Thursday, January 26, 2012
Here we go again
Another professional athlete makes some irresponsible statements and a major newspaper is more than happy to perpetuate the mistake by publishing his comments. This time, Brian Urlacher of the Chicago Bears admits that he would hide potential TBI symptoms form the team's medical staff so that he could continue to play. The comments are incredibly irresponsible and they give kids terrible ideas on how to usurp their medical staffs and stay on the field. It is because of incidents like this that the education of the public slows to a crawl. It would be my hope that at some point, the NFL would be able to fine athletes for comments like this, but I don't see that ever happening without risking a lawsuit from the ACLU.
Thursday, January 19, 2012
A recent, concerning event
A couple of weeks ago, we hosted our biggest wrestling tournament of the year. It is a two day event using eight mats in our field house. The event starts on Friday night with four groups of four round robin that determine the seeding for the two eight man double elimination brackets in each weight class for Saturday. Needless to say, there is a lot of wrestling and certainly a lot of opportunity for injury to occur.
On Saturday, a young man came limping over to me from a visiting team and asked me to look at his knee. He was unable to bear full weight on the leg and most of the pain was on the medial side. It turns out, according to his history, he likely injured his knee early in the fall during his football season. He was able to "grit it out" and competed through the rest of football and here we are in early January looking at it after his opponent twisted his leg. As it turns out, when I stressed the knee with a valgus stress, it opened up by about a centimeter compared to his contralateral knee. Obviously, the concern was very real at that point and I disqualified him from continuing. According to the coach, he was completely unaware of the prior status of the injury and he agreed with my decision to end the kid's day.
The most concerning part of this injury is the parent involvement. Granted, I have dealt with my fair share of kids that were neglected or ignored by their parents and minor injuries have gone untreated. This seemed to be of an entirely different level. The MCL that was injured was not, by any measure, insignificant. It was only by luck that this young man didn't end up with a far worse injury by continuing to participate in athletics and not get the injury looked at by a medical professional. I am not sure whether this school employs a certified athletic trainer or not at this time. However, this situation is demonstrates why there should be an AT employed at every school. This young man should not have been participating and this should have been caught much sooner.
On Saturday, a young man came limping over to me from a visiting team and asked me to look at his knee. He was unable to bear full weight on the leg and most of the pain was on the medial side. It turns out, according to his history, he likely injured his knee early in the fall during his football season. He was able to "grit it out" and competed through the rest of football and here we are in early January looking at it after his opponent twisted his leg. As it turns out, when I stressed the knee with a valgus stress, it opened up by about a centimeter compared to his contralateral knee. Obviously, the concern was very real at that point and I disqualified him from continuing. According to the coach, he was completely unaware of the prior status of the injury and he agreed with my decision to end the kid's day.
The most concerning part of this injury is the parent involvement. Granted, I have dealt with my fair share of kids that were neglected or ignored by their parents and minor injuries have gone untreated. This seemed to be of an entirely different level. The MCL that was injured was not, by any measure, insignificant. It was only by luck that this young man didn't end up with a far worse injury by continuing to participate in athletics and not get the injury looked at by a medical professional. I am not sure whether this school employs a certified athletic trainer or not at this time. However, this situation is demonstrates why there should be an AT employed at every school. This young man should not have been participating and this should have been caught much sooner.
Monday, January 2, 2012
New tech to detect TBI
Another new piece of technology is being talked about that may help diagnose serious head injuries. This new device detects hematomas in the skull as a result of a head injury. Subdural hematomas, by definition, are classified as moderate and severe traumatic brain injuries. These are not mild TBIs, commonly referred to a s concussions.
Mild TBIs are more insidious and involve the process of calcium and potassium ions crossing the cell membranes and causing an energy crisis in the brain. There is no bleeding to speak of in an mTBI. Therefore, it must be made clear that this new piece of technology, while it may prove useful, will not rule out mTBIs. This must be very carefully explained each and every time this piece of technology is purchased and used to test for a head injury. Otherwise, it will have the same problems that CT scans and MRIs do when emergency room staff erroneously tell a victim of an mTBI that they are fine because the test came back negative.
Mild TBIs are more insidious and involve the process of calcium and potassium ions crossing the cell membranes and causing an energy crisis in the brain. There is no bleeding to speak of in an mTBI. Therefore, it must be made clear that this new piece of technology, while it may prove useful, will not rule out mTBIs. This must be very carefully explained each and every time this piece of technology is purchased and used to test for a head injury. Otherwise, it will have the same problems that CT scans and MRIs do when emergency room staff erroneously tell a victim of an mTBI that they are fine because the test came back negative.
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