Starting in 2012, helmet reconditioners will no longer accept helmets 10 years or older. Leagues that have depended on reconditioning their helmets every year and cannot afford replacement gear will be most affected. Although helmets do not prevent concussions, most experts agree that newer ones are preferable to used, and an older, unreconditioned helmet might increase the risk of injury. Many leagues ask their booster clubs for assistance with fundraising as this issue has now reached a critical phase. Limited grants for replacement helmets by leading manufacturers are now available for eligible youth leagues in several areas around the country. Applications are now being accepted for youth football programs seeking to replace their league's helmets before the start of the 2012 season. The Centers for Disease Control and Prevention, USA Football and partnering organizations have introduced a helmet replacement program for youth in underserved communities. It is estimated the program will provide almost 13,000 new helmets to athletes in low-income communities beginning in July 2012. To qualify a league must meet the following criteria: - Operate a youth football league (no middle or high school programs) - Live in one of the following areas: Cleveland, New Orleans, New York, or the San Francisco Bay area - Serve an economically disadvantaged area The application process requires registration at USA Football, the governing body for youth football under the NFL. The application is accessible only after viewing a concussion awareness video and pledging to utilize USA Football's resources to educate members of your league before the 2012 season. A visit from an official to verify the ages and number of helmets exceeding 10 years of age in your inventory will occur by mid-June, with new helmets arriving prior to the beginning of the 2012 season. Participating helmet manufacturers include Rawlings, Xenith, Riddell and Schutt. Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

As a new womens' lacrosse referee I initially had mixed feelings about the ongoing debate on the use of helmets in play. Listening to the discussion in referee training sessions that stressed the finesse of the game and the need of the referee to control or slow down play, verses the struggle I felt as a person having a medical degree and realizing the potential hazards of brain injuries, I tried to see both sides. Some people think that helmets will make the game more physical. But after my first official day as a referee standing on the sidelines watching my daughter’s middle school team begin their game, my beliefs became clear. Female lacrosse players need to wear helmets. During the first eight minutes of the game there were three injuries, one related to a child’s head and neck. This player had been checked from behind causing her neck to snap back. She then fell and hit her head on the turf. I witnessed every parent’s/referee’s/coach’s nightmare: a player down and seizing. To my dismay, this player returned to play in less than three weeks and went on to have another concussion and seizure. She is now barred from impact sports for the rest of her life. What I found out about my local school district surprised me and motivated me to try to educate parents and give people the best information possible. After speaking to the athletic trainers in my school district, I was made aware that high school students are given baseline concussion testing but younger players are not. We are now in the process of offering that testing to younger players. Also, while coaches can have in-person or online concussion training it seems that more could be done to help the coaches and parents become more informed about concussions. There are numerous issues that could explain the high incidence of concussions in women's lacrosse. One might be to consider the nutrition and health of girls playing the game today. Both men and women today are better nourished and physically stronger, faster and more powerful than the players of previous years. This has created a weight imbalance as some players can actually outweigh others by a large margin. The physics of combining speed and extra mass can lead to a dangerous combination. Equipment has also evolved to allow for lighter and faster sticks, causing unintended hits in some instances, I'm sure. Another factor is the increase in new players due to the popularity of the sport. Putting players of different skill levels in the same game can set up a difficult dynamic. It is important for players to be aware of their body position in space and reference to other players. This is a skill that comes with time and coaching. Coaching is another aspect of the game that helps teams work together better and control the speed of their game. Neck strengthening exercises can decrease the whiplash motion often caused by a hit to the cranial region. As for me, I have now completed my first season as a referee. I feel that helmets and proper body equipment in womens' lacrosse will make the game safer for everyone. My feeling is that there are too many factors that increase the potential for head injuries and we should mitigate them as best we can. While I realize helmets do not prevent concussions, I do believe they would be helpful to protect young women from unintended hits to the head. Dr. Lori McGowan is an Adjunct Professor of Biology at Harrisburg Area Community College in Harrisburg, Pennsylvania.

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. 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 plhttps:// 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/

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

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 first of three private screenings was held in Chicago on May 15th for "Head Games," a documentary on the sports concussion crisis. From acclaimed director Steve James (Hoop Dreams, The Interrupters) and award-winning producer Bruce Sheridan, Head Games takes a deeper look at the devastating and long-term effects of concussions in all sports. Inspired by events from the book Head Games written by Christopher Nowinski, the film offers eye-opening insight and cutting-edge science on head trauma from the nation’s leading medical experts. Additional screenings will be held June 6 at the Boston University School of Medicine Albany Street Auditorium and June 7 in Philadelphia at the Translational Research Center (TRC) Rubenstein Auditorium. Watch the trailer Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

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

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.

As female participation in sports grows rapidly, there is a popular notion that there are gender-related differences in athletes' responses to sports-related concussion, and prior research has supported these gender discrepancies. However, a Vanderbilt University Medical Center study, conducted to review symptoms and neurocognitive findings in male and female high school soccer players, shows no gender-related differences. "There has been good data that suggests girls score worse on neurocognitive testing following a sports-related concussion. Our hypothesis was that a tightly-controlled study would replicate what others have shown previously," said Scott Zuckerman, M.D., a neurosurgery resident who conducted the study with colleagues at the Vanderbilt Sports Concussion Center. The researchers selected 40 male and 40 female concussed patients who were matched, as closely as possible, for age, medical/psychiatric history, years of education, lack of special education assistance, history of psychiatric treatment, number of prior concussions, timing of pre- and post-concussion testing, and sport (all engaged in soccer). This is the first study to control for type of sport played when looking a gender differences, Zuckerman said. "Prior studies have used mixed groups of athletes from a variety of sports. We suspected that since concussions vary from sport to sport (i.e., helmets vs. none, varying biomechanical forces, etc.), if the variable of sport was controlled, gender differences might disappear." The only significant gender-related difference they could identify was that female soccer players reported a greater number of symptoms post-concussion. There were no significant differences in post-concussion neurocognitive scores. "We were somewhat surprised and were not sure what to expect in such a tightly controlled population," Zuckerman said. "Our hypothesis was that females would experience greater levels of acute, post-concussive, neurocognitive impairment than males, fitting with what most of the prior literature says, but we found virtually no difference between males and females." Zuckerman said this is a significant finding for the treatment of sports-related concussion. "When we see any child after concussion, we don't want to make snap decisions based on gender. Gender may not be as big a modifying factor as previously thought." This study is the first from V-SCoRe, or Vanderbilt Sports Concussion Research. Collaborators include Allen Sills, M.D., Gary Solomon, Ph.D., Andrew Gregory, M.D., Alex Diamond, D.O., and Jonathan Forbes, M.D., and medical students Mitchell Odom and Young Lee. "This effort is just getting off the ground, and we're investigating many more modifying factors in concussion, including age, sleep, symptoms, prior history of attention deficit disorder," Zuckerman said. "Our goal is to create new knowledge in this area and help providers better understand when a young athlete can return to play safely." Story Source: The above story is reprinted from materials provided by Vanderbilt University Medical Center, via Newswise. Journal Reference: Scott Zuckerman et al. Response to acute concussive injury in soccer players: is gender a modifying factor? Clinical article. Journal of Neurosurgery: Pediatrics, 2012 DOI: 10.3071/2012.8.PEDS1239