John Markoff wrote a first-person story for The New York Times last week about the memory loss he suffered after sustaining a concussion, and other injuries, after an accident on his bike. Markoff wrote that he broke his nose, had scrapes and stitches on his face, had a deep cut on his knee and was knocked unconscious in his July 3 crash.

But Markoff, who had been riding alone, had a 20-minute memory gap. He could not remember the accident or what caused it.

In The Times, Markoff said he watched the Tour de France when he was recovering. American entrant Chris Horner had sustained a concussion, but still finished. Then, according to Markeoff, Horner “turned to his coach and asked, ‘I crashed? I finished?’”

Markoff said he could relate. He was determined to find out why he crashed.

He wound up doing that, as other cyclists apparently have, by using data from his GPS device. He has a Garmin model that not only tracks location and speed but also a rider’s heart rate and pedaling rate.

Markoff uploaded that data and learned that at the time of his accident his speed in eight minutes had gone from 30 mph to 10 mph to zero, according to his account in The Times. He also saw the exact location of his crash.

So Markoff went back to the wooded area where he had his accident. He saw a slim long pothole that easily could have caused his accident, and flashes of what happened that day finally came back to him.

Markoff isn’t the only one who has used a GPS device to figure out exactly what happened in an accident. His account quotes a lawyer who believes that witnesses  who can testify about accidents based on GPS readings could become a new category of expert witnesses in court.  

http://www.nytimes.com/2011/09/06/science/06accident.html?ref=science

You can bet that’s the question that’s in everyone’s mind after the news broke Friday that the 28-year-old was found dead in his Minneapolis apartment. An autopsy was set for today, Saturday.

The New York Times Saturday characterized Boogaard as “one of the toughest fighters in the NHL.” When he joined the Rangers, he was quoted as saying, “I am not afraid to do what I do.” Maybe he should have been.    

http://www.nytimes.com/2011/05/14/sports/hockey/rangers-player-is-found-dead-in-his-home.html?_r=1&ref=todayspaper

At 6-feet-7 and 265 pounds, Boogaard was built for the brutal game of hockey. He joined the Rangers last summer, after signing a $6.5 million contract, after playing for the Minnesota Wild.

According to The Times, Boogaard was involved in seven fights this season, and the last one, “the 70th of his NHL career,” resulting in a serious concussion. That took place Dec. 9 in a scrap with the Senators’ Matt Carkner.

Boogaard had been not been able to play since that fight, and he had been convalescing in Minnesota. He had complained to The Star-Tribune of Minneapolis that he had to wear sunglasses when he went outdoors because the sun bothered his eyes.

So why did he die? Did the concussions he suffered during his career, particularly the horrendous one last December, play a part in his death? Was he depressed after not being able to play most of the season?

Hopefully, we’ll have an answer soon. 

New York Times sports writer Alan Schwarz, the paper’s concussion expert, did an analysis, headlined “Ski Team’s Protocols Fail Vonn,”  of her recent experience with brain injury. Vonn opted to race in skiing championships in Germany, and came in second.  

http://www.nytimes.com/2011/02/14/sports/skiing/14vonn.html?_r=1&ref=todayspaper

Essentially, Schwarz was trying to convey what a huge risk Vonn had taken by skiing while she was recovering from a Feb. 2 concussion she sustained during a training run.

As The Times wrote, Vonn and the U.S. Ski Team “appeared to hit the trifecta of concussion no-no’s: They called the injury mild, blindly followed so-called concussion tests, then discounted clear signs that her injury remained.”

Roughly a week after her brain injury, Vonn passed concussion tests, according to Schwarz. Those tests gauged memory and balance. So Vonn raced in the super-G at the world championship, placing seventh. During that race, Vonn later said she was “in a fog,” according to Schwarz.     

He quoted her as saying, “My head just isn’t thinking fast enough. I can’t process the information fast enough, and that gets me behind on the course. My body is one gate ahead of where my mind is, and that’s not a good way to ski.”

As Schwarz so eloquently put it, “Rarely has any athlete so clearly described the real-time cognitive effects of an unhealed concussion.”

But Vonn was undaunted by her feelings after that race. She rested last Wednesday, took more concussion tests on Thursday and did a practice run, and also did a full-bore run on Friday. According to Schwartz, on that Friday run Vonn “lost focus” halfway down the course.

Despite her mental problems while racing, and heeding the neurological tests she had passed, Vonn raced Sunday and finished second.

http://www.nytimes.com/2011/02/14/sports/14skiing.html?ref=todayspaper

“If an NFL player was allowed to compete under those conditions, the team (and league itself) would be roundly flayed for endangering his health,” Schwarz wrote.

He took the U.S. Skiing and Snowboard Association to task repeatedly for  saying in press releases that Vonn had sustained a “mild” concussion. The assocation also defended its concussion protocol, saying that its tests were up to date and that Vonn had not shown any symptoms or flunked a test before a race.

Skiing officials defended that protocol despite Vonn’s “subsequent fogginess and impaired balance midway through all three races,” according to Schwartz.

After coming in second Sunday, Vonn said she had made a safe choice to race since she had passed all her medical tests.

But one slip, one bad move, caused by her concussion could have destroyed Vonn and her skiing career, which is the point of Schwartz’s analysis. That’s because getting hit in the head while still recovering from a concussion can lead to permanent brain damage.

The bravado of a top athlete should not trump safety, and protecting one’s brain.    

Apparently the show must go on, even if your lead actress has suffered a concussion.

The new $65 million Broadway musical “Spider-Man: Turn Off The Dark” has been plagued by problems and mishaps. During its first preview performance last Sunday, actress Natalie Mendoza was hit in the head by a rope that was holding a piece of equipment, The New York Times reported Saturday. The accident happened when the actress was standing offstage.

http://artsbeat.blogs.nytimes.com/2010/12/03/concussion-sidelines-spider-man-actress/?ref=theater

And even though the director and producers knew that their lead actress had suffered a concussion from that blow, Mendoza acted in the show’s second performance Wednesday night against the advice of her doctor, according to The Times and the actress’s spokesman.

I guess Mendoza hasn’t been reading the sports section and all of its stories about the dangers of not taking it easy when one sustains brain injury like a concussion. And I guess her director and the show’s producers haven’t been reading those stories, either. 

That’s foolish behavior on everyone’s part, particularly Mendoza.

Her spokesman told The Times that the actress didn’t tell the show’s producers about the accident Sunday because she didn’t think she was hurt. Mendoza went to her doctor Monday, who said she had a concussion. Her sent her to a specialist, who was then hired by the production. That specialist agreed that Mendoza had a concussion.

Tuesday morning Mendoza tweeted a one word message: “Concussion.” She also told the production about her concussion diagnosis on Tuesday.

And then she performed Wednesday, which was not a good idea, as anyone who knows anything about concussions would know. By the end of the show, Mendoza had a headache and was nauseous, The Times reported.

She didn’t perform last Thursday, and it was announced on Friday that she will be on hiatus from the play for a brief period.

So far three “Spider-Man” actors have been hurt as the production prepares for its Jan. 11 opening. Mendoza plays the villainess Arachne. 

http://www.usatoday.com/yourlife/health/medical/2010-10-15-1Abrain15_ST_N.htm?csp=netvibes

As someone who has spent their career as an advocate for brain injury victims, I have to say that I’m skeptical about all the early claims, hype and optimism about this new test.

The USA Today story said that  this biomarker test, which detects the proteins that are released into the blood stream when the brain sustains damage, correctly identified TBI in 34 patients.    

 The test would be of special importance to the Army, which is trying to cope with a deluge of soldiers who have sustained concussions and other brain damage in the wars in Iraq and Afghanistan. An estimated 300,000 troopes serving on those two fronts have suffered concussions, typically from bombs, according to a study cited by USA Today.

For one, I can’t see how this test would be capable of diagnosing the wide spectrum of injury that has come to be known as MTBI.  The risk of a supposedly miraculous diagnostic tool is that it creates a new myth of certainty about brain damage.

 Mike Gittleson, who was the University of Michigan’s football strength and conditioning coach for 30 years, believes young athletes should be doing neck-strengthening exercises to protect themselves from brain injuries. In fact, I agree with him that such exercise should be mandatory, in both high school, college and even the NFL. 

Gittleson retired from Michigan in 2008, but his work for a sports-clothing company since then has taken him to more than 250 colleges. From what he’s witnessed, few schools are promoting neck exercise. Essentially, we are training all parts of the body except the one that can help steady and protect one of our most valuable organs, the brain.

 Gittleson wants to change that. He recently addressed the Collegiate Strength and Conditioning Coaches annual Convention in Orlando, Fla., about the issue. He is asking that the group make knowledge of neck anatomy a part of  its certification and argues that neck-strengthening exercises must be taught to athletes.

Physicians who study concussions agree that stronger necks can lessen, or diffuse, the impact of blows that cause concussions. So says Dr. Robert Cantu, who is a co-director of Boston University’s Center for the Study of Traumatic Encephalopathy.

Cantu and Dr. Dawn Comstock are almost done with research on how neck length, diameter and strength factor into head trauma.    

 Another researcher, Ralph Cornwell, is conducting a study of 24 college-aged women and men who haven’t done neck exercises.  He will do tests where these people will be moving, as if a car, but then suddenly be stopped. Cornwell will measure how much their heads jerked by watching film of the test participants and digital mapping. 

He will then have the 24 participants do neck exercises for a period of time, and retest them to see if there is any change in their range of motion when their movement is suddenly stopped.

At least one former Michigan player, Steelers linebacker LaMarr Woodley, credits Gittleson’s neck training with  helping  him play college and pro football without suffering any concussions.  That’s pretty good proof in favor of neck-strengthening.

The NCAA considers preventing or reducing the number of concussions important enough that it is making these football and wrestling rule changes in an off-year of the usual two-year process. Rules changes related to health and safety are permitted in off-years.

In the case of college football, wedge blocks will be barred this fall. http://www.google.com/hostednews/ap/article/ALeqM5gbHbzEBOEXVznRpzE1YuMBCaj9eQD9F3Q5NG0

The NCAA’s Playing Rules Oversight Panel approved that change Thursday.

The NCAA is following in the footsteps of the National Football League, which a year ago prohibited wedge blocking on kickoffs because of safety concerns. The NCAA now says that when the team receiving a kickoff has more than two players standing within two yards of one another, shoulder to shoulder, it will be assessed a 15-yard penalty — even if there is no contact between the teams, according to the Associated Press.

This change is being instituted because NCAA studies have found that 20 percent of all injuries occurring on kickoffs result in concussions.

And the NCAA Wrestling Committee is recommending a change to an injury rule to better protect competitors who show signs of a concussion, the organization said Friday. http://www.ncaa.org/wps/portal/ncaahome?WCM_GLOBAL_CONTEXT=/ncaa/ncaa/ncaa+news/ncaa+news+online/2010/association-wide/wrestling+rules+panel+recommends+rule+to+add+concussion+protection_04_16_10_ncaa_news

The proposed change is to Rule 6.2, which was suggested to read: “If a contestant is rendered unconscious, or shows signs of a concussion or spinal injury, that wrestler shall not be permitted to continue in the match or return to competition without approval of a physician or certified athletic trainer.”

In essence, the change adds concussion symptoms to the list of injuries that require medical attention and positions athletic trainers and physicians as the authorities for that oversight.

The Football Rules Committee and Soccer Rules Committee took similar actions earlier this year.

 “Committee members thought it would be prudent to limit the decision-making responsibility for whether a student-athlete may continue wrestling after showing signs of a concussion to a physician or certified athletic trainer,” committee chair Brad Traviolia, who is also the deputy commissioner of the Big Ten Conference, said in a statement.

The Playing Rules Oversight Panel (PROP), which will meet via conference call June 2, must approve the change.

In January, PROP endorsed efforts by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports to manage concussion issues more effectively. PROP instructed each rules committee to thoroughly review its policies in the areas of stopping play for injuries and to consider instituting rules that may further prevent head injuries.

Detroit Lions tight end Casey FitzSimmons, who has sustained several concussions, Wednesday announced that he is retiring from the National Football League.  http://www.detnews.com/article/20100414/SPORTS0101/4140414/1361/Concussions-force-Lions-TE-FitzSimmons-to-retire

FitzSimmons, who has been playing in the NFL for seven years, cited his concerns about his “several documented concussions,” which included one he suffered in a Dec. 6 game against Cincinnati.

“This has been a very difficult decision,” FitzSimmons said in a statement. “I feel like 2009 was one of the best seasons of my career, because I was so consistent, and was able to contribute in a variety of ways.”

But FitzSimmons is concerned about his health.

“If it wasn’t for the concussions, I would not be retiring,” he said. “It’s frustrating because the rest of my body is still capable of playing at a high level in the NFL. However, given the seriousness of the risk associated with continuing to play, I have to listen to the advice the team has given me.”

A case in California is shaping up as a test of whether the National Football League is liable for the dementia that is striking retired players who sustained head injuries during their careers.

 The details of the case are carefully spelled out in a lengthy Page One story in The New York Times by sports writer Alan Schwartz, whose aggressive coverage of the NFL-concussion issue has been submitted for a Pulitzer Prize. http://www.nytimes.com/2010/04/06/sports/football/06worker.html?ref=todayspaper

 The detailed story centers of the case of Ralph Wenzel, who was a NFL lineman from 1966 to 1973. He was diagnosed with dementia when he was 67.

 His wife, Dr. Eleanor Peretta, filed a workman’s compensation claim on her husband’s behalf in California. Apparently, retired pro athletes from across the country file claims in California for injuries they sustained decades ago.

 That’s because under California law, any pro athlete who played even one game in the state “is eligible to receive lifetime medical care for their injuries from the teams and their insurance carriers,” according to The Times.

 In fact, right now some 700 former NFL players have filed claims in California, and they can expect to get settlements of anywhere from $100,000 to $200,000. 

 Those lump sums have been for injuries such as injured shoulders and knees. But Wenzel’s case is significantly different, and could be precedent-setting. That’s because it is blaming Wenzel’s former employment as a football player for his devastating onset of dementia.

 The case could be worth over $1 million for Wenzel and his wife, and could also result in the NFL being held liable for similar awards from retired players who have developed Alzheimer’s disease, on the hook for $100 million or even more, according to The Times.

 The looming issue scared the Arena Football League, which just resumed operations, enough that it decided not to have a franchise in California. http://www.nytimes.com/2010/04/06/sports/football/06arena.html

 Schwartz has a follow-up story on the NFL-workman’s compensation issue Tuesday. http://www.nytimes.com/2010/04/07/sports/football/07bengals.html?hpw

In that piece, he describes how NFL teams now starting to contest the workman’s comp claims filed by former players in California. And some teams, to avoid the problem in the first place, are including clauses on their contracts that say players can only file for workman’s compensation in the state where their team plays.

For example, the Cincinnati Bengals now have a clause in player contracts that says they can only file for workman’s compensation in Ohio, according to The Times.