Advanced Methods in Understanding Athletic Brain Injury

The most crucial issue facing the NFL in projecting its long-term viability (not to mention maintaining its staggering financial success of the last two decades) is how they handle the pink elephant in the room known as”Traumatic Brain Injury” aka TBI. One way to gain insight into an athletes relative risk of  suffering TBI is to peer into their unique DNA.
I am a proud founding partner of Athleticode, as it’s mission – to protect athletes from injury (including brain) honors the men whom I battled on the Gridiron throughout the 70’s and 80’s and woman who take part in sports where their heads may clash. Below is an open letter written by Athleticodes Founder and CEO, Former New Orleans Saints linebacker Dr. Jim Kovach, which is mandatory reading for those who care about the safety of all athletes. PK
By ATHLETICODE | Published: AUGUST 29, 2010
Open Letter Regaring Genetic Testing and ConcussionConcussion has become a concern to every athlete in a sport where head collision is possible, as well as to those professionals who have dedicated their careers to keeping athletes safe. A month ago, the large majority of athletes believed that only long-time players who had suffered repeated incidents of severe concussion had any cause for concern.

However, this changed dramatically with the recent death of 26-year-old Chris Henry, a former NFL wide receiver who participated in 55 NFL games with no history of concussion, but who possessed a particular variant of a brain protein responsible for protecting neurons called APOE4. An autopsy requested by Chris’ family revealed severe neurodegenerative damage in this young player who had never suffered an on-field concussion.

Athletes and the rest of society quickly grasped the implications – concussions are not a prerequisite for cognitive or neuropathological problems that athletes with head trauma may develop. Nor is the syndrome of chronic traumatic encephalopathy (CTE) – a condition that can currently only be diagnosed at autopsy – restricted to older, battle-scarred athletes. In fact, logic suggests strongly that someday soon we will be reading the first report of an even younger athlete than Chris with evidence of CTE.

Chris’ death sheds light on just how little is known about the biology of what happens over long periods of time when the brain experiences high impact forces and – importantly – about the role that genetic variation among athletes might play in the response to repeated head trauma.

Like 25% of the population, Chris is reported to have had one copy of the APOE4 gene variant. Previous reports of athletes experiencing multiple head injuries showed that the APOE4 Code is present in higher frequencies in athletes experiencing cognitive and/or behavioral difficulties than in members of the general public.

While additional research is needed, there is now strong suggestive evidence that at least some athletes with multiple concussive or even sub-concussive head injuries are at a higher risk of cognitive and/or behavioral problems later in life. For example, in studies involving former NFL players, it has been shown that about half of the players developing cognitive problems possess at least one copy of APOE4.


Think about this. If NFL players possess APOE4 at the same frequency as the general public, this would mean that 400 NFL players have the same APOE4 variant as Chris did. This fact alone calls for comprehensive longitudinal studies that track outcome based on genetic status of APOE4, and for research to search for possible additional gene variations associated with head trauma, concussion or their sequelae. Yet, to date, this call to action has not resonated among the teams, the league, or even players.

And let us not restrict our thinking to the NFL or even football – think about college and yes, even think about high school athletes participating in soccer, ice hockey, lacrosse and any sport in which an athlete could hit their head. The fact is that genetic testing, baseline cognitive testing, and rigorous longitudinal assessment are the primary research tools we have. And of these, genetic testing may well prove to be crucial for arming athletes and those around them with information about possible risks associated with playing. But if athletes are not tested, then by definition this important information will never be available.

Genetic testing of athletes must be deployed in many studies of various cohorts of athletes in a variety of sports. Responsible studies must start now, around the country and around the world.

Athleticode was founded on the premise that genetic information can be used as one of many important tools to help athletes reduce injury. Of the key members of Athleticode management, four of us are former NFL players. Like other former and current NFL players, we suffered many concussions among us. We endured weeks of double sessions characterized by day after day of splitting headaches, yet played on. We played through the dizziness of big hits, doing everything possible to minimize our symptoms of head trauma to stay on the field of competition.

We talked about these times at a recent all-hands meeting, and we decided to do our part to set the stage for a better day for all athletes who might experience head trauma.


Today we call on both the NFL and NFLPA to join us in advocating for genetic research on not only APOE but other as yet undiscovered genes that may be implicated in susceptibility to and response to not only concussion, but also repeated sub-concussive blows.

Immediate action is required, and we will act. Effective immediately:

  • Athleticode’s Athlete Report will now provide customers who sign up for APOE testing with information regarding their APOE Code and actionable advice to reduce the incidence of sport-associated head trauma and its possible consequences.
  • Athleticode is developing comprehensive plans to offer research testing, at a discounted price, of APOE and other gene codes previously implicated in response to concussion, in order to create a database of NFL Players – past and present – to serve as a resource to all academic institutions seeking to conduct longitudinal studies of the role of genetics in influencing player health and outcomes.
  • Athleticode will establish a network of interdisciplinary academic and business collaborators to enhance the understanding of the basic mechanisms of head injury and injury response, and to speed the development of new technologies and approaches to identifying, preventing and treating the consequences of repetitive head injuries.
  • Athleticode will make a donation from the proceeds of every Athlete Report sold to the general public to support neurologists and other professionals conducting systematic cognitive testing on athletes in order to help these athletes establish a cognitive ‘baseline’ that can be measured over time.
  • Athleticode will publish information on ‘actionable’ steps athletes can take to improve brain health, including those related to pre-habilitation exercises, diet and other decisions controlled by the athlete.

Athleticode is committed to working with you, the athletes, to provide you with the latest information in an area of sports science that is moving fast, but that is of critical importance for identifying – and protecting – athletes at greatest risk of injury.

As former players, our motivation is to assist young athletes by serving as a resource of the most valuable asset that can be currently offered – Knowledge. In sport concussion, knowledge is an actionable end – truly in these times, knowledge is power.

Join the team – contact Athleticode today to lend your voice to this effort.

Best regards,

Athleticode Inc. Co-Founders

Jim Kovach | Pete Koch | Hoby Brenner

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NFL Players and Risk of Brain Injury

This is an excellent article that speaks clearly about the inherent risk of brain injury to NFL players. PK

The NFL’S Concussion Policy Requires gibberish Translation (i.e. Attorneys) by Spencer Hall

That’s a pair of engineers climbing a radio tower 1700 feet into the air without any constant safety measures, something allowed by OSHA, the agency responsible for regulating work safety in this country. The reasoning: safety measures would slow down the job unnecessarily, and as long workers and employers are okay with this, men will continue to be paid to climb radio towers with nothing between them and death by gravitational force.

The NFL functions similarly.

Star-divide

If you play in the NFL, there are no illusions about the conception of risk in the general sense. You may not sue the NFL for a broken leg, because it was you out there running around with Bernard Pollard, and Bernard Pollard does what he does. Sometimes that includes breaking legs, or arms, or however else he can maim the main across from him. You knew that when you got in the cage with the tiger, sir: the mauling is really just instinct enabled by design.

So let’s accept a certain amount of danger associated with playing football. It is not the only dangerous job, and it is certainly not the only one that does not want OSHA or any other outside authority regulating what goes on between employer and employed.  The only time this happens is when one side refuses to recognize the terms of reality, which is unfortunately rather common. (Hint: see rest of article.)

If you want the human, emotional, and disturbing side of the NFL’s continuing stonewalling re: concussions and their nasty aftereffects, Hashiell Dammit has it here. The chief takeaway for a fan of football at any level is that you have to assume a modicum of responsibility for fueling the bloodsport in front of you. It’s a transaction: your interest fuels the game, and your culpability is balanced by the players acceptance of risk and their high salaries. This is not a case of a chicken factory worker mangled by a malfunctioning deboning machine: this is football, and like a hundred other dangerous jobs it requires a certain acceptance of risk.

The definition of that risk, though, must change with sane work practices. Window washing is dangerous, but acknowledging that doesn’t negate the need for a safety belt, or to deny that the wind exists as a factor in the danger. This is what the NFL has in fact done towards the issue of concussions, first denying it, then acknowledging they exist but hiring two doctors whose opinions stood in stark disagreement with the weight of majority medical opinion. In short: no lasting effects, no damage, and thus no disability. Science!

[/lawsuit goes POOF!]

[/adjourn to lunch at steakhouse]

(Find the simplest answer here : either these two men were unrecognized geniuses, or they were chosen because their opinions aligned with the legally convenient path of least effort for the NFL. It’s probably the latter, but if you like to make your logic sweat under the burden of proof, you go right ahead and do that.)

The UFC’s concussion policy in the state of Nevada for a concussion is 45 days out of competition. Please note the date on that linked article: 2007, three years ago now. The UFCstill has better concussion protocols than the NFL does (mostly because it has to under Nevada law.) This is from the Department of Redundancy and Redundancies, but the entity in question here is the NFL, which is a corporation, loyal only to its shareholders in its decisions. They don’t act morally or responsibly, and you shouldn’t be surprised or shocked by that since by definition is what they do.

They can be influenced to to the right thing the hard way: by costing them money, something shareholders tend to frown upon in a corporate setting. Concussions exist; they are mismanaged at the team level on a weekly basis; this behavior bleeds down into the college level and beyond as a matter of practice; their effects are long-lasting, pernicious, and can result in personality change, chronic pain, depression, and a possible correlation with suicidal behavior.

The science is there, and the litigation will follow, since litigation is the only stimulus a corporation will respond to besides anything denting the bottom line. No one would point to a broken rib sticking from a player’s torso and deny it was a.) there, and b.) potentially affecting his future health. Yet this is what the NFL is doing with concussions now, and enough lawyering up along the way will undoubtedly help change this. Curse them all you like, but when the opposition starts speaking jibberish, you need someone who can argue in their language. (And nothing says gibberish more than the NFL’s current policies and practices re: concussions.)

The Man Who Protects the Worlds Wealthiest Athletes

Meet my former teammate, dear friend  and one of the most powerful men in the NFL, MLB and NBA  that you have never heard of – “Big Daddy” Rich Salgado. In this expose you will meet the man who protects the men who make millions as our nations elite professional athletes. Notably Big Daddy’s story is chronicled by former North Carolina All-American volleyball player cum journalist Kelly Davies. PK

Interview with a Sports Professional: Richard “Big Daddy” Salgado

by Kelly Davies 09-28-2010

“All I want to do is make pizza.”

Not the phrase you’d expect to hear out of the mouth of a respected life insurance provider to some of America’s best athletes.

“You know I joke around and say that I’m the owner of a pizza shop and all I want to do is make pizza. I don’t want to be a player as a financial advisor. I don’t want to be their accountant. I don’t want to be their concierge. I don’t want to do those things. I want to do my job and I ask everyone else to do theirs and I’ll do mine.”

Richard “Big Daddy” Salgado is onto something. He is where he is because he’s been in and around the NFL for fifteen years. Currently, as the president of Coastal Advisors LLC, an insurance consulting firm for high net worth individuals, professionals, and athletes, “Big Daddy” is a well-known name on the sidelines and in the locker room.

When I spoke to him, he was heading out to the Hamptons for some R&R. He was returning from a meeting up at Syracuse University with client and Head Football Coach Doug Marrone. He’d been at the NHL Draft a few weeks prior. He was gearing up for a trip to the west coast for MLB All-Star Weekend and the ESPY Awards. This guy is everywhere, but that is what makes him so visible, so available to athletes who may not even think about insuring their livelihoods.

“Guys look at you like you’re crazy. They say, ‘I’m not going to die!’ So most people ask me first thing, ‘What do you do?’ when they see me around all the time. And then ‘Ok, who do you do it with? And why do you do it?’ And then I usually get a current client to speak to them and they explain to them why I’m the best at what I do.”

Simple? Hardly. “Big Daddy”, who was given his nickname by a former college teammate, has developed a solid network of high-profile current and former athletes as clients. Names like Michael Strahan, a man he speaks fondly of as a friend and a role model, as well as Reggie Bush, Larry Fitzgerald, Jeremy Shockey, Randy Moss, and Brian Griese.

“I’ve been doing this for 15 years. I’ve slept at stadiums. I’ve done everything from carrying laundry bags to getting guys restaurant reservations and car deals that their own agents couldn’t do. They would come to me. The credibility came from me starting on the ground and now I’m up at the… umm… I’m not at the penthouse… I’ll never be at the penthouse.  I’m still a foot soldier regardless because of the traveling that I do and everything. But I would say that the guys that are successful are the guys that are honest and just do the right job.”

Successful? Absolutely.

Salgado is moving into the world of Hollywood with a few producers interested in his services. He currently insures musicians, a skateboarder, and even his neighborhood’s mailman. But I wanted to know how the process works in the professional sports world.

“It works in two facets: you have college kids that are in their junior and senior year who want to protect their future earnings. We set up a career-ending policy and protect them for the draft process. Therefore, they can go to sleep at night knowing that if God forbid something were to happen – if they got hurt, if their opportunity to be drafted would be gone – they could still be financially secure. The other is when they become a pro. We sit down and insure what they currently have on the contract and discuss life insurance.”

“Big Daddy” is living proof that life is far too valuable to take for granted. Two years ago, Salgado suffered a brain aneurysm that his doctors fortunately caught and removed. A nineteen-inch scar across his head remains as a daily reminder that what we’ve got is so precious.

“But that is one thing that a lot of kids don’t like to talk about,” says Salgado. “No one likes to talk about dying. That’s always the biggest thing. You’ve been told you are healthy and they are not worried about not being healthy.”

Reality is written on his forehead.

“Life is real and anything can happen to anybody. That is the one thing that I tell guys all the time. If you don’t believe what I’m telling you, then just look at the top of my forehead because it is noticeable and people see it all the time. I’m a guy that right now is never insurable for the rest of my life and thank God that I have the insurance that I had in place. How do we protect you? Those are honest straight up issues. I’m living proof of it everyday and I show it to guys everyday.”

“Big Daddy” grew up on Long Island, NY and played football at the University of Maryland. It’s clear that Salgado has always been interested in taking care of people. Living in Pittsburgh after college, he stepped up in a huge way to help out his Terrapin college roommate and the then quarterback for the Steelers, Neil O’Donnell.

“I moved to New Jersey to take care of Neil’s father who suffered a severe stroke. They needed someone to move him, most importantly, because he was a big guy. So, I went home to take care of Neil’s father while Neil played football. I became Mr. O’Donnell’s physical therapist, valet, etc.”

He’s a specialist now. He’ll demand that you let him do his job… for the long haul.

“I am there with the client for life,” Salgado told Access Athletes. “Whereas, the agent isn’t going to be there with you if you can’t play, and the financial advisor is only going to be with you as long as you have money with him. But the insurance policy is something that we have forever. That is the difference between what we do and what all those other professionals do.”

He’ll tell you to call him or reach out via email. He’s inordinately easy to talk to for a man who has earned a nickname with the word “Big” in it.

“That’s why some people are threatened by me because my strength is relationships.”

With a TV deal in the works, “Big Daddy” has no intentions of slowing down. He just knows what he is good at and keeps that his priority.

“That is what I think is successful. When you get a guy who wants to control everything and be the all-in-all to the athlete, well what if that guy makes a mistake and he is doing everything for you? What does he do? Does he fire himself? That is as easy and sensible as you can get. Keep it easy. I keep it easy and I keep it real.“


Do Impressive Workouts Translate to Kicking Butt on the Field …?

I think of myself as more of a ‘jack-of-all-trades” when it comes to Athlete Performance training, corrective exercise, fat loss, strength development … there I go again, rattling off categories of exercise … That fact is I’m curious about nearly everything (undoubtedly due to my ADD which is another story) which has me constantly investigating which are the best methodologies for developing athletic performance? Along this line of thought; his site is tremendous http://www.athleticdevelopmentblog.com/ and the men that write it; Joe Bonyia and Renato Grammatica are outstanding yet I wonder exactly how beneficial it is for athletes to spend valuable time and energy performing plyometrics, etc drills? Does linebacker Ray Lewis do them? Does the best NFL linemen Jake Long or the best receivers Andre Johnson and Anquan Bolden do them? Are they necessary to optimize performance?  PK

Redirecting Plyo Progressions by Joe Bonyia and Renato Grammatica

Continuing the theme of Speed Training with No Space, this post will disclose our stance on plyometric training. Plyos are a critical piece in our programs, but only a piece. Within a training session we will spend about 15 minutes jumping and about 45 or more minutes strength training. Our primary focus is strength, but with limited space, the best way to transition improvements in strength to game performance is through plyometrics.

Plyometric drills improve a number of athletic and physiological capacities including multi-directional acceleration and deceleration by way of improved neuromuscular coordination and enhanced muscle-tendon mechanics and/or elasticity.  As long as the appropriate progression is selected, plyos can be used with any athlete from final stage rehabilitation and beyond. I don’t believe there is a critical, minimal level of strength an athlete needs to achieve before they are able to participate in plyo exercises. Kids jump out of trees, play hopscotch and leap frog with very little “strength”; however, an increase in body size will make plyos more stressful. Again, intelligent loading parameters through direction, height, distance, and ground contact time (response) should be used accordingly.

More importantly, when taught with a technical emphasis, multi-directional jumps, hops, and bounds improve athletes’ ground preparation or anticipation. The foot must contact the ground correctly for the body to have a fighting chance to decelerate safely, rapidly, and then re-accelerate in the desired direction without wasted steps or energy. Haphazardly preparing the body for ground contact can lead to ankle sprains, knee injuries, and generally inefficient movement leading to premature fatigue over the course of a game, practice, or conditioning session (a HUGE risk factor for injury).

The plyo-map is different for every athlete; stronger males who need to work on top end speed may spend more time with more reactive jumps, while a female high school soccer player may need to progress toward multi-directional drills for ACL injury prevention. My suggestion for most field and court sport athletes is to pair a jump, hop or bound with deceleration or stabilization emphasis and some type of lower amplitude (short distance, low height) reactive drill with a change-of-direction emphasis. Over the course of a program, the two types of drills will actually progress toward each other and converge into authentic multi-directional plyo drills.

In the video below I demonstrate different types of hops with most of the plyo-parameters I mentioned above. I also demonstrate some drills with a change of direction emphasis. I apologize for the length of some of the clips; I demonstrate some of the more technical drills a few times to provide evidence that I’m not attempting to become a Youtube hit, and that these drills are applicable for trained athletes with appropriate progression.

For more the most comprehensive presentation on the physiology and application of plyometric training, check out Nick Winkelman’s webinar on power development at SCWebinars.com. I also have a presentation there that covers my philosophy on multi-directional ground preparation.

JB

Hall of Fame quarterback Blanda dies at age 83

George Blanda

Blanda spent 26 seasons in the NFL as a quarterback and kicker

He spent 10 seasons with Chicago, seven with the Oilers and nine with the Raiders

Blanda was inducted into the Pro Football Hall of Fame on Aug. 1, 1981

ALAMEDA, Calif. (AP) — George Blanda, who played longer than anyone in pro football history and racked up the most points in a career that spanned four decades, mostly with the Chicago Bears and Oakland Raiders, died Monday. He was 83.

“We are deeply saddened by the passing of the great George Blanda,” the Raiders said Monday in confirming his death. “George was a brave Raider and a close personal friend of Raiders owner Al Davis.” The Pro Football Hall of Fame said on its website that Blanda died Monday after a brief illness.

Blanda retired a month shy of his 49th birthday before the 1976 season. He spent 10 seasons with the Bears, part of one with the Baltimore Colts, seven with the Houston Oilers and his final nine with the Raiders.

“Football lost one of it’s all-time greats,” Hall of Fame coach John Madden said. “He was the best competitor and clutchest player that I ever coached and I don’t know if there was anyone better that anyone else coached. George Blanda was a Hall of Famer in every way.”

Blanda held the pro scoring record when he retired, with 2,002 points. He kicked 335 field goals and 943 extra points, running for nine touchdowns and throwing for 236 more.

He also threw for 26,920 yards in his career and held the pro football record with 277 interceptions until Brett Favrepassed him in 2007. His points record stood until it was topped by several players in recent years.

“It certainly doesn’t bother me,” Blanda said about losing the scoring record. “The one record I was happy to get rid of was the one for the most interceptions, when Brett Favre got that one.”

A moment of silence was held in Blanda’s honor before Monday night’s Green Bay-Chicago game.

It was a five-game stretch for Oakland in 1970 that is the lasting imprint of his career. As a 43-year-old, Blanda led the Raiders to four wins and one tie with late touchdown passes or field goals.

Later that season, he became the oldest quarterback to play in a championship game, throwing two touchdown passes and kicking a field goal in Oakland’s 27-17 loss to Baltimore in the AFC title game. His performance that season earned him The Associated Press Male Athlete of the Year.

Blanda joined the Oilers of the new American Football League in 1960 and played 16 seasons before hanging it up for good following the 1975 campaign. He led the Oilers to the first two AFL titles, beating the Chargers for the championship following the 1960 and ’61 seasons.

He nearly won a third straight title when he led the Oilers back from a 17-0 halftime deficit to the Dallas Texans in the 1962 title game before losing in double overtime.

“George Blanda will always be remembered as a legend of our game,” NFL Commissioner Roger Goodell said in a statement, “including his amazing career longevity of 26 seasons in four different decades. George’s multi-talented flair for the dramatic highlighted the excitement of pro football during an important period of growth for our sport.”

Blanda began his memorable run in 1970 by throwing three touchdown passes in place of an injured Daryle Lamonica in a 31-14 win over Pittsburgh on Oct. 25. The following week he kicked a 48-yard field goal in the final seconds to give the Raiders a 17-17 tie against Kansas City.

Blanda was just getting started. He threw a tying touchdown pass with 1:34 remaining and then kicked the game-winning 52-yard field goal in the final seconds the following week in a 23-20 win over Cleveland.

He followed that with a 20-yard TD pass to Fred Biletnikoff in place of Lamonica in a 24-19 victory over Denver the next week, then kicked a 16-yard field goal in the closing seconds to beat San Diego 20-17 on Nov. 22.

“The game that I remember the most was playing against Cleveland in 1970,” he once said. “We were down 20-13 and I came in and we got a touchdown and then we got a field goal in the last three seconds.”

Blanda entered the NFL out of Kentucky as a 12th-round pick (119th overall) of the Chicago Bears in 1949. He spent most of the next decade with the Bears, leaving to play one game for the Colts in 1950. After winning the Bears starting job in 1953, Blanda promptly lost it the following season because of injury. His playing time at quarterback quickly diminished and he retired in 1959 at age 31 when Chicago planned to make him a full-time kicker. It was a short-lived break because he then joined the AFL’s Oilers the next season.

Blanda was one of the new league’s many prolific passers, throwing for 19,149 yards and 165 touchdowns in seven seasons for the Oilers. He was the AFL Player of the Year in 1961, holds AFL single-game passing record of 464 yards on Oct. 29, 1961, against Buffalo, and was chosen the league’s all-time kicker.

“We did all the strategy right on the field,” he once said. “Today, the coaches call all the plays, so all the quarterbacks have to do is perform. They are more or less programmed.”

Oilers owner Bud Adams said Blanda’s flair was a reason the AFL attracted so much attention.

“He was the perfect fit for the start of the AFL, joining our league from the NFL and displaying the ability to lead a high flying offense,” Adams said in a statement. “His play garnered our league a lot of attention and fans. We had a celebration last year in Houston for the 1960 and 1961 AFL championship seasons and the team hall of fame members and it was great to have George join us and remember fondly those early years.”

In 1967, the Oilers thought Blanda was at the end of his career, but the Raiders picked him up as a backup quarterback and kicker and he lasted nine more seasons.

“A seemingly ageless wonder, George inspired legions of fans over a 26-year career, with his clutch performances as a quarterback and place kicker. He will be truly missed,” said Steve Perry, executive director of the Pro Football Hall of Fame.

Three Great Tips on Getting Your Food Right!

What I Think …

“Only the curious will learn and only the resolute overcome the obstacles to learning. The quest quotient has always excited me more than the intelligence quotient.” ~Eugene S. Wilson
Strength. Strength of Mind, Body and Soul. I see a society that has become a spectator, rather than a participant in the development of these fundamental area’s of Personal Excellence. Today I am sharing a video that will inspire you (I sincerely hope) to dig deep and commit yourself to your training. Note that this video does not feature an NFL or Olympic athlete but rather a young woman whose strength, technique and obvious commitment to personal excellence is obvious. Thanks to Bret Contreras for posting this video of  Kellie Davis this on his outstanding Blog.