Football season is almost upon us, and just in time comes this reminder of what athletic trainers need to be ready for as pre-season approaches. The New England Journal of Medicine recently published this correspondence piece online. It contains video of an actual C6 fracture in real time, and the article describes the events which took place during and after injury. You can see the axial load component take place; but what makes this most interesting is that it contains, what researchers believe to be for the first time, true data as it relates to forces imposed on an athlete during an actual cervical injury. Not to dramatize, but this is HUGE. This could potentially be a big step forward in the prevention of catastrophic cervical injuries. Many of us speculate, but this gives us some real data to sink our teeth into.
Hang on to your pocket protectors, this is going to get geeky...
The players helmet was equipped with a fascinating bit of technology known as the Head Impact Telemetry System (Simbex), which utilizes several accelerometers within the helmet that measures not only impact location, but magnitude as well. As I learned a month ago in New Orleans, in order to quantify this data, one must take into account both linear and rotational forces (think 3D movements; most collisions in sport don't involve just one plane of movement but several). As stated in the article, The Gadd Severity Index (GSI) and Head Injury Criteria (HIC) were used to help compile data. Now to break it down. The GSI is a standard that can help predict a helmet's ability to accept and quickly decrease forces upon impact, which can then help protect the brain. HIC looks more at head acceleration, and duration of the acceleration, also very important when examining potential injuries, or in this case actual injury. Of interesting note, acceptable GSI values during helmet testing are 1200 for football helmets and 1500 for lacrosse helmets, noted in this study on lacrosse helmets (a great article I use in class each semester). You'll notice that the levels reported in this specific athlete that the values were well below those levels.
It's good to know that this athlete was cleared to play basketball after a period of recovery. For you students out there, please take note that this athlete suffered BOTH a concussion and a cervical fracture, truly reiterating the fact that you must examine/rule out both on the field. A concussion is a serious and potentially catastrophic injury, and a cervical fracture must always be initially managed as a catastrophic injury in terms of emergency management. His Borg pain scale values were between 3 and 5, which some might incorrectly assume to be higher with such an injury. It is a good clinical reminder for us to not rely solely on one evaluative finding, but the combination of several when making clinical decisions.
Hang on to your pocket protectors, this is going to get geeky...
The players helmet was equipped with a fascinating bit of technology known as the Head Impact Telemetry System (Simbex), which utilizes several accelerometers within the helmet that measures not only impact location, but magnitude as well. As I learned a month ago in New Orleans, in order to quantify this data, one must take into account both linear and rotational forces (think 3D movements; most collisions in sport don't involve just one plane of movement but several). As stated in the article, The Gadd Severity Index (GSI) and Head Injury Criteria (HIC) were used to help compile data. Now to break it down. The GSI is a standard that can help predict a helmet's ability to accept and quickly decrease forces upon impact, which can then help protect the brain. HIC looks more at head acceleration, and duration of the acceleration, also very important when examining potential injuries, or in this case actual injury. Of interesting note, acceptable GSI values during helmet testing are 1200 for football helmets and 1500 for lacrosse helmets, noted in this study on lacrosse helmets (a great article I use in class each semester). You'll notice that the levels reported in this specific athlete that the values were well below those levels.
It's good to know that this athlete was cleared to play basketball after a period of recovery. For you students out there, please take note that this athlete suffered BOTH a concussion and a cervical fracture, truly reiterating the fact that you must examine/rule out both on the field. A concussion is a serious and potentially catastrophic injury, and a cervical fracture must always be initially managed as a catastrophic injury in terms of emergency management. His Borg pain scale values were between 3 and 5, which some might incorrectly assume to be higher with such an injury. It is a good clinical reminder for us to not rely solely on one evaluative finding, but the combination of several when making clinical decisions.
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