They’ve each had a son on the verge of dying after being struck on the head by a batted ball and suffering a skull fracture that required emergency surgery. Gunnar Sandberg, 16, was in a coma for three weeks; Cole Schlesner, 15, spent four days in a coma and remained in a hospital for another six weeks.

[The families] both want to see improved safety measures in the youth game — Sandberg a return to wood-only bats, Schlesner the use of helmets by pitchers…. (from USA Today article)

Basically, they are for any change that will make the game safer for kids. Who can blame them? No one expects that a high school baseball game could end in a catastrophic, life-changing injury.

Although there are no hard data linking metal bats to an increase in injuries, there are plenty of anecdotes. Plus, bat manufacturers are quick to try to sell metal bats based on superior performance, but seem to back off when it comes to injury. They say that “exit speeds” off metal bats are only about 6 mph greater than those for wooden bats. On the other hand, those concerned with safety argue that:

• Metal bats have a “trampoline effect,” the result of the bat compressing and bouncing back when hit by a baseball. Wood bats don’t compress as much because they’re not hollow.
• Some metal-bat barrels are as much as half-an-inch wider in diameter than wood, increasing the size of their “sweet spot.”
• Metal bats are lighter and have more of their weight on the handle, which makes them easier to swing faster.
• In unregulated travel-team tournaments, such as the one where [Cole Schlesner] got hurt, there are no restrictions on bat performance. Before the 2001 season, the National Federation of State High School Associations required high schoolers swing bats in which the differential in weight (in ounces) and length (in inches) is no greater than 3. The previous standard allowed a differential of 5, meaning players could swing bats (such as the popular 34-inch, 29-ounce model) that provided ample plate coverage without sacrificing bat speed. (from USA Today article)

Cole Schlesner’s life was forever changed. he was taken to hospital by helicopter, had surgery to remove part of his skull, and spent time in a coma.

“When he awoke from his coma, he could not talk or walk and his right side was paralyzed. Despite up to nine hours a week of outpatient rehabilitation, he has difficulty walking and lacks full use of his right side. His cognitive development has improved to where he can function in school with some accommodations, but recently he has lost the ability to articulate some syllables and words. His father estimates the cost of his care so far at between $750,000 and $1 million, with 80% to 90% covered by insurance.” (USA Today)

Next Steps

North Dakota has banned metal bats, but other states are considering similar measures. A few individual baseball leagues have made the switch to wooden bats, but not many. There are some research studies being conducted–one at the bioengineering lab at Brown University–to objectively examine whether metal bats are significantly different from wooden bats in terms of their ability to cause catastrophic injuries.

These studies may not fully answer the questions though: researcher Dan Russell, associate professor of applied physics at Kettering University, admits that some of his work has been funded by bat manufacturers. There will, no doubt, be cause for skepticism if his studies show that metal bats are no more dangerous than wooden bats.

In the long run, money may end up helping to change safety regulations. When a larger percentage of metal bat profits have to go to pay the costs of injured children, the manufacturers may decide to take safety seriously. (Last year, manufacturer Hillerich & Bradsby was order by a Montana court to pay $850,000 to the family of a teen player killed by a line drive off a metal bat.)

Meanwhile, we like the advice of Cole Schlesner’s father, who “advocates youth pitchers using helmets, as his three other sons do now.” (USA TODAY)

USA Today article: “As Injuries Mount, Debate Over Metal Baseball Bats Continues”

The National Football League (NFL) has released its official, new poster, which clearly lists symptoms of concussion and potential long-term effects. In one section, the poster says that traumatic brain injury (TBI) can lead to “…problems with memory and communication, personality changes, as well as depression and the early onset of dementia.”  This is the most honest and blunt statement of the hazards of football by the NFL since, well…ever.

According to an article in the New York Times, players welcome the posters:

“That poster is shocking,” said Domonique Foxworth, a cornerback for the Baltimore Ravens. “It gives people facts before they take risks. But it’s not exactly a new revelation.”

Matt Birk, the Ravens’ center, said: “To put it out there in writing in locker rooms, at least it’s publicly acknowledging that, ‘Hey, this is real.’ There’s risks in everything you do, and this one is real. You can’t sweep it under the rug anymore.”

On the poster (which may or may not be different from what is said on the field), players are told that “playing through” a concussion could cause permanent brain damage. The advice is to report symptoms, get checked out by medical staff, and then take time to recover.

Although this is a great and long over-due first step, the New York Times reports that a lawyer for the NFL wrote a memo discrediting connections between football head trauma and long-term cognitive decline. The article continues:

The letter, obtained by The New York Times, explained, “We can point to the current state of uncertainty in scientific and medical understanding” on the subject to deny players’ claims that their neurological impairments are related to football.

Sadly, that adds credence to the football league’s “chew ‘em up and spit ‘em out” reputation when it comes to players’ health. The problem is that if a player wrecks his knee, he loses his job…but if he wrecks his brain, he could lose his memory, his family, his entire sense of self. We’re glad to see that the posters provide solid medical information. Maybe, eventually, the message will sink in. The next step is to make sure players are respected for taking it slow after concussion.

To read the full New York Times story, click here: NFL Concussion Poster

A study of nearly 200 Vietnam vets found that 13% of those with penetrating head wounds developed epilepsy more than 14 years later. A few veterans had new seizures that popped up 35 years after the initial injury.

The results of the Vietnam Head Injury Study, published in the journal Neurology, confirmed that epilepsy is common after injuries that pierced the brain, such as from bullets or shrapnel. But why it takes so long for some vets to develop seizures remains a mystery.

According to an article in the Los Angeles Times:

“There are all sorts of things that can contribute to a [late-onset] seizure, including sleep deprivation, excessive drinking and other kinds of illnesses,” Grafman said. [study coauthor Jordan Grafman, chief of the Cognitive Neuroscience Section of the National Institute of Neurological Disorders and Stroke]

The study showed that soldiers who retained pieces of metal in their brains were at heightened risk for seizures, as were those with larger brain lesions (these also predicted a higher frequency of seizures).

This is a great piece of information, and we believe it probably is applicable to other penetrating head injuries, such as from a car wreck or assault. We’ve always known that the brain is a delicate and mysterious organ, and this study shows that the true effects of wounds don’t always show up immediately. Long-term follow-up is important for everyone with a serious brain injury.

“You can have an injury and get better, but with time, people don’t always do as well as they should,” said Dr. Gerald Grant, associate professor of neurosurgery at Duke University in Durham, N.C., and a former Air Force neurosurgeon. “It shows us that this is a chronic disease.” [also from the LA Times article]

Not all injuries heal with time. Brain injury is not like breaking a bone… it’s more like dropping a computer on the floor. There’s a chance that the wiring will remain intact, but you won’t necessarily see the actual damage until you run the machine for awhile.

We can’t say this often enough: Every head injury holds the potential to cause brain injury. And now we can add that brain injury holds the potential for lifelong problems, including seizures, cognitive deficits, and memory issues.

To read more about the effects of traumatic brain injury, see the HensonFuerst TBI web page.

The non-profit Horsepower Therapeutic Learning Center calls on different aspects of horsemanship to develop athleticism, memory, balance, and speech among people who lost some of that function.

“There’s three different stations,” said Jan Clifford, executive director and founder of Horsepower, Inc. “They’re working on the farrier, who provides the footwear for the horses. They have a riding segment where they actually ride the horses and work on balance and speech. Then they have a section where they go in and work on memory and recall, working on different things that horses and equestrian activities do.” (from the News14 story)

The news piece tells the story of Brandy Gilliam who was hit by a car 11 years ago. She spent 3 months in a coma, and another year in the hospital. She has participated in the Horsepower program for three years, and has experienced significant improvements in her posture, walking, and speaking abilities.

This amazing program provides help to more than 250 people every year. There is no cost to the participants, thanks to a grant from the Winston-Salem Foundation.

To read or watch the full news story, click here: News14 Carolina.

To read more about Horsepower, visit their website here: www.horsepower.org

For more information about the Winston-Salem Foundation, click here: Winston-Salem Foundation

And if you have legal questions about traumatic brain injury, visit our website here: HensonFuerst Law (www.lawmed.com)

Now that the Fourth of July weekend is upon us, many families will be spending every spare minute around the pool or at the beach. Most of us have fond memories of those “Hey, watch me dive” days from our childhood. I remember one summer when my cousin slipped while running around the edge of the pool and split his lip on the concrete… and another year when my teenage friend nearly drowned after body surfing in the dark.

In hindsight, it is obvious that we were all pretty lucky that our injuries weren’t worse than that. Those memories just as easily could have been tragic. Head and neck injuries can result in brain injury, paralysis, coma, or death.

Today’s summer advice is about water safety, so that our kids have fond summer memories, too.

Ocean Play

According to Hoag Hospital’s Project Wipeout, most injuries in the ocean are caused by the powerful surge and pull of waves. Serious injuries can occur in a number of ways:

“When your body tumbles in the waves, gets thrown by the waves to the ocean floor or when your head spears into the sand; your head can be forced down onto your shoulders, pushed forward into your chest or pushed backward further than it can naturally extend. And once spinal cord damage is sustained, little can be done to medically repair it. The result is severe pain, paralysis, the inability to breathe on your own or even death.” (Project Wipeout)

• Don’t jump off piers or jetties.
• Don’t enter the ocean alone.
• When body-boarding, hold the board so it extends past your head–if  a board is held closer, a wave can flip the board backward toward the head and neck.
• Make sure you know where sandbars are before riding surf.
• Don’t enter the ocean drunk.

Swimming Pool Play

According to LiveStrong.com, supervision at the pool is the number-one safety rule:

“One-on-one adult supervision is recommended for children. If supervising a child, you are too far away if you are unable to reach the child with an outstretched arm. Young children under 7 and non-swimmers should wear a PFD, personal flotation device, when in water at or above chest height. Flotation toys are not intended to prevent drowning. Implement the buddy system for everyone. Good swimmers and adults alike should never swim alone.” (LiveStrong.com)

Diving

• Don’t dive in less than 9 feet of water. A good rule of thumb is if there is no diving board, diving is not allowed. That means no diving into the shallow end of a pool, or into an above-ground pool.
• If you can’t see the bottom, don’t dive. You never know when there might be submerged items in your dive path.
• Don’t dive into unfamiliar waters…even if others are diving.
• Get training before doing back dives or fancy dives, or diving from diving blocks.
• Don’t try to dive through or over objects.
• Never dive from pool structures, such as slides or ladders… or from retaining walls, rooftops, balconies, or fences.
• Don’t dive drunk or under the influence of drugs.
• Don’t dive alone.

Sliding

• Don’t let anyone slide head-first…even adults.
• One slider on the slide at a time.
• Slide only if the water in the landing area is free of objects or other people.
• The landing area in front of a slide should have a minimum depth of 5 feet.

To read our other Summer Safety Tips…

Tip #1: Heat Illness.

Tip #2: Summer Auto Wrecks.

Tip #3: Medications that Don’t Mix with Heat.

RESOURCES

Lifesaving Resources, Inc. Spinal Injuries in the Aquatic Environment; Part 1: Prevention. (Gerald M. Dworkin, reprinted from 1987 Parks & Recreation. (http://www.lifesaving.com)

Hoag Hospital’s Project Wipeout. A nonprofit hospital’s program to save lives and prevent injuries at the beach. (http://www.hoaghospital.org/ProjectWipeout/AboutProjectWipeout.html)

Christopher & Dana Reeve Foundation’s Summer Safety Checklist. (http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.5283099/k.6B65/Summer_Safety_Checklist.htm)

LiveStrong.com. ( http://www.livestrong.com/article/124389-private-swimming-pool-safety/#ixzz0sTuyKsvE)

Weeks of vacation and sultry weather make outdoor sports more popular, and whenever people get active, there are bound to be injuries. This week, the American Association of Neurological Surgeons (AANS) issued a reminder to enjoy summertime sports safely.

Over a one-year period from 2008 to 2009, the numbers of head injuries rose for nearly every sport (the single exception: Trampoline!). Heading the list (pun intended) are bicycling, water sports, baseball and softball. Cyclists suffered the most head injuries–more than 85,000 were reported in a single year, up from about 71,000. And the number water-related head injuries more than doubled, from 11,200 to than 28,700.

“By taking a minute or two to use your head, you can help prevent potentially life-altering and tragic consequences,” Dr. Gail Rosseau, a Chicago-area neurosurgeon and AANS spokeswoman, said in an association news release.

Surprising and Preventable Causes

When it comes to cycling, the AANS reports that at least part of the blame for the increase in injuries comes from–get this: use of cell phones! “Sidetracked cycling” is is as dangerous as “distracted driving.”

The AANS offers the following safety recommendations:

• To prevent biking accidents, the organization encourages riders to use helmets, obey traffic signals, avoid uneven surfaces, wear bright colors and reflectors at night, and avoid cell phone use.
• To increase water safety, AANS advocates for adult supervision of young children, careful diving in conjunction with accurate water-depth information, keeping gates locked around backyard pools, avoiding alcohol consumption during water-related activities, following posted instructions at public places, and enforcing a strict ban on potentially dangerous rough play.

And don’t forget that using cell phones while supervising young children around swimming pools could also be dangerous. If attention is needed, give attention. Of course, if you’re a glass-is-half-full kind of person, you could take the AANS report as a license to turn off the cell phone and enjoy your time outdoors. Summer, sports, and safety–that’s having it all!

This week, a press release from C.S. Mott Children’s Hospital (part of the University of Michigan Health System) reports on a recent poll, and talks about the next step in recognizing concussions: parents.

According to the article, two-thirds of parents of young athletes worry that their children will get a concussion while playing school sports, but 50% don’t know if their children’s school has a concussion policy. One-third of parents are unaware of the dangers of repeated concussions, which can include permanent brain injury, early dementia, or even death.

Experts believe that a young athlete who suffers a concussion should not return to play for at least two weeks, and some brain injury specialists believe that injured players should sit on the sidelines for three full months to give the brain a chance to heal.

It can be difficult to diagnose a potential concussion on the field. Contrary to popular belief, most concussions do not result in a loss of consciousness…and symptoms may not occur for several hours after the injury. Young athletes may not recognize that they are hurt, or they may be afraid to mention symptoms for fear of losing playing time or of disappointing a coach or a parent.

What parents should know

Parent involvement in guarding against repeat concussions is critical.  Any time you suspect that your child has received a head injury, watch for these common signs and symptoms of concussion:

• confusion
• loss of memory (amnesia)
• headache
• dizziness
• a sensation of the world spinning (vertigo)
• imbalance
• lack of awareness of surroundings
• nausea and vomiting

If these symptoms appear after a head injury, consult a medical professional promptly for a full evaluation. Don’t allow a coach to pressure your child into playing before he or she has recovered. When in doubt, talk with a doctor.

For more information, click here:   “Concussion in Sports” from the Centers for Disease Control and Prevention (CDC)

To read the full C.S. Mott Children’s Hospital press release, click here: “Parents Ill-Prepared to Reduce Kids’ Concussions Risks”

If you have legal questions about concussion and brain injury, go to the HensonFuerst dedicated Brain Injury page. At HensonFuerst, if you have questions, we have answers.

The sport?  Cheerleading.  And compounding the tragedy of injury is the fact that only 20-25 states list high school cheerleading as a sport… the NCAA doesn’t recognize cheering as a championship sport… and unless the number has changed since December 2009, only 3 colleges consider cheering a sport–none in North Carolina. (Statistics from Journal of Athletic Training 2009)

Call a Sport a Sport.

While “recognition” might seem like a minor point, it has major ramifications for safety.  A “sport,” performed competitively and for entertainment, requires strict guidelines to ensure the safety of athletes. In 1980, when cheering was still primarily about leading the crowd in cheers, there were fewer than 5,000 emergency room visits. Today, cheering involves highly skilled gymnastics (as well as being tossed in the air and trusting that someone will be there to catch you).

Without the sanction of being a sport, cheerleaders often have to practice in areas that make injuries more likely, such as an asphalt parking lot or a team member’s backyard.  A “sport” requires coaches to have a certain level of training and certification; a “sport” puts limits on the risks required of the participants; and a “sport” makes training and safety an integral part of practice and performance. Unfortunately, in most schools, cheering lacks safety, limits, and trained coaches.

Gimme an A-C-T-I-O-N.

One of cheering biggest and most vocal supporters is Frederick O. Mueller, Ph.D., Director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill (UNC-CH). The group’s 26th annual report devotes a special section to cheerleading injuries, which describes the current state of cheering as a sport, details specific catastrophic injuries and how they occurred, and suggests sample guidelines that could help prevent cheerleading injuries. As quoted from the report (available here):

“Is cheerleading an activity that leads the spectators in cheers or is it a sport? If the answer is to entertain the crowd and to be in competition with other cheerleading squads, then there must be safety guidelines initiated. The authors of this research question why it is called cheerleading, when competitive cheer has nothing to do with leading the crowds at athletic events in cheering for the athletic teams on the playing field. Following are a list of sample guidelines that may help prevent cheerleading injuries:

1. Cheerleaders should have medical examinations before they are allowed to participate. Included would be a complete medical history.
2. Cheerleaders should be trained by a qualified coach with training in gymnastics and partner stunting. This person should also be trained in the proper methods for spotting and other safety factors.
3. Cheerleaders should be exposed to proper conditioning programs and trained in proper spotting techniques.
4. Cheerleaders should receive proper training before attempting gymnastic and partner type stunts and should not attempt stunts they are not capable of completing. A qualification system demonstrating mastery of stunts is recommended.
5. Coaches should supervise all practice sessions in a safe facility.
6. Mini-trampolines and flips or falls off of pyramids and shoulders should be prohibited.
7. Pyramids over two high should not be performed. Two high pyramids should not be performed without mats and other safety precautions.
8. If it is not possible to have a physician or certified athletic trainer at games and practice sessions, emergency procedures must be provided. The emergency procedure should be in writing and available to all staff and athletes.
9. There should be continued research concerning safety in cheerleading.
10. When a cheerleader has experienced or shown signs of head trauma (loss of consciousness, visual disturbances, headache, inability to walk correctly, obvious disorientation, memory loss) she/he should receive immediate medical attention and should not be allowed to practice or cheer without permission from a physician.
11. Cheerleading coaches should have some type of safety certification. The American Association of Cheerleading Coaches and Advisors offers this certification.
12. The NFHS should make cheerleading a sport, which will place cheerleading under the same restrictions and safety rules as all other high school sports. The NCAA should follow this same recommendation.”

HensonFuerst commends the research and activist efforts of Dr. Mueller and his team. We represent the interests of far too many children and young adults whose lives have been shattered due to head trauma or other catastrophic injury. There are few things in life as heartbreaking as broken potential. We agree that it is time to let recognition and regulations catch up to this fast-moving, physically demanding sport. Yes, sport. Let’s at least make an effort to stop the hemorrhage of young, enthusiastic lives.

To report a cheerleading injury to make statistical reporting more accurate, go to www.cheerinjuryreport.com, sponsored by the National Cheer Safety Foundation. For more information about traumatic brain injury, or to request a legal consultation for a cheer injury, visit our dedicated web page. If you have questions, HensonFuerst has answers.

(Related and interesting articles can be found here: Flying without a net: Cheer injuries on rise. MSNBC and Cheerleading is leading cause of catastrophic injury in young women, ScienceDaily.)

People who sustain a head injury sometimes end up with a vision problem called “vertical heterophoria syndrome,” or VHS, in which the eyes go out of alignment with each other.  This causes many different symptoms related to eye strain, sense of balance, and the ability to see straight. Symptoms include dizziness, headaches, light sensitivity, double vision, difficulty ready, motion sickness, poor coordination, drifting while walking, lightheadedness, nausea, etc.  These symptoms can greatly reduce quality of life, and can be a challenge for doctors to treat successfully.

The Michigan researchers discovered that when people with VHS were fitted with special glasses that realigned the images so that they appeared in line again, symptoms were reduced by more than 70 percent. (April 2010 issue of Physical Medicine and Rehabilitation)

“Treatment [of traumatic brain injury] involves a multifaceted approach, including physical therapy, occupational therapy and multiple medications, and can take years to complete,” says Jennifer E. Doble, M.D., a physiatrist at St. Joseph Mercy Hospital, Ann Arbor.  ”Prismatic lens treatment seems to allow the other therapies to be effective more quickly. And as a result, patients get better quicker, reducing the time and cost of caring for this patient population.” (press release, PR Newswire)

We can get behind anything that helps brain injured people get better faster!

The attorneys of HensonFuerst remain committed to helping people with brain injury. We’ll keep you informed of other medical breakthroughs on our HensonFuerst brain injury webpage.

“Nearly 30,000 veterans have suffered some kind of traumatic brain injury in the wars in Afghanistan and Iraq – an estimated 2,000 of them severe enough to put warriors into comas or leave them with severe disabilities. Yet eight years into the wars, testimony before Congress shows veterans still suffer yawning gaps in coverage for what has become the conflicts’ signature wound.”   (News & Observer, 5/23/2010)

“…part of Pittman’s brain has gone dormant, and on most days, he can’t think straight. He leaves the room and forgets what he was searching for. He gets migraines so piercing that his right eye wanders. Anger comes easily, inspiring rages that sometimes have his wife terrified for herself and the couple’s 3-year-old daughter.”