head injury

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Is There A Lesson About Treadmills In Sandberg Spouse Death? Yes: Keep Exercising

(MilitaryHealth/Flickr)

(MilitaryHealth/Flickr)

In this 2013 file photo, Sheryl Sandberg, COO of Facebook, and her husband David Goldberg, CEO of SurveyMonkey, walk to a conference in Sun Valley, Idaho. (Rick Bowmer/AP)

In this 2013 file photo, Sheryl Sandberg, COO of Facebook, and her husband David Goldberg, CEO of SurveyMonkey, walk to a conference in Sun Valley, Idaho. (Rick Bowmer/AP)

The subject line of an email I got last night didn’t mince words: “Exercise can kill you.”

Not exactly the conclusion I’d draw from the tragic death of Sheryl Sandberg’s husband, Dave Goldberg, who is reported to have died of head trauma and blood loss after falling off a treadmill while on vacation in Mexico.

Not surprisingly, the flukish, apparently accidental death of a high-profile spouse led to predictable follow-up stories on the dangers of exercising on treadmills.

From Quartz, under the headline, “After Dave Goldberg’s tragic death, it’s worth a reminder: Treadmills are dangerous:”

Treadmills are notorious for causing accidents—occasionally fatal ones. The machines’ powerful motors and fast-moving belts can punish any momentary loss of balance with bruises, sprains, broken bones, friction burns, or worse. Distractions like watching TV or reading while running increase the likelihood of an injury.

The Washington Post reports on the “risks of treadmills in the era of smart phones:”

But his freakish accident actually isn’t that rare. Every year, tens of thousands of Americans are injured on treadmills. Thousands are taken to the emergency room. A handful die.

Data suggests that the problem is getting worse. As high-tech, high-powered treadmills proliferate, so, too, do the digital distractions that make the machines even more dangerous…

“Almost 460,000 people were sent to the hospital in 2012 for injuries related to exercise equipment,” according to USA Today. “The vast majority—nearly 428,000 were treated and released for their injuries—but about 32,000 were hospitalized or were dead on arrival.”

Treadmills account for the majority of such exercise equipment injuries, Graves told The Washington Post in a phone interview. In a study of 1,782 injury reports from 2007-2011, she found that “treadmill machines comprise 66% of injuries, but constitute approximately only 1/4 the market share of such equipment.

But wait, a reality check, please. Stuff happens. Unpredictable, tragic, life-altering stuff. And we, the survivors, need to keep steady and continue to care for ourselves and for those we love. And that includes exercise.

I asked Dr. Eddie Phillips, director of the Institute of Lifestyle Medicine and an assistant professor of Physical Medicine and Rehabilitation at Harvard Medical School, for his take, and he offered this perspective:

Despite the tragic and paradoxical death of a high profile individual exercising on a treadmill to improve his health we must not lose site of the overwhelming evidence of the benefits of increased physical activity for everyone. Treadmill accidents are rare compared to the pandemic of preventable disease and death from physical inactivity in the majority of the population. Avoiding exercise and remaining sedentary ensures universal increased risks of diseases like diabetes and heart disease as well as premature death and increased health care costs. Continue reading

A Boxer’s Brain And The Evolution Of Sports-Related Head Injuries

(don's athletics/Flickr)

(don’s athletics/Flickr)

(This post originally appeared on Boston University’s Research News website as “Head Examiner: Neurologist Ann McKee Talks About Battered Brains, Tangled Tau, And The Future of Sports“)

By Barbara Moran

For Ann McKee, every brain tells a story. And sometimes it’s a tragic one. McKee, a professor of neurology and pathology at the Boston University School of Medicine (MED), is the director of neuropathology for the Veterans Affairs New England Healthcare System, and also directs BU’s Chronic Traumatic Encephalopathy Center. Chronic traumatic encephalopathy (CTE) is a degenerative brain disease found in athletes with a history of repetitive brain trauma. McKee first identified its telltale mark—tiny tangles of a protein called tau, clustered around blood vessels—in the dissected brain of a boxer who had been diagnosed with Alzheimer’s disease.

Although most people associate CTE with professional football players, McKee has found it in the brains of soccer, hockey, rugby, and baseball players as well. Her research has alerted the public to the long-term dangers of repetitive hits in sports and raised tough questions about safety. McKee was invited to speak about this growing public health concern at the annual meeting of the American Association for the Advancement of Science (AAAS), the world’s largest general scientific society, held in February 2015 in San Jose, CA. She told BU Research the story behind her discovery of CTE, and what it might mean for the future of sports.

BU Research: You’re a world expert on tau protein, which has been implicated in Alzheimer’s, CTE, and other brain diseases. Have you studied tau your whole career?

McKee: Yes. I love tau.

Why?

It’s beautiful, the way it collects throughout the nervous system and just sort of fills up the nerve cell. It’s always been quite lovely to look at, visually captivating. I mean, how crazy is that? But it’s true.

When you started studying tau, you were studying Alzheimer’s?

I was interested in Alzheimer’s, but I also worked on PSP (progressive supernuclear palsy), and something called corticobasal degeneration.

Those are not so famous.

No, they’re not so famous. But I got very involved in defining what these individual diseases looked like. It’s like being at the Smithsonian and being really interested in one collection of pottery or something. And once you start understanding it, you start seeing all these differences, and it’s like “Whoa!”

Brains with CTE show a distinct pattern of tau protein, seen here in brown. The two slides on the bottom come from the brain of a 66-year-old ex-NFL player. The slides on top are from a 65-year-old man without CTE. Photo courtesy of Ann McKee

Do you remember the first time you saw a brain with CTE?

Yes. It was phenomenally interesting. The first case was Paul Pender, a professional [middleweight] boxer here in the Boston area. He had twice been world champion. That was my first time seeing it under the microscope. I looked at the slide and it was like “Oh my God! This is so amazing. I’ve never seen anything like this.” It just blew my mind. That was 2003.

How did it look different than, say, a brain with Alzheimer’s?

Alzheimer’s disease has these beta amyloid plaques that look like small puffs of smoke throughout the brain. Continue reading

Study: Head-Blows In Single Sports Season May Impact Brain Health, Test Scores

When it comes to potential head injuries, I’m feeling pretty good about my daughters’ sports choices these days: Taekwondo, track, yoga, African dance.

Of course, injuries — head and otherwise — can occur anytime, anywhere. But I have to say, with the wave of new data emerging about the the scary long-term effects of repeated head blows, I’m pleased that they have, so far, shown no interest in hardcore contact sports like football or ice hockey, where head injuries are more common.

But I probably shouldn’t be feeling so puffed-up on this issue quite yet: even sports not typically associated with repeated head bonks are being reevaluated. (See, also: cheerleading.)

One local grandmother told me how concerned she is about her 11-year-old grandson, a soccer fanatic who dreams of playing professionally, and has already had a concussion and other injuries. “He tells me how much he loves soccer,” the grandmother says. “And when I asked him, ‘What about the injuries?’ he says, ‘Oh, that’s just part of the game.’ This certainly takes some of the joy out of watching him play. I’m very worried about what all this is doing to his brain.”

And a Newton mom, who had steered her son away from football and hockey, now has new worries: her 9-year-old just got a concussion skiing. “I think we’ll continue to let him ski, but we just hope he’ll be smarter, more aware — we tell him ‘It’s your head!’ Maybe we should have him wear a helmet all the time.”

The latest study by researchers at Dartmouth published online in the journal Neurology focused on the most notorious contact sports, but found that even one short season of play may change the brain in ways that negatively impact learning, memory and cognition.

Here’s more from the news release:

New research suggests that even in the absence of a concussion, blows to the head during a single season of football or ice hockey may affect the brain’s white matter and cognition, or memory and thinking abilities. The study is published in the December 11, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology. White matter is brain tissue that plays an important role in the speed of nerve signals.

“We found differences in the white matter of the brain in these college contact sport athletes compared to non-contact sport varsity athletes,” said study author Thomas W. McAllister, MD, of Indiana University School of Medicine in Indianapolis. “The degree of white matter change in the contact sport athletes was greater in those who performed more poorly than expected on tests of memory and learning, suggesting a possible link in some athletes between how hard/often they are hit, white matter changes, and cognition, or memory and thinking abilities.”

The work was completed while McAllister was with the Geisel School of Medicine at Dartmouth in Hanover, NH.

The study involved 80 concussion-free Division I NCAA Dartmouth College varsity football and ice hockey players who wore helmets that recorded the acceleration-time of the head following impact. They were compared to 79 non-contact sport athletes in activities such as track, crew and Nordic skiing. The players were assessed before and shortly after the season with brain scans and learning and memory tests. Continue reading

Don’t Be A Bicycling Statistic: One Key Way To Stay Safer

Tanya Connolly, 37, crushed under a tractor-trailer in South Boston last Monday. Doan Bui, 63, killed by a speeding pickup truck on a busy Dorchester thoroughfare the Friday before. Alexander Motsenigos, 41, victim of a hit-and-run in surburban Wellesley late last month.

In major metropolitan areas like Boston, it often seems as if every week brings news of another bicycling death — or, as in this past week, more than one — usually in an unequal clash between vehicle and rider. Biking experts say that as more people take to two-wheel travel — surely a good thing — more accidents are also likely. Below, writer David C. Holzman describes his own bike crash, and shares a key safety technique that many riders ignore: Helmets save lives, but they have to be worn right.

By David C. Holzman
Guest contributor

The treetops seemed far away, as if through the wrong end of a telescope. They were all green, leafy, and dreamlike — like my memory of Seattle before I moved away at age eight.

The dream quickly soured as it began to dawn on me that I might have had a bicycle crash. But that didn’t make sense. Even in my stupor, I remembered that I was a very experienced cyclist, and very safety-conscious.

I began trying to wake myself up, as I’d done so easily in the lucid dreams of my early childhood. But it wasn’t working, and I couldn’t even shift the scene. Shock was cushioning me, like emotional Novocaine; nonetheless, I could feel the fear growing ominously more perceptible.

“When you are hit by a car, if your helmet can move, it will.’
Now I saw two women standing over me. “Am I dreaming?” I asked, fully expecting I was. (I had to be. Crashes didn’t happen to me.) “No, honey, you not dreaming,” one of them said in a dialect common in northeast Washington, DC.

I took five or ten seconds to grasp that I really was lying on my back in the street, and not in a bad dream. Once I did, I thanked the women “for watching over me,” actually thinking that they had come to protect me, the feelings of gratitude washing over me like an ocean wave on a beach.

Then one of them asked me for two dollars. Heretofore, I hadn’t moved a voluntary muscle outside of those involved in speech, but now, almost as if her voice was a hotline to my motor cortex, I pulled my wallet from my pocket, opened it, found a twenty and two ones, and gave her the latter. Had she asked for the twenty, I probably would have given that to her.

Memorial for a bicycle crash victim in Cambridge (Rachel Zimmerman)

Memorial for a bicycle crash victim in Cambridge (Rachel Zimmerman)

Soon the women had disappeared, and a crowd gathered. I asked someone where I was. I was able to trace the route in my mind from my home, at 1200 Jackson St. North East, two miles to Rhode Island Avenue and First Street North West, but I still didn’t know where I had been going, or even whether I still worked at Insight Magazine, or whether I had been laid off, an event which had occurred four and a half months earlier.

Then someone informed me that my face was “all messed up.” I don’t understand why, but suddenly my head was much clearer, and I knew I would be fine.

I looked at my watch. It was 8:20 a.m. on September 6, 1991. I realized I’d been on my way to the doctor’s office, for an annual checkup. I’d crashed about 10 minutes earlier. I’d have to reschedule the appointment.

The guy who told me my face was messed up was partially correct. As my then-four-year-old niece, Beth, said with obvious bemusement when she first saw me the next day, “Uncle David, you need to wash your face!”

I’d been going around 15 to 18 mph when I hit a large bump in the road that I hadn’t seen, wrenching the handlebars out of my hands. That’s the last thing I remember. Despite the tight chin straps, the force of the crash on my helmet had pushed it so far askew that my cheekbone had kissed the pavement, acquiring an impressive bruise, and a laceration which I think had to be taped shut. Luckily the straps had been tight enough to keep my helmet on my skull, or I probably would not be writing this warning.

So I’ve been appalled to see air between the chin straps of helmets and the chins of about one third of the cyclists on the Minuteman Trail, where I run or ride my bicycle just about every day. Chin straps on helmets should be snug, like one’s shoe laces. Continue reading