Learning the hard way about protecting the brains of athletes

Former boxing champion Emile Griffith recently passed away at the age of 75.  He died while living in a nursing facility where he required full personal care.  He suffered from dementia pugilistica.

Dr. Harrison Martland first described “dementia pugilistica “ (boxer’s dementia) in 1928 while working as a forensic pathologist in Newark, NJ.  He reported consistent changes in the brains of fighters on whom he had performed autopsies.

Now known as Chronic Traumatic Encephalopathy (CTE) this form of dementia is accompanied by disorders of movement similar to Parkinson’s disease as well as dramatic changes in personality.

CTE is not restricted to combat sports like boxing and MMA but is also seen in participants of high velocity collision sports like football and hockey.  Repeated blows to the head will alter the function of the complex network that allows for normal neurological function.

Neurologic research has now centered on trying to determine why some athletes will develop CTE and others will not.  Imaging studies of the brain and genetic testing have thus far failed to provide a reliable screening tool for athletes.

Studies have shown that young, developing brains are more vulnerable to traumatic injury from concussive blows. These injuries can result in chronic headaches and learning disabilities if they are not managed properly.

The most important approach to treatment is removing the athlete from an athletic contest to avoid further injury.  A period of rest that includes avoiding reading, computer work and texting allows the brain to recover.

On Aug.  8, Backus will host an educational session for parents, coaches and officials involved in youth sports events.  Anyone interested in participating should contact Backus Hospital at 860-889-8331, ext. 4211 for details. 

The single most effective way of dealing with this potentially disabling problem is through education.

Ultrasound technology growing in sports medicine

The use of ultrasonic sound waves to produce images of structures deep within the human body is very common. Applying this technology to the diagnosis and treatment of sports injuries is gaining popularity.

On my most recent trip to Haiti, I was asked to participate in a series of lectures sponsored by the American Medical Society for Sports Medicine for the Haitian Olympic Federation.  Among the other faculty members was Dr. Thomas Trojian, a primary care sports medicine specialist and associate professor at the University of Connecticut. 

Dr. Trojian finds ultrasound to be an important part of his practice.  “Ultrasound is an emerging imaging study that provides a new dimension to the physical examination of athletes,” said Trojian.

The science of acoustics has fascinated scientists since ancient times.  Over the past 60 years, ultrasound has gained popularity in medical imaging.

Ultrasound can provide increasingly detailed studies of soft tissue within the human body.  In utero, pictures of fetuses have become so refined that they allow physicians to perform corrective procedures at this early stage of life.

In sports, ultrasound produces dynamic images of tendons and muscles as a limb or appendage is moving.  This is a distinct advantage over the static (non-moving) images seen in X-ray, CT or MRI.

In sports, these images can specifically demonstrate tears, inflammatory changes or bleeding within muscles and tendons.  One great advantage is that ultrasound does not expose the patient to radiation therefore making it safe to use in young athletes.

Most recently, ultrasound is being used to guide the placement of therapeutic injections to areas of injury resulting in pain relief and rapid healing.

Ultrasound provides a safe office-based technology to get injured athletes at any level back to their sport sooner. 

Time to rethink how to protect young pitchers

Among the most dreaded scenes to witness in sports is a baseball player, coach or fan being struck in the head by a line drive.  The damage that results from being struck by a ball coming off a bat can be very serious and even deadly.

Recently, baseball fans witnessed two pitchers, J. A. Happ and Alex Cobb being struck in the head by line drives.  To many, it was the sound of the ball striking the skull that was most upsetting.

One of the most severe injuries happened last September when Brandon McCarthy, a pitcher for the Oakland A’s, was struck in the head by a line drive that resulted in a fractured skull and hemorrhage that required surgery.  This June he suffered a seizure while in a restaurant and currently requires anti-convulsive medications.

It is no secret that athletes have become bigger, stronger and faster.  While this is a big concern in high-velocity collision sports like football, it is also a factor in baseball.  A baseball typically leaves the wooden bat of a major league baseball player at approximately 100 miles per hour (faster with a metal bat).

The human skull is made of bone and is designed to protect the brain and the blood vessels that supply the brain.  A direct blow to the skull can result in fracture and tearing of these blood vessels. It may also cause a shearing of nerve cells with subsequent long-term symptoms of concussion including headache, dizziness, nausea and confusion.

The challenge at this time is how to protect the brains of pitchers at all levels of play.  The obvious answer is to have pitchers begin wearing helmets.  Many pitchers find this impractical, but newly available Kevlar and gel liners that fit into a standard baseball cap may be a partial solution.