she began crying in pain and shouted at the doctor to stop.

“We’re almost done,” she said the doctor told her and continued the procedure.

“It was full-body, electrifying, knife-stabbing pain,” she said. After it was done, she said she lay sobbing on the table in physical and emotional pain. “It felt violating, too, to have that pain that deep in your core where you feel the most vulnerable.”

Would you like to share your own experiences of coping with pain and navigating the medical system? Fill out this form, and we may include you in a collection of reader stories.

Studies consistently show that women who have not experienced vaginal birth have much higher pain during IUD insertion compared with women who have given birth. A Swedish study found that among 224 women who had not given birth, 89 percent reported moderate or severe pain. One in six of the women said the pain was severe.

Although numbing agents and local anesthetics are available, they are rarely used.

In some cases, women have sued physicians for ignoring their pain. Dozens of women sued Yale University claiming that during an egg harvesting procedure at its infertility clinic, they were supposed to be receiving the powerful painkiller fentanyl. But some women were getting only diluted pain medication or none at all, according to lawsuits filed in the state Superior Court in Connecticut.

Later, the clinic discovered a nurse had been stealing vials of fentanyl and replacing the painkiller with saline solution. The nurse pleaded guilty last year and was sentenced for tampering with the drugs.

One of the plaintiffs, Laura Czar, wrote about her experience for Elle magazine, describing it as “a horrible, gut-wrenching pain,” and told a doctor at the time, “I can feel everything you’re doing.” Despite her protests, the doctor continued.

Yale said in a statement that it “deeply regrets” the women’s distress and has “reviewed its procedures and made changes to further oversight of pain control and controlled substances.”

Racial disparities in pain management
For Sharee Turpin, the pain of sickle-cell disease sometimes feels like tiny knives slicing her open. Sickle cell disease is an inherited blood disorder that can cause suffering so severe, its attacks are called “pain crises.”

But when Turpin, who is Black, experiences a pain crisis, the 34-year-old does not rush to the ER in Rochester, N.Y. Instead, she combs her hair, mists some perfume and slips on her “Sunday best” in hopes that the doctors and nurses won’t peg her as a drug seeker, she said.

Sometimes, Turpin gets a care team that understands her pain. Other times, she is treated as a bother. “I’ve even been told ‘shut up’ by a nurse because I was screaming too loud while I was in pain,” she said.

Abundant research shows racial bias in pain treatment. A 2016 study found half of white medical students and residents held at least one false belief about biological differences between Blacks and Whites, and were more likely to underestimate Black patients’ pain.

“The management of pain is one of the largest disparities that we see between Black people and White people in the American health-care system,” said Tina Sacks, an associate professor at the University of California at Berkeley and author of “Invisible Visits: Black Middle-Class Women in the American Healthcare System.”

Labeling women “hysterical” or blaming psychological causes
Research shows men in chronic pain tend to be regarded as “stoic” while women are more likely to be considered “emotional” and “hysterical” and accused of “fabricating the pain.”

Carol Klay, a 68-year-old from Tampa, had endured years of chronic pain from arthritis, degenerative disk disease and spinal stenosis. During a hospital stay last year, her doctor noted in her medical record that she was crying “hysterically.”

Klay said she was crying because she was unable to sit, stand or walk without agony, and the doctor had removed morphine from her cocktail of pain medications. She wonders whether the doctor “would have called me hysterical if I was a man,” she said.

Tampa General Hospital said it could not discuss specific patients, but stated: “Patient treatment plans, including medication orders to reduce pain, are prescribed by multi-disciplinary clinical teams.”

Research shows women’s physical pain is also often attributed to psychological causes.
Jan Maderios, a 72-year-old Air Force veteran from Chipley, Fla., said the trauma of having pain dismissed by doctors has stayed with her for years. She saw about a dozen doctors in the early 1970s for pelvic pain. When clinicians could not identify the cause of her pain, she was referred to a psychiatrist.

“You start to doubt yourself after so many medical experts tell you there’s nothing wrong with you,” she said.

After a hysterectomy in 1976, Maderios learned that fibroid tumors in her uterus had been the source of her pain. She said learning her pain was real — and physical — “made all the difference in the world.”

Why women’s pain complaints often aren’t taken seriously
During a 33-hour labor with her first child in 2011, Anushay Hossain, 42, of D.C., opted for epidural pain relief but said she still felt it all — every contraction, every cramp and every dismissal of her pain by her medical team. The doctor reassured her that she was getting the maximum dosage of pain medication.

In fact, she wasn’t getting any at all. She said her epidural had slipped out. By the time the error was caught, she was shaking uncontrollably and in need of an emergency Caesarean section, she said.

“There’s a pain gap, but there’s also a credibility gap,” said Hossain, author of “The Pain Gap: How Sexism and Racism in Healthcare Kill Women.” “Women are not believed about their bodies — period.”

This pain gap may stem, in part, from the fact that women have historically been excluded from medical research. It wasn’t until 2016 that the National Institutes of Health (NIH) required sex to be considered as a biological variable in most studies it funded.

“We’re making progress,” said David Thomas, special adviser to the director of NIH’s Office of Research on Women’s Health. “But we do have a long way to go because there’s this whole institutional approach to doing research — pain and beyond — where it tends to be male-focused.”

Nearly 95 percent of U.S. medical school students said instruction on sex and gender differences in medicine should be included in curriculums, according to a 2015 survey. But only 43 percent said their curriculum had helped them understand those differences and only 34.5 percent said they felt prepared to manage them in a health-care setting.

“It is changing, but it’s changing very slowly,” said Janice Werbinski, immediate past president of the American Medical Women’s Association and chair of the mentorship committee of the association’s Sex and Gender Health Collaborative.

How women can advocate for better pain care
It took decades to solve the mystery of Maureen Woods’s chronic pain. Woods, 64, of Myersville, Md., started having joint pain in her teens and, over the years, told dozens of doctors her pain was “debilitating,” she said. Some told her it was all in her head. In 2017, she was diagnosed with hypermobile Ehlers-Danlos syndrome, a connective tissue disorder often causing loose joints, dislocations and chronic pain.

She said women who are not being heard should keep advocating for themselves. “You have to go with your gut — something is wrong and I need to find a doctor who can figure it out,” she said.

Marjorie Jenkins, dean of the University of South Carolina School of Medicine Greenville, urged women against feeling pressured to accept an “everything is normal” non-diagnosis.

“If your provider does not appear to be listening to you or believing what you’re saying, then you need a new provider,” Jenkins said. “You are the client, you are the customer and you are the owner of your health.”

Women can also take a family member, friend or other support person who can corroborate their stories, said Alyson McGregor, an emergency medicine professor at the University of South Carolina School of Medicine Greenville and author of the book “Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It.”

Particularly in emergency departments, she said, there can be an inherent bias. “There’s this assumption that women are emotional and they’re anxious and that that’s the main issue,” she said.

From heart disease to IUDs: How doctors dismiss women’s pain
Several studies support the claim that gender bias in medicine routinely leads to a denial of pain relief for female patients for a range of health conditions
Read more: https://finance.yahoo.com/news/heart-di ... 23544.html

greybeard58
Posts: 2511
Joined: Sat Aug 21, 2004 11:40 pm

New research could make diagnosis, treatment and prevention more effective for everyone — especially women

Post by greybeard58 » Thu Feb 23, 2023 10:24 am

New research could make diagnosis, treatment and prevention more effective for everyone — especially women

It was a freak accident, and at first it didn’t seem like a big deal.

UBC student Rori Wood was practicing with her teammates on the Thunderbirds women’s rugby team. During non-contact drills, another player caught her in the eye with an elbow.

“I was like, oh, that hurt. My eye was throbbing, and there was a cut, but I wasn’t too worried about it because it didn’t feel like that big of a hit,” she remembers.

As one of the team’s veteran forwards, Rori was used to the scrums and tackles that come with the position. Her main concern was getting the eye cleaned up and making sure it didn’t swell too much before the next day’s match.

But a few hours later her head began to hurt — really hurt — and she felt sick to her stomach. There was a feeling of sensory overload: “When my parents picked me up to go to the doctor, everything was so, so bright. Like, a literal fog. And sound just hurt. I wore earmuffs to the appointment.”

With the help of artificial intelligence, UBC researchers have demonstrated that concussed brains create ‘neural detours,’ re-routing information along alternative pathways.

Rori was diagnosed with a mild traumatic brain injury, or concussion — her first. She was prescribed rest and quiet for the first few days, followed by a slow and measured return to everyday activities, with check-ups along the way. Most of the symptoms resolved within a month, and in about six weeks Rori was cleared to return to full-contact play.

But her recovery wasn’t always easy: “After you start to feel better, you second-guess yourself. You hit the turf in practice and you think, am I okay? I even started worrying that the concussion had affected my lungs, though rationally I knew that my cardio was fine. You question what’s real and what’s in your head.”

Talking to teammates helped. “Hearing their [concussion] stories made me feel less isolated and helped me understand what I was going through,” she says.

“It also made me realize that no two concussions are the same.”

Concussion can be tricky to diagnose and challenging to treat. Because the circumstances of every injury are unique, every patient’s symptoms and recovery will be different — sometimes very different. Like Rori, most people will see their symptoms resolve fairly quickly. But some will struggle with neurological and psychological effects that linger for months or even longer.

Over the past decade, guidance on recovery has changed to reflect evolving ideas about neuroplasticity and how the brain heals. Activity is now seen as essential to recovery after the initial acute injury phase.

But while concussion symptoms are well documented — and the patient’s experience of symptoms remains the best tool we currently have for both diagnosis and treatment — we know comparatively little about how concussion affects the brain.

“The location and force of the impact, the patient’s sex, age, history of head injury, and their individual physiology all contribute to how the brain responds to trauma,” says Dr. Naznin Virji-Babul, a UBC professor in the Department of Physical Therapy and the Director of the Action-Perception Lab at the Djavad Mowafaghian Centre for Brain Health.

These changes are often too subtle to identify in individual patients using classical neuroimaging analysis. However, with the help of artificial intelligence, Dr. Virji-Babul and neuroscientists across UBC are beginning to unlock the mystery of concussion and the brain. Their work has the potential to change the way we diagnose, treat and even prevent mild traumatic brain injury.

Beyond symptoms
“We now know that concussion causes increased functional connectivity in specific areas of the brain,” Dr. Virji-Babul explains.

“So if you imagine a river blocked by falling rocks after an earthquake, the water doesn’t stop. It spills over the riverbank and from one river you end up with multiple streams running around the obstruction. This is what we see happening in patients after concussion — the brain re-routes the flow of information to compensate for the injury.”

In a recent landmark study, she and her team mapped these ‘neural detours’ in adolescents. Using resting-state electroencephalogram (EEG) data and advanced statistical physics, they analyzed the flow of information between brain regions in both healthy and concussed patients. From this data, the team showed that the injured brains consistently re-routed information along four alternative neural pathways.

“What emerges is an incredible picture of neuroplasticity in action,” she says.

In a follow-up study, the team will investigate how the neural detours affect cognition, how long they last, and whether they alter the trajectory of brain development. Their findings will have important implications for the treatment of concussion in adolescents.

In the meantime, Dr. Virji-Babul and her collaborators have also developed a deep learning algorithm that classifies concussion from raw EEG data with up to 97% accuracy. Their goal is to create an objective, clinically accepted, brain-based automatic classification tool that physicians can use in real-world settings to diagnose concussion.

“The advantage of raw EEG data is that you don’t need to filter it in a lab. And because EEG devices are easily portable, an experienced doctor could use the tool on, say, a rugby pitch at the time of the injury,” Dr. Virji-Babul says.

Because early diagnosis and treatment is so important, accuracy is imperative. The EEG tool could help doctors catch concussions where the symptoms are initially very mild, like Rori’s.

The information could then be used as a data point to track changes in the patient’s brain during recovery — useful for measuring progress and for fine-tuning treatment protocols.

Understanding concussion’s longer-term effects
The longer-term effects of concussion are another area of urgent concern for brain researchers.

“The biomechanics of repetitive concussive and sub-concussive trauma is a key area of study, especially in athletes,” says Dr. Lyndia Wu, an assistant professor in UBC’s Department of Mechanical Engineering and School of Biomedical Engineering. “Until we fill the gaps in our knowledge, we could be missing opportunities for interventions in care and prevention.”

Dr. Wu is leading an innovative five-year study that tracks these effects in male and female hockey players and other UBC varsity athletes who play high-impact sports.

At the beginning and end of each season, and following any in-season concussions, the athletes undergo extensive neurological testing to create ‘before and after’ snapshots of their brains. Then, during the season, the players are filmed at practices and games, their every impact recorded. When possible, they wear special motion-tracking mouthguards that measure the biomechanics of the hits. The impact data are analyzed with the brain snapshots using advanced modelling and analytics to create what will eventually become one of the world’s most comprehensive pictures of sports concussion and repetitive mild head trauma to date.

“We’re hoping that our insights from the study’s different data sets could help to refine treatment and diagnostic protocols for athletes and non-athletes alike — and make protective equipment safer,” Dr. Wu says.

Both Dr. Wu’s and Dr. Virji-Babul’s research could also yield new insights into how concussion affects women differently from men.

Women and concussion
It’s well documented that females report more symptoms than males and take longer to recover. Why?

“There is evidence to suggest that hormones play a role in these differences. But the fact is, we don’t know enough, because concussion is understudied in women,” says Dr. Virji-Babul, who in 2020 was appointed Senior Advisor to the UBC Provost on Women and Gender-Diverse Faculty.

That’s why, she says, it is important that studies like Dr. Wu’s focus on athletes of both sexes, and include researchers with diverse expertise from diverse backgrounds.

“Better tools begin with better data. If our goal is to make diagnosis, treatment and prevention more effective for everyone, then it’s not enough to make breakthrough discoveries for one group of people.”
— Dr. Naznin Virji-Babul
Director of the Action-Perception Lab
In her own work, Dr. Virji-Babul is expanding the EEG study to include an equal number of female and male participants, matched by age, symptoms and other criteria, in order to generate robust, representative data from which any sex-specific effects can be readily flagged and analyzed.

“Better tools begin with better data. If our goal is to make diagnosis, treatment and prevention more effective for everyone, then it’s not enough to make breakthrough discoveries for one group of people. We need to understand whether and how concussion affects people’s brains differently — and share that knowledge,” she says.

Treating the whole patient
Ultimately, biomechanics, sex differences and individual brain physiology are just a few of the factors that affect how people experience and recover from mild traumatic brain injuries. There are many more, including mental health, gender, socio-economic status, and cultural background. The goal of brain-based research is to give clinicians another set of tools to help them diagnose and treat each patient in all of their complexity.

To this end, Dr. Shelina Babul, a clinical professor in UBC’s Department of Pediatrics and an expert in knowledge translation, is working with concussion researchers at UBC and beyond to make sure their discoveries reach physicians and the public through platforms like the Concussion Awareness Training Tool (CATT), which is regularly updated to reflect the evolving science of concussion.

“Between UBC and the work being done provincially, BC is really leading the charge to making the lives of British Columbians and individuals across the country safer when it comes to brain health,” Dr. Babul says.

Rori Wood, meanwhile, has great expectations for the Thunderbirds this year.

“We’re ranked first in our conference and second in the country. I think we have a legitimate shot at the national title,” she says.

As she and the other veterans welcome new players to the team, Rori will make herself available as a friend and a mentor. She hopes that none of her new teammates will have to go through what she did, but if they do, she’ll be ready to share her concussion story.

“I hope it will make the experience a little easier for them.”


Unlocking the mysteries of concussion and the brain
New UBC research could make diagnosis, treatment and prevention more effective for everyone — especially women.
Read more: https://www.med.ubc.ca/news/unlocking-t ... the-brain/

UBC concussion study could pave the way for safer hockey
High-tech mouthguard tracks head impacts during varsity hockey playoffs
Read more: https://news.ubc.ca/2022/03/17/high-tec ... -playoffs/

greybeard58
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The Forgotten History of Head Injuries in Sports

Post by greybeard58 » Fri Feb 24, 2023 2:37 pm

The Forgotten History of Head Injuries in Sports

In July, 2015, Stephen Casper, a medical historian, received a surprising e-mail from a team of lawyers. They were representing a group of retired hockey players who were suing the National Hockey League; their suit argued that the N.H.L. had failed to warn them about how routine head punches and jolts in hockey could put them at risk for degenerative brain damage. The lawyers, unusually, wanted to hire a historian. A form of dementia called chronic traumatic encephalopathy, or C.T.E., had recently been posthumously identified in dozens of former pro football and hockey players; diagnosable only through a brain autopsy, it was thought to be caused by concussions—injuries in which the brain is twisted or bumped against the inside of the skull—and by recurring subconcussive blows to the head. In the media, C.T.E. was being described as a shocking syndrome that had never been noticed in sports outside of boxing. In essence, the legal team wanted a historian to tell them what science had known about head trauma, and when.

Casper, a history professor at Clarkson University, in upstate New York, had majored in neuroscience and biochemistry, worked in a lab studying dementia in mice, and earned his Ph.D. in the history of medicine from University College London. His dissertation explored the emergence of neurology in the U.K.—a history that included the study of shell shock and head injury in the First and Second World Wars. Casper agreed to work for the hockey players. He turned his attention to a vast archive of scientific and medical papers going back more than a century. In constructing a time line of how knowledge on head injuries evolved from the eighteen-seventies onward, he drew on more than a thousand primary sources, including medical-journal articles, textbooks, and monographs.

Reading the research in chronological order was like listening to physicians and scientists conversing across time. The dialogue spanned several eras, each charting rising concerns about head injuries from different causes—from railroad and factory accidents to combat in the World Wars, and from crashes in newfangled automobiles to the rise of college and professional sports. Casper found that physicians had begun to worry about repeated head injuries as early as the eighteen-hundreds. In 1872, for example, the director of the West Riding Lunatic Asylum, in England, had warned that concussions, and especially repeated concussions, could result in mental infirmity and “moral delinquency.” Other asylum doctors called the condition “traumatic insanity” or “traumatic dementia.” From that time onward, discussion of the long-term effects of head injuries in varying contexts, including sports, surfaced again and again. Physicians recognized lasting sequelae of severe head trauma, and sometimes expressed concern about the consequences of milder head blows, too.

Today, C.T.E. is the subject of furious controversy. Some of the debate has been stoked by researchers affiliated with the sports industry, who argue that we still don’t know for sure that head blows in football, hockey, soccer, or rugby can lead, decades later, to the dramatic mood problems, the personality changes, and the cognitive deterioration associated with C.T.E. These experts maintain that, before we rethink our relationship with these sports, we need scientific inquiries that meet highly rigorous standards—including longitudinal studies that would take fifty to seventy years or more to complete. In the meantime, millions of children and high-school, college, and pro athletes would continue butting heads on the field.

Casper believes that the science was convincing enough long ago. “The scientific literature has been pointing basically in the same direction since the eighteen-nineties,” he told me. “Every generation has been doing more or less the same kind of studies, and every generation has been finding more or less the same kinds of effects.” His work suggests that, even as scientific inquiry continues, we know enough to intervene now, and have known it for decades. It also raises important questions about how, and how much, old knowledge should matter to us in the present. If Casper is right, then how did we forget what’s long been known? And when does scientific knowledge, however incomplete, compel us to change?

According to Casper and other historians, the collision between sports and concussions began around the eighteen-eighties. American-style football, a descendant of rugby, was gaining in popularity at Ivy League colleges, and violence was fundamental to its allure. Players who wore stocking caps but no padding executed mass plays, such as the “flying wedge,” that led to savage clashes. Sometimes, young men died on the field. “Concern about concussions has a history in football as long as the game of football itself,” Emily Harrison, a historian who teaches epidemiology and global health at the Harvard School of Public Health, told me.

Football’s “first concussion crisis”—which Harrison wrote about in 2014—ensued after a study of Harvard’s football squad in 1906 reported a hundred and forty-five injuries in one season, nineteen of them concussions. In a commentary, the editors of the Journal of the American Medical Association (JAMA) singled out cases in which “a man thus hurt continued automatically to go through the motions of playing until his mates noticed that he was mentally irresponsible.” This behavior, they noted, suggested “a very severe shaking up” of the central nervous system, which, they argued, might have serious consequences later in life. Football, they concluded, was “something that must be greatly modified or abandoned if we are to be considered a civilized people. ”According to Harrison’s research, some leaders within the Progressive political movement had been calling for football’s abolition, on pacifist grounds. But that year President Teddy Roosevelt, the nation’s foremost mainstream Progressive, spearheaded the establishment of the Intercollegiate Athletic Association—a precursor to the National Collegiate Athletic Association. The association introduced reforms such as protective gear and the forward pass, which somewhat reduced bodily injuries and deaths. But the changes also introduced unintended effects. The incidence of concussions actually increased as players crashed into heavier body padding. As the First World War began, pacifism fell out of vogue, and football was valorized as a means of instilling manly values in boys. At the same time, ice hockey, which had first appeared in the late nineteenth century, became notorious for its violence, including brutal fistfights. Observers started calling for compulsory helmets in hockey in the nineteen-twenties. But the over-all trend was toward normalization: it became increasingly routine to hear about head injuries in sports. (The N.C.A.A. began requiring headgear in football in 1939; the N.H.L. wouldn’t mandate helmets—which can prevent skull fractures but not concussions—for hockey players until 1979.)

In 1928, in JAMA, a pathologist named Harrison Martland published the first medical report on punch-drunk syndrome. Martland, who was the chief medical examiner of Essex County, New Jersey, had performed hundreds of brain autopsies on people with head injuries, including a boxer. “For some time fight fans and promoters have recognized a peculiar condition occurring among prize fighters which, in ring parlance, they speak of as ‘punch drunk,’ ” he wrote; boxers with obvious early symptoms were “said by the fans to be ‘cuckoo,’ ‘goofy,’ ‘cutting paper dolls,’ or ‘slug nutty.’ ” Drawing on his own investigations and those of his colleagues, Martland concluded that the condition probably arose from single or repeated head blows which created microscopic brain injuries. With time, these small injuries would become “a degenerative progressive lesion.” Mild symptoms manifested as “a slight unsteadiness in gait or uncertainty in equilibrium,” he found, while severe cases caused staggering, tremors, and vertigo. “Marked mental deterioration may set in, necessitating commitment to an asylum,” he warned.In his research, Casper looked deeply into Martland’s work. Impressed by its quality, he found that the pathologist had begun with a wider inquiry into brain injury, then had turned to the sport of boxing as an illustrative case for the hazards of head trauma. In Martland’s time, it was clear that boxers weren’t the only athletes in danger: another researcher, Edward Carroll, Jr., noted that “punch-drunk is said to occur among professional football players also,” and urged officials to make it clear to laypeople and athletes that “repeated minor head impacts” could expose them to “remote and sinister effects.” (Today, leading researchers believe that repetitive subconcussive hits—impacts that jar the brain but don’t cause symptoms—are a major cause of C.T.E.) Martland’s work was a widely publicized landmark. In 1933, the N.C.A.A. released a medical handbook on athletic injuries, written by three leaders in the emerging field of sports medicine—Edgar Fauver of Wesleyan University, Joseph Raycroft of Princeton, and Augustus Thorndike of Harvard—which cautioned that concussions “should not be regarded lightly,” and noted that “there is definitely a condition described as ‘punch-drunk’ and often recurrent concussion cases in football and boxing demonstrate this.”

As part of his expert-witness research for another lawsuit—Gee v. N.C.A.A., the only sports-concussion case to complete a jury trial—Casper obtained proceedings from the annual N.C.A.A. conference held in December of 1932, several months before the medical handbook was published. At the meeting, Fauver, the Wesleyan doctor, spoke about the risk of long-term brain damage: “As a medical man, it is perfectly obvious to me that certain injuries that seem to be rather mild when they occur may show up five, ten, fifteen, or twenty years later, and become very much more serious than first expected,” he said. “This is particularly true of head injuries.” Fauver cited the dangers of both blows in boxing and “repeated concussions in football.” Twelve years later, in 1944, another team physician wrote in the N.C.A.A.’s official boxing guide that, while the punch-drunk condition wasn’t common in amateur boxers, cases had been known “to occur among wrestlers, professional football players, victims of automobile or industrial accidents, etc.”

By the fifties, punch-drunk syndrome was being described as dementia pugilistica and chronic traumatic encephalopathy. At that point, Casper told me, “there was a clear consensus that repeated concussions produce both acute and long-term problems.” In a 1952 journal article, Thorndike, the Harvard physician, reviewed “serious recurrent injuries” across college sports. He advised that athletes who had more than three head injuries, or who suffered a concussion that resulted in a more-than-momentary loss of consciousness, should avoid further contact sports altogether. “The college health authorities are conscious of the pathology of the ‘punch-drunk’ boxer,” he wrote.

Casper’s historical work, begun in 2015, painted a clear picture: for at least seven decades, if not longer, many prominent physicians and sports organizations, including the N.C.A.A., had been well aware that concussions from a variety of sports could cause cumulative, crippling brain damage. “People who wanted to know could know,” Casper told me. “People who wanted to warn could warn.” The truth continued to be acknowledged as the twentieth century drew to a close. “The blow is the same whether it’s in boxing or in football,” a physician with the American Medical Association told Congress, at a 1983 hearing on boxing safety; cumulative nerve-cell damage from repeated impacts, he went on, “may lead in some people to the punch-drunk syndrome.” As an example of a serious football head injury, the doctor mentioned former Giants star Frank Gifford, who had taken a season-long hiatus from the game after being “knocked cold for twenty-four hours.” Gifford would later be diagnosed with C.T.E. after his death, in 2015.

The science had evolved through the decades: using new tissue-staining techniques, researchers were able to detect abnormal lesions in the brains of deceased boxers. But, at that time, clinical guidelines for managing concussions didn’t mention any risk of C.T.E, and no similar studies were being done on football players. “There may be a substantial prevalence of chronic brain damage in football players, but at this time no one seems to know,” George Lundberg, the editor of JAMA, wrote, in 1986. “One senses that the football enthusiasts, including the sports medicine establishment, may not want to know.”

In the mid-nineties, as pro football grew more violent, concerns about concussions in the sport attracted new attention, and a flurry of scientific investigations got under way. In the early two-thousands, a neuropathologist named Bennet Omalu performed a brain autopsy on Mike Webster, a player for the Pittsburgh Steelers. Omalu diagnosed punch-drunk-like lesions in Webster’s brain, and found similar lesions in the brains of other players. His discovery confirmed what had long been known—and yet, for better and worse, it was perceived as a bombshell surprise.
Around that time, Casper told me, part of the medical literature on brain injury and sports “took a kind of right turn.” The N.F.L. had convened a committee on mild traumatic brain injuries, which had begun producing studies; an international committee of industry-affiliated experts known as the Concussion in Sport Group produced reviews and consensus statements. Collectively, these researchers were creating a body of work that downplayed the risks of concussions. For centuries, autopsy studies had been a vital method for understanding disease: the postmortem discovery of lung tumors, for instance, had helped establish the dangers of asbestos. But a core contention of defenders of the contact-sports industry was that, no matter what pathologists uncovered in football or hockey players, causal links hadn’t been demonstrated between repetitive head trauma and C.T.E. They pointed out, for example, that it was unclear how C.T.E. lesions led to particular symptoms. The standards of scientific rigor that C.T.E. skeptics invoke were widely adopted only in the late nineties. According to Casper and other critics, their main effect in the controversy over concussions in sports has been to emphasize uncertainties and obfuscate what’s known. Michael Buckland, a neuropathologist at the University of Sydney who directs the Australian Sports Brain Bank, told me that “we seem to have gone backwards in our understanding” of head injuries in sports. The Sports Brain Bank has identified C.T.E. in twenty-two dead athletes, most of whom played rugby or Australian-rules football. Many aspects of C.T.E. remain to be elucidated, Buckland said, but that doesn’t negate the larger history of knowledge about blows to the head and neurodegenerative disease.

Casper has turned the historical assessment that he first assembled for the hockey players into a hundred-and-fifty-page document, which he has since used as a blueprint for declarations in several other sports-concussion lawsuits. The lawsuit against the N.H.L. was settled out of court; Gee v. N.C.A.A., which was filed by the widow of Matthew Gee, a former college football player, ended in a not-guilty verdict last November. (The case was complicated by multiple health conditions that may have contributed to Gee’s death.) During the trial, Casper’s testimony was countered by expert witnesses in neurology and sports medicine who’d been retained by the N.C.A.A. “We don’t know with certainty at the present time that playing intercollegiate football irrefutably results in you developing C.T.E., or that playing intercollegiate football can lead to neurodegenerative disease,” James Puffer, formerly a team physician at the University of California, Los Angeles, testified. Without “irrefutable” evidence, Puffer said, there was no reason to warn college football players about the risk of C.T.E. (The Centers for Disease Control and Prevention and the National Institutes of Health, however, acknowledge a causal connection between repeated head trauma and the disorder.)

Other skeptics, including expert witnesses retained by the N.H.L., have disputed Casper’s reliance on “anecdotal” case reports, and objected to his citation of old studies that deployed less sophisticated scientific methods than are used today. They argue, moreover, that because definitions of concussion have changed over time Casper’s account conflates severe brain injuries with milder ones. “A concussion back then was defined as a cerebral hemorrhage or a skull fracture,” Brian Hainline, the chief medical officer of the N.C.A.A., told me. Hainline argues that the old literature on punch-drunk syndrome and dementia pugilistica referred to boxers who’d suffered this kind of serious traumatic brain injury; he also maintains that dementia pugilistica differs from modern-day C.T.E.

Casper says that his historical work has uncovered no paradigm shifts in the definition of concussion, which has long been understood as an injury that can range in severity. He firmly believes in the continued relevance of the old research. Jeremy Greene, a medical historian and physician who directs the Institute of the History of Medicine at Johns Hopkins University, described as “presents” the tendency of contemporary clinicians to devalue old studies of disease because they weren’t produced with “the truth-making apparatus of the present day.” Such case studies, Greene noted, have been the foundation on which medical knowledge in the West has been built, especially in neurology; to dismiss them outright is “to say that we know the world better than anyone in the past could have—that we have progressed so much past prior generations that we must fundamentally discredit their knowledge.” It’s important to be mindful of older studies’ lack of modern methodology—but to reject their findings as intrinsically irrelevant is to risk “a willful denial of what has been known.”

As science advances in sophistication, the goalposts move. By modern standards, truly understanding C.T.E. might mean detailing how recurring head blows trigger degenerative processes in nerve fibers at a cellular level. But league managers, coaches, athletes, and parents are neither neuroscientists nor jurors in a civil trial: what they need is actionable intelligence. So far, the actions taken by those in charge have included concussion protocols, rule changes, and measures to reduce contact during practice. But the repeated head impacts implicated in C.T.E. persist despite these steps. When does the state of knowledge obligate us to change contact sports further—or alter our views of them?
The worldwide popularity of football, ice hockey, soccer, and rugby in youth leagues and school sports makes head trauma in those games an issue of public health. “Public health and medicine are two different things,” Adam M. Finkel, an environmental-risk expert at the University of Michigan School of Public Health who formerly worked at the Occupational Safety and Health Administration, told me. In the public-health paradigm, the responsible approach is to “warn people, inform people, protect people,” Finkel said. Public-health officials would fail if they sat on their hands for years or decades, then leaped to the most draconian measures to stop a suspected culprit; they succeed, Finkel said, when they weigh the potential costs and benefits across a continuum of sensible protective actions, which might be implemented well before accumulating science proves causation. “The simple question is, how much should we do based on how much we know?” Finkel said.

In her 2014 article, Harrison, the Harvard historian, wrote that the first concussion crisis in the U.S. faded, and then slipped from collective memory, “because work was done by football’s supporters to reshape public acceptance of risk.” The sport’s managers “appealed to an American culture that permitted violence, shifted attention to reforms addressing more visible injuries, and legitimized football within morally reputable institutions.” Back then, advertising and newspaper coverage glorified the young men who took on the risks of the sport. Today, football is marketed to fans in glitzy state-of-the-art stadiums, including at the college level. “A great deal of money and effort has gone into convincing people that risks that were unsettling should actually feel just fine,” Harrison told me.

To a great extent, we collude as consumers of violence for the sake of entertainment. Damar Hamlin’s terrifying cardiac arrest reminded viewers that N.F.L. players aren’t action figures; Tua Tagovailoa’s multiple concussions, and their consequences, have shown that the N.F.L.’s much-touted concussion protocols have left plenty of danger in the game. And yet we keep watching—and, in some cases, signing our children up to play. As Casper sees it, American society is engaging in a self-deception rooted in old attitudes about punch-drunk syndrome. He notes that the old street slang applied to afflicted boxers—“slug nutty,” “punchy,” “slaphappy”—was largely pejorative; in surveying oral histories, literary works, and other similar sources, he has found that suffering athletes have often been stigmatized as lower-class, semi-deranged malingerers. Getting hit over the head became the stuff of jokes, as in the physical comedy of the Three Stooges.

In the twenties and thirties, Martland aimed to reframe punch-drunk syndrome as a genuine illness. But naming the disease after its slang label may have been a misstep. “Its medicalization ran straight into a countervailing belief about losers—losers in boxing, losers in life, losers in general,” Casper has written. “To medicalize such individuals was to fly in the face of a culture that made them jokes.” Stigmatization made it easier for people to see sports-induced brain damage as a kind of personal failing. In 1978, a “Dean Martin Celebrity Roast” television broadcast that celebrated Joe Namath featured “O.J. Simpleton,” a head-bandaged, speech-slurring character in football gear. In the years before his death, Mike Webster’s painful struggle with mental illness, homelessness, and debt was represented in the media less as a medical tale and more as a deeply troubled Hall of Famer’s spiral into the gutter.

Last summer, a new systematic review of recent studies on C.T.E. found that they met a set of criteria for establishing that repetitive head impacts cause the disorder. The authors, led by experts at Boston University and the Concussion Legacy Foundation, a nonprofit, urged officials to swiftly implement aggressive measures that could “minimize and eliminate” recurring head hits, especially among children. It was a pivotal analysis, conducted according to modern scientific standards, and it validated what the historical record has said all along. But the fact that the report was even needed “made me very infuriated,” Casper told me. “How many more examples of Mike Webster do you really need? There’s something about it that seems sort of like Jonathan Swift to me.” In “Gulliver’s Travels,” Gulliver visits Lagado, the capital of a nation where doctors of “the Academy” conduct pointless and impractical experiments while everyone else lives in poverty. Researchers who are skeptical of C.T.E. strike Casper as similar to Lagado’s scientists: they are arguing about technicalities while ordinary people get hurt. Casper is writing a book about the history of concussions, to be published by Johns Hopkins University Press. I asked him what he thinks should be done about football and other contact sports. He and his colleagues have called for a broader diversity of views on the expert panels that write clinical concussion guidelines, and for more transparency about industry conflicts of interest. Other advocates have argued for promoting flag football, banning American youth tackle football, or delaying the age when kids start playing it; heading has been eliminated in some age groups of youth soccer in the U.S. and the U.K. Casper is skeptical about reforming the actual practice of football: he thinks the game can probably never be “neurologically viable.” At the same time, he said, “football’s way too woven into the fabric of American culture at this point to talk about something like banning it.”

Pro athletes still box; people still smoke cigarettes. What’s needed, he told me, is fulsome disclosure. Contact-sports participants and their parents should be explicitly warned about chronic brain damage—especially college athletes, who are presumably attending school to improve their minds. The N.C.A.A. notes that, since 2014, it has provided fact sheets, which schools may voluntarily use to educate their student athletes, that mention possible long-term problems from concussions. “Ongoing studies raise concerns,” the handout says. “Athletes who have had multiple concussions may have an increased risk of degenerative brain disease and cognitive and emotional difficulties later in life.” But it’s not known whether every N.C.A.A. athlete actually receives these materials, Casper said—and, for an eighteen-year-old, the warning should be blunt and unequivocal, along the lines of the Surgeon General’s warning on cigarette packages. Athletic facilities should post huge warning posters, Casper told me, explaining what could happen to your brain. “Put ’em up in every locker room, and make sure they’re up every year. And that’s it,” he said. “That’s the best I think we’re probably ever going be able to do.”

The Forgotten History of Head Injuries in Sports
Read more: https://www.newyorker.com/news/annals-o ... -in-sports

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