Articles Posted in Sports Injuries

When attention focuses on the question of sports and traumatic brain injuries we usually think of football, hockey or boxing. A new study from Boston University, however, highlights the potential TBI dangers of a sport we do not often think of as violent: soccer.

As outlined by the New York Times earlier this week, the study focuses on “encephalopathy, the degenerative brain disease linked to repeated blows to the head” which, it reports, “has been found posthumously in a 29-year-old former soccer player, the strongest indication yet that the condition is not limited to athletes who played sports known for violent collisions.” Equally intriguingly, the newspaper notes that the soccer player died of ALS, commonly known as Lou Gehrig’s Disease, and offers evidence that the repeated head trauma involved in soccer may have played a role in his development of the disease at the relatively young age of 27.

The man mentioned in the article was a top-level college and semi-pro soccer player. The Times quotes his parents remembering his love of the game, and the pride he took at being good at heading the ball. It quotes a doctor who performed a brain examination after the player’s death saying that he had “extensive frontal lobe damage” of a type more commonly associated with football than soccer. The article cautions that there is no way to establish an irrefutable link between the game and these brain injuries, but the BU study concludes that this, and other data, are cause for both concern and for further study.

When the news broke right before New Year’s that Michael Schumacher, arguably the world’s most famous race car driver, had been seriously injured in a skiing accident it immediately focused public attention on safety and winter sports.

According to numerous media reports Schumacher was skiing ‘off piste’ (a common term at European resorts referring to terrain which is open to recreational skiers but is not groomed or marked specifically as a trail) with his son at the French resort of Meribel on December 29 when he lost control, fell and struck his head on a rock. Schumacher suffered a traumatic brain injury and has been in a medically-induced coma ever since. He has undergone two surgeries and, according to CNN, doctors describe his condition as “stable but critical.”

That same CNN article (see link below) contains an especially important point regarding the accident. According to CNN “a French prosecutor investigating the ski accident… said that speed was not an important factor.” CNN reports French officials telling the media that Schumacher was traveling at “the speed of a very good skier on a slope which was not very steep” and also ruled out a fault with the race car driver’s skis. It has been widely reported that Schumacher was wearing a helmet at the time of the accident.

A story published last week in the Los Angeles Times spotlights both the help technology can offer in the fight against traumatic brain injuries, and the surprising resistance that such technology can, and does, encounter.

The paper reported on a “wireless alert system” that can be placed in football helmets. Sensors placed inside the helmet trigger an alert on a smartphone or a similar device carried by a coach or trainer on the sidelines if the wearer suffers a potentially concussion-inducing blow to the head. The system, according to the paper, “gains data from five sensors placed on a plastic-like, paper-thin lining placed on top of helmet padding. The sensors measure linear and rotational acceleration as well as the duration and location of a hit. A computer chip in the helmet transfers data to a hand-held alert monitor – typically carried by a trainer – via a low power signal similar to Bluetooth.” The system can be adjusted according to the level of play (middle school v high school v college).

One might have imagined that the main problem this raised for high schools was financial – the systems cost about $150 per unit. When one LA area high school offered the sensors to all 120 of its football players earlier this year, however, only 20 stepped up to purchase them. What surprised even the school’s head athletic trainer, however, was the reason: according to the LA Times “parents worried about sons being pulled from games and missing playing time. Several said they dropped the sensor topic after their sons declined to wear one.” The trainer told the paper, “In the society we live in, the knowledge is there but the parents, I don’t know – it confused me.”

The widely reported news that “the NFL has agreed to pay $765 million to settle a lawsuit brought by more than 4500 players and their families,” as The New York Times reported this week, is welcome news for former players suffering from traumatic brain injuries and other physical and mental problems linked to the violent, hard-hitting nature of life in the NFL. The broader potential for good in this settlement, however, lies in what it may do to raise awareness about a troubling, and persistent, problem.

At the Times noted, this week’s settlement can be seen as a legal victory for the NFL. It represents less than 5 percent of the league’s annual revenues and spares the NFL both the potential expense and the certain bad publicity of an endless stream of lawsuits by individual players and their families. The paper also notes that “among the terms of the agreement is that the settlement is not to be regarded as an admission of guilt by the league.” Such clauses are not uncommon in settlements like these, but it is difficult to believe that many fans – along with players, parents and coaches at all levels of the game – won’t interpret it that way.

Frankly, that would be a good thing. The League’s reticence on the subject of concussions and TBI has long served as subtle, if perhaps unintended, encouragement for players and coaches at lower levels of the sport. Measures like the one passed here in Oregon earlier this year to encourage youth safety have often encountered resistance from some players, coaches and fans.

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.

In a recent article in the New York Times Dr. Robert C. Cantu, a professor of neurosurgery at Boston University, issued a thoughtful, yet passionate, call for parents and school officials to rethink the way we approach youth sports here in the United States.

Writing that he meets with some 1,500 concussion patients each year, Dr. Cantu lays out the case for lowering the degree and intensity of contact that younger children experience across a range of sports. “In light of what we now know about concussions and the brains of children,” he writes, “many sports should be fine-tuned.” Dr. Cantu writes that children under 14 are fundamentally more vulnerable than older teenagers or adults. “A child’s brain and head are disproportionately large for the rest of the body,” he notes. “And a child’s weak neck cannot brace for a hit the way an adult’s can. (Think of a bobblehead doll.)”

He begins the piece by focusing on football, where he believes tackling should be eliminated for children under 14, but emphasizes that head trauma, concussions and brain injuries are all more common in other sports than is popularly believed. His piece goes on to propose rule changes in soccer, ice hockey, baseball, softball, field hockey and girls’ lacrosse – many of which are not activities most of us think of as contact sports.

A lengthy article published this week in Washington’s Kitsap Sun looks at the issue of traumatic brain injuries – particularly concussions – among young athletes. As the paper notes, “the U.S. Centers for Disease Control and Prevention estimates more than 3.5 million concussions – defined as traumatic brain injuries – occur each year on ball fields and (in) sports venues across the country.”

The article focuses on the Zackery Lystedt law, a measure enacted in Washington in 2009 that prevents high school age and younger athletes “with suspected concussions from returning to the playing field without authorization from a licensed health care provider.” The law is named after a junior-high football player who suffered permanent brain damage and disability as a result of a 2006 game. The paper notes that “return-to-play legislation modeled after the Lystedt Law has since been adopted in 39 other states.”

According to, Oregon’s own youth sports-focused TBI legislation, enacted about the same time as the Washington Law, offers some key safeguards but does not go nearly as far. A important difference is that Washington teens must be pulled from a game or practice if there is reason to believe that they may have suffered a concussion. Here in Oregon removing the athlete from competition or practice only becomes mandatory once they exhibit symptoms of a possible traumatic brain injury. Once an athlete has been pulled from the field both states require written clearance from a medical professional before the player can return to practices or competitions.

A recent op-ed published by The Oregonian calls for parents to take more care, and schools to take more responsibility, when it comes to preventing concussions and traumatic brain injuries among student athletes, especially younger athletes still in high school.

The column was written by James Chesnutt. He is identified in the article’s footer as a doctor and the “medical director of the OHSU sports medicine program.”

In the article he says that he is writing to encourage “all Oregon high schools to agree to a management protocol to help their student athletes deal with concussions.” He writes: “The protocol calls for schools to establish a plan to help a student recover.” This, he adds, could include time off from school following a head injury.

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.

50 SW Pine St 3rd Floor Portland, OR 97204 Telephone: (503) 226-3844 Fax: (503) 943-6670 Email:
map image