
{"id":25869,"date":"2012-05-10T10:36:10","date_gmt":"2012-05-10T14:36:10","guid":{"rendered":"http:\/\/www.carrborocitizen.com\/main\/?p=25869"},"modified":"2012-05-10T09:52:30","modified_gmt":"2012-05-10T13:52:30","slug":"unc-researcher-advances-study-of-sport-related-concussion","status":"publish","type":"post","link":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/2012\/05\/10\/unc-researcher-advances-study-of-sport-related-concussion\/","title":{"rendered":"UNC researcher advances study of sport-related concussion"},"content":{"rendered":"<p>By Taylor Sisk<br \/>\nStaff Writer<br \/>\nBigger. Stronger. Faster. That\u00e2\u20ac\u2122s how we\u00e2\u20ac\u2122re building our young athletes today. More durable? Arguably, in some respects. But we haven\u00e2\u20ac\u2122t yet figured out how to engineer a more shock-absorbent skull.<\/p>\n<p>And when these young athletes\u00e2\u20ac\u2122 heads collide, as they will \u00e2\u20ac\u201c on the gridiron, for example, or the ice \u00e2\u20ac\u201c they sometimes do so at accelerations of upwards of 180 g\u00e2\u20ac\u2122s. <\/p>\n<p>(To give you some perspective, if you drove your car into a wall at 25 miles per hour and your head hit the windshield, the impact would register at about 100 g\u00e2\u20ac\u2122s.)<\/p>\n<p>Kevin Guskiewicz knows well the cost of such contact. In addition to being a concerned football and hockey fan, with four sons who play organized contact sports, he\u00e2\u20ac\u2122s Kenan Distinguished Professor and chair of the department of exercise and sport science in UNC\u00e2\u20ac\u2122s College of Arts and Sciences, co-director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center and research director for the Center for the Study of Retired Athletes. <\/p>\n<p>Last September, Guskiewicz was awarded a MacArthur Fellowship, a prize given to groundbreakers in a wide variety of fields. He\u00e2\u20ac\u2122ll receive $500,000 over the next five years to spend as he deems appropriate, advancing his work as a researcher and reformer in the field of sport-related concussion.<\/p>\n<p>Guskiewicz\u00e2\u20ac\u2122s research has found that each year in this country some 300,000 sport-related head injuries are sustained, and his work with retired NFL players has underscored the high correlation between multiple concussions and the early onset of neurodegenerative changes, including depression and dementia.<\/p>\n<p>In the past three weeks, two former NFL players have committed suicide. Ray Easterling, 62, who had suffered from depression and dementia for 20 years, was one of seven former players who have filed a class-action suit against the league, claiming it has failed to properly treat concussions and for years failed to acknowledge the issue. He committed suicide on April 19.<\/p>\n<p>Then last week, Junior Seau, 43, a linebacker who had played organized football for nearly 30 years, shot himself in the chest. His family is now deciding whether to allow his brain to be donated for research.<\/p>\n<p>A third player, Dave Duerson, 50, who reportedly was suffering from degenerating short-term memory loss, shot himself to death in February 2011, leaving a note that read, \u00e2\u20ac\u0153Please, see that my brain is given to the NFL\u00e2\u20ac\u2122s brain bank.\u00e2\u20ac\u009d<\/p>\n<p>Concussion has been defined as a \u00e2\u20ac\u0153traumatically induced alteration of awareness or consciousness,\u00e2\u20ac\u009d which may cause a loss of balance, headaches, amnesia, sleep disturbances, vertigo and hearing loss.<\/p>\n<p>Several years ago, Alan Schwartz of the New York Times asked a high school football player whether he would tell his coach if he was once again experiencing concussion-like symptoms: \u00e2\u20ac\u0153No chance. It\u00e2\u20ac\u2122s not dangerous to play with a concussion. You\u00e2\u20ac\u2122ve got to sacrifice for the sake of the team. The only way I come out is on a stretcher.\u00e2\u20ac\u009d<\/p>\n<p>Bigger. Stronger Faster. But more aware today of the hazards? \u00e2\u20ac\u0153Yes,\u00e2\u20ac\u009d says Guskiewicz, \u00e2\u20ac\u0153but we\u00e2\u20ac\u2122ve got to continue to do better.\u00e2\u20ac\u009d<\/p>\n<p><strong>\u00e2\u20ac\u02dcPerplexed\u00e2\u20ac\u2122<\/strong><br \/>\nGuskiewicz is from Latrobe, Penn., outside Pittsburgh, big-time football country. \u00e2\u20ac\u0153Football\u00e2\u20ac\u2122s in my blood,\u00e2\u20ac\u009d he said. He grew up playing the sport, but realized that a future as a player wasn\u00e2\u20ac\u2122t in the cards.<\/p>\n<p>Instead, sports medicine became his passion.<\/p>\n<p>He enrolled in a premier sports-medicine program at West Chester University near Philadelphia, dual majored in sports medicine and journalism, and then moved on to the University of Pittsburgh and a trainer\u00e2\u20ac\u2122s gig with the Pittsburgh Steelers for two-and-a-half years. The Steelers paid for his education and he left Pitt with a master\u00e2\u20ac\u2122s degree in physics and sports medicine.<\/p>\n<p>\u00e2\u20ac\u0153While I was working for the Steelers,\u00e2\u20ac\u009d Guskiewicz said, \u00e2\u20ac\u0153I was perplexed by the arbitrary way decisions were made about concussion. We had all these special tests and clinical measures to assess ankle injuries and knee injuries and shoulder injuries, but there was so little on head injury.\u00e2\u20ac\u009d<\/p>\n<p>He thought to himself, \u00e2\u20ac\u0153My goodness; the brain is a pretty important organ, and how in the world do we not have more sophisticated ways of assessing this injury?\u00e2\u20ac\u009d<\/p>\n<p>He continued on to doctoral work at the University of Virginia, writing his dissertation on the effects of concussion on balance measures.<\/p>\n<p>One of the first confirmed cases of chronic traumatic encephalopathy (CTE) in a retired professional football player was former Steeler Mike Webster. Webster\u00e2\u20ac\u2122s decline, post-NFL, into destitution and severe depression was well documented. He died in 2002, of heart failure, at age 50; his death certificate indicated that he suffered from \u00e2\u20ac\u0153chronic concussive brain injury.\u00e2\u20ac\u009d <\/p>\n<p>Webster\u00e2\u20ac\u2122s autopsy showed tau protein deposits on his brain. These deposits, Guskiewicz said, create neurofibrillary tangles similar to those found in Alzheimer\u00e2\u20ac\u2122s patients, causing depression, emotional outbursts and issues with executive functioning that can be linked to dementia. <\/p>\n<p>Similar deposits are now being found in the brains of other former athletes who played contact sports in which repetitive impacts to the head occur, and also have been found in younger athletes \u00e2\u20ac\u201c as young as 18 years old.<\/p>\n<p>Unfortunately, they can only be identified in vitro, after death.<\/p>\n<p><strong>A different game<\/strong><br \/>\nSeveral things have changed about the game of football in the past few decades.<\/p>\n<p>\u00e2\u20ac\u0153Equipment is better,\u00e2\u20ac\u009d Guskiewicz said, \u00e2\u20ac\u0153which is good and bad. It\u00e2\u20ac\u2122s good in that we\u00e2\u20ac\u2122re doing a better job of protecting against catastrophic injuries, such as skull injuries and drastic acceleration and deceleration of the brain that can cause vessels to rupture.\u00e2\u20ac\u009d <\/p>\n<p>But better helmets mean athletes tend to use their heads more \u00e2\u20ac\u201c that is, they tend to lead with their heads when tackling. <\/p>\n<p>\u00e2\u20ac\u0153It\u00e2\u20ac\u2122s a more aggressive game today,\u00e2\u20ac\u009d Guskiewicz said. \u00e2\u20ac\u0153We do see that blocking and tackling techniques have changed over the years \u00e2\u20ac\u00a6 and so the physics of the collisions are more problematic.\u00e2\u20ac\u009d<\/p>\n<p>Advocates have proposed protecting kids from contact sports till, say, 14 years old, restricting organized leagues to flag football, noncontact hockey and soccer that prohibits heading the ball.<\/p>\n<p>Guskiewicz is against that. Motor-learning studies, he said, show that kids begin to develop skill and coordination and to use their kinesthetic abilities to protect themselves at 8 years old up through 14 or 15. <\/p>\n<p>\u00e2\u20ac\u0153I think that\u00e2\u20ac\u2122s when my kids have learned to protect themselves,\u00e2\u20ac\u009d he said, \u00e2\u20ac\u0153and they\u00e2\u20ac\u2122ve done it in an environment \u00e2\u20ac\u201c in Pop Warner football or youth hockey \u00e2\u20ac\u201c where those leagues control for weight and age. \u00e2\u20ac\u00a6 In middle school or high school football, a kid may strap on pads for the first time and now you could be that 115-pound kid going up against a 180-pound kid, and the hits are more significant at that age.<\/p>\n<p>\u00e2\u20ac\u0153So I think there\u00e2\u20ac\u2122s something valuable that takes place during those developmental years, if you have good coaching and good equipment and the proper techniques are being taught.\u00e2\u20ac\u009d<\/p>\n<p>According to research released in April by UNC\u00e2\u20ac\u2122s National Center for Catastrophic Sports Injury, with which Guskiewicz works closely, the number of high school football-related brain injuries with permanent disability had been in single digits since 1984 but rose to 10 in 2008 and 2009 and to 13 in 2011. <\/p>\n<p>Guskiewicz believes the incident rate of football-related concussions is on the rise across the board.<\/p>\n<p>But, at the youth level, and probably the high school level, he said, \u00e2\u20ac\u0153I really think that 85 to 90 percent of the increased rate has to do with reporting. I think that we\u00e2\u20ac\u2122re closing the gap on the number of reported concussions and unreported concussions.\u00e2\u20ac\u009d <\/p>\n<p>Several states, including North Carolina, Texas and Oregon, have passed legislation that requires coaches and medical staff to be educated in detecting and responding to symptoms of concussion. Some states\u00e2\u20ac\u2122 laws require emergency personnel to always be on site during games.<\/p>\n<p>At the pro level, kick-offs \u00e2\u20ac\u201c in which 11 members of one team hurtle downfield at full speed in the direction of 11 of the other\u00e2\u20ac\u2122s, likewise advancing \u00e2\u20ac\u201c have been a primary source of head and other injuries, sometimes generating those aforementioned 180-plus g\u00e2\u20ac\u2122s. A rule change imposed last season designed to better protect players has resulted, Guskiewicz said, in a 42 percent reduction in kick-off concussions, with no dramatic impact on the game.<\/p>\n<p>The NFL is also more strictly enforcing rules against players leading with their heads, fining and sometimes suspending players for violations.<\/p>\n<p>Guskiewicz sits on the NCAA\u00e2\u20ac\u2122s concussion committee and the NFL\u00e2\u20ac\u2122s head, neck and spine committee and helped write concussion guidelines that are now recommended by the National Athletic Trainers Association and the American College of Sports Medicine.<\/p>\n<p><strong>Bigger still<\/strong><br \/>\nAt UNC, Guskiewicz does neurocognitive and balance tests on about 80 percent of student-athletes \u00e2\u20ac\u201c those involved in contact sports \u00e2\u20ac\u201c which are used as a baseline to assess damage and track recovery in the event an athlete later sustains a head injury. And in 2004, he and his colleagues began equipping the football helmets of all UNC players with sensors that measure the force of every hit, collected during every practice and game, thereby gathering invaluable data.<\/p>\n<p>Most probably, our young athletes will grow bigger, stronger and faster yet \u00e2\u20ac\u201c advances in science and technology will see to that, and it\u00e2\u20ac\u2122s not likely high schools, colleges or professional leagues will set a limit on how much muscle mass an athlete can nurture. <\/p>\n<p>Guskiewicz will be using his MacArthur money to further advance his research, \u00e2\u20ac\u0153to grow that pot of money,\u00e2\u20ac\u009d he said, offering a portion of it as matching funds to organizations in a position to help further the study \u00e2\u20ac\u201c perhaps the NCAA, the NFL or the National Operating Committee for Standards in Athletic Equipment.<\/p>\n<p>In the early days of his research, Guskiewicz was routinely met with resistance. Today, the data continues to mount. Lives are at stake, and continued education is critical.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bigger. Stronger. Faster. That\u00e2\u20ac\u2122s how we\u00e2\u20ac\u2122re building our young athletes today. More durable? Arguably, in some respects. But we haven\u00e2\u20ac\u2122t yet figured out how to engineer a more shock-absorbent skull.<\/p>\n","protected":false},"author":9,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-25869","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/25869","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/comments?post=25869"}],"version-history":[{"count":1,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/25869\/revisions"}],"predecessor-version":[{"id":25870,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/25869\/revisions\/25870"}],"wp:attachment":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/media?parent=25869"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/categories?post=25869"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/tags?post=25869"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}