Concussion in Sport

Leave a comment October 21, 2014 drworobec

I recently attended a conference on concussion management and I learned a lot. No, make that a LOT lot. Concussion research has progressed dramatically since I graduated eight years ago, and there’s a void in proper concussion management amongst the sports medicine community. The conference I attended is hoping to change that.

Let me change your thinking for a minute. You’ve likely been told that a concussion is a coup/contracoup injury, meaning the brain bounces against the front of the skull, then the back of the skull, creating an injury. Research shows that is not the case. In fact, a concussion is actually a stretch/sheer injury of the brain’s white matter (the neuron’s axons), causing biochemical changes within the brain cell. That’s why most concussions show no brain damage on CT or MRI. Concussions are a temporary, recoverable injury. Hmmmm…..

Here’s the thing with concussions. They’re under-reported because players do not want to be taken out of the game.

Here’s the other thing: the brain’s most vulnerable period is in the time period immediately following a concussion, so not pulling a player from the game and subsequently providing a thorough return-to-play protocol is dangerous. In fact, the research suggests that there is no cumulative effect of concussions, so long as the player has completely recovered from the initial concussion (Eckner et al., 2011).

So how do we safely manage concussion in sport?

Well, pre-injury baseline testing can certainly help. Since symptoms alone are a poor indicator of an athlete’s concussion healing, baseline testing allows us to measure many things (balance, reaction time, cognitive ability, memory, visual processing, capacity, etc) and compare the results post-concussion to a pre-injury ‘normal’ state.

Imagine this common scenario: a 13-year old gets concussed in a hockey game. Seven days later, they are feeling good and feel ready to return to the ice. The child is adamant- no headaches, no dizziness, no concentration problems. So how do we know they’re safe to return? Well, let’s see how their balance compares to their ‘normal’…. their reaction time…. their memory. Let’s make sure that we test several areas of brain function to be sure we’ve passed that dangerous vulnerable period (Lazzarino et al., 2012). Let’s be as sure as the latest research allows us to be.

In fact, it’s my hope that standardized baseline testing becomes mandatory for all children in all sport. It’s time.

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Burlington Sports & Spine Clinic is a part of the Complete Concussion Management network of clinics across Canada.
Give us a call to schedule your organization for baseline testing.

I Preach Movement

Leave a comment October 7, 2014 drworobec

***This post was originally written as a Guest Blog post for Momstown.ca.

This is my final post for Momstown, as I’m finding the time commitment to be too much when my personal blog is where my true passion lies. It’s been a great experience with a wonderful company and I’ve learned a lot about the world of blogging!***

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With a five-year-old and a two-year-old in my house about to embark on their respective SK and Nursery School starts, I’ve been thinking a lot about the ‘teacher role’ I’ve played in their lives to date. I’ve been fortunate to work part-time, and so I’ve been able to spend the vast majority of my daytime hours with their amazing little selves by my side.

I’ve thought back to the practical skills I’ve taught them: putting on coats, taking off shoes, washing hands. I’ve thought about the academics: colours, numbers, shapes. I’ve thought about the life skills: taking turns, using manners, saying hello. But if I had to choose one thing, just one thing, that I’m proud that they’ve learned from me, is that I’ve taught them to move.

They’ve learned that movement makes you strong. Movement makes you grow. Movement makes you confident, capable, and full of life. That movement makes you healthy. That movement is simply a part of life.

I practice what I preach, and I preach movement. They see me come home from the gym in the wee hours of the morning, tired and sweaty and happy. They see me huffing and puffing as I push them through the snowy streets in the running stroller. They see that we choose bikes rather than cars, exploring rather than TV, and playgrounds rather than movie theatres. They see movement not as a daily chore, not as a ‘physical activity requirement’, but rather as a normal part of every day.

Have you seen this phrase floating around?

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I couldn’t agree more.

Teach your kids to move.

Cozy and ready to go for a run.

Love the Snatch

2 Comments September 23, 2014 drworobec

Let me tell you about a girl named Jen Young. This girl goes to my gym. This girl is 30 years old. This girl also happens to have cervical cancer that has now metastasized to her liver.

September is Gynaecological Cancer Awareness Month, and with her September 27th fundraiser approaching (in the form of a Crossfit Master’s Competition at Burlington’s Crossfit Altitude), it seems only fitting to share her story. Here is a post she wrote on her blog only one year ago:

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I haven’t posted in long while. My spare time has been filled with my new part-time jobs coaching at CFA, and writing for Sweat RX magazine (getting paid to write has unfortunately trumped writing up recipes for free on the interwebs :). I am sad to say that it is not a tasty new dish that has me busting out my slightly rusty blog again; I decided to hijack my own recipe space to share en mass some recent news and subsequent reflections.

The News

On Sept 6 I found out that I have cervical cancer. I spent 10 very anxious days having no idea how bad it was or what was coming next and finally, yesterday, the results of some extra testing confirmed that it is a small cell neuro-endocrine tumor. This is a particularly nasty sort that normally lives in the lungs, apparently, and has a tendency to spread. It is also very rare. My Doctor is apparently somewhat of a Bigwig, and he and his Biggerwig colleague have seen only a dozen cases in their 20 years. However, I’ve caught it fairly early, and Bigwig assures me he has killed much larger beasts of its kind. I will kill it also. But it will come at the cost of several weeks of chemo (I start next week), then several weeks of radiation and probably major surgery, to make sure it doesn’t resurrect.

I don’t know if I will feel well enough to move, let along work out; some people are knocked on their asses, while others feel mostly fine, but I hope to visit CFA nevertheless as much as possible.

That’s the Readers Digest version. To those in my life, please don’t be shy about talking to me about it. I (probably) won’t burst into tears. Ladies especially, I’m very willing to talk about the details of discovery and diagnosis if you’re curious (men, don’t worry, I won’t start talking about the cervix here ;).

So onward to the philosophical part and the motivation for the title of this post.

The Ramblings

During those 10 days of waiting, and even today after learning the gory details, I find that I’ve actually surprised myself by not having a 24 hour meltdown. My cousin went through a similar ordeal ~5 years ago (also cervical cancer under the age of 30, coincidentally) and I distinctly remember thinking, “I don’t know how she’s so strong and positive, I would be a mess.” And when I first found out, I was a mess, for about 5 hours. But then, channeling my cousin, I gathered my composure and I went to my box to coach and to work out, because that’s what I’d planned to do, and I didn’t particularly feel like crying anymore.

It was a surreal experience, watching everyone around me carry on as though their world hadn’t just stopped spinning….because for them, it hadn’t. I have a new appreciation for this: you never know what’s going on in someone else’s life. Be kind, always.

I capped the very surreal day with a doozie of a WOD (100 burpees, interspersed with either 2 rope climbs or 5 deadlifts, every minute on the minute) that left me weeping (only half because of the rope climbs) in a heap on the floor.

I have had the occasional meltdown since then; last Sunday the frustration of 200 double-unders squeezed the emotion right out of me and I found myself sobbing in the back lot during the rest period. But these periods of stress and panic are far fewer than I had expected, which has lead me to conclude that CrossFit has made me far more capable of handling the Real Life unknown and unknowable than I ever imagined possible.

CrossFit, and especially competing in CrossFit, has trained me to accept what I can’t control. I don’t pick the daily WOD, I don’t influence who else shows up to compete, and I certainly can’t do much about their performance and eventual score. Fretting about what others are doing (or what has happened to other people with cancer) won’t help me to do better. Whining about a workout won’t change it, and no amount of moping is going to make my cancer disappear.

As I sat in my car in the parking lot after the first news, having a good cry and wondering how I would deal with what was to come, something Brit said once, ages ago, came sharply to mind. “You know,” she said, “if I lost a leg or something, I’d just go win the Paralympics instead.” She may have been joking, but it struck me as inadvertently profound life advice. More recently, I interviewed Stouty, an adaptive athlete and fantastic crossfitter, who lost the use of both legs and actually DID go win at the Paralympics.

I am entirely in charge of my own actions and attitude. I can’t control what the treatment will do to my body, but I can do my best to prepare it with good food and sleep, and I can manage my stress by staying as positive as possible.

I am approaching this cancer as I would approach a heavy bar; determined, ready, and convinced that it will go overhead, because I trust that I have trained sufficiently. I know that my body is in the best shape it’s ever been in, and I trust that crossfit and paleo have made my body as strong as it possibly can be.

I feel physically prepared to win this battle, but I also feel mentally prepared. This last 10 days has proven to me that even though “Murph” and “Fran” make me feel anxious over the pain I know is coming, I also know, without a doubt, that I will finish them, one way or another, and that you all will be there cheering until the very last rep.

I refuse to let this disease dictate my every waking moment. I will not let it take the joy from things I love to do, and the people I love to be with. CFA is my sanctuary; a place where I know that I can go and forget the world for an hour of shared pain and exhaustion, or find a hug if I need one. Thank you all for making CFA the place that has prepared me for this, and that I am confident will help me through it.

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Please come out to support a great cause on Saturday.