Posts Tagged ‘concussion’

I’ve been listening to The Monday M.A.S.S. podcast, and in a recent episode, the hosts Chris Coté and Todd Richards discussed the mandatory helmet rule for under-18 competitors in Olympics-sanctioned park and street skateboarding events.   Based on what I saw in the X Games Shanghai replays, X Games doesn’t have such a rule.  World Skate, however, does, and last year, Jagger Eaton was disqualified as a result of the head of delegation of the Brazilian Federation of Skateboarding filing a complaint.

There’s a lot to unpack with that particular incident, especially as Jagger’s DQ allowed Brailian skater Murilo Peres to advance to the finals.  The idea of filing complaints fuels the criticisms of skateboarding’s inclusion into the Olympics.  There’s bureaucracy, regulation, and competitivenessthings directly in opposition to skating’s free-wheeling, anti-establishment rules.  I’m not sure the complaint was filed out of concern for Jagger’s safety but rather a seizing of the opportunity to advance.  Not exactly cool.

However, safety is something to consider.  The brain is still developing in adolescents, and although helmets don’t prevent brain injury, they at least protect the skull, which in turn protects the brain and also doesn’t finish growing until adulthood.  Last year, a pilot study was published in Frontiers in Neurology that revealed adolescent mice with a mild brain injury don’t suffer worse effects from a subsequent injury.  Their skulls do get changed, which could be a means of protection from future injuries or a consequence of development being altered.  There isn’t a clear answer, and this is just one study.  Also, note that they specified “mild” TBI.

Skateboarding is going to reach a broader audience with the Olympics.  Not everyone is going to have someone to teach them how to fall properly or access to skateparks where you don’t have to worry about cars and random obstacles (I mean, I used the back of the couch as a balance beam after watching gymnasts in the 1996 Olympics).  It’s better for the competitive skaters to set an example for young kids whose development may be impacted by injuries to the skull and brain until we obtain more information the consequences of early TBI.

References
McColl, Thomas J et al. “Mild Traumatic Brain Injury in Adolescent Mice Alters Skull Bone Properties to Influence a Subsequent Brain Impact at Adulthood: A Pilot Study.” Frontiers in neurology vol. 9 372. 25 May. 2018, doi:10.3389/fneur.2018.00372

Advertisements

A couple weeks ago, I attended the ConTex Kickoff Brunch.  It was mostly an introduction to the program, which aims to study mild, sports-related traumatic brain injury in patients ages 12-20 and get an idea of how TBI is being treated in the Dallas-Fort Worth Metroplex.  I was able to get some important information that I didn’t cover in a previous post about TBI in relation to action sports.

There I am in the blue and green shirt.  Photo from UTSW Dept of Neurology and Neurotherapeutics

There I am in the blue and green shirt. Photo from UTSW Dept of Neurology and Neurotherapeutics

There’s between 1.6 and 3.8 million reported concussions every year.  Many experts believe that there is a significant amount of under-reporting due to lack of knowledge of symptoms (you don’t have to lose consciousness and CAT scans can be negative) and a strong desire to not get sidelined, whether you’re playing football or skating.  Much of the focus has been on football because that’s where the funding comes from and it is America’s beloved pastime.  However, you can get a concussion from any sport so it’s important to have safe practices and be aware, regardless of what you’re doing.

Women actually have an increase incidence of concussion.  Some of it is due to more reporting, and some of it is due to head size and neck strength.  Thus even if the female athletes are doing fewer spins at a lower height, the risk they face is nothing to overlook.

So what can the action sports community do? (That was a question I asked.)  Learn about concussions and its various symptoms.  Have our friends and family study them up too.  Go to your annual physicals so that you and your doctor have an idea of what is “normal” for you; that will allow them to spot something out of the ordinary that could be a long-term side effect.

Football players have the Maddocks Questions to check up on an athlete who has been hit.  I propose an action sports version:
1. What’s the name of the park?
2. What trick were you doing?
3. What’s the last trick you landed?
4. Who are you skating/riding with?
5. [for contests] Who’s in the lead?

Although there have been interesting developments in TBI research related to biomarkers (proteins that the body produces in response to a concussion) and genetics, lack of resources and funding have produced a need for better statistics on injured groups and long-term studies.  We have no idea why some people develop chronic traumatic encephalopathy (degeneration of the brain) and others don’t.  Moreover, a lot of the focus remains on treatment rather than prevention.  This is why it’s important for everybody to do their part in staying safe.  Even though action sports has prided itself on pushing forward against all odds, sometimes it’s better to sit out.

Around the time I began my new job in the Department of Neuroscience, BMX rider Brett Banasiewicz sustained traumatic brain injury (TBI) from a crash. That was when I started to connect the dots between science and action sports with the realization that not only could action sports make science more interested, but science could help action sports. Too many action sports athletes were sustaining terrible injuries that they couldn’t just bounce back from. The impact of TBI on football players had generated a lot of buzz, but what about the other sports?

Last February, I went to the 2014 Paul M. Bass Neurosurgery Symposium on Traumatic Brain Injury to learn about the latest treatments and prevention methods and to find a way to pass this onto the action sports community. We don’t have a single governing body like the NHL or NFL even though medical staff at events have been doing a wonderful job. Worse is that kids aren’t doing this at school or in a club so the environment can’t be controlled. Sure we have Camp Woodward, but you also have kids who go to the parks on their own or just hit the streets. The action sports community has to educate itself, as well as the doctors who don’t know what someone was doing to have wound up with an injury or the rationale behind wanting to recover ASAP (I’m reminded of the scene in The Crash Reel where Kevin Pearce argues with his family and doctor about hitting the slopes again).
crash reel poster
The Crash Reel and Kevin’s story also helped spark my interest in neuroscience research related to TBI.

Probably the most relevant fact I learned from the symposium was that helmets don’t prevent concussions. But don’t ditch your helmet just yet! They do help against head injuries as a whole by preventing skull fractures and hemorrhaging, but they do nothing to keep the brain from getting jostled inside the skull. Therefore, we need to start examining other ways to minimize TBI in addition to promoting helmet use.

In the case of football, the best proposed solution was modified behavior. Players are learning the proper technique to tackle and block while coaches keep an eye on risky habits that need correction. Now action sports outside of the Olympics generally don’t utilize coaches, but newcomers have to learn from somebody (or something). It is important to pass along knowledge of how to fall in a way that minimizes injury and to know the techniques behind moves like the double cork which bring the head close to another object. Although it’s fun to see people hucking big tricks, a little bit of planning could save a life.

Scientists and doctors are working to better address when injuries do happen. The 4th International Conference on Concussion in Sport has released definitions and guidelines for proper diagnosis, treatment, and management. Less than 10% of TBIs result in loss of consciousness so I recommend looking at their list of symptoms to know whether your friend should go to the hospital.

The symposium also introduced ways scientists have been studying TBI. Most of the research has focused on football players and military veterans even though the majority of TBI actually results from falls and car crashes. I decided to look up any possible studies involving action sports, and to my surprise, I found that Weber State University students used Dew Tour competitors for their subjects last year. The linked article discusses looking at the athletes’ blood for biomarkers, which can be anything from genes, enzymes, cells, or even a measurement (think blood pressure). TBI, or any sort of injury, triggers cell death so scientists can look at neurons for damage or check for the contents that dead cells release.

This past season, the students also employed the Shockbox, helmet sensors that detect head acceleration upon impact. The results could be used to determine course changes that would keep athletes from hitting their heads as hard. The takehome message is that we all have to work together to make action sports safer without having to compromise the fun of pushing the human body.