Discover and read the best of Twitter Threads about #Concussion

Most recents (23)

Today for #ConcussionWeek, we will discuss how you should counsel #pediatric #concussion patients on return to school/play.

Guidance is important, since most will not be seen in follow-up and it's important to avoid prolonged rest/school removal.

pubmed.ncbi.nlm.nih.gov/26130391/
Several RCTs have really changed how we look at activity after a #concussion diagnosis.

⭐️Early exercise protocols demonstrate improved recovery.⭐️

pubmed.ncbi.nlm.nih.gov/30715132/
So what does that mean for physical activity?

⭐️Evidence suggests early symptom limited exercise in the 1st week following injury. ⭐️

Avoid contact sports.

pubmed.ncbi.nlm.nih.gov/34600629/
Read 5 tweets
#Concussion Week! 🧵
Our first goals – review symptoms and accurate diagnosis.

Make sure to view the whole thread for some great videos to enhance your physical exam!

Symptoms:
Concussion symptoms can be grouped into 4 areas:
- Physical
-Sleep
-Cognitive
-Emotional
Symptom Review
Physical: HA, n/v, dizziness, balance and vision problems, photo/phonophobia
Sleep: Difficulty falling/staying asleep, sleeping more
Cognitive: Difficulty concentrating, remembering, feeling slow and foggy
Emotional: irritability, anxiety, depression, mood changes
Any robust diagnosis is supported by the physical exam. In #concussion, vestibular testing is critical . One battery is the visio-vestibular exam (VVE). VVE is reliable from the #ED and accurately distinguishes concussed v. non-concussed.

pubmed.ncbi.nlm.nih.gov/32745919/
Read 14 tweets
Welcome to #Concussion Week! For the next 7 days, we’ll be focusing on pediatric concussion.

Why?

The prevalence is high, there are updates to practice guidelines, and your ED/acute care management has an important impact on outcomes. 🧵
First, lets look at prevalence, follow-up and broad outcomes:

->200k/yr ED visits for pediatric concussion
-Only ~45% diagnosed in ED have f/u
-30% have symptoms >28 days, w/ physical, cognitive, emotional and social impacts
This #concussion week, we will
-Review concussion symptoms and accurate dx #FOAM #MedEd
-Discuss expected progression including recovery, expected time course, and when to refer early
-Outline recommended anticipatory guidance for recovery and activity management
-Have fun!
Read 8 tweets
LISTEN: Donald Parham Jr. is at the hospital with a brain/spine injury. Joe Buck says he'd never speculate on an injury, then speculates DP's arm tremors were bc "it's cold tonight, at least by Los Angeles standards."

Ladies and gents, meet rock bottom for sports broadcasting.
Context: @ConcussionLF has only #concussion education program for sports media. Taught at 20 universities. We've offered to train football broadcasters for free. Turned down bc #NFL provides their own training on concussions. Lesson 1: Don't say the c word concussionfoundation.org/programs/media…
The coverage of #DonaldParhamJr’s brain injury last night was unacceptable.

We created the @ConcussionLF Media Project to train sports media how to cover #concussions accurately and responsibly.

Better coverage helps protect kids like these:
Read 4 tweets
Despite suffering a head injury during the first test last week, the Lions are still hoping to feature Welshman Dan Biggar in their next match. His participation has been called into question by @ProgressiveRug.
The Lions secured a 22-17 victory over the Springboks but 31-year-old Biggar was removed for a head injury assessment (HIA) after a heavy knock to the head, from which he didn't return.
amp.rugbypass.com/news/elephant-…
Biggar's injury comes days after the Drake Rugby Biomarker Study and isn't the first recent #concussion, after Luke Cowan-Dickie returned to play just a week after hit that left him unconscious for a minute in the Gallagher Premiership final.
Read 5 tweets
Today the @CommonsDCMS Committee published their report on the problem of concussion in sport. Here is a thread of some of the issues the report raised and its recommendations. #concussion #concussioninsport (1/25)
Despite the need for acquired brain injury to be taken seriously by sport, both written and oral evidence to this inquiry support the health benefits to people through mass participation in sporting activity. (2/25)
The reality is that, for most people playing grassroots sport, there is no one to stop them continuing to play, after a head injury, except themselves. That is how far down the knowledge and awareness of concussion and how to respond to it must reach. (3/25)
Read 30 tweets
⚽️You've probably heard "#ItsComingHome!" being thrown around recently by English football fans in the lead up to Monday's @EURO2020 Grand Final between England and Italy.

Our experts discuss the #grandfinal, #sportsscience and #soccer's role in culture and society. A thread.
“The grand final will reinforce the idea that Aus is being left behind. The game will provide us with a glimpse of what the #postpandemic world sport will look like: vaccinated populations going back to life as usual." Dr Steve Georgakis. @Bizani
“Soccer is a very popular sport in Australia, with over 1 million adults and just under 700,000 kids under 14 in Australia playing it. Women and girls comprise 30% of soccer players in Australia." Dr Lindsey Reece. @LindseyReece28 #WomensSport
Read 6 tweets
Here's a short thread of the questions I asked the Minister for Sport, Nigel Huddleston MP, in the latest session of @CommonsDCMS' inquiry into #concussion in sport. (1/8)
In most jobs health and safety is of paramount importance and action can be taken when/where it fails. I asked the Minister what is stopping concussion in professional sport being seen as an industrial disease. (2/8)
I then asked the Minister why brain injuries through sport are not classed as an industrial disease. He says it's only recently we've seen a correlation between concussion and dementia. I then told him the PFA report says dementia in boxers was identified in the 1920s. (3/8)
Read 8 tweets
1/

@US_FDA approved the #Qcollar jugular compression device to "protect athletes' brains during head impacts."

This decision was based on VERY FLAWED DATA and does NOT demonstrate the safety or effectiveness of the Q-collar.

Read detailed thread⬇️

bit.ly/3q9ZZJL
2/

Here is the text from the @FDADeviceInfo press release.

If you don't understand the highly nuanced #MRI technique known as DTI, these results sound straightforward and convincing.

THEY ARE NOT. Don't be fooled by these numbers!🤔

I will dissect these in the thread below. Image
3a/

"No significant changes" is based AVERAGE response, not individual.

First, an easy-to-understand analogy below.

If half the sample experiences an increase and half experiences a decrease, they can cancel each other out to falsely suggest "no change" when one does exists! Image
Read 24 tweets
Over 70 former professional rugby players are preparing for legal action against the sport’s governing bodies according to this report.

The group litigation seems to be in its early stages, but World Rugby & Unions will be starting to get twitchy.

THREAD on the key issues 👇🏼
1) Duty of care

Do the governing bodies (World Rugby, RFU, WRU etc) owe players a duty of care in respect of their health and safety? The answer is almost certainly yes (see for example Watson v BBBoC).
2) Breach of duty

Have the governing bodies breached this duty? This is the first of the major hurdles for any litigation.

The question is essentially whether they acted reasonably in the circumstances.

Did they know about the dangers of concussion and fail to act?
Read 17 tweets
(1/7) If your child has a #concussion, do you trust their coach will do the right thing? Are you sure?

This secretly recorded shock video shows @bentoncardinals girls' HS basketball coach threatening a player who reported concussion symptoms to her athletic trainer.

Watch:
(2/7) Coach Kerstyn Bolton threatened her player with the "worst 30 minutes of her life" in practice because the player did the right thing and reported her symptoms.
(3/7) Bolton compared her own THIGH INJURY (!!) to her player's potential brain injury, calls the player selfish for not pushing through, and even praised a teammate who played through a past concussion.

newspressnow.com/multimedia/vid…
Read 7 tweets
I have serious questions surrounding the medical care of Michigan State QB Brian Lewerke & his apparent concussion in the Illinois game last week. Based on the player’s self-report, I believe Lewerke should be diagnosed with a concussion. Thread 👇freep.com/story/sports/c…
Disclosure: MSU invited me to lecture on concussions & CTE last year, & I have a tremendous amount of respect for the medical team. But I feel the need to speak up as I believe public statements are setting the wrong example for youth sports on concussion recognition & response.
Video: Watch MSU QB Brian Lewerke run left and strike his head on an opponent's knee. He is clearly slow to get up, and his teammate immediately waived to the sideline, presumably for medical help.

He stayed in the game. The next play he threw a bad interception.
Read 14 tweets
Does the woodpecker-inspired #Qcollar protect the brain & prevent #concussion?

Take 3 minutes to read this fully referenced thread presenting evidence that a jugular compression collar is unlikely to keep athletes safe

Please SHARE, help inform others!

bit.ly/QCollar
Thread/2a

The #Qcollar is based on the idea that jugular compression increases blood in the brain to create a "bubble wrap" effect, which prevents the it from bouncing around inside the skull.

According to the company, this mechanism is found in Nature.
bit.ly/2KqTJvS
Thread/2b

From the company's promotional video, the device is justified based on reducing brain "slosh" by:

1) Replicating the animal adaptations (see 18:00 in video)
3) Replicating effects of "higher altitude" exposure (see 21:57, again at 36:00)

bit.ly/33sHyGk
Read 57 tweets
A thread about Gary Bettman, the NHL & how the league of denial used Todd Ewen’s case to cast doubt on a link between repeated brain injuries and CTE

Thank you to @rwesthead for covering the concussion hearing in depth

#NHL #FridayReads #CTE

tsn.ca/widow-of-forme…
2/ The widow of Todd Ewen sued the National Hockey League on Tuesday, claiming the #NHL cynically exploited a botched analysis of her husband’s brain, which later tested positive for #CTE

Even in death, former players are not safe

#FridayFeeIing #TBI

scribd.com/document/40853…
3/ “Unbeknownst to Kelli Ewen, Dr Lili-Naz Hazrati served as an expert witness for the #NHL in multidistrict litigation...”

"Had [Dr. Hazrati] disclosed her conflicts of interest, Kelli would never have sent Todd's brain to her” Ewen said

#Concussion

nytimes.com/2018/11/30/spo…
Read 9 tweets
After a period of slow docket activity, it appears that the #NFL fight with their insurers in NY Supreme Court is becoming rather fiery. While most documents are under seal, here are a few interesting excerpts of those that aren't.
Letter from Insurers to the Judge:
While the above represents the typical MO of the #NFL I found this snip rather interesting. No choice but to retain @PaulWeissLLP ???
"The relevant point noted by the Insurers was simply that the NFL Parties embarked upon the process of retaining counsel of their own choice immediately upon being sued and at no time, asked the Insurers to appoint counsel or even to provide input on potential firms." Makes sense
Read 24 tweets
This isn't a one-off. I played football at the university level. When you get a concussion, they don't send you to a neurologist, they send you to a musculoskeletal physician that specializes in sports injuries, who by their own admission have no idea when it comes to the brain.
Apart from that, they still use the ImPACT Test, or similar models that are quite simply garbage. I've been faking my way through these stupid tests since I was 14, players botch them intentionally to lower their baseline and hasten their return to play after a concussion.
It's well known that this happens, nobody talks about it, have to keep the players on the field. After suffering two concussions in two months, with symptoms still lingering today after four months, I should have been sent to someone who knows what they're talking about.
Read 6 tweets
With the opt in/out date deadline on Jan 18th 4 the @NHL #concussion lawsuit I wanted to revisit this breakdown from @SheillaDingus on the red flags of the settlement:

1/ A potential life & death situation is noted, in which the #NHL says “live or die...

advocacyforfairnessinsports.org/nhl-concussion…
we don’t care, just don’t ask us for any money.” Players are instructed to file a claim from the Additional Payment Fund—if they live long enough

2/ The NHL control of testing procedure immediately drew a red flag. It is notable that the cost of testing is NOT included....
in the total value of the settlement but is instead an uncapped fund under COMPLETE control of the NHL

It seems odd that no one to my knowledge has reported this

“In the big picture the cost of these exams is de minimus, particularly when the NHL is in control of these exams”
Read 12 tweets
Colin Campbell, the long-time disciplinarian — now the senior executive vice-president of hockey operations with the @NHL — is shown in correspondence to term anti-violence advocates alternately as “greenpeace pukes” & “tree huggers”

#SundayMorning #SundayFunday #SundayThoughts
2/ In a 2009 email to @TSN_Sports & Bob McKenzie (@TSNBobMcKenzie) Campbell seeks counsel in an apparent desire to help remove fighting from the game: “I hated fighting . . . had to do it though . . . particularly in the 70’s, but it is stupid.”
3/ And then, four years later, in an email to fellow TSN correspondent Darren Dreger (@DarrenDreger) Colin Campbell writes he is, in fact, “for fighting.”
Read 10 tweets
Right, rugby (and other contact sport) friends, gather round and let me try to share with you some slides & ideas I presented at the @NFLResearch Conference on Collision sport in London last week. This set was on nudging safer behavior, it’s a thread. But it’ll have pictures…1/
2/ First, a philosophical issue that *SHOULD* influence actions (subtly). Change is hard. It’s resisted. That’s as true in the #NFL as it is in #rugby, and in any other sport. These quotes are basically interchangeable - players, coaches, media etc - push back against change.
3/ However, we also can’t allow the tail to wag the dog - if risk is too high, change IS necessary. But how much? The key question, for me, is how you achieve “change without change?”, as this slide asks? Change X but not Y (the sport) (too much). That’s key to getting buy-in.
Read 48 tweets
1/Bettman was consistent in answering the many questions in his deposition: Because there is no medical or scientific certainty, he said, there is no reason to warn @NHL players about the risks of #CTE Nor is there reason, even after the premature deaths...washingtonpost.com/opinions/the-n…
2/in recent years of several #NHL “enforcers” such as Bob Probert , Wade Belak, Rick Rypien, Derek Boogaard & Steve Montador to look for a link between fighting in hockey & brain injuries. “I think the sample has been too small,” Bettman said... #tbi washingtonpost.com/opinions/the-n…
3/when asked about the players who died “I would respectfully suggest that, as tragic and as unfortunate as it is, there isn’t even enough circumstantial evidence to draw any conclusions.” Asked whether he had ever spoken to family members of these players washingtonpost.com/opinions/the-n…
Read 4 tweets
Study on soccer. It shows that females who close their eyes during a header & are not seeing a hit coming may be at greater risk for #concussion So if you don’t see the hit, are not prepared for it, you may be at greater risk for being injured #TBI #nhl
sciencedirect.com/science/articl…
I am implementing Vision Training into @TPDHockey I train 1300 kids every week. They will all be getting a baseline test & vision training twice a week to better expand their peripheral vision to better prepare them for hits they wouldn’t see coming prior to this type of training
The anecdotes I will be posting the next couple hours/days are from @clarkjf
Read 3 tweets
1/ If u have played the game the way I have, this clip is not that difficult to break down. Notice Wilson’s right skate before or at the initial point of contact. It is leaving the ice intentionally, which means he thrusts his body into an upward direction, which is towards the
2/ head of Reese. If we look at the left skate during the point of contact, Wilson is rising up onto his toe, as if he is trying to jump, hence the reason he ended up sitting on the dasher of his own bench after the hit. It is clear that Reese sees Wilson coming but that has very
3/ little to do with the fact that Wilson clearly makes contact with the head/jaw of Reese, in direct result of jumping and thrusting his body in an upward motion. Bc of this, we have a human being who may get the right diagnosis of a #concussion yet will he receive the treatment
Read 4 tweets

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