Unnecessary roughness? Players question NCAA’s record on concussions


In the early 1900s, college football was a brutal sport. An increasing number of deaths and injuries prompted action from President Theodore Roosevelt and led to the establishment of what would later be known as the NCAA.

The National Collegiate Athletic Association was founded to protect the health and safety of college football players, but more than 100 years later, it appears the organization has abandoned that directive.

In an email to CNN, the NCAA said that best health and safety practices are entrusted to the schools and that universities must police themselves.

“NCAA enforcement staff is responsible for overseeing academic and amateurism issues,” the email said. “They do not have authority to make legal or medical judgments about negligence.”

That raises a question about whether the NCAA will enforce the new return-to-play rules that could be imposed if a preliminary settlement reached with about two dozen former players is approved by a federal judge. The rule would prohibit players with a concussion from going back on the field the same day, but it’s contingent on a vote by NCAA membership.

That’s led to criticism of the settlement, which proposes a number of regulations to help protect student athletes.

If the NCAA isn’t enforcing health and safety, will the new rule make a difference?

Missed signs?

In 2011, the NCAA failed to investigate what is arguably the worst-case scenario: when a player dies.

Derek Sheely, 22, collapsed on the practice field at Frostburg State in Maryland after complaining of a headache to his coaches. According to the family’s lawsuit, he had been subjected to 13 hours of contact practice within three and a half days.

He died six days later.

An anonymous email later sent to the parents alleged the coaches knew he’d been bleeding with a lump on his head for several days, yet when he complained of not feeling well, one coach said, “Stop your bit****g and moaning and quit acting like a pu**y and get back out there Sheely!”

The letter says the coaches continued yelling at him after he collapsed.

A teammate, Brandon Eyring, later told CNN that there were plenty of warning signs ignored.

“They were more focused on building tough football players than on safety in my opinion,” Eyring told CNN. “It’s kind of the culture. Just, again, again, the only word I can put is gladiator. You’re going to fight, unfortunately to the death, I mean that’s kind of how it happened and it’s not metaphorical at this point, that’s kind of what happened.”

The NCAA, which has rules for everything from meals to autographs, has one rule when it comes to concussions: schools must have a plan. But the NCAA has no specific requirements about what must be in the plan.

The toll on young athletes

Two lives forever changed and two cut short. These four players have one thing in common: they all suffered head injuries on the field.

“I think there’s a big gap in what they care about. It’s pretty obvious,” Derek’s father, Ken Sheely, told CNN. “They haven’t even been very subtle about what they care about. They will protect the safety of their pocketbook.”

Sheely’s attorneys say Frostburg State violated that rule but was not held accountable.

Frostburg State said it can’t comment on Sheely’s death because of the family’s lawsuit. The NCAA said it was saddened by the death, but, “nonetheless, we disagree with the assertions and allegations made against the NCAA.”

The Sheelys have sued the NCAA and, individually, the coaches and trainer involved.

The defendants responded to the lawsuit saying they are not responsible for Sheely’s death and that football is a dangerous sport that always carries risk.

The $75 million settlement won’t completely eliminate that risk, but it will at least establish a fund for current and former athletes to get testing for brain injuries. It also will force the NCAA executive committee to recommend that it establish, for the first time, rules that specifically dictate how schools deal with concussions.

The Sheelys are not part of the federal suit that reached a preliminary settlement. They are skeptical it will make a difference, and they’re not alone. Reform advocates say it falls short of addressing key issues – such as the number of contact practices per season, which even the NFL has addressed in the past few years.

“This settlement is shameful. It definitely does not go far enough. It does not actually protect the players any better than the players are being protected now,” said Ramogi Huma, president of the National College Players Association, the group that has organized or taken part in many of the recent reform movements.

Devastating effects

The NCAA has known there are two major contributors to concussions: the number of contact practices and how soon a player returns to play.

For more than a decade, the NCAA did little to address studies — even some they paid for — showing concussions have a devastating effect on college athletes, especially football players.

In 2003, the NCAA partially funded two studies that showed that athletes need a full week to recover from a concussion and that players with one concussion are likely to have more.

It wasn’t until 2010 that it made any move at all on concussions. Even then, the only step it took was to put out guidelines — not rules — for best practices.

“The NCAA does have a problem,” said Dr. Robert Cantu, a Massachusetts neurosurgeon who is one of the nation’s top researchers for head injuries in sports.

Cantu’s research has shown that concussions can lead to memory impairment, Alzheimer’s disease, depression and suicide.

“I’m very disappointed that they didn’t proactively put in place best practices for management of concussion when they knew what really should be done,” Cantu said.

Despite all of Cantu’s and other extensive research, the NCAA told CNN “there is very little published science to guide us at this point” and said that is the reason the NCAA implemented guidelines, not rules.

“The guidelines state that these recommendations may become NCAA rules as definitive medical evidence becomes available. For now, though, they are designed to set a norm for each school,” the NCAA said.

Earlier this year, the NCAA announced a $30 million project with the Department of Defense to study concussions.

“It draws a lot of parallels to the cigarette makers, you know, tobacco industry,” said Huma.

“They’ve known for quite a while of the problems associated with concussions and how they should be managed,” he said. Instead of looking out for the athletes, Huma said the NCAA is “sitting back and doing nothing and cashing in on lucrative TV revenues and ticket sales. You know at the very least, if it’s not illegal, it’s definitely immoral.”

While a rule limiting return-to-play rules could be forced on the organization as part of the settlement, nothing will change to limit contact practices.

Instead, the NCAA guidelines, still allow athletes to have contact practice twice as much as pro athletes in the NFL during the season.

During the spring practice season, the NFL has eliminated contact practice, while the NCAA has not.

That’s upsetting to the parents of Owen Thomas, a University of Pennsylvania player who in 2010 became one of the youngest athletes to be diagnosed with chronic traumatic encephalopathy.

It’s a disease born from head trauma, linked to depression, and diagnosable only after death.

Thomas committed suicide at 21.

“College sports is a business,” said Kathy Brearley, mother of Thomas. “We wouldn’t allow a public company to behave that way with its workers.”

Dr. Robert Stern, of the Sports Legacy Institute at Boston University, was part of the team that studied Owen Thomas’ case. He said he was shocked to find CTE in Thomas’ brain since he never had a documented concussion.

Stern thinks Thomas instead had several subconcussions, which do the same damage as a concussion but have no symptoms.

No symptoms make it silent and dangerous.

“These football hits are around 20G per hit,” Stern said. “… That’s probably the simplistic equivalent of a car driving 30, 35 miles per hour into a brick wall. Imagine that 1,000 to 1,500 times per year. That repetitive force to the head with the brain moving inside.”

The more players practice with contact, the more susceptible they are, Stern said.

Back in the game

If a federal judge accepts the preliminary settlement, return-to-play could change in college football. Right now, there is nothing stopping a player from being put back on the field after a concussion.

An internal NCAA email that says an athlete is not “precluded from returning to athletics activities” after a concussion.

It also says, “It would not be appropriate to … penalize a coach … even if the student athlete was required to participate after having been diagnosed with a concussion.”

That was evidenced this year when the NCAA did nothing when Michigan quarterback Shane Morris suffered a blow to the head during a televised game — one that was obvious to viewers watching. Morris was put back into the game minutes after being hit, and the team later said it was because of a lack of communication. But the public was outraged, and Michigan’s athletic director later apologized, saying the protocol would change to make sure it doesn’t happen again.

That kind of self-policing doesn’t always happen.

According to his lawsuit against the NCAA, that’s how Adrian Arrington, 28, got hurt so badly. Arrington was first to file the lawsuit that led to the federal settlement proposal.

He says he suffers daily migraines, memory loss and frequent seizures.

He says he spent months complaining to his trainers when his symptoms began at Eastern Illinois University. But the only response he says he got was to take anti-seizure medication.

Adrian’s father, George Arrington, told CNN that in September 2009, during the game that led to his son’s sixth concussion, he saw the coaches getting ready to return Adrian to the field.

He “couldn’t hold himself up, but he got to the sidelines. They were patting him on the back, but I knew something was wrong. … They called for him to get back into the game,” Arrington said.

He got up from his seat above and ran to the sidelines.

“I said, ‘Adrian’s not going back into the game.’ “

George Arrington put an end to his son’s football career.

Eastern Illinois University told CNN it can’t comment on Arrington’s allegations because he has a pending lawsuit.

But what happened to him happens to many football players. They are often returned to practice or games after concussions, simply because the NCAA has no rules to stop that from happening.

An NCAA survey done in 2010 found that half of college trainers admitted to putting an athlete back in a game after the athlete suffered a concussion. The same survey cited pressure from coaches as part of the problem.

Running out of options on the play

A recent NFL settlement would put money into the pockets of athletes with diagnosed injuries, but this settlement will not.

Instead, if accepted, it will all be designated for research, screening and lawyer fees.

Guys such as Arrington will be able to pursue personal injury claims in court. But some of the athletes with injuries will not, because their cases fall outside the statute of limitations.

One of those guys is Stanley Doughty.

Doughty was recruited by 35 schools as a break-out Louisiana high schooler and then chose to play for the University of South Carolina. He remembers two very hard hits while he was there.

“I can hear voices, but I couldn’t actually move,” he told CNN, recalling the first time he was hit during a practice in 2004. He says the school took him to see a specialist who told him he was fine. The next season, during a game against Tennessee, Doughty told CNN he again went numb, felt temporarily paralyzed, but was told by a trainer to “toughen up” and get back in the game.

The team’s injury report for Doughty shows he had a nerve injury at the cervical spine. The school’s response was that Doughty had suffered what in football is called a “stinger,” or temporary numbness, and said it is common practice to send a player back into the game “after symptoms subside.” The team cleared Doughty to continue playing the rest of the season.

Doughty’s lawsuit says the Kansas City Chiefs’ trainer told him he was too injured to play football when he left South Carolina in 2007 to play for the NFL.

His dream of playing in the pros was realized for a split second and then taken away.

“Basically they told me I could be paralyzed from the neck down,” Doughty said.

South Carolina disputes that Doughty’s injuries were serious and says he did not seek any further treatment after his “stinger.” It says “the university provided appropriate and extensive medical care” for Doughty “including treatment by team athletic trainers, physicians and out-of-state specialists.”

But now Doughty is 30, out of work and doesn’t have a degree. And with this proposed settlement, he has no more legal course of action.

Source: Ganim, Sara. “Unnecessary Roughness? Players Question NCAA’s Record on Concussions.” CNN. Cable News Network, 30 Oct. 2014. Web. 30 Oct. 2014.

When can you return to play after a concussion?


Let’s face it, no one wants to get hurt playing sports, but not all injuries are created equal. Playing through a mild injury to the ankle, knee, or shoulder is something that most players are happy to do, but playing through a head injury of any intensity is a recipe for long term issues.

Concussions are one of the most serious injuries in sports, however proper management and return to play guidelines will help minimize negative long term effects. Every concussion is different and each individual must be treated based on their unique presentation. Concussions are no longer graded as mild, moderate, and severe, and although this makes it more difficult for coaches to prepare for a player’s return, it also eliminates the pressure or stigma when a player takes “longer” than predicted to recover.

Fortunately, the vast majority of concussions result in less than 2 weeks of missed time. The remaining concussions may take weeks, months, or longer to fully heal. The management of these concussions is slightly different with an extended period of rehabilitation, however each concussed individual will need to progress through the same steps when looking to return to sports.

Following a concussion, athletes will be monitored and progressed based on their symptoms which include headache, dizziness, feeling in a fog, nausea, memory and cognition, special tests that assess eye movements, ability to resume reading and computer skills, as well as computer-based neuropsychological testing.

Computer-based neuropsychological testing, such as ImPACT, has assisted medical professionals and athletes with return to play decisions over the past 10-15 years. ImPACT is better able to detect subtle changes in brain function, such as reaction time, compared to a typical examination. Baseline ImPACT tests are now administered to nearly all professional and college teams, and many high school and youth organizations. These tests assess function in the healthy uninjured brain. If an injury occurs, testing can be compared to the original test and/or to norms that have been established for age, sex, education level, etc. When used in conjunction with a medical professional’s objective examination and patient’s reported symptoms, return to play decisions can be made with increased confidence.

When symptoms resolve with rest and the physician’s objective examination is passed, a gradual progression of activity begins assuring that the athlete does not have an increase in symptoms. If signs or symptoms return at any point, the level of activity is decreased until the individual can tolerate it without additional symptoms. The following are recommendations from University of Pittsburgh Medical Center(UPMC) regarding progression of athletes following a concussion. The key is that each individual will progress at his/her own pace. Once the individual has completed all five steps without an increase in signs or symptoms of a concussion, they may return to play in a game.

Each athlete needs to complete each of the following stages of progressive activity:

Stage 1 – 30 -40% max heart rate, 10 -15 min of cardio exercise, very light aerobic conditioning, stretching, and very low level balance.

Stage 2 – 40-60% max heart rate, 20 to 30 min of cardio exercise moderate aerobic conditioning, light weight strengthening, and low level balance activities.

Stage 3 – 60-80% max heart rate, strengthening, conditioning, balance, and concentration activities, moderate aggressive aerobic exercise, 80% max strengthening activities, and impact activities such as running and plyometrics.

Stage 4 – 80-90% max heart rate, resume aggressive training in all environments, non-contact only, aggressive strength training, and sports specific training.

Stage 5 – 100% max heart rate, contact activities that are sport specific, full training with contact and continue aggressive strength training.

Return to play decisions following a concussion can be difficult; however with proper medical guidance and honesty from athletes, the likelihood of a second concussion greatly decreases. Remember we only get one brain, treat it kindly.

Source: Cammarota, Brian. “When Can You Return to Play after a Concussion?”Philly.com. N.p., 29 Oct. 2014. Web. 29 Oct. 2014.

Ask a Doc Several factors can trigger asthma attacks


While walking up a flight of steps recently, I heard what sounded like someone whistling at me. While I was flattered at first, I turned around to see the person behind me taking a puff on her inhaler. She had developed some wheezing brought on by the exertion of climbing the stairs. She mentioned to me that she had been diagnosed with asthma and was having a particularly bad day given the heat and humidity we had been experiencing at that time.

Asthma is a condition in which the airways become inflamed after exposure to various triggers. The result is narrowing of the airways due to spasm and excess mucus secretion. This can make breathing difficult by causing chest tightness, chest congestion, cough, wheezing and/or shortness of breath.

The first thing to understand is that each of these symptoms may be seen not only in asthma but in a multitude of other diseases and conditions. People who experience any or all of these symptoms should see their doctor. The diagnosis of asthma is made by pairing a thorough clinical history and exam with a simple non-invasive pulmonary function test.

Once the diagnosis of asthma is established, you and your doctor can than determine the optimal treatment and develop an asthma action plan which is the course of action you will take when you feel that your asthma symptoms are flaring up.

For some people, asthma is no more than a nuisance. For others, it can be a major problem that interferes with daily activities.

Clinically, asthma severity is broken down on a scale of least to most severe as follows: mild intermittent asthma, mild persistent asthma, moderate persistent asthma and severe persistent asthma. Each asthma patient falls into one of these categories based on the frequency of their symptoms.

There a few key things that you can do to minimize the likelihood of developing an asthma attack, the first of which is to identify the triggers that generally lead to your symptoms. Asthma comes in several forms, a few of which include:

* Exercise-induced asthma, which is precipitated by exertion and may be worse with extreme heat or cold. Humidity may also predispose to exercise-induced asthma symptoms.

* Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust.

* Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches, grasses or pollens.

Asthma treatment is broken down into maintenance therapies and rescue therapies. In a nutshell, maintenance therapies are meant to prevent symptoms, while rescue therapies are are meant to treat symptoms that have already developed.

Inhaled steroids are the mainstay of the maintenance class of therapies. Other classes of medications are available as add-on therapy if the inhaled steroids alone do not adequately prevent asthma symptoms.

The rescue therapies are fast-acting bronchodilators, which serve to open up the airways but do nothing to alleviate the inflammation that causes them to spasm and secrete mucus in the first place.

In recent years, a few novel therapies have been developed for the treatment of the severe persistent class of asthma. An injectable medication known as Xolair can help to alleviate symptoms in some of these cases. Finally, the FDA has recently approved a medical procedure, known as bronchial thermoplasty, designed to improve asthma symptom control and is an exciting treatment option for the right patient.

In summary, if you have any of the above symptoms, be seen by your doctor. If a diagnosis of asthma is established with a thorough history, physical exam and pulmonary function testing:

1. Attempt to identify and avoid, when possible, all known triggers.

2. Take all of your asthma medications as prescribed

3. Keep an asthma action plan that will be the course of action you are to take if and when you suffer an asthma attack.

Regardless of the asthma severity in any particular patient, attacks can occur and be severe unless treated in an appropriate and timely manner. Treatment may help you breath better and, more importantly, may save your life.

Source: Saltin, Corey. “Ask a Doc Several Factors Can Trigger Asthma Attacks.” – Sentinel & Enterprise. N.p., 28 Oct. 2014. Web. 28 Oct. 2014.

Death rate among children suffering from asthma soars because of ‘complacency’ over life-saving medication


The number of children who have died from asthma attacks in the past two years has sky-rocketed, new figures have revealed.

The latest New South Wales child death review found that in the last 10 years, 20 children have died from the respiratory disease but the alarming figure is that half of those deaths occurred in the past two years.

It was also found, there were more deaths in 2010, 2012 and 2013 than in previous years and more than two thirds of those children were male, twice the rate of  girls for the same period.

In most cases, it’s been put down to complacency, the children who died from asthma had factors that may have increased their risk of death.

These included sub-optimal level of asthma control, insufficient follow-up after a hospital visit, poor adherence to recommended asthma medication or action plans and exposure to tobacco smoke.

Surprising figures in the past two years have seen the number of children dying from asthma attacks has increased in NSW

The report states the majority of the children had more than one risk factor, while insufficient follow up after a hospital admission was a factor for eight children who did not visit a doctor.

For four children, it was unclear who in the family was overseeing the child’s asthma management.

While in relation to the fatal asthma attack, in six cases there were indicators that the child or the child’s family may not have recognised early signs that asthma symptoms were slowly worsening, or may not have fully appreciated the severity of the child’s condition.

NSW Asthma Foundation CEO Michele Goldman says the figures are surprising since there has been a downward trend in childhood related deaths in the last decade.

‘They show asthma is not being taken seriously, some deaths could have been prevented,’ she said.

‘The foundation strongly advises people to take asthma more seriously, making sure children have an asthma action plan in place and preventative measures are taken regularly (because some people get caught out).’

‘When the child does start to expose symptoms, something must be done within minutes.’

Ms Goldman says there is still a lack of understanding because asthma is a complex disease which impact people differently.

‘To find the right medication, to find the right dose is not the simplest thing in the world but education is key,’ she said.

The Asthma Foundation regularly conducts survey in a bid to get a reading of how well asthma is controlled and other key issues.

‘Most people thought it was well controlled but three quarters of cases are not well controlled according to our asthma test.’

Australia has the highest incidence of asthma in the world, with every one in ten Australian suffering from the disease.

But over the last decade there has been a significant decrease in deaths.

‘There was 1000 deaths in the late 1980s and recently there’s been around 400 deaths,’ said Ms Goldman.

‘There’s still more work to be done.’

The Asthma Foundation has encouraged people on its website to take the asthma control test, a way to work out your level of asthma control.

It asks five questions, including, how often you’ve had shortness of breath, and the asthma score will assist health care professionals in helping sufferers to reach the best asthma control possible.

Source: Ziniak, Amy. “Death Rate among Children Suffering from Asthma Soars Because of ‘complacency’ over Life-saving Medication.” Mail Online. Associated Newspapers, 26 Oct. 2014. Web. 26 Oct. 2014.

Blood test could take the guesswork out of concussions


A portable, rapid blood test to detect concussion. It sounds like science fiction, but it’s in development now. And it takes the guesswork out of diagnosis.

It’s like a portable laboratory – a handheld device developed by healthcare company Abbott. A few drops of blood on a cartridge and the i-Stat goes to work. Within minutes, the rapid blood analyzer can measure a range of organ functions and blood gases. The results help nurses and doctors make treatment decisions – right at the bedside. It does the same on the battlefield – military medics use the device to help assess injured soldiers.

But the Department of Defense has another idea in mind for the diagnostic tool – they’ve asked Abbott to develop a new cartridge capable of detecting specific biomarkers associated with concussion or mild traumatic brain injury (TBI).

Dr. Beth McQuiston, Abbott Medical Director and Neurologist: “When you cause damage to the brain, markers come out that you can then measure. And you can measure those with two or three drops of blood.”

Jim Stewart, Abbott Diagnostics Research Director: “Each of those little gold spots is a chip that goes in the cartridge.”

They print them in bulk — tiny chips designed to detect and analyze the specific concussion markers.

Jim Stewart: “Basically the protein is there. It can be seen, and now our challenge is to see how far we can push that.”

Hundreds of test cartridges come down the assembly belt each day – at the end the experimental chips are dropped in.

Jim Stewart: “The chip contains a biological component, an antibody that will recognize the TBI protein.”

Dr. McQuiston: “The problem we’re having with mild TBI is it’s not always clear. You’re not sure if someone has had a concussion.”

Concussion is a clear threat in combat. Staff Sergeant Matthew Ritenour served two years – leading his squad along the frontlines in southern Afghanistan.

Staff Sergeant Matthew Ritenour: “I’ve known guys who have had blast trauma and ended up having brain damage because of it, even though they didn’t have to be medevaced and they didn’t lose a limb. It still did damage to their brains.”

He says a definitive concussion test could be helpful … in the right situation.

Staff Sergeant Ritenour” “If you’re in combat, down range, sometimes you can’t sit a guy out. It doesn’t work like that. But in training, if you know someone has a brain injury and they just need to rest, let their brain heal, it’s definitely beneficial.”

But the test has the potential to make an impact beyond the battlefield.

Dr. McQuiston: “If you look at high school students or college students playing competitive sports, the majority of time these athletes do not lose consciousness when they have a concussion.”

During Hunter Hillenmeyer’s eight-year career with the Chicago Bears, the linebacker suffered five documented concussions. In college there was one, as well, and another during his high school days.

Hunter Hillenmeyer, former Chicago Bears Linebacker: “I played from 2003 to 2010 and even in that time period the attitude around what a concussion is — treating them, diagnosing them, return to play guidelines — all changed dramatically. I had a concussion in 2004, my first in the NFL, and I went right back in. I played the entire second half with very little memory of the game, and that would never happen today.”

And if the concussion test makes its way to the sidelines, youth and professional sports could change dramatically. But Hunter is hopeful the research will continue toward treatment.

Hunter Hillenmeyer: “The diagnosis of concussions is just one piece of it, but if they’re getting to the level where they know a specific protein is released upon impact, they’re getting closer to figuring out some of the metabolic changes that might happen at the tissue level where there will eventually be treatments. That’s where my mind is going. When do we get towards treatment and solutions, because the diagnosis of concussion is just one very small piece of the puzzle.”

Concussion and mild traumatic brain injuries are a staggering problem in the United States – approximately four concussions occur every minute. The CDC puts the cost at 77 billion dollars a year.

Source: Czink, Katherin, and Dina Bair. “Blood Test Could Take the Guesswork out of Concussions.” WGNTV. N.p., 23 Oct. 2014. Web. 23 Oct. 2014.

Understand risks of concussions in youth sports


The beginning of October was tragic, when three high school football players in different states suddenly died in football-related events. None of the accounts have publicized an exact physical cause of death, but head injuries are always suspected. The deaths compound the controversial topic of concussions in youth sports, especially since a study last year by the Institute of Medicine found that high school football players are twice as likely to suffer concussions than even those in college.

However, Dr. Arno Fried doesn’t want to sound the alarm bell; he wants to sound the school bell — emphasizing the need to educate the public on the care and treatment of concussions. Fried, whose practice features concussion evaluation and treatment, is a nationally renowned neurosurgeon at Advanced Neurosurgery Associates in New Jersey.

Fried’s philosophy does not so much center on concussion prevention — although he does promote enforcing behaviors such as wearing bike or ski helmets — as it does on identifying head injuries so that athletes don’t suffer from multiple concussions.

These days, the challenge is two-fold: first, recognizing concussion symptoms and making sure a health professional supervises sporting events; the second is proper evaluation for clearance to resume play.

What exactly is a concussion?

“The definition has been changing,” Fried explains. “It is a temporary dysfunction of the brain due to an impact. While there is not a single mechanism, it is typically an acceleration/deceleration. The impact of a hit stops the skull, but the brain continues to move and thus hits the inside of his skull. This causes damage to the blood vessels and/or nerves. It is also possibly associated with long-term microstructural changes to the brain.”

Concussions are the most common type of sports-related brain injury, with an estimated 1.6 million to 3.8 million sports-related concussions a year. The American Academy of Pediatrics has reported that emergency room visits for concussions in children 8 to 13 has doubled, and concussions have risen 200 percent among teens 14 to 19 in the last decade.

According to the American Academy of Neurology, clear differences in concussion risk between male and female athletes have not been demonstrated for many sports; however, in soccer and basketball there appears to be greater risk for female athletes.

There is strong evidence indicating that a history of concussion/mild traumatic brain injury is a significant risk factor for additional concussions.

Research confirms that an understanding of concussion is still evolving. A report last year from the Institute of Medicine on sports-related concussions in youth finds that while some existing studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions, and what are both the short-term and long-term consequences of concussions down the road.

However, here are some important facts to know:

• Make sure there are qualified personnel at sporting events who know how to evaluate participants for concussions. These experts have a variety of tools to determine the presence of concussions on the spot.

• Know the symptoms, such as headache, dizziness, blurred vision and trouble concentrating. Some of these symptoms may appear right away, while others may not be noticed for days or months after the injury.

• If you suspect a concussion, follow the current dictum: When it doubt, sit them out.

• Educate youth participants. There is no glory is “toughing it out.” In fact, there is risk of multiple concussions, including a repeat concussion within a short time, a highly dangerous phenomenon called second impact syndrome.

Concussion education can work.

Of note is a Canadian elementary school, which (following a district-wide concussion education program) recently had a boy who hurt his head in a volleyball match. He attempted to stay in the game, but his teammates refused to resume play until he left the court.

In the event of a concussion, make sure you enforce complete rest. Complete rest of the brain following any level of concussion could help avoid later problems. Complete rest, up to 10 days or even longer, entails ceasing physical/sports activities, as well as avoiding television, computer, texting, etc.

• Do not return to activity too soon. There are over 40,000 youth concussions occurring annually, yet it is estimated that over 40 percent of high school athletes return to action prematurely.

• Follow up. A qualified health care professional can best assess when it is safe to resume activities.

Most of all, Fried also believes in an informed public. “I am not a big believer in forcing rules. I think we should advise families when it comes to clearing players. If someone is perfectly fine, he can return to football. But generally, I would tell him or his parents the risks.”

As is apparent in the NFL, the problem is the accumulation of concussions. “I believe the focus should be on the long term effects of concussions, which are just becoming known,” Fried says. “Our job is to counsel families and patients of the risks.”

Yet there is an aspect of risk that Fried, even with his experience dealing with the brain, thinks we must accept. His own grown sons played lacrosse and soccer through college, and he saw a number of players incur concussions.

“I think of it more as a father, that concussions are a part of life,” he says. “What are you going to do, stop sports? The benefits of sports, such as teamwork and camaraderie, far outweigh the risks.”

Source: Averbuch, Gloria. “Concussions Youth Sports.” Asbury Park Press. N.p., 21 Oct. 2014. Web. 21 Oct. 2014.

Glass of Water Please


Water is what makes up 60 percent of a human bodies weight. it is vital to every system in the body. to work properly. So how much water should one consume on a daily basis? It turns out the answer is not so black and white. It is not as easy as saying drink eight glasses of water a day please.

The popular eight glasses a day advice has no actual scientific evidence to back it up, it is thought to remain popular because it is an easy thing to remember. The amount of water one should drink is based on many factors. Every day an average human loses up to two cups of water during daily life alone.

Twenty percent of the water a human needs can be obtained through food. Most fruits and vegetables are made up of 50 percent or more water. Common drinks on the market are mostly water, including coffee, tea, juice, and soda.The main ingredient is water, so it counts towards liquid intake. According to the Journal of the American College of Nutrition, drinking moderate amounts of caffeine will not cause more loss of water in the body.

Environment plays a roll in the amount of water needed to remain hydrated. Living in a humid, hot region will cause one to sweat more and lose water quicker then one living in a cool place. Drinking extra glasses of water with help in gaining the water back. If the climate is too cold skin may lose moisture from exposure of indoor heat.

Any form of exercise that causes one to sweat will lose water. Normal exercise, like biking or jogging, one should drink two extra glasses of water to replace what was lost. Excessive exercise, anything that takes over an hour, such as marathons, will require more water. Depending on how much one sweats and how hard the activity is. Loss of sodium levels may occur and sports drinks are preferred.

Other factors like illness or health conditions play a factor in the amount of water one should intake. Diarrhea and vomiting are major sources of water loss in the body. Drinking many glasses of water with encourage hydration. A fever will also increase the amount of water needed. People with heart failure or certain organ issues may be advised by a health care professional to restrict intake as it may cause more damage.

Drinking a glass of water may also please the skin. Skin that is hydrated looks healthier and stays more firm making it look brighter. It will flush out toxins in the body that can keep skin looking dull.

When one does not take in enough water they become dehydrated. Signs of dehydration are dry mouth, weakness, light headedness, thirst and excessive thirst. Severe dehydration signs are loose skin, rapid breathing, sunken eyes and weak pulse. Both types of Dehydration are dangerous.

If one becomes dehydrated their body may go into shock because there is not enough fluid in the blood stream to carry the blood to where it needs to go. Two glasses of water upon waking can serve the body well.  Kidney and heart failure may occur as well. It is important to stay hydrated. Having a bottle of water near or a glass where one sits may remind them to take a sip from time to time.

The amount of water that should be taken in has many variables but it does not have to be complicated. Drinking when thirty, working out will help keep from becoming hydrated. Before drinking a cup of coffee in the morning, please have a glass of water first.

Source: Sears, Paul. “Glass of Water Please.” Guardian Liberty Voice. N.p., 19 Oct. 2014. Web. 19 Oct. 2014.


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