Tag Archives: concussion

When Bats Attack: New Design Should Improve Safety

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Collegiate ballplayers like this athlete from the U.S. Air Force Academy started using the redesigned bats in 2011. Image courtesy Wikimedia Commons/Danny Meyer, USAF/Public Domain

Doctors  know about concussions from football, lacrosse, hockey, and similar contact sports, but what about baseball? Apparently, aluminum baseball bats have been implicated in severe injuries and even deaths in school-aged children.

How? It comes down to physics. According to researchers at Washington University in St. Louis, the aluminum bats currently in use can cause the baseball to rebound so quickly, and with so much force, that even an attentive pitcher can’t always get out of the way in time.  In a tragic example, they cited the 2010 death of a 13-year-old pitcher in Vermont — killed by a line drive off an aluminum bat — and noted there have been other reports of similar fatalities.

To cut down on the risk of serious injuries and deaths from hard-hit line drives, the National Collegiate Athletic Association last season started mandating the use of a new style of aluminum bat. The new bat is engineered to put less energy behind the ball once it’s hit, so it is less likely to cause serious harm.

Here’s one of the researchers explaining of the features of the new bat:

This year, the new bats will be used by high school players as well. The National Federation of State High School Associations will enforce the use of the new bats, so ideally the hazards of school baseball will be limited to bug bites and sore jaws from hours of gum-chewing in the outfield.

–Heidi Splete (@hsplete on Twitter)

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Filed under Family Medicine, Pediatrics, Sports Medicine, Video

A New Weapon Against Concussion

Sports-related concussions are a growing concern in scholastic and professional athletics, as more studies have shown lasting effects from even a single blow to the head.  Concussions have also become a major concern for physicians, who are often pressured to clear athletes to return to play.

Courtesy Wikimedia Commons user Patrick J. Lynch/Creative Commons

Earlier today, I heard a little about what is increasingly being deployed as a new weapon in the quest to learn more about sports-related concussions: the accelerometer.  Dr. Dan Garza, an emergency and sports medicine physician at Stanford Hospital and Clinics, and medical director for the San Francisco 49ers, discussed Stanford’s use of accelerometers in the helmets of football players and of female lacrosse and field hockey players. (Virginia Tech announced a similar program back in 2007.)

The goal: to get real-time data on what kind of hits these players are taking. During practices and games, the players wear mouthpieces outfitted with accelerometers and gyrometers “that measure the linear and rotational force of head impacts,” according to the Stanford news story on the just-initiated program.

It’s also rimmed with microchips that transmit the accelerational force (known as G force) data to coaches on the sidelines. Dr. Garza said the mouthpieces are a bit eery with their red glow. “They look like Christmas trees out there,” he told his audience, attendees at the American College of Emergency Physicians Scientific Assembly in San Francisco.

Dr. Garza shared a game film from the Stanford Cardinals’ contest against Washington State on Oct. 15 in which wide receiver Chris Owusu received what looked to be a helmet-to-helmet hit (story here). He dropped to the ground and lay there for a bit. On the sidelines, Dr. Garza and his crew received the data from Mr. Owusu’s mouthpiece. They determined that the force of impact was equal to 184 Gs.

That type of accelerational force is considered deadly (for more on G forces, see here and here). For comparison purposes, astronauts only sustain up to 40 Gs at launch and an Indy race car driver might pull 3 Gs in a tight corner. Forces over 100 are usually only encountered in motor vehicle accidents.

Dr. Garza and his colleagues will use the data in a wider study. In the Stanford release, Dr. Garza said the study  “will build toward establishing clinically relevant head-impact correlations and thresholds to allow for a better understanding of the biomechanics of brain injuries.” It may also help with diagnosis and subsequent management of concussions.

Stanford’s football program is being especially closely watched these days, as its quarterback, Andrew Luck, is considered to be a potential number one pick in the NFL draft next year.

The NFL recently announced that it would restart a long, broad look at concussion among its players.  The league has also bankrolled a head-injury program overseen by the Boston University Center for the Study of Traumatic Encephalopathy.

As more attention has been focused on sports-related traumatic brain injury, Congress has gotten involved also. The Senate Commerce, Science and Transportation Committee is having a hearing this Wednesday on companies marketing supposed anti-concussion equipment.

—Alicia Ault (on Twitter @aliciaault)

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Sports concussions leave sneaky side effects

When he was a teenage lacrosse player, Dr. Brandon Cornejo suffered a mild concussion. He was awake during the trip to the hospital in his parents’ car. And he painfully recalls the resulting cognitive and emotional side effects that messed him up academically, socially, and psychologically.

Lacross sticks image by Yarnalgo (Wikimedia Commons).

The worst part, though, was that he spent 16 years not even knowing he had suffered the traumatic brain injury, because he had no memory of it. He wasn’t aware of a “before” or “after” the injury, so he didn’t know that his struggles were caused by the concussion. Instead he blamed himself, floundering in anger, confusion and depression.

Now a chief resident in psychiatry at the University of Wisconsin, Madison, Dr. Cornejo told his story at the annual meeting of the American Psychiatric Association to impress upon his colleagues the challenges of helping patients with traumatic brain injury, especially athletes.

“These mild injuries can have profound effects on your self-concept and your experience as a human being. They can change the course of your life,” he said.

In 1991, he was a straight-A student in his junior year at a college preparatory high school and the son of proud Latino parents who had never attended college themselves. He and his family were looking forward to him getting a scholarship to finance college.

Dr. Cornejo (Photo by Sherry Boschert)

After the concussion, his grades tanked. He barely got by with Cs and Ds. His girlfriend dumped him. He became very emotional. He remembers 6-9 months of bad fights with his parents. “The likelihood is pretty high that this was related to the loss of consciousness,” he said. “For years, I considered myself `not good at’ certain things because of my academic performance in my senior year.”

His behavior frustrated and shocked him. One time he exploded in “road rage,” which embarrassed him even though no one was there to witness it. Another time when he was ordering oatmeal in a restaurant, he could not recall the words for brown sugar.

“I developed a significant depression, a huge depression. In retrospect, I have a hard time distinguishing between depression produced by traumatic brain injury and depression because I wasn’t performing academically. My family was counting on” a scholarship, he said. That motivation and a lot of hard work eventually got him back on track academically, and somewhere in his freshman year of college he started to regain some self-esteem.

Years later, in 2007, his father casually said, “Remember that time you got knocked out, and we took you to the hospital?” Dr. Cornejo could dredge up only two memories — one of his coach staring down on him on the field, and the other of being in the back seat of the family car, with his mother saying, “Brandon, you’re really scaring us. Why do you keep repeating yourself?”

At the time of the injury in 1991, understanding of traumatic brain injury was just beginning to emerge, and the primary care physician who saw him for follow-up told his parents that their son should be fine, and they should keep an eye on him for a couple of weeks.

Today, Dr. Cornejo hopes that physicians would not allow young athletes with traumatic brain injury to return to play as quickly as he did, because repeat concussions carry much higher risks. He wishes that helmet designers would improve their products. And he urges all physicians to educate not only patients but their families and significant others about the potential sequelae of traumatic brain injury.

Because the patients may not remember.

–Sherry Boschert  @SherryBoschert on Twitter

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