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

Researchers at Nationwide Children's Hospital in Columbus, Ohio, found that of the 14,635 high-school sports injuries reported during the 2008-2010 school year, 13% were concussions. The majority of them were uncomplicated, in fact, 40% of the students who suffered concussions saw their symptoms disappear within three days. Most returned to play within three weeks, but a significant number -- about 25% -- returned to play the same day they were injured, a situation many state concussion laws are designed to address. "This improper practice was widespread," noted researchers Mallika Marar, Natalie McIlvain, Sarah Fields and R. Dawn Comstock, who found it in 12 of the 20 sports they studied. "This clearly violates the consensus statement on sports-related concussion, which recommends that no adolescent athlete who sustains a concussion should return to play on the day of the injury,"reported WPTV.com. Other findings included: Most common symptoms: headache (94.2%), dizziness (75.6%) and difficulty concentrating (54.8%) More than one: Eleven percent had suffered concussions before, highest rate of recurrence was boys' wrestling (20%) Most by number: football (47%) followed by girls' soccer (8.2%) Most common practices/games: games; exception was cheerleading, participants were 10x more likely to be hurt during practice Most by gender: boys; although concussions in girls' sports represented a higher number of overall injuries Most common occurrence: athlete-to-athlete contact; girls were more likely to suffer a concussion from striking the ground or being struck by another players' piece of equipment such as a hockey stick The study was published in the January edition of the American Journal of Sports Medicine. Source: Study: High school athletes return from concussion too soon -- WPTV.com Questions/comments? Contact Jean Rickerson at Jean@SportsConcussions.org

The Dynavision D2 ™ is an FDA cleared medical device with a long history concerning sports performance enhancement and an even longer history concerning neuro visual rehabilitation of stroke and brain injured patients. Physical medicine rehabilitation practitioners have used it to train brain injured patients to improve hand eye coordination since the 1980s. With a pedigree from the neuroscience community concerning rehab and from the sports community for improving performance it was a logical fit that the D2 ™ be applied to the management of the athlete with a concussion. The Dynavision D2 ™ is a light board with 64 lights mounted in a board along with a small screen. The primary task is to hit the red or green lights. It assesses speed and coordination. When the computer screen and lights are used together there are numerous tasks the athlete can be asked to do. Several universities and professional sports organizations have adopted the Dynavision D2 ™ as part of the concussion management program, and for good reason. The Dynavision D2 ™ can be used as part of baseline testing. The results of the baseline tests are used for comparisons should a concussion occur. These same athletes may also train their eye hand coordination using the Dynavision D2 ™ for performance enhancement. This means the device is familiar to them and true baseline and performance parameters can be obtained. After a concussion, the Dynavision D2 ™ can be used as part of a traditional neuro cognitive examination and monitoring program. The baseline Dynavision D2 ™ results can be compared to repeat tests to see if deficits are present. Further, programs designed to assess multiple brain cognitive parameters can be performed in just a few minutes. The three tests assess: eye-hand coordination while multi-tasking, memory and cognition, cognition and executive functions. Observing the subject and noting their scores allows for an assessment of their concussion status. One of the strengths of the Dynavision D2 ™ is that it has an established cadre of programs that anyone can use. These programs can be used for rehab, prehab and diagnostics. Plus it has a relatively intuitive program option that allows more experienced practitioners and ADT trained individuals to design their own programs to meet their needs. This means that the Dynavision is a highly flexible and adaptable platform. Every person who works with athletes, injured athletes and neuro patients knows that each person is different and unique; training and rehab methods need to be personalized. Fortunately the Dynavision allows us to customize the programs to address the needs of the patient. There are numerous anecdotes where a patient who expresses a deficit that he/she is having to a rehab person who can write and try a program to help that patient during that very rehab session. One of my patients at the concussion clinic in theUniversityofCincinnatiwas injured in a wind storm. During her baseline neuro exam, we utilized the tests mentioned above and additional tests based on her specific results. The D2 was able to demonstrate the patient was unable to multi-task, making numerous math errors on simple 1 digit additions. In addition, based on a general neuro exam, the patient exhibited deficiencies in ocular motor, memory and executive function. This patient specifically benefited from the D2 as part of her neuro exam because the D2 gave measurable, unbiased results. The results of the exam were utilized to incorporate D2 training into her rehab program to improve binocularity, reaction time, multi-tasking, and cognition skills. In my opinion, without using the D2, this patient’s rehab would not have been as successful and it could have been possible to overlook subtle deficiencies that D2’s measurable results are able to track. In the center of the Dynavision D2 ™ is a tachistoscope; or small computer screen. This screen is used in several of the evaluation and rehabilitation methods. It adds tremendous flexibility to the system because it can be used to add tasks to what the subject is required to do. With the tachistoscope the patient can now be required to do a hand-eye task as well as reading or other task from the screen. This allows for multitasking to be performed and adds to the flexibility and strength of the Dynavision D2 ™ as a tool to manage the concussion patient. Repeating the evaluations on the Dynavision D2 ™ can be used as part of quantitative monitoring of the subjects as they progress through concussion rehab. The Dynavision produces reliable numbers that reflect the subjects’ performance or highlights deficiencies. When the Dynavision D2 ™ is used as part of the rehab training it becomes a cornerstone in the patient’s care and the patient can see, based on their own results, how well they are doing. Rehabilitation methods can be tailored to the needs of the patient and with many years of experience from the stroke and brain injury literature there are numerous options for the Dynavision D2 ™ to aid in a concussion rehabilitation program. About the Authors: Dr. Clark is a certified athletic trainer, professor of neurology and member of the concussion management team in the University of Cincinnati. He is an expert in complications post acquired brain injury and has published several texts and over 100 scientific articles. Mrs. Umberg is a former concussion patient and the patient referred to in this Case Study. Having used Dynavision as part of her rehab program she has since become a patient advocate and team member in the concussion management team in the University of Cincinnati and Dynavision Trainer. Disclaimer; the statements made are not screened or approved by the FDA. Source: Joseph F. Clark and Jennifer A. Umberg Department of Neurology, University of Cincinnati, Cincinnati Ohio; 45267-0536. Corresponding author: Joseph F. Clark, Professor of Neurology, joseph.clark@uc.edu.

SportsConcussions.org Named One of Constant Contact’s 2011 All Stars SportsConcussions.org recognized for achieving exemplary marketing results SEQUIM, Wash. — April 4, 2012 – SportsConcussions.org, a non-profit concussion education organization, has received the 2011 All Star Award from Constant Contact®, Inc., the trusted marketing advisor to more than half a million small organizations worldwide. Each year, a select group of Constant Contact customers are honored with the All Star Award for their exemplary marketing results. SportsConcussions.org’s results ranked among the top 10% of Constant Contact’s customer base. “We’re pleased to be recognized by Constant Contact for achieving strong marketing results, said Jean Rickerson, CEO and Founder of SportsConcussions.org. “Constant Contact’s tools have helped us reach a large audience with the all-important message regarding sports-related concussions in a very efficient way. We look forward to increasing our communication efforts even more in the coming year, to help protect more athletes. We are very grateful to all of our customers who follow us on our website, on social media and through our weekly newsletter. Our goal is to provide them with ideas and resources so they can protect athletes in their local communities.” Constant Contact looked at the following criteria to select this year’s All Stars: · Frequency of campaigns, events, and surveys · Open, bounce, and click-through rates · Event registration rates · Survey completion rates · Use of social features · Use of mailing list sign-up tools “There is nothing we like more than to see our customers finding success. It’s the reason Constant Contact was founded, and it’s a thrill to see the fantastic results that our All Stars are achieving,” said Gail Goodman, CEO of Constant Contact. “This group is really leading the charge when it comes to delivering relevant, engaging content that drives real business results. We salute this year’s All Stars for their success, and are honored to have played a part in their achievements.” About SportsConcussions.orgSportsConcussions.org is a non-profit organization dedicated to raising awareness about sports-related concussions. According to the Centers for Disease Control and Prevention (CDC) up to 3.8 million people suffer from a recreation- or –sport related concussion each year. SportsConcussions.org is anchored by a website that is update daily, featuring news, ideas and resources for school districts, leagues, coaches, parents and athletes. The organization also holds community workshops and conferences, and establishes baseline testing programs. About Constant Contact, Inc. Constant Contact is revolutionizing the success formula for small organizations through affordable, easy-to-use Engagement MarketingTM tools that help create and grow customer relationships. More than half a million small businesses, nonprofits, and associations worldwide rely on Constant Contact to drive ongoing customer dialogs through email marketing, social media marketing, event marketing, and online surveys. All Constant Contact products come with unrivaled KnowHow, education, and free coaching with a personal touch, including award-winning customer support.

It is not yet known why girls suffer concussions at a higher rate than boys. The most prevalent theories range from lesser neck and upper body strength, to better reporting among females, to hormonal differences. Researchers at Emory University in Atlanta are currently in the third phase of a clinical trial designed to determine if the hormone progesterone, normally associated with female reproductive processes, can protect damaged neurons. Administered within four hours of the injury and lasting for three days, results of the treatment have been positive so far. Although catastrophic injuries in sports are rare, the question regarding applicability of a related treatment for concussion remains open. Pilot study highlighted efficacy Every 15 seconds, someone in the United States sustains a significant traumatic brain injury. Approximately 2 million adults and children in the United States suffer from traumatic brain injuries each year - leading to 50,000 deaths and 80,000 new cases of long-term disability, according to the Centers for Disease Control and Prevention. Despite the enormity of the problem, scientists have failed to identify effective medications to improve outcomes following a traumatic brain injury. Emory researchers, however, concluded in an earlier pilot clinical trial that giving progesterone to trauma victims shortly following brain injury appears to be safe and may reduce the risk of death and long-term disability. Their previous three-year study, called ProTECT I (Progesterone for Traumatic brain injury--Experimental Clinical Treatment), enrolled 100 participants at Grady Memorial Hospital. It was designed to evaluate whether progesterone can be administered intravenously in a safe and reliable way. "We found evidence that progesterone is not only safe for use in patients suffering from traumatic brain injuries," says Wright. "We also found a 50 percent reduction in mortality in those patients treated with progesterone. Even though this was a small pilot study, we found signs that progesterone improved functional outcomes and reduced disability in patients with moderate brain injury. "By expanding our test sites to 17 major trauma centers across 15 states and enrolling more than 1,000 patients, we hope to confirm these preliminary findings and determine if progesterone benefits victims of acute traumatic brain injury," says Wright. Progesterone common in males and females Progesterone is naturally present in small but measurable amounts in the brains of males and females. Human brain tissue is loaded with progesterone receptors. Laboratory studies suggest that progesterone is critical for the normal development of neurons in the brain and exerts protective effects on damaged brain tissue. Donald G. Stein, PhD, Asa G. Candler Professor of Emergency Medicine, Emory School of Medicine, and director of Emory's Department of Emergency Medicine Brain Research Laboratory, pioneered discoveries regarding the effect of progesterone following traumatic brain injury - first discovering the neuro-protective properties of progesterone in the laboratory more than 25 years ago. "The results that we are now seeing, and hope to continue validating, are an incredible and gratifying reward for more than 25 years of concentrated research," says Stein. "My work first started when I began to notice evidence that women tended to respond to treatment and recover better than men after suffering from brain injury and stroke. Many people do not realize that it's not just a female hormone; both men and women produce progesterone directly in the brain, as well as other tissue. "Ultimately, we learned that progesterone basically does in brain injuries what it also does during fetal development - protect cells and tissue," says Stein. "To now witness the translation of this laboratory research into a treatment that may have life-saving benefits is breathtaking." Source: A Hormonal Remedy for Brain Injuries is Explored --The New York Times -- June 21, 2012 Atlanta To Serve as National Epicenter for Promising Phase III Brain Injury Treatment Trial - Emory University Photo courtesy of (c) 2008 Eddy Grady@creativecommons.com Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

PITTSBURGH – The unpredictable nature of concussions is one of the most frustrating factors to the millions of sufferers each year, but early neurological indicators and symptoms can predict a protracted healing time in certain cases, according to specialists at UPMC and the University of Pittsburgh School of Medicine. “It’s a highly variable injury with a variety of outcomes,” said Michael “Micky” Collins, Ph.D., director of the UPMC Sports Medicine Concussion Program and co-investigator of the Pitt/UPMC study published in the February issue of Neurosurgery. “We see some patients who take a day or two to recover, and some who take a year or longer to recover. If clinicians had a way of determining within two days of injury who’s going to take a month or longer to recover, that’s a very important piece of information to have. It’s a game-changer.” The study, one of the first to examine concussion prognoses, showed that specific neurocognitive “cut-off” scores derived from ImPACT™ (Immediate Post-concussion Assessment and Cognitive Testing) improved clinicians’ ability to predict which sports-related concussions could take longer –- as much as five times longer -- to rehabilitate than others. They found, in as many as 85 percent of the cases, the scores could warn athletes, parents, coaches, schools, teams and health professionals when a concussion is likely to take on average a month to heal. Such an objective prognosis could help clinicians to better prepare a treatment plan, arrange academic accommodations for students and set tangible expectations for return to play and school, Dr. Collins said. The study reviewed 108 high-school football players who were given ImPACT tests within a median of two days after their concussions. Fifty boys experienced a recovery lasting, on average, 33 days before returning to play, and those longer rehabilitations could be forecast by specific “cut-off” scores in ImPACT Visual and Processing Speed testing. Migraine and cognitive symptoms also appeared to have predictive power. Study participants who scored above the threshold levels recovered within a median of seven days. “We’ve established statistical ‘cut-offs’ that indicate people who take a month or longer to recover,” Dr. Collins said. “Eighty percent of concussed people recover inside of three weeks. This prognostic information allows us to develop a risk profile of athletes who don’t recover well from this injury. Other study authors include Brian Lau, B.S., from the Pitt School of Medicine, and Mark Lovell, Ph.D., the Concussion Program’s founding director who retired from UPMC last summer. About UPMC Sports Medicine Cohttps://n Program The first-of-its-kind UPMC Sports Medicine Concussion Program, established in 2000, is the largest multi-disciplinary clinical and research program that focuses on the diagnosis, evaluation and management of sports-related concussion in athletes of all levels. The UPMC clinicians and researchers treat more than 13,000 patients a year, and published more than 75 clinical research studies in peer-reviewed scientific journals. About ImPACT ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) is an independently validated and researched concussion-evaluation system that has become the most widely used in the United States. Co-founded in the early 1990s by Drs. Mark Lovell, Joseph Maroon and Michael “Micky” Collins, who have a proprietary interest in ImPACT Applications, Inc., ImPACT is a 20-minute test that is a standard tool used as part of comprehensive clinical concussion management adopted across the NFL, NHL, NBA, Major League Baseball, college and high-school athletics -- with roughly 3 million people tested. Source: UPMC press release- https://www.upmc.com/mediarelations Photo courtesy UPMC

Common sense has led many to believe that youth football players can't possibly sustain high-impacts like their adult counterparts. But veteran correspondent Stone Phillips' report "Hard Hits, Hard Numbers," features researchers at Virginia Tech (VT) who recently turned that theory upside down when they analyzed impact data from the helmets of 7- and 8-year old players in Montgomery County, Virginia. Accelerometers placed inside seven helmets wirelessly transmitted data to scientists on the sideline for a season's worth of practices and games, with surprising results. The bottom line? Maybe it's time to take another look at practices, drills, and helmet design to minimize the forces absorbed during an average season. Regardless of the significance of the impact, none of the players sustained concussions during the season. Therein lies an enduring mystery, why small impacts can cause concussions in some players while others walk away from big hits. The force of acceleration is often measured in g. Fighter pilots may "pull" 9g in an F-16, a sneeze may register 3g. They're part of everyday life. But because of the heightened interest in sports-related concussions, researchers are looking at a multitude of ways to reduce brain impacts for everyone from adults to youth. But first, they had to identify if there was even an issue at all. Worth a look The VT study was the first of its kind to measure the impacts sustained during youth football. Having worked for nine years recording over 150,000 hits with the helmet impact system at the university, researchers turned their attention to an area youth league. The forces averaged about 15g, meaning half of the hits measured below that level, the other half above. In one case, well above. One hit measured 100g, a big hit by college standards. Most of the more forceful impacts came during practice. Highlights from PBS NewsHour include: - reseachers believe 98g or above is a red flag for a possible concussion - a total 753 impacts were recorded - average player sustained 107 impacts in one season; high school players average about 500; college players sustain about 1,000/season - there were 38 impacts of 40g or greater; almost every one occurred during practice - six impacts measured over 80g the lower range VT researchers consider to be the risk of concussion - youth football players lack strong neck and chest muscles of older players to maintain head stability - 50, 60, 70g loads were surprising - location of impact is important as are individual differences and tolerances - there is more helmet-to-helmet contact in youth football than occurs in older players; most impacts occurred to the front of the helmet - more head-to-ground impacts found at college level Changes afoot Researchers concluded that addressing changes in practice would likely reduce the number of impacts per season, an important factor in any youth sport. Less contact drills, fewer contact practices and other modifications would be beneficial, particularly as the effects of sub-concussive hits, impacts that may cause changes in the brain without causing symptoms, continue to be studied. Source: Stone Phillips Reports Pint-Size Footbal Players Take Big-League Hits -- PBS NewsHour -- April 3, 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

Coy Wire was a team captain for the Buffalo Bills (2002-2007) and the Atlanta Falcons (2008-2011) during his nine years in the NFL. An All-American Honors athlete at Stanford University, Coy was the first player to lead the Cardinal in both rushing and tackles. He was a recipient of the NFL’s Ed Block Courage Award. Q: What would you tell athletes about concussions? The NFL is in a state of evolution and recent changes will only make it safer for younger athletes. The league and the NFLPA (National Football League Players’ Association) have made huge strides to address the concussion issue, while maintaining the excitement of the game for both fans and players. It’s important that all athletes remember that you only get one brain and as we learn more about the long-term and adverse effects of contact sports and repetitive head injury, we know that smaller hits over the course of a career- even a high school career- can accumulate. Learn to recognize the symptoms of head trauma. You can have headaches or you might be slightly dizzy …these are all bearable and many athletes mask these symptoms by taking a Tylenol and then they go out and play again. But a concussion is not an ankle or shoulder injury…later in life you can have surgery on that ankle or have knee replacement surgery but you only get one brain. You can’t get a brain replacement. If you mask head trauma you can be risking increased problems in the future for Alzheimer’s or dementia. Head trauma has to be looked at very differently. Yes, in a way it’s a body part like a shoulder, but your brain must be treated very differently. You can ice and elevate an ankle but can’t do that with your brain. Real damage may show up later in life …and it’s not just football, it can happen in any sport. We used to look at toughness and playing through injuries as a badge of honor. That you were tough both mentally and physically and that continuing to play while hurt brought you the respect of your peers. But we need to change the culture now, and that starts with you. You need to believe that it’s OK to miss a game or a week or longer. If you do have to sit out, it means you were playing hard and you took one for the team. You shouldn’t feel ashamed. And if you care about your friends and your teammates, keep them from harm.https:// If you see a friend of yours doing something to hurt themselves, like playing with a concussion, step up and help them. You’re doing them a huge injustice by allowing them to continue to play. You are your brother’s keeper. Become a hero in their life and help them realize what they probably know deep down inside anyway. Someday they’ll look back and know what you did for them, and they’ll respect you more, later in their lives. Be a leader and help change the game. Help create a new norm. Coy Wire is the author of Change Your Mind; 10 Unconventional Secrets to Retrain Your Brain; March 2012. He is an inspirational speaker and mind coach. For more information contact him at https://www.coywire.com/

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