Articles Posted in Spinal Cord Injuries

On a day when the NFL has settled a landmark lawsuit over player concussion (a subject on which I’ll write more later this week) it is worth remembering the measures closer to home that we all need to take to protect our kids from traumatic brain and spinal cord injuries.

A recent report published by SafeKids Oregon outlines the scope of the situation: Last year 1.35 million children arrived in emergency rooms with sports related injuries. Fourteen percent of those injuries were to the head. The group at greatest risk are 12-15-year-olds, who account for nearly half of all youth sports injuries. Though football is the sport we most often associate with concussions and other head injuries, among young athletes the most dangerous sport in terms of concussions was ice hockey which, all by itself, accounts for 31% of all youth sports concussions. Football accounts for only 13%, a bit behind wrestling and tied with soccer. The study notes that in sports played by both boys and girls the latter tend to report higher incidence of concussions, but speculates that this may have more to do with social pressures than with the relative tendency of boys and girls to suffer from the injuries.

Most importantly, however, the study notes that “a Governor’s signature is the beginning of the game, not the fourth quarter.” Put another way: state laws designed to protect young athletes are only as good as the parents and coaches who enforce them. SafeKids Oregon notes that the federal government’s Centers for Disease Control and Prevention offers a free online training program, known as “Heads Up”, for adults supervising youth sports.

A recent article in The Oregonian offered the following somewhat surprising revelation: despite deaths from motorcycle crashes having “more than doubled since the mid-1990s” several major motorcycle-focused lobbying groups are advocating for fewer regulations and less enforcement concerning helmets.

The paper writes that lobbyists and their congressional allies want the National Highway Traffic Safety Administration to be “blocked from providing any more grants to states to conduct highway stops of motorcyclists to check for safety violations such as the wearing of helmets that don’t meet federal standards.”

Even more shockingly, “the rider groups are seeking to preserve what essentially is a gag rule that since 1998 has prevented the agency from advocating safety measures at the state and local levels, including helmet laws.” The article notes that the gag rule is supported both by grassroots-based riders groups and by lobbyists working for motorcycle makers. It is surprising to learn that just 19 states require all motorcycle riders to wear helmets – though also a relief to find that Oregon is one of them. Even more surprising, however, is the revelation that state legislatures have been rolling back helmet laws for years. The article notes that in the late 70s all but three states required everyone on a motorcycle to be wearing a helmet.

They are not slickly produced but, arguably, ought to be up for some sort of award. Throughout the long hockey season the NHL has not only been assessing tough penalties on players who cross the line in what was already a rough sport: the league has been going out of its way to explain its decisions as part of hockey’s efforts to reduce traumatic brain injuries and other serious injuries to players.

As the season began the league hired Brendan Shanahan, a recently retired player known for his toughness throughout a long and distinguished NHL career, as its Senior Vice President of Player Safety. Enforcing new rules governing blind-side hits, hits to the head and other dangerous maneuvers, Shanahan has spent the season handing out suspensions both for moves that would have been legal a year go and for others that were never legal, even in the rough-and-tumble world of the NHL.

What is different is that these disciplinary actions are not announced merely with press releases from the league office. Every one of these suspensions is explained by Shanahan himself in videos posted on the league’s website. In these videos Shanahan replays video of the infraction in slow motion, usually from several angles, and explains in detail the reasoning that led both to a decision to suspend a player and to the particular punishment he has meted out. There’s nothing quite like it anywhere else in professional (or college) sports.

An excellent online article at Motherlode, the New York Times’ parenting blog, considers the question of fighting and youth hockey. I have written on a number of occasions about the risk here in Oregon of traumatic brain injuries and spinal cord injuries in sports, especially at the college and pro levels and in heavily physical sports such as football and hockey.

The Times article, however, looks closely at the question of youth hockey. This level of the sport needs to receive more attention not only because it involves children, but also because children are more prone to injuries than highly trained (and better-equipped) professionals. On a deeper level, youth sports also require our attention because it is here that young athletes establish habits that can be extremely difficult to break as children become teens and teens become adults.

As Motherlode notes, the NCAA long ago proved that you can have exciting hockey games without fighting, “but youth hockey has so far followed the lead of the National Hockey League and allowed – even tacitly encouraged – fighting in some youth leagues for players from 16 to 20.” Now, however, the article notes that USA Hockey and Hockey Canada are both considering rule changes that would effectively outlaw fighting in non-professional leagues throughout North America, possibly as early as next season.

Kevin Pierce’s long journey back to snowboarding is an object lesson for everyone here in Oregon concerned about traumatic brain injuries in sports. Once one of the world’s top riders and a likely member of the 2010 US Olympic team, the snowboarding star was severely injured “when he fell and hit his head on the icy wall” of a halfpipe where he was training.

A few weeks short of the second anniversary of that accident, Pierce got back on a snowboard, last week according to the New York Times. The paper reports that his road to recovery has been long and slow. That first run, at a ski resort in Colorado, was a slow cruise down an easy slope: “No tricks. No big air,” the newspaper reported.

Even now, Pierce’s life remains marked by “an unsteady walk, blurry vision and a diminished memory.”

The National Hockey League’s 2011-12 season kicked off last night with both the defending Stanley Cup champion Boston Bruins and the team they edged out last summer, the Vancouver Canucks, losing close fought, first-night match-ups.

Those games (along with a Montreal-Toronto contest) were the first official ones to be played under new NHL rules that severely restrict (but do not entirely ban) hits to the head during play. Long known as a fast and violent game, professional hockey has shown increasing concern for the long-term health of its players in recent years. Concussions and traumatic brain injuries emerged as a concern partly because of changes in the game itself – players are larger, skate faster, hit harder and wear better padding than their predecessors a generation (let alone half a century) ago, and the wear and tear on their bodies shows. The issue became especially salient for the league in the wake of several high-profile injuries that have sidelined star players for extended periods of time.

The most notable examples are Boston’s Marc Savard who has never completely recovered from a grade 2 concussion sustained in March 2010, and Pittsburgh’s Sydney Crosby, arguably the league’s most famous active player, who has not played since the beginning of the year after suffering two hits to the head in rapid succession during games on January 1 and January 5.

A class action lawsuit filed in Salem is taking aim at a perhaps surprising target. According to area television station KDRV the lawsuit alleges that a major insurance company has been “fraudulently denying claims after car crashes.”

The target? USAA, a banking and insurance giant that deals exclusively with current and former members of the military and their families. Because of its focus on the military community USAA has long cultivated a customer-friendly, service-oriented image far removed from that of most commercial banks and insurance companies.

The Oregon suit, however, charges the company with “using medical reports by physicians to say treatment for injuries suffered in car crashes were not medically necessary. Plaintiffs allege in their suit that the insurance medical reviewers of their cases never even talked or consulted with them.” The station’s report said USAA “declined to comment on the lawsuit.”

A recent column in the Capitol Hill newspaper Roll Call highlights a potentially serious attack on patients rights here in Oregon and elsewhere, one that has received relatively little notice in the months since the new Congress convened.

The focus of the piece is HR 5. Formally titled the Help Efficient, Accessible, Low-Cost, Timely Healthcare Act (i.e. the “HEALTH Act”), it is billed as a centerpiece of Republican efforts to repeal and replace the health care reform act passed by President Barack Obama and the Democrats last year. According to the federal government’s legislative bill-tracking service, Thomas.gov, the bill is co-sponsored by about half of all the Republicans in the House. Among Oregon’s congressional delegation only Rep. Greg Walden, whose district covers much of rural eastern and central Oregon, is a co-sponsor.

The official summary says that the bill “sets conditions for lawsuits arising from health care liability claims.” In particular, it establishes a three-year statute of limitations for most health-care related injuries. In addition, the bill “limits noneconomic damages to $250,000 (and) makes each party liable only for the amount of damages directly proportional to such party’s percentage of responsibility.” It also forbids the awarding of punitive damages “in the case of products approved, cleared or licensed” by the federal Food and Drug Administration (FDA).

A Florida court case involving a defective car seat and a resulting severe spinal cord injury to a child can serve as an important reminder of the crucial role our courts play in holding large companies accountable for the damage they can cause in ordinary people’s lives.

As outlined by the American Association for Justice, the case concerns a Florida girl, now age 7, who suffered a severe spinal cord injury when her father’s car was involved in an accident. Unbeknownst to the father his daughter, then only two years old, “had unfastened the clip (on her child seat) before the collision, leaving her restrained only around the lower torso and permitting a lap-belt-only injury to her spinal cord.”

The article notes that attorneys working for the girl’s parents discovered that the car seat’s manufacturer “had received more than 800 complaints about children unfastening the clip and it had subsequently replaced the clip with a two-piece version that children could not unfasten.” Even so, the manufacturer contended this action on its part was related to “convenience” rather than “safety” and moved to have the suit dismissed. After losing that dismissal motion the company settled with the victim’s family for an undisclosed sum.

A poignant reminder of the long-term effects of concussions on football players cane over the weekend when Terry Bradshaw revealed in a blog post that “he is suffering from deficits in short-term memory and impairments in his hand-eye coordination,” according to the Los Angeles Times. The newspaper reports that the former Pittsburgh Steelers quarterback, a long-time NFL commentator on television, attributes his ever-worsening problems to “at least six concussions” sustained during his NFL career.

Bradshaw, of course, played in the 1970s and it might be argued that today’s players are better-trained and use better equipment than their predecessors. Two minutes watching NFL films from that era, however, will show any viewer that while today’s equipment may be better, today’s players are bigger, stronger, play the game faster and hit much, much harder than those of a generation ago.

Bradshaw’s revelations of the ongoing effects of brain injuries come at a time when the league is trying to improve its less-than-stellar record of caring for players once their careers are over. It also, as the paper notes, arrives at a time when team officials and players in the worlds of football and hockey are increasingly aware of the damage lesser hits can cause. The Times cites a doctor at UCLA who mentions the cumulative effects of multiple less-than-concussion-level hits – an issue that the NHL has recently begun paying particular attention to.