July 10, 2014
By Jazelle Hunt
Despite the flurry of news about NFL lawsuits over concussions, the problem affects far more athletes at the high school and junior high school level, according to federal government statistics.
In 2009 alone, nearly 250,000 youth age 19 or younger were treated in emergency rooms for sports and recreation-related injuries that included concussions, according to the Centers for Disease Control and Prevention. Between 2001 and 2009, the rate of such visits rose 57 percent.
Concussions occur when the brain is shaken violently against the skull. Although concussions are the most common brain injury, widespread awareness and concern about this issue in the world of student athletics is fairly recent.
But it is especially relevant for Black communities, particularly young men most likely to die from traumatic brain injuries, according to the CDC. And according to data from research nonprofit, Child Trends, 50 to 60 percent of Black American high schoolers were on a sports team in 2011.
In severe or untreated cases, they can cause brain damage, seizures, emotional distress, and death—in fact the CDC estimates that 5.3 million U.S. citizens are living with disability as a result of a traumatic brain injury (or TBI, an umbrella term that includes concussions).
“From an athletic trainer perspective concussions have always been a big concern. Coaches seemed to think that injuries increased because [athletic trainers] were there, but really it’s that awareness is increased,” says Jennifer Rheeling, a veteran athletic trainer in D.C. Public Schools and chair of the Sports Medicine Advisory Committee for the D.C. State Athletic Association.
“In the last five years particularly with the NFL starting to talk about it, and the lawsuits, has helped immensely now that people get it on a mainstream level. What they thought was just getting their bell rung was really a concussion.”
On the most diligent and well-resourced student teams, players take baseline tests—a battery of motor skill drills and survey questions to record their individual peak cognitive health—and have athletic trainers who check for signs of decline. If a concussion is suspected, a player does another test to compare those results to his or her baseline. The ImPACT Concussion Management program is currently the program of record for these tests among school athletic programs.
But according to Dr. Vernon Williams, neurologist and medical director of the Sports Concussion Institute, a lack of access to care compounds the (now fading) problem of awareness. ImPACT, for example, costs a minimum of $400 per year for 100 baseline tests and 15 post-injury tests for one school. Meanwhile, many schools and school districts, largely populated by Black and brown children, routinely have to make cuts to balance their budget.
“We have coaches who understand the need, but they have different resources. For example, we know baseline testing for people in contact collision sports can help evaluate when people get injured,” Dr. Williams explains. “But it’s uncommon for people to have access to state-of-the-art baseline testing. Players, school systems, and parents don’t have access to those funds. But we can still implement treatment using creative measures.”
Currently, Dr. Gary Harris, who specializes in computer engineering and serves as associate provost for Research and Graduate Studies at Howard University, is working with engineering students and the Bison football team to devise an inexpensive concussion monitoring system, using an open source platform.
(“Open source” is a tech industry term that means the equipment and information to create this system is public as opposed to proprietary, so as to encourage others to innovate and improve on the idea).
The project uses a computer chip attached inside the helmet that measures impact up to 100 gs of force. For reference: a sneeze is about 2 or 3 gs of force on the human body; an F-16 fighter jet barrel roll exerts 7 to 9 gs; a car crash at 45 mph is about 60 gs. Concussions usually happen with collisions between 80 and 120 gs.
The chip records the force of impact for every collision—it can be programed to transmit this information wirelessly, say, to a cell phone app. Or, it can be downloaded from the helmet using a USB cable. It can also be programed to send an alert when a hit exceeds a certain threshold.
“You can have an entire team’s list where you know all their shock, trauma, and incidents on file,” says Dr. Harris. “We still don’t know the threshold of force for brain damage, we don’t know how many hits it takes, but the first thing we have to do is collect the data.”
Each of these chips costs approximately $30.
Technology is also being used to improve care and outcomes the aftermath of serious concussion cases. Interactive Metronome, a health tech company that creates neurological research-based brain training programs and activities, is one example. The activities are designed around “brain timing”—the ability to clap to a beat, for example. As users play games and do activities that test their reaction time, those brain cell connections are repaired and strengthened. Originally (and primarily) used to improve motor skills and cognitive function in children with ADD/ADHD, the program is beginning to see success with TBI rehabilitation.
“We fit into concussions in a new way, which is helping out when those [post-concussion] symptoms don’t dissipate,” says Nick Etten, vice president of Strategy and Business Development at Interactive Metronome. “There’s a lot of emphasis on technology these days—it’s really important in the world of concussions and cognitive rehab. We’re starting to understand that there was a big void in information.”
Technology has helped improve identifying and treating concussions; on the prevention front, sports health care professionals now have the backing of the law. In all 50 states, a student athlete must be immediately removed from play if a concussion is suspected, and cannot return to practice or play without medical clearance. Some states also mandate that a student must remain free of symptoms or remain on the injured list for a set period of time, even if they gain medical clearance immediately.
But there are still holes in preventing these injuries.
“There’s clearly benefits to legislation in terms of drawing attention to the issue of concussions and having some foundation across the board with how they should be managed,” says Dr. Williams. “I think there are some variables…related to who should be allowed to clear players.”
He and Rheeling have both seen athletes on under-resourced teams get clearance from an emergency room resident, for example, in contrast with athletes who take a concussion test against their baseline with their team’s athletic trainer. They’ve also seen instances of students underreporting their symptoms, coaches resisting care recommendations, and parents being lax in monitoring their child’s rest after a concussion.
Emerging laws are attempting to add another layer of protection by regulating the number of weekly practices involving rough contact drills, thus reducing exposure to collisions and risk of concussion. Trainers, coaches, parents, and athletes can also receive guidance through resources such as the American Academy of Neurology online Sports Concussion Toolkit, and organizations such as the Sports Legacy Network.
“We’re at the end of the beginning as relates to concussion management. We’re learning more every day and the process will continue to evolve,” says Dr. Williams. “We’re out of the phase of explaining what a concussion is, identifying symptoms…. It’s no longer an unrecognized epidemic, we’re aware of the issues and that [a concussion] has to be managed effectively.”
July 03, 2014
By HOWARD FENDRICH
It was clear something was wrong with Serena Williams from the moment she began trying to warm up for her Wimbledon doubles match Tuesday July 1.
She weakly pushed volleys into the net from a couple of feet away. She whiffed on practice strokes. She even had trouble with the simple task of collecting tennis balls from the ball kids.
After Williams was examined for about 10 minutes on the sideline by medical staff, including a check of her blood pressure, the match began. After three games, though, an out-of-sorts Williams and her partner, older sister Venus, stopped. The tournament referee’s office and WTA later said Serena, who lost in singles Saturday, had a viral illness.
“I am heartbroken I’m not able to continue in the tournament,” Serena said in a statement. “I thought I could rally this morning because I really wanted to compete, but this bug just got the best of me.”
About 1 1/2 hours after leaving the court, Serena walked out of the All England Club, still wearing her white match outfit, and with a tournament towel draped around her waist. She got into a car and was driven away.
“Unfortunately, Serena has been feeling unwell for the past few days and she just couldn’t play to her potential today,” Venus said. “I’m really proud of her for trying because we just love playing doubles together.”
They have won 13 Grand Slam doubles titles as a pair, including five at Wimbledon. In singles, the 32-year-old Serena is ranked No. 1 and owns 17 major championships, the most among active women; five came at the All England Club.
“We were all looking forward to a great match. From the bottom of my heart, I thank all of the fans for their cheers and understanding,” said Serena, who was beaten in three sets by 25th-seeded Alize Cornet in the third round of singles. “I look forward to returning to Wimbledon next year.”
While being looked at by a doctor before the start of the second-round doubles match against Kristina Barrois and Stefanie Voegele, Serena hunched over and covered her face with her hands.
During the delay, one of the Williams’ other sisters, along with Serena’s agent and her hitting partner, left their seats in the stands.
Eventually, play began. With Serena serving in the third game, she was broken at love with four double-faults. One of the best servers in the women’s game, she hit balls that bounced before reaching the net.
At love-40 in that game, chair umpire Kader Nouni took the unusual step of climbing down from his perch and walking over to speak to Serena. She then served another double-fault to fall behind 3-0.
Serena and Venus walked to the sideline holding hands, and Nouni announced to the crowd at No. 1 Court: “Ladies and gentlemen, unfortunately, Miss Williams has to retire.”
Serena wiped away tears as she walked toward the court’s exit.
Her career has been marked by health problems.
She missed eight months after having surgery on her left knee in 2003, the year she had completed a self-styled “Serena Slam” by winning four consecutive major titles. Days after winning Wimbledon in 2010, Williams cut both feet on broken glass while leaving a restaurant, leading to two operations on her right foot. Then she got clots in her lungs and needed to inject herself with a blood thinner. Those shots led to a pool of blood gathering under her stomach’s skin, requiring another hospital procedure. In all, she was off the tour for about 10 months, returning in 2011.
June 26, 2014
By Howard Fendrich
AP Tennis Writer
LONDON (AP) — Let others wonder when or whether Venus Williams might move on from tennis. She’s not ready to contemplate going anywhere just yet.
Even as her early losses accumulated, even as Williams got older and was forced to deal with health issues, she never entertained the idea of quitting.
Here she is, at age 34, once again a factor at Wimbledon, site of five of her seven major titles. And there’s a matchup against another former champion looming.
Williams overcame a slow start Wednesday for a 7-6 (4), 6-1 victory over 41st-ranked Kurumi Nara of Japan to reach the third round at a Grand Slam tournament for only the second time in her past 10 appearances.
“I don’t like watching it on TV. I want to be out there. I’m not about the easy thing. Life is a challenge. For me, when I leave tennis, I want it to be on my own terms. I want to know that I rose to every challenge. I want to look back with no regrets,” Williams said. “Everyone messes up. Everyone chokes. Everyone gets tight. Everyone loses matches they should have won. But as long as you walked out there and you gave it your all, you can look back with no regrets.”
Williams, a former No. 1 who is seeded 30th, revealed three years ago she was diagnosed with an energy-sapping autoimmune disease.
A year ago, she skipped Wimbledon because of a back injury. She hasn’t been to the fourth round at a major since 2011 at the All England Club. But the American will return to that stage if she beats that year’s titlist, Petra Kvitova.
“She likes to play on the grass,” Kvitova said, “and I’m totally the same.”
Williams fell behind 3-0 against Nara, then started finding the mark. In the tiebreaker, Williams again began poorly and trailed 4-1 before grabbing six points in a row for the set.
Nara, 22, spoke about this being a “very special” occasion for her, because she watched Williams on television “when I was a child.”
A reporter asked Williams about being the oldest woman left in the tournament, and she jokingly pumped her fists.
“Wisdom has served me well,” said Williams, who later returned to Court 3 to win a first-round doubles match with her sister Serena. “I’ve worn my sunscreen, so I haven’t aged terribly. My knees are very tight, not saggy. And the crow’s feet have been kept at bay. So I’ll give myself an A-plus.”
The sixth-seeded Kvitova played with her right leg heavily taped because of a recent injury but had zero trouble in a 6-2, 6-0 victory over 59th-ranked Mona Barthel. The biggest names sent home were No. 8 Victoria Azarenka, the two-time Australian Open champion beaten by Bojana Jovanovski 6-3, 3-6, 7-5; and No. 7 David Ferrer, who lost 6-7 (5), 6-0, 3-6, 6-3, 6-2 against qualifier Andrey Kuznetsov.
Azarenka missed most of this season with an injured left foot and is still working her way back into top form. A telling stat: She converted only 3 of 16 break points, which she called “just ridiculous.”
Sam Querrey, an American ranked 67th, was at 9-all in the fifth set against 2008 Australian Open finalist Jo-Wilfried Tsonga when play was halted because of fading light.
In all, the results were nothing like those “Can you believe that?” outcomes of the first Wednesday in 2013, when Roger Federer was among seven players who have been ranked No. 1 to exit the field in less than 10 hours.
The man who defeated Federer that day, Sergiy Stakhovsky, lost his next four Grand Slam matches. But Stakhovsky pulled off another surprise Wednesday, eliminating French Open semifinalist Ernests Gulbis.
Defending champion Andy Murray and last year’s runner-up, 2011 titlist Novak Djokovic, both won. Murray’s 6-1, 6-1, 6-0 victory over Blaz Rola, who won the 2013 NCAA singles championship for Ohio State, was devoid of drama. That wasn’t the case with Djokovic’s 6-4, 6-3, 6-7 (5), 7-6 (5) victory over 35-year-old Radek Stepanek, a serve-and-volleyer who tumbled to the grass repeatedly.
On the final point, Djokovic hit a forehand that landed near a line and was called out. Djokovic challenged the ruling, and Stepanek held his hands in a prayer pose, then knelt on the grass, hoping for help. The call went Djokovic’s way, though, and the men hugged.
“Around 3 1/2 hours, Centre Court, crowd involved, great points, a lot of entertainment,” the top-seeded Djokovic said. “Definitely, I’ll remember this match.”
By Michael Rubinkam
The NFL agreed this week to remove a $675 million cap on damages from thousands of concussion-related claims after a federal judge questioned whether there would be enough money to cover as many as 20,000 retired players.
A revised settlement agreement filed in federal court in Philadelphia also eliminated a provision that barred anyone who gets concussion damages from the NFL from suing the NCAA or other amateur football leagues.
In January, U.S. District Judge Anita Brody had denied preliminary approval of the deal because she worried the money could run out sooner than expected. The settlement is designed to last at least 65 years and cover retired players who develop Lou Gehrig’s disease, dementia or other neurological problems believed to be caused by concussions suffered during their pro careers.
“Some of the players were concerned and asking questions about whether they could be in a deal if they weren’t sure there’d be money there for them 40 years from now if they get sick, God forbid. ... That’s what drove these changes,” said plaintiffs’ lawyers Christopher Seeger.
More than 4,500 former players have filed suit, some accusing the league of fraud for its handling of concussions. They include former Dallas Cowboys running back Tony Dorsett and Super Bowl-winning Chicago Bears quarterback Jim McMahon, who suffers from dementia.
The original settlement included $675 million for compensatory claims for players with neurological symptoms, $75 million for baseline testing and $10 million for medical research and education. The NFL would also pay an additional $112 million to the players’ lawyers, for a total payout of more than $870 million.
The revised settlement eliminates the cap on overall damage claims but retains a payout formula for individual retirees that considers their age and illness. A young retiree with amyotrophic lateral sclerosis, or Lou Gehrig’s disease, would receive $5 million, a 50-year-old with Alzheimer’s disease would get $1.6 million, and an 80-year-old with early dementia would get $25,000.
Even with the cap removed, both sides said they believe the NFL will spend no more than about $675 million on damage claims by ex-players.
Brody will decide later whether to accept the new settlement terms. She still has to rule on a petition by a group of seven players who say the settlement pays them nothing for symptoms ranging from headaches to personality changes.
Critics of the deal have also said the league, with annual revenues approaching $10 billion, was getting off lightly. Lawyers for the plaintiffs said the settlement avoids the risk of a protracted legal battle.
Seeger said any ex-player who opts out of the settlement and pursues litigation on his own would have to overcome a stiff NFL defense. The NFL has a range of legal arguments at its disposal, and a player would have to prove that his illness was caused by a concussion suffered during his pro career, he said.
“Continuing to litigate against the NFL is a long and uncertain road that can take them many years and ultimately leave retired players with nothing at all,” he said. “No one should take lightly any decision to abandon the benefits provided by this agreement.”
The proposal does not cover current NFL players, nor does it include an admission from the league that it hid information from players about head injuries.
“Today’s agreement reaffirms the NFL’s commitment to provide help to those retired players and their families who are in need, and to do so without the delay, expense and emotional cost associated with protracted litigation,” NFL Senior Vice President Anastasia Danias said in a statement.
One of the plaintiffs is Kevin Turner, who played for the Philadelphia Eagles and New England Patriots and is now battling ALS.
“The compensation provided in this settlement will lift a heavy burden off of the men who are suffering,” he said in a statement. “I am also personally comforted by the knowledge that this settlement is guaranteed to be there for any retired player who needs it.”
It’s not clear when the judge might rule, but Seeger said he is hopeful that preliminary approval will come in the next few weeks.
AP Pro Football Writer Barry Wilner contributed to this report.
June 19, 2014
By TIM REYNOLDS
LeBron James is leaving.
For a family vacation, that is.
The Miami Heat star said that’s his first order of business, and during the time away from basketball he’ll start the process of moving past this season and looking toward the future.
“I just want to win. That’s all that matters to me,” James said June 17 after emerging from the final team meeting, one where coach Erik Spoelstra urged his team take plenty of pride from the season, even though the end result was an NBA Finals loss to San Antonio. "I haven’t even begun to even think about what my future holds or what I have in store. I will sit down with my team at some point, my family as well. Today definitely wasn't the day.
“If my family is happy, then I’m happy and able to perform at a high level.”
If so, then they’ve been happy during his first four years in Miami: James has been to the NBA Finals all four seasons in which he’s played for the Heat, capturing two championships, and no one in the league over that span has logged more minutes, made more field goals or won more games than the four-time MVP.
James, Dwyane Wade and Chris Bosh can all become free agents, though none have made decisions on whether they’ll opt out. They came together amid much fanfare in 2010, and this summer might be similar in many ways for that trio, the Heat and the NBA as a whole — with all eyes on what they’ll do.
“I feel more at ease this time,” James said, adding that “2010, it was out of control. It was the craziest summer I’ve ever been a part of. ... I’m definitely in a better place right now even though in 2010 I got put out in the postseason earlier than I expected or didn’t accomplish what I wanted to, and I have kind of the same feeling now.”
James said that at some point, he, Wade and Bosh will gather to talk about their plans. They have until June 29 to inform the Heat whether they will exercise their rights to become free agents — moves that in all three cases would not prohibit them from returning to Miami. Bosh revealed Tuesday that the group will meet with Heat president Pat Riley as well, to get the team’s vision for what next season's roster would look like.
“I’m sure Riley has a finite plan moving forward,” Bosh said. “I guess it kinds of really starts with him, just listening to him, kind of get his feel for the situation. He’ll plug ’em wherever something is needed.”
The basketball court was still in place inside Miami’s arena on Tuesday, but there will be no game there until next season. Game 6 of the NBA Finals would have been Tuesday night and for the first time since 2011, the Heat were saying goodbyes to one another without the backdrop of a championship parade.
“There’s not a whole lot you can say that's going to alleviate some of the pain and frustration that we’re all feeling right now,” Spoelstra said. “We understand why our team was built. There’s high expectations. And with that when you don’t get to where you want to go, there’s sometimes that pain that’s deep.”
Spoelstra said he’s concentrating more on the draft right now than mourning the end of the season, or getting ready for free agency.
“We have a couple weeks to figure it out,” Spoelstra said. “We have a great track record. And we have a championship, first-class organization. That is our best selling pitch.”
James said he didn’t need to hear what Miami has to offer. He already knows.
“I understand what this team and this franchise brings to the table,” James said.
In the coming weeks, he’ll have a better sense on whether if he’ll need to go grab a seat somewhere else to win more championships.
“That’s what Riles is so great at and obviously Spo’s going to get into it and see guys who can help us get better,” James said. “Every team in the NBA continues to get better every year and we need to get better as well. We have some holes that need to be filled.”
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