Bug Off! Why 'Skeeter Skidaddler May Be An Ideal Team Fundraiser

How many times have you watched a game or tournament and the only thing you recall years later were the flies and mosquitoes?

I can remember coaching many a Memorial Day soccer tournament, and mostly what I recall were the black flies that always seemed to hatch at the same time (Is it just me or does it seem that many athletic fields are built close to swamps?) Not to mention the bites I got from those nasty green heads when I was trying to sunbathe on the sandy beach where I grew up in Massachusetts.  'Skeeter Skedaddler

This week MomsTeam added a new sponsor to our fundraising page: ‘Skeeter Skidaddler®: a 100% natural, great smelling, non-greasy insect repellent for your team, family and friends. The brainchild of an organic farmer from Maine, it is a brilliant fundraising idea (pure Yankee ingenuity, actually): raise money for a team, a club, or for a trip to a tournament, by selling a product that coaches, players and spectators can actually use at games or tournaments.  It is, as they say, a true win-win (and, if the team wins, I guess, a win-win-win). 

I know it may be hard, with a couple more months of winter staring most of us in the face, to think about warm weather and summer insects, but that actually makes this the ideal time, as you scrape the ice off your car, to let you mind drift to the warm weather and all the fun you, your family, and your friends could have this summer without all those pesky black flies and mosquitoes (not to mention the satisfaction of being able to say to the pests as you take out your can of 'Skeeter Skidaddler, "Bug off!").

Check it out by clicking here.


Prayers for Jack Jablonski

Everything I do today will be overshadowed by concern for a young raising star hockey player, Jack Jablonski, and the struggle he is going through days after suffering partial paralysis from a severed spinal cord when he slammed head first into the boards when he was illegally checked from behind by two opposing players during a holiday tournament in Minnesota.

As parents we always hope such an injury won't happen to our own children, and when it does, it puts everything in perspective. Last night, Jack's parents posted a message on his CaringBridge wall last night after surgery with the caption "Never Give Up":

It is with a heavy heart that we write this entry tonight. Jack's surgery today to fuse his vertebrae was a success, but it also confirmed that his injury was horrific.
Jack has limited mobility and no movement in his lower body. As we feared, he will not be able to walk or skate. This news is devastating to Jack and everyone who loves him. Our hope and dream is that he will be able to prove this prognosis wrong.
Our priority is to help Jack accept and transition into his new life, a life that we did not plan, but one that we have to embrace. We have a mountain to climb, but with your support, we know that Jack's youth, strength and determination will help him make remarkable strides.
It's been a difficult day, but now we know what lies ahead. Words cannot express our gratitude for the global support that Jack has received. Keep your thoughts and prayers coming." 

The outpouring of support for Jack on Facebook, Twitter, and in blog post like this one, has been heartwarming.  Typical was this Tweet:

"Pray_for_JABS #JABS no more STOP patch on the back of hockey jerseys. There needs to be a #JABS patch for the players to rethink their actions on the ice!"

As parents, whether it be sitting in the stands or before going to sleep at night, the worry that our child will suffer a catastrophic injury like Jack's playing sports is always there; most of the time all we can do is hope and pray that our children will be kept out of harm's way. A parent's worst nightmare has come true, unfortunately, for the Jablonskis.

An injury like Jack's will no doubt be discussed in locker rooms and at kitchen tables around the country. Could it have been prevented? Were the players who hit Jack from behind trying to intentionally knock him out of the game? What can be done about checks into the boards from behind of the kind that left Jack paralyzed? 

"It wasn't a booming hit," Wayzata (Minn.) JV coach Duke Johnson told the Minnesota Star Tribune. "Was it a check from behind? Yes. Did our kid take eight strides and then hit him? No."

We will probably never know what was in the minds of the players who hit Jack Jablonski.  What we do know is that, while accidents happen in any sport, injuries like Jack's provide the opportunity to re-visit, once again, the question of injury prevention in youth sports, to do some real soul-searching about ways to make sports safer. 

In hockey, perhaps it means stiffer penalties for hits from behind, especially along the boards, where the injury such a hit can cause can be catastrophic. Only if we think long and hard about ways to make hockey safer will Jack's injury be more than a tragedy for him, his family, his teammates, friends, and community. Only then will we make sports for our kids as safe as it can be.





The Winter Olympics: Coming Up Faster Than You May Think!

Prior to 1992, both the summer and winter Olympic games were always held in the same year. Now, for the first time since 1992, we will be treated to two Olympic Games this year, winter and summer.

I know what you are wondering: how did I miss that the 2014 Winter Olympics in Sochi, Russia had been moved up two years?  Well, relax, you didn't.  The Winter Games I'm talking about are the inaugural Winter Youth Olympic Games (YOG), set to begin a ten day run just over a week from now on Friday, January 13th in Innsbruck, Austria, a city which has already hosted two memorable Winter Olympic Games (1964 and 1976).  The summer Olympics are still set for London, which will become the first city to host three Olympics (1908, 1948, 2012).   Fortunately, I am not a tridecaphobic, so the fact that the Winter YOGs start on a Friday the 13th is no cause for concern. Youth Olympics 2012

The Youth Olympic Games were created in response to growing global concerns about childhood obesity and the declining participation of children in sports, especially among children from developing nations. The age range for youth participating in the YOGs is 14 to 18 and there is a strong cultural Culture and Exchange Program, which was developed as a component for each celebration.

International Olympic Committee (IOC) President, Jacques Rogge,  says "there will be several goals for the YOG, with the top including; bringing together the world's best young athletes, offering an introduction into Olympics, innovating in educating and debating Olympic values."

Special birthday

As anyone who has been reading my articles and blogs for MomsTeam over the past eleven years knows,* I am a huge fan of the Olympics, especially the Winter Games. Perhaps it is because I was born during a blizzard during the 1952 Winter Olympics in beautifiul Oslo, Norway, on the day figure skater Dick Button won a gold medal after becoming the first to successfully land a triple jump (a triple loop) in competition, or all the skiing I did growing up, or my dream of one day skiing in the Olympics.  Emotionally, I know it is because, as a young athletic girl growing up in a pre-Title IX world, the only time women were valued for their athleticism in any concentrated way was during the Olympics.

Teacher, teacher

Even though there hasn't been much hoopla or publicity about the YOGs, at least not yet, I think this may be an ideal time for parents to ask their children's teachers to talk about the Games in their classrooms.  I will be blogging about some of the members of the U.S. team over the next ten days leading up to the Opening ceremonies.  Chances are some will be on the U.S. team in Sochi two years from now or in 2018, when the Winter Games will be held in Pyeonchang, South Korea. In the meantime, you may want to bookmark the Games' official website: http://www.innsbruck2012.com/en.

* Here are some of my other articles and blogs about Olympics past:

A Lifelong Dream: Attending the Olympic Games

Not To Win But To Take Part

Ice Hockey at Fenway: 2010 U.S. Women's Olympic Hockey Team Practices In Shadow of Green Monster

Vancouver Olympics Next Stop For U.S. Women's Hockey Team

Women's Hockey: Gold Medal Showdown At Vancouver Olympics

Seventh Heaven: Canadian Fans Made The Difference

Lindsey Vonn's World Cup Win at Garmisch-Partenkirchen Brings Back Memories

Vancouver 2010 Paralympic Winter Games: A Tale of Two Brothers

Angela Ruggiero: My Personal Reflections On Her Retirement



Top Youth Sports Story of 2011: New Concussion Safety Laws

Every day at MomsTeam the staff talks about the best and worst youth sports stories of the day. Each year we vow to post a Top Ten list, as do our friends at the Positive Coaching Alliance, with their "Top 10 Responsible Sports Moments," or, select the top youth athlete, as the folks do at Sports Illustrated for Kids.

But we realized that selecting ten stories or one kid to highlightt when there are over 50 million kids playing sports in fifty states just isn't possible. The simple fact is that there are thousands, if not hundreds of thousands, of "responsible moments" and millions of great young athletes whose spirit, desire to excel, and sportsmanship deserve to be recognized.

But if I had one story to pick from the year just past to highlight, the one I believe deserved to be recognized above all others was the passage by so many states in 2011 of youth sports concussion safety laws.

An amazing total, by our count, of twenty states and the District of Columbia passed such laws in 2011, bringing the total from just eleven at the beginning of the year to thirty-one and Washington, D.C. at the beginning of January 2012.  All have been passed since Washington State's groundbreaking Zackery Lystedt Law was enacted a mere two and a half years ago in May 2009.

As someone who has been working tirelessly for over a decade on the issue of concussion safety in youth sports, it was incredibly gratifying to see so many states jump on the concussion safety bandwagon.  When I spoke to a concussion safety summit in April 2008, I was critical of the lack of leadership by the NFL to that point on the issue, but I am happy to report that has changed: it was no doubt due in no small measure to the backing of the NFL that so many states passed concussion safety laws during 2011, and the league is to be applauded for its lobbying efforts.

The real winners of all the new laws, of course, are the kids.  In the states with strong concussion safety laws, they won't be allowed to play until they and their parents have been provided information about the dangers of playing with, and failing to report, a concussion; no longer will coaches will be allowed to put winning ahead of an athlete's short and long term health by returning them to the same game or practice if a concussion is suspected; and, written clearance from a health care professional with expertise in concussion evaluation and management will be required before an athlete is allowed to return to play, minimizing the chances of a premature return that could not only jeopardize a player's very life, but delay his or recovery for months, even years, and leave him with permanent cognitive deficits.

We still have work to do, of course.  There are nineteen states that have yet to pass strong concussion safety laws. Incredibly, despite all of the attention concussions have received, there are still six states (Arkansas, Georgia, Kentucky, Mississippi, Montana, and West Virginia) where no legislation is even pending.

But as we begin 2012, the fact that 20 states passed concussion safety laws in 2011 has to be celebrated, one last time, for the remarkable achievement it represents towards improving the safety of contact and collision sports.

All of us at MomsTeam, and all of you who visit our site each day, will have a very special 2012 indeed if I am able to report this time next year that every single state in the country has followed Washington State's lead. 

Let's work together to make it happen!




Concussion Awareness At All-Time High But Athletes Want to Keep Playing Despite Risks

A new poll by ESPN: The Magazine contains some good news and bad news about sports concussions.  A confidential survey of 300 high school football players, 100 coaches, 100 parents, and 100 athletic trainers in 23 states reported that concussion awareness is at an all-time high but that players, and to a lesser extent their parents, continue to downplay the risks:

  •  Asked to rank where their group fell among all four groups on its level of concern about concussions, there was a concensus that athletic trainers worried the most (1.6 on a 4-point scale with 1=most concerned and 4=least), and players the least (3.5). A troubling sign: athletic trainers appear to still be under pressure from players and parents to rush their return to play.  Said one Ohio ATC, "I find myself buckling to that pressure more than I'd ever imagine."   I am disappointed to hear that there are still parents out there who appear willing to put their kids' health at risk  for athletic glory.
  • Very few coaches said they were willing to risk a star player's health by keeping him in the game with a concussion in order to win the state title game, with parents and ATs in agreement, although whether coaches walk the walk when it comes down to crunch time is highly debatable. Players, however, continue to exhibit a winning-at-all-costs attitude, with a majority (54.1%) saying that they would rather win the game with the star playing despite a concussion than lose the game because he was benched.  No wonder that study after study finds under-reporting of concussion symptoms by high school athletes.
  • Even though headache is, far and away, the number one reported symptom of concussion, a majority of players (55.4%) felt it didn't warrant a benching until a clear diagnosis was made, putting them at odds, once again, with coaches (33.7%), ATs (29.7%) and parents (24.2%).  Nice to see only one in four parents thinking that it was okay to return.
  • Asked whether running a decent chance of permanent brain damage was worth it if a player had a good chance of playing in the NFL, a majority of coaches, parents, players and ATs said it wasn't. More than a third (134 out of 300) players, however, said the risk was worth the reward, just further evidence that we need to do a better job of getting through to the kids on the long-term risk of brain damage from playing professional football. Nearly one in five coaches chose "wealth over health" as well.
  • Although nearly three out of four responded either "no chance" or "doubtful" to a player's chances of playing the weekend after suffering a concussion, players are still resistant, with one Georgia player telling ESPN, "My coaches sort of say, 'You're not playing' and it take a lot to convince them to change their minds."
  • Helmet safety appears to be a growing concern.  While all four groups gave passing grades to the condition of their football helmets, they all were concerned about where the funds were going to come from to replace worn-out helmets or send them out for reconditioning.  "My school says we don't have money for new helmets or for fixing up old ones," one Michigan linebacker told ESPN. "I have the same beat-up helmet I had last year."  Alarmingly, twelve players gave their helmets a failing grade, more than the other three groups combined (four).  The message to parents: check your child's helmet for a NOCSAE certification sticker, and demand that the program follow the manufacturer's recommendations on annual or bi-annual reconditioning. 

For the most comprehensive youth sports concussion information on the web, visit the MomsTeam Concussion Center in the Health and Safety Channel.
Source: "Concussion Confidential," ESPN: The Magazine (accessed at http://sports.espn.go.com/espn/news/story?id=5925876 on December 21, 2010)

North Carolina Moves To Require Athletic Trainers for Every High School

Add North Carolina to the growing list of states that is getting serious about high school sports safety.

During the past school year, five North Carolina student-athletes died, including football players Matt Gfeller, Atlas Fraley, and Jaquan Waller (the last from second impact syndrome), and two basketball players.

In the wake of the deaths, the state is taking four important steps to improve the safety of high school sports.

First, high school athletic directors, meeting at their 38th annual conference, are getting serious about the importance of educating coaches about the signs and symptoms of concussions and preventing second impact syndrome, something I have been pushing for years.

Second, at least one county in the state is considering an upgrade to Xenith football helmets, which could help reduce concussions, especially for players with a history of concussions. Safe, technologically advanced helmets for every child are clearly a must.

Third, schools are working on Emergency Action Plans (EAPs) to make sure they are ready to respond in the face of an emergency. Again, much work needs to be done in this area.

Fourth, a new bill (Senate Bill 864) was introduced last week into the North Carolina legislature funding the hiring of licensed athletic trainers (LATs) for every high school in the state, a step that I have also supported for years. Working under a specific protocol designed in consultation with a supervising licensed physician, LATs coordinate daily, on-site athletic health care for secondary school athletes. Having an LAT in each high school is, I believe, the single best step that can be taken to protect high school athletes from injury and ensure that, when they are injured, they do not return to play before they are physically and psychologically ready.

According to James R. Scifers, ATC, President of the North Carolina Athletic Trainers' Association and Associate Dean of the College of Health & Human Sciences at Western Carolina University, only 42% of the state's 379 high schools have a full-time LAT on staff, a percentage which tracks the national average. "This bill has been on our radar screen for years," says Scifers. "We realize the challenges in getting the bill enacted into law with the economy where it is. But if nothing else we will be educating the public and the legislature on the need for LATs in each high school educated in the prevention, assessment, recognition, management and rehabilitation of sports- related injuries."

It is a tragedy, of course, that any athlete has to die before a state begins to intensify its efforts to take the steps needed to reduce the risk of catastrophic injury or death in high school sports, much less four athletes in a single school year.

That North Carolina, a state with a rich tradition of producing some of the best athletes in the country and one that takes its high school sports very seriously, is taking the lead to make the safety of high school athletes such a priority, especially in tough economic times when funds are scarce, is remarkable and worthy of the support of all parents, coaches, administrators, and trainers.

Here's hoping every state in the country follows its lead.

Average: 4.5 (2 votes)

Concussions: Follow The Leader?

Sports concussions continue to be big news.

As visitors to this site and readers of my countless blogs, articles, and editorials on the subject of concussions already know, however, concussions have been important to me and MomsTeam for a lot longer.

It is thus with a certain amount of pride and satisfaction that I have watched as Congress and the national media in recent weeks have joined me on the sports concussion bandwagon and called the N.F.L. out for its lack of leadership on this critical public health issue.  Editorials in newspapers have joined me in criticizing the NFL for its foot dragging. In a November 1, 2009 editorial, for instance, the Las Vegas Sun faulted the league for "repeatedly downplay[ing] research linking concussions to long-term brain injuries", despite what MomsTeam's concussion expert emeritus, Dr. Robert Cantu, told Congress was "growing and convincing evidence" of such a link. It concluded that "the NFL's current stance is putting players at all levels at serious risk" because "college, high school and youth football leagues often follow its lead on safety issues."

 Injured Football Player

More ATCs

MomsTeam has long recommended that a certified athletic trainer (AT) be on the sidelines of every high school football game. In my view, and many others, it is simply a disgrace that less than half of the nation's high school have an AT on staff. It is unfortunate that we, as a nation, seem so penny-wise but pound-foolish when it comes to health care that scarce resources are devoted to hiring assistant coaches so our high school teams can win more games when the money could be better spent hiring trained professionals to keep our athletes - the vast of majority of whom are not going to become professional athletes - safe.

We pay to have nurses in our schools (although, as the H1N1 flu epidemic has shown, there are fewer and fewer of them, too, and they are often spread way too thin); but considering the overall health risk to students, why don't we pay to protect more of our high school athletes, especially those contact sports at greatest risk of long-term or catastrophic injury or death?

Teaching proper tackling

A recent NATA study shows that high school players are at greater risk for concussive events in part because they haven't learned proper tackling techniques. Youth Sports Parents has consistently promoted the efforts of coaches like Bobby Hosea to teach players to use what he calls "Dip n' Rip" (a tackling technique in which a football defender stops the ball carrier with an upward thrust across the chest and shoulders, not by leading with his helmet).

Proper tackling technique needs to be taught at every level, from Pop Warner to high school. At least one concussion expert thinks it might eliminate up to half of football concussions at the youth and high school levels. Not surprisingly, witnesses at the Congressional hearings also emphasized the need for teaching better tackling techniques.

Culture change

For the last several years I have also been urging a change in the culture of football, which, from the NFL on down and since the earliest days of the sport, is for players to walk off the pain, take a hit like a man, be a warrior and gladiator, and to keep concussion symptoms to themselves, sometimes with tragic consequences.

As the keynote speaker at a national sports concussion conference in April 2008, and in articles on this site I have proposed that coaches actively, consistently and repeatedly encourage honest self-reporting by athletes of concussion symptoms (and reporting by teammates of symptoms shared with them by other players) and suggested that they make the failure to do so a violation of team rules. Just such a team approach to concussions was suggested by one of the witnesses at the Congressional hearing.

Once again, though, efforts to change the culture of football (and all contact sports, for that matter) have been and continue to be complicated by the NFL's attitude towards head injuries, which still, in my view, sends the wrong message to youth athletes. "Walking off the pain in an N.F.L. game turns into walking it off in a Little League game - the trickle-down effects on high school and college players are very real and can be fatal," warned Representative Hank Johnson, Democrat of Georgia, at the recent Congressional hearings.

I have been working hard the past ten years to educate parents about the risks concussive events pose to their children. As the national concussion conference in April 2008 - a conference attended by representatives of the N.F.L. - I called on the league to do more to educate youth and high school players about the dangers of concussion (especially from failing to report them).  I specifically called on the N.F.L. to sponsor a public service advertising campaign on the subject.

So I was happy to hear, more than a year and a half later, N.F.L. Commissioner Roger Goodell grudgingly agree, under pressure from lawmakers, to create public-service announcements to educate the public about the seriousness of concussions.

Kids' brains are different

Hopefully, such PSA's won't reflect the NFL's position before Congress that the same standards for concussion management and return to play should apply from youth football to the pros. The N.F.L.'s one-size-fits-all position flies in the face of research showing that youth, middle school and high school players recover from concussive events much more slowly than professionals. And it appears to completely ignores the consensus of concussion experts, expressed as recently as this past March, "strongly endorsing" a "more conservative return to play approach" for children and adolescents than for the pros, including an outright ban on a same-day return to practice or play.

We know we have a long way to go in concussion education and management when, according to a recent study by researchers at Nationwide Children's Hospital in Columbus, Ohio, as many as 4 out of 10 concussed high school athletes are allowed to return to the practice and playing field in violation of current guidelines, including an astounding 16 percent who are allowed to return to the same game after being hard enough to cause a loss of consciousness. How many more Zack Lystedts and Ryne Doughertys will it take before the message gets through that permitting a player to return to the field before his brain has healed from a concussive event (whether involving a loss of consciousness or not) puts them at unacceptable risk of a second, catastrophic or sometimes fatal, head injury.

Reasons to be more cautious

The Congressional hearings and recent stories in magazines like The New Yorker give parents more reasons than ever to be cautious about letting their sons play football. Based on a 2005 North Carolina study of retired pro players founds those with three or more concussions had increased risk of mild cognitive impairment after age 50, the lead author, Kevin Guskiewicz, recently told the Baltimore Sun that it was reasonable to "assume that a high school player who likewise had three or more [concussive events] during his high school years would potentially be predisposed to some of these same long-term neurodegenerative conditions that NFL players are," but there's no evidence - at least yet - for that.

A telephone survey of over 1,000 former NFL players conducted by the University of Michigan's Institute for Social Research and commissioned by the N.F.L. found, alarmingly, that former players were being diagnosed with Alzheimer's or similar memory-related diseases at a rate 19 times higher than the normal rate for men aged 30 through 49

Most troubling, perhaps, is recent evidence, highlighted in The New Yorker article, that playing football may be dangerous even to those who don't ever experience a concussive event; that players in the so-called trenches (on the offensive and defensive line), may be at risk of early dementia (in the form of a condition called chronic traumatic encephalopathy or C.T.E.) from the cumulative effect of the  sub-concussive blows they sustain over the course of their careers every time the ball is snapped. We simply don't know whether all those hits are, as a former N.F.L. lineman characterized them in a recent posting on Deadspin.com, tiny "time bombs planted in our brains with fuses of indeterminate length." 

Tough choices for parents

Given the increased focus on head injuries in football, parents have naturally become more and more concerned about what playing football will mean to their child's long-term health. Recent news stories have recounted how parents of football players have been torn about whether they should let their kids continue playing and describe the prospect of long-term injury if they keep playing as "kind of scary." Some report having decided not to let their kids play football based on the new evidence.

Again, this is something I faced ten years ago. As I have recounted on these pages, I ultimately decided to end my son Spencer's football career after his sophomore year in high school because to continue playing, given his history of concussions and learning disabilities, posed, in my view, an unacceptable risk of long-term injury.  And this was long before studies began coming out showing just how potentially dangerous football was to a player's long-term mental health.

I am not now and have never suggested that parents simply refuse to let their children play football. But parents do need to make the decision based on complete information; information which they still do not have. Concussion experts candidly acknowledge that little is currently known exactly about long-term health risks of concussion for N.F.L. players, much less players whose football careers end in high school or college.

More research is needed over a longer period of time before we will know - if we will ever know - just how dangerous football is to the human brain - particularly the developing brain of a youth, middle school or high school player. There is not now and never will be a one-size-fits-all answer. It is likely that the American obsession with football will continue for decades to come. But at the very least we - and the NFL - need to continue to provide the very best information.

Average: 5 (1 vote)

No Video Games After Concussion: A Defense

The other day I received an email from a neuropsychologist at a well-known New England medical center (I'll call him "Dr. A" for short) wondering whether there was any evidence to support the recommendation made in a number of articles in our concussion center, as well as videos, that, as part of the cognitive rest a concussed student-athlete needs during concussion recovery, he or she should not play video games:

"I do not necessarily disagree," Dr. A said, "but what evidence is there that kids should do no video's etc while symptomatic?  I think its good practice - if not extremely difficult to actualize - but is this just "mom's advice" or are you referring to some evidence? We are trying to validate different recovery protocols and I am looking for studies to support particular approaches (such as abstinence from activity). Am having a hard time finding anything.  Please let me know if your advice is evidence based or not."

As is my practice, I immediately forwarded Dr. A's e-mail to the staff for comment, and, after collecting responses, answered his e-mail, in part, by saying, "Most of the neuropsychologists that we work with, such as Rosemarie Scolaro Moser, PhD, will tell you that a child, after suffering a concussion, should not be playing video games. There are references in any number of studies and consensus statements, including the 2008 Zurich consensus statement1 and a 2010 clinical report from the American Academy of Pediatrics2 that recommend cognitive rest, and specifically say no video games (the latter says "Other activities that require concentration and attention, including playing video games, using a computer, and viewing television, should also be discouraged, because they may exacerbate symptoms.")(emphasis supplied). But our most recent recommendations against the playing of video games is derived from a book by one of our concussion experts, William P. Meehan, III, M.D., Kids, Sports and Concussions (2011) at page 82: "Cognitive rest requires avoiding cognitive activities, such as reading, writing, doing homework, playing games such as chess or Trivial Pursuit, playing video games, text messaging, working online, and so forth." (emphasis supplied).

I went on to say, "Is that advice based on peer-reviewed studies? No. It is based on common sense. Is it 'mom's advice'? No. It is based on advice from an impeccably credentialed concussion expert, William P. Meehan, III, M.D., the head of the Sport Concussion Clinic at one of the top pediatric hospitals in the world, Children's Hospital Boston, and the author, or co-author, of numerous peer-reviewed studies."

I went on to say that, "In fact, just last week, I covered an all-day summit presented by the National Athletic Trainer's Association on "Preventing Sudden Death In Youth Athletes" on Capital Hill.  Among the presenters was Kevin Guskiewicz, PhD, ATC, the Kenan Distinguished Professor at the University of North Carolina at Chapel Hill and founding director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center and the Center for the Study of Retired Athletes, who talked about the need for cognitive rest after concussion, and said, point blank, "this includes video games."

Dr. A responded, in part, as follows: "While I personally agree with most of what you say and what you are putting out there, I have some scientific and practical disagreements. First, (practically) I fear there is a serious disconnect between what professionals are saying and what is really happening. To prescribe 'do nothing' is a sure way to get noncompliance. Having parents and athletes learn how to pay attention to their symptoms seems a much more responsible approach to recovery. Difficult to do, but in some ways, no more difficult than telling a kid to "do not do video" (for example). Working with and monitoring the number of kids I do, I can tell you that even most parents don't know what their kids are doing. We risk making ourselves irrelevant by telling people to do things they cannot or will not do. And without the knowledge, we come across as moralizing. My suggestion is to just make it clear that these are "common sense" approaches to recovery and that research is ongoing."

Dr. A. continued, "Some of the problem is that there is little research to support the statements. I have reviewed the research of all the people you speak of - including Zurich and there is no evidence behind the statements about rest. The one clinical trial of bedrest got negative results. So at least that seems clear. The rest of the literature that does exist actually suggests something different - that some levels of physical activity are good for healing the brain. We even think we understand the mechanisms for this to be true (in part related to a brain chemical called BDNF). Mental exertion is much more difficult to pin down and operationalize. Again, paying attention to what makes someone feel worse is an important component. Parents need to pay attention to their kids. Not an easy task. The field is riddled with inconsistencies and poorly understood mechanisms. I think you web site is useful and primarily good. I just caution you to be less sanguine about the validity of all you offer. This whole business is a work in progress."

After again circulating Dr. A's response to the staff for comment, I responded with the following:

"I agree to some extent with what you are saying. We don't say complete bed rest by the way, and yes, you are correct that there is some suggestion, at least with respect to those diagnosed with post-concussion syndrome, that mild aerobic exertion3 may be helpful, as we point out in referencing the Buffalo protocol and other expert videos."

Based on Dr. A's input, and because MomsTeam is constantly striving to make sure that all of the information on our site is as current as possible, reflects both majority and minority positions, and to let users know where advice is based more on anecdotal evidence than peer-reviewed studies, I told him that, "We softened the black and white of the advice about cognitive and physical rest and added the caveats you suggested about using common sense, monitoring a child's symptoms and what makes them worse and cutting back where necessary, and that research is ongoing."  "But," I said, "I don't agree that we are moralizing or being sanguine about the great unknowns in the concussion area. That you seem to discount the views of an international consensus of experts in the Zurich statement about the importance of cognitive rest for youth athletes is fine, but a minority view.

Taking your comments into account, we have revised and updated the following articles to present your point of view (which I continue to believe is a minority position, so it is reflected as the view of "some experts"). The first of the three articles is one of the strongest articles in our entire concussion library and provides parents a very good overview of what they should be doing, and not be doing, in the immediate aftermath of a sports concussion:

  1. Concussions: Parents Are Critical Participants in Recognition, Treatment, Recovery;
  2. Concussion Recovery Starts With Both Physical and Cognitive Rest; and
  3. Gradual Return to Play After Concussion Recommended.

"And, in fact, to come full circle, I believe 'mom's wisdom' or "mom advice' is also important and should always be considered.  Of course, there will be clueless parents, but we find for the most part sports parents are pretty tuned in."

As proof of MomsTeam's continuing commitment to valuing the role of mothers in youth sports - the perspective, of course, from which I have always approached the subject of youth sports, here and in my book, Home Team Advantage: The Critical Role of Mothers in Youth Sports - I also alerted Dr. A. to an extraordinary series of articles and videos MomsTeam will be releasing soon which specifically taps in to the wisdom of a mother, Dorothy Bedford, and what she learned about concussions during the fourteen-month long odyssey she took with her daughter, Heidi, as she struggled to recover from her third sports-related concussion.  [We have already released two videos featuring Dorothy, one cautioning parents about the impact of concusssion on a teenager's ability to drive, the other, coincidentally about the very subject of the need for cognitive and physical rest!]

Eating crow

As it turned out, my e-mail exchange with Dr. A. ended with his praising MomsTeam and eating some crow:  "I did not mean you or your group! Sorry. I am referring to the universe of "experts" out there -- there is a lot of hysteria. And I wince when an expert says kids should not go to school with a concussion (maybe yes, maybe no) [Note: This may be another area where we may disagree; Dr. Meehan, for one, recommends that a child stay out of school, at least for the first couple of days]. I was involved peripherally with Zurich and there are points of disagreement. Mine are not so strong as to throw the whole thing out as overall, it was the best that could be done and still stands as a model (we modeled [our state's] consensus after it!). But there is no research to speak of - Buffalo (and our study), and some stuff from BC are the only clinical studies. Our pedi neurosurgeon and I had a tiff over a pt. whom I said should rest and she said: 'based on what?' We challenged each other to find the data - guess what? Not much and since I cited Zurich I was forced to eat some crow when I tracked it all down. There is a lot of animal research that is interesting.

"'My bad' for not being more clear about moralizing. I think your web page is about the best I have seen. Many thanks for taking my suggestions seriously. After 15 years of trying to get people to pay attention, I can't believe I am now saying this! Keep up the good work."

All in days work. All in a day's work, Dr. A!

1.  Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br.J. Sports Med. 20090: 43:i76-i84.

2. Halstead, M, Walter, K. "Clinical Report - Sport-Related Concussion in Children and Adolescents" Pediatrics. 2010;126(3):597-615 (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;126/3/5...).

3.  Leddy J, et. al. A Preliminary Study of Subsymptom Threshold Exercise Training for Refractory Post-Concussion Syndrome, Clinical J of Sport Med 2010; 20(1):21-27 (doi: 10.1097/JSM.0b013e3181c6c22c).


Watching Kids Play Sports Can Be Tough For Some Safety-Conscious Parents

My first-born son, Taylor (granted, he is only older than his two triplet brothers by a minute!), has taken up a new sport: Ice climbing. He loves it, but I have to say I am less than thrilled. Should I worry?

I am often asked by safety-conscious parents for advice on how to be less nervous watching their children play sports. The questions come from first-time sports dads watching their children play sports against bigger kids to moms who admit to biting their nails during their sons' wrestling matches and football games.

I even have a small file of e-mails from parents who refuse to watch their children play sports at all. I always find these e-mails sad. For me watching my triplet sons and their friends - whether it was on the baseball diamond, lacrosse field, soccer pitch or football gridiron - was almost always a joy. Sure, there were times when I worried about their physical safety (particularly when it came to watching Spencer play football). I think all parents worry and it wouldn't be natural if they didn't.

For years I have been responding to e-mails from worried parents by reminding moms that it is perfectly natural for them to be concerned about their child's safety playing sports because moms have been the "guardians of children at play" since prehistoric times and by suggesting that it didn't do any good to worry about what, in all likelihood, was an injury that wasn't going to happen.

I give the same advice to dads, even if most of their e-mails weren't about their nervousness around watching their kids play. I also tell them about the short meditation/prayer that I used to say before their games: "Please let my children play strong and smart, be fair and have fun." I decided early on in my time as a sports parent that accidents do happen but most of them can be prevented if the kids play smart and the adults running the program have done their homework.

An experienced rock climber

But what about my concern about Taylor's ice climbing? It's not like he's a novice climber. He climbs almost every day, whether outdoors or indoors on a rock climbing wall at a gym. He has gone rock climbing in New Zealand, South Africa and all over the United States from Alabama to Colorado, Tennessee to New York, New Hampshire to Massachusetts. 

While he does not recall much of his very early rock climbing "career" I have great pictures of him climbing on stone walls in Connecticut when he was less than two years old and later at the age of four in the Great Falls National Park in Virginia. Taylor, Spencer and Hunter Great Falls 1985

Later, he spent a couple of summers at a camp in the Adirondacks hiking and mountain climbing, and two summers in high school climbing, dirt biking, and kayaking in the West. It wasn't until he was attending Skidmore College in upstate New York that he fell in love with rock climbing.

Wake-up call

Now a grown young man, he is on his own. I rarely worry about him because I know he is smart and cautious. The one time he had a very serious fall was in Ithaca New York when he fell down a deep gorge, landing in the water barely able to swim because of a serious gash in his calf. The wound later became seriously infected.

Fortunately, the accident was a real wake-up call. Taylor realized that it was entirely preventable. He was climbing without ropes, at night. Amazing how a brush with death will teach you valuable lessons.

Fact is that I have only watched Taylor climb in person only once since he was a little boy. (It has more to do with the day- or week-long treks that he and his climbing buddies take together to the best climbing spots, which are usually deep in the woods and far from the beaten-path, than my apprehension). 

It was on a trip to Arizona we took together a couple of years ago when I was promoting my book. We took a hike out into a canyon. I was glad Taylor was there to protect us from the rattlesnakes and delighted that all those summer wilderness adventures that I sent him on when he was a teenager had paid off! 

An extreme sport?

Recently, I was filling out a life insurance form to obtain a rate quote and one of the things I had to check off were answers to a question in big, black bold letters asking: Do you engage in any of the following activities? Underwater diving? Motor racing? Aerial Sports (ballooning, parachuting, sky diving, hang gliding). Rock Climbing? Taylor rock climbing in South Africa

While I am mesmerized when watch the videos of Taylor and his friends rock climbing all over the world (well ... at least most of the time), I guess the bottom line is that I am not all that comfortable with the knowing that he has taken up ice climbing.

But, perhaps I shouldn't worry. After all, ice climbing wasn't on the list! 

Are your children involved in extreme sports? How to you handle the stress and worry?

Taylor has posted a great a question in our forums: If the vast majority of deaths and injuries in youth sports take place in traditional sports, shouldn't these sports be labeled as "extreme" just as much as the so-called extreme sports?

What do you think? Are extreme sports safer than other sports?

meiceclimbing-TheFilm-MomsTeam_Video_Preset.flv12.57 MB

No Bull: Sports Drinks Fuel Young Athletes Playing Team Sports

Sometimes you just can't believe what you read online or in the newspaper.

You may have seen the headlines or heard the buzz:  "Energy Drinks May Give Young Sports Teams An Edge, Study Says" trumpeted one; "Energy drinks boost stamina, enhance performance of young team players," said another.

Time to rush out to the nearest supermarket to stock up on energy drinks for your young athlete. Right?

Not so fast.  

Sports drinks & energy drinks are not the same!

Dig deeper and you'll soon discover that what the articles are talking about aren't energy drinks at all.

Nope.  The drink that researchers at the University of Edinburgh in Scotland say helped 12- to 14-year-old athletes in the study play, on average, 24% longer before exhaustion during stop-and-go, high intensity team sports was a solution containing 6 and 8% carbohydrates and electrolytes; in other words, a sports drink.

How could the media confuse energy drinks and sports drinks and use the terms interchangeably when they are so fundamentally different?  Heaven only knows. 

"We weren't researching energy drinks," says Dr. John Sproule, lead author of the sports drink study and a professor in the Department of Physical Education, Sport and Leisure Studies at the University of Edinburgh. "It was the press that decided to use the term 'energy.'"

While energy drinks have become extremely popular among adolescents and young adults in recent years, with many young athletes seeing them as a quick and easy way to maximize athletic performance, many groups, including the National Federation of High School Associations (NFHS), recommend against their use for re-hydration and warn that consumption may hurt not help athletic performance by causing side effects as bloating, abdominal cramping, diarrhea, light headedness, and impaired sleep.  Energy drinks are not sports drinks: they contain higher concentrations of carbohydrate (usually 9-10%) and calories than a sports drink, and high amounts of caffeine, both "natural" (from herbs and untested nutritional supplements) and synthetic, which aren't in sports drinks. 

So, now that we have that straightened out, what should the take-away of the Scottish study be for sports parents?

Pretty simple: that sports drinks, like Gatorade, consumed right before and at 15-minute intervals during prolonged stop-and-go team sports such as soccer, football, ice hockey, basketball, volleyball, and lacrosse actually help young athletes play better, longer.

Or, to put it another way, sports drinks work. And that's no bull.



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