concussions

Discussion of Minnesota Girls High School Hockey

Moderators: Mitch Hawker, east hockey, karl(east)

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

Study suggests a dose-dependent effect in female athletes

Post by greybeard58 » Mon Feb 21, 2022 10:41 am

Study suggests a dose-dependent effect in female athletes

New study: Differential exposure to subconcussive head impacts in collegiate female athletes is associated with differential change in reaction time and inhibitory control performances on executive saccadic oculomotor testing.

Differential Change in Oculomotor Performance among Female Collegiate Soccer Players versus Non-Contact Athletes from Pre- to Post-Season
Read the study: https://www.liebertpub.com/doi/10.1089/neur.2020.0051

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

A career-ending third concussion retired VanEtten

Post by greybeard58 » Tue Feb 22, 2022 2:18 pm

A career-ending third concussion retired VanEtten

Two world champion rings and an Olympic Silver medal in ice hockey don’t come easy.

“My dreams got pulled from me, I faced a lot of adversity in my time,” said Oak Hammock Physical Therapy Director, Karen VanEtten.

Adversity includes broken bones, a collapsed lung and internal bleeding for VanEtten who spent her childhood and early 20s playing ice hockey. A career-ending third concussion retired VanEtten after winning Silver with Team USA in the 2010 Vancouver Olympics.

“What’s it like to be full speed and realize you’re playing in the Olympics,” asked VanEtten. “Or getting your first assist? Scoring your first Olympic goal, scoring two goals in the semi-finals. And getting to do that with people that you’ve spent ten years with developing friendships and becoming lifelong friends and honestly, all of that pales in comparison to getting to share this experience with my family.”

As a professional ice hockey player VanEtten went as Karen Thatcher, her maiden name. Her passion for her sport’s career transitioned into a love for elder healthcare by inspiring Oak Hammock residents to keep an Olympian’s mentality.

“And I found that working over the course of my career, working with older individuals was really what I enjoyed most,” mentioned VanEtten.

“I was able to learn in those sessions as much from you as I was able to teach you and being able to help those individuals recover and do those independent functional mobilities like go to the bathroom by themselves or get dressed by themselves that is where I found joy in my work.”

VanEtten shared her ice hockey career with more than 50 Oak Hammock residents as a way to promote the benefits physical therapy offers. She’s now the physical therapy director at the retirement community.

“And I think it’s going to make a big effect on the rehab group here at Oak Hammock,” said Resident Pat Collier. She mentioned how she resonated with VanEtten as her own daughter faced challenges reaching Olympic goals. After hearing VanEtten’s story, residents dressed the part with her Olympic jersey, silver medal and championship rings.

“I think this would be a story that should be told to all young people who are involved in sports. Yes, they work hard, it’s very difficult sometimes they come up on the winning end and sometimes they have to cope with the adversity along the way,” said Collier.

“This young woman is definitely teaching them a lesson.”

Former Olympian trades hockey sticks for scrubs at Oak Hammock
Read more: https://www.wcjb.com/2022/02/21/former- ... k-hammock/

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

Hormonal imbalances after brain injury

Post by greybeard58 » Thu Feb 24, 2022 1:54 pm

Hormonal imbalances after brain injury

Brain injury may occasionally cause damage to the hypothalamus and/or pituitary gland, which are small structures at the base of the brain responsible for regulating the body's hormones. Damage to these areas can lead to insufficient or increased release of one or more hormones, which causes disruption of the body's ability to maintain a stable internal environment (homeostasis).

If damage to the pituitary gland leads to a reduction in hormone production the resulting condition is known as hypopituitarism.

What are the symptoms of hypopituitarism?
In the early stages after brain injury most people's hormone levels are severely affected, making diagnosis of hypopituitarism difficult. Later in the recovery process it may become clear that some symptoms are caused by hormonal changes and some rehabilitation units test for this on assessment. However, there are currently no clear guidelines in place for the assessment and treatment of pituitary function after brain injury and more research is needed to determine the scale of the problem.

The effects of pituitary and hypothalamus injury are many and varied because of the huge amount of hormones which can be affected. Some symptoms are similar to the more common effects of brain injury and that is another reason why the problem may be underdiagnosed.

Examples of overlapping symptoms are:
• Depression
• Sexual difficulties, such as impotence and altered sex drive
• Mood swings
• Fatigue
• Headaches
• Vision disturbance
Other symptoms include:
• Muscle weakness
• Reduced body hair
• Irregular periods/loss of normal menstrual function
• Reduced fertility
• Weight gain
• Increased sensitivity to cold
• Constipation
• Dry skin
• Pale appearance
• Low blood pressure/dizziness
• Diabetes insipidus

Each symptom is caused by a change in the level of a particular hormone that is produced by the pituitary gland. There are many possible causes of the above symptoms, particularly after brain injury, so a thorough assessment is required before any diagnosis can be made.

How are hormonal imbalances assessed?
If you suspect you or a relative may be experiencing the symptoms of hypopituitarism, or any other hormonal condition, you should speak to your GP. If they feel it is appropriate, they will be able to refer you for further assessment with a specialist in the field, such as an endocrinologist. They will be able to run a variety of hormone level tests and may refer you for a scan to look for signs of damage to the hypothalamus or pituitary gland.

How is hypopituitarism treated?
In the early stages, hormonal problems can cause a condition called neurogenic diabetes insipidus, which is characterized by increased thirst and excessive production of dilute urine. This is due to a reduction in secretion of a hormone called vasopressin (anti-diuretic hormone) and can be treated by administering desmopressin (manufactured anti-diuretic hormone) and replacing lost fluids.

In the later stages, where hypopituitarism is confirmed, treatment may be given. Hormone replacement therapy may be used to restore hormones to normal levels, which should help to manage the symptoms. There are different treatments available, depending on the particular hormones involved and the nature and extent of the symptoms.

The assessment and treatment of hypopituitarism after brain injury is a complex process and more research is needed into the potential long-term benefits of hormone replacement therapy. As with any treatment, you should discuss the pros and cons with your doctor before making any decisions.

Further information and support
There are a number of studies into hypopituitarism after brain injury, but as yet the full extent of the problem is unknown. It seems to occur mainly after severe brain injury, however some studies have shown that damage to the pituitary gland may occasionally occur after seemingly minor head injuries. You should be particularly aware that many of the symptoms can be caused by damage elsewhere in the brain, and if this is the case treatment for pituitary dysfunction will not be effective.

Contact the Headway helpline (email helpline@headway.org.uk) if you need further support or have any questions about the information on this page.

Hormonal imbalances after brain injury
Read more: https://www.headway.org.uk/about-brain- ... mbalances/

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

Erin Ambrose opens up about her struggles with anxiety and depression

Post by greybeard58 » Sat Feb 26, 2022 12:22 pm

Erin Ambrose opens up about her struggles with anxiety and depression

Number 23, a right-shot defenceman from Keswick, Ontario … Erin Ambrose.

This is who I feel I am always competing to be more than. To be better than.

I have always been that kid who plays hockey, and for as long as I can remember I have struggled with thinking that others see me as only that. Do people look at me as Erin Ambrose the hockey player, the girl whose life revolves around hockey?

While that alone can have a profound impact on someone, imagine what it feels like when you think you are not good enough at the one thing you are known for.

I have often asked myself, “What’s the point? Who can I really be if I can’t even be who people think I am?” These are the feelings that suffocated me after being released from Olympic centralization in November 2017. As the thoughts race through my mind, I remind myself that I know I have been here and I have overcome this before. I have shown myself that I am stronger than I ever thought I could be. I know that I will not go down that deep hole again. And I know that I am MUCH more than just a hockey player.

For many Canadians, 2010 was a banner year for hockey. It was the year of a home-ice Olympics, of double gold for our women’s and men’s teams, and of one of the most pivotal steps in my hockey journey. I was a member of the Toronto Jr. Aeros in the Provincial Women’s Hockey League. I had been named to Team Canada for my first IIHF Women’s U18 World Championship and came home from Chicago a gold medalist. I was on a path of deciding where I would attend university.

But none of those things quite filled me with the joy I felt I should have as a 16-year-old chasing her hockey dreams. With each exciting achievement that came and went, there was a massive amount of emptiness I still felt inside. Hockey was my escape from all that was happening at home, and thankfully, I had teammates that truly cared about my wellbeing. My captain at the time became somebody I could count on as I minimized the amount of time I wanted to be at home. For those who know me, I am a huge family person, so not wanting to go home was a big concern and should have been a red flag.

As the hockey season came and went, I continued to have issues with my overall happiness and struggled to “find myself.” I changed schools and started living with a teammate (who was one of my best friends) in hopes of turning the page and getting myself out of my own head and back to enjoying my teenage years. I longed to find true happiness and escape the emptiness that weighed on me daily. I felt more distant than ever from my family, found myself questioning if I wanted to be involved with Hockey Canada and, most alarming, there were days that I contemplated my future. I found myself questioning my will to be alive.

Eventually, I decided to open up to both my mom and sister about what and how I was feeling. It was a huge relief. They reassured me that I was not alone, nor did I have to live this struggle on my own. I learned that depression and anxiety ran in the family. I talked with my doctor about these fears, the constant darkness and my concern about my well-being, and we were able to create a plan of action moving forward. Although I am constantly fighting against my anxiety, I am proud that I have taken strides in managing the highs and lows.

To start working through what was holding me back, there were aspects of my life I needed to start to embrace and accept. For one, my sexual orientation was something I had been hiding for years. The stress of constantly wondering if I would be accepted took a toll on my well-being. But my family has been so supportive through it all, and to say they love me for who I am would be the understatement of the century. It is something that many people deal with differently and I cannot pretend to sit here and say it did not affect me or that I didn’t question if it would just be “easier” to try to push it away and hide who I am. But that isn’t what makes me happy, and it never would have. As much as I struggled to choose to be myself and live the real me, I can tell you, with so much happiness, that as a proud LGTBQ+ member, it is WORTH it to be yourself and be PROUD of it.

I wish I could just fast-forward to the fall of 2017 and tell you how those challenges had prepared me to overcome the biggest disappointment of my life – my release from Olympic centralization. Little did I know that the years leading up to then would be a roller-coaster of experiences and hardships, with so many highs but just as many lows, turns and dips.

In 2012, I excitedly accepted an athletic scholarship to Clarkson University. Let the wild ride begin. Placed on academic probation after only one semester, I was dealing with an eating disorder I did not want to acknowledge and continued to use hockey as my escape. Everything in my life seemed to be going straight downhill, but on the ice I was thriving. So, I ignored the issues. At least, I tried to. But my priorities were off and I was not happy with myself. I could not understand why I felt so unhappy in life but continued to succeed as a hockey player.

By the end of my junior year, I was back on track academically, but very unhappy. For the first time in my life, hockey was no longer there to save me. I spent the year on my own and truly focusing on myself. As hard as it was, it was something that was long overdue. I connected with those who cared about me as a person and not just a hockey player. I leaned heavily on my family and made a conscious effort to be more attentive to my relatives back home. I worked to be more present in my roommates’ life and I was much happier being surrounded by my teammates, even though I was not happy with my hockey situation.

The reality is, hockey had always been my safe place, and I had that taken away from me. From that moment on, I felt like I had lost that sanctuary, which resulted in an increase of anxiety and triggered a series of anxiety attacks. I began writing more, isolating myself and trying to express myself in other ways, doing whatever I could to try and find an answer. As someone who thrives on routines (they help diminish my anxiety and help me cope with daily highs and lows), when I lost that hockey routine – and ultimately my happiness at the rink – everything changed and I relied heavily on focusing on others and ignoring the thoughts and feelings I had. When I lose myself, I throw myself into the happiness of others. This has, and always will be, something that is important to me, although detrimental at times to my mental state.

With my senior year coming to an end and post-college life approaching in the spring of 2016, I was still struggling immensely with day-to-day anxiety even as I felt more at peace with myself. As I continued to work myself out of the dark hole of depression, my anxiety increased ten-fold with the unknown ahead. Anxiety is not something that can just be checked off in a box in the morning to overcome for that day. There are different triggers for different people and so many different levels of anxiety. I began to realize that anxiety attacks came on during situations where I lacked control. Crowds, unknown places and uncertainty became overwhelming, especially when I was without people that understood what my triggers were. The fear of going out on my own was more than I could handle and truly hindered finding my comfort and confidence at the rink that I was still trying to rediscover.

Then came the biggest unknown, and the biggest challenge of my hockey career. I moved to Calgary in August 2017 to centralize with Hockey Canada in hopes of being named to Canada’s Women’s Olympic Team for the 2018 Games in PyeongChang. Every day, I made sure to write in my journal anything I felt was important from that day; I found this helped immensely in dealing with the stress and anxiety I was feeling.

Truth to be told, this was one of the toughest years of my life. I arrived to centralization out of shape and found myself playing catch-up and doing extra conditioning (stress level increases). Every day we needed to perform, regardless of how we were feeling both mentally and/or physically (stress level increases). Don’t get me wrong, centralization was one heck of an experience and I am so thankful I got to be a part of it. But as a first-time centralized athlete, I had no idea how to manage my anxiety and struggled to find balance. I was in constant contact with our mental performance coach and our doctor – I felt like the weight of my anxiety was becoming overwhelming.

But this wasn’t the time to deal with my mental health. It was the time to make the Olympics and put hockey first.

November 20, 2017. I can tell you every single detail about the day. That is the day I was released from centralization and sent home. My dreams of playing in the Olympics were gone, just like that. I felt like my world was ending. I remember our Mel Davidson, our general manager, asking me if I was okay. I obviously wasn’t, but I knew she was concerned about my mental state, and she had every right to be. This news crushed me. I didn’t know how I could face my family. I felt like I had let them down. Within a day, I also lost the opportunity to be around my teammates and closest friends, and my ultimate goal of playing in the Olympics.

All of this changed in the blink of an eye and I found myself wondering who I wanted to be moving forward. It sounds dramatic, but I truly would not wish the pain I felt on my worst enemy. Knowing all you have worked your entire life for, the person you felt like everybody saw you as, was taken away from you so quickly. In response to my pain, I made a hard decision and moved my life to Montreal. I felt like I had to get away and get myself out of a dark place. Most importantly, I had to get out of it on my own. And I did just that.

What makes me even more proud is that I am happier with myself than I have ever been. I still struggle, immensely, with the daily grind of finding happiness. But I have learned and continue to learn to love me for who I am. Yes, I wear No. 23. Yes, I shoot right. Yes, I play defense. But I also wear my heart on my sleeve, I care about those around me and I value respect and loyalty. I am empathetic. I am goofy. I am a competitor. I am strong.

Oh, and I play hockey, too.
Erin

P.S. I’m not going to insinuate that I am an expert on anxiety and depression. But what I want people to know is that anybody can struggle. My mom, my sister and my nana are my inspiration; each one of them have not only lived their lives but have been BEYOND successful in everything they do while fighting this battle. I battle every day with anxiety and depression, as well as with believing and knowing that I am more than Erin Ambrose, the hockey player. So, whoever you are, whatever you are doing, know that you are more than what your job title makes you. You belong, you are amazing and you will be even better tomorrow.

About the author
Erin Ambrose made her debut with Canada’s National Women’s Under-18 Team in August 2009 as a 15-year-old and remains the youngest player to play for the U18 program, as well as its all-time leading scorer among defencemen. Her international career has included 81 games at every level of Canada’s National Women’s Program, two gold medals and a silver at the IIHF U18 Women’s World Championship, and silver and bronze at the IIHF Women’s World Championship. She also won a pair of gold medals with Ontario Red at the National Women’s Under-18 Championship in 2009 and 2011, and added silver at the 2011 Canada Winter Games.

In My Words: Erin Ambrose
https://www.hockeycanada.ca/en-ca/news/ ... depression

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

Driving may be impaired after a concussion

Post by greybeard58 » Tue Mar 01, 2022 8:03 am

Driving may be impaired after a concussion

Highlights


Slower reaction time during driving simulation was detected among symptom-free concussed individuals.


Slowed driving-reaction time may be a safety concern after concussion and warrants further inspection.


Driving reaction-time outcomes did not correlate with any computerized neurocognitive domains.


Computerized neurocognitive testing is not a viable driving-reaction time surrogate measure.


Further research is needed to understand post-concussion driving performance and develop clinically feasible driving measures.

Slowed driving-reaction time following concussion-symptom resolution
Read more: https://www.sciencedirect.com/science/a ... 4620301216

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

Detailed description of Division I ice hockey concussions: Findings from the NCAA and Department of Defense CARE Consort

Post by greybeard58 » Wed Mar 02, 2022 8:45 pm

Detailed description of Division I ice hockey concussions: Findings from the NCAA and Department of Defense CARE Consortium.
By Kathryn L Van Pelt,Jaclyn B Caccese,James T Eckner,Margot Putukian,M Allison Brooks,Kenneth L Cameron,Megan N Houston,Matthew A Posner,Jonathan C Jackson,Gerald T McGinty,Cameron J Hillis,Thomas W McAllister,Michael A McCrea,Steven P Broglio,Thomas A Buckley
Jan 18, 2021

Since concussion is the most common injury in ice hockey, the objective of the current study was to elucidate risk factors, specific mechanisms, and clinical presentations of concussion in men’s and women’s ice hockey.
Ice hockey players from 5 institutions participating in the Concussion Assessment, Research and Education (CARE) Consortium were eligible for the current study. Participants who sustained a concussion outside of this sport were excluded. There were 332 (n = 250 male, n = 82 female) athletes who participated in ice hockey, and 47 (n = 36 male, n = 11 female) who sustained a concussion.
Previous concussion (OR = 2.00; 95% confidence interval (CI): 1.02‒3.91) was associated with increased incident concussion odds, while wearing a mouthguard was protective against incident concussion (OR = 0.43; 95% CI: 0.22‒0.85). Overall, concussion mechanisms did not significantly differ between sexes. There were specific differences in how concussions presented clinically across male and female ice hockey players, however. Females (9.09%) were less likely than males (41.67%) to have a delayed symptom onset (p = 0.045). Additionally, females took significantly longer to reach asymptomatic (p = 0.015) and return-to-play (RTP) clearance (p = 0.005). Within the first 2 weeks post-concussion, 86.11% of males reached asymptomatic, while only 45.50% of females reached the same phase of recovery. Most males (91.67%) were cleared for RTP within 3 weeks of their concussion, compared to less than half (45.50%) of females.
The current study proposes possible risk factors, mechanisms, and clinical profiles to be validated in future concussions studies with larger female sample sizes. Understanding specific risk factors, concussion mechanisms, and clinical profiles of concussion in collegiate ice hockey may generate ideas for future concussion prevention or intervention studies.

Copyright © 2021. Production and hosting by Elsevier B.V.

REFERENCES
PubMed

ABOUT THE AUTHOR
View all posts by adminadmin
Kathryn L Van Pelt,Jaclyn B Caccese,James T Eckner,Margot Putukian,M Allison Brooks,Kenneth L Cameron,Megan N Houston,Matthew A Posner,Jonathan C Jackson,Gerald T McGinty,Cameron J Hillis,Thomas W McAllister,Michael A McCrea,Steven P Broglio,Thomas A Buckley
Kathryn L Van Pelt

Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY 40536-0230, USA. Electronic address: kloc223@uky.edu.
Jaclyn B Caccese

College of Medicine School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio 43210, USA.
James T Eckner

Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, 48108, USA.
Margot Putukian

University Health Services, Princeton University, McCosh Health Center, Princeton, NJ 08544, USA.
M Allison Brooks

Department of Orthopedics and Rehabilitation, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705-2281, USA.
Kenneth L Cameron

Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA.
Megan N Houston

Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA.
Matthew A Posner

Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA.
Jonathan C Jackson

10th Medical Group, United States Air Force Academy, Colorado Springs, CO 80840-4000, USA.
Gerald T McGinty

Sports Medicine, Athletic Department, United States Air Force Academy, U.S. Air Force Academy, CO 80840-9500, USA.
Cameron J Hillis

Novant Health, Charlotte Independence Soccer Club, Cornelius, NC 28031, USA.
Thomas W McAllister

Department of Psychiatry, Indiana University, Indianapolis, IN 46202, USA.
Michael A McCrea

Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Steven P Broglio

Michigan Concussion Center, University of Michigan, Ann Arbor, MI 48109, USA.
Thomas A Buckley

Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA.

https://www.physiciansweekly.com/detail ... consortium

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

Former contact sport athletes needed

Post by greybeard58 » Tue Mar 08, 2022 10:37 pm

Former contact sport athletes needed

NOW ENROLLING: Project S.A.V.E. We're looking for former male and female contact sport athletes age 50+. Results could inform strategies to treat & prevent symptoms associated w/head impacts from contact sports.

Study Information:
S.A.V.E. stands for Study of Axonal and Vascular Effects from repetitive head impacts. The major goal of this study is to determine how repeated head impacts from playing contact sports can lead to long-term thinking, memory and mood problems.

The results of this study could inform on strategies to treat and prevent symptoms associated with head impacts from contact sports.

What does Participation in the study include:
• A 1-2 day study visit at either Boston University or the University of California, San Francisco.
• Each visit will consists of an enhanced MRI of the brain; neurological, cognitive, self-report mood and behavior exams; blood samples; and optional lumbar puncture.
• Participants will return annually.

Who is eligible to apply for the study?
• Men and women age 50 or older who played 5+ years of a contact sport, including American football, ice hockey, soccer, lacrosse, boxing, full contact martial arts, rugby and wrestling.

Contact information
To participate in Boston:
Phone (617) 358-6545
Email: joinhope@bu.edu

To participate in San Francisco:
Email: karen.smith@ucsf.edu

Funded by the NIH: National Institute of Neurological Disorders and Stroke, National Institute of Aging

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

Children and youth are at higher risk of developing mental health issues following a concussion

Post by greybeard58 » Thu Mar 17, 2022 4:14 pm

Children and youth are at higher risk of developing mental health issues following a concussion

“Young people who sustain a concussion are at a 40% higher risk of mental health issues, psychiatric hospitalization, and self-harm compared to those who sustain an orthopedic injury.” New, large CHEO study finds children age 5-18 with a concussion and no previous mental health visits in prior year developed increased rates of:
Suicidal ideation
Anxiety
Behavioral disorders
Mood & eating disorders
Schizophrenia
Substance use disorder
...vs children with orthopedic injuries.



Children and youth who sustain a concussion are at increased risk of developing mental health issues shows a new study of children and youth aged five to 18 across Ontario, Canada over a 10 year period.

Led by researchers at the CHEO Research Institute, the population-based retrospective cohort study was published by JAMA Network Open on March 7, 2022, indicates that young people who sustain a concussion are at a 40% higher risk of mental health issues, psychiatric hospitalization, and self-harm compared to those who sustain an orthopedic injury.

“This study shows that concussions can be much more than a physical head injury, there can be long-term emotional and cognitive impacts on a child’s life that we have to be mindful of and help address,” said Andrée-Anne Ledoux, the study’s lead author and a scientist at the CHEO Research Institute, a pediatric health-care and research centre in Ottawa, Canada.

This is the first study of its size and length of time to examine the association between a concussion and subsequent mental health issues amongst children and youth with no prior mental health visit in the year before their injury. The study compared two cohorts made up of 1) 152,321 children and youth with concussion, and 2) 296,482 children and youth with orthopedic injury, excluding anyone who had a mental health visit within the previous year. It found that primary outcomes of mental health conditions such as anxiety and neurotic disorders, adjustment reactions, behavioural disorders, mood and eating disorders, schizophrenia, substance use disorder, suicidal ideation, and disorders of psychological development were more prevalent in the concussion cohort than the orthopedic group. Secondary outcomes in the concussion cohort included self-harm, psychiatric hospital and death by suicide.

“During concussion follow-up visits, it’s extremely important for physicians to screen for mental health issues and factors that might predispose children to a mental health problem. By intervening early and providing children and adolescents with the right tools to cope and adapt to the trauma and symptoms of a concussion, we can help them become more resilient and prevent the impacts of long-term mental health issues,” said Ledoux, who is also an assistant professor at the University of Ottawa.

Consistent with smaller cohort studies, Ledoux’s study found that concussions were associated with a significantly increased risk of self-harm. In contrast to some other studies, it did not find a significantly higher risk of suicide, which was likely due to the low number of deaths by suicide in the population studied. Despite not being statistically significant, it is clinically relevant that the concussion group studied had approximately twice the incidence rate of suicide, again signaling the importance of thorough post-concussion monitoring for mental health issues.

“Knowing there is an increased risk for children and youth to develop mental health issues post-concussion, parents can be on the lookout for worrying indicators and be open to speaking with their child about what they are feeling and experiencing. Together, they can seek out the appropriate tools and care from a physician or a mental health specialist,” said Ledoux.


Children and youth are at higher risk of developing mental health issues following a concussion
Read more: https://www.cheoresearch.ca/about-us/media/news/3506/

Reference: Ledoux, A.-A., Webster, R.J., Clark, A., Fell, D., Knight, B.D., Gardner, W., Cloutier, P., Gray, C., Tuna, M., Zemek, R. Mental Health Outcomes in Children and Youths Following a Concussion. JAMA Netw Open. 2022;5(3):e221235. doi:10.1001/jamanetworkopen.2022.1235
Read the study at: https://jamanetwork.com/journals/jamane ... le/2789683

Findings: This cohort study included 448,803 children and youths with concussion or orthopedic injury and found that children and youths who had sustained a concussion had a 40% increased risk of developing a mental health issue compared with age- and sex-matched children and youths with an orthopedic injury.

Meaning: In this study, concussion was associated with an increased risk of mental health issues, psychiatric hospitalization, and self-harm among children and youths aged 5 to 18 years.

Conclusions: In this study, concussion was associated with an increased risk of mental health visits, psychiatric hospitalization, and self-harm among children and youths aged 5 to 18 years who had sustained a concussion compared with their contemporaries who had sustained an OI. Our results suggest that clinicians should (1) assess for preexisting and new mental health symptoms throughout concussion recovery; (2) treat mental health conditions or symptoms or refer the patient to a specialist in pediatric mental health; and (3) assess suicidal ideation and self-harm behaviors during evaluation and follow-up visits for concussion.

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

Second Annual Resilient Minds Virtual 5k walk/run on March 20, 2022

Post by greybeard58 » Sat Mar 19, 2022 10:40 am

Second Annual Resilient Minds Virtual 5k walk/run on March 20, 2022

The second annual Resilient Minds Virtual 5K for the Concussion Legacy Foundation will be held on March 20, 2022. Help support concussion and post-concussion syndrome research and education. Registration is only $25 per runner/walker and is available for individuals and teams. All proceeds go directly to the Concussion Legacy Foundation.

Resilient Minds 5K hosted by Lauren Wong and Courtney Spitzer

Wong and Spitzer are both former Cornell University gymnasts who have experienced a number of concussions that heavily impacted their involvement in sports, academics, and daily functioning. They are organizing this race to support the Concussion Legacy Foundation because they understand the pain and frustration of healing from concussion and post-concussion syndrome and hope to support the education and research improving the lives of those experiencing these injuries.

During the inaugural race last year, Resilient Minds raised over $9,000, with over 125 runners and walkers participating. These included a few national champions in their respective sports, many NCAA athletes, two fantastic mom groups, and numerous traumatic brain injury survivors and their supporters. A shout out to our top fundraising teams: B.A.M.R. Fresno-Clovis, Not-So-Speedy Spitzers, and WCEG.

Join the Resilient Minds 5K, a virtual run/walk for the concussion community supporting CLF on Sunday, March 20.

Register for the 5K run/walk: https://www.classy.org/event/2022-resilient-5k/e387041

Donate: https://www.classy.org/give/387041/#!/donation/checkout

Support by purchasing swag at the event store: https://www.bonfire.com/2022-resilient-minds-5k160/

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

Concussion research diving into world of women’s hockey

Post by greybeard58 » Wed Mar 30, 2022 3:11 pm

Concussion research diving into world of women’s hockey

A newly-launched study at a B.C. university is taking concussion research to a place it’s never been before — the world of women’s hockey.

Players from the school’s teams will start wearing high-tech mouthguards this spring to capture data for University of B.C. researchers who study concussions.

Experts will explore on-ice head injuries in both men’s and women’s hockey.

The women’s game, however, is an area of research that has been understudied, according to Dr. Lyndia Wu, an expert in brain injury biomechanics at UBC’s faculty of applied science.

“There’s a lack of women’s sports data,” she said.

“Given that ice hockey is a high-concussion incident sport, it’s a good idea to expand to this population.”

Wu told Black Press that past research has shown women in sports tend to have a lower tolerance for getting concussed, as well as a longer recovery profile compared to their male counterparts.

Before arriving at UBC, Wu conducted similar research for the football team at Stanford University in California while working on her PhD.

Sports concussion research conducted globally — up until this point — has been primarily allocated to the men’s side of the coin.

But the new B.C.-based study is determined to investigate the differences between men and women hockey players when head injuries are suffered, as well as the potential long-term effects that come along with it.

“There’s been not enough research on female athletes who’ve suffered a sport-related concussion, and so looking at and comparing to male athletes will potentially provide some insight into the sex differences that occur,” said Dr. Paul van Donkelaar, a professor in the school of health and exercise sciences at UBC’s Okanagan campus.

Sensors built inside the mouthguards will capture the speed and direction of bodychecks on the ice, with data live-streamed in real time to a research tablet.

“If anyone has watched women’s hockey at its highest level, they know it’s physical,” said UBC Thunderbirds women’s hockey head coach Graham Thomas.

“The technology in this mouthguard has never been seen before,” Thomas added.

As part of the pending five-year project, players will be given periodic assessment tests that track their brain health over time, based on the data collected through the newly-developed mouthguards.

“Severe hits to the head are what most people are aware of, but even milder hits may have significant effects if they happen multiple times over the years,” said Dr. Alexander Rauscher, an associate professor in the department of pediatrics.

An undisclosed number of players will begin wearing the mouthguards immediately, in time for the Thunderbirds’ upcoming playoff schedule.

Thomas, who recently led the school’s women’s team to a Canada West title, told Black Press that despite some reluctancy from select players, he expects more and more to participate in the research project by next season.

“If we could get more data and be part of future change, then that’s always a good thing.”

‘A lack of data’: B.C.-based concussion research diving into world of women’s hockey
UBC research will be among the first to explore head injuries for women’s athletes
Read more: https://www.terracestandard.com/sports/ ... ns-hockey/

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

Concussion in Sport Group's credibility "is at an all-time low"

Post by greybeard58 » Fri Apr 08, 2022 3:41 pm

Concussion in Sport Group's credibility "is at an all-time low"

A butterfly flapped its wings last June and nine months later sport is still dealing with the fallout. It happened when Dr Steve Haake, a professor of Sports Engineering at Sheffield Hallam University, was confronted with a case of self-plagiarism committed by a contributor in a set of conference proceedings he had edited in 2006. It got Haake thinking about a similar incident in his life from around the same time. In 2000, he wrote an article called Physics, Technology and the Olympics, for Physics World. In 2012, he was surprised to find much of that same article repeated, verbatim, in an editorial published in 2005 by the editor in chief of the British Journal of Sports Medicine, Dr Paul McCrory. After dealing with the one old case, Haake decided, at last, to do something about the other.

You may not have heard of McCrory – Haake didn’t know much about him either – but if you have played or watched a contact or collision sport in the last 20 years he has had a hand in your pastime. McCrory was a founder member, and the co-chair, of the Concussion in Sport Group. They produce a consensus statement which is supposed to sum up the existing research into concussion, and which shapes medical practice in the field across grassroots and professional sport. They are funded by World Rugby, the IOC and Fifa, among others. McCrory has been one of the most influential figures in the field for the last 20 years.

The BJSM eventually agreed with Haake that there was a “significant overlap” between the two pieces. McCrory explained that it had been an editing error, that a draft version of his article had been uploaded by mistake. And that is where the matter might have rested. But the story was picked up by an organisation called Retraction Watch, where it caught the attention of an academic named Nick Brown. Brown describes himself as “a self-appointed data police cadet”. He and friend James Heathers had previously exposed flaws in the work of the former Cornell professor Brian Wansink, among others.

Brown decided to start digging into McCrory’s back catalogue. He soon found more articles that contained similar “significant overlaps” with other publications. Within hours of these coming to light, McCrory had stepped down from CISG. One of CISG’s key roles is to evaluate new concussion research. It’s a job that requires the trust of the community of people doing the research, especially since CISG uses such strict eligibility criteria. That strictness is ostensibly why they have always adopted such a conservative position on the risks of chronic traumatic encephalopathy. It says there is not enough proof. According to the group’s most recent consensus statement, it’s still not possible to say that there is “a cause-and-effect relationship” between CTE and concussion. McCrory was the lead author.

The chain of events that followed Haake’s decision to deal with that one case of plagiarism from 2005 has left the governing bodies that relied on CISG in the years since having to explain why they invested so much stock in their work and decide whether they will continue to stand by it. The group’s credibility, which had already been called into question by campaign groups and politicians during the DCMS hearings into concussion in sport last year, is at an all-time low. Their latest conference, which has already been postponed twice, is due to be held in Amsterdam later this year.

This is a problem for World Rugby in particular, and not just because of their involvement in the legal test cases about how their sport handled concussion in the years they were being guided by CISG. Rugby union’s governing body currently operates a six-day return-to-play protocol, meaning it’s possible for a player to be concussed one Saturday, and, if symptom-free, they can be back playing by the following Saturday (although in practice players are often out for much longer). It used to have a mandatory three-week stand-down for concussed players, but this was changed to bring it in line with the recommendations made by CISG in their 2012 consensus paper, of which, again, McCrory was the lead author.

In the last year the AFL has increased its return-to-play period to 12 days and the Rugby Football League increased its return-to-play period to 11 days. World Rugby has come under pressure to increase its return-to-play too, but hasn’t – it says this is because of a belief that a blanket time-limit would mean that players start under-reporting symptoms (if they are right about that, it suggests they still have more work to do on their player-education programmes because the players still don’t understand exactly what’s at stake, although, given that last CISG Consensus statement questions the link between CTE and concussion, they are not alone in that).

What World Rugby has done instead is adopt what it describes as a more “individualised” approach to the issue, in which the time it takes to return-to-play is decided on a case-by-case basis. This shift, which is in line with the advice from their independent concussion working group, suggests it is already trying to put distance between itself and the policies laid out by CISG, which they relied on for so long.

This “individualised” approach is fine in theory, but in practice inevitably leads to inconsistencies in the way concussed players are managed. If it’s going to work, everyone involved, especially players, former players and their families, has to have complete faith in all the different processes the sport is using to diagnose concussions and manage the return to play.

Given these are the same systems that allowed Tomas Francis to play on after he showed evidence of concussion against England, and which have allowed Wales to say they are happy to pick him again to play tomorrow even though he had a previous concussion in November, that is not the case.

How a plagiarism problem has started to shift rugby’s concussion protocols
World Rugby has begun to put distance between themselves and the policies laid out by CISG
Read more: https://www.theguardian.com/sport/2022/ ... -protocols

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

"And know that you don’t have to do it alone."

Post by greybeard58 » Wed Apr 13, 2022 4:06 pm

"And know that you don’t have to do it alone."


During every pregame skate, I used to look into the crowd and wonder what the fans could see.

I mean, like, what could they really see?

Could they see the cuts on my hands — and the blood on my laces — from obsessively lacing and relacing my skates again and again?

Could they see the bags under my eyes from having gotten just two hours of sleep for the fifth straight night?

Could they see the pain I was going through from trying to work up the nerve to tell the coach that tonight was the night when it was just all too much, and I couldn’t play?

I’ve been an NHL player for 11 years. And until very recently, I’ve had untreated obsessive-compulsive disorder, or OCD as we commonly know it.

There is simply no way to overstate the impact it’s had on my career, and on my life. It controlled me, it almost broke me for good. And there were times when I thought I might never be able to tell a story like this. But I’m here, and I am.

I want to tell this story because, really, it’s not about me. It’s about what happened to me, yes — but it’s not about me. It’s about, hopefully, getting people help. Even just one person. I know, without a doubt, that there are athletes and people all around the world suffering from the same thing I do, or something similar. Because I understand what OCD, if left untreated for too long, can do to a person.

The thing is, in the beginning, it seemed harmless. And I remember the beginning.

I mean the very, very beginning.

When I was little, maybe seven or eight years old, I’d count the trees when I would go on car rides with my parents. I’d be in the back seat of our caravan, and I’d watch them go by.

One, two, three, four.

Then I’d restart.

One, two, three, four.

The faster we went, the faster the trees would pass and the faster I’d count.

It didn’t seem out of the ordinary. It was just … I don’t know, the way I was.

My OCD manifested itself in different forms throughout my life. When I was in junior hockey, and even when I played at BU. I worried constantly about injuries. I’d think about my knees when I was on the ice, despite never having had any knee problems before. I had a chronic groin injury from when I was younger, and when it would be flaring up, I’d just drop down into a squat while I was doing everyday things to make sure it was O.K.

It was that feeling of a lack of control that eventually triggered the negative thoughts — like the ones I used to have during pregame skates.
And it’s almost this entirely separate part of your brain that gets activated when this happens. For me, my ability to play hockey never felt threatened when I was young. I grew up in Winnipeg, and like so many kids, I wanted to play in the NHL. And I always knew deep down that I was going to make it. My dad and grandfather had both played in the NHL. It’s all I ever wanted to do. It’s all I ever wanted to be.

For a long time, I didn’t have negative thoughts on the ice. I obsessed over my game, but in a positive way. I wanted to be the best player I could be because it was … it was everything to me.

My OCD played a role in making me the player I was. And I know there are many athletes out there who have that same connection. They might be afraid to seek help because on the outside they’re “succeeding” and they won’t want to change anything. I know I can tell them that that isn’t the case, but I also know they might not believe me.

Because I probably wouldn’t have believed it, either.

When the Nashville Predators took me in the first round of the draft in 2008, it was such an incredible moment to experience with my family. I had no negative thoughts or concerns about any of my OCD tendencies. I was just me. Colin Wilson, NHL player. That’s what mattered. And at the time I don’t think the term OCD had ever been brought up to me or had even crossed my mind.

I’d always tried to hide anything I did that could have been classified by others as superstitious or odd. But once I reached the NHL, I basically couldn’t anymore.

I remember in 2010, my rookie year, when Predators GM David Poile sat me down with assistant GM Paul Fenton, team psychologist Gary Solomon, and my parents and told me I had OCD.

They had noticed after picking up on a preflight routine I’d go through at airports.

To be honest, I’m a bit hesitant to talk about this part, because my tendencies, my experiences, they’re personal to me. And I don’t want anyone to read this and feel bad for me, or to think I’m glorifying what I went through. But I feel it’s important because the element of control — of having it or not having it — is what pushes people with OCD into dark places.

Before a flight, I had things I needed to do. I had to clean up all the trash around our gate. Every single wrapper, piece of plastic, you name it. Into the trash. Then I had to be the last passenger on the plane, no matter what. Then, finally, I actually had to talk to the pilots. It didn’t have to be about anything specific, but I had to at least talk to them. After I did all that, I felt safe to fly.

It stemmed from a fear of flying I’d had ever since I was a kid — and had grown into this routine. It all revolved around control of the situation. I needed to feel like I had a hand in what was going on.

But at the time I completely discounted what David Poile and everyone else was telling me. I was a 20-year-old living his dream in the NHL. I felt fine, I felt healthy.

There’s no chance I have that, I thought.

I don’t know what would have happened if I had taken that talk more seriously. Which is one of the reasons I want to help those who are facing the same things I did, because I know what it’s like being on the other side of the table. It can be hard to accept what you’re hearing. And I didn’t. I just ignored it and told them I would be fine. I hid myself, and my issues, from everyone.

After that, I basically spent the majority of my career in what I’d call fight-or-flight mode.

To this day, I honestly have no damn clue how I scored 20 goals in the 2014–15 season. I played each game, for years, in this state of panic because my OCD had begun to take over every element of my life. I went from obsessing over injuries off the ice to thinking I was going to get hurt every time I stepped on it — thinking I'd get hurt every shift. Or feeling like my skates weren’t tied properly. I’d have to stay in the locker room and tie them over and over again, as tight as I could, until my hands bled. And that was just a short-term fix. For years, I felt like I was skating on stilts because my skates never felt right. But I just got into this terrible state, like a petrified animal trapped in a corner. I was almost unconscious on the ice, in a way.

I was so energized after games that I couldn’t sleep, and the lack of sleep led me down a road that I wouldn’t wish on my worst enemy. I truly mean that.

There’s a version of this story where I tell you what happened next.

I read those kinds of stories all the time, and I think they’re very powerful and important. The bravery and honesty of those who have gone through the darkest of moments and can share their experiences with others should be applauded. But what I went through is just for me to know right now, and I hope you’ll respect that.

All I can say really is that, during the Stanley Cup finals in 2017, when we were playing the Penguins — I hit bottom.

My brain blew up.

I was a shell of the person I am today.

For the three or so years leading up to that point, I had been taking Xanax and Seroquel to help me sleep. One is addictive and gets you high, the other I would refer to as a horse tranquilizer, because it would knock me out. One night I would take Xanax, the next Seroquel. During that playoff run, I had started partying more as well, to numb the pain. The combination of those pills, mixed with alcohol, and years of untreated OCD … I found rock bottom.

Those had been prescribed to me to help me. But they didn’t do that at all. They made me lose myself. The stressors I had — the OCD, the lack of sleep, the pressure of playoff hockey — those pills just seemed to amplify all that and drive me to a place I never wanted to get to.

It became so bad that I remember when we beat Anaheim to win the Western Conference finals, everyone on the team was, of course, really happy. But all I wanted to do was go home and bawl my eyes out. I was a complete emotional wreck. I felt like I hadn’t been playing my best. I felt like I hadn’t contributed enough to the success of the team and it was driving me insane.

One of the things about OCD is that you have this internal critic that nags at you — that constantly reminds you that, no matter how hard you try, you aren’t ever in control, and because you’re not, you aren’t good enough.

And in the Cup finals, I was barely able to function. I was running on fumes, my head felt like it was on fire — I felt like I was going insane.

I knew I couldn’t live like this anymore. The team and my family had noticed that I wasn’t myself. When the season ended, after we lost the Cup finals, I realized that the only choice I had was to truly heal myself. I had started talking to a therapist earlier that season when I was really struggling, but what happened in the playoffs pushed me to work on myself even more.

After Nashville traded me to the Avalanche that summer, I continued to keep my issues from nearly everyone. But one of the most important connections I’ve ever made in my life was when I was introduced to a trained plant-medicine facilitator after the trade.

The way in which so many mental health cases are treated with pills and other addictive, unhealthy measures, really didn’t sit well with me. So under the guide of my facilitator, I started taking doses of psychedelics and other similar medicines that may seem unapproachable for many. But it was that sort of alternative help that did so much for me.

The word psychedelics might put people off, I get that — but I can’t stress enough how critical they were in my recovery. That experience showed me a completely different side of myself and gave me a deep sense of spirituality. It put me in touch with a part of me that I didn’t even know existed. I felt like what I was experiencing was greater than myself, my journey, if that makes sense.
Finding this differing approach changed my life, without a doubt.

Alternative medicines are important and should always be considered when treating mental health issues.

I have a plan for how to help introduce it to others, but it wasn’t just finding myself spiritually that helped, of course.

In 2019, during my second year in Colorado, I made another really significant breakthrough — I contacted the NHLPA, which put me in touch with an OCD specialist. And meeting that person changed my life. It was like meeting with a psychic, in a way.

He asked me if I’d ever felt like I was going crazy, if I’d ever felt like my world was completely out of control. My jaw was on the floor. I couldn’t believe what I was hearing. He was asking me — almost telling me — about myself and connecting with me like someone who actually got it. He wasn’t just there to prescribe some numbing drug or tell me to just think about something else.

For the first time in my entire adult life, I felt understood.

In those sessions, I began to understand that one of the key steps in the healing process is not only acknowledging that what’s going on in your brain isn’t normal, but also, more importantly, acknowledging that it isn’t your fault.

Since I started with the specialist, I’ve learned to develop a sense of self-compassion that I didn’t have before. It’s so difficult to not blame myself when I feel my mind going to … that place. So now I do my best to be aware, to tell myself that things like that will happen from time to time, and to just assure myself that it’s going to be O.K.

I knew my OCD wouldn’t go away just because somebody could see it for what it was. And I won’t lie to you ... every day since then has been hard. I still have an internal alarm that goes off when I feel like I need to be in control. It can be exhausting to deal with. But every day since that meeting last year, it has also gotten easier.

But this last year has been tough. I had to have double hip surgery in December 2019 because of issues that came from the groin problems I’ve had since I was a kid. But my hips haven’t healed properly, and I haven’t been able to walk normally all year, so I just had to have it done again. It’s hard because I haven’t been on the ice in a long, long time. I haven’t had much control.

I don’t know when I will again, either.

If I’m being honest, I think my days of playing hockey are probably over.

I haven’t quite come to terms with it fully. But that is the truth.

I’ve done a lot to prepare for my next step in life. I’m completely sober. I’m back at school in Boston working on a psychology major. The last few years I’ve been working with a new, more traditional talk therapist who has been one of the pillars that I lean on as I transition toward life after hockey. They’ve helped me think through everything and see the next chapter of my life in a positive light.

I’m also working with a group of people I got connected with over the last three years of getting help, and we’re going to open a space in Austin for alternative medicines and approaches to mental health issues — OCD included.

We want to help people, both physiologically and neurologically, through things like neurofeedback, floating, assisted psychotherapy, and other alternative therapies that aren’t widely accessible. We’ll also have teaching programs to ensure that once you leave, you’ll know how to keep up your routines on your own. It’s going to be a space that completely strips any stigma away from mental health issues. It will be a place that will be nourishing and safe, for all those who desperately need it.

Mental health, and what we know about it, is evolving and so must the ways we treat it.

I want people to know that there are spaces where you can be yourself, where you can feel understood and loved and know that there is help there for you. I want that to be what you take out of this story.

The human experience includes an incredible amount of suffering, even if you’re living your dream. There are lots of people battling OCD right now. I know how brave they are, how strong they are for fighting it. I know it’s probably taken over their lives, and they feel like there’s nowhere to turn to, or nobody to help them … to understand them. But I want them to know that there is someone. And I hope that they know I’m here to help.

We can’t get through it alone.

If it weren’t for the people who truly helped me — my spiritual counsel, my alternative medicine facilitator, my OCD therapist and my talk therapist — I wouldn’t be the person I am today. That’s my team, and they have given me the opportunity to help others.

That’s my focus in life right now.

And like I said, I don’t know if I’ll be back out on the ice anytime soon. But I know that, no matter what the future holds for me, I did it. I played in the NHL. I lived my dream. And I fought through hell to make a career for myself. My name might not be on the Stanley Cup, and that’s fine. Because I know there is an opportunity ahead of me to not just leave my mark on the game of hockey, but also on lives all across the world.
I don’t want to pretend like I have it all figured out, because I don’t. I’m still learning as I go. But what I do know comes from what I went through. So if you’re going through it, remember this:

Be kind to yourself, to your mind.

Have patience with your soul, your body.

And know that you don’t have to do it alone.

—Colin

The Things You Can’t See
Read more: https://www.theplayerstribune.com/posts ... tal-health

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

Bob Saget's death shows the danger of head injuries. Here's what you should know

Post by greybeard58 » Thu Apr 14, 2022 5:14 pm

Bob Saget's death shows the danger of head injuries. Here's what you should know

The sudden death of actor and comedian Bob Saget last month took fans of all ages by surprise.

According to his family, the 65-year-old actor and comedian "accidentally hit the back of his head on something, thought nothing of it and went to sleep." No drugs or alcohol were involved, according to a coroner's report.

Saget had "fractures to the back of his head and around his eyes" at the time of his death, according to an autopsy report from the Orange County, Fla., medical examiner obtained by People. Saget was also COVID-19 positive at the time of his death, the autopsy noted.

While details of how exactly Saget hit his head were not released, doctors stress the importance of seeking medical care immediately if you sustain a head or brain injury.

"If you are concerned that you may have a head injury, consider getting yourself checked out," said Dr. Amit Sachdev, medical director in the department of neurology at Michigan State University.

"Unfortunately, it's all too common and we in neurology see it quite frequently that head injuries lead to bleeding," said Sachdev.

Head injuries are more common than you think
Medical experts say head injuries are very common. Dr. Joshua Marcus, a neurologist specializing in the surgical treatment of brain and spine conditions at Nuvance Healthin western Connecticut, said they're responsible for millions of emergency room visits in the U.S. each year.

According to data from the Centers for Disease Control and Prevention, in 2018, more than 220,000 people in the U.S. suffered from traumatic brain injuries (TBI), and more than 60,000 TBI-related deaths were reported in 2019. That's about 165 TBI-related deaths each day.

Those 75 and older had the highest numbers and rates of TBI-related hospitalizations and deaths, accounting for about 32% of TBI-related hospitalizations and 28% of TBI-related deaths, according to the CDC.

However, most head injuries are pretty mild, experts say.

"[The injuries] don't result in serious bleeding on or around the brain and don't result in any significant neurologic injury. And very rarely result in a catastrophe," Marcus said.

The symptoms vary depending on the injury severity
There are a variety of injuries that can happen as a result of experiencing head trauma. They can be mild, such as a bump, a bruise or a cut in the head, according to experts at Johns Hopkins University. Or the injury can be more severe, like a concussion, a deep cut, an open wound, or fractured bones in the skull.

But no matter the injury, there are different symptoms you should look out for after sustaining a head injury.

For mild injuries, individuals could experience symptoms such as sensitivity to noise and light, confusion, fatigue, irritability, a raised or swollen area from a bump or nausea, Sachdev said.

Those with more moderate to severe injuries may experience symptoms such as loss of consciousness, a severe headache lasting for days, repeated nausea and vomiting along with seizures, and more.

Long-term effects can occur if left untreated
Both Sachdev and Marcus urge that if you experience any symptoms after hitting your head that you seek medical care immediately — as untreated head or brain injuries can have long-term effects.

"If repeated head traumas occur, the side effects and complications can mount. But even in the short term from just one injury, you can have long-term effects like concentration trouble, visual difficulty, blurry vision," Marcus said.

In addition, any untreated head trauma can turn fatal due to the possibility of ongoing bleeding or swelling due to increased pressure in the brain, he added.

Overall, experts say it's better to be safe than sorry when it comes to injuries involving the head — emphasizing that in most cases patients will be all right.

"There's no level of concern that's too ridiculous. If you're concerned, go seek care," Sachdev said.

Bob Saget's death shows the danger of head injuries. Here's what you should know
Read more: https://www.npr.org/2022/02/10/10799662 ... concussion

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

"She had three concussions during high school years, which she said was one of the hardest points in her life"

Post by greybeard58 » Sat Apr 23, 2022 7:51 pm

"She had three concussions during high school years, which she said was one of the hardest points in her life"

Emma Gerike, a 2017 Bordentown Regional High School graduate who recently finished off her career at the University of Rhode Island, says playing ice hockey throughout her four years of college was like working a part-time job without pay.

“You have to put in at least three hours a day, if you want to do the bare minimum, which is not enough,” said Gerike, who played defense for the URI women's ice hockey team while also working a part-time job to earn enough to pay for tuition.

It is hard to let go of something that has played such a big role in your life and has been such a factor in shaping who you are today, according to Gerike, who says that student-athletes have to dedicate a huge majority of their lives to playing a sport in college, including starting at a young age.

Gerike was on skates by the age of three and started officially playing at eight years old. While Bordentown Regional High School did not have a girls ice hockey team, she was able to play on a travel team in Princeton.

Gerike graduated in January from her fifth year at the University and is currently waiting for the ceremony this coming May. Gerike has always been passionate about the ocean and conservation, which led her to study marine biology during her time at the school.

She is currently playing with a men’s league and pickup games, but said, “I definitely think that I will be okay with hockey not being such a big part of my life in the future. I am okay with it, especially considering how tired my body is.”

Aside from devoting so much time to the sport, it takes a huge toll on the athletes' bodies. Throughout Gerike's career, she has suffered from four concussions, a torn quad and hamstring, a shoulder and neck injury for the past two years, and is still going in and out of psychical therapy. She has not been injury free since sophomore year. With the exception of all the injuries, Gerike was still able to rack up 14 game points throughout her last season with the team.

Out of all of these impairments, the concussions have been the worst for Gerike. She had three concussions during high school years, which she said was one of the hardest points in her life.

Although concussions are one of the most dangerous injuries that can impact health for the rest of someone's life, Gerike was not ready to let go of the sport and wanted to continue playing in college.

During her college years, Gerike has had the chance of experiencing two different coaches and two very different coaching styles.

“Honestly I used to cry every day going to practice, by my junior year, it was really bad. Everyone on the team was having a really hard time and we kind of just used to play out of fear and out of doing the wrong thing,” Gerike said of her previous coach, Ashley Pagliarini.

In 2020, Ray Boudiette became the new coach. His coaching style was much different, and Gerike said she began to enjoy the sport even more.

“Last year, I know we didn't play games, but that was the most fun I ever had,” she said. “Honestly in the past two years, I don’t think I have enjoyed hockey that much before.”

Gerike has struggled with a breathing issue, which has lightened up greatly the past two years. She attributes it to lessened anxiety.

At her first ever college game, which was against Boston University, Gerike was very nervous, which is understandable considering she was out of commission for the majority of her senior year of high school due to a concussion. She was apprehensive that she would not get played and that she was not going to be good enough.

By the final game of her college career, she was a completely different player – confident and a supportive teammate.

Gerike continues to advocate for mental health and plans to carry on with her positive attitude. She will finally be able to invest more time in marine biology, now that her hockey career has ended. She is excited to advance her career and pursue her future.

“I am super big into mental health and making sure everyone has the resources that they need because the mental part is just as big as going to work out and keeping up with your fitness,” Gerike said. “Being a leader in mental health has been one of my biggest priorities.”


Bordentown Female Ice Hockey Player Reflects on Successful College Career
Read more: https://www.tapinto.net/towns/bordentow ... ege-career

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

Abigail Manzewitsch missed a majority of the season with a concussion

Post by greybeard58 » Tue May 10, 2022 7:38 pm

Abigail Manzewitsch missed a majority of the season with a concussion

Members of the Steel City Selects were no strangers to playing at nationals.

Some of the team members experienced heartbreak in overtime of the 16U final last year, and the returning 19U players suffered a loss in the national semifinals.

Coach Jim Black said that was motivation for this year’s group to get back to the national tournament and bring home the title trophy and banner.

It was mission accomplished as the team outscored opponents 15-6.

“This is such a great group of girls,” Black said. “They love each other and had each other’s backs throughout the season. With this, they will have a common bond forever.”

The team had each other’s backs through the pressure-packed championship game against the Arizona Kachinas.

After 51 minutes of scoreless regulation, Svetlana Yarosh (Cecil Township/Canon-McMillan) scored on a breakaway just 23 seconds into overtime to give Steel City the championship.

Laura Crnarich (Wexford/Pine-Richland) assisted on the winner.

Steel City, which included local products Lillian Johnson (Natrona Heights), Miranda Naylor (Lower Burrell) and Abigail Manzewitsch (Murrysville), allowed eight shots in the title game.

“A main thing all season was our commitment to defense,” Black said. “That was all the way through the lineup on the ice. We were under a goal a game from a goals-against standpoint (51 goals/54 games). When you have strong goaltenders and a solid defensive group, it’s easy to build off of that.”

It was the third time in the tournament Steel City needed extra time to win.

In its round-robin game against Team South Dakota, it won 2-1 on the fifth shooter of a shootout.

Steel City rallied against the Adirondack (N.Y.) Northstars in the quarterfinals. Trailing 4-2 in the third period, it scored twice to send the game into overtime. Crnarich scored the winner off assists from Amanda Sokol (Scottdale) and Lillian Relyea (Moon).

“Just having experienced going into overtime really helped the girls be ready for it in the championship game,” Black said. “The nerves really weren’t there.”

Black was excited to see Manzewitsch, who had missed a majority of the season with a concussion, earn two goaltending wins in the national tournament.

Casey Frank (Cranberry Township/Seneca Valley) got the start in the other four games.

Steel City, based out of the Baierl Ice Complex in Warrendale, finished the season 44-5-5 and punched its ticket to nationals with four wins at the Mid-Am District Tournament. It topped rival Armstrong in a shootout final to advance.

“Steel City and Armstrong go back a long way. It is a great rivalry for 19U Tier II,” Black said. “They usually schedule us for the last game because it usually comes down to our two teams.”

https://triblive.com/sports/steel-city- ... pionships/
Read more: https://triblive.com/sports/steel-city- ... pionships/

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

Re: concussions

Post by greybeard58 » Tue May 24, 2022 9:45 pm

Bob Saget's death shows the danger of head injuries. Here's what you should know

The sudden death of actor and comedian Bob Saget last month took fans of all ages by surprise.

According to his family, the 65-year-old actor and comedian "accidentally hit the back of his head on something, thought nothing of it and went to sleep." No drugs or alcohol were involved, according to a coroner's report.

Saget had "fractures to the back of his head and around his eyes" at the time of his death, according to an autopsy report from the Orange County, Fla., medical examiner obtained by People. Saget was also COVID-19 positive at the time of his death, the autopsy noted.

While details of how exactly Saget hit his head were not released, doctors stress the importance of seeking medical care immediately if you sustain a head or brain injury.

"If you are concerned that you may have a head injury, consider getting yourself checked out," said Dr. Amit Sachdev, medical director in the department of neurology at Michigan State University.

"Unfortunately, it's all too common and we in neurology see it quite frequently that head injuries lead to bleeding," said Sachdev.

Head injuries are more common than you think
Medical experts say head injuries are very common. Dr. Joshua Marcus, a neurologist specializing in the surgical treatment of brain and spine conditions at Nuvance Healthin western Connecticut, said they're responsible for millions of emergency room visits in the U.S. each year.

According to data from the Centers for Disease Control and Prevention, in 2018, more than 220,000 people in the U.S. suffered from traumatic brain injuries (TBI), and more than 60,000 TBI-related deaths were reported in 2019. That's about 165 TBI-related deaths each day.

Those 75 and older had the highest numbers and rates of TBI-related hospitalizations and deaths, accounting for about 32% of TBI-related hospitalizations and 28% of TBI-related deaths, according to the CDC.

However, most head injuries are pretty mild, experts say.

"[The injuries] don't result in serious bleeding on or around the brain and don't result in any significant neurologic injury. And very rarely result in a catastrophe," Marcus said.

The symptoms vary depending on the injury severity
There are a variety of injuries that can happen as a result of experiencing head trauma. They can be mild, such as a bump, a bruise or a cut in the head, according to experts at Johns Hopkins University. Or the injury can be more severe, like a concussion, a deep cut, an open wound, or fractured bones in the skull.

But no matter the injury, there are different symptoms you should look out for after sustaining a head injury.

For mild injuries, individuals could experience symptoms such as sensitivity to noise and light, confusion, fatigue, irritability, a raised or swollen area from a bump or nausea, Sachdev said.

Those with more moderate to severe injuries may experience symptoms such as loss of consciousness, a severe headache lasting for days, repeated nausea and vomiting along with seizures, and more.

Long-term effects can occur if left untreated
Both Sachdev and Marcus urge that if you experience any symptoms after hitting your head that you seek medical care immediately — as untreated head or brain injuries can have long-term effects.

"If repeated head traumas occur, the side effects and complications can mount. But even in the short term from just one injury, you can have long-term effects like concentration trouble, visual difficulty, blurry vision," Marcus said.

In addition, any untreated head trauma can turn fatal due to the possibility of ongoing bleeding or swelling due to increased pressure in the brain, he added.

Overall, experts say it's better to be safe than sorry when it comes to injuries involving the head — emphasizing that in most cases patients will be all right.

"There's no level of concern that's too ridiculous. If you're concerned, go seek care," Sachdev said.

Bob Saget's death shows the danger of head injuries. Here's what you should know
Read more: https://www.npr.org/2022/02/10/10799662 ... concussion

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

Study links concussion to changes in gut bacteria

Post by greybeard58 » Thu Jun 09, 2022 11:58 am

Study links concussion to changes in gut bacteria

The inherent difficulties in properly diagnosing concussion have scientists searching far and wide for biomarkers that clearly reveal the extent of a brain injury. For scientists at the Houston Methodist Research Institute, this search has led them to the communities of bacteria in the gut, where they've found that changes following a concussion could be used to reveal the state of recovery.

Where severe consequences of an impact to the head such as skull fractures or brain swelling may show up through X-ray imaging or CT scans, microscopic injuries that damage nerve cells may be so subtle that they go undetected. Having the subject self-report on things like dizziness, blurred vision or nausea is therefore the go-to diagnostic technique for medical experts making on-the-spot assessments, but the risk of underreporting and secondary brain injuries is very real among competitive athletes with an aversion to warming the bench.

The idea that concussion may create specific biomarkers that can be leveraged for a timely and definitive diagnosis is therefore an appealing one, with a number of research teams making inroads in this space. Blood testing is an area where we're seeing a lot of activity, with the FDA even approving the first such test in 2018, which traces two proteins that appear in the blood after a brain injury. Saliva and urine testing are other techniques showing potential.

Recently, scientists have also begun to explore the potential of our gut bacteria to reveal the tell-tale signs of a brain injury, and studies on animal models and cell cultures have provided promising signs. The Houston Methodist team investigated this further by tracking 33 college football players over the course of a season, collecting blood, stool and saliva samples at three intervals along the way to build a picture of their gut microbiomes.

Following instances of concussion, the team found a decrease in levels of two bacterial species that are normally abundant in healthy individuals. They also found correlations between proteins linked to traumatic brain injuries in the blood and bacteria linked to brain injuries in the stool. These may be the result of inflammation, caused by the concussion, that alters the proteins and molecules circulating through the body, breaching the intestinal barrier and reshaping gut bacteria and metabolism.

Together, these results offer early evidence that "detecting changes in the gut microbiome may help to improve concussion diagnosis following head injury," the researchers write in their paper. Much more work is needed, including studies with larger sample sizes, but these types of biomarkers could also one day be used to not just confirm concussion, but gauge how well a patient is recovering from the injury, according to study author Sonia Villapol.

"Until your gut microbiome has returned to normal, you haven't recovered," she said. "This is why studying the gut is so useful. It doesn't lie. And that is why there is so much interest in using it for diagnostic purposes."

Following instances of concussion, the team found a decrease in levels of two bacterial species that are normally abundant in healthy individuals. They also found correlations between proteins linked to traumatic brain injuries in the blood and bacteria linked to brain injuries in the stool. These may be the result of inflammation, caused by the concussion, that alters the proteins and molecules circulating through the body, breaching the intestinal barrier and reshaping gut bacteria and metabolism.

Together, these results offer early evidence that "detecting changes in the gut microbiome may help to improve concussion diagnosis following head injury," the researchers write in their paper. Much more work is needed, including studies with larger sample sizes, but these types of biomarkers could also one day be used to not just confirm concussion, but gauge how well a patient is recovering from the injury, according to study author Sonia Villapol.

"Until your gut microbiome has returned to normal, you haven't recovered," she said. "This is why studying the gut is so useful. It doesn't lie. And that is why there is so much interest in using it for diagnostic purposes."

Study links concussion to changes in gut bacteria
Read more at: https://newatlas.com/medical/study-conc ... -bacteria/

The research was published in the journal Brain, Behavior, & Immunity—Health.
Read the study at: https://www.sciencedirect.com/science/a ... 462200028X

Source: Houston Methodist Research Institute via MedicalXpress
Read more at: https://medicalxpress.com/news/2022-05- ... sions.html

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

5 years later

Post by greybeard58 » Sat Jun 11, 2022 1:26 am

5 years later

Jincy Dunne was probably just the neighborhood kid running roller hockey rinks, singing soulfully in the church choir, growing into her big heart and growing big dreams the first time her mother imparted this important advice.

“Leave people and places better than you found them.”

Today, she’s found comfort in how she’s spent the past five years: leaving Ohio State women’s hockey in better shape than anyone else ever has.

“I’m so glad Jincy chose there,” Jessica Dunne, her sister and former Buckeye teammate, said. “Our relationship is better for it. And obviously, Ohio State is better for it.”

Following her fifth and final season, Jincy’s left a permanent mark on the program. She’s as decorated a player as it’s ever seen, and she drove it through its most successful surge.

Ask Tatum Skaggs, her roommate and teammate: “She’s going to be idolized at Ohio State.”

But it didn’t come without palpable pressure. Even before becoming a Buckeye, her greatness meant growing expectations, mainly from herself. A leader from the start, she ends her career a legend, all the while realizing the opportunity that pressure presented.

“Pressure is a privilege,” Jincy said. “It’s not a curse. The higher-up I got, people were counting on me. As a teammate, as a captain, as a friend, as a daughter, I want to be someone that’s dependable. Pressure is going to come with that. You can see it as something that causes you to shut down, or something that causes you to rise up and be stronger. If you feel under pressure, your faith is too small.”

In other words, a career full of fierceness, fearlessness, and faith proves no moment was ever too big for Jincy Dunne.

Not in her earliest days on the ice, when her chance to make a name meant playing with the boys. Sure, Jincy traveled with local girls’ teams too, but at the time, in O’Fallon, Missouri, the best development for any budding star came as a part of the AAA St. Louis Blues. She practiced with future NHL draft picks – among them 2016 sixth-overall pick Matthew Tkachuk. And develop she did, both her skill set and a confidence in it.

“For most girls, even when they’re talented, that’s hard when boys are getting to the age where they can hit. She did it so well because she was super smart, skilled, gritty, and such a good skater,” Jessica said. “The fact that Jincy did it for that long, at that level, being the only girl on the team, that’s very difficult.”

Not in her youth hockey heyday, when she was centralized in Boston for Team U.S.A. tryouts. At 16 years old, she would have been the youngest skater in team history to go to the Olympics. Instead, she became the final cut from that year’s silver-winning squad.

“I definitely felt like I failed,” Jincy said. “It’s devastating and disappointing when you work all year round. But it’s all part of the process. You got to learn to trust it and not get frustrated.”

Not in her time with the U.S. team at the youth level – a kind of consolation. Not even in the 2015 U18 International Ice Hockey Federation (IIHF) World Title, where ever-poised Jincy scored a goal in regulation and the gold-medal-game-winner in overtime. Such heroics helped her earn the tournament’s Best Defenseman honors.

Fierce, fearless, faithful, and fully trusting of the process.

“She handled getting cut with so much grace and then got right back at it. She went to extra workouts, extra skates,” Jessica said. “She’s just driven differently.”

Not in her first season really playing at Ohio State. The year before, a serious concussion kept her injured, and isolated, her entire first season in Columbus. That all made for “a difficult transition.” But as a redshirt-freshman, Jincy’s teammates voted her an assistant captain.

“Her first playing year was my first year, so I had to really depend on the returners and who they wanted their captains to be,” Nadine Muzerall, then a first-time head coach, said. “They voted for her. And I didn’t question it because I knew who Jincy was. I recruited her at Minnesota.”

Before she’d even once suited up in Scarlet and Gray, she was a proven leader.

“It was well-deserved,” Jessica, then a junior, said. “It’s not normal when you haven’t played yet. But Jincy is not a normal person or player.”

Not in her first game as a starter, where she dispelled any doubt her on-ice presence mattered.

“When we went to RPI for our first game that year, she got a goal. It was her very first game,” Jessica said. “That was very rewarding for her, and that’s my favorite memory. It was the only game I remember where we were defensive partners the entire game. I slid it over to Jincy at the point, and that’s how Jincy got her first goal. Being able to assist my sister’s first goal, being able to witness it, being present with our close group of friends on the team, it was such a surreal experience.”

Not over the next couple years, when Jincy’s impact became very real. With the privilege of pressure, she’d proven to be the real deal. And her consistency was living in a class all its own.

“You don’t understand. She’s been one of the most consistent people we’ve had,” Muzerall said. “We were overplaying her. She was playing almost 70 minutes a weekend, and still performing. Most people were playing half that. That’s a lot of stress, responsibility, and expectation. But you had no clue she felt that pressure. That’s what makes her elite.”

Not in her senior season, which, in cementing her legendary status, made a serious statement. Especially not in the game that punctuates it. In the WCHA Finals, only the program’s second appearance in the game, three exhausting periods weren’t enough. Her team reached its second overtime period in as many days – first against defending National Runner-Up Minnesota, then reigning National Champion Wisconsin.

“I don’t think anyone expected us to win,” Jincy said, which means no one expected the Buckeyes’ most blissful moment ever to come next. Not even Jincy.

“Honestly, I was just looking to get the puck as far up the ice as possible so I could get off. It was a long shift for me,” she said. “I saw Tatum cut. I threw it up there just hoping she could get it deep. She ended up doing way more.”

If by “way more” Jincy means the biggest goal in the history of the program, she nailed it. And more or less, she created it. Her preparation and poise formed a flick of the wrist into folklore.

“How many people can say their last game was an overtime win against the Badgers and they won the best conference in the country?”

With Ohio State, nobody can – just Jincy and her fellow seniors. It’s fitting, really, considering Jincy made a career out of accomplishing things nearly nobody else has. Three times an All-American. Twice an assistant captain. Twice the team’s true captain. One point away from 100 in her career.

“And she would’ve gotten that last point in our next game,” Skaggs is sure.

As Skaggs’ “lifelong friend” hangs it up, her accomplishments will too be hung, forever.

“Jincy wanted to help build a program, not just be another number. When we win, it means that much more because she helped build it,” Muzerall said. “When she comes back with her kids and she sees the banners that get hung, she can say, ‘Look what Mommy did.’ That’s what leaving a legacy is about.”

Though her final season ended with uncertainty, the Buckeyes are certainly in a much better place than when she found them. And compared to the lasting impact she’s made on the program, the impact she’s made on its people will last even longer.

“Jincy was always someone I looked up to,” Olivia Soares, fellow 2019-20 captain, said. “She’s naturally gifted not only in her athletic ability, but also in her ability to lead. She’s been an excellent friend to me, and she’s someone who really exemplifies the type of character, work ethic, and commitment that you look for in a teammate.”

“She’s more like family to me,” said Skaggs. “I knew Jincy prior to putting the same jersey over our heads. She’s just been a rock for me in so many different forms. She’s the first person to text and ask how my day is going, or if I want to go to lunch. She just made my overall experience so much more welcoming and warming.”

No matter what she and her teammates did, there’s no shaking what could have been. An abrupt ending cut short more memories – both with the program and her people.

“We just had one of the best moments in our lives, but we didn’t really have time as a team to reflect on it and enjoy it,” Jincy said. “Not even a few days later, our season is canceled. And two days after that, everyone’s gone. It was sad.”

Today, there’s pressure to move past the fact her final postseason was suddenly stolen; pressure to move forward in her hockey career with a heavy heart, all the while pursuing a Master’s degree in coaching through one more year at Ohio State.

But by now, it’s clear how Jincy prevails under pressure.

“She’ll be a great coach. She’s incredibly humble and kind. She lets her faith lead everything,” said Jessica. “That’s the kind of leader I would buy into, one who practices what they preach. She’d bring a lot out of her players and really try to emphasize not just growing as players, but as people.”

“I’d hire Jincy right now,” Muzerall added. “But she’s trying to make the Olympics. As long as I’m a coach here, I’m trying to get parts of the Buckeye family back into the family in any way possible. She’d be my first call.”

Extending her career in hockey presents the opportunity to expand her legacy in leadership – one that’s unwavering, unfazed, and unfinished.

As for the legacy Jincy leaves at Ohio State? Ask her sister.

“Unparalleled.”

Unparalleled
Read more: https://ohiostatebuckeyes.com/the-people/unparalleled/

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

Reeling from suicides, college athletes press NCAA: ‘This is a crisis’

Post by greybeard58 » Sun Jun 19, 2022 6:15 pm

Reeling from suicides, college athletes press NCAA: ‘This is a crisis’
At least five college athletes have died by suicide in recent months, sparking calls for more support from the NCAA.

By Molly Hensley-Clancy
May 19, 2022 at 10:00 a.m. EDT
Listen to article
16 min

When the first college athlete died by suicide this year, Kate Intile thought of the time her own sport had left her in months of darkness. After she was cut from a storied college running program, “I wasn’t able to find any worth in myself,” she said. “I’ve never felt like less of a human.”
As an elite college cross-country runner, Intile said she had been body-shamed, pushed through injuries and made to feel worthless when her times did not measure up. When she learned in March of the suicide of Katie Meyer, a charismatic goalkeeper who had helped Stanford to a national championship in soccer, Intile feared for her former teammates and other college athletes.
“It felt like it was only a matter of time,” Intile said.
At least four more NCAA athletes have died by suicide in the two months since Meyer’s death, three of them young women. Intile, who now runs for Oregon State, said the fear has only grown.

“It’s a constant worry you have in your life, on top of everything else,” Intile said. “This could happen to me; this could happen to my teammates. My parents are worrying about me. It’s this vicious, anxious spiral of ‘Where is everyone at?’ and ‘If someone’s not okay, what do I even do?’ ”
Intile, other current and former college athletes and advocates told The Washington Post they see the moment as a mental health crisis for college athletes. The factors that have exacerbated it — the pandemic, social media, the rising pressures on young people — are shared by many college students, experts say.
But the deaths of Meyer and the other athletes have shaken the close-knit community of elite college sports, sparking fear and anxiety, according to athletes and others working in college sports.
“Nervous is a good word for it,” said Christopher Bader, the assistant athletic director of mental health and performance at the University of Arkansas. “One of the scariest parts of our job as psychologists, in general, is the not knowing. I can see somebody every week for an hour a week, and that’s only 1/168th of their week. There’s 167 other hours that I don’t see them; that’s the scary part when you hear of things like this.”
For some athletes, including Intile, the concern has sharpened into anger at a system they say is inherently harmful to college athletes’ mental health. As athletes have traded news of the deaths, they’ve been strategizing how to keep one another safe and brainstorming ways to reform what they view as broken systems at their colleges. Meanwhile, Intile said, “Not once have I seen the NCAA even make a statement.”
In a statement to The Post, the NCAA said it required schools to provide mental health services to athletes and that it consulted extensively with experts to create best practices for care.
“The mental health crisis in this country touches every aspect of society, and the NCAA acknowledges the urgency and magnitude of this issue,” said an NCAA spokesman, Christopher Radford. “We also understand that the mental health crisis has been exacerbated — for student-athletes and others — by the isolation and other impacts of COVID-19.”
But athletes and advocates have pushed back against the idea that the deaths by suicide are simply a reflection of the wider, and well-documented, mental health crisis among all young people. The challenges faced by athletes are sharply distinct from those of other college students, they argue: relentless hours, physical injury, limits on social circles that are confined to teams and can disappear with injury or poor performance.
The family of one athlete who died by suicide in recent months, Wisconsin runner Sarah Shulze, said in a statement that they believed the stress of college sports had contributed significantly to her death. “Balancing athletics, academics and the demands of everyday life overwhelmed her in a single, desperate moment,” they wrote in April.
Scholarships and spots on teams can hang on individual games and meets; coaches and athletic departments, paid and funded based in part on how athletes perform, lean heavily on the young people they are tasked with overseeing.
And unlike with most students, advocates said, there is a billion-dollar oversight body charged with guiding and protecting college athletes. The NCAA last convened a formal task force on mental health in 2017, and though it updated its best practices in 2020, critics said the organization has not done enough to prioritize athletes’ mental health when it comes into conflict with issues such as practice time, coaching and compensation.
Athlete safety and the NCAA’s business model are “fundamentally opposed to one another,” said Andrew Cooper, a former college runner and activist who has called for dismantling the NCAA. “The more money pumped into the system, the more pressure on coaches, the more pressure gets put on athletes.”
For some, the NCAA’s silence in the face of athletes’ deaths this year, and the worries of their teammates and competitors, has been conspicuous.
“Saying something would be better than nothing,” said Morgan Ferrara, a former Division I soccer player who is now a PhD student at the University of Houston, of the NCAA. “I want to see them acknowledging these things are going on, putting in place some sort of steps that you’re going to force institutions to follow.”
Chad Asplund, a sports medicine doctor who worked in several Division I athletic departments, compared the NCAA’s focus on how college athletes should be allowed to profit off their personal brands with what the organization has done in the face of the recent deaths of athletes.
“All this [name, image and likeness] talk,” Asplund said, “and there’s been zero talk of the epidemic of suicide.”


Paying the ‘athletic tax’
Mackenzie Fitzpatrick’s dark moments came after a string of injuries kept her off the softball field for much of her career at the University of Connecticut.
“I was really struggling — I just felt completely isolated from my team, really alone,” she said. “I felt like a burden to everyone around me, [to] our trainers and doctors, being in the training room every day.”
For a while, she hid all of it from coaches and teammates. Like many people struggling with mental health in and out of sports, Fitzpatrick feared being seen as weak, she said. But the reasons behind it were, she thought, particular to college sports.
“It’s the culture of college athletics — we talk about the grind, no days off, no time off, the idea that the people that are successful are the ones that never turn off their switch,” Fitzpatrick said.
When she finally sought therapy on the advice of the team doctor, her coaches were supportive. But she found that between classes and sports, she didn’t have a single hour in her schedule for therapy. Fitzpatrick had to ask her coach if she could come late to practice once a week, she said, an accommodation she knows some coaches would never allow.
Pietro Sasso, an assistant professor at Stephen F. Austin State University in Texas who has studied mental health in college sports, calls it an “athletic tax.” College sports “have such compressed schedules,” Sasso said. “Their demands don’t let them get access in the same way other students have the privilege of.”
College athletes experience mental health struggles at the same or higher rates than typical college students, studies have shown. Many college students, especially part-time students and those with families, face time pressures, and mental health stigmas persist in virtually every corner of society.

A 2015 study found that college athletes had a lower rate of suicide than the general college population. In the midst of a broader crisis in mental health on college campuses, there is no data yet to show how the suicides of college athletes in 2022 compare with the rate of young people as a whole.
But the number of NCAA athlete suicides in the first four months of 2022 alone appears to be substantially higher than the rate in the past. That 2015 study found 35 college athlete suicides between 2003 and 2012, less than four per year. The vast majority of those deaths — 29 — were men, another significant difference from this year.
The NCAA’s shameful neglect of women’s basketball has been exposed, and it starts at the top
Dan Romer, the research director at the Annenberg Public Policy Center at the University of Pennsylvania, pushed back against the idea that there was a particular crisis among athletes, arguing that the system of mental health care is broken across colleges as a whole. Romer researches mental health in young people, including the effects of social media and suicide.
“It’s not just athletes — the real crisis is in the university and colleges themselves,” Romer said. When students approach colleges with mental health struggles, Romer said, particularly in the midst of a crisis, they often push to remove the student from campus. And Romer said that he has seen colleges effectively cover up student suicides, fearing contagion with other students — but also fearing bad publicity.
“If students feel like they aren’t going to get help, then they aren’t going to seek it,” Romer said.
But even as young people everywhere experience mental health problems at unprecedented rates, young athletes’ particular struggles are often deeply ingrained in the culture of college sports.

Jayden Hill, a Division II track runner at Northern Michigan University, was “always the first person” to reach out to someone struggling with their mental health, said her mother, Christine Hill. She saw herself as an advocate, Hill said, and would support friends and even strangers by text and over social media.
When it came to Jayden’s own lifelong struggle with mental health, though, she was hesitant to speak up publicly, Christine Hill said. “She never wanted to be seen as weak. She was so terrified that somebody would think that she wasn’t strong.”
Hill was one of several college athletes who died by suicide in April.
Her identity had been wrapped up in her sport since she was small, Hill’s family said. She dreamed of running in the Olympics, keeping a framed USA sprinter’s uniform outside her room. But when she started running in college, Hill’s times dropped, her mother said. “She put so much pressure on herself to do well,” Christine Hill said.
Hill’s coaches were supportive, her mother said. But she worried about disappointing them anyway, worrying they had expected more when they brought her to the university. “I think she started to feel like she was a burden, like to her coaches she was a burden,” Christine Hill said. “She didn’t want to be a burden.”

More money, more pressure
An increasing focus on mental health in sports has led more colleges, especially at larger Division I schools, to add mental health professionals who work exclusively with athletes, increasingly from inside locker and training rooms.
The NCAA’s best-practices guidelines, released in 2016, call for campuses to create “interdisciplinary teams” focused on mental health, including trained practitioners who are not simply performance coaches focused on on-field showings. The organization recommends screening students for mental well-being along with physical health.
At Arkansas, Bader heads a team of three mental health professionals who are focused on outreach to athletes. He has seen “huge growth” in the past 15 years, he said, as awareness grows.
Bader said he’s happy with the NCAA’s best-practices guidelines. Anything more rigid, he said, such as requirements for every school, could impose unnecessary standards in a field where flexibility and adaptability are necessary. “We need to put continued attention on it,” Bader said. “Advocacy and education are huge for us.”
For activists such as Intile and Cooper, more significant systemic changes are necessary. The pressures and stressors faced by young athletes, they argue, are linked directly to the massive college sports industry, and especially to the NCAA.

Especially at the top divisions, NCAA sports, they say, incentivize winning above all else, tying pay and bonuses for coaches and athletic departments whose athletes notch victories. That is true in nonrevenue sports, such as running, and even moreso in sports like football and basketball, where winning teams can rake in millions for colleges.
“It was drilled into our head, the goal is to compete for and win national championships, and that implies ‘at any cost,’ ” Intile said of her time running cross-country at the University of Colorado Boulder. “It’s a sink-or-swim program, and if you sink, you sink hard.”
Intile described practices she said were damaging to her mental health and that of her teammates, including pushing her to run through injuries that later became more serious. She underwent a “body composition test” monthly, she said, where a clinician would pinch their bodies as they stood clad in a sports bra and running shorts. The exam room’s large windows looked out on the weight room, where other athletes were often present.
“We would fight for the early morning appointment so you wouldn’t have to eat breakfast, and football [players] wouldn’t be there [in the weight room],” Intile said. “You walk out with Sharpie marks all over your body. Everyone knows you got body comped this morning — it was like a physical representation of the fact that you had to go through trauma.”
In a statement, the University of Colorado said it recently made body composition tests voluntary as a result of athlete concerns, consulting with a Student Athlete Advisory Council in recent months about the policy, and that it offers “extensive resources" to athletes in mental health.
The university “is committed to the physical and mental well-being of our athletes, and that commitment serves as the cultural foundation of not just our cross-country team, but of all our programs,” said Steve Hurlbert, the university’s director of communications.
Many college athletes “are viewed as wins and losses, not as people,” said Asplund, the sports medicine doctor. Asplund is now the executive director of the U.S. Council for Athletes’ Health, a consulting firm that specializes in college sports.
“They’re disposable commodities where coaches and universities chew them up and spit them out,” Asplund said. “There’s not a focus on the individual athlete; it’s all on the outcome.”
On the other side of the coin from coaches paid to win games, Cooper notes, are college athletes who are not paid a cent — but who put what is often the equivalent of a full-time job into their sport, despite an NCAA rule that technically caps the time they spend on athletics at 20 hours per week of official practices and training. That number excludes many mandatory activities for athletes, like travel and physical therapy. “People don’t understand the demands that are placed on athletes,” Cooper said. “You’re going constantly from 6 a.m. to 9 p.m. every day, month in and month out.”
Cooper argues that the only way to deal with the conflict he sees between the NCAA’s incentives and athletes’ mental health is to dismantle the organization, or at least dramatically reform the structure of college sports. Allowing athletes to unionize and be paid for their labor, he said, gives them control over their working conditions.
“The NCAA has created an environment where athletes are treated like cattle,” Cooper said.
Other dramatic reforms include pushing to incentivize athlete development and health in coach pay and evaluations at competitive programs; substantially cutting back hours, offseason training and travel; and cracking down on abusive coaching practices.
New rules that give college athletes control over their own name, image and likeness have finally given athletes a chance to make money off their sport. But that, too, has come with a mental health cost, something the NCAA acknowledged as part of a review of how the new rules have affected athletes.
Young female athletes, especially, have found that the main way they can earn income through college sports is with their social media presence.
Sedona Prince, an Oregon basketball player who is among the most famous college athletes on TikTok — and whose viral video ignited an uproar over the NCAA’s unequal treatment of men and women at its basketball tournaments — posted a tearful video last month saying she was taking a break from the platform. She described how her growing fame among her classmates had led them to treat her like an object.
“I’m not any different because I’m on TikTok. I’m still a person,” Prince said in the video. “My mental health has really been declining for a long time, to the point where I’m really at my lowest right now.”

‘It’s not enough’
In their frustration with the NCAA, some college athletes have taken it upon themselves to act.
Weeks after Katie Meyer died, Fitzpatrick remembers being shaken. “That’s when I recognized this is a crisis,” Fitzpatrick said. “I was like, ‘This needs to be bigger.’ ” She went on a “rant” on Instagram, she said, demanding change from the broader athletics community.
“It’s not about ‘checking in’ anymore. It’s not enough,” Fitzpatrick wrote on her page.
Just a few days after the post, Fitzpatrick’s own close-knit sport lost a student to suicide: Lauren Bernett, the starting catcher on the James Madison team that starred at the Women’s College World Series last year.
Fitzpatrick met with her team administrator and printed fliers with QR codes that direct athletes to mental health resources. But she wants to see the same urgency from college sports’ most powerful forces.
“I don’t know what’s going on with the NCAA,” Fitzpatrick said, “but there needs to be more.”

https://www.washingtonpost.com/sports/2 ... al-health/

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

"Waiting for another tragedy makes no sense"

Post by greybeard58 » Sat Jun 25, 2022 1:33 pm

"Waiting for another tragedy makes no sense"

If Mark Moore can make a compelling case that more needs to be done to prevent concussions, certainly he can speak to their devastating effects.

His younger brother, Steve, had a promising NHL career ended by a broken neck and concussion suffered in a 2004 blindside attack by Todd Bertuzzi. Not long before that infamous act of thuggery, Mark saw his own hockey dream die after he experienced the first and only known concussion of his career, when a smaller teammate’s helmet unexpectedly struck him under the jaw during a collision in practice while playing for the Pittsburgh Penguins organization.

Mark’s ensuing symptoms, among them pressure in the head that can make him dizzy and disoriented, were life-altering enough that he had to turn down a tryout from the Montreal Canadiens.

“It was just awful to have to call the Canadiens and say, ‘I can’t play,’” Moore said. “It was like, are you sure? It seemed like they were wondering if I was crazy … I was willing to risk my life, but I literally couldn’t play.”

Nearly two decades on, some symptoms can still flare up if Moore, a 45-year-old father of two, isn’t careful. Which is a stark reminder: As much as there’ve been plenty of recent advances in concussion awareness and prevention, some brain injuries don’t fully resolve.

“There’s no cure (for concussions). For me, there’s no cure; for Steve, there’s no cure,” Moore said. “So my mind goes to prevention: What can I do to help make sure what happened to us doesn’t happen to other people?”

As a law professor at the University of British Columbia, Moore sees potential in national concussion safety legislation. In 2018, Ontario passed Rowan’s Law in memory of 17-year-old Rowan Stringer, an Ottawa-area high school rugby player who played through concussion symptoms in the days before she died from the effects of a head injury. And while Rowan’s father, Gordon Stringer, said at the time that he hoped the Ontario legislation would lead to similar laws across the country, some four years later that hope remains unfulfilled.

To that end, Moore recently collaborated on an academic paper with Dr. Charles Tator, the renowned Toronto brain surgeon and concussion expert, that called for concussion safety laws to be enacted in all of Canada’s provinces and territories. While Rowan’s Law came in reaction to a needless death — and while every other state acted after Oregon passed Max’s Law, named after a high school football player who suffered a traumatic brain injury — Moore said it’s his hope that another tragic impetus won’t be required for Canada-wide reform.

“Waiting for another tragedy makes no sense,” said Moore. “We’ve got these laws in all 50 states and in Ontario. We don’t need to reinvent the wheel. Let’s just get it done without having to wait for another preventable tragedy.”

Tator, in a recent interview, said there are misconceptions that needs to be set straight. The law, for one, isn’t designed to punish athletes who concuss fellow competitors in the course of play.

“People ask me, ‘Do you want to see youngsters put in jail because they bodychecked somebody?’ No,” Tator said. “The legislation doesn’t have big teeth. No one has gone to jail.”

But the law, Tator and Moore say, comes with many benefits.

One is education. Athletes and their parents, coaches, trainers and organizers are required to acknowledge their review of concussion awareness resources. Another is the establishment of concussion management standards. How long to hold out an athlete who has experienced a concussion and when it’s safe to return to play — the law aims to ensure athletes and their overseers base these decisions on the current science, rather than leaving them to chance.

And there’s yet more upside: The law would ideally require sports organizations to establish a code of community conduct that instills what Tator and Moore call “a concussion safety culture.” The hope, Tator said, is that predatory behavior becomes tempered by common sense, not to mention an obligation to the common good.

“You hope you can instill an attitude in people where it’s not a matter of killing the opponent that’s important. There are other more important things,” Tator said. “We don’t want to see stretchers on the ice; we want to see players on the ice.”

Moore, for his part, said that when it comes to prevention of concussions, there’s a lot more than can be done. In hockey, for instance, he cites the enduring presence of equipment with hard outer shells that can do significant and needless damage, notably elbow pads and shoulder pads.

“There was once attention on the elbow and shoulder pads, but the attention gets diverted and it never gets solved,” Moore said. “Then it’s hard to get the attention back to it.”

Once-intense scrutiny on the toll of head injuries in hockey has also waned in recent years, which, along with the pandemic, could be responsible for the lack of follow-through on national concussion safety legislation. And though there’s not yet sufficient data to prove Rowan’s Law has produced demonstrable improvements, Moore and Tator don’t see that as a reason to delay.

“It’s something that can be done. I don’t know what the downside is. And you could save lives and potentially prevent many, many concussions,” Moore said.

Moore and Tator, in attempting to remind their fellow Canadians that concussions remain an intractable problem that shouldn’t be ignored, are hoping it won’t take another preventable tragedy to put the matter of national legislation back on the table.

“Even to someone who’s not a professional, these can be life-changing injuries. In cases like Rowan’s, they’re fatal. If there’s no cure, we sure better do everything we can to prevent them,” Moore said.

“If they came out with a cure tomorrow where you could be back to 100 per cent recovered by taking a pill, maybe I would be less worried about prevention, but that’s not on the horizon. I don’t think we’re anywhere close to having a cure.”

There should be concussion safety laws from coast to coast: ‘Waiting for another tragedy makes no sense’

Once-intense scrutiny on the toll of head injuries in hockey has waned in recent years. That along with the pandemic could be responsible for the lack of follow-through on national legislation.

Read more: https://www.thestar.com/sports/hockey/o ... sense.html

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

Abby Pieper's long road back

Post by greybeard58 » Sat Jul 02, 2022 12:30 pm

Abby Pieper's long road back

Abby Pieper will be the goalkeeper on Wednesday when the Williamston girls soccer team plays in the Division 3 state semifinals.

Pieper was in goal in the semifinals last season, too, when the Hornets' state title dream ended a game short. She and her teammates were driven to get back to this spot this season.

But up until just a few months ago, it looked like Pieper might not get that chance.

Pieper returned to the field only about six weeks ago after pair of head injuries suffered in her favorite sport — hockey — left her with devastating concussion symptoms, including a loss of vision in one eye. The injuries led to more than four months of anguish for Pieper and her family.

“Throughout the whole time, there were thoughts in my head,” Pieper said. “I didn’t think I was ever going to get my vision back. I didn’t know how severe it was until the doctors told me.

"They considered it as a traumatic brain injury, like getting in a car accident and hitting your head on the steering wheel. That’s how they explained it (to me)."

The post-concussion symptoms hit about 10 days after the injury – months of nausea, vomiting, headaches, dizziness, sleeping problems, loss of balance, never-ending trips to the doctor’s office and various types of therapy. At times, there was a lot of doubt – and, at times, a large sense of doubt both internally and externally as to whether Pieper would ever play sports again.

The incident

Soccer is the only sport Pieper plays for the Hornets, but her true passion – and her best sport – is hockey. That’s one of the reasons Pieper and her family moved to Lansing from Marquette three years ago – there were more opportunities for girls hockey players here in the Capital City than Up North.

She has been a standout on the ice playing center, first with the Meijer AAA Hockey 19U team in the 2020-21 season – tallying 12 goals and 10 assists in 40 games – before moving to the Belle Tire team this past season. And it was this past December playing club hockey where she suffered two injuries that changed everything.

The two incidents happened on back-to-back days at a tournament in Chicago. In the first game, Pieper was streaking down the ice, was then tripped by an opponent and hit the back of her head hard on the ice.

The next day, Pieper was backchecking and dove to stop an opponent on a breakaway. In doing so, she slid awkardly into the goalpost.

“In my right eye, the vision was just gone,” Pieper said. “All I remember is getting up and I thought my eye was actually out of my socket. The only reason I remember those two plays is because I’ve got the videos of them. I don’t remember going to the hospital, I don’t remember coming home.”

Pieper’s dad, Jeff, watching from the stands, initially thought Abby had broken her collarbone. But the news was much worse. As he approached the bench, he heard Abby say that she couldn’t see out of her right eye.

“I heard something I wasn’t prepared for,” Jeff said. “It was a tone I’ve never heard my daughter speak with before, so I knew that it was serious.”

Once in the emergency room, it was determined that there was no structural damage in the brain, and there was an interruption in the communication between the eyeball and the part of the brain where the vision is processed.

Doctors kept shining lights in her eye and completed numerous eye tests without response. However, on one of the final tests, using a very bright flashlight, Abby could see a flash of white light an inch from her eye.

“We left Chicago and we went back that to light and that flash so many times in a six-month period waiting for her,” Jeff said.

The long road back

Sports are the most important thing in Pieper’s life. That doesn’t make her all that different from a lot of high school-aged student-athletes. But her drive to be a success in those sports is extraordinary.

The road to recovery was filled with missed goals, doubt, a delayed return of vision and days where Pieper would have to do her schoolwork by herself in a room in the library. Her sensitivity to light and background noise could cause major headaches.

Pieper was grinding through physical, occupational and speech therapy for three-hour sessions every two or three days.

“I did not lose my speech, but with the concussion, it was hard to be able to form words and communicate properly,” Pieper said. “We also worked on my memory because it was very difficult to remember things.”

Attending school was very difficult. Pieper would try her best to alternate half-days from morning to afternoon, but every day, she’d eventually call one of her parents to pick her up.

“I didn’t have the motivation and it was giving me such bad symptoms," Pieper said.

“The background noise was a really bad symptom. … In the library, I was allowed to turn the lights off when I wanted.”

The school tried to accommodate whatever Pieper needed to help her succeed.

“She would have trouble even at a family dinner, with people conversing, because of the background noise," said Pieper's mother, Leslie. "That was difficult. It took a little bit to adjust to the one eye, I think she did a great job adjusting and getting through.

“She had all A’s before (the injury), so they knew her work ethic, so that helped with them giving a little more leeway. She didn’t ask for any special treatment except for not sitting in the louder classes."

But the journey was possibly just as big of a struggle mentally. For more than two months, Pieper had not experienced any progress in regaining her vision in her right eye. The result was extreme frustration with what seemed like a failing process.

Then came something of a turning point in February. In an attempt to boost her spirits, Pieper’s doctors allowed her to skate on the ice with her hockey team. No contact, of course.

And it worked in changing her mindset.

“It felt like a breath of fresh air,” Pieper said. “That’s when I started to really work hard during my therapy because I was like, 'This is what I need to work hard at, and if I have the opportunity to do it again, I want to do this again.' So that’s when I started to step up my intensity of therapy.”

Breakthrough and recovery

It was about 2 1/2 months later, in March, when her vision finally started to return. The post-concussion symptoms were still prevalent, but there seemed to at least be an end in sight.

As Jeff tells it, there were little milestones. The bright lights Pieper could only see initially turned into big bold letters, then to smaller letters, then colors and then being able to track things with her eye.

“With all of the obstacles, the determination and the perseverance ... in my world, she defines a hockey player,” Jeff said.

And then, one spring day, out of nowhere, it actually happened.

It’s pretty easy for Pieper to remember the date when her full vision returned: April 19.

“I started to get a little bit of vision, and then from there it really took off," Pieper said. "For the last few weeks, it was blurry and then it came back. It was progressively just getting better.”

Pieper also got a boost mentally when she read how similar her story was to USA women's hockey star Amanda Kessel. Kessel suffered concussion-like symptoms similar to Pieper – the headaches, light sensitivity – and spent 18 months away from the ice.

Pieper and her family constantly referred to the website of Kessel's doctor, Micky Collins, for information throughout the entire process.

Finally, back to the pitch

All of her doctors, and Williamston’s trainer, officially cleared Pieper to play two weeks after her full vision returned. That's when she started for the Hornets in their May 4 soccer game against Haslett.

It wasn’t just any game, though. Haslett was ranked No. 3 in Division 2 at the time, and – like Williamston – is playing in the state semifinals on Wednesday night. And unlike the other hockey and soccer games from December to April that Pieper had circled on her calendar with the hopes of returning, this one was actually happening.

And not only did the Hornets win, but they didn’t allow a goal, winning 1-0.

“That’s her personality. She wanted that game so bad,” said Williamston coach Steve Horn. “That was the game she wanted to be back for. Things lined up perfectly so she could get back.”

Since Pieper's return, the Hornets are 8-1, with that loss coming in a shootout.

In last year's state semifinal, a 1-0 loss to Detroit Country Day, Pieper made 11 saves to keep Williamston close. With the top-ranked Hornets taking on third-ranked Pontiac Notre Dame Prep at 8 p.m. Wednesday at Parker Middle School in Howell, Pieper might be called upon again for a key save.

But she’ll be ready. Horn, her teammates, her parents and everybody else knows it.

“I love her mentality,” Horn said. “She has a bulldog mentality. Abby is a big-game keeper.”

Return to hockey?

Once the soccer season ends, Pieper is planning to begin playing hockey again later in the summer. She’s still chasing the dream of playing college hockey.

Pieper says she’ll need to be 100% mentally ready for it before she steps back on the ice. Her parents might be a little more nervous about it, but sports have always been Pieper’s life.

“If we took sports away from her, she wouldn’t be the same person,” Leslie said. “At this point, I think that would hurt her more.

“I just want her to succeed at whatever she chooses.”

Whether she does or doesn’t play hockey, Pieper is taking everything as a game-by-game approach.

“I’m lucky to even be playing soccer this season,” she said. “Every game I get to play, I’m thankful for everything."

'Every game I get to play I'm thankful': Williamston soccer player returns after devastating injuries
Read more: https://www.lansingstatejournal.com/sto ... 612467001/

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

Risk of head injury associated with distinct head impact events in elite women's hockey

Post by greybeard58 » Sun Jul 10, 2022 2:39 pm

Risk of head injury associated with distinct head impact events in elite women's hockey
Show all authors
G. Kosziwka, L. Champoux , J. Cournoyer, ...
First Published December 1, 2021 Research Article
https://doi.org/10.1177/20597002211058894
Article information



Abstract
Head injuries are a major health concern for sport participants as 90% of emergency department visits for sport-related brain injuries are concussion related.1 Recently, reports have shown a higher incidence of sport-related concussion in female athletes compared to males.3 Few studies have described the events by which concussions occur in women's hockey,2,7,8 however a biomechanical analysis of the risk of concussion has not yet been conducted. Therefore, the purpose of this study was to identify the highest risk concussive events in elite women's hockey and characterize these events through reconstructions to identify the associated levels of peak linear and angular acceleration and strain from finite element analysis.
44 head impact events were gathered from elite women's hockey game video and analyzed for impact event, location and velocity. In total, 27 distinct events based on impact event, location and velocity were reconstructed using a hybrid III headform and various testing setups to obtain dynamic response and brain tissue response. A three-way Multivariate Analysis of Variance (MANOVA) was conducted to determine the influence of event, location and velocity. The results of this study show that head- to-ice impacts resulted in significantly higher responses compared to shoulder-to- head collisions and head-to boards impacts however, shoulder and boards impacts were more frequent. All events produced responses comparable to proposed concussion threshold values.21 This research demonstrates the importance of considering the event, the impact characteristics, the magnitude of response, and the frequency of these impacts when attempting to capture the short and long term risks of brain trauma in women's hockey.
Keywords
Sports-related concussion, concussion, mTBI
Introduction
Head injuries are a major public health concern for sport participants. According to the Canadian Institute for Health Information, 9 out of every 10 emergency department visits for sport-related brain injuries are concussion related.1 Concussion is also known as mild traumatic brain injury (mTBI) and is the most common form of traumatic brain injury. Participants of contact sports, such as ice hockey, experience a higher risk of head injury, due to increased exposure to head impacts in addition to players moving at fast speeds.2 Recently, reports have indicated a higher incidence of sport-related concussion in female athletes compared to their male counterparts.3–5 Women's ice hockey is a high velocity sport, which includes many situations that involve impacts to the head. The NCAA Injury Surveillance System (ISS) reported women's hockey to have the highest rate of concussions (0.91/1000 A-Es) of 16 males and female collegiate-level sports,6 despite body checking being illegal. Thus, It has been reported that head impact events occur approximately half as frequently in women's hockey as in men's hockey.7,8 As a result, it is understood that the higher incidence of concussion in women's hockey when compared to men's hockey is not a result of increased head impact exposure. Researchers have identified concussive events in ice hockey in an attempt to explain gender differences.2,3 The most common event causing concussion in women's hockey occurs when players fall, hitting their head against the ice or onto the sideboards of the arena. However, the non-concussive head impact event that is most frequent in women's hockey is player to player collisions accounting for 50% of all head impacts; and falls to the ice or boards resulting in a head impact only accounts for 30% of total head impacts.8 The differences in rules between males and females does not support why there is an increasing concussion reporting in female players. To further understand the discrepancies in the incidence of concussion diagnoses and further understand how the risk of head injuries is created in women's hockey, the frequency and magnitude of common head impacts needs to be analyzed. The purpose of this study was to document the most common head impact events in elite women's hockey players and compare the peak linear acceleration, peak rotational acceleration, and peak maximum principal strain between the events to determine the type of head impacts creating risk of head injury in elite women's ice hockey.
Methods
Fifteen games of elite women's ice hockey were analyzed to catalogue head impact events. The videos included games from online archives of the Canadian Women's Hockey League (WHL), the National Women's Hockey League (NWHL), and International Ice Hockey Federation (IIHF) between 2015 and 2017. Head impact event inclusion criteria consisted of head impacts where resulting head motion could be clearly observed. A total of 35 head impacts met the inclusion criteria including 13 head-to-shoulder, 18 head-to-board, and 3 head-to-ice events.
Additional video analysis was performed to obtain head impact characteristics necessary for laboratory reconstructions such as impact velocity, and impact location/angle. Impact velocity from collisions events was calculated using Kinovea (version 0.8.20) to determine the distance between the head of the player and the impacting surface over the time needed for the impact to occur.9 The time prior to the impact was set at a maximum of 0.2 s to minimize the error associated with a change in velocity prior to the impact. This method of video analysis requires additional inclusion criteria to minimize errors in velocity calculations: 1) the head must be visible in the few frames (<5) prior to and at the moment of impact and 2) the presence of markings near the impact location on the ice must be visible to allow for calibration of the distance. Impact velocities from head-to-ice events were determined using MADYMO (TASS International, The Netherlands) where the limbs and positioning of the model was manipulated to replicate the condition observed on the video. No other metrics were obtained from MADYMO. Impact locations were catalogued using the reference grid presented in Figure 1.

Figure 1. Transverse and vertical reference grids used for determination of head impact location.
Ten head-to-shoulder, six head-to-boards and four head-to-ice impacts could be analyzed for velocity and location and were included for reconstructions. The ranges of velocity for each event type are presented in Table 1.
Table 1. Impact velocities of head-to-shoulder, head-to-boards, and head-to-ice included for laboratory reconstructions.

Table 1. Impact velocities of head-to-shoulder, head-to-boards, and head-to-ice included for laboratory reconstructions.

View larger version
Reconstructions were performed using the three most common impact locations for each event type (Figure 2) and impact velocities consisting of the average for each event and an upper and lower boundary of ±1 m/s. In the case of head-to-ice events, only two impact locations were recorded. An additional impact location to the side of the head was reconstructed as it represents a common impact location for concussive impacts in women's ice hockey as reported by.2

Figure 2. Impact locations selected for reconstructions for head-to-shoulder, head-to-board, and head-to-ice events.

Figure 3. Pneumatic linear impactor consisting of a steel frame (A), compressed air tank (B), piston chamber (C), impacting arm (D), time gate (E), impacting cap (F), sliding table (G). (Meehan MSc Thesis, 2019).

Figure 4. Monorail drop rig shown with vertical rail (A), motorized release system (B), drop carriage (C), 45° steel anvil (D), time gate (E), concrete base (F).

Figure 5. Mean peak resultant linear acceleration for the board, ice, and shoulder events.

Figure 6. Mean peak resultant angular acceleration for the board, ice, and shoulder events.

Figure 7. Mean MPS for the board, ice, and shoulder events.
Equipment
Linear impactor
A pneumatic linear impactor was used to represent shoulder-to-head impact conditions. The system consists of a pneumatically accelerated impacting arm encased in a standing frame of mass 13.1 kg. When engaged the arm moves towards a helmeted headform mounted on a sliding table allowing it to slide with little resistance after impact. This sliding table that supports the Hybrid III headform can be adjusted to five degrees of freedom including fore-aft (x-axis), lateral (y-axis), up-down (z-axis), fore-aft (y-axis), and axial (x-axis) rotation of the neckform. This allowed the impact location and direction described from the video analysis to be accurately reflected by the headform test set up.10 An electronic time gate measures impact velocity just prior to impact and was used to match the impact velocities obtained from video analysis.
A shoulder pad cap consisting of a nylon disc covered with 142 mm of vinyl nitrate R338 V foam material under a Reebok 11 K shoulder pad was mounted on the end of the impacting arm to represent shoulder-to-head collisions.11 A shoulder-to-head event is considered a high mass event where the striking mass has been calculated to be approximately 15% of the striking player's mass.12 The average body mass of a women's hockey player on the Canadian national women's hockey team is listed as 70 kg.13 Effective mass for women's elite hockey players can be calculated as approximately 10.5 kg. In this study, a striking mass of 13.1 kg was used as it is the lowest mass that can be used with the linear impactor. Karton et al. demonstrated that the effect of striking mass had little effect above 10 kg when using an MEP striker.14 It is unlikely it would have a different effect using a compliant surface such as the shoulder.
Monorail drop Rig
In this study, the monorail drop rig was used to represent head to ice falls and head to board impacts. The headform and neck were attached to a drop carriage affixed onto a monorail drop rig of maximum height of 4.7 m rail. A pneumatic piston is responsible for releasing the drop carriage and attached headform when It reaches the appropriate height for the desired impact velocity. The impact anvil can be adjusted to represent various surfaces including ice or hockey boards.
Hybrid III headform and unbiased neck
In this study, a Hybrid III 5th-percentile female headform with a circumference of 21.2 inches and composed of steel covered in a vinyl skin, was used to recreate head impact events in women's hockey (Humanetics, Plymouth, MI, USA). An unbiased neckform designed to allow similar movement in all planes of motion without directional bias was used for the reconstructions. This unbiased neckform was scaled from the 50th-Hybrid III neckform15 with four centred and unarticulated rubber butyl disks (radius 27.5 mm; height 18.0 mm) recessed slightly (3.2 mm) and serially inside aluminum disks (radius 34.5 mm; height 12.5 mm) (Figure 2). Nine single-axis accelerometers positioned in a 3-2-2-2 array captured the three-dimensional acceleration-time curves for linear and rotational acceleration.
Finite element model
Linear and rotational acceleration time histories were used as an input to the University College Dublin Brain Trauma Model (UCDBTM) to calculate maximum principal strain (MPS). The UCDBTM was developed using CT and MRI scans and validated using cadaver data16 and is modeled as viscoelastic to represent the shear behavior of brain tissue as elastic for the compressive behavior’s of brain tissue. Results are presented as a gradient of deformation from low to high. In terms of maximum principal strain, results are presented as a percentage of strain. Additional brain material properties are described by Horgan & Gilchrist (2003). The compression of the brain tissue was defined as elastic. The shear characteristic of the viscoelastic brain was expressed:
G(t) = G∞ + (G0 − G∞)e−βt
with G∞ representing the long term shear modulus, G0 the short term modulus, and β the decay factor.
Statistical analysis
Three one-way ANOVAs were used to determine the difference in peak linear acceleration, peak rotational acceleration and MPS between head-to-shoulder, head-to-board, and head-to-ice events. Tukey's post hoc tests were then conducted to determine mean comparisons between variables. Significance was accepted at p < 0.05.
Results
The mean peak linear acceleration, peak rotational acceleration and MPS are presented in Table 2. Significant differences between head impact events were detected for each of the variables. Differences in peak linear accelerations were detected between head-to-ice and both head-to-shoulder (p < 0.01) and head-to-board events (p < 0.01), where head-to-ice events were significantly greater than the other two types of events. There was no difference in peak linear acceleration between head-to-shoulder, and head-to-board events (p = 0.1). Peak rotational acceleration was statistically greater in head-to-ice events compared to head-to-shoulder (p < 0.01), and head-to board (p < 0.01). There were no significant differences between head-to-shoulder and head-to-board for peak rotational acceleration (p = 0.376). The maximum principal strain was significantly different between all three impact events. Head-to-ice was greater than both head-to-shoulder (p < 0.01), and head-to-board (p < 0.01). The MPS associated with head-to-shoulder events was also significantly greater than head-to-board events (p < 0.01).
Table 2. Mean peak linear acceleration, peak rotational acceleration, and MPS for head impact events. () = z scores.

Table 2. Mean peak linear acceleration, peak rotational acceleration, and MPS for head impact events. () = z scores.

View larger version
Discussion
The purpose of this study was to identify the most common head impact events in elite women's ice hockey and compare dynamic response and maximum principle strain between each event type to determine how risk of injury occurs in women's hockey. The most frequent event type documented in this study was head to boards, accounting for 51% of the impacts (18 impacts). The shoulder to head represented 37% of the impacts (13 impacts) and the head to ice accounted for 12% (4 impacts). This distribution of events is different from previously reported distribution of concussive or non-concussive events. Concussive injury events reported in women's ice hockey, are caused primarily by falls to the ice or boards representing approximately 50–60% of diagnosed concussions; but represent only 30% of overall head impact frequency.2,3,8 Despite penalties awarded for body checking in women's hockey, collisions cause 27–42% of concussions in elite women's hockey.2,3 The differences between concussive event types and the distribution of impact events presented in this study can be explained by our methodology and player sample. The diagnosis associated with the events of this study were not available publicly and may include a mix of both concussive and non-concussive events and were limited to what could be observed clearly on video. In addition, the population used in this study is composed of professional women's hockey players as opposed to high school and college players. These players are highly skilled and may have learnt to protect themselves better over time than high school and collegiate players. In contrast, men's professional players sustain concussion primarily via shoulder to head impacts accounting for 53% of concussions,17,18 which is likely a result of allowing body checking in men's hockey.
Head to ice impacts only represented a low proportion of head impacts but resulted in significantly higher peak resultant linear acceleration and peak resultant rotational acceleration when compared to head to board and shoulder to head impacts. Head to ice impacts resulted in an average peak linear acceleration of 123.6 g and an average peak rotational acceleration of 9518 rad/s2. Both measures fall far above reported values resulting in concussion in ice hockey.18 The high average velocity (4.8 m/s) of head to ice impacts observed in this study with the addition of the low compliant surface of the ice, may be the reason for high magnitudes of dynamic response.19 Although not frequent, these high values demonstrate the continued need for hockey helmets to be developed to protect against falls to the ice, as this is a high-risk event for concussion. To avoid falls to the ice, skating and balance skills should be developed at an early age. The head to boards impacts and shoulder to head collisions did not have significantly different peak linear and rotational accelerations.
Maximum principal strain (MPS) was the only measure to indicate significant differences between the all three head impact events highlighted in the study. Head to ice falls resulted in the highest average MPS of 0.51 compared to the head to board (0.19) and shoulder to head events (0.27). Similarly to dynamic response, MPS identifies head to ice has the riskiest events in terms of magnitude. The mean magnitude of MPS for the three events represent approximately 50% or above risk of concussion.20,21
While peak linear and rotational acceleration reported significantly higher values in the head to ice events than head to boards and shoulder to head; MPS demonstrated differences between all three event types. This suggests that MPS may be more sensitive to change in direction, slope, and duration of acceleration as opposed to only using magnitude of head acceleration.22 For example, the longer duration of the shoulder to head compared to the head to boards impacts may have contributed to the higher values of MPS.
While head impacts to the ice produced the highest MPS, it was far less frequent than the shoulder to boards accounting for only 11% of the head impacts documented in this study. The head to boards (51%) and shoulder to head (37%) impacts occurred much more frequently and the MPS associated with these events represents above 50% and 80% risk of concussive injury, respectively. Currently, the standards test for ice hockey helmets include only a flat drop test; a similar mechanism to a fall to the ice.23 Therefore, in order to properly protect against concussive injury in elite women's ice hockey, head impacts to the boards and shoulders of opposing players need to be considered when designing and testing protective equipment. Standards organizations could aim to decrease MPS and test using moderate magnitude, long duration impacts.
Several researchers have demonstrated that a higher number of concussions are reported by female athletes in comparison to their male counterparts competing in the same sport.4,24,25 Female athletes also experience concussions differently than males reporting more symptoms of greater severity and needing longer recovery times.26–29 Interestingly, the dynamic response and brain tissue deformation values reported in this study have similar or lower magnitudes than those reported in elite male hockey,18,30 with the exception of MPS for head to ice events which can be attributed to the smaller mass of the head form used to conduct women's reconstruction. The frequency of head impact events observed in this study is much lower than what is seen for professional men's hockey players.17,18 This suggests that the difference in prevalence of concussion and recovery may not be related to how the game is played but may be due to internal factors such as willingness to report injury. While elite men's ice hockey is a full-time job for the players, women who participate in ice hockey at the elite level are typically not paid as well as the men. The highest paid women in the NWHL in 2016 earned $25,000 a year and the CWHL did not pay its athletes until 2017 with a salary ranging from $2000 to $10,000. This suggests that the athletes in these leagues need an additional source of income such as another occupation and may be less willing to play injured. While there have been no known studies connecting salary and willingness to report injuries, the difference in pay between men and women could be a reason for the difference in incidence of concussion due to willingness to report the injury. Other biological factors beyond the scope of this study may be able to further explain the differences in injuries incidence between male and female hockey players.
Limitations
Only 15 games were available for analysis, which resulted in a low number of impacts that could be analyzed. Some impacts were excluded from this analysis due to obstruction of the view during the impact. This could have skewed the distribution towards impacts of higher magnitudes that resulted in replays from the broadcast and allowed for better analysis. In addition, the 5th percentile Hybrid III head form may not represent all head sizes of the observed players but they produce highly reproducible results, which make them useful for impact testing. Finally, the finite element brain model is based on a 50th percentile male and was scaled to calculate the maximum principal strain of female athletes. No model representing female athletes currently exists.
Conclusion
The most common head impact events in elite women's ice hockey based on video analysis of 15 games were: head to boards (51%), shoulder to head (37%), and the head to ice events (12%). Falls to the ice demonstrated the highest dynamic response values compared to head to boards and shoulder to head. MPS was highest in head to ice followed by shoulder to head, and finally head to boards, however, shoulder to head and head to boards impacts occurred more frequently and still resulted in a high-risk event for concussive injury. This suggests that protective equipment should be designed to protect against these events to reduce the risk of head injury in elite women's hockey.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.
ORCID iD
L. Champoux https://orcid.org/0000-0003-2954-6050
References
1. Canadian Institute for Health Information , Head’s Up on Sport Relates Brain Injuries, https://www.cihi.ca/en/heads-up-on-spor ... injuries-0 (2018, accessed 25 November 2020).
Google Scholar
________________________________________
2. Delaney, JS . Mechanisms of injury for concussions in university football, ice hockey, and soccer. Clin J Sport Med 2014; 24: 233–237.
Google Scholar | Crossref | Medline
________________________________________
3. Agel, J, Dick, R, Nelson, B, et al. Descriptive epidemiology of collegiate women’s ice hockey injuries: national collegiate athletic association injury surveillance system. 2000-2001 through 2003-2004. Journal of Athletic Training (National Athletic Trainers’ Association) 2007; 42: 249–254.
Google Scholar | Medline | ISI
________________________________________
4. Dvorak, J, McCrory, P, Kirkendall, DT. Head injuries in the female football player: incidence, mechanisms, risk factors and management. Br J Sports Med 2007; 41: i44–i46.
Google Scholar | Crossref | Medline | ISI
________________________________________
5. Gessel, LM, Fields, SK, Collins, CL, et al. Concussions among United States high school and collegiate athletes. J Athl Train 2007; 42: 495–503.
Google Scholar | Medline | ISI
________________________________________
6. Hootman, JM, Dick, R, Agel, J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train 2007; 42: 311–319.
Google Scholar | Medline | ISI
________________________________________
7. Brainard, L, Beckwith, J, Chu, J, et al. Gender differences in head impacts sustained by collegiate ice hockey players. Med Sci Sports Exercise 2012; 44: 297–304.
Google Scholar | Crossref | Medline | ISI
________________________________________
8. Wilcox, B . Head impact exposure in male and female collegiate ice hockey players. J Biomech 2004; 47: 109–114.
Google Scholar | Crossref
________________________________________
9. Post, A, Koncan, D, Kendall, M et al. Analysis of speed accuracy using video analysis software. Sport Engineering 2018; 21: 235–241.
Google Scholar | Crossref
________________________________________
10. Walsh, E . The influence of impact location and angle on the dynamic impact response of a hybrid III headform. Sports Eng 2011; 13: 135–143.
Google Scholar | Crossref
________________________________________
11. Rousseau, P, Post, A, Hoshizaki, TB. A comparison of peak linear and angular headform accelerations using ice hockey helmets. J ASTM Int 2009a; 6: 1–11.
Google Scholar
________________________________________
12. Rousseau, P, Hoshizaki, TB. Defining the effective impact mass of elbow and shoulder strikes in ice hockey. Sports Biomech 2015. In press.
Google Scholar | Crossref | Medline
________________________________________
13. Hockey Canada , Canadian National Women’s Team Roster 2018-2019, https://www.hockeycanada.ca/en-ca/team- ... teamid=179 (2019, accessed 25 November 2020).
Google Scholar
________________________________________
14. Karton, C, Hoshizaki, TB, Gilchrist, M. The influence of impactor mass on the dynamic response of the hybrid III headform and brain tissue deformation. ASTM International 2013; Mechanism of Concussion in Sports: 23–40.
Google Scholar
________________________________________
15. Walsh, K . Comparative analysis of hybrid III neckform and an unbiased neckform. Sports Eng 2018; 21: 479–485.
Google Scholar | Crossref
________________________________________
16. Horgan, TJ, Gilchrist, MD. The creation of three-dimensional finite element models for simulating head impact biomechanics. Int J Crashworthiness 2003; 8: 353–366.
Google Scholar | Crossref | ISI
________________________________________
17. Hutchison, MG, Comper, P, Meeuwisse, WH, et al. A systematic video analysis of national hockey league (NHL) concussions, part II: how concussions occur in the NHL. Br J Sports Med 2015; 49: 552–555.
Google Scholar | Crossref | Medline | ISI
________________________________________
18. Post, A, Hoshizaki, TB, Karton, C, et al. The biomechanics of concussion for Ice hockey head impact events. Comput Methods Biomech Biomed Engin 2019; 22: 631–643.
Google Scholar | Crossref | Medline
________________________________________
19. Post, A , et al. Peak linear and rotational acceleration magnitude and duration effects on Maximum principal strain in the corpus Callosum for sport impacts. J Biomech 2017; 61: 183–192, Elsevier td,.
Google Scholar | Crossref | Medline
________________________________________
20. Kleiven, S . Predictors for traumatic brain injuries evaluated through accident reconstruction. Stapp Car Crash J 2007; 51: 81–114.
Google Scholar | Medline
________________________________________
21. Zhang, L, Yang, KH, King, AI. A proposed injury threshold for mild traumatic brain injury. J Biomech Eng 2004; 126: 226–236.
Google Scholar | Crossref | Medline | ISI
________________________________________
22. Post, A, Oeur, A, Walsh, E, et al. A centric/non- centric impact protocol and finite element model methodology for the evaluation of American football helmets to evaluate risk of concussion. Comput Methods Biomech Biomed Engin 2014; 17: 1785–1800.
Google Scholar | Crossref | Medline | ISI
________________________________________
23. ASTM F1045-16 , Standard performance specification for Ice hockey helmets. West Conshohocken, PA: ASTM International, 2016.
Google Scholar
________________________________________
24. Covassin, T, Swanik, C, Sachs, M. Sex differences and the incidence of concussions among collegiate athletes. J Athl Train 2003; 38: 238–244.
Google Scholar | Medline | ISI
________________________________________
25. Dick, RW . Is there a gender difference in concussion incidence and outcomes? Br J Sports Med 2009; 43: i46–i50.
Google Scholar | Crossref | Medline | ISI
________________________________________
26. McLeod, TCV, Leach, C. Psychometric properties of self-report concussion scales and checklists. J Athl Train 2012; 47: 221–223.
Google Scholar | Crossref | Medline | ISI
________________________________________
27. Broshek, DK, Freeman, JR. Psychiatric and neuropsychological issues in sport medicine. Clin Sports Med 2005; 24: 663–679.
Google Scholar | Crossref | Medline | ISI
________________________________________
28. Kutcher, JS, Eckner, JT. At-risk populations in sports-related concussion. Curr Sports Med Rep 2010; 9: 16–20.
Google Scholar | Crossref | Medline | ISI
________________________________________
29. Covassin, T, Schatz, P, Swanik, B. Sex differences in neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery 2007; 61: 345–351.
Google Scholar | Crossref | Medline | ISI
________________________________________
30. Rousseau, P . Analysis of Concussion Metrics of Real-World Concussive and Non-injurious Elbow and Shoulder to Head Collisions in Ice Hockey. PhD Thesis. University of Ottawa, Canada, 2014.
Google Scholar

View Abstract

https://journals.sagepub.com/doi/full/1 ... 2211058894

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

The national suicide hotline is changing to 988 starting Saturday

Post by greybeard58 » Sun Jul 17, 2022 11:43 am

The national suicide hotline is changing to 988 starting Saturday

By Lenny Bernstein
Updated July 15, 2022 at 8:55 a.m. EDT|Published July 14, 2022 at 4:47 p.m. EDT

The nationwide hotline for mental health emergencies switches to a simple 988 number on July 16. (Jenny Kane/AP)

The nationwide hotline for mental health emergencies switches to a simple 988 number on Saturday, a transition that is expected to bring millions more calls, chats and texts into a system where readiness to handle the surge varies from place to place.
At the same time, advocates hope the renewed focus on emergency assistance, and the spending that has accompanied it, will prompt expansion of other mental health services that are in desperately short supply in many communities.
“I look at 988 as a starting place where we can really reimagine mental health care,” said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, a nationwide grass-roots group. “We’re really looking at a fundamental tide shift in how we respond to people in mental health crisis.”
The network of more than 200 local call centers, drastically underfunded throughout its history, fielded 3.6 million calls, chats and texts in the 2021 fiscal year, according to the federal Substance Abuse and Mental Health Services Administration (SAMHSA). Officials expect that to jump to 7.6 million contacts in the coming year, as the National Suicide Prevention Lifeline — 800-273-TALK (8255) — gives way to 988. The 800 number will remain active indefinitely. (The expected increase in contacts doesn’t include a hotline option reserved for veterans.)
Experts hope LGBTQ youth will call 988, a new suicide lifeline number
The hotline in Tucson, for example, is widely considered the gold standard for comprehensive care of people suffering mental health crises. When someone calls that city’s hotline, trained counselors help resolve the emergency on the phone 80 percent of the time. If they can’t, one of 16 “mobile crisis teams” is dispatched to the caller’s door — or any other location — day or night.

And those who need even more assistance can be brought to the city’s “stabilization center,” where psychologists, doctors, nurses and other specialized personnel provide everything from urgent mental health care to drug treatment medication.
The arrangement keeps people who may be considering suicide or have other acute mental health needs out of emergency rooms and jails, reduces police and EMT involvement in behavioral health cases and speeds aid to the people who need it.
“We have the space. We have the staff. We have the training,” said Margie Balfour, chief of quality and clinical innovation at Connections Health Solutions, the company that runs the Tucson stabilization center.
SAMHSA organized what had been a collection of individual call centers into a nationwide network in 2004, awarding the contract to operate and grow the system to the nonprofit Vibrant Emotional Health (then known as the Mental Health Association of New York City.)
The call centers are funded by local, state and federal resources, creating wide variation in each center’s ability to handle its call volume. When local centers are swamped or unstaffed, centralized backup centers across the country respond. There are 14 now and as many as 17 will be operating by August.
But local centers are preferable, because staff there are better acquainted with nearby mental health resources, officials said. Their ability to handle capacity varies substantially by location.
In the first quarter of 2022, for example, North Carolina was able to handle 90 percent of its calls in-state while Illinois responded to just 20 percent, according to Vibrant data.
The overall network’s capacity was able to address 85 percent of calls, 56 percent of texts and 30 percent of chats, according to a government report, citing a December 2020 analysis. Already, increased hiring and spending has improved call centers’ ability to keep up with demand, said John Draper, executive vice president at Vibrant.
Xavier Becerra, secretary of the Department of Health and Human Services, said in a briefing for reporters this month: “988 will work if the states are committed to it. It won’t work well if they’re not. There is no reason, no excuse, that a person in one state can get a good response and a person in another state will get a busy signal.”
A lack of resources can be dangerous: The Wall Street Journal calculated recently that 1 in 6 callers hangs up without reaching anyone.
Research has repeatedly confirmed that call-in lines are highly effective in their mission. A trained counselor who listens to and empathizes with a caller or texter can help him or her past a short-term crisis on the phone in the vast majority of cases.
Staff and volunteers also are taught how to separate a person with thoughts of suicide from whatever might be used to commit harm, send family or friends to help, arrange follow-up care or contact law enforcement if necessary.
“Suicidal crisis callers report significant reductions in intent to die, hopelessness, and psychological pain over the course of their crisis call,” Columbia University researchers Madelyn Gould and Alison Lake wrote in a September report on 988 and suicide prevention to the National Association of State Mental Health Program Directors.
They added that “crisis counselors are able to secure the caller’s collaboration on an intervention on over 75% of imminent risk calls.”
SAMHSA has spent more than $280 million to bolster the system and Congress allocated $150 million more.
“Our goal is to make 988 like 911,” Becerra said. “If you are willing to turn to someone in your moment of crisis, someone will be there. 988 won’t be a busy signal. 988 will get you help. That is the goal.” But he made clear that the states, not the federal government, will have to fund call centers on a continuing basis.
The number of suicides in the United States rose steadily from 29,350 in 2000 to 48,344 in 2018, before declining to 45,979 in 2020, according to the National Center on Health Statistics. In the wake of the coronavirus pandemic and other factors, government and health officials agree that the country is in the grip of a mental health crisis, especially among younger people, with sharply rising rates of depression and anxiety.
Equal mental health insurance coverage elusive despite legal guarantee
Tucson’s continuum of services grew over 20 years, a collaboration of the state, county and private participants, Balfour said. Now officials around the country point to its program as a model for other locales.
Dispatchers for the mobile crisis teams sit with 911 dispatchers and sometimes redirect calls for police to pairs of clinicians instead, Balfour said. Police are trained to bring people to the stabilization center instead of hospitals or jails when appropriate. They can be in and out in minutes, rather than spending hours with patients in an emergency room. There is a dedicated entrance at the facility for law enforcement so officers don’t have to remove and store their weapons, she said.
Available slots for follow-up care at mental health clinics are entered into the hotline’s computer, easing access to help. The hotline handles about 10,000 calls per month, Balfour said. The stabilization center handles about 1,000 adults per month as well as 200 to 300 children and teens, she said.
It has an observation area with chairs for 34 adults and 10 younger people and an adult inpatient unit with 15 beds, where patients can stay three to five days, she said, including while they withdraw from drugs and begin medically assisted treatment. The beds help prevent hours and days “boarding” in emergency rooms untreated while hospital personnel search for a bed in an appropriate facility.
The center strives for “90 minutes from door to doc” and turns away no one, including walk-ins, Balfour said. Patients may be suicidal, violent, intoxicated, psychotic or detoxifying.
“Our model is we take everybody,” she said. “We want the people that typically get denied at other places. We want those high-acuity, potentially violent people.”
If you or someone you know needs help, visit suicidepreventionlifeline.org

https://www.washingtonpost.com/health/2 ... tline-988/

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

To Anybody Going Through It

Post by greybeard58 » Mon Jul 25, 2022 1:51 pm

To Anybody Going Through It

To Anybody Going Through It
BY KEVIN LOVE
SEP 17 2020


Being depressed is exhausting.

That’s one of the cruelest ironies about mental health. When you’re in a dark place, everyone around you — all your friends and family — they just want to see you doing what you love again, being happy, being “the old you.”

Sometimes it feels like the world is looking at you saying things like, “Come on, man, just get over it. Don’t think like that. Just move on.”

But what people on the outside don’t always understand is that it takes all of your strength and willpower just to exist. Just to keep on going. Battling depression, battling anxiety, battling any mental health disorder … it’s all just so unbelievably exhausting.

That’s been on my mind a lot lately, considering the millions and millions of people around the world who have lost their jobs, or lost their loved ones, or who are just dealing with the unprecedented anxieties of being a human in 2020. I know so many people out there are suffering right now. I’m no different. I’m still going through it. Even after all the work I’ve tried to do on myself over the last two-and-a-half years, some days are just brutal.

Let’s just call it what it is. Some days are total s*&%, right?

It feels good just to say it.

Even in the best of times, my default setting was often dread. That’s just the way I’ve been wired since I was a kid. It’s like there’s a constant, low-level threat that I can sense in the pit of my stomach from the moment that I wake up in the morning. It’s like this white noise humming in the background, and it’s saying, Something bad is going to happen, any second now. That sense of dread would often be amplified by something in the news or by social media, and at any point could send me into a spiral.

My way out was always basketball. But I don’t mean that in some cliché way — where I would go to the park, roll the ball out and suddenly everything would be O.K. It was a different kind of thing entirely.

The best way I’ve ever heard it described was in the HBO documentary on Robin Williams after his death. He was talking about the only way he could combat his demons was to wake up in the morning and ride his bike until he had absolutely nothing left in the tank, and then at night he would go up on stage and do a two-hour stand-up set and just pour all of himself into it — every single ounce of himself, until he was just totally wrung out, mentally and physically.

Anything to stop the thoughts. Because the thoughts can be disturbing.

That resonated with me so much. Ever since I was a kid, I’d often put myself through h@#/ in the hopes of numbing my mind. I used to think of it as going into my “pain tank.” If I wore myself out to the point of exhaustion, then I’d be mentally on empty, too. It was like I had to wring myself out completely so that at the end of the day I was just blank.

Everybody who goes through mental health issues has a unique story, but for me (and I think this is probably true for a lot of people), my entire identity was tied to one thing in a really unhealthy way. Way before I was in the NBA or even in college, my self-worth was all about performing. I was what I did, which I think a lot of people can relate to, whether they’re a chef or a lawyer or a nurse or whatever the profession. I just happened to play basketball.

When I wasn’t performing, I didn’t feel like I was succeeding as a person.

I didn’t really know how to be comfortable in my own skin. I could never just be unapologetically Kevin, walking into a room. I was never in the moment, alive. It was always the next thing, the next game, the next, next, next. It was like I was trying to achieve my way out of depression. And so I guess it’s not surprising that some of the darkest moments of my life happened when that crutch of basketball got taken away.

This is still hard to talk about, but I feel like it might resonate with people out there who are going through something right now. People who have lost their jobs (and their sense of purpose) during this crisis. People who … I don’t know … maybe just need to hear this.

Everybody knows about my anxiety attack during the Atlanta game back in 2018. That’s become, over time, easier to talk about. Especially with the overwhelming support that I’ve gotten. In a way, it’s almost ironic that I’ve become known for this one incident, because that was the first and — thank God — the only time that I’ve experienced a debilitating panic attack in public like that. But that moment, as terrifying as it was, was just the tip of the iceberg, in a lot of ways. It was the culmination of years and years of me suppressing a lot of issues. I’ve never really talked about the other side of my mental health issues, which is a much more complicated and subtle battle with depression.

Five years before the panic attack that everyone knows about, I was probably in the darkest period of my life. I’d only played 18 games with the Timberwolves that season, breaking my right hand twice, and that was when this whole … I guess you’d call it a facade or a character that I had sort of built up …. it all started crumbling. I was in a cast. My identity was gone. My emotional outlet was gone. All I was left with was me and my mind. I was living alone at the time, and my social anxiety was so bad that I never even left my apartment. Actually, I would rarely even leave my bedroom. I would have the shades down most of the day, no lights on, no TV, nothing. It felt like I was on a deserted island by myself, and it was always midnight.

Just … dark. Dark and alone with my thoughts. Every. Single. Day.

And I want to make it clear that I know how fortunate I was, compared to most people. I knew then and I know now. I didn’t have to worry about my bills, or kids, or anything like that. But none of that mattered. My whole sense of purpose was tied to my job, and with that gone, every little thing that went wrong, no matter how small, just started compounding and compounding.

That’s the thing that people on the outside don’t fully understand. Nothing major has to happen to start a spiral. It can happen over the smallest thing in the world. Because when you have depression you can fall apart at any moment disproportionate to the circumstances.

Then it’s just…. Shame.

It got to the point that year where I was simply paralyzed with depression. And of course, I’m not about to show my weakness to anybody, right? I was tucked away in my apartment, and nobody could see me suffering. The only time I would leave my apartment was to work out, because that was the only place where I felt like I added value to the world, period. To those around me, I would put on a brave face.

Fake facades are hard to keep up.

The future started to feel meaningless. And when it gets to the point where you lose hope, that’s when the only thing you can think about is, “How can I make this pain go away?”

I don’t think I have to say much more than that.

If it hadn’t been for a couple of my closest friends, I don’t know if I would be here today telling my story. And 99.9% of the people in my life probably don’t know how bad it got for me. But as hard as that might be for them to hear, I feel like I need to get that off my chest for the people out there who might be in a similar situation right now.

When I was sitting in that dark room, I just couldn’t see how things were ever going to get better. And if there’s somebody out there right now who is reading this — even just one person — who is sitting in that same dark room, having those same thoughts….

All I can say to you is this:

Talk to somebody.

You would be amazed at how freeing it is just to talk to somebody, and tell them the truth about what you’re going through.

And listen, I’m not trying to sell you some fairy-tale version of mental health. It took me years and years — h&%#, it genuinely took 29 years for me to realize what I needed.

I needed medication. I needed therapy.

I still need those things now, and I probably always will.

There are still days where I look at social media, or I see the news, and my anxiety gets triggered. But sometimes I get triggered by almost nothing at all. Just simple negativity is enough to start a spiral of overgeneralization.

Oh, my coffee was s this morning? I must be s#$%. I’m a horrible human being.

There are days when I don’t want to get out of bed. That’s just the truth. And that’s why I wrote this.

I think that sometimes — because of all the incredible support I’ve been given, and because of my platform as an NBA player — people see me as some kind of Finished Product. Or some kind of Success Story for Mental Health or something. They see the curated version of me, and not the real person.

The fact is, the real person is still dealing with his deep-seated s#$% every single day. The real person is still trying to learn how to control his anger and anxiety. And the real person, by the way, never would have been able to tell his story in the first place without the courage of DeMar DeRozan, who blazed that path for everybody in the league today.

The real person’s story didn’t end when the Cavs won an NBA title, and suddenly it was all good, and then the credits rolled, the end.

No. The truth is, the deepest sense of joy and peace that I’ve gained in my life doesn’t have anything to do with basketball. It definitely doesn’t have anything to do with money or fame or achievement.

You don’t achieve your way out of depression.

No, as sweet as it was to win an NBA title for the city of Cleveland, that wasn’t the happy ending. That was my job, which is now a different thing from my identity and my self-worth. One of the best days of my life happened after I started working through my issues with a therapist, and I walked into a room for the first time and I was just 100% my authentic self. I was comfortable in my own skin. I was alright with just being Kevin. I wasn’t thinking about the next thing. I was just in the moment, fully alive. And I can tell you from experience that you can live for years, but not be really alive and fully present for 30 seconds at a time.

If you would’ve told me back in 2012, when I was at my lowest, that I would ever feel at peace like that, walking into a room, I just wouldn’t have believed it. I was coming off a season where I was an All-Star, All-NBA, and won a Gold medal at the London Olympics. But I was completely unaware of the darkness that was about to consume me.

Look, I’m not trying to sell you some happy ending. All I can do is just be as honest as possible about a really dark period in my life.

So here it is.

When I was lying on the floor of the trainer’s room during my anxiety attack back in 2018, it was probably the single scariest moment of my life. I was gasping for air, and my heart was pounding out of my chest, and I really thought that death was a possibility. And I’ll never forget how our trainer, Steve Spiro, he just kept asking, “Kevin, what do you need? What do you need? What do you need?”

What do you need?

That’s the question, isn’t it?

That’s everything.

I spent 29 years trying to figure it out.

What do you need?

For me, I guess what I needed was to talk to somebody.

For me, what I needed was to know that I wasn’t alone.

If you’re struggling right now, I can’t tell you that this is going to be easy.

But I can tell you that it does get better.

And I can tell you that you are definitely not alone.

To Anybody Going Through It
Read more: https://www.theplayerstribune.com/en-us ... tal-health

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

"The impact of OSA can be lifelong and life limiting so regardless of causation it is an important consideration for ath

Post by greybeard58 » Tue Aug 09, 2022 4:54 pm

"The impact of OSA can be lifelong and life limiting so regardless of causation it is an important consideration for athlete's health"

Obstructive sleep apnea (OSA), a frequently under-diagnosed sleep disorder, may lead to future poor health, performance, and wellbeing. Increased OSA prevalence has been reported in individuals who have had a head injury.

Conclusions
This study suggests that the prevalence of OSA in contact sports is around 30.0% (95% CI, 24.0–36.0%) but this may be higher as not all studies used overnight sleep studies to screen for sleep disorders. Whilst retired athletes have a higher prevalence than current athletes this may be age-related and furthermore detailed studies are required to conduct fully adjusted analyses. Player position might be important as there is a known difference in players report physique between playing positions, this requires further investigations. Some research suggests head impacts and exposure to repeated head impacts may be an alternative mechanism for developing OSA. The absence of data for popular full-contact (Australian Rules Football), semi-contact (Boxing and Fight Sports) and limited contact sports (Soccer) is palpable. Sleep disorders such as OSA are treatable, but if left to manifest can have detrimental impacts on performance, recovery, and general health of athletes. The impact of OSA can be lifelong and life limiting so regardless of causation it is an important consideration for athlete's health.

Obstructive Sport Apnea (OSA) and contact sports: A systematic review and meta-analysis
Read more: https://www.sciencedirect.com/science/a ... 3622000178

OSA study cites this study regarding ice hockey:
Sleep of professional athletes: Underexploited potential to improve health and performance
Read more: https://www.tandfonline.com/doi/full/10 ... 16.1184300

Post Reply