Wisconsin governor Scott Walker signed youth concussion legislation into law today at Lambeau Field in Green Bay. Support for the bill came from physicians, student-athletes, the NFL's Green Bay Packers and other organizations. NFL Commissioner Roger Goodell has exhibited an unwavering committment to the adoption of concussion legislation nationwide, starting with the Washington state concussion law named after middle school football player Zackery Lystedt, who was injured during a game in 2006. Like the Lystedt Law, Wisconsin's concussion law calls for the removal of any athlete suspected of having suffered a concussion and requires a player to obtain written medical authorization before resuming activity. The new law also requires the state Department of Public Instruction to work in conjunction with the Wisconsin Interscholastic Athletic Association to develop guidelines and education standards for parents, coaches, and athletes. Source: Walker signing bills legalizing wolf hunt, cracking down on youth concussions -- Star Tribune --April 2, 2012 Questions/comments? Contact Jean Rickerson at Jean@SportsConcussions.org

Reducing the number of concussions suffered by student-athletes is on the minds of many, including those that lead some of the most prestigious universities in the nation. Soon, following in the footsteps of changes made last year to Ivy League football programs, athletes in other sports may see the adoption of more protective measures as well. Ivy League football players saw significant changes in their practices last season after the eight presidents, two of whom are medical doctors, acted to reduce the number of impacts to their student-athletes' brains in an effort to minimize concussions. In July 2011 the Ivy League Concussion Committee developed a new set of regulations limiting full-contact practices to two per week, three less than allowed by the NCAA. In addition, of the preseason "two-a-days" only one can be full contact. Similar sport-specific regulations may be applied to other activities such as lacrosse, hockey, and soccer in the near future. “We are leading other conferences,” said Ivy League Executive Director Robin Harris. “I don’t know of any conference looking at this in the same manner that we are. We really see this as an area that we can be a leader in terms of the medical care safety of our athletes as well as in terms of the research we contribute to our collective understanding of concussions and athletics,” according to the The Harvard Crimson. Ivy League Deputy Executive Director Carolyn Campbell- McGovern was apart of this game change, “A lot of the recommendations from the football report were naturally going to be applied to other sports as well, particularly the education components, sideline testing components, and any other of those types of enhancement,” Campbell-McGovern said. Recommendations for each sport, lacrosse, soccer, and hockey, will likely be different. On Wednesday, the Ivy League Concussion Committee met in New York to discuss what changes will be made. The committee will also review recommendations made by each sport's subcommittee. Athletic trainers, including Harvard Head Athletic Trainer Brant Berkstresser, physcians, and administrators make up the concussion committee. It is co-chaired by presidents David Skorton of Cornell, and Jim Kim of Dartmouth. Harvard Medical School instructor and doctor at Children's Hospital Boston's Division of Sports Medicine, Michael J. O'Brien has ideas for change. He says he sees 300-400 concussions every month, 98 percent of them sports-related. “The bigger risk is the athlete who gets injured, flies under the radar a little bit and gets a hit a few more times in that game or in the next two or three games. The injuries to that athlete tend to be exponential, their threshold to injury is much worse, and the damage is exponential. Using computer based testing to get objective information rather than just reporting symptoms would help," O'Brien said. Source: Ivy League Aims to Abate Concussions - The Harvard Crimson March 30, 2012 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

SEQUIM, Wash. -- Battle-tested and a little weary from last fall’s high school football season, Travis Anderson, an experienced EMT and paramedic John Riley, understand the nuances of concussions. Athletes who — if they are conscious – say they are ‘fine,’ coaches who may not be sure an athlete needs medical attention, and parents told by ER staff that rest is the prescription for recovery, trying to make sense of the mountain of hospital medical bills. They’ve seen it all, and it’s not easy. First responders like Anderson and Riley from Clallam County Fire District #3 in Sequim, Wash., are a luxury for school districts around the country. Part of a crew made up of paid staff and volunteers, they wait in the corners until given the signal by a coach or referee, or a player goes down and stays there. Like other on-field personnel they can’t see every impact and don’t always know if an athlete is deteriorating on the bench after a big hit. They depend on an educated coaching staff and fellow teammates for their cues. Anderson said,”We’d like to be called sooner rather than later. If there’s any question, especially with a suspected concussion, call us.” Too little care Only about 42 percent of high schools nationally employ athletic trainers, a dismal number in the eyes of many concussion experts who continue to advise against any school district or private organization offering contact sports without proper sideline medical care. Given the budget crises facing many school districts, it is not surprising so few heed this advice. But the challenges in rural areas are even greater. Long distances separate football fields from hospitals and fire stations can serve several high schools. Resources are simply too lean. Many sports-related concussions “Our fire department provides sideline staff for high school football games, and as many junior varsity games as we can. We consider it part of our community service effort and quite frankly, we feel strongly about protecting our student-athletes and their futures,” said District #3’s Fire Chief, Steve Vogel. His first responders have been on the sidelines at Sequim School District's games since 1982. Chief Vogel’s staff has a long history dealing with sports concussions. Former Sequim football player Adrien Gault suffered a catastrophic brain injury during a game in 2006 and was airlifted to a Seattle trauma center where doctors gave him a four-percent chance of survival. He continues to work through his recovery. This past fall, a Sequim student suffered a brain aneurysm during a Friday afternoon PE class and died a few days later. That same Friday there were six significant concussions on the football field a few hundred yards away, said a well-informed source, turning the field into a war zone. Fire District #3 was there for it all. “There were more concussions during that one game than I’ve seen in my entire career, including my time as a running back in high school,” said Anderson. “It was a rarity.” Neither he nor Riley, who played tight end in high school remember suffering concussions during their football careers. They believe they’re seeing so many due to increased awareness trickling down from the NFL. Anderson said, “I think the attention on the concussion issue in the NFL is having an affect on all levels of the game, all the way down to the youngest players.” Emergency Medical Services for Children (EMSC) Guidelines and training for first responders come in the form of online education modules and concussion-related drills practiced several times a year. Soon-to-be-released state protocols developed by emergency room physicians, critical care nurses, EMTs, and others who make up the state committee of the federal Emergency Medical Services for Children program include a sports-concussion guide for first responders. Upon distribution, this document will provide a handy reference for those who attend youth and high school athletic events. “The Emergency Medical Services for Children (EMSC) program works to ensure proper pediatric care is available on ambulances and in hospital emergency departments nationwide,” said Ian Weston, Co-Director of the EMSC program headquartered in suburban Wash. D.C. “Emergency care providers are integral in ensuring our children get the right care when it counts.” When to call 911 Concussion symptoms can be subtle and may not appear right away, leaving room for mistakes to be made if athletes are not properly monitored when a concussion is suspected. The following are symptoms that require a call for emergency evaluation: •headaches that worsen •seizures •neck pain •very drowsy, can't be awakened •repeated vomiting •increasing confusion or irritability •weakness, numbness in arms and legs •unable to recognize people/places, less responsive than usual For more information see Should we call 911?, signs and symptoms Photo: (L) John Riley (firefighter/paramedic); (R) Travis Anderson (firefighter/EMT) Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

MINNEAPOLIS – A new study suggests that head impacts experienced during contact sports such as football and hockey may worsen some college athletes’ ability to acquire new information. The research is published in the May 16, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study involved college athletes at three Division I schools and compared 214 athletes in contact sports to 45 athletes in non-contact sports such as track, crew and Nordic skiing at the beginning and at the end of their seasons. The contact sport athletes wore special helmets that recorded the acceleration speed and other data at the time of any head impact. The contact sport athletes experienced an average of 469 head impacts during the season. Athletes were not included in the study if they were diagnosed with a concussion during the season. All of the athletes took tests of thinking and memory skills before and after the season. A total of 45 contact sport athletes and 55 non-contact sport athletes from one of the schools also took an additional set of tests of concentration, working memory and other skills. “The good news is that overall there were few differences in the test results between the athletes in contact sports and the athletes in non-contact sports,” said study author Thomas W. McAllister, MD, of The Geisel School of Medicine at Dartmouth in Lebanon, N.H. “But we did find that a higher percentage of the contact sport athletes had lower scores than would have been predicted after the season on a measure of new learning than the non-contact sport athletes.” A total of 22 percent of the contact sport athletes performed worse than expected on the test of new learning, compared to four percent of the non-contact sport athletes. McAllister noted that the study did not find differences in test results between the two groups of athletes at the beginning of the season, suggesting that the cumulative head impacts that contact athletes had incurred over many previous seasons did not result in reduced thinking and memory skills in the overall group. “These results are somewhat reassuring, given the recent heightened concern about the potential negative effects of these sports,” he said. “Nevertheless, the findings do suggest that repetitive head impacts may have a negative effect on some athletes.” McAllister said it’s possible that some people may be genetically more sensitive to head impacts. The study was supported by the National Institutes of Health and the National Operating Committee on Standards for Athletic Equipment. Source: American Academy of Neurology -- May 16, 2012 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org Photo courtesy of JamieLWilliams (c)2006 CreativeCommons.com

Pop Warner, the nation's largest youth football organization announced Tuesday it is taking steps to eliminate hits to the head and reduce the number of concussions suffered by players. Chairman of the Pop Warner medical advisory board, Dr. Julian Bailes said, "The impact of head-to-head contact causes the most severe concussions, so we felt it was imperative that Pop Warner take a proactive approach and limit contact in practices. We're trying to take away all at once the head-to-head contact in practice." Pop Warner is the nation's oldest and largest youth football, cheerleading and dance program, with over 400,000 members ranging in age from 5-14. Starting in August many teams practice nine hours a week until Labor Day when most are then shortened to six hours. Research has shown that some of the hardest hits and many concussions occur during practice, not games. New rules prohibit head-to-head hits and limit contact in practices to 40 minutes a day. Full-speed head-on blocking and tackling drills where players line up more than three feet apart are no longer allowed. In April 2012, veteran journalist and former Dateline co-anchor, Stone Phillips produced a report entitled, "Hard Hits, Hard Numbers," detailing a Virginia Tech study on head impacts in youth football. Accelerometers placed inside 7- and 8-year-old players' helmets recorded hits from 15g-100g, surprising researchers. Previously, many believed that players that age did not have the speed or strength to deliver hits of those magnitudes. Over 4 million sports- and recreation-related concussions occur each year in the United States and more than half of those are suffered as a result of football, reported NBC News. Source: Ahead of Season, Pop Warner renews safety emphasis -- USA Today -- June 12, 2012Pop Warner limits contact in practice --boston.com -- June 12, 2012Pop Warner issues new safety regulations -- NBC News --June 12, 2012Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org Source: Pop Warner limits contact in practice -- Boston.com -- June 12,2012 Pop Warner issues new safety regulations -- NBC News --June 12, 2012 Questions/comments? contact jean@SportsConcussions.org

Alzheimer’s disease and Chronic Traumatic Encephalopathy (CTE) are both “neurodegenerative diseases.” That is, they are brain diseases that result in the progressive destruction of brain cells, eventually leading to cognitive, behavioral, and other impairments. Both diseases also lead to dementia. The distinction between Alzheimer’s and dementia is very often misunderstood, even by many doctors. “Dementia” is a clinical syndrome defined by memory and other cognitive impairments that are severe enough to cause difficulties in social and/or occupational functioning (i.e., reduced independence in functioning). Dementia is not an illness or a disease. Dementia is not a “mild” form of Alzheimer’s. Rather, it is analogous to “fever,” in that it tells you that you are sick, but doesn’t say what is causing the problem. Similarly, dementia means that there is something wrong with the brain’s functioning, but not what is causing it. Several illnesses and diseases can lead to dementia, including Alzheimer’s disease which accounts for approximately 75% of all cases of dementia. However, several other neurodegenerative diseases result in dementia, including CTE. Alzheimer’s and CTE are distinct diseases. Both Alzheimer’s and CTE can only be accurately diagnosed postmortem through a neuropathological examination of the brain. There have been several new scientific breakthroughs over the past few years that now allow doctors and scientists to be much more accurate in diagnosing Alzheimer’s during life. However, at this time, there is no method of diagnosing CTE during life, although our group at the Boston University Center for the Study of Traumatic Encephalopathy (CSTE) recently received a grant from the National Institutes of Health to begin developing these types of tests. One of the major differences between Alzheimer’s and CTE involves what causes each of the diseases. There is no known specific risk factor that leads to Alzheimer’s. For CTE, however, it is believed that repetitive brain trauma (including concussions and subconcussive blows to the head) is a necessary, but not sufficient risk factor. That is, everyone that has been found to have CTE in postmortem examination has had a history of repetitive brain trauma, including athletes (e.g., football and hockey players, boxers and wrestlers), as well as others, such as combat military personnel, developmentally disabled individuals who repeatedly bang their heads, and victims of domestic abuse. Boxers and football players (especially lineman) appear to be the most likely to get the disease because of the repetitive brain trauma exposure. But, it is important to note that not everyone with a history of repetitive brain trauma will develop CTE. Our center is currently conducting research into the other potential additive risk factors, such as genetics, age of initial brain trauma exposure, frequency and overall duration of exposure, etc. This research will hopefully lead us to understand why one person gets the disease and another person does not. This line of investigation, along with our new study to develop methods of diagnosing CTE during life, will eventually lead to effective treatments and prevention strategies. Robert A. Stern, Ph.D. is a Professor of Neurology and Neurosurgery; Co-Director, Center for the Study of Traumatic Encephalopathy; Director, Clinical Core, BU Alzheimer's Disease Center, Boston University School of Medicine.

Concern over longevity issues stemming from a string of injuries including back-to-back concussions, may have contributed to Chris Owusu's omission from the first seven rounds of the NFL draft this weekend. But Stanford's talented receiver, who turned in one of the fastest times in the 40-yard dash at the NFL Combine in February and was considered a possible top 100 prospect during his senior year, was signed by the San Francisco 49ers shortly after the draft concluded on Saturday. Owusu, one of Andrew Luck's go-to receivers missed the end of his senior season including two Bowl games after suffering two concussions in three weeks, his third in a little more than a year. Admitting to frustration because his symptoms cleared rapidly after each injury, he was not authorized by Cardinal physicians to return. Considered a third-round talent, Sports Illustrated's Jim Trotter spoke to several general managers about Owusu. "He's off our board," says one general manager. "He was from the start. It wouldn't matter if he was RG3, he'd still be off our board. With that kind of history it's not worth the risk of him being seriously injured, especially with all the attention you're going to receive. If you draft him you're going to be under the microscope the whole time. Every time he gets hit it's going to be magnified tenfold." For the 49ers, Owushttps://oo good to pass up. "Chris wasn't wiped off our board," 49ers general manager Trent Baalke said Saturday when he met the media at the conclusion of the draft. "You've got to remember, he was cleared to play by the same group of doctors that work with us on a regular basis. He certainly was not off our board," according to NBC SportsGroup. Owusu was taking part in a Stanford School of Medicine research project when he suffered at least one of his concussions. Researchers recorded impact data from players wearing high-tech mouthguards in an effort to gain a better understanding of the forces that cause the injury. Source: Read more: https://sportsillustrated.cnn.com/2012/writers/jim_trotter/04/25/draft.concussions/index.html#ixzz1tSyGvhE8 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org Photo: (c) Maveric2003@creativecommons

USA Football and Steelers' staff had a host of recommendations for increasing concussion safety for area youth football players at Saturday's coaches clinic at the UPMC Sports Complex in Pittsburgh. Know the signs and symptoms. Teach proper tackling technique. Limit full-contact padded practices. "The whole idea is to help our kids play the game of football the right way," Steelers president Art Rooney II said to nearly 100 youth coaches, according to the Pittsburgh-Post Gazette. The Centers for Disease Control and Prevention estimates there are 3.8 million sports and recreation-related concussion annually. Most injuries are sustained while bicycling, followed by organized contact sports such as football and ice hockey and playground mishaps. Last month, data were released on the forces incurred over the course of a full season by 7- and 8-year-old football players in northern Virginia. The magnitude of the hits were measured using accelerometers placed inside several helmets. Many were comparable to forces felt in a pillow fight, but some were on par with those sustained by high school or collegiate players. The higher magnitude forces typically occurred during practices, not games. Ed Passino, Northeast regional manager for USA Football urged coaches to limit full-contact practices. "One thing that we're teaching throughout the country is that you don't have to hit every day in practice," Passino said. "It's not 1950 anymore. Update the way you handle practice. "Maybe you only hit one day a week, you can still conduct form tackling without full-on collisions." The eight Ivy League presidents, two of whom are medical doctors, limited contact practices for their football teams last summer, allowing fewer than the NCAA. USA Football concussion safety information Source: Concussions at head of youth coaches camp -- Pittsburgh-Post Gazette -- May 20, 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org 7 completed 18 scheduled

President Obama's recent remarks regarding concussions in football reopened the discussion of the safety of the game just days before Super Bowl Sunday. In an interview appearing in the New Republic Obama says, "If I had a son, I'd think long and hard before I let him play football. And I think that those of us who love sports are going to have to wrestle with the fact that it will probably change gradually to try to reduce some of the violence." Leaders from sports-related organizations including pee-wee, high school, college and professional have worked for several years now to understand the injury, provide guidance to athletes and coaches, and fund research related to the effects of brain trauma. Changes have been broad and deep. NFL Commissioner Roger Goodell has surrounded himself with the most well-respected medical professionals in the concussion field, seeking their council. As co-chairmen of the NFL Head, Neck and Spine Committee, Drs. Richard Ellenbogen (chief of neurosurgery, Univ. of Washington) and Hunt Batjer (President of the Neurological Society of America) have assembled an impressive team, including senior adviser Dr. Robert Cantu, co-director Center for the Study of Traumatic Encephalopathy. Chronic traumatic encephalopathy, or CTE, is a degenerative brain disorder suspected to be associated with repetitive hits to the head. Previously only diagnosed post-mortem, evidence of the disease was recently found in five former NFL players who took part in a groundbreaking diagnostic study at UCLA. The committee is also actively involved in improving on-field recognition and assessment policies, helmet technology, and brain impact research. In 2011, the NFL dedicated over $100 million over the next decade to medical research, with the vast majority of those dollars committed to the science of concussions, their prevention and care. Concussions have always been a part of sports, and have never been limited to football. Soccer, volleyball, wrestling, lacrosse, bicycling, and yes, playground activities can all cause concussive injuries. Girls are at risk as much as boys. Seniors and soldiers suffer too. Change of this magnitude takes time. Those athletes who have paid the price through their individual suffering are heroes, having opened the door for the rest of us, exposing an issue whose time is due. Former NFL linebacker Junior Seau, who tragically took his own life in 2012 at age 43, was later diagnosed with CTE, which many believe contributed to his death. He and the other NFL, NHL and professional boxers who died at a young age and were later diagnosed with CTE, have commanded our attention. In 2006, Zachery Lystedt suffered a debilitating brain injury during a middle school football game at age 14, and now fights daily to escape his wheelchair. Zachery, with the help of Commissioner Goodell and the NFL, led us to develop legislation in almost every state helping to safeguard youth athletes from the effects of concussions. Zach's hero, Baltimore Ravens Ray Lewis will play in Sunday's Super Bowl. Zach and the estimated 111 million viewers will watch a safer game, one that is still evolving, striving to maintain the integrity of the contest while preserving the health of its players for the future. Thankfully, visionaries like Commissioner Goodell appear in the right place at the right time. Under his leadership the NFL has, and is, providing a road map and the necessary funding to investigate the questions and find solutions that will improve our understanding of risk as it applies to protecting our youth, preserving the competitive spirit, and honoring the bonds that bind us as teammates and fans. Photo courtesy: Creative Commons; copyright dcJohn 2004