INDIANAPOLIS – Linemen in college football shield the quarterback from would-be tacklers, but what’s to protect these burly linemen from health threats associated with their size? Exercise alone won’t do it, according to new research from the American College of Sports Medicine (ACSM).

Two-thirds of Division I linemen studied were obese, putting them at significant risk for metabolic syndrome and insulin resistance compared with players at other positions. High levels of physical activity—shown to help prevent obesity, diabetes and other chronic diseases—weren’t enough to counteract the health threats brought on by the linemen’s weight and lifestyle factors, researchers found. The study is the first to report on the prevalence of the metabolic syndrome and insulin resistance in a large cohort of Division I collegiate football players.

“These findings are consistent with a recent study showing retired NFL linemen were twice as likely to develop metabolic syndrome as players of other positions,” said lead researcher James R. Borchers, M.D., MPH. “Given the serious health consequences of these conditions, we need to study college football players over time—and we need to counsel them about managing their health risks.”

Borchers pointed out that, while this study revealed similarities between Division I linemen and their professional NFL counterparts, the comparison may not apply to football players at Division II and Division III schools.

The study measured 90 football players, grouping them according to positions played. Group A comprised offensive and defensive linemen; Group B included wide receivers and defensive backs, and Group C consisted of tight ends, linebackers, quarterbacks, punters and kickers. Participants were measured for body composition, blood pressure, insulin level, cholesterol and other factors. Eight percent were overweight (20-25 percent body fat) and 21 percent (all linemen) were obese, with at least 25 percent body fat. Twenty-one percent of participants were found to have insulin resistance, a condition associated with coronary artery disease and diabetes. 

Forty-two percent of obese participants had metabolic syndrome, defined as showing abnormality in at least three of the following five measures:

-          Triglyceride

-          HDL-C

-          Abdominal obesity

-          Glucose

-          Blood pressure

Metabolic syndrome is thought by some to be a more important risk factor than tobacco use in the future development of coronary artery disease. While high levels of physical activity are known to reduce the rate of metabolic syndrome among adolescents, the relationship between activity and metabolic syndrome in obese individuals is unclear. Today’s Division I football players have significantly higher body fat and total body mass than their counterparts of the 1980s and ‘90s, giving rise to additional concerns about their long-term health.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 35,000 international, national, and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

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NOTE: Medicine & Science in Sports & Exercise® is the official journal of the American College of Sports Medicine, and is available from Lippincott Williams & Wilkins at 1-800-638-6423. For a complete copy of the research paper (Vol. 41, No. 12, pages 2105-2110) or to speak with a leading sports medicine expert on the topic, contact the Department of Communications and Public Information at 317-637-9200 ext. 133 or 127. Visit ACSM online at www.acsm.org.

The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine

Sports Medicine / Fitness
Article Date: 22 Oct 2009 -

As debate continues over health system reform, a proposal with vast preventive power is drawing widespread support. Scientists, physicians, public health experts and others have rallied in favor of the Physical Activity Guidelines for Americans Act of 2009. The measure (S. 1810 in the Senate and H.R. 3851 in the House), provides that the Department of Health and Human Services update federal physical activity guidelines at least every five years.

The bill’s sponsors reflect bipartisan support for healthy lifestyles as preventive medicine: Reps. Bart Gordon (D-TN), Mary Bono Mack (R-CA), Ron Kind (D-WI) and Zach Wamp (R-TN); Sens. Tom Harkin (D-IA) and Sam Brownback (R-KS).

“The first federal guidelines for physical activity, released in October 2008, were a big step forward,” said James Pivarnik, Ph.D., FACSM, president of the American College of Sports Medicine (ACSM). “The American public would be well served by guidelines that are updated regularly, like federal guidelines for nutrition, based on the latest scientific and medical information.”

ACSM led the call for federal physical activity guidelines, and a number of its members lent their expertise to the process of developing them. In 2006, ACSM convened a broad coalition of more than 40 organizations, resulting in six key calls to action - including the creation of regular updates to federal physical activity guidelines. Another recommendation, a National Physical Activity Plan, is under development. Many organizations involved in the 2006 policy roundtable are among those who have endorsed the Physical Activity Guidelines for Americans Act (click here for list ).

Helping Americans of all ages and health status increase their level of physical activity can do much to cut health care costs, improve individual quality of life and boost productivity, according to research by ACSM experts and others. Physical activity and exercise have been shown to reduce the risk of chronic diseases and conditions including overweight and obesity, diabetes, cancer, heart disease, osteoporosis and others. Recent research shows:

- Seventy-five percent of every dollar spent on health care goes toward treatment of chronic diseases.
- Estimates project that, by 2010, 20 percent of children in the U.S. will be obese.
- 52 percent of U.S. adults do not meet minimum recommendations for physical activity. Only 35.8 percent of high school students are physically active 60 minutes or more, five days per week; just 33 percent attend physical education classes daily.
- Those living in poverty, people of color, people with disabilities, and rural residents face increased obstacles to engaging in safe physical activity and suffer significant disparities in their overall health status.

“Given the low cost of exercise-as inexpensive as a pair of walking shoes-and its manifest health benefits, we need to do all we can to help people engage in appropriate types and amounts of physical activity,” said ACSM’s Pivarnik. “I hope that, while Congress wrestles with health reform legislation, they will pass the guidelines act with its potential for a huge payoff in terms of preventive health care and of dollars saved.”

Source
American College of Sports Medicine

Coaches Vs. Cancer and Health Insurance Reform 2:18

Coaches Tubby Smith, Oliver Purnell, John Thompson III, Mike Brey, and Ed Dechellis describe how cancer has affected their personal lives as they visit capitol hill with the American Cancer Society to speak out for cancer prevention and research. October 14, 2009 (public domain)

Coaches Vs. Cancer and Health Insurance Reform 2:18

Coaches Tubby Smith, Oliver Purnell, John Thompson III, Mike Brey, and Ed Dechellis describe how cancer has affected their personal lives as they visit capitol hill with the American Cancer Society to speak out for cancer prevention and research. October 14, 2009 (public domain)

A high percentage of collegiate and professional athletes begin the season dehydrated, putting their health at risk even before they begin strenuous workouts, according to researchers at Indiana State University.

The rate is especially high among football players, with as many as four out of five members of one college team exhibiting dehydration during pre-season physical examinations, said Susan Yeargin, assistant professor of athletic training in Indiana State’s College of Nursing, Health, and Human Services.

With many teams undertaking grueling workouts twice a day during some of the hottest weeks of the year, football players are especially at risk from dehydration, Yeargin said. That risk was recently in the spotlight in Louisville, Ky. where a high school coach faced reckless homicide charges for the August 2008 death of a player who succumbed to heatstroke. Prosecutors claimed the coach there acted irresponsibly by withholding water from athletes during a practice.

Ideally, the ISU study could help others to avoid a similar fate.

“We hope that our study will serve to educate players, coaches and health care providers and help ensure a higher level of safety for athletes at all levels,” Yeargin said.

Approximately 80 percent of NCAA Division I football players and 50 percent of NFL players who participated in an ISU study were found to be dehydrated during pre-season physical examinations, Yeargin said. Approximately 30 percent of NCAA Division III players were dehydrated.

Dehydration affects the human body in many ways, Yeargin said.

“It’s going to affect an athlete’s physical performance they’re not going to have the dexterity to catch the ball correctly, they’re also going to have cognitive effects such as trouble remembering plays,” she said. “Physiologically, their core body temperature could be higher than it should have been if they were hydrated. Their heart rate will be higher, and they’re going to perceive that they’re working harder than they actually are.”

The study, conducted at the start of the current football season, involved the teams of Indiana State and Rose-Hulman Institute of Technology as well as the Indianapolis Colts.

Indiana State student-athletes in volleyball, cross-country and soccer were also surveyed. Fewer participants in those sports were found to be dehydrated.

The study also served to show athletes how they can self-regulate their hydration level, said Lindsey Eberman, assistant professor of athletic training.

“One factor is teaching them about urine color and how they can self-recognize how hydrated they are. We think that has a significant impact on their day-to-day practices. If they recognize their hydration level as lower, they can instill the correct pattern of behavior to ensure that they become hydrated before the next practice,” Eberman said.

Urine that is clear in color indicates sufficient hydration while a dark yellow or brown color indicates an individual is dehydrated, she said.

Many athletes, football players in particular, showed improvement in just one day after receiving tips from Indiana State professors and students about ways to self-monitor their level of hydration.

“We saw really good results for that,” Yeargin said. “A good number of the guys came back hydrated after following those tips.”

Another goal of the research is to stress to team physicians and athletic trainers the importance of collecting accurate data during physicals, Yeargin said.

“When they get a baseline body mass on someone during pre-participation physicals they need to make sure that it is a “true” baseline measurement. If they’re going to use that as their primary starting point measurement and the person actually weighs more than that because they were dehydrated when it was taken, then health care providers can’t trust any of their other weight measurements for the rest of pre-season,” she said.

A side benefit of the study is that it educated undergraduate athletic training majors about the importance of research, the professors said. Coincidentally, their study was conducted during the time of the Kentucky high school coach’s trial and Yeargin and Eberman took their students to Louisville last week to sit it on the proceedings.

“The involvement of students in research is so important to the profession of athletic training. Students need to realize how significant research is and how they can apply it to their clinical practice,” Eberman said.

“It can help me if I happen to research in grad school or in the professional community because I will have a better understanding of the importance of research and how to do it,” said Tiffani Vaal, a junior from St. Meinrad.

“As a freshman I had no interest in getting involved in research. I thought it was way too much work, but now that I’ve seen it I know I can do it and it’s interesting,” added Shannen Falconer, a junior from Winnebago, Ill.

Falconer, who was a student-athlete in high school, did not expect such a high percentage of Division I athletes to exhibit dehydration.

“You know you’re going to work hard and sweat a lot and yet to come in already dehydrated was really surprising,” she said.

Source: Indiana State University

National Athletic Trainers’ Association’s Fair Practice Lawsuit Settlement Benefits Members

The National Athletic Trainers’ Association (NATA) announced today that an out-of-court settlement was reached in its Fair Practice Lawsuit against the American Physical Therapy Association (APTA) on Sept. 21, 2009. The NATA filed suit against the APTA for antitrust violations that unfairly restricted athletic trainers from practicing manual therapy and gaining access to continuing education courses on manual therapy. The case was scheduled for a status and scheduling hearing in Federal District Court in Dallas on Sept. 22.

The centerpiece of the settlement is a Joint Statement on Cooperation between APTA and NATA, signed by the president of each association’s board of directors. Highlights of the Joint Statement include:

- That physical therapists are neither the exclusive providers of manual therapy nor the exclusive providers of physical medicine and rehabilitation services. The APTA agrees with NATA that athletic trainers are qualified to perform these services.

- That the scopes of practice of athletic trainers and physical therapists overlap.

- APTA recognition of athletic trainers as health care professionals qualified to assist their patients.

- That APTA will not make false or misleading statements about athletic trainers, including improper references to them as “unqualified,” “not qualified,” “non-qualified” or any variation of these terms. The APTA agreed that it will not make false or deceptive statements that mislead patients, employers or others regarding athletic trainers.

- That athletic trainers are qualified and authorized to provide interventions within their state scope of practice and licensure.

- That decisions related to reimbursement are to be decided by public and private insurers, state and federal legislators and regulators, patients and other stakeholders.

- That athletic trainers are qualified to pursue continuing education in manual therapy, and that APTA’s internal policies regarding continuing education does not apply to athletic trainers in the 47 states where ATs are licensed or regulated.

“I am pleased that we can move forward with respect for each profession’s knowledge, skills and abilities in manual therapy and physical medicine and rehabilitation,” said Marjorie J. Albohm, MS, ATC, president of NATA. “In this time of health care reform, it is more important than ever that all health care professionals work as a team to deliver high quality, safe, affordable patient care. Athletic trainers contribute to their patients’ wellness, physical activity level and musculoskeletal health, no matter the age of the patient.”

Albohm said the settlement is also a victory for patients, public and private health insurers, employers and physicians because they will all have increased access to and choice of health care professionals. “We look forward to delivering therapy services and protecting the welfare of our patients,” she said.

The two national associations agreed to confer periodically on issues of common interest and areas of friction, as they arise. “We look forward to a spirit of mutual cooperation with the APTA,” Albohm said. “But we will be vigilant in protecting our members’ ability to practice to the fullest extent of their scope of practice and qualifications,” Albohm said.

NATA filed the civil lawsuit in February 2008 because of ongoing anti-competitive actions taken by the APTA. NATA was informed by members in Fall 2007 that the APTA and the Orthopaedic Section of the APTA had taken actions to restrict athletic trainers’ access to education in – and the practice of – manual therapy techniques. Manual therapy is included in the athletic training competencies, scope of practice and licensure. NATA believed that the APTA’s attempt to limit access to manual therapy courses was an attempt to prevent athletic trainers from competing fairly with physical therapists in providing therapy services.

Both associations will issue the “Joint Statement on Cooperation” to their respective members. Additionally, APTA and NATA will provide a prominent link to the joint statement on their home pages for one year and on a public-access Web page for an additional 24 months.

To review the Joint Statement on Cooperation and other related documents, go to http://www.nata.org/.

Source
National Athletic Trainers’ Association (NATA)

Concussions are by far the most common, and one of the most difficult to manage injuries seen in sports today. According to the Centers for Disease Control and Prevention, there are between 1.6 million and 3.8 million brain injuries that occur in sports each year – and 63,000 occur in high school athletes alone. The National Academy of Neuropsychology (NAN) and National Athletic Trainers’ Association (NATA) have joined forces on a national and local grassroots campaign to educate the public, athletes, health professionals, coaches, parents, administrators and others about concussion in sports. The overarching objective of the campaign is to raise awareness of the importance of identifying concussions and implementing appropriate management when they do occur.

As a centerpiece of the NAN and NATA efforts, a 12-minute educational video titled “Concussions in Hockey: Signs, Symptoms and Playing Safe,” has now been released nationally. The video, sponsored by the National Hockey League and the NHL Players’ Association, features comments from Mike Modano of the Dallas Stars and retired NHL players Pat LaFontaine and Eric Lindros. It is available as a free online download on affiliated Web sites, including http://www.nanonline.org/, http://www.nata.org/, http://www.nhl.com and http://www.nhlpa.com/ and also available, upon request, at a cost of $10 at http://www.nata.org/brochures/.

“Concussions can be serious injuries if not treated properly. Concussion symptoms can affect players in all areas of their lives including their physical, emotional and cognitive functioning,” said Ruben Echemendia, PhD, NAN past president and director of the NHL’s Neuropsychological Testing Program. “Swift and appropriate evaluation by trained sports medicine professionals is crucial before an athlete returns to play. That is why we counsel students and coaches to err on the side of caution and ‘when in doubt, sit out.’”

This educational campaign explicitly urges athletes to immediately consult with their athletic trainer, team physician or coach if they think they might have a concussion. “Even if an athlete’s symptoms appear to be very mild, if they don’t feel right, they must immediately tell somebody in charge,” Echemendia said.

For more information, NATA has published a position statement (pdf download) on concussions, which is available at www.nata.org/statements/position/concussion.pdf. NAN has also published a sports concussion white paper, which is available here.

The National Academy of Neuropsychology (NAN) is a professional association founded in 1975 to advance Neuropsychology as a science and health profession, to promote human welfare and to generate and disseminate knowledge of brain-behavior relationships. NAN has become a vibrant organization of the world’s leading scientist-practitioners, academics, clinicians and researchers in the field of brain functioning. The association’s current membership is over 3,500 with representation by 17 countries. Visit http://www.nanonline.org.

Source
National Athletic Trainers’ Association (NATA)

** SPORTS MEDICINE / FITNESS News **

Work out with friends for a natural high

Exercise classes or going for a run with a friend will make you feel better than working out alone, according to new research published today in the Royal Society journal Biology Letters.

When we exercise, happiness’ hormones called endorphins are released by the body giving us a natural high’, a feeling of elation. To find out if this hormone release is affected by working out in a group, a team of scientists from the University of Oxford measured endorphin production in a group of rowers, both when they exercised alone and when they trained together as a team.

Endorphins help to reduce the feeling of pain and Emma Cohen and her team carried out a pain threshold test before and after the exercise sessions as a way of measuring how much endorphins had been produced.

Their results showed sportsmen to have a significantly higher tolerance to pain after exercising in a group than they did after exercising alone, suggesting that their group workouts led to a greater production of feel good endorphins.

Not only do these results imply a benefit to exercising with others, they also help to explain why group activities like dancing, laughing and making music make us feel so fantastic. A greater production of endorphins during these activities, suggest the authors, could be a way to help humans to bond in groups and improve social interactions.

The Royal Society, the national academy of science of the UK and the Commonwealth, is at the cutting edge of scientific progress. We support many top young scientists, engineers and technologists, influence science policy, debate scientific issues with the public and much more. We are an independent, charitable body which derives our authoritative status from over 1400 Fellows and Foreign Members.

 Athletes With Smaller ACLs May Be More Susceptible To Injury

 
——–A study comparing images of the knees in people who did and didn’t have previous injuries to the anterior cruciate ligament suggests that people who tore their ACLs are more likely to have a smaller ligament than do similarly sized people who have never injured a knee.

Researchers calculated the total volume of the ligaments based on magnetic resonance images of human knees. The ACLs among those with previous injuries were, on average, about 10 percent smaller than were ACLs among those without an injury.

In those with previous injuries, the uninjured ACL in the opposite knee was measured for the study. Their ligaments were compared to the ACLs in uninjured people of similar height and weight.

Those who had torn their ACLs had experienced noncontact injuries, meaning the injury occurred during some sort of movement of the body rather than because of a blow to the knee.

Researchers caution that the retrospective study does not mean that a smaller ACL will necessarily result in injury. Instead, they say the research offers more clues about the variety of factors – such as activity level, neuromuscular coordination, gender and muscle strength – that appear to be contributors to ACL injury.

In this group of participants, weight was the strongest predictor of ACL volume.

“If you compared two people of the same weight, based on our data set, we would expect the injured person had the smaller ACL,” said Ajit Chaudhari, assistant professor of orthopedics at Ohio State University and lead author of the study.

Knowing that the knee’s anatomy can influence susceptibility should help researchers who are trying to figure out why ACL injuries occur and who is most likely to experience these injuries, Chaudhari said. Most study results guide the assignment of a percentage of risk to one or more factors associated with torn ACLs, but to date no research had looked solely at the size of the ligament in injured and non-injured knees.

The research is published in a recent issue of the American Journal of Sports Medicine.

The anterior cruciate ligament, responsible for rotational stability in the knee, is located behind the kneecap and is one of four ligaments that join the thigh and shin bones. Noncontact tears of the ACL tend to occur in athletes when they pivot, stop quickly or land from a jump. Previous research suggests that college-age women athletes are at three- to 10-times higher risk of tearing their ACLs than their male counterparts, depending on the activity, but scientists have not determined why this is.

“Comparisons of the volumes of ACLs between men and women have been done, which have suggested that ACL volume may matter. Studies have also found that female ACLs had fewer fibers than male ACLs that were tested. But even with those findings, any differences between males and females could be a coincidence. There are so many variables that interact that you can’t really tell what’s causative unless you compare people who have had an injury to those who haven’t had an injury,” said Chaudhari, also director of Ohio State’s Sports Biomechanics Laboratory.

He and colleagues took MR images of the knees of 54 participants, who were divided into two groups. Volunteers with previous injuries were matched with uninjured participants of the same age, gender, height and weight.

The previously injured participants’ healthy knees were imaged for the study. Chaudhari said the fibers of a torn ACL tend to fray like a rope, meaning the volume of injured ACLs could not be measured in a meaningful way. Chaudhari recently presented related research that indicated that there is no significant difference in the size of two ACLs in the same body.

Researchers used the MR images to determine the outline of each ACL under the guidance of an orthopedic surgeon experienced in operating on injured knees. They validated this method of determining ACL volume by practicing the measurement technique on five pig knees obtained from a butcher.

Of the 27 injured participants, 16 had smaller ACLs than their matched controls. Overall, the injured group had an average ACL volume of 1,921 cubic millimeters, while the control group had an average volume of 2,151 cubic millimeters.

In this group of participants, weight and height were strongly correlated as potential variables affecting the size of the ligament.

Chaudhari said that based on what is currently known about the fibrous makeup of the ligament, it’s no surprise that a smaller ACL is more susceptible to injury.

“If you have a weaker ACL, it’s more likely to tear if all other factors are equal,” he said. “If being larger in size means the ACL has more fibers, then that would make it stronger. If the individual building blocks are of similar strength, then it comes down to how much total tissue there is.”

It’s too soon to consider knee imaging as a way to screen potential athletes, Chaudhari said, because of the high expense and the fact that knowing the size of the ACL still doesn’t tell the whole story of how the knee will react to activity.

“I would certainly not say in any way, shape or form that people should start using ACL size as a determinant of whether they should play any sport,” he said.

But what it does tell researchers is that there might be more than one way to go about trying to prevent knee ligament injuries. While many prevention efforts focus on the strength of muscles surrounding the knee, Chaudhari and other researchers hope to study whether the ACL itself can be made stronger, or larger, or both, while a child is still growing and developing.

This work was supported by the OSU Roessler Scholarship Fund, the Wright Center for Innovation in Biomedical Imaging, and a National Institutes of Health Clinical and Translational Science Awards grant.

Co-authors are Eric Zelman of the College of Medicine, David Flanigan and Christopher Kaeding of the Department of Orthopedics, and Haikady Nagaraja of the Department of Statistics, all at Ohio State.

Source:
Ajit Chaudhari
Ohio State University
————————————–

** SPORTS MEDICINE / FITNESS News **

End Of Summer Means Football Season: Prevent Potentially Tragic Head And Neck Injuries
http://www.medicalnewstoday.com/articles/161545.php

Every year, there are tragic stories about athletes who suffer life-altering football-related injuries to the brain and spine. According to the American Association of Neurological Surgeons (AANS), in 2008, football contributed to the second highest number of sports-related head injuries, behind cycling. Of the nearly 41,000 people treated for football-related head injuries at U.S. hospital emergency rooms, 16,900 were age 14 and younger. As far as spinal cord injury, football comes in as the third leading sports-related cause after diving and cycling.

While football is a collision sport with inevitable risks, most serious neurological injuries can be prevented by following a few safety measures,” stated Brian R. Subach, MD, FACS, a Virginia-based neurosurgeon who is a team spine surgeon for the Washington Redskins. “Although data indicate a reduction in the number of cervical cord and brain injuries with incomplete neurological recovery when compared to data published in the early 1970s, basic rules need to be followed and injury prevention taken seriously by the players, parents and coaches,” added Dr. Subach.

Injuries to the cervical spine are usually associated with high-velocity collisions between players, causing acceleration or deceleration of the head on the neck. Acceleration often causes a whiplash type of extension force on the neck, while deceleration often results in forward-bending (flexion) forces. Spear-tackling or spearing, banned in American football since 1976, occurs when a player uses the top of the helmet as the first point of contact with another player. Spearing was banned secondary to the high number of associated cervical spine injuries and quadriplegia. Advances in the construction of helmets and shoulder pads, as well as proper coaching from an early age have combined to dramatically reduce the number of serious injuries.

The National Center for Catastrophic Sport Injury Research tracks a number of neurological injury statistics related to football. Statistics from 1977-2008:

Football Neck and Head Injury Statistics and Cases

– Cervical-spine injuries are estimated to occur in 10-15 percent of all football players, most commonly in linemen and defensive players.

– During the past 32 years, there have been a total of 295 football players with incomplete neurological recovery related to cervical spinal cord injury (SCI): 243 high school players; 33 college players; 13 professionals; and six sandlot players.

– From 1984-2008, there have been 121 traumatic brain injuries with incomplete recovery.

– A 17-year-old high school football player was injured in a preseason scrimmage. He was assisting on a tackle from the linebacker position. He flipped over and landed on his head on the turf. He is now quadriplegic.

– A 20- year old college football player suffered a cervical spine injury during a game, causing transient paralysis. He made a full recovery but was advised that his football career is over.

– A 16-year-old high school football player was injured while tackling during a game after a helmet-to-helmet hit. He underwent surgery to remove a blood clot from the brain and has recovered, but was advised to never play football again.

– A 14-year-old high school football player was hit on the left side of the head four times during a practice drill. He underwent surgery to remove a blood clot from the brain, was in a medically induced coma, had surgery, and was scheduled for another surgery in three months. He has not fully recovered.

Concussion

A concussion is an injury to the brain that results in temporary loss of normal brain function. A blow to the head is a common cause of concussion. Cuts or bruises may be present on the head or face, but in many cases of concussion, there are no external signs of trauma. A “Second-impact” syndrome results in acute, often fatal brain swelling that occurs when a second concussion is sustained before complete recovery from a previous concussion. The impact is thought to cause vascular congestion and rapidly increasing intracranial pressure, which may be difficult or impossible to control.

According to the AANS, the annual incidence of football-related concussion in the United States is estimated at 300,000. At the high school level, studies show that while 10 to 15 percent of athletes playing contact sports sustain concussions each year, only a fraction receive proper treatment. Some team physicians and trainers evaluate an athlete’s mental status by using a five-minute series of questions and physical exercises known as the Standardized Assessment of Concussion (SAC). More recently, teams have employed ImPACT, a 25-minute computer based testing program specifically designed for the management of sports-related concussion. A player who has sustained a concussion is three to six times more likely to sustain another one. “While the decision on when an athlete is ready to return to play isn’t straightforward, every player should receive baseline neurological testing before the season so that the results can be used for comparison in the event the athlete receives a blow to the head,” said Dr. Subach.

Football-Related Head and Neck Injury Prevention Tips

– All players should receive preseason physical exams and those with a history of prior brain or spinal injuries, including concussions, should be identified.

– Football players should receive adequate preconditioning and strengthening of the head and neck muscles.

– Coaches and officials should discourage players from using the top of their football helmets as battering rams when blocking, hitting, tackling, and ball carrying.

– Coaches, physicians and trainers should ensure that the players’ equipment is properly fitted, especially the helmet, and that straps are always locked.

– Coaches must be prepared for a possible catastrophic SCI. The entire staff must know what to do in such a case, because being prepared and well informed might make all the difference in preventing permanent disability.

– The rules prohibiting spearing should be enforced in practice and games.

– Ball carriers should be taught to not lower their heads when making contact with the tackler to avoid helmet-to-helmet collisions.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 7,600 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves.

Source: American Association of Neurological Surgeons

Brain Damage In Amateur Boxers Detected By Blood Test
http://www.medicalnewstoday.com/articles/161475.php

A blood test can now be used to detect brain damage in amateur boxers. Deterioration of nerve cells seems to occur even after a two-month break from boxing. This is shown in a new study from the Sahlgrenska Academy.

The results of the study conducted by researchers at the Sahlgrenska Academy and the Erciyes University Medical School in Turkey are published in the current issue of the scientific journal Brain Injury.

The findings constitute further evidence that repeated blows to the head may damage the brain.

‘The blows seem to lead to a deterioration of nerve cells that lasts for a relatively long time. It is important that this is made known to participants in sports that involve kicks and blows to the head and to parents who let their children participate’, says Henrik Zetterberg, Reader at the Department of Psychiatry and Neurochemistry at the Sahlgrenska Academy.

The study included 44 Turkish amateur boxers, whose blood samples were collected in the beginning of a training camp after a two-month break from boxing. The results were compared to those found in a healthy control group. The researchers analysed several proteins that can be used to identify brain damage, and found that the levels of one protein, called NSE, were higher among the boxers than in the control group.

‘Their levels were high even after two months off from boxing. This indicates that the harmful processes in the brain continue even if the boxers have not recently experienced head trauma’, says Zetterberg.

The same team of researchers has previously been able to show that amateur boxing leads to increased levels of brain damage markers in spinal fluid.

‘A blood test is much easier to take, and it would be interesting to test athletes repeatedly following matches and while they recover from knockouts to see how the levels of NSE change over time. These types of biomarkers could be useful in sports medicine to help decide when an athlete should abstain from training and competition. But the method must first be evaluated further’, says Zetterberg.

Source:
Henrik Zetterberg
University of Gothenburg

Young Athletes At Risk For Heat Illness As Fall Sports Begin
http://www.medicalnewstoday.com/articles/161222.php

As the start of another school year looms and practices for fall sports begin, young athletes – and not just football players – are challenged by the hot weather and face significant heat injury and illness risks, say experts from the American College of Sports Medicine (ACSM).

Education, planning, acclimatization, modification, and monitoring are all key to keeping heat injuries and illnesses at bay – effective prevention strategies that coaches supervising practices often don’t implement, says Michael F. Bergeron, Ph.D., an ACSM Fellow and Trustee and one of the nation’s most highly regarded youth sports heat stress experts.

“Teaching coaches the warning signs of heat illness would be a huge step toward prevention,” said Bergeron, who co-wrote the ACSM Roundtable Consensus Statement on Youth Football Heat Stress and Injury Risk. “But it’s not enough. Coaches need to progressively introduce practice duration and intensity, as well as the uniform and any protective equipment, so that young athletes can safely adapt. Regular fluid breaks should be mandatory and practice should be appropriately modified for safety as the heat and humidity increase. Long gone are the days of refusing players water or using heat as a strategy to ‘toughen up’ a player. Unless the coach wants a collapsed athlete – or worse – on the field, it’s just not acceptable. All athletes need to be closely monitored for signs and symptoms of developing heat illness, and participation should immediately stop and medical attention should be promptly sought at the earliest point of recognition.”

The National Center for Catastrophic Injury Research, commissioned by the National Federation of State High School Associations, says that “heat-related deaths continue to be the cause of a majority of indirect deaths” in high school sports. In the report, heat stroke and other heat illnesses were experienced in variety of sports, including cross-country running and wrestling, with wrestlers working out in heat-holding rubber suits to try to “make weight” for events. Even marching bands should be concerned and take precautions – a study at the 2009 ACSM Annual Meeting showed band participants had heat illness risk and levels similar to those of athletes.

“I’ve attended numerous junior tennis tournaments where kids were competing from morning to dusk in excruciatingly hot summer conditions,” Bergeron said. “Football might get the most attention for severe heat-related injuries and illnesses, but the risk in other sports is very real.”

The ACSM Consensus Statement provides helpful prevention guidelines that can be applied to all outdoor sports, not just football:

- Avoid holding practices between 12 and 4 p.m., typically the hottest hours of the day (although later hours can also be as hot or hotter).

- When heat is extreme, hold practices indoors or use outdoor practices as lighter walk-through sessions.

- Increase the frequency and duration of rest breaks in the shade during practice, and give plenty of opportunities for sufficient fluid consumption.

In addition to promoting these proven heat illness prevention strategies, ACSM is developing new initiatives to educate not just coaches and schools, but also sport governing bodies and policymakers on heat illness prevention.

Source
The American College of Sports Medicine