President Obama leads initiative to prevent concussions in our youth

2014-11-28 11:55:39 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

Obama Concussion Summit President Barack Obama, with introducer Tori Bellucci, delivers opening remarks at the White House Healthy Kids & Safe Sports Concussion Summit in the East Room of the White House, May 29, 2014. Belluci suffered multiple concussions as a youth and high school athlete. (Official White House Photo by Pete Souza)

President Obama recently announced $85 million has been committed to youth sport concussions by national sport leagues and government agencies to research, educate and prevent these serious brain injuries in our youth. The synergy of everybody working together is the key to making progress.

Yesterday, I visited WAKR morning show host Ray Horner in studio to discuss this topic. We also talked about Carlos Santana's recent concussion and placement on the disabled list.

Below is an audio file and transcript of our discussion. Originally aired on 1590 WAKR-AM on June 4, 2014.

Note: Music was played over the stream for the first minute of the audio.



HORNER:  us in studio once a month ... talkin' sports medicine and that's Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital.

Joe, you have spent a lot of time, a lot of effort and passion, I might add, doing research in the fight against concussion in youth athletics, taken to the high school and beyond. This week, President Obama addressed concussions.

DR. CONGENI: Yeah, um, youth sports concussions, we don't have all the answers, so I was pretty excited this week to see the press conference where ... 85 million dollars, $85 million, have been committed to youth sports concussions to try and figure out what's going on, what the problems are, what the issues are.

a lot of different people teaming up to do that. You saw the NFL put in, I believe, $30 million and the NCAA $25 million. A lot of it is going to the NIH (National Institutes of Health).

Dr. Joe Congeni Dr. Joe Congeni

The synergy of everybody working together is what's exciting to me. Right now, nationally everybody's kinda working on their own trying to answer some of these questions. And, one of the good things about this national effort is I think it will give some synergy of everybody working together and so I'm excited about this effort.

HORNER: With the dollars going in, that's one of the big steps in the right direction. Now, how to use those properly? Where would you like to see that dollar and research go towards the most?

DR. CONGENI: Well, I'll tell you where I would like to see it go the most, and what I'm excited about is when you read the press transcript, as I did and went through it and everything, I think all 4 of the major prevention areas were touched on. So, to prevent and answer these questions, there are 4 areas.

I know sometimes we beat the drum here and talk about this a little bit. No. 1, education. The problem with concussion is it isn't just enough to educate just medical people. You have to educate players, coaches, athletes, officials, educators because, you know, brain rest and everything after a concussion. There are so many different people, but education is key. That was No. 1.

No. 2 is research. We're not going to get anywhere without researching this. Most of the research that has been done, as you know, Ray, has been in professional athletes, college athletes, maybe some high-school studies, but nothing really in the youth level.

There is no N-C-double-A for youth sports, there is no N-F-L for youth sports, so having these dollars go to youth sports and research was really good. That was No. 2.

No. 3 is we need people to help screen and pick these injuries up early. As you know, they're subtle early on, and the best to do that are athletic trainers.

We have trouble getting athletic trainers into high school settings and they are no where around in youth settings. And, there was some discussion about for major sporting events in youth sports, paying and getting athletic trainers. I was super excited about that one.

The final part is you and I talk about is technology. We have to have monies to come up with new technology to look at ways to do a better job picking this up. And, there was discussion about new technology. 80 to 85 percent of kids will get better within a week, 2 weeks and so forth. 15 percent will not.

So, I like the fact that the monies would be given to those 4 major areas of prevention.

So when all comers of kids with a concussion, young people, the kind I see in youth sports, 80 to 85 percent of kids will get better within a week, 2 weeks and so forth. 15 percent will not.

HORNER: So difficult, I mean each sport has their own problems when we talk about concussions. So often we have a tendency to center in on the football aspect, but you could go soccer, you could go baseball.

I think Major League Baseball is doing a much better job with their concussions. Matter of fact, we see Carlos Santana (Cleveland Indians) right now on the disabled list.

But when that trickles down to the youth area, there's a lack of knowledge, maybe by coaches, in everything. And also, you need dollars to take care of that. How can we improve that on the Little League and youth areas, Joe, where it's real difficult?

DR. CONGENI: Yeah, it is real difficult, and thanks again for bringing up the point about that this is not just NFL based. Soccer was involved, basketball was involved, baseball for youth sports. And again, like I said, it's so fragmented nationally. So, if you look at guidelines for youth baseball, there are at least 5 or 6 different national bodies that people look at. And so, we need to bring that together.

We need the synergy of all these people working together to get some of these answers, and that's one of the biggest things that I hope comes out of this is that there is going to be some working together, not only within a sport, like baseball, if we're gonna take baseball for instance, but also with multiple sports working together. And that's what I really hope happens the most.

But, you and I mentioned, education is the key. And, that is the one area, Ray, 'cause I've been doing this, you know, 25 years, where I see the most progress, too. And, I'm really excited about that.

When we see athletes, you know, this is physical exam time of the year, or I'm out in the schools and I see young kids, I think there is a heightened awareness now, finally, over 10 years. I think kids are getting it about what it is about concussion and understanding it a little, but we have to do even better.

HORNER: Yeah, and I know from being a Little League coach the last 2 years, we've had to go through some protocol, forms, education pertaining to concussions that was never there before.

DR. CONGENI: Yeah, and with all that, I know a lot of gnashing of teeth and it's gonna be hard and everything, but don't you believe that there is a heightened awareness of everybody?

HORNER: Yeah.

DR. CONGENI: When there is a kid hit, a play at the plate, a kid getting hit by a batted ball or pitched ball or something like that, people are starting to ask the questions, "Hey, the way this kid is acting, could it be ? We better keep an eye on this kid. We better send him home."

You know, it's not always so easy. The first couple of hours a lot of times, it's just kinda generally how they feel and then 12 hours later, 24 hours they're starting to show all the symptoms of concussion. I hope that there's increased awareness of coaches and others involved to , "Hey let's keep an eye on that kid."

HORNER: Joe, for parents out there listening to us this morning that have a son or daughter in youth softball, baseball, a lot of youth soccer programs are rolling right now, let's one of these youths between 8 and 11, 8 and 12 get a concussion. How dangerous is that for them going forward as they look to get into middle school and high school sports on down the line.

DR. CONGENI: Well, I mean you're teeing it up for me. That's exactly what this press conference is all about. We can't really say. We need more research to be able to say down the road.

What we do know, Ray, is no doubt if it's missed early on, then, you know, it might be the second or third concussion before somebody picks these up, then definitely it has a chance of being one of those more significant concussions that can take weeks or months to get better. So, we want to pick 'em up as early as we can.

But, to answer the question about prognosis and really know what it's gonna do to my kid, what's the risk of more injury, what's gonna happen down the road, we cannot answer those questions. Those are difficult questions to answer and we need more research. And that's why this is such an important initiative.

HORNER: What struck you when you saw Carlos Santana go on the disabled list with concussion-like symptoms?

DR. CONGENI: Well, what struck me the most and what's a teaching point about that one is they didn't know right away. He was hit, he played. It was the day later, 2 days later . That's the way these are. That's called a Monday morning concussion, and that's really tough.



Kids just don't act right at first. A parent watching a kid at home, they're not acting right, they're not sleeping right, they are feeling sick to their stomach, queasy. Hey, I'm just not right.

Then 12 hours later, 24 hours later, okay they're having problems with thinking, they're having dizziness, they're having problems with, you know, visual symptoms, and then you have them checked out and, oh my gosh, they have a concussion.

Santana's wasn't obvious initially. It was a few days later, right, before he went on the DL.

HORNER: Mmmhmm. There was a player last year, maybe a year and a half ago, Justin Morneau (of the Colorado Rockies) in Major League Baseball, sliding into second, got a concussion.

DR. CONGENI: Yeah.

HORNER: He was on the disabled list for, like, 6 months. In those cases there, he just couldn't clear it out? I know, I'm trying to be specific, but in a case like that, a long and enduring recovery period, what happens?

DR. CONGENI: Yeah, with those, we don't know. Was he having multiple , you know, a cumulative effect of what we call sub-concussive blows before that that made it ? Was it the type of concussion he had? There's one called the vestibular concussion with dizziness that seems to last longer.

So when all comers of kids with a concussion, young people, the kind I see in youth sports, 80 to 85 percent of kids will get better within a week, 2 weeks and so forth. 15 percent will not.

The big question we want to know from this research coming up in the next 5 to 10 years is what makes that 15 percent? Why are there some kids that 6 weeks, 6 months to recover never get back to where they have to be told they're done with their career? That certainly happens at our center. You know that, Ray.

What's with the 15 percent? You know, the 80 or 85 percent that seem to get better they go on their way maybe within a week, maybe less. You know some kids are better within 24 to 48 hours. We know that.

What we're really looking at is what's up with that 15 or 20 percent, like Morneau, who gosh, it took a couple of years and they're just happy now that he finally, he was in town this week, he's finally acting like himself and playing like himself again. It took half a year or more for him to recover from his concussion.

HORNER: Alright, Joe, great stuff. Thanks for coming in.

DR. CONGENI: Okay. Thanks, Ray. Have a great week.

HORNER: You too. Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital.

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