Terry Zeigler's Blog

Posted by Terry Zeigler

Although the NFL commissioner has not yet admitted a link between multiple concussions in retired NFL players and chronic traumatic encephalopathy, the research is mounting and it is time for adult athletes and parents of young athletes to start paying attention to the possible long term effects of multiple concussions.

The danger with concussion is that a concussion cannot be diagnosed through visual means by either a CT scan, x-ray, or MRI. Athletes who receive head injuries and are treated in emergency rooms are typically released with little to no follow-up. Emergency room physicians are looking for life-threatening injuries that are caused by bleeding in and around the brain. When they are not seen, the patients are sent home.

There is so much more information now available on the recognition of concussion along with specific tests that can be objective tools to measure the effects of concussion. The latest tool is actually a check list with which athletes can monitor the length of time of their signs and symptoms. It is now recognized that the length of the symptoms determines the degree of the injury.

As long as athletes are symptomatic with any signs of concussion (confusion, disorientation, nausea, dizziness), athletes need to be sidelined from sports.

The latest research shows that athletes with concussions will heal faster with no physical or cognitive activity. It has always been known that athletes need to be physically still after a concussion, but the new research is showing that they also need to quiet the cognitive processes of their brains.

Research also shows that successive concussions cause an increase in the intensity and the length of related signs and symptoms. Initial concussion symptoms may last only one to two days, but successive concussions can cause symptoms to linger for weeks and even months.

The key in preventing additional brain injury is to ensure that the athlete's brain has completely healed before they are allowed to resume physical activity. The athlete also needs to be tested with physical exertion tests prior to being allowed to re-enter practice to ensure that exertion does not bring back the symptoms.

Last and one of the most difficult questions for an athlete and or the athlete's parents to ask is when should an athlete retire from sports if the athlete has suffered multiple concussions.

The research coming out of Boston is going to push this question at the NFL level, but it also needs to be asked at the collegiate and high school levels. When is the risk to play greater than the benefits of participation?

Posted by Terry Zeigler

According to the Los Angeles Times (October 29, 2009), a jury awarded a family a large sum of money stating that the manufacturer of the Lousiville Slugger baseball bat did not adequately warn user of the bat of the possibility of catastrophic injury and/or death from the bat.

Brandon Patch (age 18) died from being hit in the head by a ball hit off of the bat of a Louisville Slugger while he was pitching in an American Legion baseball game in 2003. As unfortunate and devastating as this injury was for the family, I'm not sure bringing a suit against the manufacturer of the bat is a beneficial move for the sport. It opens up the door for hundreds of lawsuits from families whose children were injury by balls hit by an aluminum bat.

The rationale was that the bats "are dangerous because they cause the baseball to travel at a greater speed" (Los Angeles Times, October 29, 2009). The family argued that "their son did not have enough time to react to the ball before it hit him in the head".

Even professional baseball pitchers do not have time to react to a batted ball (and they use wooden bats) and are frequently the victims of balls to the head and face. It is a risk inherent in the sport and in the position.

My fear is that all kinds of lawsuits will be brought on all types of equipment from families of kids that have been hurt. The industry's response will probably be "caution" stickers on the pieces of equipment (just like football helmets) and required educational training of all kids on the risks of catastrophic injury in sports. This will eventually stop the lawsuits, but the underlying cause will still exist.

Rather than bringing lawsuits against the baseball/softball bat undustry, maybe the focus should be on restricting the use of aluminum bats to a younger age group.

Posted by Terry Zeigler

With the release of the catastrophic injury report from University of North Carolina last year, evidence was released for the first time about the severity of injuries that are being sustained by young girls in the sport of cheer. Although there is differing opinion as to whether this report overstates the number of injuries or understates the number of injuries due to the lack of a standardized reporting system, the bottom line still needs to be increased awareness and education for all involved with this sport.

The more I have read and researched the number and types of injuries involved in cheer, the more it stands out that adults are being asked to coach or supervise groups of cheerleaders with sometimes little to no background in tumbling and/or stunting. Even with qualified, experienced coaches, the athletes will still risk severe injury because of the types of stunts they are doing.

It is also clear that some schools are content with "pep" squads whose squads cheer and dance from the sidelines at games. Their sole purpose is to encourage and to "cheer" on their teams. If this is the primary goal of these teams, then a simple solution is to require that these types of teams keep their feet on the ground. They could be coached or "supervised" by a teacher on campus and these "coaches" would not require advanced training.

However, If a school would like to allow its teams to tumble and stunt, then they should require coaches with experience in tumbling, spotting, and stunting. These coaches should also be required to have and maintain certification in first aid/CPR/AED and have an emergency plan in place in the event of a catastrophic injury. These coaches should be educated as to the proper strength requirements for their teams as well as knowledgable in safe progressions for all tumbling and stunt skills.

These teams should have access to certified athletic trainers for advanced medical care and treatment of injuries. Emergency medical equipment should also be on hand including a fully stocked first aid kit and an AED.

Competitive/performing cheer squads should be required to follow published safety rules as to proper equipment and surfaces to tumble/stunt on. Last, the cheer squads should have a mandatory injury reporting protocol so that all injuries that occur can be reviewed and studied for future prevention.

While more research is being gathered, differentiating between a "pep" squad and a "cheer" squad and requiring that "pep" squads keep their feet on the ground could be one way to make the sport safer.

Posted by Terry Zeigler

Kevin Dare's life was cut short performing in the sport he loved - the pole vault. Although his life ended tragically, his family has pushed on and become national advocates for safety in the sport of pole vaulting.

Because of their efforts, thousands of dollars have been raised to increase awareness about the risks in pole vault, to create new safety rules for the sport, and to create, design, and market specially designed helmets for the sport of pole vault. Their efforts to increase the safety of pole vault will undoubtedly save the lives of young vaulters.

Their efforts should be acknowledged not only because they have been successful in their purpose, but because they chose to take Kevin's death and use the situation to help others. It would have been understandable for this family to have retreated and withdrawn, but they did the opposite.

They used their pain as a source of strength. They worked closely with the university that Kevin loved and teamed up with Penn State to continue to honor his name. I think Kevin would be truly proud of what his parents have accomplished in his name.

The Dare family can be a model for others to follow. If a life is lost in sport and the cause is something that could have been prevented, then it is time to do something about it. Family and friends can be the best advocates for change because they have the most invested emotion to drive that change.

May we all be advocates for making sport a safe place for our children. If the sports arena isn't a safe place for our children, it is time to make a change.

Posted by Terry Zeigler

Death from heat illness is completely preventable. An athlete dies from heat illness only if the current published guidelines to protect athletes from exertional heat illness have not been followed.

The problem is in getting the information on the recognition and prevention of heat illness into the hands of coaches (especially coaches working with youth sports). Athletes at the collegiate and professional levels are surrounded by sports medicine professionals who know and understand how to prevent heat illness in their athletes. It is their job to monitor their athletes and ensure that coaches follow established guidelines.

The difficulty is getting education and training at the high school, junior high, and youth sports levels. Because there are fewer sports medicine professionals working with these athletes (mostly budgetary reasons), the responsibility for protecting athletes falls onto the shoulders of the athletic administrators, and head and assistant coaches.

Many of the coaches at the high school and junior high level are walk-on or part-time coaches. Their salary stipends are minimal and most are hired because of their experience/expertise with a sport. These factors make mandatory training difficult at this level.

However, coaches are required to have training in first aid and cardiopulmonary resuscitation. It might be wise to include a mandatory training session on recognizing the signs and symptoms of heat illness and reviewing specific guidelines on how to adjust specific practice factors to protect their athletes.

Parents can also help protect their children by learning the same guidelines and confronting coaching and/or administration when they are not being followed. Watching in silence is not an option if a coach has crossed the line and athletes are in jeopardy.