Responding to Head Injuries on the Playing Field: An Athlete’s Perspective

Editor’s Note: This week, PAR is pleased to welcome guest blogger Alex Trujillo. A senior at Holderness School in Plymouth, New Hampshire, Alex is an intern this summer in the production department at PAR. He recently had the opportunity to try out our new Concussion Recognition & Response™ app.

As a high school athlete, I experience the culture of sports in an acute way from the inside. Every day on the field, I am in an environment that perpetuates toughness, playing through pain, doing whatever it takes to win, and doing this all for the good of the team. While in principle this is not so horrible (even though it goes against the dogma that fun should be the underlying principle of amateur athletics), it is often taken too far in the wrong ways.

PAR’s Concussion Recognition & Response™ app is part of the growing trend that discourages “toughing out” injuries to the head, as these specific injuries can have extremely negative effects on an athlete if not handled properly. This trend challenges old–fashioned coaches who speak of the “glory days” when one played through absolutely any injury, coaches who believe that the new wave of players should embrace this antiquated ideology. The athletes of today are bigger, stronger, and faster than ever before. Yet some coaches put their athletes in danger by pushing them in ways that are perilous to their health. It is good for a coach to motivate and push a player to their physical limits and beyond. This is what good coaches do: They get the most out of every player on their team. However, some coaches try to push their players through injuries, such as concussions, without knowledge of the severity of the injury. Playing through strained muscles, soreness, bumps and bruises, aches and pains is all part of sports. However, a head injury is not something that can be “toughed out.” Research has shown that some cases of degenerative brain diseases, for example Parkinson’s, Alzheimer’s, and various other ailments, can be attributed to continuous abuse of the head over the course of an athletic career. The culture of toughing out all injuries, including those to the head, needs to stop now. The first step towards a change in culture is education about the topic, which is what PAR’s new Concussion Recognition & Response app can help to do.

I have tried the app out myself, and it is very easy to use. It takes the user through a series of yes or no questions, listing symptoms of a concussion and whether or not the athlete displays any of those symptoms. Included are ways to record how the injury occurred, immediate and delayed symptoms, and GPS coordinates to show of the location of the incident.

It would make me feel safer and more supported as an athlete if this app was available on the sideline. If I were to sustain some kind of head trauma—get my “bell rung”—it would be comforting to know that an educated decision about whether to continue playing could be made, even when I was not in the presence of an athletic trainer.

New “children’s book” illustrates bedtime frustration with a dose of humor

The recent electronic release of Adam Mansbach’s “Go the F— to Sleep” has taken the Web by storm. The book, which features as narrator a tired parent attempting to put his child to sleep for the night, combines mock-sweet prose with bursts of exasperation and annoyance. If you’re a parent, and you remember the sleepless nights—and you have a sense of humor—this amalgamation of genuine parental love with the eye-rolling that goes along with nighttime routines will probably strike a chord with you.

The book and its release bring up several interesting issues, including the frustration experienced by all parents of young children. Ranging from mild annoyance to real anger, the feeling can be surprisingly overwhelming. Parenthood is generally advertised as a joyous walk through a meadow, and, for some, discovering that the meadow is filled with divots, bumblebees, and sharp branches is a shock. Though it could be said that the book uses strong language for shock value, for most readers, the use of expletives serves to highlight just how intense the aggravation can be.

The book’s message goes a little deeper, though, as it effectuates a collective sigh of relief in its readers who are parents. Many parents inherently feel guilty about having negative feelings about parenthood. It may be psychologically reassuring for a young parent to know not only that many—okay, most— children have trouble going to sleep at night, but also that he or she is not the only one who finds the bedtime routine—and, for that matter, any routine that requires the parent to coerce the child—a vexing experience.

So, what do you think of the book? Do you think it’s vulgar and/or inappropriate? Do you think it serves a purpose in letting parents know they’re not alone? Are you willing to admit that it could have been written from your very own thoughts? Most important, do you have any tips for those of us who are trying to put little ones to sleep every night?

New App Helps Coaches and Parents Recognize and Respond to Possible Concussions in Young Athletes

A new Concussion Recognition & Response™ app from PAR allows coaches and parents to quickly determine whether an individual is exhibiting and/or reporting the signs and symptoms of a suspected concussion. In less than 5 minutes, coaches and parents can complete a checklist of possible signs and symptoms to help them decide whether to remove the child from play and seek medical attention. The app also provides home symptom monitoring for post-injury follow-up. Designed for the iPhone®, iPad®, iPod® Touch, or Android device or tablet, the app is now available for download from the Apple® App StoreSM or Android Market.

Using information from the CDC’s Heads Up: Concussion in Youth Sports program, the app guides users through a set of questions to determine the likelihood of a suspected concussion based on observations by the parent or coach as well as symptoms reported by the athlete. The device’s GPS records where the incident took place; its camera enables you to photograph the injured party; e-mail allows you to forward accurate information and documentation to a health care provider.

After follow-up with health care providers, the app enables a parent or caregiver to record a child’s symptoms through periodic evaluations, which are tracked during the hours, days, or weeks following an injury. This information can be e-mailed to health care professionals, providing an update on the athlete’s recovery.

The app also includes a Return-to-Play Guide that helps protect children and athletes from further injury by guiding them through a 5-step, tiered exercise routine. In collaboration with the child’s health care provider, parents and coaches can use the guide to ensure that the child is able to handle added exercise without further injury or discomfort. The app’s concussion information section provides general information about concussions along with answers to frequently asked questions for parents and coaches.

Users may customize the look and feel of the app with sport-related themes, including hockey, football, and lacrosse—and more themes will be available soon.

PAR’s Concussion Recognition & Response app was developed by concussion experts Gerard A. Gioia, PhD, and Jason Mihalik, PhD. Gioia is a pediatric neuropsychologist and the chief of the Division of Pediatric Neuropsychology at Children’s National Medical Center, where he directs the Safe Concussion Outcome, Recovery & Education (SCORE) Program. Mihalik is an assistant professor in the Department of Exercise and Sport Science at the University of North Carolina; he currently serves as the co-director of the Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center.

PAR will donate a portion of all proceeds from the sale of this app to support concussion research at the Children’s National Medical Center and the Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center.

Physics Whiz Kid Doesn’t Let Asperger’s Slow Him Down

Jacob Barnett, a 12-year-old boy from Hamilton County, Indiana, has caught the attention of researchers from some of the most prestigious universities in the country with his challenge to Einstein’s theory of relativity. Jacob grasps some of the most complex concepts in mathematics and physics. Instead of junior high school, he attends Indiana University-Purdue University Indianapolis (IUPUI), where there is a movement to get him on board as a paid research assistant. Recently, he created a YouTube video in which he explains his work, using markers on the windows of his home to show the mathematical calculations behind some of his ideas. Not bad for a boy who didn’t speak his first words until after his second birthday and has been diagnosed with Asperger’s disorder, a mild form of autism. But then again: Einstein didn’t speak until age four, and many psychiatrists now believe that he may have had Asperger’s disorder, as well.

Early on, Jacob’s parents were concerned that he might have problems in school. “Oh my gosh, when he was two, my fear was that he would never be in our world at all,” Jacob’s mother told The Indianapolis Star last month. “He would not talk to anyone. He would not even look at us.” Instead, his abilities have soared. He taught himself algebra, geometry, and calculus, leaving high school at age eight and enrolling at IUPUI, where he is currently studying and excelling in his advanced physics and mathematics courses.

Although they give him plenty of opportunities to explore his interest in physics, Jacob’s parents also insist that he spend time with friends his own age. He plays video games and basketball with friends; he has a girlfriend and he recently attended his first dance.

In his YouTube video, Jacob explains his expanded hypothesis, based on Einstein’s theory of relativity. Professors at the Institute for Advanced Study in Princeton, New Jersey have followed Jacob’s work with interest. “The theory that he’s working on involves several of the toughest problems in astrophysics and theoretical physics,” Professor Scott Tremaine wrote to Barnett’s family.

Jacob’s professors at IUPUI agree. “We have told him that after this semester . . . enough of the bookwork. You are here to do some science,” physics professor John Ross told The Indianapolis Star. “If we can get all of those creative juices in a certain direction, we might be able to see some really amazing stuff down the road.”

The Stigma of Mental Illness: Coping—and Fighting Back

As those who work in the field of mental health know only too well, mental illness carries a stigma that adds a significant burden to the challenges already facing many clients. Unlike other medical conditions such as cancer or heart disease, mental illness is often seen as a personal weakness or a character flaw. The detrimental effects of this stigma are well understood. In his 1999 Mental Health Report, former Surgeon General David Satcher asserted that “Stigma assumes many forms, both subtle and overt. It appears as prejudice and discrimination, fear, distrust, and stereotyping. It prompts many people to avoid working, socializing, and living with people who have a mental disorder. Stigma impedes people from seeking help for fear the confidentiality of their diagnosis or treatment will be breached.”

What perpetuates the stigma? Unfortunately, it’s not just outdated social attitudes. In fact, negative images and distortions about mental illness abound in current popular media. The National Alliance on Mental Illness (NAMI), an advocacy group for people affected by mental illness, publishes a regular column on their website called “StigmaBusters”, which asks members to send in alerts about stereotypes they find in the media. Examples include a November 2010 episode of the popular musical comedy “Glee”, which mocked and trivialized bipolar disorder in a scene where a “crazed” Mary Todd Lincoln is shown shouting at a teapot. A recent issue of Vs., a high-end fashion magazine, features actress Eva Mendes as a patient in a psychiatric institution, writhing on a bed to keep from being restrained. A new television commercial for Burger King shows “The King” on a rampage, chased and then taken away by men in white coats. Some of the most egregious examples have appeared around Halloween. This past fall, “The Pennhurst Asylum,” a Halloween “insane asylum” attraction, opened on the grounds of the former Pennhurst State School and Hospital outside Philadelphia, sparking a controversy that included protests from former residents of the facility (http://www.nami.org/).

If negative images in the media are helping to form the popular perception of mental illness, what are some ways to help clients cope with their effects and counter the stereotypes that the images perpetuate? Advocacy organizations like NAMI offer support to individuals with mental illness and their families, and participating in groups like “StigmaBusters” is one way that people can become advocates, doing their part to fight inaccurate and hurtful representations of mental illness. The Mayo Clinic website (http://www.mayoclinic.com/health/mental-health) is another excellent resource that describes steps to cope with stigma, including advice on how to seek support and educate others about mental illness.

And it’s not all bad news in the media. The Voice Awards, sponsored by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), recognize writers and producers of television and film who have given voice to people with mental health problems by incorporating dignified, respectful, and accurate portrayals of people with mental illness into their scripts, programs, and productions. In 2010, a Voice Award for best documentary went to actor Joe Pantoliano for his film No Kidding, Me Too!, which explores the journey of several individuals with mental illness and includes a candid account of his personal struggle with depression. Although best known for his roles in The Matrix, Memento, and the televisions series “The Sopranos,” Pantoliano is an activist, working to raise social awareness and understanding of mental health through a non-profit organization that he created to encourage members of the entertainment industry to help educate the public about mental illness. “We know this is a tough fight,” says Pantoliano. “We know years of ingrained socialization causes people to recoil or isolate anyone with the scarlet letter of mental illness…. However, we also know that by releasing the talents of those with mental illness—by giving them the opportunity to use their outstanding artistic and intellectual skills—we will vastly improve the world. And this is a cause worth supporting” (http://nkm2.org/about-us/).

In your practice, is stigma affecting your clients? How do you help clients to cope with stigma, and what resources have you found to be most useful? We want to hear from you, so post your comments and let’s start the conversation!