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Rodney Harrision as a Charger and Newscaster

Rodney Harrison urges players to ‘not depend on the NFL’ and not return to field if they are hurt as it ‘is not worth it’

By Patrick Djordjevic, dailymail.com, October 3, 2022

 
Sunday Night Football analyst Rodney Harrison issued a passionate plea to NFL stars to not return to the field if they get hurt following the handling of Tua Tagovailoa’s distressing situation Thursday night.

The two-time Super Bowl champion’s comments follow a joint statement by the NFL and NFLPA in which changes to the concussion protocol are said to be imminent.

Harrison’s comments and the statement come in the wake of Miami Dolphins quarterback Tua Tagovailoa being taken to hospital with a concussion in Thursday night’s game vs. Cincinnati.

The incident came after the Dolphins quarterback surprisingly finished out his side’s win over the Bills last Sunday, despite receiving a brutal hit in the first half.

Harrison, a 49-year-old retired pro, played 15 seasons in the NFL, nine with the San Diego Chargers before his final six in Foxborough with New England.

‘I would get hit, the entire stadium was spinning around and I would go back into the game,’ Harrison said of his playing days on NBC’s SNF pregame coverage.

‘It’s not worth it — and I would implore these young men; don’t go back on that football field if you get hurt.’

Tua Tagovailoa on the turf after his second concussion in a week

‘I don’t want them to have to feel like me and so many other former players that had to deal with concussions; whether it’s depression, anxiety, paranoia, broken relationships, not being able to communicate with your spouse and things like that,’ Harrison continued.

‘It’s a lot — CTE takes you to a dark place and I want these players to know it’s not worth it.

‘Please take care of yourself. Don’t depend on the NFL, don’t depend on anybody. If there’s something wrong with your head, report it.’

On Saturday, the NFL and NFLPA announced they are working collaboratively to modify the aforementioned protocols and anticipate changes to occur in the ‘coming days.’

The statement, released Saturday evening, read: ‘The joint NFL-NFLPA investigation into the application of the Concussion Protocol involving Miami Dolphins’ quarterback Tua Tagovailoa remains ongoing. Therefore, we have not made any conclusions about medical errors or protocol violations.

‘The NFL and the NFLPA agree that modifications to the Concussion Protocol are needed to enhance player safety.

‘The NFLPA’s Mackey-White Health & Safety Committee and the NFL’s Head Neck and Spine Committee have already begun conversations around the use of the term “Gross Motor Instability” and we anticipate changes to the protocol being made in the coming days based on what has been learned thus far in the review process.

‘The NFL and NFLPA share a strong appreciation for the unaffiliated neurotrauma consultants who contribute their time and expertise to our game solely to advance player safety. This program has made our game safer for the athletes who play it for the past twelve seasons.

The gravity of Tagovailoa’s injury last weekend vs. the Bills — and the broader discussion surrounding protocols — were reinforced Thursday against the Bengals, as he left the field on a stretcher following another brutal blow to the head.

This time, Tagovailoa was diagnosed with a concussion and hospitalized (he was discharged Thursday night and flew home with the team), lending credence to the idea that he shouldn’t have been playing in the Dolphins’ Week 4 matchup to begin with.

The quarterback was officially diagnosed with a back problem Sunday and with concussion protocols claimed to have been followed.

Tagovailoa is said to be in good spirits on his road to recovery if his statement on Twitter Friday is anything to go by.

‘I want to thank everyone for all of their prayers and support since the game last night,’ he wrote.

‘It was difficult to not be able to finish the game and be there with my teammates, but I am grateful for the support and care I’ve received from the Dolphins, my friends and family, and all the people who have reached out.

‘I’m feeling much better and focused on recovering so I can get back out on the field with my teammates.’

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Kurt Busch pulls out of NASCAR playoffs because of concussions

Kurt Busch Pulls Out of NASCAR Playoffs Because of Head Injury

Michelle R. Martinelli, For the Win, August 25, 2022

 
Kurt Busch is not returning to the NASCAR race track in the near future. The No. 45 23XI Toyota driver is pulling out of the playoffs and will miss the beginning of the postseason, 23XI Racing announced Thursday morning.

The team did not specify exactly how many playoff races Busch will miss, but he has not competed in the last five Cup Series events.

Along with missing more races, the 44-year-old driver is withdrawing from NASCAR playoff contention, providing the remainder of the unqualified drivers with an additional opportunity to make the cut for the 16-driver, 10-race postseason, set to start September 4 with the Southern 500 at Darlington Raceway.

Busch, the 2004 Cup champion, has not raced since July 17 at New Hampshire Motor Speedway. The weekend after that at Pocono Raceway, Busch spun and crashed hard into the wall during a qualifying round and was able to get out of the car on his own. However, he has not been medically cleared to return to racing and previously noted he’s experiencing “concussion-like symptoms.”

He also previously announced that he would not compete this weekend in the regular-season finale at Daytona International Speedway, marking his sixth straight missed race.

Kurt Busch celebrates in victory lane after winning the AdventHealth 400 at Kansas Speedway (Photo by Chris Graythen, Getty Images)

More via 23XI Racing on Thursday:
“As much as I wanted and hoped to be able to get back in the No. 45 car to make a playoff run with our team, it’s still not the right time for me,” said Busch. “In addition to not being cleared to return to racing, I know that I am not ready to be back in the car. I respect the sport of NASCAR, my fellow drivers and the fans too much to take up a playoff spot if I know I can’t compete for a championship this season. The decision was not an easy one, but I know it is the right thing to do. I will continue to take time to heal and strengthen as I prepare to be back in the car and will do all I can to help 23XI continue the success we have had this season.”

With Busch sidelined, 19-year-old Xfinity Series driver Ty Gibbs – the grandson of NASCAR team owner Joe Gibbs – has been filling in behind the wheel of the No. 45 Toyota and will continue to do so.

As we recently wrote, this is an awful situation for injured Busch, but he should be applauded for his transparency about his head injury in a sport where concealing it has often been the norm.

After winning at Kansas Speedway in May, Busch qualified for the 10-race playoffs. Although he has not entered every race since his injury, NASCAR granted him a medical waiver to keep him playoff eligible in a tight competition for the postseason.

But NASCAR confirmed 23XI is withdrawing the waiver request, and the governing body added in its own statement:

“Kurt Busch has managed this difficult situation like the champion that he is. Working closely with his doctors, every decision made has been in the best interest of his health, his competitors and the sport. Kurt has NASCAR’s full support as he continues to heal, and we look forward to seeing him return to the race car.”

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High school injury reports analyzed by InvestigateWest and Pamplin Media show that girls are twice as likely to get concussions as boys in Oregon. Girls in the 13U age group, pictured above, are the youngest allowed to use headers.
 

The Concussion Gap: Head injuries in girls soccer are an ‘Unpublicized Epidemic’

Lee van der Voo, InvestigateWest, photos by David Ball / Pamplin Media Group

 
When it comes to concussion in sports, all eyes are on football, or so it seems. But it’s not just football that causes a high number of head injuries among young athletes.

Another culprit? Girls soccer.

National research has found girls are more likely to suffer a concussion than boys in any sport. In 2017, researchers at Northwestern University generated national headlines when they found concussion rates among young female soccer players were nearly as high as concussion rates for boys playing football — and roughly triple the rate of concussions in boys soccer.

In Oregon, injury reports from public high schools analyzed by InvestigateWest and Pamplin Media Group mirrored that trend, showing soccer concussions were second to those from football between 2015 and 2017. What’s more, at the schools that included the gender of injured athletes, there were nearly twice as many reports of possible concussions for girls playing soccer than boys in the sport.

The rate of concussions in girls soccer worries local experts like Jim Chesnutt, a doctor in sports medicine at Oregon Health & Science University, who says those injuries are not widely recognized, even as concussion rates rise for girls playing soccer.

“In a lot of ways, it’s a growing epidemic for young girls that I think has gone unpublicized,” said Chesnutt, co-director of the Oregon Concussion Awareness and Management Program and a member of the Governor’s Task Force on Traumatic Brain Injury.

More exposure, more injury

It’s understandable that much of the youth concussion conversation centers on football, given the physical contact that is visibly — and audibly — evident on every play, as well as the large rosters and the lengthy lists of players who are injured.

But if you compare girls soccer with football, and only look at the high school participation and injury data, “you’re missing a gigantic part of the picture,” according to Michael Koester, a doctor of sports medicine at the Slocum Center in Eugene. He directs its sports concussion program and serves as the chair of the Sports Medicine Advisory Committee for the National Federation of State High School Associations.

Koester notes that high school boys play eight to 10 football games per season, and typically play other sports in the off-season.

Girls, however, play 15 to 20 soccer games in a high school season, but when that season ends, they may play another 80-plus games throughout the winter, spring and summer with club teams, said Koester, who, like Chesnutt, is a medical adviser to the Oregon Schools Activities Association.

“If we’re looking at injury risk by athletic exposure,” which is one practice or game, a standard in evaluating risk, Koester said, female soccer players probably are playing five if not 10 times more practices and games than football players.

And Koester doesn’t see the trend ending.

“The thought used to be that this was all revolving around, ‘Wow! They want to get their kid a scholarship,’ ” he said. “Now it’s kind of gotten to the point where there’s so much single-sport participation that we see kids that are specializing in sport early, just so they’ll be able to make their high school team.”

Single-sport athletes are more prone to injury in any sport. According to a study by scientists at the University of Wisconsin, high school athletes who specialized in just one sport at an early age were twice as likely to suffer injuries to their lower extremities.

“We see a lot of overuse injury among girls playing soccer,” Koester said. “We see a lot of ACL injury among girls playing soccer. It’s a well-known problem.”

Aggressive play

Another factor is the evolution of sports.

Angella Bond is an athletic trainer for Tuality Sports Medicine and works on the sidelines with athletes at Hillsboro schools. Anecdotally, she said, all athletes push to be bigger, faster and stronger. Soccer is no exception, nor are girls.

As athletes develop, they take bigger hits at higher speeds, and competitive games build on their momentum. As competition grows in girls soccer, the sport is trending to be more aggressive, she said.

“Unfortunately, I think that happens with girls sports,” she said. “Arms fly a little bit more.”

Chesnutt agreed. “I think over the years, soccer has become more physical,” he said. “And I think the physical contact and the aggressive nature of that physical contact is more associated with concussions.”

According to the American Academy of Pediatrics, soccer — unlike football, ice hockey and lacrosse — is not a “collision sport.” But it is a “contact sport” because athletes “routinely make contact with each other or inanimate objects.”

Header balls, though often singled out as a source of concussions, are not necessarily to blame.

The force created when a soccer ball meets a head can rattle a brain, but data increasingly points to other factors when competitors vie for a ball in the air.

According to a study by The Research Institute at Nationwide Children’s Hospital, while headers accounted for 27 percent of concussions, it was knocks with other players on aerial play — including head-to-head contact and arms and elbows to the head — and contact with the ground that accounted for 70 percent of those concussions in girls soccer, suggesting aggressive play is a factor in most concussions involving headers.

Why girls?

But why are girls more prone to concussions than boys while playing soccer? The prevailing theories focus on their weaker neck-muscle development, weaker body strength (needed to stabilize the neck and head during aerial play), and more frequent contact with the ground. A year ago, a study in the Journal of the American Osteopathic Association found that female high school soccer players took twice as long as male players to recover.

It’s also possible that girls don’t benefit as much from early treatment. A recent study published by the American Academy of Pediatrics found that girls are five times more likely than boys to stay on the pitch and play through a head injury.

And the soccer community has been slow to recognize the hard hits its girls are taking. Instead, soccer is at the forefront of the cultural empowerment of girls.

Local experts concerned about concussion risk note that sports, including girls soccer, have plenty of benefits. Just being physically active is good for kids, and sports like soccer help establish lifelong fitness habits, teach team-building skills, and promote character development and assertiveness.

“The worry is that the take-home message is that (girls soccer) is healthy and fantastic and nothing can be bad about it,” said Koester, who says an opposite negative message, equally extreme, is more often associated with boys playing football.

Greater awareness needed

Concussion education and awareness in girls soccer is paramount, according to local experts such as Chesnutt.

“I think the way to decrease it is to really analyze how we can modify the amount of body contact that goes on in soccer to limit the dangerous aggressive behavior that is associated with concussion,” he said.

Unlike youth football, a sport that’s adjusting to new information about concussions all the time, soccer has largely failed to address new information about concussions, Chesnutt said.

Football, for example, has reduced head-to-head helmet play, limited full-contact practices and games, and zeroed in on the specialty teams with the highest concussion rates.

“Football has really done, I think, an exceptional job of identifying some areas where there have been some definite higher incidents and some problems,” said Chesnutt, who lectures nationally about youth concussions. “As a group of coaches, leagues, parents and referees, they’ve all looked at it and come up with some solutions that have decreased concussion rates. And I think it’s time for soccer to do the same thing.”

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New Rules to Protect Your Kid’s Noggin

May 25, 2019, Parents Magazine

 
Children bonk their head all the time when they’re wrestling with siblings, playing soccer, and just being clumsy-and it’s easy to worry that a bump could turn into something bigger. After all, more than 800,000 kids in the U.S. get a concussion every year. For the first time, the Centers for Disease Control and Prevention has released specific “return to learn” and “return to play” guidelines for head injuries, based on 25 years of research. One doctor shares the big takeaways.

ALWAYS take any injury beyond a light head bump seiously. A concussion occurs when a bump, blow, or jolt to the head or a hit to the body makes the brain bounce or twist in the skull. This creates chemical changes and can sometimes damage brain cells. “If your child complains of a headache or dizziness, is nauseous or vomiting, appears dazed, or sleeps more or less than usual, it’s time to get a doctor’s evaluation,” says Dennis Cardone, D.O., associate professor of orthopedic surgery and pediatrics and co-director of the NYU Langone Concussion Center. Even toddlers can get a concussion from a tumble, so look for changes in their behavior such as not wanting to nurse or eat or losing interest in toys.

If diagnosed with a concussion, your child will need menlal rest, says Dr. Cardone. That means taking a break from all activities for two to three days, and after that, starting with light aerobic activity. He may need to attend school for only half the day or do little to no homework (he won’t mind this rule!). However, he shouldn’t return to any sports or strenuous activities that have a high risk of falling or contact (think: field hockey, gymnastics, climbing a tree) until he’s been cleared by his doctor, which should be within a few weeks.

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Junior Seau, shown at his beloved Pacific Ocean in the ESPN Films “30 for 30” documentary “Seau,” which premieres Thursday. (ESPN Films)

ESPN hits the mark with documentary ‘Seau’

By Tom Krasovic, September 20, 2018, San Diego Union Tribune

An aerial view of the Oceanside coast, in full sparkle and splendor below, grandly eases viewers into “Seau,” an ESPN Films documentary in the “30 for 30” series that debuts Thursday on the streaming service ESPN+.

It’s a sunny scene, the Pacific Ocean’s turquoise waves illuminated as they roll toward the white beach. The late Junior Seau told friends he found peace paddling on these waters, deep into his life alongside the town where he’d grown up.

Up at dawn with a yellow long-board and oar in hand, Seau had only a short walk from his beachfront home to the water.

Yet the former Chargers linebacker, role model and local philanthropist was then also writing in a journal of bouts with depression, memory loss and perceived guilt. There were headaches, too, and nights plagued by insomnia. “Buddy,” he’d told a friend and professional soccer player who’d suffered a brain injury from heading a ball, “I’ve had a concussion since I was 15.”

Diary entries also revealed feelings of humiliation and embarrassment over not living up to expectations of others and himself, and of feeling used by others.

“The world has nothing for me,” Seau pens in one entry, the cursive words all too legible.

One of Seau’s surviving adult children, after reading the grim line aloud, wonders why his father didn’t regard his family as something in this apparent world of nothing.

Why couldn’t they have been a lifeline for him to reach out and grasp?

“Seau,” produced and directed by Kirby Bradley, lets viewers draw their own conclusions about a complicated life that ended one May morning six years ago, at age 43, with a self-inflicted gunshot wound to the chest, but not before we hear from an array of family members, friends and experts in football and brain science.

At the end of the 90-minute film, themes of redemption and hope are raised.

“Let’s all walk from here being better for having known Junior Seau and the impact he had on our lives,” NFL quarterback Drew Brees, a former Chargers teammate of the Hall of Fame linebacker, concludes near the film’s end.

Former Chargers lineman Aaron Taylor notes that in death, Seau drew extraordinary attention to the link between head trauma and a degenerative brain disease, CTE, revealed in a tissue sample sent to a brain scientists at the family’s request.

Exciting beginnings and success are a thread to the film, followed often by bitter detours or hurtful endings.

Seau took to sports at Oceanside High with a passion that rivaled his stunning blend of size, speed and agility. If he was slamming into football ball-carriers or catching passes, scoring baskets or throwing the discus and shot, he was a “force of nature” for the green-and-white-clad Pirates, observers said.

A flood of football scholarship offers came to the small home where Seau and his brothers slept in a tiny garage.

Jubilation ensued when Seau chose USC, keeping him close to his parents and siblings and the tight-knit Samoan-American community in Oceanside. A similar celebration arose in 1990 when the Chargers drafted him fifth overall. “I’m a real momma’s boy,” Seau said, pulling on a blue team cap.

Playing for his beloved “Diego,” he led the long-struggling Chargers to the playoffs in just his third season, and their first Super Bowl two years later. “Now the world is gonna know the San Diego Chargers,” he told some 70,000 celebrants in Mission Valley after the team returned from claiming the 1994 AFC title in Pittsburgh.

The flip side?

If Oceanside lost a game in which he played, Junior lost his lunch money. It was the price his father exacted.

The thrill of signing with USC gave way to humiliation when a failed admittance test made him ineligible as a freshman. His father refused to talk to him in response, deeming the failure an embarrassment to the family. After a dominant junior year with USC, there would be no senior year. Making money was the next step, in no small part because he wanted to support his parents and other family members.

The Chargers couldn’t build upon their Super Bowl season, and the team’s constant losing wore on Seau.

When the Chargers traded him in the spring of 2003, after 13 seasons with the club, Seau was hurt that the team — Stay Unclassy, San Diego? — called not him but his agent to tell him the news. “I know that was hard on him,” said the agent, Steve Feldman.

Gina Seau was working for the Chargers in marketing when she first met Seau early in his NFL career.

She recalled “very kind eyes” and a “very soft voice” that almost “didn’t match the size and stature.”

The two would marry, but erratic behavior that Gina Seau linked to numerous football-related head injuries — “My head is on fire,” he told her — led to a divorce in 2002. The two remained friends. Believing that driving off a steep coastal cliff in October 2010 wasn’t an accident, Gina pleaded with her former husband to get help.

Here’s hoping that if there’s a “Seau II,” events yet to transpire bring more developments of redemption. Say, a cure for CTE.

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Ann C. McKee, chief of neuropathology at the VA Boston Healthcare System, which houses the world’s largest brain bank devoted to CTE research, examines a brain earlier this month.(Photo: Robert Deutsch, USA TODAY)

Researchers close in on CTE diagnosis in living, one brain at a time

By Nancy Armour, August 24, 2018, USA TODAY

BOSTON – Submerged in chemicals in the stainless-steel bowl is the key to life and, researchers hope, death.

It’s a human brain. That of a man who played college football in the 1950s, to be exact. His family donated his brain to get answers for themselves, but what’s found could lead to more answers about chronic traumatic encephalopathy, the devastating neurodegenerative disease linked to concussions and repetitive head trauma from football and other contact sports.

“Our main objective, our overarching goal, is to help the people who are living. To be able to diagnose this disease during life,” says Ann McKee, chief of neuropathology at the VA Boston Healthcare System, which houses the world’s largest brain bank devoted to CTE research.

“If we can diagnose it, we can monitor it and test therapies to see if they’re effective in treating this disease,” says McKee, director of the CTE Center at Boston University’s School of Medicine. “It would really dramatically increase our ability to point out genetic susceptibilities for this. We’d be able to look at how much is too much in certain individuals or certain positions in certain sports.”

As another football season begins, it inevitably leads to questions and fears about head trauma and its long-term damage. How many hits are too many? What can parents do to protect their children or players do to protect themselves? Are athletes in certain sports more susceptible?

Most important, which athletes will develop CTE – or Parkinson’s or ALS (amyotrophic lateral sclerosis) – and why?

The answers will come from brains such as the one McKee dissected this month, when USA TODAY Sports toured the brain bank.

The brain bank has more than 500 brains, most of them donated by former athletes or their families who suspected CTE because of mood swings, behavioral changes, depression or dementia. Of those brains, more than 360 had CTE, McKee says.

SEARCHING FOR CLUES

The arrival of a brain sets two teams in motion. One set of clinicians talks to the family to find out more about the donors. Did they play any sports? If so, what and for how long? When did they start? Did they experience any other kind of head trauma, say from an automobile accident, domestic violence or military service? Did they have drug or alcohol problems? How did their mental health change, and when did that occur?

Separately, and usually without any information about the person whose brain it was, McKee and her researchers study the brain. It is cut in half, and one half is stored in a minus-80-degree freezer, so it will be available for molecular, genetic and biochemical studies.

The other half is then photographed and sectioned. After removing the brain stem, McKee uses what looks like a bread knife to cut slices of the brain about a quarter-inch thick.


Ann C. McKee slices the brain into segments about a quarter-inch thick as part of in-depth, time consuming research on the organ. McKee hopes the work will unlock answers to CTE. (Photo: Robert Deutsch, USA TODAY)
 
Simply by looking at the brain, McKee can tell a few things. The brain of this man, who was in his 80s when he died, has shrunk, noticeably smaller than it should be for a man who once played football. The folds of the brain, normally pressed tightly against one another, are loose and have gaps between them, some large enough that the tip of a finger could be inserted.

She points to the ventricles, chambers in the middle of his brain that are filled with fluid during life. They should be small, but these are “just gigantic.”

“As the brain shrinks, they expand. What this indicates is there’s been enormous shrinkage of the brain,” McKee says. “Those are huge.”

The hippocampus, a section in the middle of the brain that controls memory, is small but not abnormally so for a man in his 80s. If it was, that could be an indication of Alzheimer’s. But a membrane that runs from one side of the brain to the other, normally thick like a rubber band, has shrunk. In some spots, it’s almost invisible.

“This is looking more like frontal predominant atrophy, and that could mean CTE because Alzheimer’s almost always affects the hippocampus,” McKee says. “At this point, I always want to know, ‘What is it? Let’s look under the microscope.’ But you have to wait.”

CTE can’t be seen by the naked eye, and it takes at least three weeks to prepare slides of the brain tissue.


 
CTE is caused by tau, a protein in the brain released as a result of head trauma. When tau clumps together, it damages brain cells and can change the brain’s function. Though tau causes Alzheimer’s, McKee says, the tau that causes CTE looks distinctly different.

Under a microscope, it can be seen in telltale brown spots.

“CTE is very focal. In fact, in its early stages, it’s in the crevices. It just piles up. And that’s around blood vessels,” McKee says. “That’s very different. Alzheimer’s never does that.”

As CTE progresses, those clusters or clumps of tau will spread, and the disease will become more severe. That’s why, in the early stages of disease, stages 1 and 2, the symptoms usually relate to behavioral changes or mood swings. In stages 3 and 4, the disease is exhibited in memory loss.

“We think there may be more pathology in the young players than we’re appreciating just with the tau protein,” McKee says. “We think there’s maybe white matter structural changes or maybe inflammatory changes that are responsible for that loss of control, which is so difficult for the individuals.”

‘EVERY CASE IS A MYSTERY’

Once the slides have been examined, the pathologists and clinicians will come together for a conference. At this point, neither knows what the other does. The clinicians detail what they’ve learned about the brain donor’s history and suggest a diagnosis. The pathologists will then say whether the brain tissue confirms it.

“Every case is a mystery,” McKee says. “It’s not the same way you usually solve a mystery. I solve the pathology first, and then you go back and find out (the history). And then you try and put the two together.”

Some former players and their families once were reluctant to donate their brains, but that stigma largely has disappeared. So much so that McKee said brains arrive at the Boston bank almost every day.

Though that lengthens the time it takes to reach a definitive diagnosis, it will shorten the time before a living diagnosis can be found. In addition to the work done in her lab, McKee shares tissue samples with researchers around the world.

“What we want to do is establish the risk, educate people, educate parents, educate players,” McKee says. “So if they’re unwilling to risk that future self, if they’re unwilling to take that risk because it’s too high for them personally, we want to give them enough data so they can make a very sound and wise decision.”

When that day comes, it will change sports forever.

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CARSON, CA – AUGUST 03: Bronze medal winner Dave Mirra speaks in a press conference after the Rally Car race during the summer X Games 14 at Home Depot Center on August 3, 2008 in Carson, California. (Photo by Christian Petersen/Getty Images)

Months after committing suicide, Dave Mirra has become the first action sports athlete to be diagnosed with CTE

by Robert Silverman, vocativ.com (May 24, 2016)
 
After BMX biking legend Dave Mirra committed suicide on February 4 of this year, his wife had his brain tested for chronic traumatic encephalopathy. Sadly, the result came back positive, rife with tau proteins dotting both his temporal and frontal lobes after years of enduring an unknown amount of concussive and sub-concussive trauma. This makes Mirra the first action sports athlete to be diagnosed with CTE.

The neuropathologist went so far as to equate the condition of his brain to that of NFL players and other contact sport athletes that have been posthumously diagnosed with the disease. “I couldn’t tell the difference,” Dr. Lili-Naz Hazrati said.

In an exclusive interview with ESPN: The Magazine, Mirra’s wife Lauren describes the agonizing final weeks of his life, the transformation of his formerly vibrant personality into something different and darker, prone to wild mood swings and unprovoked crying jags or bouts of exhaustion, his mind clouded and wracked with depression.

“I remember seeing him sitting on our bed one day, in the last month of his life,” she said. “I had just gotten out of the shower and saw him hunched over with the blankest lost look. I sat down next to him and held his hand. I said, ‘What is wrong? Are you OK?’ And he just shrugged his shoulders. He couldn’t even speak. He didn’t know. He couldn’t put it into words. He was lost. He was helpless. It was completely different from who he was.”

“He was gone. I could see straight through him,” she continued. “It was the hardest thing to see, looking at someone you love, and you can’t have a conversation with them, and you can see straight through their eyes.”

Lauren Mirra doesn’t know what her exact plans might be for the future, but her overarching hope is that she’ll be able to find a forum in which to speak out, to encourage best practices and prevention measures, without coming across as an ideologue out to ban action sports altogether.

“Through him we have an opportunity to help and change,” she said. “Beauty from ashes. That’s how I will always choose to see it.”

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UCSF Researchers Advocate Prioritizing Teens for Education and Prevention

by Scott Maier (August 17, 2016) — The number of Americans diagnosed with concussions is growing, most significantly in adolescents, according to researchers at UC San Francisco. They recommend that adolescents be prioritized for ongoing work in concussion education, diagnosis, treatment and prevention.

The findings appear online August 16, 2016, in the Orthopaedic Journal of Sports Medicine.

“Our study evaluated a large cross-section of the U.S. population,” said lead author Alan Zhang, MD, UCSF Health orthopaedic surgeon. “We were surprised to see that the increase in concussion cases over the past few years mainly were from adolescent patients aged 10 to 19.”

Concussions are a form of mild traumatic brain injury resulting in transient functional and biochemical changes in the brain. They can lead to time lost from sports, work and school, as well as significant medical costs.

Though symptoms resolve in most concussion patients within weeks, some patients’ symptoms last for months, including depression, headache, dizziness and fogginess. Neuroimaging and neuropathological studies also suggest there may be chronic structural abnormalities in the brain following multiple concussions.

Recent studies have shown an increase in traumatic brain injuries diagnosed in many U.S. emergency departments. Smaller cohort studies of pediatric and high school athletes also have indicated a rise in concussions for certain sports, such as football and girls’ soccer. However, this is the first study to assess trends in concussion diagnoses across the general U.S. population in various age groups.

In this study, Zhang and his colleagues evaluated the health records of 8,828,248 members of Humana Inc., a large private payer insurance group. Patients under age 65 who were diagnosed with a concussion between 2007-2014 were categorized by year of diagnosis, age group, sex, concussion classification, and health care setting of diagnosis (emergency department or physician’s office).

Overall, 43,884 patients were diagnosed with a concussion, with 55 percent being male. The highest incidence was in the 15-19 age group at 16.5 concussions per 1,000 patients, followed by ages 10-14 at 10.5, 20-24 at 5.2 and 5-9 at 3.5.

The study found that 56 percent of concussions were diagnosed in the emergency department, 29 percent in a physician’s office, and the remainder in urgent care or inpatient settings. As such, outpatient clinicians should have the same confidence and competence to manage concussion cases as emergency physicians, Zhang said.

A 60 percent increase in concussions occurred from 2007 to 2014 (3,529 to 8,217), with the largest growth in ages 10-14 at 143 percent and 15-19 at 87 percent. Based on classification, 29 percent of concussions were associated with some loss of consciousness.

A possible explanation for the significant number of adolescent concussions is increased participation in sports, said Zhang, MD, who is also assistant professor of orthopaedic surgery at UCSF. It also may be reflective of an improved awareness for the injury by patients, parents, coaches, sports medical staff and treating physicians.

For example, the U.S. Centers for Disease Control and Prevention “HEADS UP” initiative has caused numerous states such as California to alter guidelines for youth concussion treatment.

Many medical centers also are establishing specialty clinics to address this, which could be contributing to the increased awareness. At UCSF, the Sports Concussion Program evaluates and treats athletes who have suffered a sports-related concussion. The team includes experts from sports medicine, physical medicine and rehabilitation, neuropsychology and neurology. Their combined expertise allows for evaluation, diagnosis and management of athletes with sports concussions, helping them safely recover and return to sports.

Other UCSF orthopaedic surgery contributors to the Orthopaedic Journal of Sports Medicine study were senior author Carlin Senter, MD, associate professor; Brian Feeley, MD, associate professor; Caitlin Rugg, MD, resident; and David Sing, clinical research associate.

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.

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LOUDON, N.H. (AP), (July 16, 2016) – He was one of NASCAR’s first superstars, but Fred Lorenzen’s memories of his Hall of Fame career have dimmed as he battles dementia. His Daytona 500 victory, the wins he piled up to become NASCAR’s first $100,000 driver, his life on the road, all have been largely extinguished.

Lorenzen still has flickering moments when he remembers the days when he was NASCAR’s “Golden Boy” for his rugged, movie-star looks. Like in recent years, when he visits Chicago Speedway, not far from his assisted living facility.

“His face just lights up when he’s there,” said his daughter, Amanda Lorenzen Gardstrom.

Nearly 45 years after his last Cup race, Lorenzen hoped he would still make his mark on the NASCAR community. Inspired by Dale Earnhardt Jr.’s decision to pledge his brain to the Concussion Legacy Foundation, Lorenzen became the second known driver to make the same decision.

Gardstrom made it official Friday with a pledge to Legacy co-founder Chris Nowinski. As auto racing grapples with the issue of concussions and head trauma, one of NASCAR’s pioneers is now alongside Earnhardt in the donation queue.

“As a family, we decided we wanted to support Dale Junior and all work together toward a healthy future for these drivers,” she told The Associated Press.

Earnhardt’s concussion history – he missed two races in 2012 – spurred his decision to pledge his brain to the Legacy, a group that works with Boston University on research into chronic traumatic encephalopathy, or CTE, a degenerative disease that doctors believe is caused by repeated blows to the head.

Gardstrom is convinced the 81-year-old Lorenzen has CTE as a result from years of brutal wrecks and hits from the 1960s, one of the most dangerous eras in racing history. Lorenzen won the Daytona 500 in 1965.

“He never stopped to heal,” she said.

She wants to help, and knows her father does, too, and advance the understanding of concussions and their treatment in NASCAR.

“It’s the younger generation that we really need to educate,” she said. “They’re young, they’re hungry, but when they get in a wreck and get a concussion, they know if they don’t get back in the car, someone else is going to take it. We want to change the culture of the sport.”

Earnhardt has become the face of concussion awareness in sports and will skip Sunday’s Sprint Cup race at New Hampshire Motor Speedway because of concussion symptoms. There is no timetable on when NASCAR’s most popular driver might return.

The 41-year-old Earnhardt had already intended to be an organ donor, so he said in April that giving up his brain made sense. Earnhardt said he was motivated by reading about three former Oakland Raiders who donated their brains in honor of teammate Ken Stabler. The quarterback’s brain showed signs of CTE.

“I think the protocols and the advances that we have made in trying to protect ourselves are great things,” Earnhardt said at his pledge announcement. “I’m excited about what NASCAR has done. They have really taken this head on.”

Gardstrom felt the same sense of motivation when she read about Earnhardt’s pledge. She said Lorenzen, inducted into the NASCAR Hall of Fame in 2015, first showed signs of dementia about a decade ago. He has memory loss and uses a wheelchair at Oak Brook Healthcare in Illinois.

The Elmhurst, Illinois, native was one of NASCAR’s first stars to hail from outside the sport’s Southern roots.

“The hardest part right now is that his racing memories are starting to go,” Gardstrom said. “That was the one thing that was really wonderful, to connect and see him light up when he talked about racing.”

She’d like to see others in the sport talk more about concussions.

“That hasn’t necessarily been a hot topic of conversation in any of our meetings,” Sprint Cup champion Kyle Busch said.

Six-time NASCAR champion Jimmie Johnson was part of a 54-member panel that picked Lorenzen for induction into the hall. Johnson has yet to consider donating his brain to the Legacy.

“I am an organ donor so it wouldn’t bother me to do that, but it’s something I’ve not taken steps in and have not discussed at all,” he said.

In the 15 years since Dale Earnhardt’s death at the 2001 Daytona 500, NASCAR introduced a series of measures designed to keep drivers safe, from helmet and restraint systems to impact-absorbing barriers along concrete walls, all designed to cushion high-impact blows.

NASCAR also mandated in 2013 that drivers submit to baseline neurocognitive assessment. When a driver in NASCAR can’t return his damaged car to the garage, a trip to the care center is required. Under a new three-step process, a driver showing any indication of a head injury must go immediately to a hospital. Concussed drivers must be cleared by an independent neurologist or neurosurgeon before they can get back in a race car.

Gardstrom wants NASCAR to take even more steps.

“We don’t have to wait until more drivers’ brains are studied to make a better concussion protocol,” she said.

Former athletes in other sports have sued their leagues, contending the risks of concussions were hidden from them so they could return to competition. Gardstrom has no interest in a lawsuit.

“No money is going to bring my dad back, but what my goal now is, is to make sure the NASCAR family doesn’t have to go through the similar things we’re going through now,” she said.

Lorenzen hasn’t been forgotten by today’s racing stars – they appreciate a driver who won 26 times in the Cup series. Tony Stewart introduced Lorenzen at his hall induction. Jeff Gordon leaned in for a chat with “Fearless Freddie” last year at Chicagoland before the race.

“He was such a humble guy, that I don’t think he ever realized what an impact he had on the sport,” Gardstrom said.

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