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Anoka HS alum Briana Scurry "The problem with concussions is a lot of us suffer in silence"

Soccer star Briana Scurry still remembers the day she knew she wanted to be an Olympian: It was 1980, and Scurry, then 8 years old, watched on TV as the underdog men's U.S. Olympic ice hockey team beat Team USSR in Lake Placid, NY.

"I was so inspired, I rose up from the couch and declared to my parents that I wanted to be an Olympian," Scurry says. "They, thankfully, were nurturing of that little inspiration and helped me hone my skills in all different sports through high school."

Scurry would go on to become one of the top goalkeepers in the history of U.S. women's soccer. She won two Olympic gold medals, in 1996 and 2004, and a World Cup in 1999. But her soccer career ended abruptly in 2010, when she was playing in the new Women's Professional Soccer league and a member of the opposing team collided with her, crashing her knee into Scurry's right temple.

"My whole life changed from that moment," Scurry says. "I knew there was something really wrong. ... That was the last soccer game I've ever played.”

The collision left Scurry with a traumatic brain injury, which resulted in constant, excruciating headaches, blurred vision, cognitive problems and depression. She was unable to work and the league soon collapsed, leaving her without a medical team or training facility to help her. To make matters worse, Scurry's insurance company refused to cover the surgery she needed to repair the nerve that was the source of her pain, and she was reduced to pawning her two gold medals.

"It was the most difficult thing I'd ever done in my life," Scurry says of selling her Olympic medals for $18,000. "But it was the patch and the temporary fix that I needed to get some stability in order to continue to press forward and get the help I needed."

Scurry credits Chryssa, the woman who would become her wife, with helping to pressure the insurance company into covering her surgery and therapy — and with helping her buy back her Olympic medals. In 2017, Scurry became the first Black woman to be inducted in the National Soccer Hall of Fame. She tells her story in the new memoir, My Greatest Save.


Interview Excerpt
On her life-changing traumatic brain injury in 2010

In the first half I bent over for a low ball coming from my left-hand side, and as I was going to make that save and I was bent over, the attacking player came from the right-hand side and, trying to get her toe on the ball in front of me, crashed into the side of my head with her knee. And I never saw her coming. [Because] I didn't see her, I couldn't brace at all for it. So I was completely exposed. She crashed into me. We bundled over. And, of course, my first thought was, Did I make the save? Sure enough, I had the ball in my hands. ...

I had had concussions before — you get some blurry vision, you get some sensitivities. And then ... it fades away, like the wave of the emotions and the issue fade away and you get clarity again. But I wasn't getting clarity. I was tipping to the left. The names on the jerseys were blurry. And at half time, which blew maybe seven or eight minutes later, I was walking off the pitch and ... my trainer came into the pitch to meet me, and she grabbed my hands and she said, "Bri, are you okay?" And I said, "No, I'm not." ...

For the longest time, I was mad at [the player who crashed into me]. I found out what her name was and exactly who she was. And for several years, I was angry at her for putting me in this position, for not avoiding contact with me. I realized over time that my anger towards her wasn't helping me and ... for a long time wished I could undo that hit. And when you're in an emotional state like a concussion, you are essentially disconnected from yourself. And I had all these symptoms and I was so angry at her. And I prayed so many days. I was like, "Why couldn't you have just missed me?" Because I was a different person now. I changed emotionally, I was different. My confidence, my focus, all these different things. And I was so lost in the wilderness.

On having suicidal thoughts because of her emotional and physical symptoms
I was in that state of emotional distress. I had emotional and physical symptoms. I had depression. I once stood on the ledge of a waterfalls in Little Falls, New Jersey, and contemplated suicide. The railing where the falls were was really low and the water was just rushing over the falls and I could feel the mist of that water on my face. And I contemplated jumping over and I knew if I did that I wouldn't survive it because I couldn't swim. And the water was so high because it had rained just recently. I knew if I go into this water, I'm never coming out. But what stopped me was the image of my mom and some official, some law enforcement official knocking on her door and notifying her that her baby was gone. I couldn't do that to her. So that image got me off the ledge and onto some solid ground, literally. And after that, I decided I wasn't going to commit suicide while my mother was alive because I just couldn't do it to her. And that was the beginning of my journey back to me.

A brain injury cut short Briana Scurry's soccer career. It didn't end her story
Read more: https://www.npr.org/2022/07/27/11127318 ... ain-injury

Remembering McKenna Elizabeth Brown

McKenna Elizabeth Brown of Palm Harbor, a 16 year old Senior at East Lake High School, passed away on August 7th. McKenna loved life, her family, God, hockey, The Chapel, her teammates, and friends. She was the beloved daughter of Hunter and Cheryl McCormick Brown. She is survived by her older brother, friend, and mentor MacCallum. She was a best friend and advocate to her sister McKinley. Her grandparents are Sharon McCormick (Tampa), Ruth Brown, & Jim Gardhouse (Guelph Ontario, Canada), and Jean McCormick (Seminole). She has aunts, uncles and many cousins in Missouri, Canada, and Europe. She was preceded in death by grandfathers Don Brown and Kenneth McCormick Sr.
McKenna's service will be Saturday, August 13th at The Chapel in Trinity, 8833 Mitchell Blvd. Trinity, FL, 34655. Visitation will be from 10-12 and the service will begin at 12.
In lieu of flowers we request you consider making a donation in McKenna's name to either the BU CTE Brain Bank or the American Foundation for Suicide Prevention.
BU
https://www.bu.edu/cte/financial-support/
or
AFSP
https://supporting.afsp.org/index.cfm?f ... tCEALw_wcB
To send flowers to the family or plant a tree in memory of McKenna, please visit our floral store.

Published by Hubbell Funeral Home & Crematory on Aug. 10, 2022.

https://www.legacy.com/us/obituaries/na ... n-obituary

NEW SUICIDE PREVENTION LINK https://988lifeline.org/

Female athletes underrepresented in sports science research

As Title IX's first generation ages, research needed to identify effects of playing sports
Read more: https://www.usatoday.com/story/sports/c ... 353912002/

The Incidence of Concussion and Symptom Non-Reporting Among Professional Women's Ice Hockey Players
David A Bloom, Darryl C Whitney, Guillem Gonzalez-Lomas, Cordelia W Carter
PMID: 34605752
Abstract
Background: Female ice hockey players have rates of sports-related concussion that are similar to male participants at various levels of play, despite differences in the rules that do not allow for body checking in the women's game. At the elite level, there are limited data regarding concussion rates and concussion symptom reporting. Therefore, it was hypothesized that there would be a high incidence of concussion and concussion symptom-reporting in professional women's ice hockey players.

Methods: A survey was given to 54 players in the National Women's Hockey League at the end of the 2018-2019 season. Players reported on the number of concussions diagnosed by a physician throughout their careers, the number of times they have had concussion symptoms, if they had ever continued playing after experiencing concussion symptoms, and if they had ever failed to report concussion symptoms to a medical professional or coach.

Results: Fifty-four players completed the survey. Thirty-one (57%) respondents reported at least one concussion diagnosed during their playing career, with 16 (30%) reporting two or more diagnosed concussions. Thirty-six (67%) players reported experiencing concussion symptoms at least once, with 26 (48%) reporting two or more occurrences of such symptoms. Of the 36 players who had experienced symptoms of concussion, 25 (69%) reported that they continued playing at least once after experiencing concussion symptoms. Seventeen players (36%) reported that they did not initially tell anyone about their concussion symptoms on at least one occasion, while seven players (19%) never disclosed their symptoms.

Conclusion: There is a high incidence of sport-related concussions reported in women's professional ice hockey players as well as an alarming rate of symptom nonreporting.

Clinical relevance: This study provides new data on rates of concussion and symptom non-reporting among female professional ice hockey players and will aid clinicians in decision making when caring for these athletes.

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https://pubmed.ncbi.nlm.nih.gov/34605752/

Concussion increases risk of behavioral and emotional problems in kids

University of Rochester researchers have been at the forefront of efforts to understand how blows to the head impact the brain, including how concussions change brain structure . Now researchers at the Del Monte Institute for Neuroscience have found that kids who experience a traumatic brain injury (TBI), even a mild one, have more emotional and behavioral problems than kids who do not.

“These hits to the head are hard to study because much of it depends on recall of an injury since the impacts do not all require a visit to a doctor,” said Daniel Lopez, a Ph.D. candidate in the Epidemiology program and first author of the study out today in NeuroImage. "But being able to analyze longitudinal data from a large cohort and ask important questions like this gives us valuable information into how a TBI, even a mild one, impacts a developing brain."​

Researchers used MRI and behavioral data collected from thousands of children who participated in the Adolescence Brain Cognitive Development (ABCD) Study. They revealed children with a mild TBI experienced a 15-percent increased risk of an emotional or behavioral problem. The risk was the highest in children around ten years old. Researchers found that children who had a significant hit to the head but did not meet diagnostic criteria for a mild TBI also had an increased risk of these behavioral and emotional problems.

The University of Rochester Medical Center is one of 21 research sites collecting data for the National Institutes of Health ABCD Study. Since 2017, 340 children from the greater Rochester area have been part of the 10-year study that is following 11,750 children through early adulthood. It looks at how biological development, behaviors, and experiences impact brain maturation and other aspects of their lives, including academic achievement, social development, and overall health.

Researchers hope future ABCD Study data will better reveal the impact these head hits have on mental health and psychiatric problems. “We know some of the brain regions associated with increased risk of mental health problems are impacted during a TBI,” said Ed Freedman, Ph.D., associate professor of Neuroscience and co-principal investigator of the ABCD Study at the University of Rochester. Freedman also led this study. “With more time and data, we hope to gain a better understanding of the long-term impact of even a mild TBI.”

Additional co-authors include Zachary Christensen, John J. Foxe, Ph.D., Laura Ziemer, and Paige Nicklas, all members of the Frederick J. and Marion A Schindler Cognitive Neurophysiology Lab that is part of the Del Monte Institute for Neuroscience at the University of Rochester. The research was supported by the National Institute on Drug Abuse, and the UR Intellectual and Developmental Disabilities Research Center.

Mild traumatic brain injury increases risk of behavioral and emotional problems in kids
Read more: https://www.urmc.rochester.edu/news/pub ... ms-in-kids

• Calls for ‘urgent action by government’ to address failures
• FA and PFA strongly criticized over concussion risk in football


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Campaign groups have welcomed the publication of a damning new parliamentary report into the management of brain injuries in sport.
The report, based on a four-month inquiry by the digital, culture, media and sport select committee, calls for “urgent action by the government to address a long-term failure to reduce the risk of brain injuries in sport”. It is strongly critical of both the Football Association and the Professional Footballers’ Association for “failing to fight hard enough or publicly enough to address the issue of concussion” and recommends an urgent overhaul of concussion management across all grassroots and elite sport in the UK.



“What is astounding is that when it comes to reducing the risks of brain injury, sport has been allowed to mark its own homework,” said the committee chair, Julian Knight MP. “The Health and Safety Executive is responsible by law, however risk management appears to have been delegated to the national governing bodies, such as the FA.
“That is a dereliction of duty which must change. The failure by these sporting organizations to address the issue of acquired brain injury is compounded by a lack of action by government. Too often it has failed to take action on player welfare and instead relied on unaccountable sporting bodies.”
Judith Gates, a founder of the charity Head For Change, described the report “as a turning point, a first step, in addressing the problem openly and taking steps to find solutions”. Gates said that while the report clearly showed that “mistakes have been made” she feels we “need to learn from these rather than apportioning blame. The focus should be twofold: immediate care for players currently suffering but education and awareness of the dangers for future players.”
The former England scrum-half Kyran Bracken, speaking on behalf of the Progressive Rugby group, said: “I truly hope the committee’s findings will be a watershed in the approach to the management and research of concussion in sport and expect to see sporting bodies being held accountable for the duty of care their employees have a right to expect.” Progressive Rugby also called on World Rugby to “urgently address the current elite return to play protocols, which we maintain are not fit for purpose”.

At the elite level the parliamentary report criticized UK Sport for running a system in which there is “no overall responsibility to mandate minimum standards for concussion and head trauma” and which “allows sports to be funded as long as their protocols look good on paper”. It also criticized the FA for not taking a stronger, sustained interest in the issue after the coroner’s verdict on the death of Jeff Astle from industrial disease in 2002, and the PFA for not pressuring the FA to do it. At the grassroots level, it criticized NHS England for failing to keep full records on concussion injuries, and for failing to ensure clinicians have the most up-to-date training.
Among its key recommendations are that the government should establish a UK-wide minimum standard definition for concussion as well as a new set of concussion protocols that all sports must use, and that the Health and Safety Executive should work with national governing bodies of all sports to establish a national framework for the reporting of sporting injuries.
It also called for UK Sport to be mandated to take a governance role in assuring that all the sports it funds raise awareness on the dangers of concussion effectively, and for UK Sport to pay for a medical officer with responsibility to ensure the safety of participants at every major sporting event.
Overall, the report recommends a move away from the conservative approach towards research into the issue advocated by the international Concussion in Sport Group, which currently underpins most UK policy, towards a more precautionary approach. It suggests the government convenes its own specialist concussion group every four years to review the existing evidence into the long-term risks of concussion, and also recommends that the government should establish a single fund to co-ordinate and pay for research.
The report is published on the same day as a landmark new study by the Drake Foundation and Imperial College in collaboration with the Rugby Football Union. The study showed that 23% of a group of 44 current elite rugby players had abnormalities in their brain structure, including small tears in their blood vessels and other “white matter” damage.


The Drake Foundation has called for “additional updates to the game’s laws and protocols to minimise players’ exposure to head impacts.” The RFU has promised more research as a priority and pledged to set up “a specialist clinical service for the assessment and management of retired elite male and female rugby players between the ages of 30-55 to individually assess their brain health.”
Richard Boardman of Rylands Law, the firm representing a group of 175 rugby players – including the former England forward Steve Thompson – bringing action against the RFU and other governing bodies, said: “It’s pleasing to see stakeholders with an interest in sport seeing the scale of this problem the same way we do. Namely, that those who have either played or are currently playing contact sports in this country, particularly at the elite level, with brain damage, is at an epidemic level.”
Thompson, a World Cup winner in 2003, has now at 42 been diagnosed with early onset dementia and told the Guardian in December last year: “It’s the rugby that’s put me through this,” adding: “The amount of head bangs I had in training. I was known for it. ‘Oh, he’s having a little sleep, he’ll get up in a minute.’”
This article was amended on 23 July 2021. The concussion in sport report was produced by the digital, culture, media and sport select committee, not the Department for Digital, Culture, Media and Sport itself as an earlier version implied in the text and headline.

https://www.theguardian.com/sport/2021/ ... ning-point

Opinion
The proof is in the numbers: 988 will save lives
By Hannah Wesolowski
September 21, 2022 at 7:00 a.m. EDT
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Hannah Wesolowski is chief advocacy officer of the National Alliance on Mental Illness.
For too long, there hasn’t been an easy, safe way for someone experiencing suicidal thoughts or a mental health crisis to get immediate help. Fortunately, that appears to be changing thanks to 988.

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The number, which became available nationwide earlier this summer, is a dedicated phone line that anyone can contact for mental health, substance use and suicidal crises. When Congress and the Federal Communications Commission designated it as an emergency line in 2020, there were questions about why the number was needed and how effective it would be. But now, we have data to support the resource: Demand for help is high, and the number is giving thousands of people the assistance they need.
The Substance Abuse and Mental Health Services Administration estimated that contact volume to 988 will more than double in its first year. The latest data since the July 16 transition shows the number of contacts to 988 via call, text and chat in August 2022 increased 45 percent over August 2021 — an increase of 152,000 contacts. That is 152,000 more people getting help when they need it most.
This significant increase in contacts has occurred even before there has been any wide-scale public awareness campaign to promote 988, so the number of contacts will likely continue to grow.
Fortunately, in the lead-up to 988’s availability, call centers and state leaders rose to the challenge to meet the increased need. The average answer time across calls, texts and chats are decreasing, and answer rates are increasing, with 20 states answering more than 90 percent of in-state calls in August compared to just seven in January.

This has real benefits. 988 connects people with trained crisis counselors who can actively engage callers and resolve crises over the phone. This reduces the need for an in-person response, which has historically been conducted by law enforcement (contributing to high rates of incarceration of people with mental illness).
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Getting help amid increasing suicidal crises

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 988. You can also reach at a crisis counselor by messaging the Crisis Text Line at 741741.
To support someone going through a mentally tough time: Offer a safe space to talk and listen. Validate and affirm their feelings. Don’t engage in toxic positivity. Don’t be pushy with advice. Ask how you can help.
Because suicide is often impulsive, reducing access to suicidal methods sharply decreases its rates. When the United Kingdom got rid of lethal gas ovens suicides plummeted. Bridge barriers, gun safes and blister packaging pills have all proven to reduce suicide.
Since the pandemic, depression, anxiety, suicidal ideation have reached historic highs, especially among children and teens. Experts say urgent reforms are needed for America’s underfunded, fragmented and difficult-to-access mental health system.
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Research has repeatedly shown that receiving support over the phone can reduce suicide risk. It can also help connect people with more mental health services to get well and stay well.
988’s success thus far gives us a historic opportunity to reimagine how we respond to people in a mental health crisis, and it couldn’t be more timely. The United States is in the midst of a mental health emergency. American adults are experiencing a threefold increase in symptoms of anxiety and depression compared to 2019. One American dies by suicide every 11 minutes.

The stats for our youth are especially dire. The number of adolescents going to emergency departments with suspected suicide attempts has skyrocketed, increasing by more than 31 percent between 2019 and 2021. At my organization, the National Alliance on Mental Illness, we witness daily what the human impact of these numbers is on individuals, families, friends and communities across our country.
As we mark Suicide Prevention Awareness Month, we owe it to our loved ones and our communities to recognize the urgent need and unprecedented opportunity we have in front of us. With the transition to 988 to access mental health and suicide emergency care, we have the potential to fundamentally transform our crisis response and save lives — but only if we continue to act.
Indeed, our work is just beginning. We need to build a full continuum of crisis services around 988 in every community. Every call, text or chat needs to be answered by a local call center with culturally competent resources. And for those who need more help, there should be an in-person mental health crisis response team available to provide appropriate, safe and effective care.

Far too often, we’ve seen mental health initiatives begin with great promise, only to fall short due to the lack of investment. 988 is a huge step forward, but we can’t stop halfway when lives are on the line. With continued investment and focus, 988 can be transformative.
Right now, mental health is a bright spot of policy cooperation and bipartisanship. In the 2021 budget, the lifeline received just $24 million. That investment has grown to more than $250 million in 2022, and President Biden has requested nearly $700 million for 988 and crisis services in 2023. That money would not only help build up 988 capacity but also support a full crisis continuum of care.
The challenge is to build on the success of the 988 rollout, both at the federal and state levels. This effort will prevent more lives from being tragically lost every day. We can and must provide the hope of a brighter tomorrow for anyone who is struggling.
If you or someone you know is struggling or in crisis, help is available.

Call or text 988 or chat 988lifeline.org.

https://www.washingtonpost.com/opinions ... e-success/

It’s never ‘just’ a concussion. Your brain is vulnerable and hurting.
Physicians say we need to recognize that concussions are brain injuries to be taken seriously

By Richard Sima
October 5, 2022 at 9:05 a.m. EDT

(George Wylesol for The Washington Post)

Listen


Our brain is soft and squishy akin to the consistency of warm Jell-O.

Though cushioned by our skull (and sometimes a helmet), our brain will still feel the effects of a strong enough impact.

After a bad blow to the head, “inside your skull, your brain sloshes around,” said John Leddy, a clinical professor of orthopedics and the director of the Concussion Management Clinic at the University at Buffalo. A concussion is labeled a mild traumatic brain injury but “the word ‘mild’ is a misnomer,” Leddy said.

As a type of traumatic brain injury, concussions are designated mild because, through the images of a standard MRI or CT scan, the brain generally looks normal because there is no obvious large-scale damage. (A visible brain bleed would bump the injury to moderate or severe traumatic brain injury.)

With advanced brain imaging, however, it is easier to see the microstructural damage to the brain’s white matter, or nerve fibers, caused by a concussion. This type of physical damage is known as diffuse axonal injury, for the harm done to axons, which are the long, thin cable-like neuronal offshoots that connect neurons and brain regions.

Emerging research suggests that diffuse axonal injury can cause immediate and persistent disruption of brain networks and may be a key contributor to the short-term and long-term consequences of concussions.

We still do not completely understand what causes a concussion, but we do know that its effects can cause widespread disruption to the brain and its normal functioning.

What’s a concussion? How many is too many? What if I hit my head on a door?

What happens inside your skull after a hit
As our brain moves, twists and rotates, the neurons shear and stretch, which causes them to indiscriminately release neurotransmitters, the molecules neurons use to communicate with one another.

This uninhibited chemical release occasionally occurs in the part of the brainstem controlling the hands and arms, and can cause muscles there to involuntarily flex and extend in what is called a “fencing response.” This is probably what happened when Miami Dolphins quarterback Tua Tagovailoa remained on the field with his arms and hands contorted and splayed above his face after his head hit the turf.

This primitive motor reflex is “almost like a traumatically induced seizure,” said Steve Broglio, a professor of kinesiology at the University of Michigan and director of the Michigan Concussion Center.

At the same time, the metabolism of the brain is thrown out of whack as it tries to fix the delicate balance of ions that neurons need to properly generate electrical signals. The brain now needs more glucose to help recover, but the concussion also decreases its baseline cerebral blood flow, causing an energy mismatch between what the brain needs and how much fuel it gets, which may contribute to fatigue symptoms.

Research also shows that concussions possibly disrupt our brain’s autonomic nervous system, including our “fight-or-flight” sympathetic nervous system and our “rest-or-digest” parasympathetic nervous system. The result is that essential, unconscious functions that the autonomic nervous system keeps carefully regulated — blood pressure, heart rate, breathing — may all be knocked off kilter by a concussion.

New symptoms can crop up weeks after the injury
A concussion can have both short-term and potentially long-lasting effects, which are still not completely understood. And the wide variety of possible physical, emotional and cognitive symptoms following a concussion reflects both the bluntness of the trauma and what parts of the brain were injured.

Soon after a concussive event, people may have amnesia about the impact, headaches, confusion or unconsciousness. They may experience ringing in the ears, nausea, disorientation, fatigue or blurred vision.

Other symptoms may crop up in the days or weeks following the injury, such as a lack of concentration, mood changes, sleep disturbances, balance problems, or sensitivities to light and sound.

How my dryer door gave me a concussion

A concussion puts the brain in a very vulnerable state, which magnifies the risk of severe concussion symptoms by orders of magnitude from a second hit, Leddy said.

The most extreme and rarest example of severe outcomes is “second impact syndrome,” where someone experiences a second head injury shortly after a first. Primarily reported in male high school football players, the second injury can lead to irreversible brain swelling and even death.

More commonly, being hit again before the brain fully recovers from its first injury can exacerbate the consequences and make symptoms more severe, numerous and persistent. Just as spraining an ankle makes it more likely to be sprained again, “once you injure the brain, it is easier to injure it again,” Broglio said.

Diagnosing a concussion
The clinical diagnosis of a concussion is still imperfect and depends on the physical signs that a physician can observe and the symptoms the patient reports. There is, as of yet, no objective measure for concussion.

In professional sporting events, it is a clinical judgment call — researchers are working to develop more objective tests for potential biomarkers — but it is best to err on the side of caution and remove the player if a concussion is suspected, Leddy said.

“The presumption of a sports medicine doctor is that this athlete is going to try to play no matter what they’re feeling,” Leddy said. “But the doctor’s job is to protect the athlete first and foremost.”

Tua Tagovailoa’s head injury spurs scrutiny of NFL concussion protocol

Just as diagnosing a concussion is challenging, predicting how long it takes to recover from one is equally tricky.

The brain is likely to compensate for the damage by reorganizing itself and its connections. For 80 to 90 percent of adolescents and adults, it takes about two weeks to recover to clinically normal levels of functioning spontaneously, Broglio said. Younger children, on average, take longer to recover, usually within four weeks. But a sizable minority of people — at least 15 percent — with concussion experience persisting neurocognitive dysfunction, though some studies suggest this percentage is an underestimation.

We still do not understand why some people are more susceptible to worse outcomes than others. The most consistent predictor of a slower recovery is the severity of the symptoms.

But generally, with proper care, one or two concussions can be manageable.

“I would never recommend hitting your head,” Broglio said. “But if somebody had one concussion, I wouldn't be too panicked.”

Repeated brain impacts and injuries, like those that can be sustained over a long sporting career, however, have been linked to an increased risk of neurodegenerative diseases, including Alzheimer’s, other forms of dementia, Parkinson’s and chronic traumatic encephalopathy, or CTE, a rare condition prominently associated with football and boxing.


Physicians say, perhaps surprisingly, that the lesson from concussion research is not to necessarily give up sports. Concussions are injuries to the brain that should be taken seriously, but physical activity is also good for the brain.

There is risk in everything we do in life, Broglio said, and all sports carry a possibility of concussion. But “the risk of not being physically active is more than getting a concussion while physically active,” he said.

But above all, when dealing with a traumatic brain injury, it is better to be safe than sorry.

https://www.washingtonpost.com/wellness ... in-injury/

Zoe Boyd (undisclosed injury) and Kendall Cooper (concussion) both returned to the lineup after missing significant time


If you want an idea on how the Quinnipiac women’s ice hockey team has been playing this year, just take one glance at Saturday’s box score.

The Bobcats recorded seven goals in their victory against Saint Anselm. The visiting Hawks recorded just seven total shots on goal, scoring only once.

Based on this statistic alone, this edition of Quinnipiac women’s ice hockey is bound for an electric 2022-23 season, one that has already started with six straight wins.

Through the first six games, the Bobcats have destroyed their opponents, remaining undefeated with a 26-4 scoring differential. The biggest contributors to this early-season explosion have been freshman forward Madison Chantler, junior goaltender Catie Boudiette and graduate student forward Lexie Adzija.

The offensive depth has been strong, featuring seven different goal scorers against Saint Anselm this past weekend. But the Bobcats have also gotten help with a couple of hat tricks. Chantler broke onto the scene early, recording one back on Sept. 30, against Boston College. Graduate student forward Shay Maloney also scored a trio of goals in Saturday’s game against the Hawks.
Maloney, a Brown transfer, was praised by head coach Cass Turner during the preseason. Turner said she would play an important role in the preseason and the former Bears captain has proved her coach right.

“I think one thing we wanted to focus on going into this weekend was putting pressure onto our offense,” Maloney said on Saturday. “All of our lines did a good job this week.”

Adzija, a team captain, had another fantastic game on Saturday, winning 17 faceoffs to go along with eight shots and her team-leading fifth goal. Her tally was one of three power play goals the Bobcats scored in the game, something Turner puts a lot of emphasis on.

“With our power play, it’s all about communication, it’s all about confidence,” Turner said on Saturday. “We are excited where we are on the power play.”

Winning the first slate of games is a fantastic start for the Bobcats, but conference play will determine this team’s out- come. Quinnipiac begins next weekend with an away match-up against Harvard on Oct. 15, before heading back to Hamden for games against Cornell Oct. 28, and Colgate Oct. 29.

The Bobcats, who are currently ranked No. 7 in the NCAA Division I rankings, are also getting healthier as the year moves along. Defensemen Zoe Boyd (undisclosed injury) and Kendall Cooper (concussion) both returned to the lineup after missing significant time.

“They are both phenomenal players,” Turner said. “They see the ice so well, they add to our offense, it’s good to get some games under their belts.”

The blue line may be bolstered by both the graduate student Boyd and the junior Cooper, but the netminders have been brick walls thus far. Boudiette is having a breakout season in her first year as a lineup regular and graduate student Logan Angers has been solid, just like she has been the last few seasons.

Boudiette, a Redding, Connecticut, native, has only allowed one goal all year, on a broken play that led to a Saint Anselm breakaway. The strong goaltending has allowed the Bobcats to play fast and fluid, knowing that the goaltending between the pipes will be superb.

As an overall theme heading into its ECAC Hockey slate, Quinnipiac emphasizes finishing strong on the offensive side of the ice and maintaining poise from the blue line and beyond. With the depth of this Bobcats team paying off to the tune of a top-10 ranking nationally, Turner and the rest of the coaching staff have their work cut out for them heading into conference play.

“We have been focusing a lot on our detail and I think if we just stick to our game plan, then we can focus on ECAC play and keep doing what we are doing,” senior forward Alexa Hoskin said on Saturday.

While the entire conference as a whole is a beast, the Bobcats have shown that they have the offensive firepower and the defensive prowess to slay the monster.

Bobcat bombardment: Women’s ice hockey claws through early-season slate with record-breaking offensive attack
Read more: https://quchronicle.com/78347/sports/bo ... ve-attack/

concussion blog

WELCOME & WELCOME BACK


Thank you for taking the time to click and visit The Concussion Blog. Over the past 10+ years a lot has changed; one thing has not – my passion for educating about concussion and athletic training.

If this is your first visit here there is a lot to see and plenty to read. If you have been here before there is not much that has changed other than reading, over the years, how much has changed.

The reason for this landing page is that I am officially re-branding The Concussion Blog exclusively on Twitter. However, this blog will remain for contact and information purposes (probably an occasional post).

The brand of The Concussion Blog is: Advancement of Management of Concussion and to Advocate for Athletic Training.

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How to reduce brain injuries in youth hockey
The risks of concussions are real. Coaches, parents and players need to have a serious conversation about retaining body checking in youth hockey.

By Star Editorial Board
Sun., Oct. 9, 2022timer3 min. read

The “fencing response” was the most disturbing thing. At least the most disturbing thing you could see.
If you were watching NFL football Thursday night, what you saw was Miami Dolphins’ quarterback Tua Tagovailoa flat on his back with forearms raised in the position associated with a traumatic brain injury.
The spectacle has once again called into question the NFL’s commitment to player safety, and restarted an American conversation about concussions in football. Canadians need to have that conversation, too, particularly with respect to concussions among young hockey players.
Concussions in youth hockey have received significant attention in recent years, and led Hockey Canada to prohibit body checking up to the Bantam (13- to 14-year old) age level. But a new study led by University of Toronto neurosurgeon Charles Tator demonstrates that the rules still leave plenty of youth in danger.
The study assessed 87 concussed hockey players between 10 and 18. Body checking was the most common cause of concussion, and in 80 per cent of cases, players experienced persisting concussion symptoms (PCS) such as memory problems, difficulty concentrating, anxiety, depression and sleep problems.
The symptoms lasted from one month to 14 years, and could therefore have had a profound effect on students’ education and quality of life.
The study estimates that if body checking were prohibited until the age of 18, 85 per cent of concussions with PCS could potentially be prevented, resulting in a 99 per cent reduction in the number of months spent suffering with symptoms.
Those symptoms are not, however, the only dangers of concussions. Multiple head injuries present even greater risks, such as “second impact” syndrome. In SIS, the brain swells rapidly after receiving a second concussion while the person is still recovering from the first

While rare, the condition often results in death, as it did in the case of 17-year-old Ontario rugby player Rowan Stringer. Stringer’s death led to Rowan’s law, which requires annual concussion education for coaches and parents.
Multiple concussions, or perhaps even repetitive subconcussive impacts, can also result in the incurable neurodegenerative condition known as chronic traumatic encephalopathy (CTE), which can lead to aggression, paranoia and dementia.
The condition among football players has received a great deal of attention thanks to the work of Boston’s Concussion Legacy Foundation, but the Foundation notes that hockey is also a common cause of CTE. And while CTE usually develops in middle age after thousands of hits to the head, it has been diagnosed in athletes as young as 17.
The easiest way to reduce the risks of developing these conditions is to reduce the risks of concussion and other head impacts. And the most effective way to do that, in hockey at least, is to prohibit body checking.
For example, a 2017 University of Calgary study led by Amanda Black found that Hockey Canada’s ban on checking for players under 13 resulted in a 64 per cent reduction in the concussion rate among 11- to 12-year-old players.
While prohibiting body checking up to the age of 18 could produce similar benefits, some coaches and players argue checking helps prevent concussions by teaching players how to take a hit — an important skill for those who plan to play elite, adult hockey.
But there is no evidence checking prevents concussions. On the contrary, a 2022 study led by the University of Calgary’s Paul Eliason assessed 941 teenage players in a league with checking, and found that those with three or more years of prior body checking experience had higher rates of concussions than those with two years or less.
Since hockey season is beginning, Hockey Canada, youth leagues, coaches, trainers, parents and players ought therefore to engage in a serious conversation about the wisdom of retaining body checking in youth hockey.
After all, hockey should be about enhancing young lives, not diminishing, or worse, ending them.
https://www.thestar.com/opinion/editori ... ockey.html

Frequency of Concussion Exposure Modulates Suicidal Ideation, Planning, and Attempts Among U.S. High School Students

Health care professionals should closely monitor mental health behaviors in adolescents with concussions. Adolescents with concussion in past year are significantly more likely to attempt suicide. Males with 2+ concussions in a year were 2x more likely than those with only 1.

Context
There is growing interest in the relation between repetitive concussions and mental health; however, studies on the relation between concussion frequency and adverse mental health outcomes among female and male youth are lacking.

Objective
To examine the association between self-reported concussion frequency and non-fatal suicidal behaviors among youth and to explore the potential interaction of biological sex.

Design
Retrospective cross-sectional survey.

Setting
National Youth Risk Behavior Surveillance System.

Participants
28,442 United States secondary school students.

Main Outcome Measure(s)
Exposure variables included frequency of self-reported sport/recreation-related concussion within the previous 12-months (0, 1, ≥2). Outcome variables included feelings of self-reported sadness/hopelessness, suicidal ideation, planning, and attempts. Covariates included age, sex, race/ethnicity, bullying victimization, sexual orientation, and physical activity.

Results
Students that reported ≥2 concussions were at significantly greater odds of reporting suicidal attempts (AOR = 2.03 [95% CI = 1.43, 2.88]) when compared to students reporting a single concussive event during the past 12-months. However, sex interactions revealed that this finding may be driven by males; the strength of associations did not increase from single to multiple concussions among females.

Conclusions
Findings from the present study suggest that adolescents who self-reported concussion were at increased odds of reporting poor mental health and suicidal behaviors. Moreover, increased number of concussive events may be associated with significantly greater odds of reporting suicidal attempts, particularly among males. Irrespective of sex, health care professionals should closely monitor mental health behaviors in adolescents with repetitive concussions, especially those that occur in close temporal proximity.

Frequency of Concussion Exposure Modulates Suicidal Ideation, Planning, and Attempts Among U.S. High School Students
Read more: https://meridian.allenpress.com/jat/art ... -Modulates
Study available as a PDF: https://watermark.silverchair.com/10.40 ... 117.22.pdf

What’s a concussion? How many is too many? What if I hit my head on a door?
An injury suffered by quarterback Tua Tagovailoa has put the spotlight on concussions. However, doctors say concussions are a common but little-understood injury in youth sports and everyday life.

By Teddy Amenabar
October 4, 2022 at 12:23 p.m. EDT


When we fall, hit our head or are tackled to the ground, our brain can bounce or twist against the skull. The result is a mild traumatic brain injury, also known as a concussion.
The head injury to Miami Dolphins quarterback Tua Tagovailoa, witnessed by millions on prime-time television, has put the spotlight back on concussions in sports. But experts say concussions are an all-too-common injury in everyday life. Overall, about 7 percent of children have had concussions, according to 2020 data from the National Center for Health Statistics. But the risk goes up significantly with age. Among 12- to 17-year-olds, about 12 percent have had concussions. Among adults, 29 percent report having had a concussion.
The Washington Post spoke to neurologists, physicians and others who study and treat concussions to answer common questions about head injuries, especially for children playing contact sports. Here’s what they had to say.

What are the symptoms of a concussion?
There are a range of physical, emotional and psychological symptoms. After the hit or fall, you may have a headache, nausea or vomiting, double or blurry vision, or sensitivity to light and noise, and feel sluggish, hazy or like you need to “wipe away cobwebs” from your brain.
Losing consciousness, even briefly, or not remembering getting hit or events right before or after the injury are also signs of concussion.
After a concussion, one-third of youths develop mental health issues
Other signs reported by parents include confusion, answering questions slowly, repeating questions, behavior and personality changes, or forgetting an instruction or assignment. Teens may talk about “pressure” in the head; feeling sluggish, hazy, foggy or groggy; and difficulty concentrating or remembering. A teen may describe “just not feeling right” or “feeling down.”
“By definition, a concussion is characterized by things that are difficult to quantifiably measure,” said Kristen Dams-O’Connor, a professor and the director of the Brain Injury Research Center at Mount Sinai Hospital in New York. She said she doesn’t have “a formula” when assessing whether someone has a concussion. While there are some observable signs, doctors often rely on the symptoms someone says they have.
Some people with head injuries are sensitive to lights or sounds for days or even weeks after the incident. You may experience mood swings and have trouble sleeping, said Angela Lumba-Brown, a professor and the co-director of the Brain Performance Center at Stanford University. And your symptoms may evolve over time, as well.

How do I know if my injury is serious?
There are some more serious symptoms to watch for, such as a headache that progressively gets worse, slurred speech, repeated vomiting or drowsiness, and loss of consciousness.
Gerard Gioia, the chief of neuropsychology and the director of the concussion program at Children’s National Hospital, said there are two conditions to consider when someone sustains a head injury: the force of the blow and whether the person is acting “functionally different” after the incident.
The words of wisdom often shared by experts are: “When in doubt, sit it out.” Meaning, if you think someone has sustained a concussion, they should stop playing the sport until they’re checked by a physician. Every state has a law on the books instructing that players with a suspected concussion can’t play again until they’re cleared by a medical professional.

What if I hit my head on a cabinet or door?
Any hit to the head or body could result in a concussion, experts say. Dams-O’Connor said many people sustain concussions while doing “everyday” tasks, such as accidentally slamming your head on your dryer door. And the most common cause of a concussion is an unintentional fall, Lumba-Brown said.
How my dryer door gave me a concussion
If you’re an adult who lives alone and you hit your head, let someone know what happened so they can check in on you, Lumba-Brown said. If your headache gets worse and does not go away, or if you’re vomiting repeatedly, feel drowsy or have slurred speech, you should call 911 or ask someone to take you to the emergency room.

Chris Koutures, a pediatric sports medicine specialist in Anaheim, Calif., and the team physician for the U.S. men’s and women’s volleyball teams, said that “if it changes the way you think, how you act or how you feel, something’s going on.”
Do people really see stars?
“Seeing stars” is a common description for a more serious concern. If the back part of your brain, known as the occipital cortex, is injured, your vision can be affected.
“People can see white spots, black spots or everything can look green or yellowish or gray,” said Kenneth Podell, director of the Houston Methodist Concussion Center. “I’ve had patients fully awake that have lost vision for a couple seconds.”
What is second impact syndrome?
Second impact syndrome is a rare but possibly deadly phenomenon in which a person sustains a traumatic brain injury while still recovering from a preexisting concussion, says Stacy Suskauer, the director of the Brain Injury Clinical Research Center at Kennedy Krieger Institute.

“How we manage concussions is largely based around preventing a catastrophic second injury,” Suskauer said.
It’s a “paralyzing thought” for parents and coaches because an athlete can suddenly die if they have the condition, Dams-O’Connor said. It’s more likely, though, that by returning to play too soon, an athlete will prolong the recovery period of their initial concussion, she said.
Physicians say there is a “window of vulnerability” when an injured brain is more susceptible to another concussion and more severe injury. “We’re not 100 percent sure what it is in humans,” Podell said. “It’s a tough study to do, but if you use the rat model, it’s two days out to four or five days out. Somewhere in that time frame, you have to be real careful.”
How do concussions affect kids differently than adults?
We often think children have a miraculous ability to bounce back from an injury such as a broken bone, but “it’s the exact opposite” for a brain injury because a child’s brain is still developing, said Mark Halstead, the director of the Sports Concussion Program at Washington University in St. Louis. Children often take longer to recover from a concussion.

Several brain injuries that accumulate over time can affect the “developmental path” for a child’s brain, Gioia said.
How many concussions are too many?
Experts say there’s no “magic number.” Halstead said you could put 10 concussion experts in a room and get 10 different answers to the question. For him, it depends on the patient, the severity of their symptoms and their goals outside the sport.
Halstead said he’s most concerned about repetitive blows to the head over a long period of time, including what are called subconcussive blows — hitting a soccer ball with your head or two players colliding their helmets on the line of scrimmage in a football game.

“It’s just common sense that repetitive injuries to a particular body part over a period of time is not necessarily a healthy thing for your body,” Halstead said.
Repeated concussions and blows to the head increase risk for neurodegenerative diseases, including chronic traumatic encephalopathy (which has been prominently tied to football and boxing).
Is there a point at which someone should stop playing contact sports?
The answer depends on whom you ask.
Lumba-Brown said that she sees a string of “three, four or five” concussions as a “warning sign” to call it quits and switch to another, safer sport.
Gioia said the “progression of the injuries” matters more than the number of injuries. He asks: Has it taken less and less force to cause each subsequent concussion? Or is it taking longer for you to recover from the same type of head injury?

If it takes two or three months now to recover from a brain injury and it used to take a week or two, that may mean the brain is “not bouncing back as well as it did before,” Gioia said.
That’s when he starts talking to athletes about retiring.
Even if you are lucky to not get hit again, just by staying in the game, you double your recovery time from the added metabolic stress of physical activity, said John Leddy, a clinical professor of orthopedics and the director of the Concussion Management Clinic at the University at Buffalo.
Are some people predisposed to getting a concussion?
Physicians know that a previous concussion puts someone at higher risk for another one. Some people may also have a genetic risk. Research has identified “genetic markers” that may make it more likely for a person to have symptoms of a concussion after a head injury, Lumba-Brown said.
Gioia said he wished there were a way to recognize whether someone is at high risk of a concussion, but science isn’t there yet. Gioia said he’s part of a group investigating whether there are “biological factors,” such as a blood test or a brain scan, that could tell whether someone will take longer to recover from a concussion.
What sports are at highest risk for concussions?
In a 2019 report, the American Academy of Pediatrics found that tackle football, girls’ soccer, boys’ lacrosse and boys’ ice hockey have the highest rates of concussion reports per athlete among high school sports.
How long does it take to recover from a concussion? What’s the treatment process?
It depends on the person and the severity of the concussion, but generally, experts say patients take three to four weeks to recover. Lumba-Brown said 20 percent of people require more than a month.
Until a few years ago, rest and recuperation required days — if not weeks — of “minimal brain stimulation,” which amounted to no screens, no books and, if possible, very little exposure to light. But the American Academy of Pediatrics updated its guidelines in 2018. Still, minimizing the use of screens, computers and video games is helpful since using them slows down recovery, probably because they provide too much stimulation for the brain to handle during its recovery, research shows.
Physicians want children to return to school sooner, and recovery plans are now step-by-step plans that slowly reintroduce activities as you start to feel better. There’s evidence for light aerobic exercise once symptoms have stabilized, research shows.
“We’re trying to find the fine line between overstimulation and total shutdown,” Koutures said.
There is no “cure” for a concussion, but there is a neurosteroid in clinical trials that may be able to speed up recovery down the road, Lumba-Brown said. Until then, adequate sleep, staying hydrated and some light exercises, “if you can tolerate” them, are the best steps toward recovery, she said.
How do you convince an athlete to stop playing after a concussion?
Koutures, the pediatric sports medicine specialist in Anaheim, said all young athletes want to play “no matter what.” But, if they have a concussion, he tells athletes they can “blame the medical team,” because the best decision is to sit out and not play.
“I tell them flat out you have one brain,” Koutures said. “We can’t transplant them.”
Richard Sima contributed to this report.
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"I definitely would give back my gold medal in a heartbeat for my health."

Olympic gold medallist Katie Weatherston says it was "unjust" of Hockey Canada to tell her it only had $4,000 available to cover medical expenses for an ongoing traumatic brain injury she sustained while playing for Team Canada.

She's now speaking out publicly and questioning Hockey Canada's priorities in light of recent reports that the organization has paid out millions of dollars in settlements for sexual abuse allegations.

"It was a slap in the face back then, when I was told they only have $4,000 to give me," Weatherston told CBC News.

"And now it's absolutely shocking what's come out and that they had no money for me, but they have money for this.… It's not fair. I don't want to see it happen to other young female athletes."

Hockey Canada has come under intense public scrutiny in recent weeks over its use of its National Equity Fund — made up in part of players' registration fees — to settle a $3.5 million lawsuit. A woman alleged she was sexually assaulted by eight hockey players in 2018, including members of the men's World Junior team.

Hockey Canada later told a parliamentary committee that it has withdrawn another $7.6 million to pay out nine complainants with sexual abuse claims since 1989.

The organization has since defended the National Equity Fund, arguing that it is used "to support anyone who might have been injured or harmed where insurance policies were insufficient."

Weatherston said she doesn't understand why this fund isn't being used to pay for her treatment.

In a media statement, Hockey Canada told CBC News that the "safety of our athletes" is its "highest priority" and that the organization has different insurance policies or self-insured funds "that may be available" to players injured at Team Canada sanctioned events.

The organization said it also has a Health Benefit Trust that covers some otherwise uninsured medical and dental expenses up to a maximum of $5,000.

Weatherston said that isn't enough.

"The medical care I need is about $30,000 to $40,000 a year," she said. "I can't afford to pay that much toward my medical bills, so I'm not getting the care I need."

Weatherston said that for the past 16 years, she's struggled with daily headaches, chronic exhaustion and the sensation of her ears popping, like she's on an airplane with a cold.

She said she's paying roughly $15,000 a year out of pocket on medical care, including physiotherapy and chiropractor appointments. Weatherston said she has also resorted to doing her own acupuncture, cupping and massages to cut costs.

Her injuries started in 2005 when she flew over the handlebars during a bike race with her team and landed on the pavement, knocking out three teeth, according to a Hockey Canada injury report viewed by CBC News.

Then, in September 2006, she was hit from behind during an inter-squad game at Team Canada's training camp. Weatherston says her head smashed into the boards.

A Hockey Canada doctor cleared her during the game to go back out on the ice, said Weatherston.

Later during the same game, Weatherston collided with a teammate and bumped heads with another in a face-off. Days later, she said, she ended up in a hospital emergency room feeling nauseated and experiencing pain at the back of her neck and at the top of her spine.

'My head didn't even hit the ice'
After time off the ice, Weatherson said, her career came to a sudden halt in 2008 after she fell during a pick-up game in Ottawa.

"My head didn't even hit the ice," she said. "I felt my brain just go splish-splosh back and forth inside my skull and I just knew that I was in trouble."

A Hockey Canada injury report written by an Ottawa doctor and dated October 2012 said that as a result of multiple concussions in 2005, 2006 and 2008, Weatherston had been left with prolonged post-concussion syndrome that was "possibly permanent."

Weatherston said she didn't sue or file an insurance claim with Hockey Canada at the time because she was still hoping to recover and go to the Olympics again.

"I was 25," she said. "I thought for sure I would get back into the game.

"You don't want to go up against Hockey Canada. You don't want to be blacklisted."

Personal injury lawyer Brian Cameron reviewed Weatherston's documents and said that while her situation is "certainly unjust and ... certainly unfair," she waited too long to sue and is now past the statute of limitations.

"The reality is, had she sued in time, Hockey Canada is insured," said Cameron. "She waited too long and now she's in the situation where it looks like she's going to have these problems over the course of her life."

Weatherston sought a legal opinion in 2013 that found she could sue for "vicarious liability" over allegations Hockey Canada's doctor was negligent by clearing her to play. The law firm said that in order to get past the two-year statute of limitations, they would have to show "there was fraudulent concealment by Hockey Canada of its knowledge of concussions," according to the law firm's report.

Emails viewed by CBC News show that it wasn't until 2012 that Weatherston got in touch with Hockey Canada for help paying her medical bills.

According to one of those emails, the since-retired head of insurance and risk management for Hockey Canada, Glen McCurdie, told Weatherston there was an accidental death and dismemberment policy that had a "traumatic brain injury component" but added that it was "relatively new" and he didn't think she'd qualify.

Weatherston said in an email to Hockey Canada that she had suffered a "chronic and what may be a lifelong injury.

"Is there anything else Hockey Canada can do to support its athletes?"

A 'shot to the gut'
Todd Jackson, Hockey Canada's senior manager of insurance at the time, responded to Weatherston in June 2014, saying the organization had already paid Weatherston $6,000 for the bike accident during training. He offered her another $4,000 to help with her ongoing medical expenses.

"Unfortunately, the $4,000 is all I have to work with. Sorry," Jackson wrote in an email to Weatherston.

CBC News's attempts to reach Jackson and McCurdie through Hockey Canada for comment were unsuccessful.

Personal injury lawyer Jacqueline Small, who has experience as a high-level athlete herself, says it's "disappointing" that Hockey Canada's insurance policy at the time only covered $5,000 for medical expenses, as most serious injuries require years of extensive rehabilitation which is not fully funded by public health care.

"Our national team players dedicate their lives to hockey and to proudly representing our country," said Small. "One would hope there would have [been] sufficient financial support for rehabilitation, given their sacrifice to the sport and to wearing the Maple Leaf jersey."

Weatherston said it was an "extra shot to the gut" to watch the Hockey Canada scandal unfold since May.

"They closed the book on me," said Weatherston. "I had a great experience with Hockey Canada, some of the best memories of my life. But I also had a terrible experience because I felt like they just threw me to the wayside.

"I definitely would give back my gold medal in a heartbeat for my health."

Her partner Alexandra Pinfold is a registered nurse. She said she doesn't understand Hockey Canada's priorities.

"Why should she suffer when they had the capacity to help?" said Pinfold. "That's not OK. It's an injustice to women in athletics, really."

Weatherston's mother Anna Weatherston said she now wonders "if it was a great idea to put her into hockey."

CBC News asked Hockey Canada why it didn't use the National Equity Fund to help Weatherston with her ongoing medical bills.

The organization said that out of "respect for privacy and confidentiality, it would be inappropriate ... to discuss an individual's specific case through the media."

"We are sorry to hear that Ms. Weatherston has concerns regarding her past injuries," Hockey Canada said in a media statement to CBC News. "Should there be new information about her medical case, we encourage her — as we would with any Hockey Canada member — to reach out to us."

Hockey Canada said its insurer "would make any determinations" about her entitlement to coverage.

Olympic gold medallist rips Hockey Canada for paying her $4K for post-concussion medical expenses
Read more: https://www.cbc.ca/news/politics/katie- ... -1.6621011

"Every athlete of every age, gender, skill level, and experience has something in common: they only get one brain that must last them throughout their lives."

Imagine that you are the parent of an 11-year-old soccer player who dreams of competing in the Women’s World Cup one day. You want to support her love for the sport while keeping her safe from harm. You are particularly concerned about brain injuries in youth sports, so you look up information about concussion protocols online.

Information published by an international group of experts known as the Concussion in Sport Group (CISG) is reassuring. They meet every several years to write updated consensus statements on concussions. Their guidelines, once called the “bible of concussion treatment recommendations,” informs concussion research, policies, and return-to-play protocols around the world.

Parents, coaches, academics, athletic trainers, physicians, and sports officials across the world rely on the CISG’s concussion statements to protect athletes at all levels of sports.

But the CISG’s guidelines have fallen far short of this goal.

As the group prepares to gather from Oct. 27 to Oct. 29 in Amsterdam to provide its latest recommendations on how to evaluate and manage concussions, now is the time for all who care about safeguarding athletes’ health to call for change. A major overhaul of the group’s processes for crafting guidelines is needed to protect all athletes at risk of brain trauma.

The CISG’s guidelines are based largely on research on professional adult male athletes. The studies cited by the CISG relied on samples that were 88% male. This is, unfortunately, not surprising. A 2022 study led by Christopher D’Lauro, a U.S. Air Force Academy professor of cognitive neuroscience, found that research on concussions among female athletes is sorely lacking. This gender gap is problematic because a growing body of research makes clear that findings from concussion research only in men cannot be assumed to apply to all athletes. But in the CISG’s highly influential international concussion guidelines, girls and women make up barely 10% of the athletes studied. Concerted efforts are needed to remedy this profound inequity and ensure that concussion guidelines for all athletes are fully inclusive of all athletes.

Children and amateur athletes are also not adequately represented in the CISG guidelines, even though they represent the overwhelming majority of athletes at risk for brain trauma. Only a tiny minority of athletes ever go on to play sports at the professional level, yet the prevailing focus of the CISG guidelines remains on professional sports, with a relative lack of attention to children and lifelong amateur athletes who are also at risk of concussion.

That the Concussion in Sport Group has largely excluded women, children, and amateur athletes in its deliberations is linked to another major problem: its ties to adult male professional sports leagues. The CISG is funded by powerful sports organizations, such as the International Federation of Association Football (better known as FIFA) and World Rugby. In fact, an analysis of the most recent CISG concussion statement found that 32 out of 36 expert panelists were affiliated with these organizations in various ways, ranging from employment connections to providing expert witness testimony in legal cases. There is ample evidence that funding from professional sports organizations presents conflicts of interest that are fundamentally in tension with public health objectives to prevent brain injuries.

In particular, the CISG has a troubling history of downplaying evidence that repeated brain trauma can cause chronic traumatic encephalopathy, or CTE. This progressive brain disease is associated with long-term symptoms that can be debilitating, including memory loss, impaired judgment, and personality changes. Australian neurologist Paul McCrory has led the CISG for more than 20 years and has been the lead author of the group’s past four concussion consensus statements, published in 2005, 2009, 2013, and 2017. Yet he has characterized the effects of concussion as “transitory” and once notoriously derided media coverage of CTE as “carry-on and hoo-hah.”

This dismissive attitude has carried directly over into the CISG recommendations. The 2017 concussion statement, led by McCrory, says that “a cause and effect relationship between CTE and concussions or exposure to contact sports has not been established.” In other words, the organization is claiming that no one knows if repeated head injuries have anything to do with symptoms of CTE.

That means that the “bible” of concussion guidance is trailing behind the National Football League, an organization that has a history of denying the risks of concussions. Even so, in 2016, the NFL acknowledged the connection between repeated concussions and long-term neurological disorders such as CTE. Subsequent research has only further reinforced a causal relationship between repeated exposure to head trauma and a heightened risk of developing brain diseases like CTE.

At a bare minimum, the Concussion in Sport Group must align its recommendations with this body of evidence to provide effective guidelines to protect athletes.

The credibility of the CISG was called into further question this year due to academic misconduct. McCrory has faced a bevy of substantiated accusations of plagiarizing and misrepresenting research. As a result, some of his publications have been retracted, and he stood down from the CISG in March 2022. This month, the prestigious British Journal of Sports Medicine announced that it would be retracting nine additional articles by McCrory as the journal continues to investigate dozens of others for additional misconduct.

I want to emphasize two points: First, as researchers Stephen Casper and Adam Finkel have noted, McCrory did not merely copy and paste other researchers’ language (as unethical as that alone would be). He also inaccurately quoted and misrepresented past research in ways that weakened recommendations for the necessary cautions to take after an athlete had experienced loss of consciousness or multiple concussions. As Casper and Finkel observe, such misrepresentations published by the head of the CISG may have “altered the interpretation of concussion science and thus shaped the content of consensus statements on concussion.”

Second, the problem of flawed CISG guidelines cannot simply be fixed by the removal of a single unethical researcher. While McCrory’s academic misconduct has been particularly egregious, he did not operate in a vacuum. For the past several decades, the CISG has been beset by conflicts of interest, has excluded the overwhelming majority of athletes who are not adult male professionals in its recommendations, and has downplayed the causal relationship between repeated head trauma and the risks of long-term neurological disorders like CTE. The result: guidelines that place athletes at greater risk of harm whenever they step out onto the playing field, court, or rink.

This month’s meeting of the Concussion in Sport Group in Amsterdam needs to be an opportunity to entirely overhaul the process by which these concussion guidelines are written. In a 2021 commentary, an interdisciplinary team of colleagues and I made several specific recommendations for a new approach to developing international consensus statements on concussion in sport. We believe that the authors of concussion guidelines should not be limited to sports medicine physicians with links to professional sports. Instead, the perspectives of pediatricians, public health experts, ethicists, athletes — some of whom have experienced concussions — and caregivers should all be included. The guidelines should be drafted in an open process with procedural transparency that includes explaining any potential conflicts of interest. Journalists should be invited to report on the proceedings and share them with the public. The journals that publish the CISG guidelines should invite independent experts to provide open and rigorous peer review.

All athletes — not just professional athletes — deserve a truly inclusive, independent, and transparent process by which to craft the guidelines on which their brains depend. The status quo is continuing to fail athletes at every level, from NFL stars like Tua Tagovailoa to 11-year-old children dreaming of competing in the World Cup one day. Every athlete of every age, gender, skill level, and experience has something in common: they only get one brain that must last them throughout their lives. It is high time that we have an international concussion group that prioritizes that all-important goal.

International concussion guidelines must protect all athletes’ brains, not just professionals’
Read more: https://www.statnews.com/2022/10/25/int ... essionals/

Concussion protocols are based on research of mostly men. What about women?

Lindsay Simpson still has questions about her concussions.

Her first one came when she was 16. At the time, she was playing for a club soccer team in Atlanta, as a promising high school goalkeeper with aspirations of a Division I scholarship and – in her biggest dreams – a professional playing career.

"I dove for the ball, and my body hit funny. I slammed the back of my head on the ground," Simpson said. "You train very well not to do that, but mistakes happen."

When she was injured in 2002, "concussion" was not the household word that it is today. For weeks, Simpson experienced mysterious symptoms and struggled at school, leaving her and her parents wondering what was wrong. "I had this horrible, excruciating headache. I couldn't be in the bright lights. I was just really not myself," she said.

Her parents took her to doctor after doctor, trying to understand what was wrong. She saw chiropractors, orthopedists, even an orthodontist.

Eventually, they saw a neurologist who suggested it could be a concussion. "He said, 'Have you had any knocks to your head lately?'" Simpson recalled.

The field of concussion research has come a long way since the early 2000s. Greater awareness among the American public – who watch every weekend as college and professional football players undergo concussion evaluations – could be the reason why U.S. teens are reporting concussions in growing numbers.

But many questions still abound, especially when it comes to the differences between men and women. Some studies have suggested that women and girls might be more susceptible to concussions, and they may need longer to recover.

Those disparities are one subject researchers are planning to discuss at this week's International Conference on Concussion in Sport. Some concussion experts hope that the major meeting in Amsterdam could lead to a consensus statement that could improve research on how concussions impact women.

Concussions took her out of the game
Outside of American football, no high school sport causes concussions at a higher rate than girls' soccer.

Nine months after her first concussion, Simpson was able to return to the soccer field. But for the rest of her career – from high school through her time as an NCAA Division I player, Simpson experienced concussion after concussion, some mild, some more serious.

Finally, in the final game of her sophomore spring season at the University of Maryland, she ran out of the box to clear a ball and collided with a player on the opposing team. Simpson's head hit the other player's shoulder. The next thing she remembers is her teammate helping her up off the field.

The symptoms – nausea, dizziness, light sensitivity, memory issues – were so intense that she had to withdraw from her courses.

Afterward, a neurologist told her that she'd never play competitive soccer again. All these years later, she said, "it still hurts, it still stings."

Now, at age 36, Simpson still has questions about the concussions that have altered the course of her life.

"The million dollar question, to me, is why? Why did I get that impact and it affected me that way – and yet you watch someone take a hit every Sunday on TV, and they're fine?" she said. "That's the question I want answered in my lifetime."

Many women get concussions, but studies have historically focused on men
Every year, millions of Americans get concussions. In a 2017 CDC survey, 2.5 million high school students – 15% of all high school students nationwide – reported having experienced a concussion in the previous year. More than 40% were girls.

Yet much of the most consequential concussion research has focused on men and boys, according to a new analysis published in the September issue of the British Journal of Sports Medicine.

Schools, teams and medical professionals nationwide rely on the guidance of three important organizations – including the International Conference on Concussion in Sport – to help guide concussion diagnosis and protocols.

Researchers looked at the studies cited by those organizations' influential concussion statements. The participants, they found, were 80.1% male to only 19.9% female.

"The startling part was just how male it was," said Julianne Schmidt, a concussion researcher at the University of Georgia and one of the study's authors.

Worse, about 40% of the studies cited included no women or girls at all. "Putting a number to it made it very clear that this is a huge imbalance, and it's going to take a lot of work to bring it back into balance," she said.

Schmidt is in Amsterdam for the latest International Conference on Concussion in Sport, where a panel of experts will begin to draft a consensus statement that reflects the latest in concussion research to make recommendations about diagnosis and treatment.

The conference normally meets every four years. But because of pandemic delays, the latest statement now dates from the 2016 meeting – a very long time ago for a rapidly evolving field in which hundreds of studies are published each year.

Because the ICCS statement is so influential, an update that reflects the imbalance of research is needed, Schmidt said – even something as simple as an acknowledgment of the gender gap and a call for more research funding.

"The doctor that's treating an NFL player on the sideline is using the same statements and guidelines that a pediatrician is using to treat a 14-year-old soccer player who's female," Schmidt said. "We can't just assume that women are miniature males."

What the research says about women and concussions
The gender imbalance stems from the origins of concussion research – studies of high-impact sports, namely American football and ice hockey, both of which are predominantly played by men.

Research access has been a factor, too: Professional sports teams and high-level college programs have dedicated medical teams, making it easier to track and diagnose concussions among those athletes than in other populations.

The gender balance has improved over the past decade as researchers have examined groups more diverse than just high-level male athletes, said Dr. Christina Lin Master, a pediatrician and concussion specialist at the Children's Hospital of Philadelphia and the University of Pennsylvania.

Researchers know that women report more concussion symptoms than men after a head impact. Now, Master said, studies are needed to figure out why.

"Is that because they have a more severe injury and have more symptoms, or is that something about gendered behavior where they are reporting more symptoms, or more likely to disclose, as opposed to hide, symptoms?" said Master.

The differences could also be biological, she said. The hypotheses there are many: One factor could be that men have stronger neck muscles than women. Another could be hormones – even menstrual cycles. It could be that women have more delicate axons, the slender fibers that connect neurons to each other.

"There's probably a little bit of 'both-and' and not 'either-or,'" Master said. And some of it may not be related to women themselves, but rather the medical staff around them: A study she led suggested that recovery times disparities among male and female college athletes could be explained by access to medical training staff.

That's where influential groups – like the ICCS panel of experts – come in, she said. An updated consensus statement could help nudge the field toward answering these questions by highlighting the gaps. "If they make a statement on what research is needed, I do think that the funding bodies pay attention," she said.

Concussion protocols are based on research of mostly men. What about women?
Read more: https://www.npr.org/2022/10/27/11316418 ... -women-men

‘Violent’ check left female hockey player with brain damage: suit

All she wanted to do was play hockey, but instead a Hudson Valley woman claims she suffered brain damage when a male goon violently cross-checked her during a game.

Chelsea Noe, 38, is now suing, arguing that the hit never should have happened.

The upstate Saugerties Hockey League was supposed to have rules barring checking, or one player slamming into another, Noe charges in a lawsuit.

But the rule wasn’t enforced on Feb. 10. 2019, Noe claims, as her club, the War Horses, took the ice against the Blue Crew.

It was the third and final period of the game when Noe — known to be the “smallest, lightest and weakest” player in the league — was struck, court papers said.

Noe asserts in the Manhattan Supreme Court lawsuit that opponent David Lynch, 50, came at her with “the weight of his entire body and the momentum of rapid movement,” slamming his stick into her back.

Lynch was known for excessive roughness, repeated hits and other violations in the “no checking” league, Noe contends.

He was penalized for the hit, but not ejected.

The Hyde Park man was a player of “substantial size, weight and strength” who was “excessively aggressive,” while Noe described herself in the lawsuit as the “least capable” of being able to defend herself against the forceful play.

Noe appears to have played just one season in the Saugerties Hockey League, appearing in 13 games for the War Horses in 2018-2019. She scored three goals and lodged 10 assists, while being given 10 penalty minutes, according to the league web site.

The cross check left Noe with a “severe traumatic brain injury,” she claimed.

She’s now unable to work or go about her daily life after injuries to her “head, brain, cervical spine, to her torso and to her extremities,” according to court papers.

The Ulster County woman now deals with cognitive impairment, chronic migraines, memory loss, nausea and dizziness, among other injuries, she charges.

Noe is suing Lynch; War Horses coach Christopher Rivers; referee William Winters; the Saugerties Hockey League; the New York State Amateur Hockey League and USA Hockey for unspecified damages.

Lynch, Rivers and the Saugerties league didn’t return messages seeking comment. Winters couldn’t be reached.

‘Violent’ check left female hockey player with brain damage: suit
Read more: https://nypost.com/2022/10/22/violent-c ... in-damage-

"We had a lot of injury issues — some season ending"

When projecting future success, many people wouldn't think much of a team that finished last season 7-19.

But despite posting a sub-par record in 2021-22, the North Shore Storm feel lots of excitement about the upcoming year because the team's losing record wasn't a result of a lack of talent or compete. "When we thought it was all over, COVID started popping back up again.

We had a lot of injury issues — some season ending," said Storm head coach Zack Vieau. The North Shore girls team is a co-op primarily made up of students from Two Harbors and Silver Bay, but from time to time the team also gets players from Grand Marais/Cook County.

"Team bonding with co-ops is a huge deal, especially with girls, and we've lost that with COVID," said Vieau. The only time many of the girls were able to be together off the ice was when they were riding the bus to and from games. Although injuries and illness plagued a large portion of the team's past season, there were still players who shined through the darkness.

Senior Livia Hoff lead the Storm in points in 2021-22 with 24. "She was out there for about 85 percent of the game and she would run everything ... she'd do two or two-and-a-half minute shifts," said Coach Vieau. Hoff graduated and will be playing Division III hockey this winter for Concordia College in Moorhead.

Even though the team lost their leading scorer, only three seniors are departing the program this offseason.

"We usually teeter around 23 players to put together a varsity and a JV. We have 39 this year," says Vieau, who went on to say that it's been a long time since the program has seen those kind of numbers. Most of the team this season will have experience playing varsity minutes, and the group will be rounded out by some new faces coming up through the youth programs. Goaltenders Megan Larson and Harper Powell split time in net last season, and with Larson now graduated, Powell will step in as the primary starter. One thing that is unique to the North Shore program and Coach Vieau is that the team will not have any captains for the upcoming year. With the large group of rising juniors, Vieau says that there will be multiple girls who he anticipates will be able to step up and lead in their own ways.

"Sometimes I felt when we put our three or four captains together it stopped the ability for other girls who wanted to lead to start leading.”

Things look prosperous for North Shore hockey in the future as well — the 12U Silver Bay team made a state tournament appearance this past spring. For more on the North Shore hockey team, things they're looking to improve this year, how Coach Vieau found the job and how a player lost a tooth out on the ice, make sure to listen to the full podcast or watch the full interview.

North Shore girls hockey is on the way up
After a tough 2021-22 season filled with illness and injuries, the Storm are excited to bounce back this year with almost double the number of players in the program.
https://www.therinklive.com/high-school ... the-way-up
Read more: https://www.therinklive.com/high-school ... the-way-up

Additional Visits for Sports-Related Concussions Associated with Several Factors

Younger age, higher symptom scores at initial presentation, previous history of concussion, and family history of psychiatric disorders are factors associated with the need for additional clinic visits among student athletes with concussion, according to study findings published in the Clinical Journal of Sport Medicine.

Researchers conducted a retrospective cohort study at a multidisciplinary sports concussion center from January 11, 2017 to January 10, 2020. They assessed 524 patients (236 were discharged after their initial clinic visit; 288 patients required additional clinic visits), aged 12 to 23 years old, evaluated for sports-related concussions at the center.

The researchers assessed various factors in patients who were immediately discharged to care under an athletic trainer compared with patients who required additional clinic visits prior to discharge to an athletic trainer. The factors assessed included patient’s age, sex, initial visit symptom score, family and personal history of psychiatric disorder and migraine, and history of prior concussion.

Young athletes requiring additional clinic visits scored higher on the initial visit symptoms score (P =.002), required more frequent imaging of the head (P <.02), and reported previously sustained concussions (P =.02). These patients also were younger (P =.014) and stated that they had a family history of migraines and/or psychiatric disorders (P <.001 each).

In particular, family history of psychiatric disorders (odds ratio [OR], 3.12; 95% CI, 1.53-6.34; P =.002), previous history of concussions (OR, 1.39; 95% CI, 1.02-1.89; P =.037), higher initial symptom scores (OR, 1.05; 95% CI, 1.03-1.05; P <.001), and younger age (OR, 0.87; 95% CI, 0.77-0.97; P =.021) all strongly correlated with additional clinic visits.

“Optimal concussion care is ideally efficient if it reduces the chances of suffering long-term adverse consequences or of entering premature return-to-play protocols,” the authors said. “Knowledge of significant variables associated with additional clinic visits may contribute to better expectations understood by patients and their families during the recovery process.”

The study has several limitations that warrant mention. Only patients who eventually were discharged to care under an athletic trainer were included; the inability to infer factors on causation of concussion-related outcomes; and the lack of follow-up regarding successful return-to-play for these athletes.

Additional Visits for Sports-Related Concussions Associated with Several Factors
Read more: https://www.neurologyadvisor.com/topics ... l-factors/
Read the study at: https://journals.lww.com/cjsportsmed/Fu ... its.6.aspx

Ava Patronas concussion

Ava Patronas, Duluth Northern Stars

Let me take a moment to introduce you to Ava Patronas, AKA Silky Mitts. Ava is a senior grinder for the Duluth Northern Stars. Ava has been a staple of the Stars program since 2018. As a freshman, she came in hot, literally. Landing herself with a concussion within the first two weeks. But it never slowed her down. She has been true to herself since day one.

Ava consistently shows up for her team, is the voice of reason, the positive thinker, the one with the one-liners that come out of left field and keeps you chuckling all the way to the bench. She has been obsessed with Bubbl'R, making numerous attempts to get “sponsored”, win giveaways on Instagram and wanted her coach to buy a Bubbl’R fridge for the locker room.

Ava drinks a Monster energy drink before games and, when encouraged to make healthier choices, she responds with "it's sugar free." Ava is also the only player Duluth coaches have ever told she needs to have her hair in a ponytail on the ice. Ava is literally always true to herself in the absolute best ways.

Ava was convinced that after being out sick this season, she “forgot how to play hockey” but that again didn’t stop her from showing up daily and pushing her teammates. Ava was dubbed Silky Mitts by a rockstar team manager in 2019 and it has stuck, even when she tells the team she lost her mitts, left them at home, on the bus, or in the locker room.

Ava always returns to the bench the true Silky Mitts way, with high fives for her teammates. Whether she gets one shift a game or 20, it does not matter. Ava will leave the rink with the same swag as she had when she arrived; rocking her Tims, joggers, Stars jacket, hat and her sunglasses.

Ava Patronas may not leave her mark on the Duluth team in the stats department, but she leaves her mark in many of the best ways that go beyond the scoreboard!

Offbeat, unsung and overlooked The inaugural Janjet Awards recognize the myriad ways players contributed to their team's success
Read more: https://www.janjet.com/story.php?storyID=23

What to watch for

The repeat concussions suffered by Miami Dolphins quarterback Tua Tagovailoa less than a week apart in September 2022 have brought the seriousness of traumatic brain injury back into the public eye and triggered scrutiny of the NFL’s concussion protocols. And the upcoming World Cup soccer competition, which begins Nov. 20, 2022, will likely include highly visible head injuries.

The Conversation asked David Howell, director of the Colorado Concussion Research Laboratory at the University of Colorado School of Medicine, to explain the latest science behind concussions and why a recently injured brain is more vulnerable to repeat injury. Howell’s work focuses on the many different areas of concussion-related dysfunction and recovery, including movement deficits, sleep problems and rehabilitation.

How widespread are concussions?

The word concussion can evoke a variety of different images for different people. While concussions are most visible during high-profile sporting events, they can also occur on the playground, during the junior varsity football team practice or on the ski slope. The effects can be just as severe for children and teens as for high-profile athletes.

Concussion effects range from mild to severe, from short term to long term, and can affect many different facets of life. A concussion is defined as a traumatic brain injury caused by an impact to the head, resulting in an alteration of brain function.

A concussion often leads to disruptions to everyday life – whether it be a job, academics, sports, physical activity or sleep. Given how unique people’s brains are and how differently they may respond to the injury, concussion recognition, diagnosis and treatment remain challenging for patients and clinicians alike.

What happens to the brain during a concussion?

There is a complex set of events that occur within the brain during and after a concussion occurs.

As a result of the trauma to the brain, brain cells – or neurons – stop functioning as they typically do when healthy. Generally there is not one specific area of the brain that is affected by a concussion. Instead, the injury can affect a widespread set of brain regions, not necessarily at the impact point. Thus, each person may experience a unique set of symptoms or functional problems following the injury.

One main problem that arises following a concussion is an energy crisis of sorts. This occurs when the brain requires a large volume of energy, in the form of glucose delivered by blood flow to the brain, to restore the injured processes. The body also may have trouble delivering blood to the brain because of a brain blood flow disruption caused by the injury, at the very time the brain needs extra energy to restore the injured areas. This mismatch can produce a variety of different symptoms people experience following a concussion.

What signs should you look for if you suspect a concussion?

Concussions produce a wide range of signs and symptoms, such as problems with walking and balance, dizziness, mood changes, disruptions to sleep and more.

Some of the main signs that health care providers look for following an impact to the head or body include unsteadiness of gait, loss of consciousness, seizures or other concussion symptoms like headache, cognitive impairment or problems with vision or balance.

It is critical that if a concussion is suspected, individuals cease playing their sport or activity. A simple mantra of “If in doubt, sit them out” should always be applied, regardless of the setting.

Why is the injured brain more vulnerable to repeat injury?

Miami Dolphins quarterback Tua Tagovailoa, who was carted off the field in late September 2022 after his second head injury in less than a week, serves as an example of how vulnerable the brain can be to additional trauma following an initial concussion.

Research shows that the rate of second concussions is highest in the immediate days following an initial concussion. In addition, recent studies have found that athletes who continue to play following a concussion experience longer recovery times and more severe symptoms.

While athletes of all ages may want to continue competing after a concussion, relying on a person with an injured brain to determine whether their brain is healthy enough to continue playing is flawed logic. Qualified health care professionals should always make these sorts of decisions for an athlete, rather than someone with a vested interest such as the athletes themselves or their coaches.

Given the energy crisis described above that occurs following a head injury, the brain simply cannot handle the added and cumulative stress of two injuries occurring in short succession. A second insult to the brain is often simply too much for the brain to handle, and the brain will preserve its most basic functions, such as breathing, above all else.

This is why it is imperative that athletes who experience a concussion be removed from the field of play and allowed to recover fully before returning to unrestricted sport participation. This often involves a stepwise reintegration approach, which allows for a gradual and safe reintroduction into physical activity at first, and an appropriately safe return to play under medical care.

You’ve had a concussion – now what?

The first step following a concussion is to stop playing sports and to rest for a day or two. Sleep is critically important in the days following a concussion.

A myth that continues to persist is that a person should be woken up every hour following a concussion. This is simply not supported by science. In fact, poor sleep after a concussion has been widely documented as being a predictor of poor outcomes, including longer recovery times and more severe anxiety, depression or cognitive symptoms. Waking someone up every hour applies to more severe brain injuries that would be ruled out by a health care provider during diagnosis.

In addition, recent guidelines and past research suggest that complete physical and cognitive rest, which is sometimes called cocoon therapy, can actually be harmful to recovery.

Therefore, it is important to keep a balanced approach in mind. Following a day or two of physical rest, people with a concussion should begin resuming light physical and cognitive activity that does not provoke or exacerbate ongoing symptoms.

When a person begins to feel better following a concussion, they should gradually add in higher intensity and greater amounts and duration of exercise, dictated by whether their symptoms are not significantly provoked. Recent studies have focused on the value of an individualized aerobic exercise program in the week following a concussion. Past work suggests that performing aerobic exercise at a heart rate just below the level at which symptoms are exacerbated is safe and effective for recovery.

It is important to note that the effects of a concussion may also result in secondary conditions, such as anxiety or depression due to the biological, social or psychological effects of the injury. A recent study showed that adolescents who sustained a concussion have a higher risk of mental health issues compared to those with an orthopedic injury.

Concussions can cause disruptions to everyday life in both the short and long term – a neurophysiologist explains what to watch for
Read more: https://theconversation.com/concussions ... for-192390
Watch the video: https://www.youtube.com/watch?v=7Lfc7aZfd0Y

Post-Concussion Misophonia

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Reminder to college athletes, NO ONE is taking responsibility for your long-term health, especially the NCAA

"Reminder to college athletes, NO ONE is taking responsibility for your long-term health, especially the NCAA.”— Chris Nowinski, Ph.D.

Under examination by NCAA's counsel, Dr. James C. Puffer repeatedly stated that the NCAA's constitution indicates that the organization shouldn't interfere with college team physicians and coaches.

"The NCAA shouldn't be responsible for creating rules on warning college athletes about the risks of concussions, a former NCAA medical committee member who is currently UCLA's football team physician testified on Friday in a California jury trial over a college linebacker's death."

NCAA Not Responsible For Concussion Warnings, Jury Told
https://www.law360.com/sports-and-betti ... es/1546876

Serious head injury

March 6, 2022. It's a day Rylee Bennett can only remember parts of.

She remembers playing in a playoff game in Windsor, N.S., with her Halifax Western Capital U18 teammates. But she can't remember how the game ended for her.

Bennett, who was 16 at the time, fell hard into the boards. Her helmet, which broke, took all the impact as her head hit the top of the boards.

"I kind of remember letting out a scream when I got hurt and our trainer rushing over, but I don't remember anything after that because I passed out," Bennett said in an interview before a team practice in Bedford.

"I just remember waking up in the hospital and I had no idea what was going on. "Bennett had suffered a serious head injury. Her brain was bleeding and beginning to swell.

The event was horrifying for her teammates and her coach, who just happens to be her father.

"Once we understood the severity of the accident, the whole day was a bit of a blur for our family," said Kevin Bennett. "Between leaving the rink and getting to the hospital and dealing with all the possibilities that were put in front of us, it was a very long 24 hours.”

Doctors were considering performing brain surgery, but fortunately the swelling around the young hockey player's brain started to recede. Her first day at the hospital is something she'll never forget.

"I was just laying in the bed in a terrible amount of pain. It was very overwhelming," said the teen, who lives in Kentville and is now a Grade 12 student at Northeast Kings Education Centre.

"Every minute, I was just waiting for the doctors to come walking through the door and tell me if I'm going to need surgery or not and would I be able to play hockey again, which was a terrifying feeling.”

A slow recovery
Even after recovery, serious head trauma can often have lingering effects. Bennett was told to take things extremely slowly when she was sent back to her home in the Annapolis Valley. She could not return to school right away, and even the simplest of tasks were difficult.

"She still had double vision in one eye, so she wasn't seeing well and her mobility wasn't great," said her father. "She was released to go home to just rest and sleep, and the neurologist gave us a long list of things not to do.”

While she was determined to get back on the ice with her team in the fall, she knew rushing back into it was not the way to go.

"At first I wasn't allowed to get my heart rate up past a certain point," said Bennett. "Running was not allowed in the beginning — nothing that involved bouncing in regards to my head.”

Bennett was skating lightly on her own when the Capitals got back on the ice for the beginning of the 2022-23 season, but she could not take part in team drills. She missed the first few games of the season, but she was gradually picking up her pace at practice.

Seven and a half months after her devastating injury, she was finally given the green light to play in a game.

"That was awesome because it didn't feel like it was ever going to happen," said Bennett. "I honestly didn't think it was going to be possible with all the emotions that I was feeling.”

1st comeback goal
Bennett said it was very surreal to be back on the ice and playing in a game. She reached another milestone on Oct. 30 when she scored her first goal since her comeback.

"I can't put into words what she went through," said Sarah MacDonnell, Capitals assistant coach. "We're just so proud of her resilience.”

Bennett's teammates, who supported her all the way through her ordeal, were thrilled to have her back on the ice and in uniform.

"She's very strong and relentless and never gives up," said Samantha Taylor, team captain. "We definitely had her back and supported her along the way. "Bennett said the support of her team helped her pull through a very dark phase.

"I don't know what I would have done if they weren't there for me," she said. "They just made me feel I could get through it when there were times when I didn't feel I could."

Young Kentville hockey player returns to ice after serious head injury
Read more: https://www.cbc.ca/news/canada/nova-sco ... -1.6645732

It's never 'just' a concussion. Your brain is vulnerable and hurting

Our brain is soft and squishy akin to the consistency of warm Jell-O.

Though cushioned by our skull (and sometimes a helmet), our brain will still feel the effects of a strong enough impact.

After a bad blow to the head, “inside your skull, your brain sloshes around,” said John Leddy, a clinical professor of orthopedics and the director of the Concussion Management Clinic at the University at Buffalo. A concussion is labeled a mild traumatic brain injury, but “the word ‘mild’ is a misnomer,” Leddy said.

As a type of traumatic brain injury, concussions are designated mild because, through the images of a standard MRI or CT scan, the brain generally looks normal since there is no obvious large-scale damage. (A visible brain bleed would bump the injury to a moderate or severe traumatic brain injury.)

With advanced brain imaging, however, it is easier to see the microstructural damage to the brain’s white matter, or nerve fibers, caused by a concussion. This type of physical damage is known as diffuse axonal injury because of the harm done to axons, which are the long, thin, cable-like neuronal offshoots that connect neurons and brain regions.

Emerging research suggests that diffuse axonal injury can cause immediate and persistent disruption of brain networks and may be a key contributor to the short-term and long-term consequences of concussions.

We still do not completely understand what causes a concussion, but we do know its effects can cause widespread disruption to the brain and its normal functioning.

As our brain moves, twists and rotates, the neurons shear and stretch, which cause them to indiscriminately release neurotransmitters, the molecules that neurons use to communicate with one another.

This uninhibited chemical release occasionally occurs in the part of the brainstem controlling the hands and arms, and can cause muscles there to involuntarily flex and extend in what is called a “fencing response.” This is probably what happened when Miami Dolphins quarterback Tua Tagovailoa remained on the field with his arms and hands contorted and splayed above his face after his head hit the turf.

This primitive motor reflex is “almost like a traumatically induced seizure,” said Steve Broglio, a professor of kinesiology at the University of Michigan and the director of the Michigan Concussion Center.

At the same time, the metabolism of the brain is thrown out of whack as it tries to fix the delicate balance of ions that neurons need to properly generate electrical signals. The brain now needs more glucose to help recover, but the concussion also decreases its baseline cerebral blood flow, causing an energy mismatch between what the brain needs and how much fuel it gets, which may contribute to fatigue symptoms.

Research also shows that concussions possibly disrupt our brain’s autonomic nervous system, including our “fight-or-flight” sympathetic nervous system and our “rest-or-digest” parasympathetic nervous system. The result is that essential, unconscious functions that the autonomic nervous system keeps carefully regulated — blood pressure, heart rate, breathing — may all be knocked off kilter by a concussion.

A concussion can have both short-term and potentially long-lasting effects, which are still not completely understood. And the wide variety of possible physical, emotional and cognitive symptoms following a concussion reflects both the bluntness of the trauma and what parts of the brain were injured.

Soon after a concussive event, people may have amnesia about the impact, headaches, confusion or unconsciousness. They may experience ringing in the ears, nausea, disorientation, fatigue or blurred vision.Other symptoms may crop up in the days or weeks following the injury, such as a lack of concentration, mood changes, sleep disturbances, balance problems or sensitivities to light and sound.

A concussion puts the brain in a very vulnerable state, which magnifies the risk of severe concussion symptoms by orders of magnitude from a second hit, Leddy said.

The most extreme and rarest example of severe outcomes is “second impact syndrome,” where someone experiences a second head injury shortly after a first. Primarily reported in male high school football players, the second injury can lead to irreversible brain swelling and even death.
More commonly, being hit again before the brain fully recovers from its first injury can exacerbate the consequences and make symptoms more severe, numerous and persistent. Just as spraining an ankle makes it more likely to be sprained again, “once you injure the brain, it is easier to injure it again,” Broglio said.

The clinical diagnosis of a concussion is still imperfect and depends on the physical signs that a physician can observe and the symptoms the patient reports. There is currently no objective measure for concussions.

In professional sporting events, it is a clinical judgment call — researchers are working to develop more objective tests for potential biomarkers — but it is best to err on the side of caution and remove the player if a concussion is suspected, Leddy said.

“The presumption of a sports medicine doctor is that this athlete is going to try to play no matter what they’re feeling,” Leddy said. “But the doctor’s job is to protect the athlete first and foremost.”

Just as diagnosing a concussion is challenging, predicting how long it takes to recover from one is equally tricky.

The brain is likely to compensate for the damage by reorganizing itself and its connections. For 80 to 90% of adolescents and adults, it takes about two weeks to recover to clinically normal levels of functioning spontaneously, Broglio said. Younger children, on average, take longer to recover, usually within four weeks. But a sizable minority of people — at least 15% — with concussion experience persisting neurocognitive dysfunction, though some studies suggest that this percentage is an underestimation.

We still do not understand why some people are more susceptible to worse outcomes than others. The most consistent predictor of a slower recovery is the severity of the symptoms.

But generally, with proper care, one or two concussions can be manageable.

“I would never recommend hitting your head,” Broglio said. “But if somebody had one concussion, I wouldn’t be too panicked.”

Repeated brain impacts and injuries, like those that can be sustained over a long sporting career, however, have been linked to an increased risk of neurodegenerative diseases, including Alzheimer’s, other forms of dementia, Parkinson’s and chronic traumatic encephalopathy, or CTE, a rare condition prominently associated with football and boxing.

Physicians say, perhaps surprisingly, that the lesson from concussion research is not to necessarily give up sports. Concussions are injuries to the brain that should be taken seriously, but physical activity is also good for the brain.

There is risk in everything we do in life, Broglio said, and all sports carry a possibility of concussion. But “the risk of not being physically active is more than getting a concussion while physically active,” he said.

But above all, when dealing with a traumatic brain injury, it is better to be safe than sorry.

It's never 'just' a concussion. Your brain is vulnerable and hurting.
https://richmond.com/its-never-just-a-c ... 66d39.html