New Years Wish 2012

I  would just like to wish everyone a safe, happy, and healthy new year.  Hopefully this year will bring many more advances that will allow every ATC to care for their athletes better and keep them participating in their chosen sports as much as possible.

NFL athletic trainers in the booth

In light of the incident with the Browns and Colt McCoy's belatedly diagnosed concussion, the NFL has decided to put an independent athletic trainer in the press box of every football game to watch each of the league's 32 teams for proper adherence to TBI assessment protocols.  This can be a unique opportunity to promote the profession of athletic training and to demonstrate that we are capable of performing more than just taping ankles and getting ice.  I hope that this will not only bring more stability to the NFL, but will also promote the safety of the players, and bring some positive publicity our profession.

Upon reading many comments of fans and others interested in the TBI crisis, I found a great many of them had a very negative response to this new rule.  Many of them were asking "Why can't a doctor just be hired to do it and forgo the AT.  To this, I have two answers.  The first is cost.  ATs are far cheaper to hire to watch from the press box than are physicians.  Secondly, according to neuropsychologist Dr. Mickey Collins at the University of Pittsburgh Medical Center, the designers of the ImPACT program, "There is a large number of athletic trainers that are practicing better medicine with regards to this injury than many physicians."  I can't think of a better endorsement than that for allowing ATs to have this chance.

One thing is certain, I will be investigating the position and see if I can get into this for a side job.  After all, it sounds like fun.

The Value of an Education

This post is a significant tangent to the theme of this blog, but I can't help but blow my horn a little.  Yesterday, I walked through my third commencement and received my Masters of Education.  My field of study was educational technologies.  Imagine that, I learned more about using current technologies for instructional purposes.  I think that has something to do with this blog, after all.  So all I really have to say here is "Yay Me!"

Colt McCoy and the Browns TBI

The Cleveland Browns are involved in a controversy.  I should also report that the sky is blue, the grass is green, and water is wet.  This time, the Browns have come under fire for how they treated Colt McCoy after he got hit by James Harrison in the fourth quarter of the football game this past Thursday night.  I was just as shocked as the rest of my colleagues were when Colt reentered the game.  His return is being reported as occurring just 3 minutes and 50 seconds of real time (not game time) after getting hit.  Local radio talk show hosts are using the incident to further their cause for ousting Pat Shurmur as the head coach and people calling in are agreeing with them.  Colt's father even discussed with a local journalist and called the Browns' actions egregious and that his son should not have returned to play. Needless to say, it has caused quite a lot of conversation locally, and a fair amount nationally.


To nobody's surprise, fans' amazing powers of prediction were confirmed when the Browns released the injury report and Colt was listed as suffering "concussion like symptoms."  According to reports, the symptoms started after the game was over.  This is not out of the realm of possibility and symptoms may not have appeared until after the game ended since it was the fourth quarter when the hit occurred.  I have seen many instances where it takes 10, 15, or even 20 minutes before any symptoms appear that would indicate the athlete's cognitive function has been compromised.  A bigger issue arises in the fact that Colt was only on the sidelines for less than four minutes.  There is no way to perform a comprehensive evaluation of a person's cognitive functions in that short amount of time.  Simply getting symptom score from the SCAT2 would be difficult in that short time given the amount of noise that was present around the evaluator and Colt in Heinz Field.  To complicate matters, Colt did complain of some pain in his thumb that the ATCs would also need to examine in that short time and Colt was lying on the field for some time after the hit while the broadcast cut to a commercial.

Granted, there were only a few people on the sideline that would know what the story is and how it unfolded, but it does seem to me that after a particularly hard hit like that, it would behoove the medical staff to at least get a concussion exam performed.  It does seem highly likely that a TBI screening was never performed on the sideline before allowing Colt to reenter the game, which would confirm Mr. Mortensen's assertions on Sunday that the Browns lied about the TBI evaluation and allowed him to return to play.  The critics' arguments are based on the fact that Colt "was suffering from concussion like symptoms" at the time of the hit because he was "obviously knocked out when the hit occurred."  I would love to know what kind of visual aid these critics were using to diagnose this because I cannot possibly confirm or disprove that Colt was indeed, "out cold."  The only person that might know that would have been James Harrison, if he bothered to look at Colt after the hit.  Unfortunately, the replays cut away too quickly to know if Mr. Harrison had looked.  I have seen a lot of athletes simply lie on the ground for a half second after a hit to "catch their breath" before getting up and running off.  This "knocked out cold" diagnosis is impossible to make from the camera angles, the existence if the helmet, and distance.  Therefore, we must rely upon what the medical staff saw at the time of the hit.  Since I wasn't there, I cannot offer an opinion and I believe that nobody else should either, especially non-medically trained radio talk show hosts and callers.

Since the medical staff will not be speaking to the press anytime soon (the federal law, HIPAA, makes it highly improbable that it will ever happen), we have to rely on the official information being released by the Browns.  This information has been tightly controlled and therefore, leads to a lot of speculation.  The problem is that the media needs to realize that they won't always be given all the answers to report and their speculations are not the truth.  This often leads to other issues that make every athletic trainer's job significantly more difficult.  The issue that faces the high school and collegiate AT is that leaves athletes and parents wondering about what the proper protocol is when their son or daughter gets hit in the head.  Why do I take so much longer to evaluate a kid when the Browns can do it in under 4 minutes?  It makes me look like a poor professional and it leaves the high school and collegiate ATs in a pinch when this situation comes up.  It then takes an extraordinary amount of time to explain the difference that I can only hope takes place after I have completed my thorough examination, not during it.

James Harrison Strikes Again

How many times does it have to happen for some fans to get it through their thick heads that the rules have changed from the days when they ran up and down the football field?  Medicine has advanced considerably and has proven that these actions have a high probability of leaving a person with a life altering injury.  The face tackling, butt blocking, and spearing techniques have been illegal at all levels of football for nearly 40 years.  What has changed is the awareness of head injuries associated with these collisions.  The rules have only recently changed to create better rules enforcement because of recent discoveries with head injuries.  I understand that this is a violent game played by consenting adults (in the NFL), but that doesn't mean the players need to be at an unnecessary risk for injury.  This risk is easily minimized by making a solid tackle at the hips using the chest and shoulders.  The headhunting and ESPN highlight reel hits are unnecessary.  This oaf has been been repeatedly fined for these actions and has not learned his lesson.  The slow motion video clearly shows that instead of lowering his level and breaking down to make a tackle, he lowers his head slightly and launches at the QB's head.  Since this is not the first time he has done this, he needs to be suspended without pay for an extended period and warned that expulsion is a consideration.

To all the former high school and college players who want to say "this is just football", think about that when it is your 7-17 year old son imitating these hits in their Pop Warner, middle school or high school games.  When it is your son who gets hit like this and ends up as a special education and special needs child as a result of of the hit.  This IS HAPPENING all over the country.  It is not well reported, but you can find the stories over the internet every year.  I would refer you to websites like http://www.theconcussionblog.com or http://www.sportsconcussions.org where you will find many resources to educate you about what is happening.  It is time for the fans of "traditional" football to wake up and realize that we can significantly decrease the injury rate and maintain the integrity of the game.

 Finally, there may also be some reason to question the Browns' medical staff as to the nature of a head injury to Colt McCoy as a result of this hit.  There have been a few reports including this one that state that McCoy doesn't remember the hit and that the media was requested to not use the intense lights on McCoy after the game.  Both of these are indications that there may have been something wrong and a possible traumatic brain injury.  I hope that there will be more comprehensive updates of Colt's status released in the next few days.