{"id":701,"date":"2012-05-21T08:07:06","date_gmt":"2012-05-21T13:07:06","guid":{"rendered":"http:\/\/nflconcussionlitigation.com\/?p=701"},"modified":"2012-07-31T16:15:50","modified_gmt":"2012-07-31T21:15:50","slug":"guest-post-is-preventing-concussions-false-advertising","status":"publish","type":"post","link":"https:\/\/nflconcussionlitigation.com\/?p=701","title":{"rendered":"Guest Post: Is “Preventing Concussions” False Advertising?"},"content":{"rendered":"

By Andrew M. Blecher M.D<\/a>.<\/strong><\/p>\n

<\/strong>Necessity is the mother of invention.\u00a0 Is it necessary to try and prevent concussions in sports?\u00a0 Absolutely!\u00a0 Recent events have made it more necessary than ever.\u00a0 So then let’s invent something to prevent them, right?\u00a0 Well many people have tried to do just that.\u00a0 We are now seeing a wave of products, new technologies, safety equipment and supplements all specifically designed and marketed to prevent, reduce or cure concussions.\u00a0 But while these ideas are all well-intentioned, are these claims really valid?\u00a0 Let’s take a look.<\/p>\n

Let’s start with the definition of concussion.\u00a0 Here it is as defined by the Summary Agreement Statement of the 1st International Symposium on Concussion in Sport (2001):<\/p>\n

\u201cConcussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.\u00a0 Several common features that incorporate clinical, pathological and biomechanical injury constructs that may be used in defining the nature of a concussive head injury include:\u00a0\u00a0\u00a0 1)\u00a0 Caused either by a direct blow to the head, face, neck, or elsewhere on the body with an \u201cimpulsive\u201d force transmitted to the head.\u00a0 2)\u00a0 Typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously.\u00a0 3)\u00a0\u00a0May result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than structural injury.\u00a0 4) Results in a graded set of clinical syndromes that may or may not involve loss of consciousness.\u00a0 Resolution of the clinical and cognitive symptoms typically follows a sequential course.\u00a0 5) \u00a0Typically associated with grossly normal structural neuroimaging studies.\u201d<\/p><\/blockquote>\n

Ok, it’s a long-winded definition but let’s take a look at feature #1.\u00a0 It can be caused by a direct blow to the head OR elsewhere on the body with an impulsive force transmitted to the head.\u00a0 What does that tell us?\u00a0 It tells us that it is not trauma to the skull that causes a concussion.\u00a0 What causes the concussion is the transmitted force to the brain.\u00a0 It could be transmitted via the skull, but it could also be transmitted from the face, neck, chest, etc because of the “whiplash” effect to the brain.\u00a0 This means that you could make the best helmet in the world with all kinds of high tech materials and air cushion systems but it still won’t prevent a concussion because the force comes from somewhere other than what the helmet is protecting.\u00a0\u00a0 For example, take the boxer who gets hit by an uppercut under the jaw and gets knocked out.\u00a0 Would wearing a helmet have made a difference?\u00a0 No because nothing ever hit the boxer’s head.\u00a0 So what then is the helmet actually protecting?\u00a0 It’s protecting the skull.\u00a0 It’s reducing the risk of skull fractures and other skull injuries.\u00a0 So how does it protect the brain?\u00a0 Let’s look at some other analogies to better understand this.<\/p>\n

If you take an egg and shake it around, what happens to the yolk inside?\u00a0 You may not damage the shell by shaking the egg but the yolk moves around freely due to the acceleration and deceleration forces from the shaking.\u00a0 This motion of the yolk within the shell damages the yoke as it bangs up against the shell.\u00a0 You could put a little helmet on the egg but the yolk still isn’t protected.\u00a0 The same thing occurs in the brain.\u00a0 The brain moves within the skull due to acceleration and deceleration forces.\u00a0 This can cause shearing of blood vessels and it can cause damage to brain cells.\u00a0 You can also think about it in terms of a car accident.\u00a0 If you are driving along at 60mph and hit another car, what is it that protects the passengers?\u00a0 Is it the hard steel frame of the car or is it the seatbelt and airbags inside of the car?\u00a0 Without the seatbelt and airbags the passengers would move around inside of the car and be injured even if the outer steel frame wasn’t significantly damaged.\u00a0 So then what we really need to prevent concussions are seatbelts and airbags for our brains inside of our skulls.\u00a0 Here’s one more example to make it clear.\u00a0 Shaken baby syndrome is caused by shaking a screaming baby back and forth to make them stop crying.\u00a0 Even though their head never hits anything, the shaking leads to brain damage.\u00a0 Would wearing a baby helmet have helped?\u00a0 Of course not.\u00a0 So how can a helmet possibly eliminate concussions in football.\u00a0 It can’t.\u00a0 Any protective device that claims to prevent concussions in a contact sport is false advertising and may be giving athletes a false sense of security.\u00a0 How can athletes be well informed of the risks they are taking when the advertising by equipment manufacturers minimizes the risks?\u00a0 The only way to prevent concussions is not to step on the field in the first place.<\/p>\n

How about the claims to reduce concussion risks?\u00a0 The idea is that the helmets reduce the forces that are transmitted to the brain during a direct hit to the head and therefore reduce the risk of concussion.\u00a0 Is this true?\u00a0 Well in order to answer that we would first have to know what the forces are that cause concussions and how they do so.\u00a0 Is there a threshold of G-force that is required to cause a concussion?\u00a0 Are longitudinal force, axial force and rotational force all equivalent or is one worse than the others?\u00a0 Is there a certain area of the brain that is more susceptible to lower forces or different types of forces than another?\u00a0 Unfortunately we still don’t know the answers to these questions.\u00a0 Until we do, it is impossible to say with certainty that we can reduce concussion risks by using a certain type of helmet or other head, jaw or dental protection.\u00a0 We also can’t rely on a force sensor to tell us when a concussion has occurred because we don’t fully understand the correlation between all force types and concussions.<\/p>\n

What about tackling technique?\u00a0 Can this prevent or reduce concussions?\u00a0 Certainly teaching athletes not to lead with their head can reduce certain direct head impacts.\u00a0 But as we learned above, even the impact to the chest or other part of the body can cause a concussion. Proper tackling technique also can’t stop the player being tackled from hitting their head against the ground and causing a concussion.\u00a0 Is proper tackling technique important?\u00a0 Of course it is.\u00a0 Will it prevent concussions? Of course not.\u00a0 Will it reduce the incidence of concussions? \u00a0We hope so.\u00a0 Concussion rates in high school are about 20% compared to only about 10% in college and the NFL.\u00a0 We believe these differences are due to poor tackling technique in high school as well as smaller neck size and muscle mass so that there is less ability to absorb the transmitted force to the brain.\u00a0 Thus, we can hope that by improving tackling technique and proper conditioning, we might be able to lower the high school concussion rate so that it approximates college or the NFL.\u00a0 This 10% reduction could be significant, but it has yet to be seen.<\/p>\n

Finally what about curing concussions?\u00a0 The only proven treatment is physical and cognitive rest to allow the brain to recover on its own.\u00a0 We are very hopeful that there may be interventions we can perform to assist the brain in recovering more quickly.\u00a0 Supplements such as omega 3 fatty acids may be of benefit to brain function and recovery.\u00a0 Increased oxygen availability (I.e. hyperbaric oxygen chamber) may also benefit the brain.\u00a0 However, as of yet we do not have any prospective randomized clinical studies to prove that these things work.\u00a0 Any supplement or treatment that is directly marketed to treat or cure concussions is misleading.\u00a0 Although there may be some benefits, we must be careful that we do not use these treatments in lieu of physical and cognitive rest and we do not return athletes to play before they are ready.<\/p>\n

Necessity IS the mother of invention and we will now be seeing the market get flooded with inventions that are necessary to stem the tide of the concussion crisis in sports today.\u00a0 New technologies and new ideas will continue to develop and concussion prevention applications will take on avenues that we hadn’t even previously considered.\u00a0 We will see helmets made from all kinds of materials, with built in sensors and airbags to minimize impacts and indicators to warn us when we should evaluate an athlete for a concussion.\u00a0 Are these ideas all well intentioned?\u00a0 Of course they are.\u00a0 Are they going to help reduce head injuries?\u00a0 I hope so.\u00a0 Are they going to prevent concussions?\u00a0 Absolutely not.\u00a0 The devices are well-intentioned.\u00a0 The marketing is not.<\/p>\n

Dr. Andrew Blecher<\/em><\/a> is a Board Certified Sports Medicine physician at the Southern California Orthopedic Institute. He provides concussion management for both amateur and professional athletes including youth sports, high school and college, and he also has experience as a physician in the NFL as well as for the Los Angeles X-Games. He is a Certified ImPACT Consultant and has lectured extensively on concussions from hospital grand rounds to national conferences. By providing continuing education to other physicians, athletic trainers, coaches, parents and athletes, he strives to improve concussion awareness and prevention. Dr. Blecher is also the Director of the SCORE Concussion program which, in partnership with the Wells Fargo Play it Safe Program, provides comprehensive concussion insurance coverage for 10 Los Angeles area High Schools.<\/em><\/p>\n

You can also follow him on Twitter for the latest concussion information: @the_jockdoc<\/a><\/em><\/p>\n

If you have purchased sporting equipment that was marketed as a “concussion reduction device,” I would like to hear your story. Please email me at PaulD_Anderson@me.com<\/a>\u00a0<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

By Andrew M. Blecher M.D. Necessity is the mother of invention.\u00a0 Is it necessary to try and prevent concussions in sports?\u00a0 Absolutely!\u00a0 Recent events have made it more necessary than ever.\u00a0 So then let’s invent something to prevent them, right?\u00a0 Well many people have tried to do just that.\u00a0 We are now seeing a wave […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[1],"tags":[63,64,66,65,44],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/701"}],"collection":[{"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=701"}],"version-history":[{"count":4,"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/701\/revisions"}],"predecessor-version":[{"id":989,"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/701\/revisions\/989"}],"wp:attachment":[{"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=701"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=701"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=701"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}