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A "ding" is not just part of the game (or job)


This past Wednesday I had the privilege of spending the afternoon with some very cool people at SEE THE LINE, Concussion Research and Awareness Symposium.

http://seetheline.ca/

There were over 250 people in attendance to hear about the research being done in this area.  Among those there were very smart people (how do you become a neuro-surgeon and publish over 300 papers in one lifetime?!?!?) and sports celebrities like Eric Lindros (one big guy) and Ron Maclean (with a jacket like that you think he was trying to be Don Cherry or something?:)  But the afternoon was not about the stars, it was about the research into this epidemic they call concussion.

Moving forward, I must first strongly emphasize that what I am about to write is not medical advice.  And I am not saying this to cover my as*.  I am saying this because concussion is a serious condition that needs to be addressed, evaluated and diagnosed by people who have the training and skill (e.g emergency room Physician).  A correct impression & diagnosis makes all the difference in terms of creating the right treatment and plan going forward.  I am simply a Massage Therapist with a modest level of training in neurology, anatomy and musculoskeletal treatments, bringing awareness of what I learned. When in doubt, as Eric Lindros told us, “have some common sense, slow it down, take the time to go in and ask (your Doctor).”  

Unfortunately, one of the most disturbing things I learned came right at the beginning of the symposium. Dr. Bob Cantu (clinician, academic, neuro-surgeon & prolific publisher) in some of his beginning salvos stated that there are now “evidence based findings that outstrip clinical judgement on return to play” guidelines.  In other words, while concussion (an umbrella term) does not show up on CT or MRI scans there are objective signs of changes (via diagnostic scans) in the brain even following careful rehabilitation of the concussed.  I am certain Dr. Cantu’s motivation was not to scare us all into a padded room and ensure our kids are in there too, but to inform us of the risks associated with contact sport and concussions.  

Fortunately, there were many informative upsides to the symposium as well enabling me and other to understand the risks, benefits, alternatives and treatments available and I’ll list a few of them here:
  • “concussion” is an umbrella term (diagnosis comprises multiple factors)
  • all concussions are not created equal
  • it’s impossible to know how long symptoms will last at the time of injury
  • concussed individuals are 3X more likely to also have musculoskeletal injuries
  • if an athlete (recreational or competitive) or person returns to play/work too rapidly, there is a heightened risk of musculoskeletal injury, recovery will be prolonged and post concussion symptoms last longer
and perhaps most alarming
  • second impact syndrome creates a loss of blood flow regulation in the brain leading to death and in survivors, a poor prognosis for full recovery
During the afternoon, despite discourses into neuropathology, diagnostic research and bobble head models, time and time again, the gold standard of treatment approach came up as, and will likely continue to be, that people having experienced a concussion must be asymptomatic at rest and progress through graded return to play (work).  

At this point I could practically stop and 80+% of readers would have what they need to ensure proper care of those who have experienced a tbi (traumatic brain injury).  On the other hand, there is a culture out there that seeks to use information to avoid detection.  I am certain now with concussion awareness this is less likely the case, but just in case, here are a few more details I learned to push home the point that there are many young people at risk should awareness not continue to grow:
  • “the way coaches coach” has a dramatic influence on hit count (the amount of physical contact in a game or practice)
  • a young childs nervous system, by in large, is not thickly myelinated (insulated) and able to withstand that amount of impact that an adults brain is
  • Physicians identify 7X as many concussions as teams with Athletic Trainers (when it doubt get it checked out)
  • prevention is most effective form of treatment
  • parental education is vitally important
  • 60-70% of trauma occurs in practice
  • 10-14 year old contact sport participants were most likely to experience  concussion
  • people do not need to be knocked out or hit in the head to have experienced a concussion
  • a "ding" is not “just part of the game”
  • heart rate monitoring may be a valuable rehabilitation tool
As we are moving back towards the school year, school sports will resume.  I tend to think, for parents of children, coaches and anyone else with concerns, concussion awareness and training would be like getting first aid training.  For more information or resources check out:

Sports Legacy Institute  
http://www.sportslegacy.org/education/wilfrid-laurier-university/

Fowler Kennedy Sport Medicine Clinic
http://fowlerkennedy.com/

or

“when in doubt get it checked out” by your Doctor

Take the time, invest in awareness and when in doubt get it checked out.  Going forward I think I may blog again about some more stuff but you know how life is, a squirrel or something shiney may distract me, so I’ll do my best to get it out soon but forgive the spelling and grammar.  In the meantime, free to contact me if you have any questions and I’ll do my best to answer or provide a direction for you going forward.


Go Well,

Simon





Up next:


How Lindros tried to check me into the boards but I evaded contact with an ask.


How the best available evidence may in fact be biased and corrupt.

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Petice458
Jan 15, 2019 1:18 AM
Petice458
Well, info about the game or job. Authorize person is actually all-rounder, the authorized person can do any type of thing. We all should be a self-dependent because it rushessay review is very helpful and important for all of us. We should share our own and not copying others.