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ST. LAWRENCE COUNTY, N.Y. — Cincinnati Bengals running back Brian Leonard has been playing football his whole life and he knows firsthand how scary a concussion can be.

Leonard said, “In a daze, you’re kind of lost, you don’t know what’s going on and sometimes you see stars. It’s kind of a scary thing.”

In recent years, doctors have looked more closely at concussions and more research has brought to light how serious they can be. With one concussion an athlete can suffer memory loss, nausea and vomiting. With a second, the effects are worse.

Many states, including New York, have worked on passing laws when it comes to the injury, but one big obstacle: Many athletes don’t want to leave the game, regardless of how they feel.

Leonard said, “Trying to get past the trainers and stuff. They’re lying to the trainers and doing stuff to keep on the field.”

Canton Central junior Jay Proulx said, “Last year I thought I may have had one, but I went through it.”

According to the Centers for Disease Control, more than 100,000 school age children go to the emergency room each year for head injuries. While a concussion can’t be prevented, many schools across New York are doing what they can to educate their youth, and make sure they know how important it is to sit out.

Proulx said, “Have a concussion check list and if you have any symptoms, talk to the coaches and they’ll take care of you.”

Tupper Lake Central sophomore Tim Ropas said, “We run tests. Coaches pull them over and work with the hospital and try to make them better.”

But in reality, contact is part of football and while players will admit they don’t think much about it during, they know the risk is there, regardless how advanced helmets or gear get.

Leonard said, “I think everyone has that’s played football, at least once in their career. It’s part of the game and I wish it wasn’t there, but it is.”

A part of the sport that could put a player on the bench.

First quarter 2011 data for workers’ comp shows a change. For the first time in nearly six years, pricing levels outside California showed an overall increase, according to a report by Towers Watson.

The information is based on surveys of 39 participating insurance companies, representing approximately 20 percent of the commercial insurance market. It is included in the company’s most recent Commercial Lines Insurance Pricing Survey.

While price reductions continued for commercial property and management liability lines, the survey showed a modest overall 2 percent price increase for workers’ comp. A company expert and workers’ comp veteran says the news is not too surprising, given the confluence of factors affecting workers’ comp.

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“There is not one thing happening in all 50 states,” said Bruce Hockman, workers’ compensation practice leader for Towers Watson. “There are trends that are common.”

Rates, Hockman said, are a function of cost and the delivery of those costs in each state. “The bottom line is, are costs going up? Sure,” Hockman said. “Investment income is down, medical costs are up, and frequency has stopped or turned.”

Hockman says the combination of those factors is driving pricing trends in many jurisdictions. One of the biggest drivers is the recent change in the frequency of claims, which had been decreasing for the past 15 years.

“Medical inflation doesn’t impact a claim that’s never been made. That’s helped in every jurisdiction,” Hockman said. “That trend is now stabilized and in some situations showing a reversal. It’s what a lot of us have been waiting for and concerned about.”

Coupled with the flattening or rising frequency are factors largely beyond the control of workers’ comp stakeholders. “As smart as we think we are, we can’t control the economy,” Hockman said. “We can hardly respond to it.”

Investment income, for example, has been volatile. “Even if delivery and benefit costs are flat, the return may not be sufficient so rates will go up,” Hockman said.

Added to the less-than-stellar investment returns have been the recession and the so-called jobless recovery. That’s impacted each jurisdiction differently.

Florida, for example, saw costs decrease following enactment of legislative reforms more than a decade ago. The poor labor market in Florida, combined with a turn in frequency, is pushing prices higher there.

New York has also had higher workers’ comp prices despite recent reforms. Hockman said the true value of the reforms has been diminished by the struggling economy.

“A lot of the reforms [in New York] had to do with the ability to return employees to work,” Hockman said. “All of a sudden we have 10.5 to 11 percent unemployment. I don’t care what the law says, in execution if there aren’t jobs to return to, it doesn’t work very well.”

Even more important to the workers’ comp system is the types of jobs lost. “This recession is adversely impacting one-third of workers’ comp, and that’s construction,” Hockman said. “In every other recessionary period we’ve come out of, the initiative that underscored the return out of the recession was homebuilding. It brought contractors, suppliers, timber people, faucet people — everybody that made something. It picked up the economy in one fell swoop. Now we don’t have that and likely not for some time.”

Hockman says a small group of national and regional professionals in the workers’ comp industry are succeeding despite the economic factors, especially state funds. He says they understand the extraordinary differences in the workers’ comp system of each jurisdiction and can wait for the economy to change.

“It will change,” Hockman said. “The question is do enough people have the patience to wait and not do foolish things in the meantime.”

http://www.riskandinsurance.com/story.jsp?storyId=533339595

In the friendly confines of a fight cage, few mixed martial arts bouts last even three minutes.
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Times Topic: Mixed Martial Arts

In Albany, the clash will not end.

With the legislative session having ended, a bill to legalize the sport in New York has, once again, been relegated to limbo status. Last month, for the second straight year, the proposed legislation cleared the State Senate. It also passed with the Assembly’s Tourism, Parks, Arts and Sports Development Committee but never reached a vote before the Ways and Means Committee.

“It’s a promotion of violence at a time when we’re trying to eliminate violence,” said Assemblyman Bob Reilly, a Democrat from Clifton Park and opponent of legalization since the bill’s introduction in 2008.

For years, concern about the sport’s violence — some likened it to “human cockfighting” — caused a number of states, including New York, to officially shun it. But powered by the Ultimate Fighting Championship, the foremost international promoter of mixed martial arts, the sport has achieved wider popularity and, in some circles, mainstream acceptance over the past half-decade.

Forty-five states now sanction mixed martial arts. New York, Vermont and Connecticut do not, though events are often held at casino resorts on Connecticut’s Indian reservations. Alaska and Wyoming do not have sanctioning bodies.

Fans of the sport and supporters of the bill have pointed to the potential economic benefits of legalization for the state, particularly at a time of great fiscal turmoil. According to a study commissioned by the U.F.C., holding two events in the state — one at Madison Square Garden, one in Buffalo — could generate over $15 million in revenue.

“New Jersey is making all the money off this, and we’ve got nothing,” said Carmine Zocchi, who teaches mixed martial arts and Brazilian jiu-jitsu classes on Eliot Avenue in Queens. “I’ve got to travel to take my fighters to shows. We should have them in the best city in the world.”

But Mr. Reilly has contested his Assembly colleagues’ claims about the economics of legalizing the sport. It might turn a profit, he says, just not for New York.

“Most of the money in sports today is in TV,” he said, citing the pay-per-view status of many marquee U.F.C. fights. “People would make money — people in Las Vegas and the U.F.C.”

On a micro-level, though, local gyms have long hoped that the passage of a bill could bolster their bottom lines. Peggy Chau, who operates Fighthouse in TriBeCa, says legalization would create a “domino effect.” An event at Madison Square Garden would draw increased attention to the U.F.C., she says, which would lead to greater interest in mixed martial arts classes at all levels.

Still, opponents of the bill cite health and safety concerns associated with the sport. In light of recent research on head injuries in football and boxing, Mr. Reilly says, promoting a combat sport sends the wrong message.

“If we wanted to legalize professional boxing today, I don’t think it would pass,” Mr. Reilly said.

According to Mr. Zocchi, recent rule changes have ensured that the worst excesses of mixed martial arts — eye-gouging and strikes to the back of the head or neck — have no place in the sport. His fellow fighters say the threat of injury lingers in any contact-heavy competition.

“Everything is violence,” said Marcelo Garcia, an expert in Brazilian jiu-jitsu with a background in mixed martial arts. “They don’t understand it’s just another sport.”

Mr. Zocchi and Mr. Garcia also noted the social benefits of organized fighting in a city like New York — benefits that would multiply, they say, with sanctioned competitions in the state.

Mr. Zocchi takes pride, he says, in taking undisciplined “street fighters” and teaching them the finer points of the sport: strategy, positioning, body control.

“People think it’s this barbaric thing,” he said. “This stuff is harder than calculus.”

By James Hufnagel

Niagara Falls is a competitive city filled with spirited people, so it’s no surprise that our youth take to rough-and-tumble contact sports with vigor and enthusiasm.

Whether it’s Niagara University hockey, lacrosse at Niagara County Community College or Wolverine football, or one of the numerous sports programs participated in by hundreds of local youngsters, access to modern, comprehensive sports medicine programs offered by Niagara Falls Memorial Medical Center greatly benefits the community.

Even when playing by the rules, sports injuries occur. A clean football tackle, a good hockey check, even an unintended fall or collision during a pick-up basketball game can result in what’s called “traumatic brain injury” or concussion.

According to the Centers for Disease Control, an estimated 135,000 children and teens between the ages of 5 and 18 suffer a traumatic brain injury during sports activities in this country annually.

The medical establishment has recently taken a second look at concussion, newly recognizing it as a serious medical condition requiring appropriate diagnostic and treatment procedures, as opposed to past practice, when a young athlete was more often than not advised to “shake it off” and get back in the game.

At the forefront of the new emphasis on concussion is Tony Surace, NFMMC’s director of Sports Medicine at its Competitive EDGE Sports Performance facility, located at the hospital’s Summit Healthplex in Wheatfield. The Concussion Clinic run by Surace at that convenient location is one of only two in all of Western New York, the other being at the University of Buffalo.

According to Surace, the medical approach toward concussion has changed significantly over the past couple years.

“It used to be, ‘Do you have a headache? Do you have dizziness? Nausea? How do you feel?’ Those are the standard symptoms someone may have when suffering from a concussion,” said Surace, who also serves as the Memorial-affiliated athletic trainer at Niagara Falls High School. “On average, it takes two to three weeks before it is safe for someone with typical symptoms to return to activity.”

Concussion is defined as the immediate and temporary deterioration of mental functioning due to trauma. Athletes who have ever had a concussion are at increased risk for another concussion, and children and teens are not only more likely to suffer concussion than adults, but also take longer to recover.

Few scenarios are scarier to parents and coaches than concussion as it occurs on the playing field.

“Basically, the brain impacts one side of the cranium (skull), and now it’s injured,” Surace said. “Whether it’s a football player, gymnast, motocross … when someone takes a hit to the head, symptoms may include headache, nausea, or even loss of consciousness. Sometimes the symptoms start to appear the next day, but that’s rare. Usually the signs appear immediately. When symptoms appear, the athlete must be pulled.”

“Before the new guidelines, some athletes would say, ‘Well, I just have a little headache. I am perfectly fine,’ and they won’t tell the coach, the doctor, their parents or their athletic trainer. And if they continue to play, and suffer a second hit to the head, it can be fatal. That’s why when someone is symptomatic, they cannot return to the game,” said Surace.

What makes patient management at the NFMMC Concussion Clinic unique is its utilization of thorough and comprehensive evaluation and treatment procedures, based on the latest medical research and guidelines of the National Institutes of Health, Washington, D.C., and the American Medical Association.

After sustaining a concussion, the patient is usually referred to the clinic by their primary care doctor, pediatrician, emergency room physician or coach, although walk-ins are welcome. An evaluation is done with a physical therapist, assisted by the athletic trainer and a physician — a trio of healthcare professionals assessing the athlete. Neurocognitive functioning is exhaustively evaluated, sometimes by computer-based testing, and results compared with standard scores or, ideally, baseline values previously obtained from the patient.

“We’ll do balance testing, neurocognitive testing, memory testing, exercise testing, symptomatic questions. We’ll measure physiological parameters like heart rate and blood pressure, and check their cranial nerve assessment, and record everything.

“We don’t start the exercise protocol until they are asymptomatic, meaning until they feel fine, which may be a certain number of weeks. We’ll give them a home exercise sheet to follow. We progress them daily.

“The first day, they will do 20 minutes of aerobic exercise on the treadmill, just to get their heart rate up. The second day, they do the treadmill and then weightlifting. The third day, we may possibly allow return to practice. The fifth and final day, we’ll see how they do and may let them return to play.

“Basically, the protocol is rest. We tell them to try to get as much rest as they can. Sometimes we will pull them out of school for a week or two weeks to let them, essentially, rest their brain. Any cognitive activity, whether they are taking tests, reading a lot, or using a computer, may exacerbate the symptoms of concussion,” Surace explained.

Surace raises particular cautions when it comes to medicating concussion. He warns that even taking a simple medication like Tylenol should only be done with physician approval, since it may mask symptoms that are relied upon to monitor the patient’s progress.

Niagara Falls Memorial Medical Center has been serving the Niagara Falls community since 1895.

June 26, 2011|By Monique Garcia, Tribune reporter

Gov. Pat Quinn on Tuesday plans to sign into law an overhaul of the state’s workers’ compensation system, a move that will slash medical rates, set new standards in determining a worker’s disability and put in place more safeguards to prevent abuse.

The governor is scheduled to mark what he calls “historic” changes with a fly-around starting at engine manufacturer Navistar in Melrose Park. He’ll then make stops at Ingersoll Machine Tools in Rockford, Kraft Foods in Champaign and Aisin Manufacturing in downstate Marion.