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The Concussion Reporting: A New Game Plan program materials found on this website have been developed in collaboration with the following team of world-class clinicians and researcher with expertise in the identification, diagnosis, treatment and management of sports-related concussions.

My Bio My Message

Laura Balcer, MD
Neuro-ophthalmologist

A love of science and my grandmother’s stories about the people she worked with in a hospital made me want to become a doctor. At NYU Langone, I’ve found a wonderful environment, not only for our patients, but for the staff and trainees as well. One of my greatest joys since coming here in 2012 has been the opportunity to mentor and teach the next generation about neurology and the many fields to which it relates.

As a neuro-ophthalmologist, I specialize in treating patients with double vision and other vision problems related to changes in the brain, either due to conditions like multiple sclerosis or injuries such as concussions. I first listen to my patients’ concerns and questions. Then I tailor their treatment to ensure it’s best for them, their work, and their lifestyle.

It’s a pleasure collaborating with the interdisciplinary team at NYU Langone’s Concussion Center. I work with rehabilitation doctors, sports medicine experts, orthopaedists, psychiatrists, neuroradiologists, and physical and occupational therapists, and all of us share the common goal of providing our patients with the best possible care at the right time.

Research conducted at the Concussion Center has led to the addition of vision testing to both sideline assessment and more in-depth testing for concussion. 

Adapted from http://nyulangone.org/ website

My Bio My Message

Shannon Bauman, MD
Primary Care Sports Medicine Physician
Medical Director of Concussion North
BSc, BScN, MD, CCFP(SEM), Dip. Sport Med

Dr. Shannon Bauman has been caring for athletes of all levels for the last 10 years, from recreational "weekend warriors" to professional and national level competitors.

Shannon grew up in Minnesota, and completed her undergraduate Bachelors of Science in Green Bay, Wisconsin participating as an NCAA athlete in tennis and soccer. She graduated from medical school at McMaster University, and completed a specialty in Family Medicine from Queen’s University.  She returned to McMaster to complete a fellowship in Sports Medicine.  She is affiliated with the Dept. of Surgery at Royal Victoria Hospital (Barrie, ON) and the University of Toronto Dept. of Family Medicine. She is a lecturer and the Division lead in Musculoskeletal medicine for the University of Toronto Post-Graduate Family Medicine program. Shannon is on the Team Physician committee for the Canadian Academy of Sports and Exercise Medicine (CASEM).

As a Sports Medicine physician, Shannon has been involved with the Hamilton Bulldogs (AHL), Toronto Rock Lacrosse (NLL), Toronto Nationals (MLL), Hamilton Nationals (MLL), World Cup Sledge Hockey 2009, 2010 Vancouver Olympics Men's Sledge Hockey, and Team Canada Senior Women’s Lacrosse World Cup.

Shannon is the Medical Director, founder of Concussion North-- a Physician led inter-disciplinary team based clinic specializing in sports injuries and sports related concussions in Barrie, ON. She is an international speaker in Concussions: and recently presented research on Gender Differences in the recovery of Sports Related Concussions at “The International Summit on Female Concussions, Headache and TBI.” She serves as a medical advisor to the Simcoe County District School Board (SCDSB) Concussion Committee and Ontario Minor Hockey Association (OMHA). She is involved in the development of medical guidelines for the management of concussions for the Ontario Neurotrauma Foundation (ONF).

Shannon also brings her own personal experience with a hockey-related concussion in 2012 to her practice. Shannon's recovery experience fuelled her interest in concussion management and led to her involvement in concussion research and the development of a network of international leaders in concussion management.  Her passion for concussion care was the impetus for Concussion North and her desire to bring together a talented team of sports injury specialists under one roof.

 

In reflecting on the culture of sport and the reasons an athlete may or may not report a concussion, I think about a 15-year-old-male elite rugby player who came to my office with his parents.

Two months earlier, he had been tackled during a game and suffered a blow to his head. Following the tackle, he had an immediate headache, but continued to play. After the game, he felt dizzy, tired, and “not right.”  But he didn’t report his symptoms to his coaches, teammates or parents.  He then returned to school with continued symptoms, which he did not report to his teachers.

After a month of continued symptoms, he finally told his parents about his injury. His parents made an appointment for him to see the family physician. The physician recommended some school restrictions, and to rest from all physical activity until cleared by a specialist. A referral was made to Concussion North, our interdisciplinary sports concussion clinic, for an opinion on return-to-play.

During our first consultation, the athlete made it clear that he was looking to be cleared to play in a game scheduled for the following day, this despite admitting that he was still experiencing symptoms of concussion during the visit.  I had a lengthy conversation with both the patient and his father about concussions and explained that return to play required assessments by all members of my team. I also explained that, once the assessments were complete, we would initiate a step-wise progression for various aspects of his care, including both his return to physical activities and, more importantly, return to learn.

Following our discussion, the patient’s father stated that his son would be upset about not being able to immediately return to rugby, despite being off all activities for 2 months without a proper assessment. I was slightly puzzled by the father’s response, but the case emphasizes the concern about not reporting concussion symptoms and the need for continued education about the importance of assessing patients for both return to play and return to school. 

Dozen questions

It also raised in my mind the following questions:

  1. Did the athlete know how to recognize the symptoms of concussion?
  2. Did coaches and other team members know how to recognize signs of concussion in their players/teammates?
  3. What is the culture of the sport of rugby around concussions?
  4. Is the environment on his team supportive for its players to feel comfortable reporting a concussion?
  5. Were there other barriers preventing the athlete from reporting a concussion?
  6. Was there a health care professional on the sideline to watch for players exhibiting signs of concussion and to conduct a concussion assessment?
  7. What can we do to educate frontline medical professionals (emergency room physicians, primary care physicians, walk-in clinic doctors, etc.) in recognizing and diagnosing concussions?
  8. What advice are the frontline physicians providing to athletes who present with concussion-related symptoms?
  9. Do physicians know where to refer such athletes when symptoms persist?
  10. Once assessed by a physician with concussion expertise, what management plan is required to ensure that the athlete can safely return to lean and return to play?
  11. How will a plan for return-to-learn and return-to-play be communicated to the athlete and parents? and
  12. How can a plan for a safe transition back to sport be communicated and supported by teammates, coaches, parents, and teachers?

Honest assessment

As a physician, I sometimes look back on my experiences as a NCAA athlete in both tennis and soccer, and ask myself, would I have been honest about my symptoms, recognizing it could mean having to miss the sports I enjoyed so much?

It’s a difficult question to answer, but it helps me to recognize the importance of reaching out to our current athletes to both educate and attempt to understand the barriers to reporting concussions and seeking care.

Research we have recently completed at my clinic, Concussion North, has helped us to identify clinical aspects of a concussion which predict a potential prolonged recovery. It also demonstrated that delayed presentation to a multi-disciplinary clinic is linked to a prolonged recovery (six months or longer).  These are just two of many reasons athletes must report their symptoms immediately, as it will ensure they are safe and ready for competition and not suffering from concussions for prolonged periods.

I am extremely excited, as a member of SmartTeams™ Board of Advisors and of its Concussion Working Group, to reach out to the people affected by concussions and encourage them to seek out the care required to safely return them to the things they love: school, play and life.

 

My Bio My Message

Andrew M. Blecher, M.D.

Dr Blecher specializes in Primary Care Sports Medicine and has been practicing at the prestigious Southern California Orthopedic Institute (SCOI) for 10 years where he has had the opportunity to care for a wide range of patients. From Little League to high school, to collegiate, to elite and professional athletes; Olympic champions, weekend warriors and award-winning entertainers have all entrusted their care to Dr Blecher to recover from their injuries in a quick, non-surgical manner.

Dr. Blecher was born and raised in the suburbs of New York City. He attended Williams College in Massachusetts where he was an NCAA All-American in Track & Field and graduated with Cum Laude honors. He then completed medical school at Tufts University School of Medicine in Boston, receiving many clinical and pre-clinical honors. After medical school, he completed his residency at UCLA’s Family Medicine program at Kaiser Permanente in Los Angeles. This training provided him with knowledge in various aspects of internal medicine, women’s health and pediatrics that could be applied to the broad field of sports medicine.

Following residency, he completed a sports medicine fellowship at the world-renowned Cleveland Clinic Foundation in Ohio. His fellowship responsibilities included the NFL Cleveland Browns and NBA Cleveland Cavaliers, as well as Cleveland’s professional hockey team and NCAA Division I collegiate soccer, volleyball and wrestling teams. The fellowship also provided him the opportunity to participate in the NFL combine and Cleveland Indians spring training. Additionally, Dr. Blecher has been part of the medical team for national and international events, including the Gravity Games, the U.S. National Gymnastics Championships, and the Ironman Triathlon in Kona, Hawaii.

A Diplomate of the American Board of Family Practice, Dr. Blecher is a member of the American Medical Society for Sports Medicine, and is also Board Certified in Sports Medicine. Additionally, he was also awarded the “Pioneer Certificate” for being one of the first to be registered in musculoskeletal ultrasound with the ARDMS certification.

Dr. Blecher provides medical orthopedic care to athletes of all ages and specializes in sports health and medical conditions related to sports participation. He provides pre-participation physical exams, exercise and rehabilitation prescriptions and has an interest in nutritional and sports supplements. He lectures extensively on current sports medicine topics such as cartilage disorders and early arthritis in the athlete. As a runner himself, he also has a special interest in running injuries. Another area of interest is concussion in the athlete. Dr Blecher has years of experience evaluating and managing concussions on the sidelines as well as in the office. He has lectured extensively on the subject at many grand rounds and national conferences such as the National Summit on Sports Concussion. He is also one of only three Certified ImPACT Consultants in the greater Los Angeles area. Dr Blecher has also served as an expert witness in landmark cases involving athletes with head injuries.

Dr. Blecher is also a leader in the growing field of Regenerative Medicine for joints, tendons and ligaments. Using biologic techniques such as Platelet Rich Plasma (PRP) Therapy, as well as injections and advanced imaging such as Musculoskeletal Ultrasound, Dr. Blecher is able to accelerate healing for many acute athletic and orthopedic injuries, as well as provide non-operative, minimally invasive treatment for many musculoskeletal injuries that would otherwise require surgery or become chronic untreatable conditions.

Currently Dr. Blecher serves as a team physician for Los Angeles Valley College, College of the Canyons (Valencia, CA) and Notre Dame High School (Sherman Oaks, CA). He has also served as a medical consultant for ESPN and as the treating physician for the Summer X-Games in Los Angeles, as well as the WTA LA Women’s Tennis Championships and USTA Men’s Tennis Farmer’s Classic. Dr. Blecher is also the Medical Director of the Center for Rehabilitation Medicine at SCOI and the Director of the SCORE Concussion Program.

In his free time, Dr. Blecher has enjoyed traveling, hiking, tennis, racquetball, soccer, skiing, whitewater kayaking, SCUBA diving and spending time with his wife and family. Having undergone multiple back surgeries himself, he has a personal understanding of what patients and athletes go through to try and return to what is most important to them.

 

Concussion safety: Overcoming the culture of resistance

By Andrew Blecher, MD

Primary Care Sports Medicine:

"It's just a bruise." "

I'm hurt but I'm not injured."

You are supposed to play through pain.

"I just got my bell rung."

"It's just a ding."

It's a badge of courage. "I can walk it off."

"I can clear the cobwebs."

"I just saw stars for a second. This happens all the time. It's no big deal."

"If I tell someone, then I will have to sit out."

"I don't want to miss this game."

"I don't want to let my team down."

"I just need to make one more play." "

Let me just finish this quarter."

"Let me just finish this game."

"I just need to get one more yard, one more basket, score one more goal, and make one more play. Really I'm fine."

The refrain is so familiar. I hear it all the time and, as an athlete myself, I remember it going through my own head. Where did I learn this? From my coaches? Parents? The media? Or was it innate? The minimizing of concussion and of injuries of any kind in sport has been around forever. That badge of honor to play injured is ingrained in us. But is it right? Is it a badge of honor to drive drunk? "I'm just a little bit buzzed. I'm really ok. I just need to drive one more mile, one more minute. Drop off one more friend." Asking someone who is drunk if they feel ok to drive is not a good idea. Someone needs to take away their keys. Asking someone who is concussed if they are ok to play is not a good idea either. Someone needs to take away their helmet. People who are mentally impaired cannot make appropriate decisions about themselves. That ding you just got in making that tackle,  or that header or when you hit the ground ... believe it or not, it made you mentally impaired.

Studies show that over 90% of concussions resolve very quickly and probably never even require a visit to the doctor's office. Most concussed athletes can safely return to play in one week. But there are some who have symptoms that last for weeks or even months. Why does this happen to some athletes and not others? Before I walk into a patient room for the first time, if the presenting complaint is ongoing concussion symptoms, I can always predict what the reason is. Either they have a risk factor in their history such as history of migraines, epilepsy, learning disability, Attention Deficit Disorder or previous concussion OR they played through their injury. Every concussion is different, but the moment an athlete tells me that they kept playing after the hit, or they didn't tell anyone, or they finished the game, or they played two more games, etc, etc, I know the athlete is going to be in for a long recovery. These are the athletes who take weeks to months to recover.

The brain needs to heal from its injury. When treated appropriately, it has the ability to do this rather quickly. But it's the times when it doesn't get the chance that we run into problems. Continuing to play on a broken leg will slow down the healing process. So does continuing to play with a concussed brain. Every fall season my office is filled with these athletes who thought they were trying to help the team by continuing to play with a concussed brain. Not only do they not play well but the symptoms get worse and they eventually end up in my office. Now not only can they not perform due to the headache and dizziness and lack of focus, but now they also can't even pay attention in school. So we sit them out of school and they miss practices and games and sometimes entire seasons and school semesters. Preventable? Absolutely. How? By changing the culture of resistance.

If you want to get back to playing as soon as possible, if you really want to do what is best for yourself and for your team, if you really want to recover as quickly as you can, then you need to give your brain IMMEDIATE rest and recovery. Your teammates and coaches should be disappointed in you for trying to hide your symptoms. They should not be proud that you tried to play through it. They should also be disappointed in themselves for not recognizing the signs earlier. You need to keep an eye on each other and report when you see a teammate acting abnormally, when something's not right. Make a pledge at the beginning of the season that, for the good of the team, you will report your own and each other's concussion concerns, that you will be vigilant about reporting, and will wear the reporting as a badge of honor. This is the culture that we need. This is what is best for the team and for each and every athlete that steps on the field. How do we create this culture? We educate on concussion. What is the biggest barrier to success? The phrase: "But this is how we have always done it in the past."

Coaches, parents, players: You now have the ball. Run with it.

Andrew Blecher, MD

Primary Care Sports Medicine

Southern California Orthopedic Institute

Van Nuys, CA

My Bio My Message

Deron Colby is a practicing lawyer with the Janus Capital Law Group in Irvine, California.  A native Southern Californian, Deron has been involved in youth sports his entire life, first as an athlete and later as a coach. In September 2001 his 17-year-old nephew, Matthew Colby, collapsed on a high school football field and later died from Second Impact Syndrome, a rare and often fatal condition resulting from multiple, successive undiagnosed/untreated concussions. Matt’s loss changed the way Deron viewed youth sports.  When his research on concussions and Second Impact Syndrome disclosed a dearth of information on the subject designed for sports parents, Deron sent an email to MomsTEAM’s Brooke de Lench to ask for her help in educating parents, coaches, athletes and health care professionals about the danger of sports-related concussions. That email led de Lench to establish the website’s pioneering concussion safety center.  As a way to help his sister, Kelli, heal from the loss of her son, Deron also established The Matthew Colby Foundation, which has provided Kelli a platform for speaking to groups of trainers, coaches and others involved in youth sports regarding the dangers of undiagnosed/untreated concussions, and led to Deron’s appearance on a number of television programs to talk about sport-related concussions, including an episode of ESPN’s investigative journalism series, “Outside the Lines.”

I’m not a doctor. I’m not a medical professional or expert on concussions. Candidly, the sight of blood makes me nauseous. I’m not qualified to explain anything in medical terms. I leave that up to those that are capable of such explanations. I’m here through tragedy. What I am qualified to tell you is a story of what happens when every single person in a long line of what I call “carekeepers” fail. What happens when the entire system shuts down. 

I still remember the day vividly as if it were yesterday.  Time doesn’t heal every wound. On the evening of Friday, September 28, 2001, I received a call from my dad that Matt, my 17-year-old nephew, had been admitted to the hospital. My dad’s voice didn’t sound right. His words were, “It isn’t good,” but he didn't provide any details.

As I was driving to hospital I tried to assure myself that it was a broken bone or something equally painful but fixable. I knew in the back of my mind, however, that it was something more. My dad isn’t easily shaken, and he was shaken. “How bad could it possibly be,” I thought, “Matt never gets sick, is strong, healthy, happy.”

Minutes after arriving at the hospital I learned that Matt had taken his last unassisted breath an hour earlier and that any further bodily functions would be machine- assisted and for the sole purpose of harvesting his organs. My family was shocked, devastated, and in a state of disbelief.

After trotting off gingerly following a few routine plays, Matt collapsed on the trainer’s table. My dad, his grandfather, described how he held Matt’s hand as a tear rolled down his cheek. Efforts to revive Matt on the way to hospital failed.  It wasn’t until months later that I learned that Matt had died from what is referred to as “Second Impact Syndrome” or “SIS.” I also came to learn that Matt’s death was preventable. Matt’s death shook the core of my family and sent shock waves through high school football, not only locally in Southern California but also nationally.

From the beginning, which followed the end of Matt’s short life, it was clear to me that concussion protocol, prevention, treatment and education, at every level, was what can only be described as a “mess.” The Internet revealed vastly differing views from respected medical professionals with no real consensus.  The state of disarray made it difficult to determine where things went wrong. That’s when I turned to Brooke de Lench at MomsTeam. That was in the fall of 2001, With Brooke’s help, I started to unravel the mystery. What I found was as disconcerting as it was astonishing. All of the carekeepers, those responsible for protecting Matt, had failed.

From the doctor who misread and misdiagnosed Matt’s symptoms, to the athletic trainer who dismissed the warning signs, to the head coach who ignored the doctor’s admonition to avoid any “head hitting,” to Matt’s friends who knew of his severe symptoms but didn’t have the training to know to tell someone, yes, even to Matt’s family. Telling is a quote from Matt’s head coach, Dave Perkins: “Matt really had no symptoms of having a head injury,” Perkins said. “He had slight headaches and he told us about them and he was cleared to play.”[1]  I know now, and hopefully Mr. Perkins knows now, that even a “slight headache” is indeed a symptom of having a head injury.  The week before Matt’s death I recall inviting him to the movies. He cancelled on me the next day, saying that he had a “really bad headache.” Less than a week later he was gone.  “Why,” I asked myself, “had everyone failed Matt so horribly?” Why didn’t I ask him more questions about his headache? Today I would have; back then I had no idea.

I’ve come to learn that it takes education and awareness, from the top of the carekeeper tree to the roots of the tree. Every single person, every branch, has an obligation to pay attention, ask questions, educate and protect our children. It’s been 15 years since Matt died. Education, awareness, identification, prevention, and treatment of head injuries, specifically concussions, has improved, there is no doubt. The question is has it improved enough? Sadly, I don’t think so.

"Coin flip"

On September 24, 2015, an article appeared in a local newspaper, The Daily Pilot, about Sutty Barbato, a standout high school football player from Corona Del Mar High School, in Newport Beach, California, a very affluent area of Southern California, mere miles from where Matt went to high school.[2] Due to what were described as “multiple concussions [Sutty] suffered during his sophomore and junior years”, Sutty spent most of his junior year in the press box. The CDM coach who sat next to Sutty that year was Dan O’Shea, the then defensive coordinator. Coach O’Shea became the head coach Sutty’s senior year. Even Coach O’Shea said that during Sutty’s junior year, he didn’t want Sutty to play another down, as he was “concerned with [Sutty’s] future.”

Incredibly, Coach O’Shea said that in the off-season before Sutty’s senior year it was a “coin flip” as to whether Sutty would play his senior year.  He said that he had a “lot of conversations with the parents, who love [Sutty] to death and who are obviously most interested in his health,” and “we were encouraging Sutty not to play.” Ultimately, Coach O’Shea said that it was “our position, along with the parents, was that it needs to be Sutty’s decision. As a young man, he’s very mature, he’s very conscious of his brain, and the need to be in complete health for the rest of his life.” Mr. O’Shea then went on to detail certain “precautions” he would take to prevent further concussions, such as no contact during practice and use of a skull cap and Guardian Cap (worn in the NFL). “So far,” said Coach O’Shea, “we’ve been OK. We cross our fingers every game that he comes out healthy.”  The article went on to laud CDM’s successes, number two ranking in the CIF Southern Section Southwest Division Poll and Sutty’s outstanding, game-changing play.

The article acknowledged that Sutty said he doesn’t really think about the possibility of suffering another concussion. Coach O’Shea said he thinks about that every day. The article ends with “I love this kid as a son.” Coach O’Shea said. “I admire him as much as any young man I’ve coached. When you love and care about someone, you want to make sure they remain healthy.”

Fourteen years after Matt’s death, Sutty’s fate is left to a “coin flip.” Fourteen years after Matt essentially decided for himself, without the benefit of what we know today about concussions, to continue to play a game that ultimately killed him, Coach O’Shea and Sutty’s parents leave it up to Sutty to make the decision to play because, according to Coach O’Shea, Sutty is “very conscious of his brain.” Sutty’s health, and his life, are left to fate and Coach O’Shea’s “crossed fingers.” You are right Coach O’Shea, when you love and care for someone, you do everything in your power to make sure they remain healthy. In Sutty’s case that should have meant never letting him strap on a helmet again.

Matt did not know best. Sutty did not know best. No one should leave the fate of their child to a flip of a coin or crossed fingers. Things have changed and for the better. But they haven’t changed enough. Only through the efforts of organizations such as MomsTeam Institute and programs like its SmartTeams™ #TeamUp4ConcussionSafety will we prevent another tragedy like Matt’s. It’s about changing attitudes, perceptions and promoting action. The decision to risk a child’s long term health and possibly death, should never be left to a child.   

[1] http://articles.latimes.com/2001/dec/07/sports/sp-12328

[2] http://www.latimes.com/socal/daily-pilot/sports/tn-dpt-sp-0925-cdm-football-sutty-barbato-20150924-story.html

My Bio My Message

Tracey Covassin, PhD

Dr. Covassin is an Associate Professor and licensed athletic trainer at Michigan State University in the Departments of Kinesiology and Intercollegiate Athletics. Her research in sport-related concussion includes sex and age differences in concussion outcomes, neurocognitive impairments, and issues associated with multiple concussions. Dr. Covassin currently directs a multi-site high school and college sport-concussion outreach program in the Mid-Michigan area. Dr. Covassin has over 65 professional publications and 80 professional presentations, and has received funding as a principal investigator from external sources including the National Operating Committee of Standards for Athletic Equipment (NOCSAE), BrainScope, National Athletic Trainers Association (NATA) Research and Education Foundation, NFL Charities, and the Centers for Disease Control and Prevention (CDC).

In 2013 she was appointed to the Institute of Medicine (IOM) and National Research Council Sport-Related Concussion in Youth Committee. After reviewing current literature on concussions, their causes and the relationship of hits to the head during sport, effectiveness of protective devices and equipment, screening and diagnosis, prevention, management and treatment, the committee released in October 2013 an evidence-based report titled “Sport-related Concussions in Youth: Improving the Science, Changing the Culture."

Dr. Covassin has recently been honored with an invitation to the White House for President Obama’s Healthy Kids & Safety Sports Concussion Summit, to speak at Fort Carson for the Defense Center of Excellence of Psychological and Traumatic Brain Injury, on an expert panel at the American Medical Society for Sports Medicine, and was a presenter in 2014 at MomsTEAM's SmartTeams Play Safe summit at Harvard Medical School.

 

Changing the Culture of Sports-Related Concussion

By Tracey Covassin, PhD

Sport-related concussion is a growing health concern, particularly in collegiate populations. Between 1.6 and 3.8 million sport- and recreation-related traumatic brain injuries occur annually in the U.S (1) and comprises approximately 5-9% of all high school and collegiate athletic injuries. (2) Approximately 40% of high school and collegiate student-athletes do not report their concussion symptoms to an authoritative figure.(3-5) Athletes who do not report their sport-related concussions can experience worse recovery outcomes (e.g., chronic post-concussion syndrome).(6) Student-athletes do not report sport-related concussion due to lack of awareness, fear of removal from participation, and not wanting to let their teammates down.(3, 5,7) Although raising awareness and improving sport-related concussion knowledge is critical, these outcomes do not guarantee changes in attitudes and reporting behaviors. (5, 8-10) Finding ways to change the culture of sport-related concussion is crucial to improving the health and wellness of student-athletes.

Sport-related concussion requires a change in our “play through pain” culture to ensure the short and long term health of our high school and collegiate student-athletes. The current “play through pain” and “show no weakness” culture may be appropriate for certain musculoskeletal injuries, but not brain injuries such as sport-related concussion. Programs that increase sport-related concussion knowledge and awareness and translate these changes into attitude and behavioral improvements toward sport-related concussion are critical for changing the sport culture. MomsTeam has developed a Game Plan for Concussion Safety which is an interactive website aimed towards changing the culture in athletes. Athletes need to be in a safe environment and feel that they will not be punished by their coaches or teammates if they report their sport-related concussion. This interactive website will provide athletes with avenues and information that will help change the culture of reporting behaviors of sports-related concussions.

References

  • 1. Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. Journal of Head Trauma Rehabilitation 2006;21(5):275-278.
  • 2. Gessel L, Fields S, Collins C, et al. Concussions among united states high school and collegiate athletes. Journal of Athletic Training. 2007;42:495-503.
  • 3. McCrea M, Hammeke T, Olsen G, et al. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 2004;14(1):13-17.
  • 4. Kaut K, DePompei R, Kerr J, et al. Reports of head injury and symptom knowledge among college athletes: Implications for assessment and educational intervention. Clin J Sport Med. 2003;3:213-221
  • 5. Register-Mihalik J, Guskiewicz K, McLeod T, et al. Knowledge, attitude, and concussion-reporting behaviors among high school athletes: A preliminary study. Journal of athletic training. 2013;48(5):645-653.
  • 6. Cantu R. Second-impact syndrome. Clinical Sports Medicine. 1998;17:37-44.
  • 7. Callaghan RC, Taylor L, Cunningham JA. Does progressive stage transition mean getting better? A test of the Transtheoretical Model in alcoholism recovery. Addiction. 2007;102(10):1588-1596.
  • 8.Anderson B, Pomerantz J, Mann J, et al. "I Can’t Miss the Big Game”: High School (HS) Football Players’ Knowledge and Attitudes about Concussions. Presented at the Pediatric Academic Societies Annual Meeting. Washington DC May 6 2013.
  • 9. Kroshus E, Daneshvar DH, Baugh CM, et al. NCAA concussion education in ice hockey: an ineffective mandate. British journal of sports medicine. 2013.
  • 10. Torres DM, Galetta KM, Phillips HW, et al. Sports-related concussion Anonymous survey of a collegiate cohort. Neurology: Clinical Practice. 2013;3(4):279-287.
My Bio My Message

Brooke de Lench

Brooke de Lench is the Founding Executive Director of MomsTEAM Institute, Inc. a 501(c) (3) non-profit organization, and Founder/Publisher of MomsTeam.com,® now in its 16th year as the most trusted resource for sports parents of comprehensive, well-researched, objective information on a wide array of youth sports health, safety, nutrition, and sports parenting topics.

Recognized as a visionary thought leader in youth sports safety and a pioneer in concussion education, Ms. de Lench is Producer/Creator of the critically acclaimed PBS documentary, The Smartest Team: Making High School Football Safer, and the author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (Harper Collins).

The recipient of a NCAA-DoD Mind Matters Challenge Concussion Education grant* she is also a member of the UN International Safeguards of Children in Sports global coalition and is currently an Expert Reviewer for the Centers for Disease Control (CDC) Report to Congress on Management of Traumatic Brain Injury in Children.

An active journalist/blogger for MomsTEAM, Ms. de Lench is a sought-after lecturer, keynote speaker, and symposium panelist on a wide range of youth sport topics. Included among her recent appearances have been as a panelist at the Coalition for Concussion Treatment Concussion Awareness Summit during Super Bowl XLVIII (2014) at the United Nations in New York City, a recent Aspen Institute roundtable on "Playing Safety: The Future of Youth Football," and the national symposium on preventing sexual abuse in youth sports organized by the National Center for Missing and Exploited Children in Washington, D.C., and, most recently, as a speaker at the University of Maryland Francis Carey Law School on "The State of Concussions," a wide-ranging symposium on how to protect athletes through advances in law, public health, and medicine.

She also spoke at and organized the SmartTeams Play Safe™: Protecting the Health & Safety of the Whole Child in Youth Sports Summit which was recently held at Harvard Medical School, Boston, Massachusetts and was invited by David Satcher, MD past Surgeon General of the United States to serve on a two year Concussion education initiative from 2013-2015.\

The founder of the “Teams of Angels”, a MomsTEAM Foundation established in 2002 at the request of twenty families whose child had suffered a catastrophic sports injury or who died as the result of a sports accident or of an undetected ailment, she and the MomsTEAM staff has worked with over 300 such families to provide support, resources and ongoing information.

A past regular participant at the annual NFL-USA Football Health and Safety roundtable, Ms. de Lench has in the past consulted with the NFL and USA Football on how to make youth/ high school football safer, and consults with schools, sports leagues and many other national sports organizations on policy development and strategies for making sports programs safer, less stressful, and more inclusive.

Ms. de Lench is veteran of more than 300 live television appearances, has appeared on all the major television networks as well as the Today Show, Good Morning America, ESPN’s Outside the Lines, HBO’s Real Sports and is quoted frequently in the print press. Her opinion pieces have appeared on the op-ed pages of major newspapers nationwide and she will be featured in a number of upcoming Canadian, British and American television shows on her work as a youth sports expert and film producer.

She also co-authored a 2015 law review article in the University of Maryland Law's Journal of Business and Technology Law, Standard-Setting by Non-Governmental Agencies in the Field of Sports Safety Equipment: Promoting the Interests of Consumers or Manufacturers.

The mother of triplet sons, Ms. de Lench is a native New Englander and lives in the Boston area and is an avid kayaker, walker, bike rider and Pilate’s enthusiast.

Brooke de Lench Wikipedia Bio and Huffington Post

*MomsTeam will become SmartTeams™ in 2016/2017 with SmartTeams-Concussions to be the first of a series of microsites to launch.

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Brenda Eagan Brown

Brenda Eagan Brown is the statewide Program Coordinator for Pennsylvania’s Brain Injury School Re-Entry Consulting Program called BrainSTEPS. She received her Master’s Degree in the educational aspects of pediatric traumatic brain injury from the George Washington University, where she now serves as an adjunct professor in the graduate school. She is currently enrolled in a doctoral program at Johns Hopkins. Brenda is a Certified Brain Injury Specialist, serves on numerous state and national advisory boards. She is published, regularly presents at the state, national and international levels and has received multiple state/national awards for her work in brain injury.

Currently, she serves as an Expert Reviewer for the Centers for Disease Control (CDC) Report to Congress on Management of Traumatic Brain Injury in Children and has also co-authored a CDC document on return to school. She was chosen as an expert concussion presenter for the Obama appointed Institute of Medicine/National Research Council committee. Spearheading development and creation of PA’s Return to Learn Concussion Team Model, she has trained over 1,060+ school based teams in PA and the program was featured in the Wall Street Journal. Brenda serves as a national consultant for state Departments of Education. She created a website with a colleague focused on empowering educators: www.getschooledonconcussions.com, and has been charged with co-leading the first national Concussion Return to Learn Consensus paper for the National Collaborative for Children’s Brain Injury (NCCBI). Most importantly, Brenda has a brother who sustained a severe traumatic brain injury while they were teenagers, which is where her passion for helping families and students began. Brenda lives outside of Pittsburgh with her husband and 18 year old boy/girl twins who are both headed off to college in the fall of 2016.

 

The nation is abuzz regarding the importance of students self-reporting concussions. We know this is imperative due to the ramifications involved in sustaining a second concussion before the first one has healed. Additionally, schools are realizing the importance of consistently managing the steps involved in a student’s return to school/learn, which takes place prior to return to sports.

When a student of any age does not report a concussion and chooses to push through symptoms at school without alerting teachers, the brain is burdened with a dual role of attempting to recover while at the same time, keep up with new learning. This can potentially prolong the recovery trajectory. If the school is made aware of the concussion, academic adjustments can be established to support symptom resolution and recovery while enabling the student to remain in the classroom learning environment. For students moving towards future goals of graduation, work, and college the implications of not receiving academic supports during recovery to alleviate potential cognitive over-exertion is crucial, as it relates to attendance, new learning, and length of recovery.

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Dave Ellemberg, PhD
Neuropsychologist

Professeur agrégé Département de kinésiologie Laboratoire de la neuropsychologie du sport et du développement Université de Montréal

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Dr. Giza is Professor of Pediatric Neurology and Neurosurgery at the David Geffen School of Medicine and Mattel Children’s Hospital and director of the UCLA Steve Tisch BrainSPORT program.   From 2009 to 2013, he was co-chair of the American Academy of Neurology’s committee which developed an evidence-based Practice Guideline for Management of Sports Concussions. He currently serves on advisory committees for TBI/concussion for the Centers for Disease Control and Prevention, the National Collegiate Athletic Association, Major League Soccer, and the United States Soccer Federation, and has served as a clinical consultant for the National Football League, NHL and MLS.

A graduate of Dartmouth College, Dr. Giza received his M.D. from West Virginia University and completed his internship at the University of Pennsylvania. He then trained in Adult and Pediatric Neurology at UCLA. Before joining the UCLA Brain Injury Research Center, he worked on the Yosemite Search and Rescue team. Dr. Giza traveled to Afghanistan in 2011 as a civilian advisor to the Department of Defense.

As we prepare for another school year, in the wake of the Summer Olympics and with all the excitement of fall athletics, our focus again comes to sports and brain health.  While we recognize that there are many positive aspects of physical activity and sports participation, we must also recognize the potential for injuries like concussions and both short- and long-term effects of these injuries.

Many organizations across the country are embarking on efforts to educate student-athletes, coaches, parents and teachers to recognize the common signs and symptoms of concussion, as well as the mantra “When In Doubt, Sit ‘em Out”.  This seemingly simple statement reminds us to protect individuals with a suspected concussion from sustaining repeat injuries during the time when their brain is more vulnerable.  Studies demonstrate that there is greater risk for both repeat concussion and musculoskeletal injury in the athlete who has not yet recovered from a concussion and returns to contact sports prematurely.  More recent research suggests that athletes who play through symptoms or report symptoms later after a concussion take longer to recover and ultimately end up missing more school and more games.

It’s important to understand that there’s no single test on the sideline that accurately diagnoses concussion or mild traumatic brain injury. The goal, then, is to identify student-athletes suspected of concussion, remove them from contact risk and ensure that they get proper medical evaluation, follow-up and eventually re-integration to academic and athletic endeavors as rapidly and safely as possible.

And while education about concussions and sports safety is an important goal, the real objective is for that education to lead to positive behavior change among athletes in terms of concussion symptom reporting.  With that goal in mind, the NCAA and Department of Defense have launched the Mind Matters Challenge to foster the development of educational interventions designed to improve concussion and brain safety behaviors in sports.  MomsTEAM Institute's SmartTeams™ #TeamUp4ConcussionSafety program is one of the evidence-based educational protocols which has been developed as part of the Challenge, and we look forward to seeing all the groups participating in the Challenge make progress in this important area.

Moving ahead this fall, it’s important to remember the 4 “Rs” of concussion: recognize, remove, recover and return to activity – start with recognizing signs of concussion and removing the athlete from contact risk.

Play safe, play smart!

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Mark Herceg, Ph.D
Neuropsychologist

Mark Herceg, Ph.D., is the Commissioner of Mental Health for Westchester County, NY. In 2015, County Executive Robert P. Astorino created a Concussion Task Force and appointed Dr. Herceg as Chair of the 28 member group. As Chair, he was the lead author of the Task Force's "10 Best Practices for Concussion Management," produced in January 2016 and endorsed by the Brain Injury Association of America and New York State Chapter.

Dr. Herceg was honored in June 2015 for his efforts to increase concussion education and awareness with the “Founders Award” by the Brain Injury Association of New York State. He has helped shape concussion management practices and increase education and awareness in Westchester County in both youth and high school sports. In 2013 he authored a chapter on concussion management in the book “In the Arena” published by the NY State Bar Association.

Prior to his appointment, he was the Director of Neuropsychology at Burke Rehabilitation Hospital where he evaluated and treated individuals with various neurological changes, illnesses or brain injuries across the life spectrum. He has over 20 years experience evaluating and treating individuals with TBI,

Dr. Herceg is an Assistant Professor of Psychology in Clinical Neurology at Weill Cornell Medical College and a Lecturer in the Department of Epidemiology and Community Health at New York Medical College. He is also a member of the Big Ten/CIC-Ivy League TBI Research Collaboration.

Dr. Herceg sits on the Executive Board of the Sports Neuropsychology Society, is a member of the American Psychological Association, International Neuropsychology Society, and the National Academy of Neuropsychology, where he is the Chair of Social Media.

Dr. Herceg received his training at the Rusk Institute of Rehabilitation Medicine/NYU Medical Center, and received doctoral degree from the Ferkauf Graduate School of Psychology.

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James MacDonald, M.D., M.P.H.

Dr. MacDonald is a Clinical Assistant Professor of Pediatrics and Family Medicine at The Ohio State University (OSU) and a Pediatric Sports Medicine Specialist at Nationwide Children’s Hospital in Columbus, Ohio.  He is Team Physician for Ohio Dominican University and Bexley (OH) High School, and is a member of USA Swimming’s Sports Medicine Task Force. He was previously Team Physician for the University of California, Santa Cruz.

Dr. MacDonald has lectured widely and written numerous journal articles and book chapters on topics in sports medicine,  and is currently conducting research on pediatric concussions with a grant from the American Medical Society for Sports Medicine.  He is an Associate Editor and blogger for the Clinical Journal of Sports Medicine (CJSM), and for the Journal of Dance Medicine and Science (JDMS).  He blogs for CJSM and maintains an active presence on social media.

A cum laude graduate of Harvard College, Dr. MacDonald received his M.D. from Harvard Medical School. He trained in Family Medicine at the Maine-Dartmouth Family Practice Residency and in Sports Medicine at Boston Children’s Hospital, and most recently received his M.P.H. from the College of Medicine at OSU.

Board Certified in Family Medicine, with a Certificate of Added Qualification in Sports Medicine, Dr. MacDonald is a Fellow of the American College of Sports Medicine as well as a Fellow of the American Academy of Family Physicians.

Dr. MacDonald has had a lifelong devotion to sports and physical activity.  He lettered in track and cross-country at Harvard, and is an active bike commuter who always wears his helmet!  He is enjoying watching his twin eleven-year-old daughter and son adopt sports ranging from soccer to karate to weight lifting.

 

James McDonald, MD

Overcoming the Culture of Resistance

I have spent almost twenty years managing sport-related concussions (SRCs) in populations ranging from elementary school to university students. For the last six years, I have focused solely on young kids: I see literally hundreds of pediatric concussions each year as a sports-medicine physician at Nationwide Children’s Hospital in Columbus, Ohio.

During these twenty years, the conversations—with athletes, coaches, parents, teachers-- around SRCs have changed, often in dramatic ways, and mostly for the better. These changes reflect both the advance in understanding we have of the injury as well as the large gap that remains.

Looking back, there was a point in time roughly five or six years ago that I found that I was rarely having too many conversations where I was needing to advocate for keeping the athlete out of sport until they were fully healed. The half-time nudge from the coach (can we get him back out for the second half) or the pushback from a parent (don’t you think she’s ready to get back on the ice) was something I encountered less frequently. The parents and coaches and teachers were on board: make sure Jane or John is completely better before we get them back on the field.

But I am still taken aback at times. I still find, even in 2016, that I am occasionally the only advocate for the youth athlete in a situation that is crystal clear. And right now, I am writing to you parents out there, and I am writing to you as a physician, as a public-health trained advocate, and as a parent myself: sometimes, you have to take a step back and remember your child may be suffering from a traumatic brain injury. The culture of resistance still exists is our circle, the circle of parents with kids in sports. And it has to change.

I am thinking of a recent incident where I was covering a large soccer tournament here in Columbus. Over one hundred elite youth travel teams from around the country and Canada had come for a weekend of games conducted on dozens of fields around the city. Many of you readers know the scene: well over a thousand athletes and their parents, siblings and coaches, staying at La Quinta and Comfort Inns, eating at Chipotles and Olive Gardens. It’s big business. Families invest an enormous amount of time and money in these events.

I was at our medical tent on the first day of the tournament when one of our certified athletic trainers (ATCs) was summoned to fetch a downed athlete. Coming back on the cart from a field a half-mile away, the ATC had a mom and her 12-year-old son. The story was that the son had been tackled in front of the goal and went to the ground hitting his head. He did not get up, and the referee summoned the coach over. The player did not lose consciousness, but he could not remember fully what had happened. He couldn’t remember whether it was the first or second half where he had been hurt. He was in tears and confused as I began my evaluation at the medical tent.

I won’t go into the details of the neurological examination I conducted, but, in brief, I concluded without much difficulty that he had sustained a concussion, but that he had not sustained a serious head injury (e.g. cranial fracture) or neck injury. I began to tell the mother that though they didn’t need to go to the ER, they did need to come back later in the day for a re-assessment by our medical staff to determine that he was neurologically stable, because if ‘things had changed’ he would need to head to a hospital. And I informed the mother that, given her son had sustained a concussion, he was done for the day, and was out for the tournament. Our Ohio concussion law, like the ones that exist in every state in the USA, is quite clear on this: his day was over, and the best he could hope for was a re-evaluation the next day by a physician to see if he were ready to begin a return-to-play protocol. Within our institution, that would mean he would be advanced to some level of physical activity short of full competition.

His tournament was over.

The mother proceeded to express her irritation with this decision. She attributed her son’s condition to his ‘poor play’ during the game, suggesting he had taken a dive and was crying more in frustration than from a head injury. She doubted my diagnosis, though she had no explanation for why her son could not explain details of his injury or the game that he should have (this is known as ‘retrograde amnesia’).

I proceeded to explain to the mother that her son’s diagnosis was clear. I literally quoted (as best I could from memory) the 2012 Zurich consensus statement1

  • Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head.
  • Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously.

I had to end the conversation at some point, as I had to head to another field to conduct other medical evaluations. I signed the requisite documents, informed the tournament director that the young man was ‘out,’ and I ended the conversation with the mother in this fashion: “It’s the law in the state of Ohio, ma’am. Your son is not playing any more in this tournament.”

It was not the most satisfactory way to end a conversation.

I will be the first to tell you in my career as a physician that I have been wrong at times where the patient has been right. This is not a story of my medical brilliance. This is not meant to be a story about how well I handled a situation.

This is a story of parental resistance to the effective treatment of a concussion, a traumatic brain injury.

If our children have sustained a concussion, or there is even good reason to suspect that they have sustained a traumatic brain injury, the best approach is caution. This decision needs to be made apart from considerations of money, and time investments, and scholarships, and any other condition than patient safety.

As bad as an ACL rupture may be, we have two knees, and our knee joint does not give us our personality or intelligence. We have one brain. It is arguably the most important argument we have. We have to treat it ‘right’.

We still have a lot to learn about SRCs, but we know without a doubt in 2016 that a concussed brain should avoid subsequent injury until it has healed.

So next time we are in the role of supporting our children in their sports, let’s work with all the members of the team on ensuring there is a sporting culture that encourages reporting of symptoms and that encourages a cautious and reasonable approach to getting back to sport. We want our kids ‘in the game.’ We want them, too, to have a healthy brain for a lifetime.

1 McCrory P, Meeuwisse W, Aubry M, et al. Consensus statement on concussion in sport. Clinical Journal of Sport Medicine 2013; 23: 89 – 117. http://journals.lww.com/cjsportsmed/Fulltext/2013/03000/Consensus_Statement_on_Concussion_in_Sport_the_4th.1.aspx, accessed 5/15/16

2 http://www.ohsaa.org/medicine/Concussions/ConcussionRegulations.pdf, accessed 5/15/16

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Tamara Valovich McLeod, PhD, ATC

Dr. Tamara Valovich McLeod is the Athletic Training Program Director, Professor of Athletic Training, Research Professor in the School of Osteopathic Medicine in Arizona, and the John P. Wood, D.O., Endowed Chair for Sports Medicine at A.T. Still University in Mesa, Arizona. Dr. McLeod completed her doctor of philosophy degree in education with an emphasis in sports medicine from the University of Virginia. She is the director of the Athletic Training Practice-Based Research Network and her research has focused on the pediatric athlete with respect to sport-related concussion.  Her current work is investigating the short- and long-term effects of pediatric sports concussion as well as recovery following concussion on traditional concussion assessments and health-related quality of life. Dr. McLeod also has research interests in the measurement properties of concussion assessment tools and educational interventions to improve concussion awareness. Dr. McLeod was a contributing author for the NATA Position Statement on the Management of Sport-Related Concussion, the lead author on the NATA Position Statement on the Prevention of Pediatric Overuse Injuries, and a consultant and contributing author on the Appropriate Medical Coverage for Secondary School-Aged Athletes. Dr. McLeod serves on numerous editorial boards, and publishes frequently in the athletic training and sports medicine journals and is a NATA Fellow.

 

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William P. Meehan III, MD
Sports Medicine Physician

William P. Meehan III, MD, is Director of the Micheli Center for Sports Injury Prevention at Boston Children's Hospital, and Assistant Professor of Pediatrics at Harvard Medical School. A graduate of Harvard Medical School, Dr. Meehan is board certified in pediatrics, pediatric emergency medicine and sports medicine. He conducts both clinical and scientific research in the area of concussive brain injury. His research has been funded by the National Institutes of Health, the National Football League, and the Center for the Integration of Medicine and Innovative Technology.

Dr. Meehan is the author of numerous medical and scientific and publications, and served as guest editor for the January 2011 edition of Clinics in Sports Medicine entitled, Concussion in Sports.

He is author of the critically acclaimed book Kids, Sports and Concussion: A Guide for Coaches and Parents, and is featured in the MomsTEAM 2013 documentary, The Smartest Team: Making High School Football Safer, which is streaming free on this website.

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Johna Register-Mihalik, PhD
Professor of Exercise & Sport Science

Johna Register-Mihalik is an assistant professor in the Department of Exercise and Sport Science at UNC-Chapel Hill. She also serves as a Research Scientist at the Matthew Gfeller Traumatic Brain Injury Research Center and the Injury Prevention Research Center at UNC-CH. She completed her undergraduate work at the University of Alabama in 2004 in Athletic Training and both her graduate (MA-2006; PhD-2010) and postdoctoral training (2012) at UNC-Chapel Hill.

Dr. Register-Mihalik’s research interests include the negative consequences, prevention, education and clinical management of sport and recreationally related traumatic brain injury (TBI). Her primary work centers on improved care, education and behavior change concerning TBI among physically active children and adolescents. In the future, she hopes to expand these injury prevention methodologies to other settings and injuries. Her work has been published in a variety of journals across the sports medicine and brain injury literature.

In addition to her professional work, she is a parent, an avid sports fan, and has worked clinically as an athletic trainer at the youth and high school sport levels.

The culture of sport and issues related to concussion are complex and multifaceted. As such, addressing these complexities requires an approach that involves stakeholders at all levels of society from the athletes themselves all the way to legislators, and the media. The more of these levels and individuals we can involve, the more likely we are to see true change that creates as positive and safe environment for sport participation as possible.

As coaches and parents, we are the adults, we are those with experience, and we are the ones who our children look up to when learning to make choices and how to respond to adversity. There is an enormous body of work that illustrates the strong influence we have on our children as both parents and coaches in the sporting environment. One of the key situations in which our influence becomes apparent is in response to injury, especially concussion, which sometimes is unseen or not as noticeable as an ankle sprain or broken bone.

We have an opportunity to set a positive example, to use the wonderful attributes of sport to not only teach our children the great things that sport has to offer such as teamwork, persistence, and working through hard things, but also how to take care of their bodies and their brains. Research shows that our words, body language, and messaging matter. It’s important that we set the context for what we want our children to learn and how we want them to respond. Pressure from parents and coaches is one of the key factors that play into young athletes’ decisions on how they respond to an injury. For instance, we want our children to be persistent and to not quit because things get tough, but we also want them to know when they are injured and should not participate. We want them to know that it is a good thing to take care of yourself and your teammates and that coming out of a game or practice because of an injury is not a sign of weakness, but a sign of strength!

We can create a community of safety by sharing our knowledge, starting community discussions, and encouraging our teams and leagues to discuss safety on a regular basis and in a positive way (not just as a box to check). It doesn’t have to be boring and in contrast to sport, it should be a part of the sport and a fun one at that. If our children learn healthy behaviors, develop positive attitudes, and come to expect a culture of safety, they will carry this with them throughout their athletic journey. We as parents and coaches can also do the same. When it is the “norm”, people will do it!

So let’s get out there and use the latest research, free and great resources, technology, and the evidence-based messages that are available through sources like the Centers for Disease Control, MomsTeam, and other websites and sources to raise awareness, educate, and train ourselves, as well as all key stakeholders in the sporting community to create a culture of safety and health!

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Carla Morton, PhD
Neuropsychologist

Dr. Morton specializes in assessment of neuropsychological functioning in children and young adults with stroke, demyelinating disorders, concussion, tic disorders, and congenital heart disease. Her patients have a variety of conditions, including prematurity, low birth weight, chromosomal abnormalities, hydrocephalus, epilepsy, traumatic brain injury, brain tumors, and epilepsy. She also has additional training in the assessment of Autism Spectrum Disorders. In additional to her clinical practice, Dr. Morton also conducts forensic neuropsychological evaluations.

Dr. Morton is a Licensed Psychologist in Texas, and she is currently completing requirement for board certification in Clinical Neuropsychology through the American Board of Professional Psychology. Dr. Morton maintains memberships in several professional organizations, including the American Psychological Association, Society for Clinical Neuropsychology, the American Academy of Clinical Neuropsychology, and the International Neuropsychological Society. In addition to her clinical work, Dr. Morton has interests in healthcare policy, legislative advocacy, and decisional capacity of minors. She is currently a staff member of the Family Advisory Council in the Neurosciences Department at Cook Children's Medical Center and has previously served as a guest member of the Ethics Committee at the University of Illinois at Chicago Medical Center. Dr. Morton has been involved in the concussion management program with the National Hockey League.

Dr. Morton has previously held the Music Therapist – Board Certified (MT-BC) credential and has served as the government relations chair for the Illinois Association for Music Therapy. She continues to maintain a specific interest in the therapeutic use of music and other creative arts.

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Rosemarie Scolaro Moser, PhD
Neuropsychologist

Rosemarie Scolaro Moser, PhD, ABN, ABPP-RP is a practicing neuropsychologist and director of the Sports Concussion Center of New Jersey, and currently serves on the U.S. Centers for Disease Control and Prevention (CDC) Expert Panel on Pediatric Mild Traumatic Brain Injury. Dr. Moser is an active scientific researcher and author of Ahead of the Game: The Parents’ Guide to Youth Sports Concussion (Dartmouth College Press). Her original research publications have appeared in journals such as Neurosurgery, Journal of Pediatrics, Brain Injury, American Journal of Sports Medicine, Journal of Athletic Training, Professional Psychology, Archives of Clinical Neuropsychology, and Applied Neuropsychology. She is a co-author of the upcoming guidelines that will be developed at the 5th International Consensus Conference on Concussion in Sport in Berlin, Germany.

Dr. Moser received her PhD from the University of Pennsylvania and completed post-doctoral training at the University of Maryland at Baltimore. She is a diplomate of the American Board of Professional Neuropsychology and of the American Board of Professional Psychology in Rehabilitation Psychology, a fellow of the American Psychological Association and of the National Academy of Neuropsychology, and has been awarded the American Psychological Association Presidential Award for Advocacy in Psychology.

Dr. Moser has served as the President of the New Jersey Neuropsychological Society, President of the New Jersey Psychological Association, and as Treasurer of the National Academy of Neuropsychology. She is an adjunct professor of clinical psychology at Widener University and has been recognized with “Top Doc” and “Best of Fitness” distinctions by Suburban Life Magazine (Philadelphia). Dr. Moser has provided concussion services for over 25 years and appears in the public television (PBS) documentary, The Smartest Team-Making High School Football Safer, and has been a longtime contributor to and concussion expert for MomsTEAM.com.

 

Concussion Reporting in Athletes: Not so simple…

By Rosemarie Scolaro Moser, PhD, ABN, ABPP-RP

Now that all 50 U.S. states and the District of Columbia have youth concussion laws in place, we have jumped the biggest hurdle, right? Then why is that there is still a BIG problem in concussion reporting? Why is it that athletes still continue to play in a game when they are concussed? In reality, changing state laws may be a phenomenal feat; however changing the culture of sport and attitudes about concussion is even harder.

Concussion education programs are step one in changing the culture and attitudes. A research 2014 study published by Register-Mihalik and co-authors revealed that only 40% of concussion events and 13% of “bell-ringer recalled events” were disclosed by high school athletes. (1) That means that more than half of these injuries were not reported. Importantly, in this study, reporting by athletes was associated with “increased knowledge” about concussion.

But a 2015 study by Emily Kroshus and co-authors found that it is not just knowledge about concussion that makes the difference in an athlete reporting concussion. (2) Rather, measuring an athlete’s “intention to report” symptoms is more strongly associated with reporting than just knowledge alone. In other words, it is the athlete's attitude before a concussion which better predicts if the athlete will report the concussion. The implications of this study are that we should not just focus on increasing knowledge, but also strongly focus on doing what we can to change athletes’ attitudes about reporting.

Yet, focusing only on the athlete is not enough. Pressure from coaches, teammates, fans and parents can also strongly influence the athlete to continue playing rather than reporting the concussion. A second study by Kroshus and colleagues in 2015 (3) revealed that more than 25% of the 328 college athletes they studied admitted that they had experienced pressure from a coach, teammate, parent, or even fan, and that such pressure, especially where it came from more than one group, increased the likelihood that the athlete would continue to play after a head impact.

Even if we target coaches and educate them, athletes continue to not report. In a 2014 study by Rivara and colleagues, 69% of concussed athletes reported that they played with symptoms. (4) Indeed, 40% of them admitted that their coaches did not know they had sustained a concussion. In fact, just because a coach had been educated about concussion did not mean that he or she was more aware of the occurrence of concussion in their athletes.

Taken together, these four studies remind us that changing the culture of sport and changing the attitudes about concussion takes more than just legislation. We need to consider myriad factors that may contribute to an athlete’s not reporting concussion, some of which may still need to be identified. Concussion education is the first step, but it must occur in the context of a multifactorial, complex psychosocial system that includes numerous “players,” not just the athletes.

1. Register-Mihalik JK, Guskiewicz KM, McLeod TC, Linnan LA, Mueller FO, Marshall SW. Knowledge, attitude, and concussion-reporting behaviors among high school athletes: a preliminary study. J Athl Train.  2013. Sep-Oct;48(5):645-53. doi: 10.4085/1062-6050-48.3.20. Epub 2013 Jul 12.

2. Kroshus E, Baugh CM, Daneshvar DH, Nowinski CJ, Cantu RC. Concussion reporting intention: a valuable metric for predicting reporting behavior and evaluating concussion education. Clin J Sport Med. 2015 May;25(3):243-7. doi: 10.1097/JSM.0000000000000137.

3. Kroshus E, Garnett B, Hawrilenko M, Baugh CM, Calzo JP. Concussion under-reporting and pressure from coaches, teammates, fans, and parents. Soc Sci Med. 2015 Jun;134:66-75. doi: 10.1016/j.socscimed.2015.04.011. Epub 2015 Apr 20.

4. Rivara FP, Schiff MA, Chrisman SP, Chung SK, Ellenbogen RG, Herring SA. The effect of coach education on reporting of concussions among high school athletes after passage of a concussion law. Am J Sports Med. 2014 May;42(5):1197-203. doi: 10.1177/0363546514521774. Epub 2014 Feb 25.

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Kelly Sarmiento
Center for Disease Control (CDC) Georgia

Kelly Sarmiento, MPH, serves as a health communications specialist in the Division of Unintentional Injury Prevention’s Home and Recreation Team. She is responsible for leading the CDC's HEADS UP campaign, which is a series of educational initiatives which all have a common goal: protect kids and teens by raising awareness and informing action to improve prevention, recognition, and response to concussion and other serious brain injuries.

Ms. Sarmiento began her career at CDC in the National Center for Injury Prevention and Control’s Division of Injury Response. In this role, she served as the health communications team lead and directed educational campaigns on traumatic brain injury and emergency response and provided strategic direction regarding health communication for the division’s state injury programs.

Ms. Sarmiento received her Bachelor of Arts degree in Anthropology and Spanish from the University of California, Santa Barbara, and her masters of public health degree from Yale University School of Epidemiology and Public Health. She has developed more than 60 educational products and tools, as well as authored over 20 presentations, abstracts, and chapters, and has received many awards for her work in public health and innovation in health communication.

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Sr Editor and Dir of Research SmartTeams

Ms.  Straus is an award-winning journalist and attorney.  She has been Senior Editor of MomsTEAM.com since its launch in 2000.  A prolific writer and editor, Ms. Straus has authored or edited thousands of articles for MomsTEAM on a wide range of youth sports safety topics, with concentrated experience writing about concussions, sports injury prevention, overuse injuries (particularly in youth baseball), nutrition, heat illness and hydration.  In May 2016, Ms. Barton Straus was honored by the American Academy of Orthopaedic Surgeons with its prestigious Media Orthopaedic Excellence (MORE) award for her article, Counting Pitches Can Save Young Players' Arms But Not Always Used Consistently.

She was co-writer and researcher for the MomsTEAM PBS documentary, The Smartest Team: Making High School Football Safer, for which she compiled the exhaustive bibliography and annotated guide to source material.

Ms. Straus is a graduate of Harvard College, where she was an Editor of The Harvard Crimson covering the nationally-ranked men's soccer, swimming, and track teams. She received her JD with honors from the Francis King Carey School of Law at the University of Maryland, where she was Associate Editor of the Maryland Law Review and elected to the Order of the Coif.

While writing and editing for MomsTEAM, Ms. Straus  has continued to practice law, most recently as a solo practitioner, with earlier stints with small, medium, and large law firms, including DLA Piper (where she began her legal career) and for ten years as a staff attorney for Mobil Oil Corporation, working primarily on antitrust and dealer franchise litigation.

A former elite high school middle distance runner, youth baseball and soccer coach and administrator, Lindsey lives on Cape Cod.  She can be reached by email at lbartonstraus@momsteam.com.

In the sixteen years I have been writing about and reporting on sports-related concussions, there have been enormous scientific advances in our understanding of the injury, in how it is managed and treated, in its risk factors, and in its effects, both short- and long-term. When  we launched MomsTEAM's pioneering Concussion Safety Center in 2001, very few outside a small group of doctors knew much of anything about concussions, and some of what they thought they knew turned out to be wrong.  Today, athletes, coaches, parents, athletic trainers, and doctors all know a great deal more, although it is safe to say that the more we know, the more we don't know.

But despite increased education of athletes about concussion signs and symptoms, about the risks to their health in the short-, intermediate- and long-term from concussions, and from continuing to play with an undiagnosed concussion, one thing which has stubbornly resisted change is the rate at which athletes report concussions.  The needle has barely moved: a 2004 study (1) reported that 40 to 60 percent of athletes did not report their concussions.  The number is pretty much the same today. (2) 

No wonder the Institutes of Health's report on sports-related concussions (3) concluded in 2013 that sports at all levels continue to be characterized by what it famously dubbed a “culture of resistance” to concussion symptom reporting. The reason, anecdotal evidence and a number of recent studies suggest, is that student-athletes often experience pressure from coaches, peers, and parents to play hurt (4), and are taught that winning at the risk of their own health is not only acceptable but expected. It is hard to believe, given what we know - and don't know - about the dangers of concussions (and of the cumulative effect of repetitive head impacts) - that athletes today still fear what may happen to them if they do not abide by what they perceive to be team and cultural norms by honestly self-reporting concussion symptoms.

MomsTEAM has been consistently advocating since at least 2004 that the best way to get athletes to honestly self-report experiencing concussion symptoms is for coaches to create an environment in which athletes feel safe in reporting.  

As a result, I wasn't the least bit surprised to read study after study over the last three or four years supporting our view and reporting that it is not so much an athlete's knowledge about concussions that affects reporting behavior, as it is their attitudes and beliefs, and those of their key influencers (coaches, parents, teammates, and even fans) which are most responsible for the chronic under-reporting of concussion symptoms by athletes at all levels of sports. (5-10)

That research shows that:

  • beliefs by athletes about what they think will happen if they report a concussion, how important those are outcomes to them, what their teammates, coach, and parents think about their behavior, and how reporting impacts team performance, are all significantly associated with concussion reporting attitudes and behavior (6,8, 9, 11);
  • a team’s concussion reporting norms are an important predictor of whether an athlete chooses to report symptoms of potential concussions to medical personnel (12);
  • fully three-quarters of athletes in one recent study perceived their own reporting attitudes to be safer than those of their teammates (12):
  • misperceived or negative concussion reporting norms tend to persist because athletes who believe their preferences for honest concussion reporting are different from the team norms are less likely than athletes who believe their preferences conform to the team norm to express those preferences for fear of social disapproval, a self-perpetuating process that has been termed the ‘spiral of silence’ (12);
  • athletes who are aware of the adverse health and performance consequences of continuing to play while symptomatic for concussion, and who believe that being a good teammate means, if you suspect a teammate may have sustained a concussion (or even taken an especially hard hit),  you should say something – to the teammate, the coach, or medical personnel,  even a parent, to make sure the teammate is checked out medically on the sports sideline – are more likely to engage in such help-seeking behavior (12); and
  • an educational intervention designed to increase rates of concussion reporting solely by encouraging deliberative, rational behavior by the injured athlete is not likely enough, because athletes who sustain a concussion do not always act rationally (after all, concussion often renders them unable to think clearly and remember things, including the symptoms of concussion).

#TeamUp4ConcussionSafety

Building on the pioneering research of Emily Kroshus, Christine Baugh, Johna Register-Mihalik, Sarah Chrisman, and Tamara Valovich McLeod, and with funding from a NCAA-Department of Defense Mind Matters grant, SmartTeams™ has developed a pilot concussion education program called #TeamUp4ConcussionSafety  which takes a new approach to tackling the problem of chronic under-reporting of concussion symptoms by focusing on changing attitudes, expectations, and behaviors of athletes and their key influencers (coaches, athletic trainers, and parents) through a multi-media educational intervention designed to:

  • correct any misperceptions by athletes that they have safer attitudes about concussion reporting than their teammates, coaches, and/or parents,
  • change any negative attitudes coaches, parents, and coaches may have towards concussion reporting;
  • engage coaches, players, parents, and medical personnel in a collaborative effort to set safe team norms and expectations about concussion reporting;
  • instill in coaches and athletes a shared understanding and belief that one of the most important responsibilities of being a member of a team is looking out for your own health and safety and that of your team members, both by immediately reporting concussion symptoms, encouraging teammates to report, and by telling someone if you observe a teammate exhibiting signs of concussion, even if they won't;
  • emphasize that immediate symptom reporting and winning are not mutually exclusive: not only is reporting in the best interests of the athlete, because it reduces the risk of further injury and a longer recovery ,  but of the team as well,  because an athlete who continues to play with concussion symptoms can hurt the team's overall performance, and, by missing more games as a result of the concussion, hurting its chances of performing at its best in future games;
  • reduce actual or perceived pressure by coaches, parents, and teammates on athletes to continue playing with an undiagnosed concussion; and
  • create a climate in which athletes feel safe in reporting their symptoms, and encouraging their teammates to do the same.

Paradigm shift

I am not so naïve as to think that concussion symptom reporting, as a result of our new program, is going increase dramatically overnight, or over one season. After all, what we are trying to accomplish is nothing less than changing the very culture of sports when it comes to concussion, from one of resistance to injury reporting to one of safety. 

In the short-term, however, we hope that athletes will learn that (1) not only are there negative health (13-15) and athletic performance consequences of continued play with concussion (16), but the team’s performance also is likely to suffer in the short-, intermediate- and long-term (16); (2) as a result, is their responsibility as a member of a team, and the sign of a good teammate, to honestly self-report to the coach and/or medical staff whenever they are experiencing concussion symptoms, and, if they suspect that the teammate may have sustained a concussion, encouraging the injured teammate to seek medical help, or reporting the teammate to the medical staff; and that (3) concussion symptom reporting should therefore be a valued team behavior.

We hope that coaches will learn that (1) not only are there negative health and/or athletic performance consequences to their players from continuing to play with concussion, but their team’s performance will also likely suffer over the short-, intermediate- and long-term; (2) conservative concussion safety practices can be implemented without negative consequences to the team’s won-and-loss record or the coach’s personal goals; (3) their attitudes and beliefs about concussion safety greatly influence a team’s culture of safety; and (4) by expressly and consistently communicating to players positive concussion reporting expectations prior to the beginning of the pre-season, again before the season starts, at discrete intervals during the season; by consistently reinforcing safety-oriented behaviors (specifically, not continuing to play with concussion symptoms, players encouraging teammates to seek medical help in case of suspected concussion, and following the return-to-play protocol after concussion); by informing players that, if they sustain a concussion, they and their teammates will provide them with emotional and social support during the recovery process; and by maintaining a continuing and open dialog about concussion safety with their team, they can increase the likelihood that players will engage in positive concussion reporting behaviors. 

In the intermediate-term, we believe that the percentage of athletes honestly self-reporting experiencing concussion symptoms will begin to increase.

In the long-term, we believe that the SmartTeams™ concussion safety program will help to create a culture of safety in which (1) athletes routinely inform medical personnel, coaches, and/or parents whenever they experience possible symptoms of concussion; (2) athletes routinely encourage teammates they suspect may have suffered concussions to seek medical help; (3) athletes routinely seek help for injured teammates if they do not self-report; (4) coaches, teammates, parents, and fans do not pressure athletes to continue playing with undiagnosed concussions; (5) fewer athletes sustain multiple concussions, experience extended recovery from concussion, or are forced to retire from sport because of their concussion history; and (6) short-, medium- and long-term adverse health consequences athletes in contact and collision sports suffer from continuing to play with undiagnosed concussions are significantly reduced, resulting in a significant benefit to society by reducing direct and indirect healthcare costs.

The only way any of this is going to happen, of course, is if all stakeholders are committed to working together as a team to create a culture of concussion safety. Unless they are, unless they pledge themselves to working, day in and day out, season after season, to creating an environment in which athletes feel safe and comfortable in reporting their symptoms, I'll be reporting again ten years from now that 40 to 60% of athletes are still hiding their symptoms. I would much prefer to be able to report by then that chronic under-reporting has become a thing of the past. 

1. McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention.  Clin J Sport Med.; 2004;14(1):13-17.

2. Delaney JS, Lamfookon C, Bloom GA, Al-Kashmiri A, Correa JA. Why university athletes choose not to reveal their concussion symptoms during a practice or game. Clin J Sport Med. 2015;25(2):113-125.

3. Institute of Medicine (IOM) and National Research Council (NRC). 2013. Sports-related concussions in youth: Improving the science, changing the culture. Washington, DC: The National Academies Press.

4. Kroshus E, Garnett B, Hawrilenko M, Baugh CM. Concussion under-reporting and pressure from coaches, teammates, fans, and parents.  Social Sci & Med. 2015;134:66-75.

5. Register-Mihalik JK, Guskiewicz KM, Valovich McLeod TC, Linnan LA, Meuller FO, Marshall SW.  Knowledge, Attitude, and Concussion-Reporting Behaviors Among High School Athletes: A Preliminary Study.  J Ath Tr. 2013;48(3):000-000. DOI:10.4085/1062-6050-48.3.20 (published online ahead of print)

6. Chrisman SP, Quitiquit C, Rivara FP. Qualitative study of barriers to concussive symptom reporting in high school athletics. J Adolesc Health 2013;52:330-5 e3.

7. Kroshus E, Daneshvar DH, Baugh CM, Nowinski CJ, Cantu RC. NCAA concussion education in ice hockey: an ineffective mandate. Br J Sports Med. 2013;doi:10.1136/bjsports-2013-092498 (epub. August 16, 2013)

8. Register-Mihalik JK, Guskiewicz KM, Valovich McLeod TC, Linnan LA, Meuller FO, Marshall SW.  Knowledge, Attitude, and Concussion-Reporting Behaviors Among High School Athletes: A Preliminary Study.  J Ath Tr. 2013;48(3):000-000. DOI:10.4085/1062-6050-48.3.20 (published online ahead of print)

9. Register-Mihalik JK, Linnan LA, Marshall SW, Valovich McLeod TC, Mueller FO, Guskiewicz KM.  Using theory to understand high school aged athletes’ intentions to report sport-related concussion: Implications for concussion education initiatives. Brain Injury 2013;27(7-8):878-886.

10. Kroshus E, Baugh CM, Daneshvar DH, Nowinski CJ, Cantu RC. Concussion Reporting Intention: A Valuable Metric for Predicting Reporting Behavior and Evaluating Concussion Education. Clin J Sport Med. 2014; Post Author Corrections: July 21, 2014 doi: 10.1097/JSM.0000000000000137.

11. Kroshus E, Baugh CM, Daneshvar DH, et al. Understanding concussion reporting using a model based on the theory of planned behavior. J Adolesc Health 2014;54:269-274.

12. Kroshus E, Garnett BR, Baugh CM, Calzo JP.  Social norms theory and concussion education. Health Ed. Research 2015;30(6):1004-1013.

13. Tavazzi B, Vagnozzi R, Signoretti S, et al.  Temporal window of metabolic brain vulnerability to concussions: oxidative and nitrosative stresses - part II.  Neurosurgery 2007;61(2):390-395

14. Vagnozzi R, Tavazzi B, Signoretti S. et al. Temporal window of metabolic brain vulnerability to concussion: mitochondrial-related impairment - part I. Neurosurgery 2007;61(2):379-389.

15. Vagnozzi R, Signoretti S, Tavazzi B, et al. Temporal window of metabolic brain vulnerability to concussion: a pilot IH-magnetic resonance spectroscope study in concussed athletes - part III. Neurosurgery 2008;62(6):1286-1296.

16. Asken BM, McCrea MA, Clugston JR, Snyder AR, Houck ZM, Bauer RM. "Playing Through It": Delayed Reporting and Removal from Athletic Activity After Concussion Predicts Prolonged Recovery. J Ath Tr. 2016;51(5):000-000. doi: 10.4085/1062-6050-51.5.02 (published online ahead of print)

 

My Bio My Message

Ben Utecht
Former NFL Professional Football Player

Ben Utecht always had big dreams growing up in the small town of Hastings, Minnesota. He loved to play football, pretending he would win the Super Bowl. He loved to sing and perform, wanting to inspire and draw audiences. Utecht’s path has seen him famously make his dreams come true, most notably by winning the 2006 Super Bowl while starring at tight end for the Indianapolis Colts.

Now, Utecht is using his passions, talents, and life experiences to help others and make positive change in the world. He is a sought-after motivational keynote speaker for corporations, conventions, and non-profit events with his MVP Program, highlighting Mind, Value, and Purpose as the “why” behind everything we say and do.  He harnesses the powerful lessons he learned during his successful elite NFL career, playing alongside superstar quarterback Peyton Manning and for Football Hall of Fame Coach Tony Dungy, to illuminate dynamic ways to succeed in business and life.

Utecht, a four-year starter at the University of Minnesota, worked his way into the NFL through talent and drive. He was undrafted, but signed with the Colts in 2004. He became one of Manning’s favorite targets, thanks to Utecht’s sure hands and 6-6 frame.

He sustained five documented concussions during his NFL career, leading him to decide to retire in 2009 in order to safeguard his health and future with a growing young family. Utecht’s football career, and the devastating concussions he endured from the game he still loves, has led him to being an outspoken – and influential – advocate for sports brain injury awareness.

Utecht uses his rich experiences and authentic voice to openly discuss brain injury awareness. He is open and honest about his ongoing neurocognitive issues, such as memory loss, and sheds a personal light on one of the most-discussed injuries in sports today. He testified about his experiences with concussions and football at a U.S. Senate hearing in 2014, as well as appearing as a featured expert panelist at the 2015 South by Southwest Sports festival in Austin, Texas on the topic of brain health and sports.

He serves as the national spokesperson for the American Academy of Neurology and the American Brain Foundation. He has earned honors for his brave honesty and advocacy, receiving the 2014 Public Leadership in Neurology Award from the American Academy of Neurology. Ben served as a Board of Director for MomsTeam Institute, Inc | SmartTeams from 2015-2016.

”It is such an honor to work alongside the American Academy of Neurology and the American Brain Foundation.,” Utecht explains. “The mission of the American Brain Foundation is to cure brain disease, and that is something that I believe will become a reality. The more we begin to care about the brain, the more we care about the essence of who we are.”

Music still remains a passion for Utecht, and he has also made that dream come true by becoming an accomplished professional singer and songwriter. He performs Contemporary and Inspirational concerts, thrilling audiences at corporate and non-profit events, and venues across the country.

Utecht’s 2014 music video for the emotional single, “You Will Always Be My Girls”, has drawn well over a million views on YouTube. The song, which Utecht co-wrote, is a love letter to his wife Karyn and their daughters, as Utecht fears that one day that his brain injuries will lead him to not know them. The touching song serves as his eternal reminder that “his girls” will always be etched in his heart.

Utecht has released four albums, and was nominated for a 2012 Dove Award for his Christmas record.

”I don’t remember a time in my life that wasn’t impacted in some way by music,” Utecht says. “I want to positively impact the lives of others through my music – when that happens, it is a powerful moment.”

Ben is the author of “Counting the Days While My Mind Slips Away” by Simon & Schuster. http://www.simonandschuster.com/books/Counting-the-Days-While-My-Mind-Slips-Away/Ben-Utecht/9781501136603Ben Utecht book

 

 

What does is mean to be great? Oxford Dictionaries defines great as “of an extent, amount, or intensity considerably above the normal or average.” Of that rhetoric, we can all agree that Peyton Manning was truly great at playing and managing the game we all love, football.

I can’t help but look back on my time with Peyton, as brief as it was, and feel that one’s greatness expands far beyond the tight spirals and perfect reads that occur on Sundays. It ventures much deeper in to the core of a person’s values and begs the question “why?” Why do you work so hard? Why does the game mean so much to you? Peyton’s retirement set the sports world straight when he shared that his drive to be the best did not originate with the goal of mastering all parts of the game of football but instead it was birthed out of his reverence for a dream: That dream being the game of football, a dream that would blossom at the highest level, the NFL.

After absorbing Peyton’s emotional good-bye, it finally clicked. The light switch activated in my mind. My brush with greatness was not just about sharing the gridiron field with a “considerably above normal” player. It was about following a man into competitive battle who sincerely relinquished every ounce of his being into operating at his fullest potential.

As a teammate, that quality was infectious. Peyton’s greatness demanded that the rest of us reach towards the same dream that he possessed in the depths of his heart. If we, as his band of brothers, could empty ourselves into the game, even if only a fraction of what Peyton gave, we would surely come that much closer to our own personal greatness.

Only when one man’s example leads 52 others to believe that their potential is more significant than they ever imagined can a team become great. The result is my dream. I was a little boy from small-town Minnesota, catching passes in the back yard from my dad, twenty years later stepping on to a Super Bowl championship field, catching a pass from Peyton Manning, and hoisting the Lombardi trophy. What a dream come true.

Thank you Peyton Manning, my quarterback, my friend, for leading me into a culture of greatness, where I challenge myself to be the best husband, father, friend, and man of God that I can possibly be. My friend, you are a great football player, but more importantly you are a great man. Let’s all take a lesson and surrender all of ourselves over to the belief that greatness lies in each of us. All it takes is reaching for a dream.

My Bio My Message

Frank Webbe, PhD

Frank Webbe earned his Ph.D. in psychology at the University of Florida and completed postdoctoral training there in teaching and in psychopharmacology/ neuroscience at the University of Mississippi. He is professor of psychology and behavior analysis at Florida Institute of Technology, research director of the East Central Florida Memory Disorder Clinic, and director of the Florida Tech Sport-Related Concussion Project and Concussion Management Program. For many years he has studied the risk factors for concussion in sport, as well as best practices for assessing and managing sport-related concussions. He oversees the annual baseline testing of more than 600 student athletes, and the trauma and follow-up evaluations for those who are suspected of having concussions. His concussion research has been funded most recently by the Department of Defense.

In both the sport concussion domain and in the Alzheimer’s disease arena, his primary interest and concern is the identification of individuals who may be at the highest risk for cognitive impairments. This interest translates into studies that identify the factors – both environmental and genetic – that contribute most to risk. He is author of the Handbook of Sport Neuropsychology (Springer Publishing) and has published widely in the professional literature. He has been invited by many organizations to speak on sport-related concussions, including the National Academy of Neuropsychology, the American Psychological Association, the National Collegiate Athletic Association, the Sport Neuropsychology Society, the American Congress of Rehabilitative Medicine, and the Consumer Product Safety Commission.

In addition to his work in sport-related concussions, Dr. Webbe has studied also standard and computerized methods of early assessment of Alzheimer’s disease, and in-home Applied Behavior Analysis interventions with family caregivers and Alzheimer’s patients. With colleague S. Ann Becker and support from the Alzheimer’s Association he also has studied the use of in-home technology for elderly caregivers

Dr. Webbe is a fellow of the American Psychological Association and the National Academy of Neuropsychology, a charter member and treasurer of the Sports Neuropsychology Society, treasurer of the NAN Foundation Board of Trustees, and immediate past Chair of the Technology Professional Interest Area of the International Society to Advance Alzheimer Research and Treatment. Dr. Webbe is a former president of the Society for Sport, Exercise, & Performance Psychology of the American Psychological Association.

Dr. Webbe has served for many years as the NCAA Faculty Athletics Representative at Florida Tech (NCAA Division II), and is past president of the national Faculty Athletics Representatives Association (FARA).

A Florida native, Dr. Webbe enjoys the outdoors and especially loves running early in the morning.

 

My Bio My Message

Scott L. Zuckerman, MD completed his undergraduate education at Cornell University in 2008, graduating magna cum laude with a Bachelor of Science in Biology & Society. He graduated from Vanderbilt University School of Medicine in 2012. There, he served as class president for four years and was awarded the School of Medicine Award of Distinction. Dr. Zuckerman's research interests include spine surgery outcomes, sport-related concussion, neurosurgery quality improvement, peripheral nerve, and endovascular and pediatric neurosurgy. He is a member of the Vanderbilt Sports Concussion Research group (V-SCORE) led by Dr. Gary Solomon and Dr. Allen Sills.

Outside of the hospital, Scott is an avid sports fan, rooting for the Yankees and Knicks. He enjoys baseball, softball, basketball, golf, crossfit, and reading about baseball history.

The debate over sport-related concussions has been thrust into the national spotlight, and is a major public health topic affecting athletes of all ages. All one needs to watch is 5 minutes of a nationally-televised football game or to overhear concerned parents at a soccer practice to grasp the magnitude of the issue and its far-reaching effects. We've also each had a friend, family member, or acquaintance who suffered a sport-related concussion and took months to return back to normal life. The bottom line is that sports concussions hit home to millions.

As a neurosurgeon, I routinely deal with severe and life threatening injuries to the brain and spinal cord. Though concussions do not require surgical intervention, as a profession, neurosurgeons are charged with the great responsibility to protect the brain and learn more about how to diagnose, prevent, and manage these transient neurologic injuries.

For the last 4 years as a neurosurgery resident training at Vanderbilt University Medical Center, I have been fortunate to be involved in the treatment of sport-related head injuries. Founded by neurosurgeon Allen K. Sills MD, neuropsychologist Gary S. Solomon PhD, and pediatric sports medicine physician Andrew Gregory MD.  the multi-disciplinary Vanderbilt Sports Concussion Center (VSCC) routinely treats youth, high school, collegiate, and professional athletes after they have suffered a concussion. Most commonly, we treat young athletes with post-concussion syndrome, where symptoms have persisted for at least one month after the initial injury. These athletes are suffering – trouble concentrating in school and unable to spend time with friends.

On the opposite end of the spectrum, I have seen the rare yet catastrophic athletic head injuries such as a young high school football player who suffered an unremarkable hit, and 5 minutes later, suddenly slumped over and was unresponsive on the sideline. After being airlifted to Vanderbilt (a Level 1 Trauma Center), he was diagnosed as having a subdural hemorrhage, a rare but life-threatening condition in which a blood clot forms around the surface of the brain causing downward pressure, where the critical structures of breathing and wakefulness herniate through the bottom of the skull.  This often requires emergent hemicraniectomy - an operation that removes half of the skull to allow the brain to swell out rather than down. Though patients like this may survive, they are left with devastating neurologic injuries. They will never play football again; they will never independently go back to school; and they will never be the same teenager they once were. 

Despite the rarity of such catastrophic head injuries, their effects are permanent for all involved. The experience is life-altering for the patient and family, as well as the surgeons, physicians, and nurses who cared for them, all of whom are left wondering, why did this particular collision cause a deadly brain hemorrhage where similar hits just cause transient symptoms? How can we make helmets safer to prevent against the rotational acceleration that causes brain hemorrhage? Could this happen to my child?" These are some of the many frustrating and scary questions that remain unanswered.

As a member of MomsTeam’s Board of Advisors, I am committed to educating parents, coaches, and players about what known medical science knows and what requires further scientific study. At times, emotionally charged media reports are meant more to attract readers than to accurately describe the science. I am personally committed to evaluating the most up-to-date research in an unbiased and rigorous way, and ensuring the right information is disseminated to the people that need it most. Through MomsTeam and the Vanderbilt Sports Concussion Center, I am committed to pursuing what is unknown and advancing the science of sport-related concussion.

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