Preliminary results show positive effects from the ongoing concussion debate

2014-11-28 11:46:36 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the blog.

Shane Morris (left) apparently suffered a concussion during a game against Minnesota. Michigan football's decision to continue playing Morris may lead to a Congressional investigation. Shane Morris (left) apparently suffered a concussion during a game against Minnesota. Michigan football's decision to continue playing Morris may lead to a Congressional investigation.

I'd like to think sport officials, physicians and organizations alike have done a good job collectively in heightening awareness around concussions. Even when there are setbacks like in this past weekend's Michigan game, where a player took a vicious hit and was stumbling around, yet remained in the game for another play or 2.

It's situations like this one that are sparking debate and forcing leagues to make necessary rule changes to keep players safe -- including FIFA's recent move to allow 3-minute evaluations on the field before a player is removed permanently.

Yesterday, I spoke with WAKR morning show host Ray Horner in studio about this topic. I'm encouraged to see some preliminary stats are showing positive effects as a result.

Below is an audio file and transcript of our discussion, which originally aired on 1590 WAKR-AM on Oct. 01, 2014.

HORNER: Dr. Joe Congeni is in our studio, Sports Medicine Center, Akron Children's Hospital. Joe takes time out of his week once a month to come on in the studio to talk about a number of issues.

Joe, for the last 2 or 3 years, you and I have talked a lot about concussions, symptoms, diagnosis, keeping players out. We're doing a better job, and then comes the Michigan situation from this past weekend. What happened here?

DR. CONGENI: Yeah, but this might be a sign that we are doing a better job and that awareness is higher. And, uh, really, I'm gonna lump it together with 2 or 3 things that have gone on in the last few months that have heightened awareness. People are paying a little bit more attention.

Dr. Joe Congeni Dr. Joe Congeni

  • The Michigan situation with Brady Hoke (head coach of the Michigan Wolverines) on the weekend. Was his quarterback stumbling around? a lot of question marks about him staying in the game.

  • The, um, FIFA situation at the World Cup, where 2 players definitely -- including in the World Cup Championship game -- were stumbling around and concussed. FIFA looked at the issue.

In the last 3 months, they came up with new guidelines. They're gonna allow a 3-minute evaluation on the field before a player has to be taken off for good. That was a good rules change, although there needs to be more.

In the NBA playoffs last year, you know, people look to the professional athletes. These things happen every Friday night, you know that. These things happen every Saturday at a basketball game in high school. ... In the NBA playoffs last year, I think it was Paul George (of the Indiana Pacers) that got hit and was stumbling around, and people had some outrage about that.

So, let's talk about that a little bit.

This is hard for me to believe that I would be defending Michigan a little bit and Brady Hoke, of all things. But, in this situation, a lot goes on. I think part of it as piling on, to be honest. He's down right now. Their program's down. I'm not sure if this was Nick Saban that there'd be as much outrage at Alabama.

I've gotta be honest with ya, but it did heighten awareness about that fact if you see something about behavior, you want to get that person off the field and get 'em evaluated at least.

HORNER: Yeah, I'll be honest with ya. I did not see the hit. I was not tuned in to any of the highlights. From what I hear, he took a vicious -- uh, well, no -- he took a good shot.

Coach Brady Hoke is under scrutiny after allowing Shane Morris to continue playing. Coach Brady Hoke is under scrutiny after allowing Shane Morris to continue playing.

DR. CONGENI: No. Vicious, vicious is a good word, Ray. I looked at the whole thing. It's vicious.

HORNER: He took quite a shot. And then, did he stumble around a little bit and come off the field? How would you characterize it?

DR. CONGENI: Yeah, he did. It was hard because he was battling a knee injury, a lower-extremity injury before that and was limping around the field. Then, he took a shot right up under the chin strap that snapped him back. You know those are the kind we worry about, but those happen in football a lot.

And, it's very hard from the sideline. First of all, you know, can a trainer run out there and just stop the play and pull him off? That's hard to do. But, both Brady Hoke and Urban Meyer said the key person here is their sideline trainer. That's who they depend on completely.

So, Brady Hoke said I was just coaching the game, watching the game. I depend totally on my trainer.

The trainer didn't get a chance to evaluate the kid. He played another play or 2 after that, after he stumbled around. But there's a lot of unknown there. Sometimes kids are stunned, or stumble for, you know, a play or 2.

The point is you need the evaluation after that. The evaluation takes 10 or 15 minutes at least. So, 3 minutes with FIFA that's a little bit light, but at least they're saying we can stop the game, look at kids, try to evaluate them. And, there is a little bit more talk about let's at least be sensitive to what happens after these big hits.

HORNER: I think you're being too kind here. ...


HORNER: ... and I'm not even pointing towards Coach Hoke because of the Michigan thing. I don't care where he's coaching, but with all the awareness out there. ... And Joe, it trickles all the way down to me, who coaches Little League and travel baseball. We have to go through a training thing now.


HORNER: So when Coach Hoke was on the sidelines, he sees his player take, as we said, a vicious shot and he's kinda stumbling around a little bit. As a coach with as much awareness as we have out there right now, I'm getting him outta there and getting him looked at right away. I don't buy the fact where he says I'm coaching the game. I don't get that.

DR. CONGENI: Yeah. Yeah. Again, I'm happy the discussion is going on ...

HORNER:  You're too kind.

DR. CONGENI: ... because everywhere across the country is it gonna heighten the awareness of the kids on Friday night and the coaches?

HORNER: You're right. You're right.

DR. CONGENI: And so the fact that this has been brought up is a big deal.

You know, I was giving a talk yesterday to med students at Kent State University, our NEOMED (Northeast Ohio Medical University) students. And they said, "Hey, 13 percent drop after ... getting rid of the kickoff. (Essentially, 80 percent of kickoffs, 80 percent-plus go in the end zone.) How about the punt? Isn't the punt a high injury? Can we get rid of the punt?" These are difficult .

A month or 2 ago, I was in New York City on a panel with a guy from The Ohio State University sitting next to me and he said, "You're changing the whole game. You guys can't make rule changes like this." On the other hand, we said, "Hey, you know, we eliminated the kickoff in the NFL."

So, there's a give and take on both sides to this thing, but at least the discussion is being had. At least I think some Friday night coaches will be thinking about it more, and soccer coaches on Saturday will be thinking about it more because of what happened at the World Cup; because of what happened to Brady Hoke; because of what happened to Paul George. It's not just a football thing.

When you see abnormal behavior let your trainers -- both Hoke and Urban Meyer said your trainers are the best trained in these things -- get that sideline evaluation in to see if that kid's concussed.

HORNER: And, Joe, I'll go on that line where someone came up to you and said, "Hey, you're changing the game." You look at the percentages of kids now playing football, it a lot the last two years. Those stats came out late last week. The participation on the middle-school, high-school level has dropped across the country.

If you don't change this game and make it safer and make the adjustments like you said, kickoffs, punts, you might not have a game in 20 years.

DR. CONGENI: That's right. We're trying to deal with that delicate balance of not being, you know, overly radical and having some good research behind the decisions we make, but making good decisions to protect kids.

So, I was encouraged when I saw that that kickoff rule had an effect, and I'm encouraged by a lot of other things that I see that there is some earlier recognition.

Remember the number from Chapel Hill last year, that study that was done at University of North Carolina. Sixty percent of concussions are still missed initially, even with all this discussion. Kids walk around on a playing field, soccer field, football field, basketball court that are concussed and we don't pick 'em up until the second or third hit.

HORNER: On the same road, different story, some more evidence came out pertaining to the young man, the Belcher kid from the Kansas City Chiefs, who took his life a couple years ago. Before that, he had shot and slain his estranged girlfriend or wife, it might be, and there was a diagnosis and study into his brain. Relate that.

DR. CONGENI: This is the tough part. Some people say, hey, you're bringing up overreacting or hysteria into this situation. That study's going on, we know that. It's less than 100 people they've found that have this really abnormal pathologic changes in the brain.

It's not a big number. There are hundreds of thousands of people that have played the sport, but on the other hand, we can't ignore that this study continues to go on. And, we're finding people that have permanent changes to the brain and we want to do everything we can to make sure down the road that we're keeping people safe.

HORNER: And that comes all the way back to the middle-school, high-school level of what Dr. Congeni is talking about. Joe, thanks for coming in. Good stuff this morning.

DR. CONGENI: Thanks, Ray. Good discussion.

HORNER: There you go. Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital, with us.

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